Instructional Concurrent Session IX

Date/Time: Sun, October 16, 2022 10:30 AM to 11:30 AM

Call to Action: Demonstrating Our Professional Value in a Time of Hyperchange

Description:

Demonstrating the value of hand and upper extremity therapy is essential in the context of rapid change. Shifting reimbursement models require us to prepare for outcomes-contingent payments and advocate for representation of our services in bundled payments. Technological advances offer innovative care opportunities but simultaneously pose threats if other disciplines and policymakers view our skilled services as interchangeable with digital unskilled services. To ensure our profession’s viability and advocate for our patients’ needs, each of us must contribute to demonstrating our professional value. Researchers and clinicians can partner to ensure that studies on our outcomes are high-quality and represent our professional voice and our patients’ complex needs. Clinicians can engage in best practices for assessment, intervention, and documentation in every clinical encounter to facilitate retrospective analysis of practice-based data. Additionally, clinicians, educators, and researchers can emphasize our unique professional contributions to hand and upper extremity care, such as activity and participation, occupation-based intervention, non pharmacological pain management, and health promotion beyond the presenting diagnosis. This intermediate session will describe the “whys” and “hows” of demonstrating our value. It will include an interactive discussion component with both peers and the presenters to facilitate reflection and knowledge translation.

Objective(s):

  • Discuss why it is imperative to demonstrate the value of hand and upper extremity therapy in the current healthcare context.
  • Describe three ways the hand and upper extremity therapist can contribute to building an evidence base that demonstrates our professional value.
  • Describe three strategies to emphasize therapists’ unique professional contributions to hand and upper extremity care.

Clinically Relevant Anatomy of the Forearm-A Deep Dive

Description:

The forearm joint represents brilliance in engineering. The shape of the ulnar and radius, the precision of the articulations of the proximal, middle (!?) and distal radioulnar joints, the sophistication of the ligamentous restraints remain beyond our complete understanding. However, a deep understanding of the anatomy and physics of the joint will sharpen your clinical decision making, selection of treatment interventions and orthotic design. We will look at bone and joint morphology, ligament structure and function, and joint kinesiology with a magnifying glass. This information will be linked directly to treatment interventions and orthotic designs for Diagnosis seen in the clinic. Is the IOL isocentric? Is that relevant? Why is supination often so difficult to recover following DRF? Why are supination splints so hard to make? Why didn’t they repair that ulnar styloid fracture? How is the lesser sigmoid notch oriented at the proximal ulna? How can I increase rotation using manual therapy techniques that are precises and effective? How do I assess the integrity of each of the four distal radioulnar ligaments? Come find out this and more!

Objective(s):

  • Attendee will be able to describe the behavior of the different elements of the IOL during the arc of pronosupination and understand the relevance of that to forearm rotational deficits.
  • Attendee will be able to teach a colleague about the reciprocal nature of the deep and superficial, palmar and dorsal radioulnar ligaments and how to test the integrity of each and DRUJ stability.
  • Attendee will understand why the geometry of pronosupination orthoses is so challenging and how to create an appropriate orthosis of their own design.

Maximizing Outcomes in all Populations: Understanding your Patient

Description:

We all know that as we care for our clients there is a relationship with adherence to therapeutic recommendations and outcomes. This session will explore the correlates of patient adherence including concordance of healthcare decisions, health literacy and readability of educational materials, and will elucidate their impact on maximizing outcomes. The session will be conducted in an interactive fashion to provide attendees with skills they can use in their clinic to improve both adherence and outcomes for all populations they serve.

Objective(s):

  • Attendees will identify person-based and instructional characteristics that influence adherence to therapeutic recommendations.
  • Attendees will identify technologies they can use to improve adherence to therapeutic recommendations.
  • Attendees will recognize and practice tangible steps they can take to improve readability and adherence to instructions they provide to clients.

The Use of a Simple Screen to Detect Early Peripheral Nerve Injuries with Elbow or Forearm Trauma

Description:

The development of a novel, comprehensive screening tool (the UEPNS) to identify early peripheral nerve injury associated with elbow and forearm trauma will be introduced. This presentation will link current evidence of PNI with elbow and forearm trauma to a comprehensive examination designed to identify levels of injury and direct optimal therapy interventions. To date, this will be the first screening tool to comprehensively evaluate peripheral nerve function after a complex elbow or forearm injury that may also lead to more appropriate and targeted therapy.

Objective(s):

  • Recognize early signs of an upper extremity peripheral nerve injury in the context of elbow or forearm trauma.
  • Correlate the signs of a peripheral nerve injury to appropriate tests early in the treatment of an elbow or forearm injury.
  • Discuss appropriate treatment interventions as a result of peripheral nerve injury early in the treatment of an elbow or forearm injury.