Influence of Purposeful Activities on Upper Extremity Motor Performance: A Systematic Review

Abstract

Following upper extremity injury, exercise-approaches are commonly used to address motor impairments. Occupation-based approaches are also used but less widely promoted and their mechanisms of action not well-understood. Movement performed during purposeful activities and occupations may yield better motor performance than during nonpurposeful tasks. This review investigated the influence of engagement in purposeful activities and occupations on upper extremity motor performance in healthy and musculoskeletal populations. Databases were searched for studies in healthy or upper extremity musculoskeletal–injured adults that compared motor performance during purposeful activities against nonpurposeful movements. Twenty-one studies of moderate quality, conducted predominantly in healthy populations, were included. Upper extremity movement quantity and quality were enhanced when performed during purposeful conditions. Purposeful activities have potential to be used following injury to enhance movement and address motor impairments to a greater extent than is currently promoted. Research in musculoskeletal populations is required.

Person-centred management of upper limb complex regional pain syndrome: an integrative review of non-pharmacological treatment

“…45,66 There was most evidence for studies that used modalities, ROM, strengthening, and graded functional activity, with scores of 58%, 68%, and 75%. 48,65,68 Incorporating occupation as exercise may be a beneficial means of enhancing movement and addressing motor impairment after upper limb injury, 91,92 and a recent review of hand therapists found that ROM exercises and functional activity practice are the most frequently prescribed physical interventions with CRPS. 85 This indicates a need for further robust research exploring the value of movement and occupation-based interventions in kinesiotherapy for CRPS.…”

A systematic review of how daily activities and exercises are recommended following volar plating of distal radius fractures and the efficacy and safety of early versus late mobilisation

“…16 The unique advantages of activity or occupation-based interventions may be underutilised in hand and wrist injury rehabilitation. 7 Purposeful activities have been shown to enhance motor performance 7 and observed to augment movement volume in healthy and musculoskeletal populations. 4,52 It is reasonable to consider that the greater ROM, function and lower pain in the early groups were in part due to the performance of daily activities.…”

“…2 Wrist mobilisation following surgical distal radius fracture repair is predominantly facilitated by active range of motion (ROM) exercises, but may also be promoted through the performance of daily activities when a splint is removed. 3 Engaging in daily activities within the first two weeks of rehabilitation may be advantageous in promoting use of familiar movement patterns, building self-efficacy, augmenting movement volume, mitigation of pain, and facilitating engagement in therapy [4][5][6][7] and may be equally effective as exercise routines. 8 While therapeutic exercise for early mobilisation following surgical repair of distal radius fracture is widely practised, 8,9 the safety and benefit of including daily activities in the first two weeks of postoperative rehabilitation has not been established.…”

“…Additionally, while activity in early mobilisation regimes is frequently alluded to in the literature, it is often poorly defined and may be overlooked as an independent therapeutic intervention. 7,11 As it is often not included in the description of postoperative regimes, but may be used in clinical practice, it is possible that early activity following surgical treatment of distal radius fractures has greater benefit than is currently understood. The lack of reporting hinders therapeutic use of evidence-based safe activity and may result in inconsistent advice on activity performance for patients in the early postoperative period.…”

Evaluation of an inpatient occupation‐based group program using a process evaluation framework

“…In rehabilitation services, there is growing evidence for the use of occupation‐based interventions to improve occupational performance and health outcomes (Dikmen et al, 2003 ; Hackett et al, 2000 ; Powell et al, 2016 ). Purposeful occupations have been seen to increase participation and enhance movement quality after upper limb injuries in comparison with nonmeaningful tasks (Collis et al, 2020 ). Occupation‐based interventions have yielded similar improvements in occupational performance in chronic stroke survivors when compared to repetitive task practise (Skubik‐Peplaski et al, 2017 ).…”