Instructional Concurrent Session 8

This session will spotlight several of the Clinical Practice Posters presented at this year's Annual Meeting. Rapid-fire presentations of interesting cases and novel treatment or educational approaches will be followed by time for discussion and audience questions. Come to learn, innovate, and collaborate.

1. Treatment for Infants with Brachial Plexus Injury (BPI): A Guide for Rehabilitation Therapists
Authors: Krystal L. Vermillion, MOT, OTR/L | Pamela E. Toto, PhD, OTR/L, BCG, FAOTA, FGSA

2. The King System: Exploring New Populations; The Role of a Hand Therapist in Breast Cancer Rehabilitation
Authors: Sarah Fench, MOT, OTR/L, CHT | Ellen King, OTR, CHT | Kelly Santel, MOTR/L, CHT | Terence Myckatyn, MD

3. A Hands-On Approach to Teaching Future Hand Therapists
Authors: Jennifer Radziak, OTD, OTR/L, CHT | Kelsey Picha, PhD, ATC | Katie Jones, MA, OTR/L, CLT-LANA

4. Nutrition and Other Lifestyle Resources to Support Thoracic Outlet Syndrome Self-Management
Authors: Melanie Hubbuck, MS, OTD, OTR/L

Level: Entry 

What happens when primary recovery following a neurological injury is thought to be completed? This course will cover common upper extremity deficits seen in individuals with past non-progressive neurological events such as spinal cord injuries and CVAs and what surgical options exist to increase functional independence. This population of individuals largely suffer from loss of functional reach, gross grasp and pinch which significantly impacts their engagement in occupation. The course will provide an overview of care provided to this population in an outpatient setting with both a focus on surgical procedures and the rehab focus post operatively from the lens of a certified hand therapist.

Level: Entry 

The incidence of brachial plexus injuries is rising at a rapid rate and has been documented to be up 50% at academic medical centers in the past five years. Surgical innovations, such as free-functional muscle transfers (FFMT), have gained momentum that optimize outcomes in a population of patients who have historically had minimal reconstructive options. Formal therapy following FFMT is crucial: to monitor for flap vascularity, instruct in motor retraining, protect elbow flexor length, and much more. These patients often travel lengthy distances to obtain surgical care at large academic institutions and later return home to remote towns for ongoing rehabilitation. Currently, there are no articles in the existing literature that provide guidance on the rehabilitation for FFMT. Therapists in smaller clinics deserve to have the knowledge and resources available to them to effectively treat patients who undergo complex free-functional muscle transfers. This presentation will provide a background about the FFMT surgery and outline the rehabilitation involved. It will also include five case presentations of one pediatric and four adult plexus injuries, including the extent of their nerve injuries, each post-operative course, and outcome videos.

Level: Advanced

In the hand therapy setting, it can be easy to focus on our patients’ injuries and to forget about the whole person, specifically the role psychology can play in rehabilitation and functional limitations. Physicians often refer patients with various hand conditions to therapy solely based on the severity of their injury/surgical needs without assessing any psychological concerns. However, patients dealing with an array of psychological factors, such as pain related coping mechanisms, pain catastrophizing, depression, anxiety, post-traumatic stress disorder, etc. may end up requiring additional therapy sessions and support. It’s crucial for therapists to be able to recognize and address these psychological factors influencing the therapeutic process. Our role is not to be psychologists, but to initiate difficult conversations to identify maladaptive behaviors and emotional distress and to ask about patients’ support systems. This entry level session hopes to empower participants to feel more comfortable discussing mental health with their patients and to feel more confident in providing support. From creating a safe space and emphasizing positivity to recognizing when to refer out to a mental health provider, participants will learn ways to effectively address these psychological concerns.

Level: Entry