REHABILITATION OF THE HAND, WRIST, AND ELBOW


Rehabilitation encompasses many aspects of improving a limb's function, appearance, and symptoms. Goals of rehabilitation include improved flexibility, strength, and dexterity. These are primarily achieved through direct handling of tissues and the performance of specific exercises. Patients will become well educated about rehabilitation during their sessions at the Hand and Wrist Center's rehabilitation unit. Patients must then take this new knowledge and apply it 7 days a week by practicing good ergonomics, performing specific exercises that they have been taught, and wearing splints faithfully in accordance with their instructions.

A Certified Hand Therapist should have an extensive scientific knowledge in the following:

• Anatomy, physiology and biomechanics of the hand
• Surgical procedures, indications and contraindications
• Wound healing
• Treatment protocols
• Physiological effects of modalities.

Each therapy patient at the Hand and Wrist Center of Houston will receive a personalized evaluation by a hand therapist, who will then implement an individualized treatment program to address specific problems. The core of the program is patient education in ergonomics and the safe use of the upper extremity to perform work and enjoy hobbies. This is complemented by hands on techniques to increase muscle flexibility, balance strengthening, and mobilize joints and tendons. For more advanced problems, custom splints are a refined addition that can make a tremendous difference in the final outcome. The core program is supplemented by thermal and electrical modalities that decrease pain and tissue inflammation while pursuing the primary treatment goals.

Therapy Facility and Equipment

The Hand and Wrist Center of Houston is located in suite 1390 of the Park Plaza Professional Building with a spectacular view of the hospital and museum district. The facility has state of the art equipment, including the latest in custom splinting materials and a Baltimore Therapeutic Equipment machine. There is ample space for each patient to enjoy his or her own therapy experience while facing out over Hermann park and receiving one on one individual attention. Parking for therapy sessions is validated.

Splinting

Custom fabricated splints play an important role in the rehabilitation process of the injured hand. There are three types of splints: static, dynamic, and static progressive. Static splints have no moving parts and are used to protect the body part in one chosen position. The purpose of a static splint is to prevent hand contracture while protecting injured tissues (bones, ligaments, tendons) that are healing. In contrast, dynamic and static progressive splints have moveable parts. These splints apply forces to the joints through a traction device made of inelastic cords, spring coils or rubber bands. They are designed to substitute for active motion following a surgical repair or for absent muscle strength. They may also be used to increase range of motion of joints through a prolonged, low-load force. Splinting is one of the most effective means utilized by hand therapists to re-gain flexibility of the injured hand. Due to the complexity of many of these splints, it is recommended that a certified hand therapist who is knowledgeable in splinting principles as well as anatomy, physiology, and biomechanics of the hand fabricate these splints. A clinician who lacks the knowledge or expertise in splinting may actually cause further damage to an injured hand with a poorly fitting splint.

Work Conditioning

Work conditioning is a highly structured individualized treatment program that incorporates work-simulated activities with conditioning tasks. An individualized treatment program is created for each patient to restore neuro-muscular-skeletal function. The employee attends every day for a minimum of two hours. The services provided at the center include:

• Progressive upper extremity strengthening and endurance
• Motor coordination activities
• Work simulated tasks
• Flexibility exercises
• Patient education on proper body mechanics and/or ergonomics
• Baltimore Therapeutic Equipment work simulator

 
 
 
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