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RecruitingNCT05891704Updated Sep 19, 2024

The Efficacy of Hand Injuries Rehabilitation Intervention Program That Incorporated Ethnic and Cultural Reference

An interventional study of Hand therapy Rehabilitation intervention program that incorporate cultural reference and Conventional Hand therapy Rehabilitation intervention program in Multiple Injuries of Hand (Disorder), sponsored by Tel Aviv University. Recruiting at 1 site in Palestinian Territory, occupied. Open to participants aged 16 Years to 65 Years. Per ClinicalTrials.gov, last updated 2024-09-19.

Sponsored by Tel Aviv University · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Primary completion was expected by Dec 2024, 1 year 11 months ago, but the record still lists the study as recruiting.
  • Started Jun 2023; still recruiting 3 years 5 months later.
Phase
Not applicable
Study type
Interventional
Enrollment
100
Allocation
Randomized
Ages
16 Years to 65 Years
Sex
All
01

Study summary

The study has three main phases. The first phase included A. Adjustment of research tools. Phase B. will examine the efficacy of the cultural intervention. Phase C. Follow-up study will be conducted after three, six, and nine months.

Read the detailed description

Trauma to the hand is a common and potentially serious injury. Work is central to most adults' occupational identity and is, therefore, a key focus for occupational therapy (OT) intervention. There is substantial evidence that supports the use of OT to target work and its positive influence on Return to Work (RTW) after injury. OT literature shows a shift regarding the awareness of cultural concerns and the broader context in which OT operates. There is currently no high-quality evidence to support the efficacy of rehabilitation programs that enhance RTW in workers with Hand Injury (HI). Aims: The proposed study aims to examine the efficacy of a hand-injuries rehabilitation intervention program that incorporates ethnic-cultural references versus conventional intervention programs. Objective and subjective measures will be used to evaluate personal and environmental aspects and address their influence on readiness to RTW, time to RTW, and, for those who will RTW, employer satisfaction about the worker's performance. Method: The Study has Three Phases: 1. A cross-sectional study to assess internal consistency and test-retest reliability and construct and concurrent validity of the study questionnaires. Study participants: Convenient sample of 60 healthy and 30 HI Palestinian participants will be recruited. Tools: Arabic Work Value Questionnaire (A-Wval), the Arabic Employment Barrier Questionnaire (A-EBQ), the Arabic Return to Work Self-Efficacy-19 (A-RTWSE-19) questionnaire, the Arabic Readiness for Return-To-Work (A-RRTW), Arabic Return-to-Work status questionnaire (A-RTWS), and Arabic Work Behavior Inventory (A-WBI). 2. Matched paired trial design method will be conducted to assess the efficacy of a hand-injuries rehabilitation intervention program that incorporates ethnic-cultural reference versus conventional intervention programs that will improve the participants' functioning in Vocational Rehabilitation(VR) and enhance Time of Return to Work (TRTW). Study participants: 100 HI participants will be first matched in pairs according to gender, age (interval of 5 years), and severity of the injury. Then, each member of a pair will be randomly assigned to the intervention group (IG) and Control Group (CG). 3. Follow-up study after three, six, and nine months.

02

Conditions studied

  • Multiple Injuries of Hand (Disorder)

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Keywords

  • Hand Injury, Values, Culture, ACT, Hand Injury Intervention
03

In context

Hand Injuries

122 studies on the registry are indexed under Hand Injuries; 35 are open to participants now.

This study's planned enrollment of 100 is above the median of 55 across 97 interventional studies indexed under Hand Injuries.

Browse Hand Injuries studies →

Lead sponsor

Tel Aviv University is the lead sponsor of 100 studies on the registry; 26 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
16 Years to 65 Years
Sexes eligible
All
Accepts healthy volunteers
No

Eligibility criteria

Inclusion Criteria: Participants will include people after acute traumatic injuries below the elbow, 16-65 years old, who were employed or functioning as active housewives prior to the injury. All participants will be Palestinian Arabs living in the West Bank

Exclusion Criteria: People with drug/alcohol abuse, central nervous lesions, psychiatric, cognitive or developmental disorder, people with bilateral injury, hand burns, rheumatoid arthritis, osteoarthritis, brachial plexus lesion, shoulder or elbow problems, complex regional pain syndrome, or any surgery during the study period. People with non-traumatic hand injuries (tendonitis, carpal tunnel syndrome, trigger finger, De Quervain's disease, and Mallet finger) will not be included

