Instructional Concurrent Session I
Blood Flow Restriction Therapy: Clinical Application for the Hand and Upper Extremity
Description:
Blood Flow Restriction Training (BFRT) is a popular technique utilized in physical training and sports rehabilitation and is gaining exposure for clinical application in traditional therapy settings. In this two hour Instructional Session, we will provide the scientific background of BFRT along with clinical application on its use in upper extremity rehabilitation. The specific procedures regarding utilizing the equipment, designing a treatment plan, and documentation/billing will be reviewed. Cases will be presented to demonstrate application and outcomes of BFRT.
Objective(s):
- Participants will demonstrate an understanding of the basic science of Blood Flow Restriction Training.
- Participants will implement Blood Flow Restriction Training within an upper extremity treatment plan.
- Participants will describe 3 upper extremity pathologies that may benefit from Blood Flow Restriction Training.
Speaker(s):
Dexterity and Prehension: Testing and Intervention
Description:
Dexterity is defined as skill and ease in performing tasks, especially with the hands.1 Skilled object manipulation requires integration of the musculoskeletal, sensorimotor and cortical systems to accomplish a functional task. Dysfunction in any system will reduce task performance. As clinicians, we recognize dexterity or the lack of dexterity, but may not routinely include formal assessment of orthopedic or musculoskeletal injuries. This session will demonstrate the importance of the routine inclusion of dexterity assessments for persons with upper extremity injuries and conditions, review validated dexterity assessment tools, provide guidance for tool selection and describe knowledge gaps and research opportunities. Interventions targeting dexterity deficits will be discussed with recommendations for incorporating occupation-based interventions early in the treatment episode and a review of the evidence supporting these intervention.
Objective(s):
- Describe the importance of assessing dexterity and including dexterity testing for demonstrating improvement over an episode of care.
- Choose the 'best fit' dexterity assessment tools for functional goals.
- Discuss the evidence behind occupation-based interventions to improve dexterity.
Speaker(s):
Thumb CMC OA: An Update on the Science and Best Practices
Description:
Thumb carpometacarpal (CMC) osteoarthritis (OA) is the most symptomatic and disabling form of hand OA and affects nearly 70% of older adults. The findings of a 2014 hand therapy practice patterns survey indicate that clients with CMC pain commonly account for a quarter or more of our caseloads. Given this, the abundance of new evidence generated by therapists, surgeons, and basic scientists, and the commonly described gap between health research dissemination and practical implementation, the focus of this session will be to share with participants the state of thumb CMC OA science regarding rehabilitation in 2022. In this session, the instructors will present new knowledge, comment on how to incorporate these new discoveries into practice, offer suggestions on how we can all work to showcase the benefits of hand therapy for this population, and facilitate hands-on training on selected assessments and interventions. Topics will include: 1) An overview of new relevant knowledge about thumb CMC anatomy and thumb CMC OA pathology/pathomechanics 2) An overview of new knowledge about thumb CMC measurement and relevant practice recommendations; 3) An overview of new knowledge about hand therapy interventions and relevant practice recommendations; 4) Hands-on training in assessment and intervention; and 5) A discussion about how to promote the longevity of our practice with this population.
Objective(s):
- The learner will relate 3 new scientific findings on thumb CMC anatomy and pathology to their future practice.
- The learner will relate 3 new scientific findings on thumb CMC OA measurement and intervention to their future practice.
- The learner will demonstrate emerging skills in the administration of selected CMC OA specific assessments and intervention.
Treating VISIs and DISIs: Cracking the Code
Description:
What is the most nerve-racking condition you see in the clinic? Is it a patient with a crush injury involving multiple fractures and tendon lacerations or….is it the young girl with progressive onset of wrist pain with participating in gymnastics? So how do we evaluate and treat wrist instability? Gain a solid understanding of volar intercalated segmental instability (VISI) and dorsal intercalated segmental instability (DISI) conditions within the proximal row as well as at the midcarpal joint. This instructional course will be covering the spectrum of instability, including clinical testing for scapulolunate (SL), lunotriquetral (LT), and the midcarpal joint with evidence-supported treatment interventions. Develop tools to systematically address the impairments you find in the clinical exam for use in the clinic on Monday morning!
Objective(s):
- Describe VISI and DISI conditions that occur in the proximal row, versus those that occur at the midcarpal joint.
- Perform clinical testing for SL and LT instability and develop a treatment plan which includes orthotic stabilization, manual techniques to maximize midcarpal motion, the integration of proprioceptive training, and recruitment of specific dynamic wrist stabilizers.
- Perform clinical testing for midcarpal instability and describe the types of orthoses that would provide support. Discuss importance of working in straight-plane motions (avoiding the dart-thrower’s plane) and describe the exercise progression for this condition.