Coordination Activities for Hand Therapy Patients

holistic view by integrating thequantitative and qualitativeresearch strategies for evidence-based practice; (4) Identify out-come measures of hand therapyinterventions based on ICF in-cluding factors of participationand quality of life. Current re-search projects will be presentedto illustrate the integration oftwo research approaches.

Methods: Teaching strategies/presentation Methods: Presentationof research projects will illustrateways to integrate quantitative andqualitative approaches in researchof hand therapy practice.Interactive discussion throughoutthe session will engage the audi-ence and facilitate exchange ofideas. Handouts will be providedto facilitate interactions withaudience.

Relevance: Leaders in hand ther-apy call for the creation of a handtherapy national data base thatwill capture critical informationthroughout the continuum of pa-tient care, clinical applicationand the science of evidence tosupport our practice (Muhleman,2006). By integrating the quantita-tive and qualitative research strat-egies, the holistic view of handtherapy interventions can be ef-fectively captured in the database.

Research/Evidence-BasedPractice

JOSEPHINE S CHAN, PHD, OTR, CHT

Coordination Activities forHand Therapy Patients.

1. Ability to define grasp, fineprehension, in-hand manipula-tion, proprioception, and kines-thesia 2. Ability to teach patientsfour activities to improve theirhand coordination 3. Ability toexplain the relevance of coordi-nation to functional hand use.

Purpose: Hand therapists applytissue-specific interventions toisolate particular anatomicalstructures in order to achieve

improved mobility and functionof the upper extremity. But apatient?s ability to perform roteexercise in itself does not guaran-tee effective, coordinated orsmooth functional hand use.Pediatric occupational therapyresources provide an excellentsource of information and ideasfor enhancing coordinated handuse. The purposes of this posterare to review the contributionsof pediatric occupational therapyto the adult hand therapy popula-tion and to present examples ofcoordination activities aimed atimproving functional hand usein patients of any age.

Methods: This poster willprovide definitions for grasp,fine prehension (pincer grasp),in-hand manipulation (shift, rota-tion, and translation), proprio-ception, and kinesthesia. Thedevelopmental sequence of gripand fine prehension will be pre-sented with examples of activitiesusing photographs to show thedelicate adjustments in motionsthat are involved in these tasks.Suggestions for grading the activ-ities to increase the coordina-tional challenge will be offered.

Results: Translating availablemotion into function requires cer-tain complex sensorimotor capac-ities of the patient?s hand use tobe intact and accessible. This is es-pecially true for fine motor handfunctions and may be apparentin the rehabilitation of either thedominant or the non-dominantextremity. Without facilitatingfine motor skills, patients mayhave acceptable flexibility of jointsand muscle-tendon units but theirmotion may look awkward andmay be lacking in smooth and co-ordinated flow, negatively affect-ing their function.

Conclusion: Coordination activ-ities that look easy may in factbe quite challenging for somehand therapy patients, even thosewith excellent range of motion.This poster presents ideas for ac-tivities aimed at maximizinghand coordination.

Relevance: The hand is a percep-tual entity that has beendescribed as an information-seeking organ. The hand allowsour patients to interpret and ana-lyze the tactile properties of size,shape, and texture and to use in-hand manipulation in order toidentify objects and handle themeffectively. Through manual ex-ploration by way of coordinatedhand use, our patients recognizethe relationship of objects to theirbodies and to gravity. Without theaccurate interpretation of thesecharacteristics, hand function iscompromised. Addressing coor-dination provides a bridge torecovery of meaningful handfunction.

Evaluation/Diagnosis/Clinical Treatment

CYNTHIA COOPER, MFA, MA, OTR/L, CHT

COLLEEN G. WEST, MS, OTR/L

Rehabiliation following totalwrist arthroplasty.

1. Description of surgical pro-cedure for total wrist arthroplastywith visual of anatomy pre- postsurgery. 2. Discuss use of ulnarsplint versus volar splint as aresult of ulnar instability or painthat can occur. 3. Present a thera-peutic guideline which can beused post operatively.

Purpose: To describe therapeu-tic intervention following a totalwrist arthroplasty. Interventionwould include splinting consid-erations post operatively, initialrom program and functional out-come/rom expectation.

Methods: Potentially a prospec-tive study of 1e3 patients. If thisis not possible, retrospective studyof previously treated patient/s.

Results: Results will includepatient outcome measurementssuch as DASH, Jebson hand func-tion test in addition to occupa-tional therapy measurements.

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