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Evaluation of the Thumb

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

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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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This course is part of our CHT Prep Program. Learn more about the full prep program here: MedBridge CHT Prep Program.

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)
  • o 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.

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