Instructional Concurrent Session VIII
Complex Flexor Tendon Injuries: Fewer Incisions, More Motion
Description:
This instructional course will review current concepts about early motion for complex injuries of the hand. The course will include principles of surgical and therapy management which will be illustrated through lecture and case presentations. Topics discussed will include:early motion for replantations, intra-articular fractures, complex fractures, and soft tissue reconstructions.
Objective(s):
- Describe the complications associated with prolonged immobilization.
- Describe the benefits of early motion to enhance tissue healing and improve functional outcomes in the hand.
- Analyze the priorities of tissue healing to choose the best management techniques for the patient's injury
Speaker(s):
Harnessing the Power of Placebos and Cortical Reorganization
Description:
This evidence based session will explore how the power of top-down cortical re-organization and placebos can be incorporated into hand therapy. RCTs have demonstrated the effectiveness of placebos for conditions including chronic pain and brain injury. In the past two decades researchers have begun to study the placebo as an active agent rather than a comparative marker. There have been a plethora of studies seeking to determine what influences the effectiveness of placebos. Factors include the patient/clinician relationship, prior experience, use of touch, rituals, conditioned response, activation of neurotransmitters, the use of medical devices, method of delivery, social bias, exclusivity, reinforcement of deeply held beliefs, perception of magnitude and perception of advanced technology. The opioid crisis in this country prompted the CDC to issue a directive to doctors to prescribe rehabilitative therapy as a first line treatment for pain. OTs and PTs are a frontline treatment for chronic pain. We must understand that chronic pain is cortically driven and multifactorial (physical, psychological and social).
Objective(s):
- Participants will describe 3-4 ways they can enhance the effectiveness of current interventions utilizing the power of placebos.
- Participants will identify instances when placebo and nocebo effects are present in their current practice.
- Participants will interpret current evidence concerning placebos' influence on central sensitization, neuroplasticity and the release of endogenous neurotransmitters.
Moving Your Wound Care Practice Forward
Description:
Simple and surgical wounds are commonly seen in daily clinical practice. But what if the wound is taking longer than normal to close? Can you identify if infection is present? Are you able to describe what you are observing in the wound bed and the peri-wound area? Are you comfortable and confident making treatment decisions for optimal outcome toward wound closure? Are you familiar with the current technology in wound coverage and dressings? This intermediate level instructional course will take a deep dive into wound care essentials for the upper extremity practitioner including cases and photo progressions of wounds through healing phases, descriptors for documentation that also indicate healing progression, treatment options for simple and more complex wounds, an algorithmic approach to selecting dressings and wound coverage, managing skin substitutes, and having that conversation with your referring provider why there are better options than wet-to-dry dressings and epsom salt soaks. Completion of this course will allow you to embrace change and move your wound care practice forward!
Objective(s):
- 1. Describe wound bed characteristics that indicate healing or non-healing traits.
- 2. Discuss wound coverage and dressings based on presence of necrotic tissue, moisture level/amount of exudate, and potential infection.
- 3. Interpret wound assessment data to determine best treatment options for wound coverage and progression toward closure.
Speaker(s):
Therapeutic Relationships: Interventions Promoting Psychosocial Coping Strategies
Description:
With thirty years of evidence suggesting psychosocial barriers exist after upper extremity injury (UEI), physicians and therapists are looking for pragmatic solutions. Hand therapists can draw from their holistic training to develop goals and interventions addressing individual needs after UEI. This course will present a novel evidence-based protocol as a guide to addressing psychosocial needs among the UEI population. Assessment options for psychosocial impacts of UEI including patient-reported outcome (PRO) measures will be presented. Specifically, the Brief-Coping Orientation to Problems Experienced Inventory (COPE) will be explored as a potential tool for defining and creating collaborative SMART goals addressing psychological or social barriers to adaptation. Individualized interventions based on the SMART goal development will be discussed through interactive presentations of case scenarios. The participants will have the opportunity to analyze the Brief COPE measure and develop SMART goals and and critique a case study. Resources and references will be provided including a booklet developed by the author.
Objective(s):
- Identify psychosocial barriers to adaptation after upper extremity injury based on current evidence.
- Discuss assessment options for psychosocial barriers after upper extremity injury.
- Critique a case study using the Brief COPE as an outcome measure.