Conservative management of hand impairment in children and adolescents with heritable disorders of connective tissue: A scoping review

Abstract

Aims

To synthesize and critically appraise available interventions in the conservative management of hand impairment for children and adolescents with heritable disorders of connective tissue (HDCT).

Methods

A search of peer-reviewed literature and online platforms were included with data regarding hand impairment and function, conservative management and outcome measures extracted and appraised. Levels of evidence were applied to published literature.

Results

Ten peer-reviewed papers, eleven webpages and YouTube videos met the inclusion criteria. Reported interventions included: strengthening, orthoses, assistive equipment, education and pacing. Evidence of intervention effectiveness and evidence-based guidance on dosage were absent, with no consistency of outcome measures monitoring intervention effectiveness. Online platforms posted by health professionals predominantly provided advice for families without clinical detail of interventions.

Conclusions

There is a consistent suite of interventions identified in both peer-reviewed literature and online platforms used by clinicians and families to manage hand impairment for children and adolescents with HDCT. Clear dosage parameters and outcome measures are needed in future intervention studies to determine the effectiveness of interventions and guide clinicians in how best to treat hand impairment. Increasing accountability and quality of online resources posted by health professionals for families is warranted to ensure dosage details and precautions are provided.

Keywords:

• Hand pain
• hand fatigue
• symptomatic joint hypermobility
• hand function
• hand impairment
• outcome measures

Acknowledgements

We would like to thank Trish Bennett Senior Librarian for her assistance in establishing the search strategy.

Disclosures

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.

Notes on contributors

Alison Wesley

Alison Wesley, BSc, GDip OT, MEd, is an occupational therapist at The Children’s Hospital at Westmead, Sydney Australia and PhD candidate through the Faculty of Medicine and Health, The University of Sydney, Sydney Australia.

Marie Coussens

Marie Coussens is a physiotherapist, PhD candidate and lecturer through the Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium.

Cliffton Chan

Cliffton Chan B App Sci (Phty), PhD, physiotherapist, is Associate Professor, Faculty of Medicine, Health and Human Sciences, Macquarie University, and affiliated with the Faculty of Medicine and Health, The University of Sydney, Sydney Australia

Verity Pacey

Verity Pacey B App Sci (Phty), PhD, physiotherapist, is Associate Professor, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney Australia.

Paula Bray

Paula Bray, BOT (Hons) PhD, occupational therapist, is network Director of Research, The Sydney Children’s Hospitals Network, Sydney Australia and affiliated with the Faculty of Medicine and Health, The University of Sydney, Sydney Australia.

Leslie L. Nicholson

Leslie L Nicholson B App Sci (Phty), PhD, physiotherapist, is Associate Professor, Faculty of Medicine and Health, The University of Sydney, Sydney Australia.