UE Diagnostic Manual - Movement Coordination at Wrist/Hand Flashcards
what conditions are considered movement coordination deficits at w/h
sprain of carpal ligaments
TFCC sprain
Sprain of thumb UCL
outcome measures associated with mvmt coord at w/h
PSFS
Quick / DASH
Patient Rated Wrist Eval
diagnostic info related to sprain of carpal ligaments
result of sudden/traumatic or gradually increased stress to tissues
diagnostic information related to TFCC sprain
result of a traumatic injury that causes excessive axial/compressive or distractive forces in ulnar dev direction
— is considered the load-bearing complex between lunate/triquetrum and ulna
diagnostic information related to thumb UCL sprain
precipitated by an angular force applied to the thumb in extended position
what are the levels of severity related to thumb UCL sprain
1 - sprain
2 - complete disruption of ligament
3 - complete disruption of ligament / volar or dorsal structures damaged
—> higher velocity of trauma = more likely trauma will occur
what is the other name for UCL sprain
Gamekeeper’s Thumb
Skier’s Thumb
range of motion finding related to mvmt coord deficit at wrist/hand
active and passive limited due to pain
– catching and/or clicking may be present with TFCC patho
– Thumb UCL has worse extension and abduction
muscle performance finding related to mvmt coord deficit at wrist/hand
may be limited due to pain and/or swelling
grip strength and grasping may be limited
palpation finding related to mvmt coord deficit at wrist/hand
edema is often present
TFCC sprain = point tenderness with palpation of it
palpation pain of UCL in thumb
joint mobility finding related to mvmt coord deficit at wrist/hand
hypermobility with specific or global direction
pain and laxity with valgus stress testing at the thumb
neuro finding related to mvmt coord deficit at wrist/hand
n/a - normal
special test related to mvmt coord deficit at wrist/hand
press test - TFCC
physical therapy interventions for mvmt coord deficit at wrist/hand
improve coordination/activation of muscles
normalize movement
reduce stress on tissue w/ bracing
functional training as progressed
what coordinated co-contraction activities are indicated
isometrics early
dynamic joint stability later
weight bearing activities are indicated in which conditions and when?
TFCC / wrist sprain
– may limit if UCL tear/ wait until it is stable
medical interventions related to mvmt coord deficit at w/h
NSAIDs
TFCC
- arthroscopic debridement
- water procedure (ulnar shortening)
Thumb UCL sprain
- surgery may be indicated if ligament is ruptured and unstable
surgical conditions for distal radius fracture
functional activities / sedentary work allow in with less than 2lbs lifting (if ORIF)
1-2 weeks immobilization
laced splint after 2 weeks
finger flexion tendon repair surgical condition
limit wrist extension
limit finger extension and active finger flexion
wear splint at all times except therapy
no lifting or gripping
