For more precise searching try:
Use the Search history to follow the searches you have carried out in this session.
In Cinahl and other Ebsco databases select the Search history link under the search boxes.
Print the search history at the end of the session to record details, such as date, database, results etc for your report.
Four techniques to quickly aid your searching:
"" "hand therapy"
AND metacarpal AND rehabilitation
OR elderly OR geriatric
Databases allow you to narrow down results by facets.
These are generally on the left of the results and typically include type of publication, date, details of population (eg age).
They will allow you to narrow your results to peer reviewed journals.