Hand Therapy and Occupational Therapy (OT)

Sanika Lawate
Sanika Lawate Executive Assistant at AHS

What is hand therapy? 

Hand therapy focuses on the upper extremities of the body, including the hands, the arms, and the shoulders (American Society of Hand Therapists [ASHT], n.d.). Therapists specialize in hand therapy and can even become certified. Hand therapists have an extensive knowledge of the anatomy and the physiology of the upper limbs, and can treat almost all injuries or disabilities that pertain to those body parts (ASHT, n.d.).

Hand Therapy by an Occupational Therapist

Not many people think of going to an occupational therapist after getting surgery on one of their upper extremities, but it might be the best option. More often than not, patients are unaware of the correct treatment plan after their surgery. Medication is prescribed and a cast or splint might be fitted, but many patients suffer after the medication is stopped and the protective cover is gone. Why? Well, because the patients have kept the injured/disabled area in one position for so long, it actually causes more pain than before. The same position can also cause the body part to lose sensation or mobility. OT is important because it undoes the damage the lack of movement causes. Patients who have suffered a major injury or are disabled can also benefit from occupational therapy, regardless of whether or not they have had surgery. For example, people suffering from rheumatoid arthritis can be taught exercises and can be given directions on how to ease pain and discomfort.

According to the American Occupational Therapy Association (AOTA), hand therapy by an occupational therapist can benefit a patient’s mental health because patients are taught how their treatment can not only rehabilitate their hand but also show them how to function in their regular life during their recovery (American Occupational Therapy Association [AOTA], 2016). Occupational therapy is all about ensuring patients take what they learned from therapy and apply it to their lives at home.

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What does treatment consist of?

An initial evaluation is done by our OTD, Emily Dayton, and during this evaluation, she carries out a series of tests to decide the plan of care for the patient. Before the patient comes in, Emily looks at their referral to see what exactly she needs to treat the patient. For patients that have had surgery, Emily will talk to the surgeon in case the surgeon has instructions on how to treat the patient. When the patient comes into the office, she asks the patient how much pain they are feeling from a scale of one to ten. This number gives her an idea on how many times the patient needs to come in per week, and how much the injury or disability is affecting the patient. Additionally, for pain management, Emily will massage or use ultrasound to help patients. 

Next, she measures the range of motion and strength of the injured body part. She will also ask how much their injury or disability is interfering with how they function at home and/or work. She examines how much sensation the patient can feel and carries out fine motor tests. These tests and measurements are done periodically so Emily can see if patients are progressing or regressing. It is helpful for referring doctors and insurance companies to know so patients can get better care and more visits.

There are various types of tools that hand therapists use to improve range of motion and strength. Each tool varies in difficulty; for example, one tool called TheraPutty comes in various colors that correspond to different levels of difficulty. Patients use the putty to help with strength and can improve decreased skills of the hand. Making different shapes, like a donut, or simply playing with the putty can help patients recover. Another tool like the putty is the Finger Strengthener which patients can squeeze to help with grip strength. For patients that are starting therapy, using the lower levels is recommended and they can work up to the most difficult level. Lastly, Emily prescribes exercises tailored to the condition the patient has, which also aid in fast recovery.  

References:

American Occupational Therapy Association. (2016). The unique role of occupational therapy in rehabilitation of the hand. https://www.aota.org/About-Occupational-Therapy/Professionals/RDP/hand-therapy.aspx

American Society of Hand Therapists. (n.d.). What we do. https://www.asht.org/about/what-we-do

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