Archive: CSM 2013: Hand Rehabilitation Programming

  • This is archived programming for CSM 2013. See current programming.

    Browse Hand Rehabilitation sessions by day. Return to the main topic menu 

    Monday, January 21 | Tuesday, January 22 | Wednesday, January 23 | Thursday, January 24 

    * Should you choose to preselect regular (not preconference) Tuesday-Thursday sessions during the registration process, please be advised that preselection is not a guarantee of a seat. Attendees are asked to preselect to better determine room size and all efforts will be made to accommodate sessions in the largest rooms possible. All attendees are encouraged to show up to sessions early. Attendees are also encouraged to select alternative sessions in the event their first choice is full. 

    Monday, January 21 (Preconference)

    Survey Course in Hand Therapy: The Basics and Beyond

    Location: Hilton Bayfront| Cobalt 501

    Time: 8:00 am - 5:30 pm

    Speakers: Carol Waggy, PT, PhD, CHT, Mia Erickson, PT, EdD, CHT

    Level: Intermediate

    CEUs: 0.9 (9.0 contact hours/CCUs)

    Preconference Pricing: Standard (1A)

    The purpose of this course is to provide attendees with a comprehensive review of wrist and hand anatomy, radiology, examination procedures, and treatment strategies. The speakers will discuss self-report measures and their use in hand therapy. Attendees will have the opportunity to practice special tests in a lab format. In addition, the speakers will present treatment approaches—including best available evidence—for fractures, tendon injuries, nerve injuries, thumb osteoarthritis, and others. Attendees will be provided with tips from the field and as well as common pitfalls in managing wrist and hand disorders.

    Upon completion of this course, you'll be able to:

    • Describe bone, ligament, and tendon anatomy of the wrist and hand.
    • Describe the interplay between the hand intrinsics and the extensor/flexor tendons.
    • Perform a wrist or hand examination that includes identifying appropriate special tests and measures based on best available evidence.
    • Identify appropriate self-report measures and be able to apply them to patients.
    • Provide evidence-based treatment to wrist and hand conditions.

    Tuesday, January 22

    Decision Making in Upper-Extremity Management Post Stroke

    Joint Program: Neurology

    Time: 8:00 am–10:00 am (See Program for Room)

    Speakers: Catherine E. Lang, PT, PhD

    Level: Multiple Level

    Persons with stroke most often receive therapy services in inpatient and outpatient facilities which specialize in neurologic rehabilitation. It is not uncommon, however, for persons with stroke to seek upper-extremity rehabilitation in specialized hand clinics. The goals of this session are to provide a comprehensive approach for assessing upper-extremity impairment and function after stroke and present a framework for selecting and tailoring interventions. The target audience is clinicians unfamiliar with this population. The session will include a review of common stroke-induced upper-extremity impairments, their underlying neural mechanisms, and clinical assessment strategies. It will also include upper-extremity function, functional assessment, and a description of how various impairments contribute to loss of function after stroke. Because a goal of stroke rehabilitation is to improve daily life, the speaker will also include a short discussion of accelerometry, an objective method for assessing upper-extremity activity outside the clinic. The session will conclude with information regarding how assessment data from each of these levels can be used in clinical decision making in order to optimize the provision of upper-extremity stroke rehabilitation services.

    Upon completion of this course, you'll be able to:

    • Describe the neural mechanisms underlying stroke-induced upper-extremity impairments and the contribution of the various impairments to loss of function.
    • Describe methods to assess upper-extremity impairments and function post stroke.
    • Discuss factors affecting how to choose the appropriate standardized assessments for individuals with stroke.
    • Discuss how results from assessments at various levels of measurement are used to make informed clinical decisions regarding goal setting, selection of interventions, and continuation of services.

    Infant Brachial Plexopathy: Nonsurgical and Surgical Management

    Joint Program: Pediatrics

    Time: 11:00 am–1:00 pm (See Program for Room)

    Speakers: Susan V. Duff, PT, MPT, EdD, OTR/L; Gregory G. Heuer, MD; James R. Bain, MD; Carol Dematteo, PT, MSc, OT

    Level: Intermediate

    The purpose of this course is to review state-of-the-art assessment and intervention strategies for infants who sustain a perinatal brachial plexus injury. Attendees will learn how to integrate the current evidence and appreciate the range in outcome from nonsurgical and surgical intervention for this population. The speakers will review assessment tools used to determine the level of injury and the degree of recovery across time including the Active Movement Scale, neural imaging techniques, ultrasound, motion analysis, and needle and surface electromyography. An algorithm used to make surgical decisions will be outlined and discussed. The presenters will review current microsurgical techniques and shoulder reconstruction strategies and examine nonsurgical treatment options. Finally, case studies will provide examples of nonsurgical and surgical outcomes from infancy to childhood. This course will end with a discussion on current intervention options and outcome for this population.

    Upon completion of this course, you'll be able to:

    • Describe clinical assessment tools and medical tests that help determine level of brachial plexus injury and degree of recovery across time.
    • Describe the decision-making and current surgical strategies available to ensure the best outcome.
    • Appreciate the outcomes from nonsurgical and surgical interventions through case study review.
    • Discuss the current intervention options available for infants and children with brachial plexus injury.

