Date of Award
Master of Occupational Therapy (MOT)
Hand Injuries -- rehabilitation; Tendon Injuries -- rehabilitation
In the field of hand therapy there are a variety of protocols for treatment of patients with tendon injury. Review other literature indicates that most of these protocols have a good anatomical and physiological basis, which then requires the application of clinical experience to decide which protocols to use when treating patients with hand injury. Experienced hand therapists tend to make observations and adapt protocols accordingly to provide patients with good therapy treatment and therefore achieve excellent treatment outcomes. However, therapists that do not see hand patients on a regular basis and do not have a consult base will tend to follow basic protocols to guide their treatment provision. In doing so, therapy is often not modified as observations are made. The purpose of this scholarly project was to develop tendon rehabilitation protocols in an easy-to-use algorithm format that would provide therapists with the clinical reasoning skills that would allow them to provide not only adequate therapy but excellent therapy and therefore achieve excellent therapy outcomes.
Following an extensive literature review combined with clinical experience, a manual of tendon rehabilitation protocols in an algorithm format was developed utilizing a biomechanical frame of reference. Protocols were organized in a week-to-week format based on the physiology of the tissue healing process, and adaptations to the basic protocols were included based on the author's clinical observations. Areas of treatment addressed included: wound care / scar control, splinting, exercises, and activities of daily living / work skills. Drawings of splints and exercises were also provided in the protocols for ease in patient application. In addition to the protocols, two appendices were also written containing the fabrication instructions and patterns for all of the splints mentioned and home program instructions.
Use of a portion of the manual as a teaching tool for occupational therapy students in an entry-level master's program indicated that it provided information in a very concise and organized manner, which allowed time for increased hands-on learning. Review of portions of the manual by therapists working clinically indicated that it would be a valuable resource in hand therapy practice. These therapists particularly liked the drawings and home programs that were made available, as well as the readability and ease of use. It is hoped that this manual will be used in both clinical and occupational therapy teaching settings, so that patients can be provided with the best possible care and achieve the best possible treatment outcomes.
Armstrong, Joni, "Tendon Injury Rehabilitation: A Manual of Algorithm Protocols for Therapists" (2007). Occupational Therapy Capstones. 165.