Date of Award

2026

Document Type

Scholarly Project

Degree Name

Doctor of Occupational Therapy (OTD)

Department

Occupational Therapy

First Advisor

Dr. Karrianna Iseminger

Abstract

Introduction: Dupuytren’s disease (DD) is a disease of the fibrous tissue called the fascia of the palm and fingers of the hand (Eckhaus, 2016). It develops over time, thickening the palmar fascia and leading to nodules and cords that flex the fingers (Pineda et al., 2024; Salari et al., 2020). The disease occurs mostly in men, with individuals of Northern European descent having a higher likelihood of disease development, alongside family history increasing the risk. This disease can result in disability for individuals, including difficulty performing certain activities such as picking up objects, donning and wearing gloves, putting hands in pockets, and holding objects (Salari et al., 2020). The treatment options that are available for individuals with DD include both surgical interventions, such as fasciotomy and partial fasciectomy, and non-surgical interventions, such as collagenase injections and needle aponeurotomy (American Society for Surgery of the Hand [ASSH], 2021). Individuals who undergo medical intervention for the treatment of DD are often referred to occupational therapists who specialize in hand therapy to regain functional use. This scholarly project aims to develop an evidence-based, occupation-focused rehabilitation guideline for certified hand therapists (CHTs) and occupational therapists (OTs) who specialize in hand therapy on the conservative management of DD and treatment following medical intervention.

Methodology: The development of this scholarly project was guided by the Ecology of Human Performance (EHP) model (Dunn, 2017). An informal needs assessment was conducted with occupational therapists at an outpatient physical therapy clinic in Casper, WY to determine what was needed in the rehabilitation guideline. A comprehensive literature review, guided by EHP, was then conducted to evaluate the available best-practice interventions for DD. Electronic databases searched included CINHAL and PubMed, as well as the archives of the Journal of Hand Therapy. Collaboration with OTs and skilled observation took place on-site.

Results: The product of this scholarly project is a rehabilitation guideline that provides patient education and step-by-step, phase-based instruction for treating DD conservatively and following medical intervention. The outcome of this product is to provide a single document guideline for practitioners to use when treating DD, reducing the need to refer to multiple sources.

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