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.
AminiD. A.KannenbergK.BodisonS.ChangP. F.Handley-MoreD.McElroyA.. . . LiebermanD. (2014). Occupational therapy practice framework: Domain & process 3rd edition. American Journal of Occupational Therapy, 68, S1–S48. https://doi.org/10.5014/ajot.2014.682006
2.
BakshiR.BhambhaniY.MadillH. (1991). The effects of task preference on performance during purposeful and nonpurposeful activities. American Journal of Occupational Therapy, 45, 912–916. https://doi.org/10.5014/ajot.45.10.912
3.
BassettS. F. (2003). The assessment of patient adherence to physiotherapy rehabilitation. New Zealand Journal of Physiotherapy, 31, 60–66.
4.
BialocerkowskiA. E. (2002). Difficulties associated with wrist disorders-A qualitative study. Clinical Rehabilitation, 16, 429–440. https://doi.org/10.1191/0269215502cr516oa
5.
BruderA. M.ShieldsN.DoddK. J.TaylorN. F. (2017). Prescribed exercise programs may not be effective in reducing impairments and improving activity during upper limb fracture rehabilitation: A systematic review. Journal of Physiotherapy, 63, 205–220. https://doi.org/10.1016/j.jphys.2017.08.009
6.
BurdonC.SpronkI.ChengH. L.O’ConnorH. (2017). Effect of glycemic index of a pre-exercise meal on endurance exercise performance: A systematic review and meta-analysis. Sports Medicine, 47, 1087–1101. https://doi.org/10.1007/s40279-016-0632-8
7.
ChungK. C.HaasA. (2009). Relationship between patient satisfaction and objective functional outcome after surgical treatment for distal radius fractures. Journal of Hand Therapy, 22, 302–308. https://doi.org/10.1016/j.jht.2009.04.007
8.
ColaianniD.ProvidentI. (2010). The benefits of and challenges to the use of occupation in hand therapy. Occupational Therapy in Health Care, 24, 130–146. https://doi.org/10.3109/07380570903349378
9.
CooperH.HedgesL.ValentineJ. (Eds.). (2019). The handbook of research synthesis and meta-analysis (3rd ed.). Russell Sage Foundation. https://doi.org/10.7758/9781610448864.14
10.
CraigP.DieppeP.MacintyreS.MichieS.NazarethI.PetticrewM. (2013). Developing and evaluating complex interventions: The new Medical Research Council guidance. International Journal of Nursing Studies, 50, 587–592.
11.
DownsS. H.BlackN. (1998). The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. Journal of Epidemiology & Community Health, 52, 377–384. https://doi.org/10.1136/jech.52.6.377
12.
DyL. B.YancosekK. E. (2017). Introducing purposeful activity kits in a hand rehabilitation practice: Effects on clinical practice patterns and job satisfaction among occupational therapy practitioners. Hand Therapy, 22, 3–12. https://doi.org/10.1177/1758998316657844
13.
EakmanA.CarlsonM.ClarkF. (2010). The meaningful activity participation assessment: A measure of engagement in personally valued activities. International Journal of Aging & Human Development, 70, 299–317. https://doi.org/10.2190/ag.70.4.b
14.
EgolK. A.KariaR.ZingmanA.LeeS.PaksimaN. (2014). Hand stiffness following distal radius fractures. Bulletin of the Hospital for Joint Diseases, 72, 288–293. https://doi.org/10.1016/s0363-5023(09)60100-3
15.
FasoliS. E.TromblyC. A.Tickle-DegnenL.VerfaellieM. H. (2002). Context and goal-directed movement: The effect of materials-based occupation. OTJR: Occupation, Participation and Health, 22, 119–128. https://doi.org/10.1177/153944920202200305
16.
HallB. A.NelsonD. L. (1998). The effect of materials on performance: A kinematic analysis of eating. Scandinavian Journal of Occupational Therapy, 5, 69–81. https://doi.org/10.3109/11038129809035732
17.
HétuS.MercierC. (2012). Using purposeful tasks to improve motor performance: Does object affordance matter?British Journal of Occupational Therapy, 75, 367–376. https://doi.org/10.4276/030802212X13433105374314
18.
HolubarM. N.RiceM. S. (2006). The effects of contextual relevance and ownership on a reaching and placing task. Australian Occupational Therapy Journal, 53, 35–42. https://doi.org/10.1111/j.1440-1630.2006.00538.x
19.
HoppeK. A.MillerB. K.RiceM. S. (2008). Occupationally embedded exercise versus rote exercise and psychosocial response in college-aged females. Occupational Therapy in Mental Health, 24, 176–191. https://doi.org/10.1080/01642120802055317
20.
KaragiannopoulosC.SitlerM.MichlovitzS.TierneyR. (2013). A descriptive study on wrist and hand sensori-motor impairment and function following distal radius fracture intervention. Journal of Hand Therapy, 26, 204–215. https://doi.org/10.1016/j.jht.2013.03.004
21.
KehoeR.RiceM. S. (2016). Reality, virtual reality, and imagery: Quality of movement in novice dart players. British Journal of Occupational Therapy, 79, 244–251. https://doi.org/10.1177/0308022615616820
22.
KingT. I. (1993). Hand strengthening with a computer for purposeful activity. American Journal of Occupational Therapy, 47, 635–637. https://doi.org/10.5014/ajot.47.7.635
23.
LinK.WuC. Y.Tickle-DegnenL.CosterW. (1997). Enhancing occupational performance through occupationally embedded exercise: A meta-analytic review. The Occupational Therapy Journal of Research, 17, 25–47. https://doi.org/10.1177/153944929701700102
24.