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Triple (Participant, Investigator, Outcomes assessor)
Enrollment
100 participants (estimated)

Study arms

  • Experimental
    Intervention group

    The Intervention Group (IG) will receive 12-16 meetings of the standard conventional hand-therapy program according to OT intervention protocols used for clients with HI. The IG will receive one hour of 2-3 sessions a week according to patient needs and convenience. In each treatment session, the participant will receive 30 minutes of preparatory activities and therapeutic exercise, 15 min of Occupation-Based Activities, and 15 min for the culturally adjusted intervention that will be based on Focused Acceptance and Commitment Therapy (FACT) with major emphasis on values. In IG Arabic cultural values will be considered in the entire therapy process, the participant will have a companion in the therapy session. The participants in IG will be provided with a home-therapy protocol, and will complete a home program that will be based on enhancement of work values. Checklist diary will be provided to participants

    Procedure: Hand therapy Rehabilitation intervention program that incorporate cultural reference

  • Active comparator
    Control group

    The Control Group (CG) will follow the identical therapy protocol as the IG which will last for 45 minutes, with no culturally relevant interventions. In addition, each participant in the CG group will receive 15 minutes of free conversation with narrative feedback regarding the therapy, the challenges and opportunities in his daily life. Home-therapy protocol that will be based on conventional intervention will be provided.

    Procedure: Conventional Hand therapy Rehabilitation intervention program

Interventions

  • ProcedureHand therapy Rehabilitation intervention program that incorporate cultural reference

    The intervention will provide a conventional hand therapy rehabilitation intervention program that incorporates cultural reference based on Focused Acceptance and commitment Therapy ( FACT).

  • ProcedureConventional Hand therapy Rehabilitation intervention program

    The intervention will provide a conventional hand therapy rehabilitation intervention program

06

What researchers measure

Primary outcomes

  1. A change in baseline of Time to Return to Work (T-RTW) to discharge from therapy and the change at three, six, and nine months are being assessed.

    the time to return to work since onset

    Time frame: Baseline Time (T1), Discharge 4-6 weeks (T2), 3 months (T3), 6 months (T4) , 9 months (T5).

  2. A change in a baseline evaluation of the Disabilities of the Arm, Shoulder, and Hand questionnaire (Quick DASH) to discharge and from therapy and the change at three, six, and nine months are being assessed.

    The self-reported upper extremity outcome measure for assessing physical function and symptoms in people with any or multiple musculoskeletal disorders of the upper limb, whose primary language is Arabic.

    Time frame: Baseline Time (T1), Discharge 4-6 weeks (T2), 3 months (T3), 6 months (T4) , 9 months (T5).

  3. A change in baseline Work Rehabilitation Questionnaire (WORQ) (Finger, Escorpizo, Bostan, & De Bie, 2014) to discharge from therapy and at three, six, and nine months follow-up is being assessed.

    ICF-based questionnaire to evaluate functioning in Vocational Rehabilitation (VR), The WORQ consists of two sections. Section 1 contains 17 socio demographic and work-related items, the work-related questions include profession, work status, work demands, VR interventions, and the amount of support received by family, employer, and labor and employment services while section two contains 40 items on functioning (18 body functions and 22 activities and participation items). WORQ captures the extent of functioning problems for all 40 items with a numeric rating scale of 0 to 10

    Time frame: Baseline Time (T1), Discharge 4-6 weeks (T2), 3 months (T3), 6 months (T4) , 9 months (T5).

Secondary outcomes

  1. Modified Hand Injury Scoring System (MHISS) (Campbell & Kay, 1996; Urso-Baiarda et al., 2008)

    MHISS is an objective anatomical assessment specifically designed for hand injuries. The hand injuries can be divided into four broad categories, such as "Minor" (\< 20 moderate (21-50 points), severe (51-100 points), and major (≥ 101 points) "Major" (worst injury). Injury severity quantified using MHISS is an important determinant of return to work after hand or forearm injury

    Time frame: Baseline Time (T1)

  2. Standard Hydraulic JAMAR dynamometer (Bellace, Healy, Besser, Byron, & Hohman, 2000), and Pinch Gauge (Radomski & Latham, 2008). A change is being assessed

    It Measures grip and pinch strength ,respectively.

