Hand & Upper Extremity Disorders In Occupational Therapy

Since one of Occupational Therapy's primary goal is to help people achieve their maximum level of functioning, there is a lot of emphasis on assessing and treating the upper extremity (UE). People can acquire an UE impairment that is related to work or a sports injury; a health related disability such as from a stroke; or maybe trauma from an accident of some type, such as a spinal cord injury. Recently, there have been a large number of returning war veterans with hand and limb amputations, and they will require education and training in how to function with a prosthetic hand or limb. If there is any kind of UE deficit or limitations, the OT will then provide the necessary treatment intervention to help them improve their ability to function.

Some OTs will specialize in treating hand and upper extremity disorders, and are called Certified Hand Therapists. The CHT has to pass a rigorous examination after years of hands-on treatment before getting this certification. They often work closely with orthopedic surgeons, both in the hospital and the outpatient clinic, to help with proper healing and return of function after surgery. This type of client will mostly be adults who are still active, although some younger and older clients are treated as well.

Some of the treatment interventions for hand and upper extremity disorders include: fabricating and applying orthotics or support splints, both static and dynamic; using various treatment modalities such as ultrasound, functional e-stim and other types of modalities to promote function, tissue healing, pain reduction or edema managment; providing range of motion, stretching and various upper extremity exercises; as well as incorporating functional tasks to help the person resume their previous liftestyle, vocation, or sports activity.

Case Study: A meat cutter partially severs his thumb at work. After surgery to reattach it he will be sent to a hand therapist for treatment. The hand therapist will fabricate a special splint to prevent movement and to promote healing. Eventually, gentle range of motion will be performed and then graded therapeutic exercises will be given. Special treatment for reducing the scar may be needed. Ultrasound may be used to help promote tendon healing. Before discharge from therapy, the client will need to demonstrate that he can grasp and hold items and will have sufficient strength in the hand to perform functional tasks, and to return to work.

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