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Evaluation of the Thumb

presented by Virginia O'Brien

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Satisfactory completion requirements: All disciplines must complete learning assessments to be awarded credit, no minimum score required unless otherwise specified within the course.

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Why is it so important to evaluate all aspects of the thumb? The thumb is the most articulate member of the hand, and the majority of fine motor activity requires the use of the thumb. It is the only member of the hand that has a “universal joint” in its column. This course will walk you through the essential portions of an evaluation of the thumb and its full movement and use potential, to uncover the puzzle of thumb pain, which creates functional deficit. This course will also cover the differential diagnoses and provocative tests; examination and assessment are important to understand within the large category of “thumb pain.” The unique thumb deserves significant attention to assess possible reasons for its pain.

CHTs, when submitting this for recertification through HTCC, this course can be used for CAT B (hand therapy courses < 3 hours in length); however, if this course certificate is submitted with the following course certificates listed below (or any combination totaling 3 hours or more), they can be submitted under CAT A (hand therapy courses > 3 hours in length).

  • Evaluation of the Thumb (1 hour)
  • Why is Thumb Pain Such a Pain? An Introduction to Dynamic Stability of the Thumb (2 hours)
  • Saving Your Thumbs: Elastic Taping, Customizing Orthosis, Joint Protection Techniques, and Adaptive Equipment (1 hour)
  • • What About a Thumb Orthosis? (2 hours)
  • Meet Your Instructor

    Virginia O'Brien, OTD, OTR/L, CHT

    A graduate of the University of Wisconsin-Madison and Rocky Mountain University of Health Professions (Provo, Utah), Virginia first became interested in hand architecture during her fieldwork days. She is actively involved in clinical and biomechanical research of the thumb and the wrist, is a member of the AOTA Evidence Exchange committee and a member of…

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    Chapters & Learning Objectives

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    1. Evaluation: Functional Impairment due to Thumb Pain?

    Chapter One reviews thumb pain and how it affects every area of function and every occupation of life. The evaluation of the thumb starts with a functional assessment.

    2. Observations and Evaluation of the Thumb

    Chapter Two will review the essential aspects of evaluating baseline range of motion (ROM) in all planes, including strength and sensory tests related to the thumb. Evidence based measures for thumb abduction ROM will be presented.

    3. Thumb Pain

    Chapter Three will review various other diagnoses, including acute and cumulative trauma or repetitive stress injuries, which can contribute to thumb pain. Thumb care is life-long so it is important to empower patients to continue to adaptively engage in life with skills to care for their thumbs.

    4. Differential Diagnostic and Provocative Tests for the Thumb

    Chapter Four will review differential diagnostic and provocative tests which add to the evaluative findings to help confirm or differentiate the pain in the thumb. This helps “paint the picture” for intervention.

    More Courses in this Series

    Why is Thumb Pain Such a Pain? An Introduction to Dynamic Stability of the Thumb

    Presented by Virginia O'Brien, OTD, OTR/L, CHT

    Why is Thumb Pain Such a Pain? An Introduction to Dynamic Stability of the Thumb

    Subscribe now, and access clinical education and patient education—anytime, anywhere—with video instruction from recognized industry experts.
    Why is the thumb such a pain? Thumb pain is a common complaint that requires careful assessment and innovative therapy. Thumb pain, due to any injury or pathology, impacts participation in every area of occupational and functional performance: ADLs, rest & sleep, work, leisure and social participation. This course presents an evidence-based dynamic stability conservative management program which will improve the anatomical and biomechanical understanding of the thumb, enhance the therapeutic use of self to advise and consult in the biomechanical knowledge of pain-free use of the thumb as well as identify and facilitate proper motor patterns. This innovative approach presents essential components necessary to facilitate life-long dynamic thumb stability and joint health.

    CHTs, when submitting this for recertification through HTCC, this course can be used for CAT B (hand therapy courses < 3 hours in length); however, if this course certificate is submitted with the following course certificates listed below (or any combination totaling 3 hours or more), they can be submitted under CAT A (hand therapy courses > 3 hours in length).