LinK.WuC. Y.TromblyC. A. (1998). Effects of task goal on movement kinematics and line bisection performance in adults without disabilities. American Journal of Occupational Therapy, 52, 179–187. https://doi.org/10.5014/ajot.52.3.179
25.
MaH.TromblyC. A.Robinson-PodolskiC. (1999). The effect of context on skill acquisition and transfer. American Journal of Occupational Therapy, 53, 138–144. https://doi.org/10.5014/ajot.53.2.138
26.
MehtaS.MacDermidJ. C.TremblayM. (2011). The implications of chronic pain models for rehabilitation of distal radius fracture. Hand Therapy, 16, 2–11. https://doi.org/10.1258/ht.2010.010022
27.
MillerL.NelsonD. L. (1987). Dual-purpose activity versus single-purpose activity in terms of duration on task, exertion level, and affect. Occupational Therapy in Mental Health, 7, 55–67. https://doi.org/10.1300/j004v07n01_04
28.
MoherD.ShamseerL.ClarkeM.GhersiD.LiberatiA.PetticrewM.. . . StewartL. A. (2015). Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Systematic Reviews, 4, Article 1. https://doi.org/10.1186/2046-4053-4-1
29.
MolineuxM. (2010). The nature of occupation. In CurtinM.MolineuxM.WebbJ. (Eds.), Occupational therapy and physical dysfunction: Enabling occupation (p. 20). Elsevier.
30.
MortonG. G.BarnettD. W.HaleL. S. (1992). A comparison of performance measures of an added-purpose task versus a single-purpose task for upper extremities. American Journal of Occupational Therapy, 46, 128–133. https://doi.org/10.5014/ajot.46.2.128
31.
PerssonD.ErlandssonL. (2010). Evaluating OVal-9, an instrument for detecting experiences of value in daily occupations. Occupational Therapy in Mental Health, 26, 32–50. https://doi.org/10.1080/01642120903515284
32.
PolatajkoH. J.DavisJ. A.HobsonS. J.LandryJ. E.MandichA.StreetS. L.. . . YeeS. (2004). Meeting the responsibility that comes with the privilege: Introducing a taxonomic code for understanding occupation. Canadian Journal of Occupational Therapy, 71, 261–264. https://doi.org/10.1177/000841740507200307
33.
RiceM. S.AlaimoA. J.CookJ. A. (1999). Movement dynamics and occupational embeddedness in a grasping and placing task. Occupational Therapy International, 6, 298–310. https://doi.org/10.1002/oti.103
34.
RiceM. S.DaviesD. M.MaitraK. (2009). Immediate versus prolonged visual exposure and object relevancy in a reaching and placing task. Al Ameen Journal of Medical Sciences, 2, 22–35.
35.
RossL. M.NelsonD. L. (2000). Comparing materials-based occupation, imagery-based occupation, and rote movement through kinematic analysis of reach. The Occupational Therapy Journal of Research, 20, 45–60. https://doi.org/10.1177/153944920002000103
36.
RiceM. S.RenockL. A. (2006). Personal preference and quality of reach in healthy adult women. American Journal of Occupational Therapy, 60, 577–586. https://doi.org/10.5014/ajot.60.5.577
37.
SackalooK.StrouseE.RiceM. S. (2015). Degree of preference and Its influence on motor control when reaching for most preferred, neutrally preferred, and least preferred candy. OTJR: Occupation, Participation and Health, 35, 81–88. https://doi.org/10.1177/1539449214561763
38.
SchmidtR. A.WrisbergC. A. (Eds.). (2008). Motor learning and performance: A situation-based learning approach (3rd ed.). Human Kinetics Press.
39.
SquiresJ. E.ValentineJ. C.GrimshawJ. M. (2013). Systematic reviews of complex interventions: Framing the review question. Journal of Clinical Epidemiology, 66(11), 1215–1222. https://doi.org/10.1016/j.jclinepi.2013.05.013
40.
SteinbeckT. M. (1986). Purposeful activity and performance. American Journal of Occupational Therapy, 40, 529–534. https://doi.org/10.5014/ajot.40.8.529
41.
TaylorS. A.KedgleyA. E.HumphriesA.ShaheenA. F. (2018). Simulated activities of daily living do not replicate functional upper limb movement or reduce movement variability. Journal of Biomechanics, 76, 119–128. https://doi.org/10.1016/j.jbiomech.2018.05.040
42.
WagnerM. R.KraussA.HorowitzB. (1995). Occupationally embedded exercise, rote exercise, and the presence of another person in an exercise context. The Israeli Journal of Occupational Therapy, 4, 397–402.
43.
Weinstock-ZlotnickG.MehtaS. (2018). A systematic review of the benefits of occupation-based intervention for patients with upper extremity musculoskeletal disorders. Journal of Hand Therapy, 32, 141–152. https://doi.org/10.1016/j.jht.2018.04.001
44.
WuC. Y.TromblyC. A.LinK. (1994). The relationship between occupational form and occupational performance: A kinematic perspective. American Journal of Occupational Therapy, 48, 679–687. https://doi.org/10.5014/ajot.48.8.679
45.
WuC. Y.TromblyC. A.LinK.Tickle-DegnenL. (1998). Effects of object affordances on reaching performance in persons with and without cerebrovascular accident. American Journal of Occupational Therapy, 52, 447–456. https://doi.org/10.5014/ajot.52.6.447
