Occupational Therapy Program Student Theses, Dissertations and Capstones

Document Type

Dissertation - NSU Access Only

Degree Name

Doctor of Philosophy (PhD) in Occupational Therapy

Copyright Statement

All rights reserved. This publication is intended for use solely by faculty, students, and staff of Nova Southeastern University. No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, now known or later developed, including but not limited to photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the author or the publisher.

First Advisor

Wendy Stav

Date of original Performance / Presentation

January 2025

Publication Date / Copyright Date

1-1-2025

Abstract

Recovery of optimal hand function is an important component of burn recovery. A valid occupation-based performance measure in the burn population does not exist. The Suitcase Packing Activity (SPA) is an occupation-based standardized assessment tool used to measure composite hand function. A prospective observational design was used to determine the inter-rater reliability and concurrent validity of the SPA in patients who sustained hand burns. Inclusion criteria included deep-partial thickness or full thickness burns to one or both hands, a passing score on a cognitive screen, and English fluency. Individuals with unstable orthopedic hand/upper extremity injuries or an amputation of the thumb proximal to the interphalangeal joint were excluded. Interclass correlation coefficients (ICC) Model 3, single rater, and absolute agreement was used to assess inter-rater reliability. Pearson’s product moment correlation coefficient (r) was used to assess the relationship between the disability of the shoulder, arm, and hand, the SPA, grip strength, and the Jebsen Hand Function Test (JHFT) total and subscale scores. Thirty patients with a mean age of 40.5 (SD 14.7) years, 66.7% male, and a mean of 11.7% total body surface area (SD 12.7) were included. The results demonstrate good to excellent interrater reliability (ICC3,1). The mean SPA Completion Time was 560.7 seconds (SD 183.2) with a range of 330 seconds to 1096 seconds, and the mean SPA Efficiency Score was 542.4 (SD 183.5) with a range of 311 to 1080. The strongest significant correlation between the SPA Completion Time and Efficiency Scores was with the JHFT checkers subtest (r = .723; p < .001; and r = .723, p < .001, respectively). There was also significant negative correlation between the SPA Completion Time and Efficiency Score and grip strength (r = -.401; p < .001; and r = .-401; p < .001 respectively). There were no significant correlations between the SPA and the DASH. This study demonstrates the reliability and validity of the SPA for use in individuals who have sustained hand burn and offers a valid tool to assess hand function after burn injury in an occupation-based manner.

Disciplines

Occupational Therapy

Keywords

burn; occupation; occupation-based assessment; rehabilitation; upper extremity function

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