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hands interventions

Interventions for hand impairments

QuestionAnswer
Interventions during the inflammation phase of tissue healing rest is advised, edema management, pain control, and positioning
Interventions during the fibroplasia phase of tissue healing starts at 4 days to 6 weeks. Formation of scar tissue. Begin AROM, splint
interventions during the maturation phase of tissue healing gentle resistive activity, avoid inflammation, dynamic or static splinting, scar tissue management
hand position to avoid wrist flexed, MP joints stiffen in hyperextension, and DIP's flexed, adducted thumb
Describe the Intrinsic Plus position wrist in neutral or extension, MP's in flexion, IP's in extension (flexor and extensor tendon repair not conducive to these positions
PROM precautions can be injurious to delicate tissues, can incite inflammation and trigger CRPS, can cause inflammation if PROM is done after heat application
Guidelines for PROM gentle and pain-free
may be more effective than PROM low load-long duration splinting
heat precaution do not use on inflamed or edematous extremity, may degrade collagen and contribute to microscopic tears, can have rebound effect, with stiffening following its use
Guidelines for use of heat use aerobic exercise to warm up tissue, elevate the extremity in conjunction with heat, monitor frequently for signs of inflammation
benefits of purposeful activity fro hand therapy produces coordinated movement patterns in multiple planes, leads to better movement quality
Benefits of occupation as means for therapy improved quality of movement and return to occupation
wound color: red revascularizing
wound color: yellow exuidate--needs cleansing and debridement
wound color: black necrotic--needs debriedment
Describe a mature scar flat and softer, has neutral color, does not blanch to touch
Interventions for edema elevation, compression, manual edema mobilization, lymphedema pumps
interventions for scar management compression, silicone gel
interventions edema control, scar management, tendon gliding, blocking exercises, place and hold, end feel and splinting
types of splinting blocking, buddy strapping, dynamic vs static
Intervention for stiff hand (as result of fx) decrease PROM/AROM if painful or swollen, static splinting during acute inflammatory phase, dynamic when joint has soft end feel
Intervention for tendonitis (more than half of occupationsl illnesses) RICE, splinting @ night, gradual mobilization balanced w/rest, prevent re-injury thru education
Intervention for lateral epicondylitis proximal conditioning and scapular stabilizing, built up handles, splinting, counterforce strap
intervention for medial epicondylitis proximal conditioning, avoid end range, built up handles, splinting, counterforce strap
Intervention for DeQuervains Disease (common type of tendonitis) avoid wrist deviation (esp w/pinching), forearm thumb spica
Intervention for nerve injuries steroid injection, night splinting in neutral, exercises for tendon gliding, aerobic exercises, proximal conditioning, ergonomic modification, postural training
Management of CRPS medications, sympathetic blocks, modalities; vaso motor challenge thru stress loading (scrubbing); change positions, temperature feedback, contrast, vibration, desensitization, water aerobics; Pt. directed therapy
Interventions for OA splinting, pain mgmt, jt. protection
Interventions for RA reduce inflammation, jt. protection, splinting, energy conservation
Created by: abascas on 2011-12-08



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