Lesson 1Structured clinical interview and chart review: key surgical details, restrictions, and red flagsThis section outlines a structured clinical interview and chart review, focusing on surgical details, precautions, comorbidities, medications, and red flags, to ensure safe, goal-directed hand therapy from the first encounter onward.
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 section explains sensorial evaluation of the hand, including static and moving two-point discrimination, Semmes-Weinstein monofilaments, and basic neurodynamic tests, with emphasis on standardized technique and safety precautions.
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 defines essential baseline metrics for the first visit, including pain, edema, ROM, strength, function, and participation, and explains how to capture them using structured documentation templates that support 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 tasksThis section reviews standardized pain assessment in hand therapy, including VAS and NRS scales, pain behavior observation, and task-specific provocation, emphasizing consistent timing, patient education, and integration into treatment planning.
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 section details range of motion assessment for the wrist and MCP, PIP, and DIP joints using goniometry and composite flexion tests, with positioning, stabilization, end-feel, and documentation tips to ensure reliable, comparable 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 section covers standardized tools for fine motor and functional hand assessment, including Purdue Pegboard, Nine-Hole Peg Test, Jebsen-Taylor subtests, and timed graphic design tasks, with scoring, norms, and clinical interpretation.
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 section addresses scar assessment after hand injury or surgery, including visual scar scales, pliability and adhesion testing, sensitivity, and digital photography, with guidance on consistent scoring and progress tracking.
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 section covers strength and endurance testing for the hand, including grip and pinch dynamometry, manual muscle testing, and repetition-based endurance tasks, with protocols, safety, and documentation for treatment planning.
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 section explains key edema measurement options, including circumferential tape measures, water volumetry, pitting scales, and figure-of-eight methods, with guidance on reliability, positioning, and consistent documentation 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