    Time frame: Baseline Time (T1), Discharge 4-6 weeks (T2).

  3. Semmes-Weinstein Monofilament Test(van Vliet, Novak, & Mackinnon, 1993). a change is being assessed

    Measures low threshold of touch perception on an ordinal scale

    Time frame: Baseline Time (T1), Discharge 4-6 weeks (T2).

  4. Visual Analog Scale. A change is being assessed

    Pain

    Time frame: Baseline Time (T1), Discharge 4-6 weeks (T2), 3 months (T3), 6 months (T4) , 9 months (T5).

  5. Return -to-work self-efficacy scale-19 (RTWSE-19). (Shaw, Reme, Linton, Huang, & Pransky, 2011). Arabic version

    The 19-item return-to-work self-efficacy (RTWSE-19) scale is a self-report measure intended to assess workers' beliefs of their current ability to resume normal job responsibilities following pain onset. Scores range from 1-10 which is obtained by summing all item scores and divide them by 19.

    Time frame: Baseline Time (T1), Discharge 4-6 weeks (T2), 3 months (T3), 6 months (T4) , 9 months (T5).

  6. The Employment Barriers Questionnaire (EBQ) (Ratzon, Starik, Huber, & Zeilig, 2019). A change is being assessed.

    A self-report questionnaire that aims to identify: 1. Potential work environment and job tasks obstacles 2. Overall level of restriction drawn by the obstacles, 3. Subjects' perception of the possibilities to make adaptations (PPMA) that might make work more accessible. The questionnaire is composed of 67 items separated into two parts. The first part assesses possible environmental barriers. The second part assesses possible job task barriers (including task limitations) in three categories: physical, cognitive and communication barriers. In each category, the items are measured by level of restriction scale (0 to 4) and PPMA (yes/no/no need for adaptation). In the second part, the frequency of the task is also estimated (0 to 4). Finally, two items assess the perception of the person on the extent of the employer's cooperation and the need for therapeutic mediation.

    Time frame: Baseline Time (T1), Discharge 4-6 weeks (T2), 3 months (T3), 6 months (T4) , 9 months (T5).

  7. The Readiness for Return-to-Work (RRTW) scale (Franche, Corbière, Lee, Breslin, & Hepburn, 2007). A change is being assessed

    The Readiness for RTW scale is developed and validated in a Canadian cohort study it consist of 13 questions for people not working which includes Precontemplation, Contemplation, prepared for action (self-evaluative and behavioral) and 9 questions for people working which include Uncertain maintenance and Proactive maintenance. Psychometric properties of the newly developed instrument suggest that the application of the Readiness for Change model to return-to-work is relevant to work disability research. Confirmatory factor analyses had satisfactory fit indices to confirm the initial model.

    Time frame: Discharge 4-6 weeks (T2), 3 months (T3), 6 months (T4) , 9 months (T5).

  8. Return-to-work status questionnaire (Boyle, Cassidy, & Côté, 2019). A change is being assessed

    A self-report return to work measure RTW at baseline and follow up. The baseline questionnaire has 24-items and elicits the following information: date of injury, days off because of the injury, current work status, reasons for not working and claim-related questions. The follow-up questionnaire is composed of 12- items addressing current working status, expectations for returning to work and reasons for not working. Nine of the items in the follow-up questionnaire are the same as the baseline questionnaire and five of them are used to generate the return-to-work status.The participant's return-to-work status could be defined as working with no modifications, working with modifications, tried to go back to work, in labor market retraining (LMR), gone back to school, or not working

    Time frame: Discharge 4-6 weeks (T2), 3 months (T3), 6 months (T4) , 9 months (T5).

  9. Work Behavior inventory (G. Bryson, M. D. Bell, P. Lysaker, & W. J. P. R. J. Zito, 1997b). A change is being assessed

    The Work Behavior Inventory (WBI) is a standardized work performance assessment instrument specifically designed for people with severe mental illness. Test construction employed rational and empirical approaches yielding a 36-item inventory with five scales. It assesses vocational functioning for people with severe mental illness. It is rated in a work setting by an employment specialist through observation and an interview with the immediate supervisor.(Bull et al., 2015).

    Time frame: Discharge 4-6 weeks (T2), 3 months (T3), 6 months (T4) , 9 months (T5).

