HandTherapyfortheNonHandTherapistKristine对于非手手疗法治疗师克里斯蒂娜

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1、HandTherapyfortheNonHandTherapistKristineMillironOTR/L,CHTQuickDASHDisabilitiesoftheArm,ShoulderandHandEveryDayModuleWork&Sports/PerformingArtsModule5511-1x25=100TotalSummary#?’sanswered-1x25=?Ex.)Ms.PanehasMedicareSinceMCdoesnotrecognizeworkorleisure,onlypage1wascompleted.Ev

2、aluationQuick,Efficient&CompleteClinicalAssessment1)HistoryofInjury&FunctionalStatus(Prior&Current)2)OrganizedExamination3)KnowledgeofDiseaseprocessS:SubjectivePt.isa__YOM/FwithDxof_______.PtisR/Lhddominant.Pt’soccupation:____.DOI______DOS______.SPS=____locationofpain_______.Fu

3、nctionalStatus(prior)=_________(Current)FunctionalStatus=_________Pt’s.functionalgoal=_______________O:ObjectiveA/PROMofinvolvedjoints-FingerHyperextensiondocumentedas(+)positivevalue.Incompleteextensiondocumentedas(-)negativevalue.ASHTGuidelines:Documentextension/flexionIndex(

4、IF)Middle(MF)Ring(RF)Small(SF)ASHTRecommendationsHowtomeasureTAMMPPIPDIP(TAM)IF+20/900/1000/90(300)MF+20/800/750/45(220)RF-10/600/70-5/30(145)SF-20/50+10/20-10/30(80)ThumbROMThMPext/flexThIPext/flexThRadialAbductionThPalmarAbductionThOppositionThAdductionWrist/ForearmROMExtensi

5、on/FlexionRD/UDPron/SupGripTesting(20lbsrequiredforIADL)JamarDynamometerTestposition-Forearminneutral,elbowflexedto90,shadducted,wrist0-30extensionand15degreeUD.ASHTrecommends3trials&average.Use2ndhandlepositionifonlyonehandlespaceisused.GripTestingcontinuedBellCurvetest-test1x

6、eachhandlespace.Besuretotesttoeliminatefatigue.Testhandsalternately.Fulleffortwillproduceacurvewith1st&5thhandleproducinglowestscores&greatestinthemiddle.Intrinsicminushandisexceptiontotherule.GripwillincreasefromI-Vduetoextrinsicflexionareatabettermechanicalpositionwithwiderha

7、ndlepositions.PinchTesting(4-7lbs)requiredforindependentADLSamearmpositionasgriptestLateralorKeyPinchTipPinch3JawChuckPinchorPalmarpinchEdemaCircumferentialmeasurements:measurelandmarks-IP’s,MP’s,DPC,Wrist,Elbjt.VolumetricdisplacementEquipmentNeeded:plastichandvolumometer,gradu

8、ated.Cylinder500ml,smallbucketorcontainer,elevatedWood