This paper provides an overview of hand therapy as a specialized branch of occupational therapy that merges principles from both occupational and physical therapy to address injuries and chronic conditions of the upper limbs. It examines the scope of practice, qualifications of certified hand therapists, the range of patient candidates—from those with acute trauma to those with chronic conditions such as carpal tunnel syndrome and arthritis—and the strategies used to restore mobility, strength, and dexterity. The paper also discusses the business and administrative dimensions of hand therapy practice, including the referral process and insurance reimbursement considerations.
Hand therapy is a specialty practice within occupational therapy. It combines elements of preventative care with recovery in order to allow individuals to regain proper mobility, dexterity, and strength in their hands and arms. As a combination of occupational and physical therapy, the practice requires a keen knowledge of the functionality of the upper limbs. It is a highly specialized practice that can help ease pain and prevent future suffering for those in need.
The practice encompasses several major factors, primarily because it deals with so many different types of injuries, conditions, and their subsequent treatment strategies. According to the research, "hand therapy is the art and science of rehabilitation of the upper limb, which includes the hand, wrist, elbow, and shoulder girdle. It is a merging of occupational therapy and physical therapy and practice that combines comprehensive knowledge of the structure of the upper limb with the function and activity" (Certified Hand Therapist, 2012). The practice merges concepts and strategies from the two larger disciplines in order to best serve patient needs. Thus, hand therapy is a type of occupational therapy that revolves around working with conditions and injuries that have impacted hand mobility, strength, and capabilities. As such, "this enables the hand therapist to work with patients to hasten their return to a productive lifestyle" (American Society of Hand Therapists, 2011).
Strategies focus on managing pain, both acute and chronic. There are also preventative treatments to help avoid surgery for ongoing conditions that may worsen without therapy sessions. Hand therapy is often used in response to "desensitization following nerve injury or trauma" and "sensory re-education after nerve injury" (American Society of Hand Therapists, 2011). Moreover, the hand specialist can teach patients essential drills and exercises that can be repeated at home in order to increase overall dexterity, strength, and range of motion. Overall, the hand therapist aims to directly address issues affecting a person's ability to use their hands so that they can once again return to work and a productive lifestyle.
Certified hand therapists have a minimum of five years of clinical experience (Certified Hand Therapist, 2012). Most are trained as occupational therapists, with 14% being physical therapists and less than 1% holding dual certification in both occupational and physical therapy (Certified Hand Therapist, 2012). These professionals are trained to account for the structure and function of the hand in relation to the injury or source of discomfort, and to generate strategies aimed at patient relief.
"Who qualifies for hand therapy and why"
"How patients access care and how costs are covered"
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