  • Evaluation of the Thumb (1 hour)
  • Why is Thumb Pain Such a Pain? An Introduction to Dynamic Stability of the Thumb (2 hours)
  • Saving Your Thumbs: Elastic Taping, Customizing Orthosis, Joint Protection Techniques, and Adaptive Equipment (1 hour)
  • • What About a Thumb Orthosis? (2 hours)
  • View full course details

    Evidence Based Intervention to Restore Dynamic Thumb Stability

    Presented by Virginia O'Brien, OTD, OTR/L, CHT

    Evidence Based Intervention to Restore Dynamic Thumb Stability

    Subscribe now, and access clinical education and patient education—anytime, anywhere—with video instruction from recognized industry experts.
    Why is management of thumb pain such an enigma? Traditional conservative management is general hand strengthening and a splint or, in proper terminology, an orthosis. Is there more that can be done and is it evidence based? The answer is yes. Innovative and evidence based intervention techniques for conservative management of the thumb that have been shown to reduce pain and improve function are presented. Muscle re-education and specific muscle strengthening, along with joint mobilization and use of appropriate modalities, are discussed. This course will also include basic principles of joint protection and present several options for thumb saving devices and postures that are excellent to have in your clinic. A stable and pain-free thumb is the goal, which has been shown to be reliably achievable.

    View full course details

    What About a Thumb Orthosis?

    Presented by Virginia O'Brien, OTD, OTR/L, CHT

    What About a Thumb Orthosis?

    Subscribe now, and access clinical education and patient education—anytime, anywhere—with video instruction from recognized industry experts.
    Thumbs may require support from an orthosis as the thumb is in “rehabilitation” to regain its stability. The choices for thumb support range from custom to prefabricated, from thumb-based to forearm-based. Thumbs may require stabilization support to reduce pain initially. How do you choose whether or not to use an orthosis, which type of orthosis to use, and what amount of support is necessary? This chapter will discuss how to select the appropriate orthosis, taking into account activity and/or rest requirements, immobilization and stabilization, and deformity reduction. Five different custom orthoses will be presented in video format. This course will present the anatomical reasoning behind making the appropriate choice for your patient, and for the individual thumb. In case you do decide to prescribe an orthosis for your patient, we'll also discuss wearing schedules, dosages of wear, and a weaning program.

    CHTs, when submitting this for recertification through HTCC, this course can be used for CAT B (hand therapy courses < 3 hours in length); however, if this course certificate is submitted with the following course certificates listed below (or any combination totaling 3 hours or more), they can be submitted under CAT A (hand therapy courses > 3 hours in length).

  • Evaluation of the Thumb (1 hour)
  • Why is Thumb Pain Such a Pain? An Introduction to Dynamic Stability of the Thumb (2 hours)
  • Saving Your Thumbs: Elastic Taping, Customizing Orthosis, Joint Protection Techniques, and Adaptive Equipment (1 hour)
  • • What About a Thumb Orthosis? (2 hours)
  • View full course details

    Saving Your Thumbs: Elastic Taping, Customizing Orthoses, Joint Protection Techniques, and Adaptive Equipment

    Presented by Virginia O'Brien, OTD, OTR/L, CHT

    Saving Your Thumbs: Elastic Taping, Customizing Orthoses, Joint Protection Techniques, and Adaptive Equipment

    Subscribe now, and access clinical education and patient education—anytime, anywhere—with video instruction from recognized industry experts.
    If the thumb has less pain with dynamic stability, why still protect the thumb joint? This course will review basic principles of light joint support with taping or customizing orthoses. Additionally, we'll present joint protection as a way to continue to save patients' thumbs for a lifetime, including options like elastic taping and appropriate adaptive techniques and equipment. It is important to have the patient learn how to protect their own thumb, to have these options for their thumb, and to have the adaptive equipment in your clinic for the patient to learn experientially. Also included is a review of proper pen holding postures.

    CHTs, when submitting this for recertification through HTCC, this course can be used for CAT B (hand therapy courses < 3 hours in length); however, if this course certificate is submitted with the following course certificates listed below (or any combination totaling 3 hours or more), they can be submitted under CAT A (hand therapy courses > 3 hours in length).

  • Evaluation of the Thumb (1 hour)
  • Why is Thumb Pain Such a Pain? An Introduction to Dynamic Stability of the Thumb (2 hours)
  • Saving Your Thumbs: Elastic Taping, Customizing Orthosis, Joint Protection Techniques, and Adaptive Equipment (1 hour)
  • • What About a Thumb Orthosis? (2 hours)
  • View full course details

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