Adirondack PT & OT: Occupational Therapy

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IN REHABILITATION OF THE HAND The Unique Role of Occupational Therapy

INSIDE: • Rehabilitation Of The Hand • The Role Of OT In Managing Post-Concussion Syndrome

• Relieve Hand Pain In Minutes • Patient Success Spotlight

Hand therapy, a specialty practice area of occupational therapy, is typically concerned with treating orthopedic-based upper-extremity conditions to optimize the functional use of the hand and arm. Conditions seen by the occupational therapy practitioner specializing in this area include fractures of the hand or arm, lacerations and amputations, burns, and surgical repairs of tendons and nerves. Acquired conditions such as tendonitis, rheumatoid arthritis and osteoarthritis, and carpal tunnel syndrome also are treated by occupational therapy practitioners specializing in hand rehabilitation. Practitioners who treat clients with conditions of the hand or arm can do so without additional formal education in most states. However, many practitioners choose to gain several years of experience before treating hand clients, and therapists may choose to become specially certified through the Hand Therapy Certification Commission (Hand Therapy Certification Commission, n.d.). Occupation-Based Hand Therapy Hand therapy typically addresses the biomechanical issues underlying upper-extremity conditions. However, occupational therapy practitioners bring an added dimension to this specialty area. They use an occupation- based and client-centered approach that identifies the participation needs of the client—what he or she wants to be able to do in daily life that is fulfilling, necessary, and/or meaningful—and emphasizes the performance of desired activities as the primary goal of therapy. The Benefits of Occupation-Based Hand Therapy Evidence indicates that clients view themselves in relation to their occupational abilities and roles. Injuries and conditions that interfere with life roles, habits, time use, activity patterns, occupational experiences, and

full participation will create a sense of dysfunction and yearning for normalcy (Custer, Huebner, & Howell, 2014). Incorporating “usual and customary” occupational activities into treatment and focusing goals on enabling performance of those activities provides benefits to clients, including: • Preserving roles and habits, as well as related psychological well- being, through attention to details of day-to-day functioning early in the rehabilitation process. • Increasing motivation for therapy and more cost-effective rehabilitation because clients can see a direct relationship between their occupational therapy intervention and being able to resume normal participation in their activities. • Making the client a partner in his or her rehabilitation. Not all intervention can or should be completed within the clinic. Consulting with the client about what he or she can and should not do outside the clinic as well as giving “homework” assignments can address occupational goals that go beyond clinical staff time and budget constraints. What Does an Occupation-Based Approach to Hand Therapy Look Like? The client–therapist relationship is key to an occupation-based approach. Occupational therapistsbegin interventionwithaclient-centeredassessment tool, such as the Canadian Occupational Performance Measure (Law et al., 2005).This type of tool will provide an occupational profile of the client that highlights functional deficits and desired occupational goals rather than focusing solely on the physical components of function. (continued inside)

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