Lesson 1Structured clinical interview and chart review: key surgical details, restrictions, and red flagsThis part outlines a proper clinical chat and record review, zeroing in on surgery details, precautions, other health issues, meds, and warning signs, to kick off safe, goal-focused hand therapy right from the start.
Essential elements of the surgical historyIdentifying surgeon-imposed precautions and limitsScreening for systemic and psychosocial red flagsMedication review relevant to hand rehabilitationOrganizing findings into a clear problem listLesson 2Sensorial evaluation: static and moving two-point discrimination, Semmes-Weinstein monofilaments, neurodynamic testingThis lesson explains hand sensation checks, covering static and moving two-point tests, Semmes-Weinstein filaments, and simple nerve movement tests, with focus on standard methods and safety first.
Static two-point discrimination proceduresMoving two-point discrimination and interpretationSemmes-Weinstein monofilament testing protocolMedian, ulnar, and radial neurodynamic screeningDocumenting sensory maps and clinical changesLesson 3Objective baseline metrics to record at first visit and appropriate documentation templatesThis section lists must-have starting measures for the first visit—like pain, swelling, movement range, strength, function, and daily involvement—and shows how to record them with templates that back clear goals and billing.
Core baseline domains for hand therapy evaluationChoosing validated outcome measures and scalesCreating efficient electronic note templatesLinking baseline data to functional goal writingStrategies for reliable follow-up comparisonsLesson 4Standardized pain assessment: VAS/NRS, pain behavior observation, pain with specific tasksWe review standard pain checks in hand therapy, including VAS and NRS scales, watching pain behaviours, and task-triggered pain, stressing steady timing, patient teaching, and fitting into treatment plans.
Administering VAS and NRS for hand painObserving and documenting pain behaviorsTask-specific pain testing for hand activitiesDifferentiating nociceptive and neuropathic painTracking pain trends across treatment sessionsLesson 5Range of motion measurement: goniometry for wrist and MCP/PIP/DIP joints and composite flexion testsThis lesson details movement range checks for wrist and MCP, PIP, DIP joints using goniometers and group flexion tests, with tips on positioning, steadying, feel at end-range, and recording for reliable data.
Goniometer alignment for wrist flexion and extensionMeasuring MCP, PIP, and DIP joint motionComposite flexion and fingertip-to-palm distanceRecording active versus passive ROM valuesCommon sources of ROM error and how to avoid themLesson 6Fine motor and functional hand assessment tools: Purdue Pegboard, Nine-Hole Peg Test, Jebsen-Taylor subtests, timed functional tasks relevant to graphic designThis covers standard tools for fine motor and hand function checks, like Purdue Pegboard, Nine-Hole Peg Test, Jebsen-Taylor parts, and timed graphic design tasks, including scores, norms, and what they mean clinically.
Standardized administration of Purdue PegboardNine-Hole Peg Test setup, timing, and scoringSelecting Jebsen-Taylor subtests for hand functionDesigning job-specific graphic design task simulationsInterpreting scores and documenting functional changeLesson 7Scar assessment: visual scar scales, pliability testing, adhesion testing, digital photographyThis addresses scar checks after hand injury or surgery, with visual scales, bend tests, stickiness checks, sensation, and photos, plus tips for steady scoring and tracking progress.
Using visual scar rating scales reliablyAssessing scar thickness, color, and texturePliability and adhesion testing techniquesEvaluating scar sensitivity and symptom reportsStandardized clinical scar photography methodsLesson 8Strength and endurance testing: dynamometry (grip, pinch), manual muscle testing protocols, endurance repetition testsThis lesson covers hand strength and stamina tests, including grip/pinch dynamometers, manual muscle tests, and repeat endurance tasks, with steps, safety, and recording for planning treatment.
Calibrating and positioning for grip dynamometryPinch dynamometry for lateral and tripod pinchManual muscle testing grades for hand musclesDesigning functional endurance repetition testsRecording strength data and monitoring fatigueLesson 9Edema measurement techniques: circumferential measurement, volumetry, pitting scale, figure-of-eightThis explains main swelling measure options, like tape around, water volume, pitting scales, and figure-of-eight, with advice on reliability, positioning, and steady recording in hand therapy.
Landmarks for circumferential tape measuresWater volumetry setup, calibration, and hygieneUsing and grading a standardized pitting scaleFigure-of-eight method for wrist and hand edemaRecording edema data and minimizing measurement error
