Instructional Concurrent Session IV
Diaphyseal Humeral Fracture Non-Operative Treatment: Biomechanical Basis of the Co-Aptation Orthosis
This session will present information regarding the biomechanical construct of a humeral diaphyseal co-aptation fracture orthosis and its appropriate use for the non-operative treatment of a diaphyseal humeral fracture in the upper arm. Non-operative fracture bracing after humeral diaphyseal fracture was introduced years ago as an effective treatment of this injury, but the technical aspect of the orthosis such as the design, fabrication and application are vaguely defined in the literature. This session will present information on the design and fabrication of an orthosis that uses specific corrective forces to re-align the humerus and the appropriate use of the device post injury. Additionally, the lecturer will provide technical information on specific corrective forces applied with this orthosis. The author(s) use a pressure sensing electrode to measure corrective forces applied to the upper limb by the orthosis and XRAY to confirm proper boney alignment has been achieved.
- Identify the correct patient population for this type of orthotic intervention
- Understanding of the practical, clinical design of the diaphyseal humeral fracture orthosis
- Understanding of the use of the orthosis in post injury recovery
How to Use Acceptance and Commitment Therapy (ACT) to Inform Hand Therapists Treatment of Patients with Chronic Pain and Disability
Helping patients return to activity or work can be challenging when pain is present. How many patients are truly 100% pain-free at discharge and expected to return to a “normal” life? Despite biomedical advances, persistent pain may be a reality for some patients. Physical pain and emotional suffering are normal parts of life. In recent years, there has been a growing interest in using Acceptance and Commitment Therapy (ACT) to inform physical and occupational therapy practice. ACT is a form of Cognitive Behavioral Therapy that includes core therapeutic processes and focuses on behavior change rather than symptom reduction. The goal of ACT is to increase “psychological flexibility” – the ability to contact the present moment more fully as a conscious human being, and to change or persist in behavior when doing so serves valued ends. ACT informed practice is both transdiagnostic as well as transdisciplinary, and helps the therapist treat pain from a biopsychosocial perspective. The focus shifts from fixing, controlling or fighting pain, to helping the patient willingly live with pain, and paves the path for a more vital, values consistent life. In this introductory session to ACT you will learn about the ACT model and how to use mindfulness-based interventions along with behavior change strategies to address unpleasant thoughts, feelings, and physical sensations related to pain. All levels!
- Describe the six processes of the ACT model.
- Illustrate the role of psychological flexibility/inflexibility in ACT
- Integrate one new technique for helping clients articulate their values and identify workable actions so they can return to physical function.
- Develop two mindfulness exercises to be used in an ACT intervention.
Introducing Occupation Kits: A Low Cost, Evidence-Based Intervention to Promote Functional Hand Rehabilitation
This short course will educate the attendees on the importance of using an occupation-based therapy approach in practice to improve outcomes, increase motivation, and increase functional performance of our patients. In addition, this short course will provide information on a tool, occupation kits, which are easily constructed and can be used in traditional hand therapy clinics to easily address meaningful activities in therapy. The goal of using an occupation-based therapy approach in a hand therapy clinic is to ensure that the rehabilitation process maintains biomechanical principles, while also enabling clients to perform meaningful activities. Occupation-based interventions have been shown to increase range of motion, strength and functional outcomes. However, despite evidence supporting occupation-based hand therapy, many hand therapists still do not use this therapy approach. Most often, hand therapists cite insufficient time, lack of resources, reliance on protocols and treatment prescriptions, and productivity and reimbursement demands as reasons for not practicing occupation-based hand therapy. Hand therapists affirm the value of using occupation-based interventions and would like to incorporate them more systematically into their practice, but do not have the tools to do so. Occupation kits can be used to address the absence of occupation-based interventions in a hand therapy clinic. These kits are collections of inexpensive and easy to obtain supplies commonly used while engaging in a meaningful activity. These kits can provide a tool to address the barriers hand therapists report when attempting to use occupation-based assessments and interventions because of their low cost, ease of transport and focus on performance of occupations.
- Define occupation-based hand therapy and examine scholarship supporting its use.
- Describe methods to create intervention tool to be used in hand therapy clinic to promote functional performance of patients.
- Integrate occupation-based intervention into current clinical practice trends and patterns.
Keeping up on a PROMIS: An Introduction to the Patient Reported Outcome Measurement Information System (PROMIS)
The Patient-Reported Outcomes Measurement Information System (PROMIS) is a collection of freely available self-reported assessment tools and item banks for measuring patient outcomes. The available assessments include general health questionnaires as well as a hand function. The unique characteristics of these tools is the potential to adapt for individual settings, but allowing comparisons between settings and populations. This instructional session will provide a brief overview of the PROMIS tools and their development. We will then discuss how they can be used in the hand therapy setting to support documentation and research. Novice to advanced therapists will benefit from the review of clinical measurement principles and evidence for comparing PROMIS with other existing outcome measures.
- To understand basic clinical measurement principles
- Describe the PROMIS system for outcome measurement, differentiating between questionnaires, forms and item banks
- Access the PROMIS repository of validated, multi-lingual outcome measurement tools
- Develop and use outcome measures tailored to the needs of their individual practice settings