REHABILITATION IN PRACTICE Work-related hand injuries: Case analyses in a Brazilian rehabilitation service ROSANA FERREIRA SAMPAIO, MARISA COTTA MANCINI, FABIANA CAETANO MARTINS SILVA, IEDA MARIA FIGUEIREDO, DANIELA VIRGI ´ NIA VAZ, & GISELE BEATRIZ DE OLIVEIRA ALVES Universidade Federal de Minas Gerais, Campus Pampulha, Belo Horizonte, Minas Gerais, Brasil Accepted October 2005 Abstract Purpose. Professionals who work with rehabilitation of the hand usually assess performance components as their main outcome measures. Intervention is aimed at normalization of deficits of these components, with the expectation that the integrity of the structures and functions of the body will revert to improvements in the client’s functional performance. The objectives of this study were to describe changes in patients who received rehabilitation in a Brazilian public hospital after having suffered hand injuries due to workplace accidents, and to examine the relations between performance components and levels of functioning. Methods. Observational cross-sectional study was used. A convenience sample was selected, including 42 patients assessed at service admission and at discharge. Assessed characteristics included grip strength, wrist and finger range of movement (ROM), sensitivity, and self-perceptions of functional performance (COPM). Statistical procedures included correlations between performance components and COPM scores and differences on selected variables at admission and discharge. Results. Significant improvements in all assessed functional components. COPM values increased more than 100% after intervention (effect size d ¼ 1.996 for performance and d ¼ 1.553 for satisfaction) demonstrating improvements in both domains. Low correlations between grip strength and COPM scores were found only at admission (r ¼ 0.314; p ¼ 0.045). When the relationship between gains in strength and COPM scores at discharge were examined, significant correlations were found with the performance (r ¼ 0.324; p ¼ 0.039) and satisfaction (r ¼ 0.0326; p ¼ 0.038) subscales. Conclusions. Results of this study provide evidence for functional gains in clients treated in a rehabilitation service and supply information about the relation between specific components and functional performance. Keywords: Rehabilitation, hand-injury, function, performance, satisfaction, occupational therapy Introduction Rehabilitation of functional performance is an out- come pursued by several professionals, however, most of them approach function in an indirect manner [1]. Traditionally, hand therapists assessed performance components as the main focus of their outcome measures [2], and the criteria for admission were centered on deficits in strength, range of movement and sensitivity, considered to be directly linked to the loss in functional performance [1]. Based on this service model, therapeutic efforts were directed at improving functioning at the level of impairments, with the expectancy that such efforts would be reverted into improvements in the client’s functional performance. Mathiowetz (1993) sug- gested that one of the contributing factors for this model of practice could have been the scarcity of standardized instruments to quantify changes in the performance of activities and tasks that are relevant to the individual [1]. Currently, with the availability of such functional instruments, some evidence demonstrates that the relation between movement components and function, once believed to be linear, is much more complex. In accordance with this line of reasoning, results of studies have not confirmed the assumption that improvements at the level of movement components are directly associated with functional improvements in daily life, work and leisure activities [3]. Correspondence: Rosana Ferreira Sampaio, PhD, PT, Adjunct Professor, Department of Physical Therapy, Universidade Federal de Minas Gerais, Rua Juvenal dos Santos, no 222, apto. 602 Luxemburgo- CEP:30.380-530. Belo Horizonte/Minas Gerais/Brazil. E-mail: rosana@dedalus.lcc.ufmg.br Disability and Rehabilitation, June 2006; 28(12): 803 – 808 ISSN 0963-8288 print/ISSN 1464-5165 online ª 2006 Taylor & Francis DOI: 10.1080/09638280500404503