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hands interventions
Interventions for hand impairments
| Question | Answer |
|---|---|
| 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
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