Abstract
The start of a new year and a year in which EFSHT will be hosting its 10th Congress jointly with FESSH in Oslo (EUROHAND 2011). I hope that those presenting at this congress will also share their knowledge with the wider hand therapy community including the readership of Hand Therapy by submitting an article. Again I would like to take this opportunity to invite new and ‘old’ authors to submit manuscripts to the journal. We have an excellent peer-review system that ensures quality but is also constructive and supportive. Although we only publish quarterly the average turnaround from submission to print is eight months and with the availability of ‘Online First’, accepted manuscripts can now be online within a few weeks of their acceptance.
This issue contains three articles which again reflect the breadth of submissions we publish.
In a review article, Saurabh Mehta and colleagues from Hamilton, Ontario present their conceptual work underpinned by a literature review, which has led to the development of the so-called ‘RACE’ (Reduce, Activate, Cognitive Reshaping and Empower) approach to managing chronic musculoskeletal pain using distal radius fracture (DRF) as an exemplar. The article presents the background to the development of a risk profile assessment based on a biopsychosocial model, which can be used to identify those patients more likely to develop chronic pain after a DRF. Of course, the next question will be how such prognostic-based treatment approaches compare to standard treatment for DRF and other conditions, and I look forward to seeing studies published which address this important question in the future.
Ingrid Göransson and Ragnhild Cederlund from Sweden present their research on the effect of a desensitization programme for hyperaesthesia in the hand after trauma or surgery. Although desensitization was developed in the 1980s in the USA very little research has been conducted to evaluate its effect. A particularly interesting aspect of their study is that they did not only focus on the proximate outcomes such as pain at rest and during use or the size of the hyperaesthetic area, but also included an assessment of the impact on occupational performance. Using the validated Canadian Occupational Performance Measure, which is a patient-reported outcome measure, they found that clinically important change had occurred after desensitization.
Finally, Robyn Midgley and Angela Toemen from London, UK present a service evaluation of an evidence-based patient pathway for surgical and non-surgically managed metacarpal fractures. This work follows on from a previously published article in which they report on the rationale and methods for developing a new pathway. Their findings show that the revised clinical pathway has resulted in fewer complications and early return to function and work, and that prolonged immobilization is often unnecessary. Further refinements have been made to the pathway and no doubt the authors will continue to evaluate its impact.