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List 2 sensory tests commonly used in hand therapy
Tests for pain, vibration, temp, or touch pressure.
Tuning forks, Semmes-Weinstein monofilament testing, moberg Pick up Test, provocative tests
What is the main goal of acute rehab in hand therapy?
Reduce inflammation
________ is used to tell you how finely innervated an area is and looks at functional implications of sensory loss.
Finger pads would be greater than or equal to ___ mm to be considered normally.
2 point discrimination
5mm
What is a short opponens splint/short thumb Spica splint mostly used for treating?
What is a dorsal blocking splint typically used to treat?
tendon repairs
List and explain 2 provocative tests
Tinels
Phalen's
2 tools to measure edema
Volumeter
tape measure
2 objective tests of sympathetic function in hand therapy
wrinkle test for nerve function
Ninhydrin evaluates sweating of the fingers
What type of splint is most commonly recommended for someone with DeQuervains or tenosynovitis?
Long opponens splint or long thumb spica (same type)
A resting hand splint is typically used for what 3 diagnoses?
Burns, CVA, RA for night use
Name 3 types of pinch and demonstrate them
2 point (or tip to tip)
Lateral or key pinch
3 jaw chuck or 3 point pinch
What is another way to test gross finger flexion without a gonimeter?
Measuring tape from end of digit to palm
What is the difference in type 1 and type 2 CRPS?
Type 1- classic reflex sympathetic dystrophy
Type 2- similar signs and symptoms, but can be attributed to a nerve injury that has been diagnoses. Burning pain too.
3 purposes of splinting
1- support the impacted area
2- correct posture or deformity
3- Compensate for weak muscles
4- Increase extensibility/decrease tightness/contracture
5- increased independence
A radial nerve injury often results in....
wrist drop
Describe 2 tx strategies to reduce fingertip hypersensitivity after injury.
TENS, contrast bath, desensitization program
Why does clawing occur in the small and ring fingers after ulnar nerve injury?
hyperextension of the MCP joints of the ring and digit 5, caused with the extensor digiform communis that is not held.
List 4 risk factors for someone to have cumulative trauma disorder
repetition, high force, awkward joint positioning, direct pressure, vibration, prolonged static positioning
A median nerve injury can result in:
Ape hand
Describe the process and progression of textures with desensitization
soft-hard-rough
variety of textures: from a cotton ball, denim, velcro on the soft side, then the hook side, sandpaper (very carefully), ect
List 8 possible components of a hand evaluation
Pt PMH, Occupational profile
standardized tests
edema
wound appearance
pain
AROM/PROM
strength
dexterity
sensation
Draw on the board where median, radial and ulnar nerve are impacted on the hand.
See photo
Explain the wrinkle test
Where wrinkles can occur after 5 min of soaking in water. If this does not happen, likely due to denervated skin.
Describe 2 techniques besides texture desensitization for the hypertensive hand.
start using it in daily occupations, as tolerated
tapping distally to proximally
vibration
heat/contrast baths
List 4 interventions for scar management.
vibration tool
scar massage
silicone gel strips
protecting the scar from the sun with clothing or sunblock