Instructional Concurrent Session IV
Emerging Applications for Nerve Transfers: Peripheral Nerve and Spinal Cord Injury
Description:
While nerve transfers have been in use for many decades, there have been a number of promising advances in recent years regarding the clinical indications and specific nerve transfer options that are now available. We will discuss the 1) use of nerve transfers to improve upper extremity motor function in patients with tetraplegia arising from spinal cord injury; 2) new nerve transfers in the distal upper extremity being employed to manage peripheral nerve injuries that were previously managed exclusively with tendon transfers; 3) the role of hand therapy and specific techniques used to optimize post-surgical outcomes
Objective(s):
- Learners will recognize the indications and specific nerve transfers being used for patients with tetraplegia.
- Learners will identify recently described nerve transfers in the distal upper extremity used to manage peripheral nerve injuries.
- Learners will be able to recognize the role of hand therapy and specific protocols and therapeutic interventions used to optimize post surgical outcomes following nerve transfers for spinal cord and peripheral nerve injury.
How Can We Help People Who Use/Inject Drugs? Hand & Upper Extremity Therapy and Harm Reduction
Description:
This course is designed for clinicians at all levels to help examine the role of hand and upper extremity therapists in the treatment of persons who inject drugs, not only in relation to injuries that can occur during the course of injection, but also related to the role we can play in the harm reduction model. Topics covered will include: types of injuries seen in the upper extremity related to drug injection and treatment; healthcare disparities faced by people who inject drugs; suboptimal health outcomes and increased disability and morbidity; stigma faced by people who inject drugs and how this can result in delay and/or avoidance of treatment; recognition of drug use as a “dark” or unsanctioned occupation; therapeutic use of self as a treatment modality including motivational interviewing; opportunities and resources for therapists’’ participation in harm reduction initiatives; grading home programs and home wound care to match the resources available to the person; and the importance of having resources for therapists to deal with their own emotions and feelings related to this population.
Objective(s):
- Participants will be able to describe common UE injuries related to drug injection and treatment options.
- Participants will be able to describe healthcare disparities faced by people who inject drugs.
- Participants will be able to describe therapists’ roles in harm reduction initiatives.
Pilates Introduction for the Upper Extremity Therapist
Description:
In recent years, pilates has gained popularity as a form of exercise. It has also been used as another tool in the world of rehabilitation. Is it an effective tool? And how does it apply to rehabilitation of the upper extremity. This session will introduce the clinician to what pilates is and how it was developed. Evidence will be provided as to its effectiveness in the rehab setting. Additional evidence will be provided as to its effectiveness specific to upper extremity rehabilitation. Three to five exercises will be introduced that clinicians can begin evaluating for use in the clinic.
Objective(s):
- Describe what pilates is and what the origins of pilates are.
- Discuss effectiveness of pilates as an intervention in the rehab setting.
- Discuss how pilates can be applied to upper extremity rehabilitation.
Speaker(s):
Restoring Hope and Function after Brachial Plexus Injuries through a Team-Based Approach
Description:
Brachial plexus injuries can have devastating impacts in all areas of a patient’s life. Therefore, addressing all areas of impact are essential to consider when determining surgical intervention. Surgical advances in nerve and tendon transfers offer hope to those who sustained brachial plexus injuries transforming a non or low functioning limb to a functional assist limb that allows for increased independence with meaningful tasks. Three nerve transfes to restore pinch, elbow flexion, and shoulder abduction will be discussed through case studies exemplifying realistic goals of each surgery. Rehabilitation after three nerve transfers will be reviewed throughout the continuum of care to ensure a greater understanding of transfer retraining for the treating therapist. To ensure optimal recovery, a team-based approach to brachial plexus injuries is essential. The speakers’ multidisciplinary approach will be discussed and involves medical support staff, several hand surgeons, physiatry, hand therapy, psychology/psychiatry, the patient, and the patient’s support system. A team-based approach ensures that not only is the physical function of the limb increased, but that the psychological and psychosocial needs of the patient are met resulting in increased quality of life.
Objective(s):
- Establish a basic understanding of surgical techniques to restore elbow, shoulder and hand function after brachial plexus injuries.
- Identify patient reported outcomes to utilize to assess psychological well-being in those that sustained brachial plexus injuries.
- Determine appropriate therapy interventions throughout the stages of rehabilitation based on tissue healing principles, patient factors, and surgical factors.