  10. Post Traumatic Growth Inventory (PTGI) (Tedeschi & Calhoun, 1996). A change is being assessed

    An instrument for assessing positive outcomes reported by persons who have experienced traumatic events. This 21-item scale includes factors of New Possibilities, Relating to Others, Personal Strength, Spiritual Change, and Appreciation of Life

    Time frame: Baseline Time (T1), Discharge 4-6 weeks (T2), 3 months (T3), 6 months (T4) , 9 months (T5).

  11. The 12-item WHODAS 2.0 questionnaire - Arabic(Badr and Abd El Aziz 2007; Üstün et al. 2010). A change is being assessed

    Measurement of health status. Provides a summering measure of functioning and disability that is reliable and valid across geographic regions, diagnostic groups, ages and genders. Can measure severity, monitor impact of programs, determine the score of individuals or groups in relation to the general population, or compare groups with respect to their disability. Explores what people do in different areas of life. All domains are mapped directly on ICF's activity and participation component: cognition, mobility, self-care, interpersonal interaction, life activities, and participation in society.

    Time frame: Baseline Time (T1), Discharge 4-6 weeks (T2), 3 months (T3), 6 months (T4) , 9 months (T5).

  12. The Medical Outcome Study Short Form 12 (Ware Jr, Kosinski, & Keller, 1996). A change is being assessed

    This short version of the SF-36 tool consists of 12 items and eight scales: physical functioning (PF), role limitations due to physical problems (RP), bodily pain (BP), general health (GH), vitality (VT), social functioning (SF), role limitations due to emotional problems (RE), and perceived mental health (MH). It has 35 possible response choice indicator variables; for example, the physical functioning item has three response choice categories, 1(yes, limited a lot), 2 (yes, limited a little), 3 (no, not limited at all). The composite physical (PCS) and mental health (MCS) scores are computed using the scores of the 12 items, ranging from 0 to 100, where zero reflects the lowest health level and 100 the highest level

    Time frame: Baseline Time (T1), Discharge 4-6 weeks (T2), 3 months (T3), 6 months (T4) , 9 months (T5).

  13. Single Subject Job Satisfaction Scale (Dolbier et al. 2005). A change is being assessed

    single-item assessment tool, that is, whether or not the participant was satisfied with his/her a) current job and b) family life. Satisfaction items were scored on a four-point Likert scale with an option of 1) satisfied, 2) fairly satisfied, 3) fairly dissatisfied, and 4) dissatisfied. It was reversely scored so that higher score indicates a higher level of satisfaction. These items were taken from the Brief Job Stress Questionnaire, The items have been frequently used in past studies to measure job and family satisfaction at the workplaces14-16). The test-retest stability over 1 yr with job and life satisfaction was rs=0.468 and rs=0.567, respectively (p\<0.001).

    Time frame: Discharge 4-6 weeks (T2), 3 months (T3), 6 months (T4) , 9 months (T5).

07

Study locations

1 of 1 sites recruiting
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started Jun 2023 (actual). Primary completion is estimated for Dec 2024, 18 months after the start.

Of 59 non-industry interventional studies with no phase under Hand Injuries, half reached primary completion within 14 months of starting (the median), counting those still running; a quarter within 8 and three quarters within 26. This study's planned 18 months is above that.

Counting every sponsor, half of 59 studies reached it within 14 months; a quarter within 8 and three quarters within 26.

How these figures are worked out, and which studies are left out of them.

Registered
May 26, 2023
First posted
Jun 7, 2023
StartActual
Jun 1, 2023
Primary completionEst.
Dec 1, 2024
CompletionEst.
Jan 1, 2025
Last update
Sep 19, 2024
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Sep 19, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT05891704
Responsible party
Navah Ratzon (Head of School of Health Profession, Tel Aviv University) — Principal investigator
First posted
Jun 7, 2023
Start date
Jun 1, 2023
Primary completion
Dec 1, 2024 (estimated)
Completion
Jan 1, 2025 (estimated)
Last update
Sep 19, 2024

Study contacts

Jumana S Daibes, PhD. student
Contact
jumana.daibes@aaup.edu
00970599672878 ext. 1279
Navah Z Ratzon, Prof.
Contact
navah@tauex.tau.ac.il
00972505468924
Navah Z Ratzon, Professor
principal investigator · Tel Aviv University

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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