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Evidence Based Intervention to Restore Dynamic Thumb Stability

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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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.

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. Mounting Evidence

Traditional conservative management of thumb pain has been to provide basic hand exercises, strengthening and possibly an orthosis, with a variety of success. Recent evidence points toward the dynamic stability approach for reduction in pain and disability.

2. Principles of Intervention & Manual Release

In this chapter, we will discuss intervention instruction to restore dynamic thumb stability, including muscle release, stretching, joint mobility re-education, and strengthening in a prescribed pattern.

3. Joint Mobilization

Thumb joint mobility can be at the root of lack of motion or developed contracture. This chapter will demonstrate five different ways to perform pain free thumb joint mobility, and how to instruct the patient in self application.

4. Muscle Re-Education Before Strengthening

This chapter will outline how to re-educate the thumb muscles to provide stability and to restore a stable balance without pinching putty. Included is a demonstration with a patient to show intervention techniques.

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