What is Hands and Upper Limbs Rehab Therapy?

Hands and upper limbs rehab therapy is a specialized physical therapy.  It focuses on rehabilitation of the hands, wrists, and upper limbs.  Thus, the therapy aims to improve the function of the hands and upper limbs to help patients regain their ability to perform everyday activities.

However, hand therapy and upper limb rehab are not the same, although they are related.

Hand therapy focuses on the rehabilitation of the hand and wrist.  It involves evaluation, treatment, and prevention.  As such, it improves the functions of the hand, wrist, and forearm.  Often hand therapy is used to treat these conditions: carpal tunnel syndrome, tendonitis, fractures, and nerve injuries.

Whereas upper limb rehab is a broader term that refers to rehabilitation of the entire upper limb, including the shoulder, elbow, forearm, wrist, and hand.  Upper limb rehab may include exercises to improve range of motion, strength, and endurance.  And it involves other interventions such as manual therapy, electrical stimulation, and ultrasound.

While hand therapy is a subset of upper limb rehab, they are not interchangeable terms.  Hand therapy is focused on the hand and wrist, while upper limb rehab encompasses the entire upper limb.

How is the therapy carried out?

The therapy involves an initial assessment and evaluation to determine the patient’s current level of function and identify any issues or impairments.  And the therapist tailors an individualised treatment plan that includes exercises, manual therapy, and other interventions based on the evaluation.

Conditions that can be treated with Hands and Upper Limbs Rehab

Hands and upper limbs rehab therapy can be beneficial for a wide range of conditions, including:

1. Carpal tunnel syndrome – a condition that causes pain, numbness, and tingling in the hand and fingers.

2. Tennis elbow – a condition that causes pain and tenderness in the elbow and forearm.

3. Frozen shoulder – a condition that causes pain and stiffness in the shoulder joint.

4. Arthritis – a condition that causes joint pain and stiffness, which can affect the hands and upper limbs.

5. Rotator cuff injuries – a common injury that affects the shoulder joint and can cause pain and weakness.

6. Tendonitis – a condition that causes inflammation in the tendons affecting the hands and upper limbs.

7. Stroke – often a common symptom of post-stroke events resulting in loss of control of hands and upper limbs

Treatment approaches used in Hands and Upper Limbs Rehab

Hands and upper limbs rehab therapy uses a variety of treatment approaches, including:

1. Exercise therapy – involves exercises designed to improve strength, flexibility, and range of motion.

2. Manual therapy – involves hands-on techniques such as massage, joint mobilization, and stretching to improve the function of the hands and upper limbs.

3. Modalities – involve the use of various physical agents such as heat, cold, and electrical stimulation to reduce pain and promote healing.

4. Education – involves teaching patients how to perform activities safely and how to prevent future injuries.

5. Functional training – involves practicing activities that are essential for daily living, such as gripping, reaching, and lifting, to improve function.

Benefits of hands and upper limbs rehab therapy

The benefits of hands and upper limbs rehab therapy are numerous, including:

1. Improved range of motion and flexibility

2. Increased strength and endurance

3. Reduced pain and inflammation

4. Improved ability to perform daily activities

5. Prevention of future injuries

6. Enhanced quality of life

How OTs and PTs are key rehab specialists in this area

Both occupational therapists (OTs) and physical therapists (PTs) play an important role in both hands and upper limbs rehab therapy, but their roles and approaches differ in some ways.

Occupational therapists focus on helping patients improve their ability to perform activities of daily living (ADLs) and other functional tasks.  They work with patients to identify activities that are important to them and develop strategies to help them perform those activities easier.  For example, occupational therapists focus on writing, dressing, and cooking.  They use interventions such as adaptive equipment, splinting, and activity modification to help patients improve their ability to perform those activities.

Whereas physical therapists focus on improving the function of the musculoskeletal system.  They use exercises, manual therapy, and other interventions to improve strength, range of motion, and endurance.  And their focus on hands and upper limbs therapies ranges from improving grip strength to a range of motion in the shoulder joint.

In some cases, occupational and physical therapists work as part of a multidisciplinary team to provide comprehensive hands and upper limbs rehab therapy.  Together, they address the functional and physical aspects of rehabilitation.  In this way, they help patients achieve their goals and improve their quality of life.

Certified Hand Therapists (CHTs)

It’s also worth noting that some occupational therapists have specialized training in hand therapy, which allows them to provide more specialized care for conditions that affect the hands and upper limbs.  These occupational therapists, aka certified hand therapists (CHTs), have completed additional education and training in hand therapy.  And they have passed a certification exam.  CHTs provide a range of interventions, from splinting to manual and exercise therapies, to help patients with hand and upper limb conditions.

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References

1. “Hand therapy intervention for hand and wrist injuries in adults” (2017) by Keijsers et al. published in the Cochrane Database of Systematic Reviews. Link: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD005158.pub3/full

2. “The effectiveness of hand therapy interventions in reducing impairments and improving function post hand trauma: a systematic review” (2017) by Randall et al. published in the Journal of Hand Therapy. Link: https://www.jhandtherapy.org/article/S0894-1130(16)30136-6/fulltext

3. “Effectiveness of physical therapy interventions for upper-limb nerve compression syndromes: a systematic review” (2018) by O’Connor et al. published in Archives of Physical Medicine and Rehabilitation. Link: https://www.archives-pmr.org/article/S0003-9993(17)31501-5/fulltext

4. “Upper limb rehabilitation after stroke: a systematic review of randomized controlled trials” (2012) by Langhorne et al. published in Clinical Rehabilitation. Link: https://journals.sagepub.com/doi/10.1177/0269215512447102