    Emerging Technologies for Enhancing Poststroke Arm Rehabilitation

    Joint Program: Hand Rehabilitation

    Time: 3:00 pm–5:00 pm (See Program for Room)

    Level: Multiple Level

    This is a joint program. See full description at Neurology programming.

    Wednesday, January 23

    Hand Therapy: Practice, Coding, Documentation, and Reimbursement

    Time: 8:00 am–10:00 am (See Program for Room)

    Speakers: Nancy J. Beckley, MS, MBA, CHC; Lynn S. McGivern, JD, LLM; Bridget Morehouse, PT, MBA

    Level: Basic

    Much confusion exists in the practice of hand therapy as it relates to the coding, billing, documentation, compliance, and practice. Can a certified hand therapist (CHT)/occupational therapist work on a Plan of Care (POC) for a CHT/physical therapist (PT)? Can each establish a POC and work together, apart? What documentation is required for splinting, or materials, or follow-up? Why are private practice hand therapists at greater compliance risk than hospitals or rehab agency providers? This session will answer these questions, as well as unravel other areas of confusion and provide a guide to compliant practice of coding, billing, and documentation.

    Upon completion of this course, you'll be able to:

    • Explain the Medicare and private-payer documentation and coding requirements for hand therapy.
    • Realize the elevated compliance risks in billing for durable medical equipment/L codes.
    • Differentiate between billing for L-codes in private practice versus hospitals, rehab agencies, and comprehensive outpatient rehabilitation facilities.
    • Differentiate between private-payer reimbursement for hand therapy for a PT versus an OT.

    Athletic Injuries of the Forearm, Wrist, and Hand

    Joint Program: Sports Physical Therapy

    Time: 11:00 am–1:00 pm (See Program for Room)

    Speakers: Kevin Lawrence, PT, MS, DHS, OCS

    Level: Multiple Level

    This session will focus on injuries of the forearm, wrist, and hand experienced by various athletes through their participation in various sports. These will include injuries to bones, ligaments, tendons, muscles, nerves, and the vascular supply. Mechanisms of injuries, examination procedures, and interventions will be presented. Criteria for "return to play" also will be covered based on the phases of healing and the demands of the sport.

    Upon completion of this course, you'll be able to:

    • Describe different injuries of the forearm, wrist, and hand related to athletics.
    • Analyze the mechanisms of injury for various athletic injuries.
    • Realize the effects of various tissues involved in the injury.
    • Perform a comprehensive examination of the injured individual.
    • Apply an appropriate intervention.

    To Stim or Not to Stim: The Role of Electrical Stimulation in the Treatment of Muscle Denervation

    Time: 3:00 pm–5:00 pm (See Program for Room)

    Level: Multiple Level

    This is a joint program. See full description at Clinical Electrophysiology and Wound Management programming.

    Thursday, January 24

    Red Flags of Lymphedema

    Time: 8:00 am–10:00 am (See Program for Room)

    Level: Intermediate

    This is a joint program. See full description at Oncology programming.

    A Review of Fractures: Adult Distal Humerus to Distal Phalanx

    Time: 11:00 am–1:00 pm (See Program for Room)

    Speakers: Emily Altman, PT, DPT, CHT; Wen-Yau Jennie Yen, PT, DPT, CHT

    Level: Multiple Level

    Effective postoperative rehabilitation of fractures requires a solid knowledge of the mechanism of fracture (the path of deforming force) and its impact on the bone itself and surrounding soft tissue structures. This course will be a fast-paced, proximal-to-distal review of fractures between the distal humerus and the distal phalanx. The speakers will describe the mechanism(s) of injury and classic behaviors/biomechanical features of each fracture. Some surgical repair options and their rationales will be discussed. The speakers believe that knowledge of the physiology of bone, soft tissue damage, and repair, and an understanding of the mechanism of injury and immediate postfracture management are the essential ingredients for knowing how to progress patients through their rehabilitation. Because of this, protocols and guidelines will not be a focus of this presentation. The presentation will include a wealth of X-ray images to illustrate the didactic information.

    Upon completion of this course, you'll be able to:

    • Describe the fundamental principles of fracture healing.
    • Describe the path of deforming forces seen in an Essex-Lopresti fracture.
    • Explain to a patient why elbow extension against resistance is not permitted following repair of an olecranon fracture.
    • Verbalize why a proximal phalanx fracture assumes an apex volar posture.
    • Explain the pathomechanics of a Bennett's fracture.
    • Recognize how to find information regarding orthopedic fractures in relevant, up-to-date literature.

    Upper-Quadrant Entrapment Lesions: PNS and CNS Dysfunction

    Time: 3:00 pm–5:00 pm (See Program for Room)

    Speakers: Susan W. Stralka, PT, DPT, MS

    Level: Intermediate

    Entrapment lesions require early recognition as well as intervention. This course will identify ways to rule out potential sources of both neurogenic and musculoskeletal disorders associated with entrapment. Emphasis will be placed on assessment procedures to identify acute, chronic, and central sensitization lesions. The speaker will discuss concepts using graded motor imagery and other treatment strategies.

    Upon completion of this course, you'll be able to:

    • Describe the common upper-quadrant entrapment sites, from proximal to distal,
    • Identify the neurogenic as well as musculoskeletal causes of entrapment lesions.
    • Differentiate Thoracic Outlet Syndrome from C7,8/T1 radicular pain.
    • Describe and recognize central sensitization.
    • Design an evidence-based treatment plan for clinical use.
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