UE Diagnostic Manual - Mobility Deficits of Wrist/Hand Flashcards
what conditions are mobility deficits at wrist and hand
wrist OA
thumb OA
distal radius fx
outcome measures for mob deficit at w/h
PSFS
DASH
Quick-DASH
Patient-Related Wrist Eval for Wrist OA
what can be used for distal radius fx outcomes? any recommendations?
DASH
Michigan Hand questionnaires
– at initial eval and 2 more occurrences
diagnostic info related to OA at wrist and thumb
thumb = most common
mostly females, 40-70
pain, aching, stiffness
tissue enlargements / swollen IP jts
what to consider when thinking OA
is pain worse in the morning?
does it get better with rest?
does it get worse as the day goes on or after strenuous work?
are symptoms unilateral?
objective information related to mob deficit at w/h
decreased A/PROM
crepitus present with either or both
capsular end feel
pain at end-ROM w/ sustained positioning
assess wrist/forearm ROM**
muscle performance related to wrist/hand mob deficit
MMT normal
strong/painless
decreased pinch strength with thumb OA
how to assess muscle performance in the wrist/hand with and without distal radius fx
w/o = grip strength, resisted, MMT
w = pinch strength
palpation finding related to wrist/hand mob deficit
OA = bony enlargement, cool effusion
joint mobility related to wrist/hand mob deficit
decreased in all direction
neurological findings related to wrist/hand mob deficit
normal
–> with distal radius fx, may use proprioceptive testing
special tests for thumb OA
CMC grind test
joint load test
for those with distal radius fx, what could also be helpful to screen for? how would you do it?
fall risk
TUG of >12
ABC scale >67%
5xSTS <12
general therapy POC intervention for distal radius fx
supervised therapy
– required for pts ≥ 60 or those with ≥ 1 complications (1x a week with HEP)
what treatment methods should therapists perform for distal radius fx
manual therapy - mob and stx
therapeutic exercise
graded motor imagery in early rehab
physical agents
what physical agents are indicated for those with distal radius fx
LASER
electromagnetic field
heat/cold therapy
what global physical therapy interventions are recommended for wrist mob deficit
increase ROM
increase joint mobility
increase muscle length
utilize / maintain improved ROM
adaptive devices
medical interventions for those with mob deficit at w/h
splinting
NSAIDs
Corticosteroid Injections
