Instructional Concurrent Session 9

Patients receiving upper extremity rehabilitation may be recovering not only from physical injury but also from the effects of crime-related trauma. The physiological effects of trauma can influence pain perception, muscle tension, attention, and participation in therapy. Without recognition of these influences, elements of engagement may be interpreted primarily through a musculoskeletal lens.

This session examines how integrating trauma-informed practice into upper extremity rehabilitation can strengthen clinical outcomes. Participants will review relevant physiology and its influence on pain and guarding, with direct application to hand therapy practice. Practical communication strategies and environmental adjustments will be discussed to support safety and resource awareness.

In alignment with the 2026 ASHT Annual Meeting theme, the session will also explore how recovery may intersect with community-based advocacy services, counseling, compensation systems, and ongoing legal processes. A clinical scenario involving a patient recovering from an upper extremity injury following interpersonal violence will illustrate how communication adjustments and awareness of external recovery factors may influence engagement and outcomes. Through guided discussion, participants will examine how these multifaceted dynamics can inform collaborative care.
Instruction will include brief focused lecture, a structured clinical scenario, and facilitated audience discussion to promote application and analysis.

Level: Intermediate

Hand therapy is grounded in precision and observation, yet much of our expertise remains invisible outside the clinic. This session explores how visual art; specifically anatomical and functional illustration can bridge clinical practice, education, and advocacy in hand therapy. Drawing from combined experience as a Certified Hand Therapist and visual artist, the presenter demonstrates how small, everyday visual practices can amplify our collective voice, support clinical excellence, and make the value of hand therapy more visible.

Aligned with the 2026 ASHT Annual Meeting theme, “Bridging the Gap: Collaborating and Amplifying Our Voices,” participants will learn practical, accessible ways to integrate visual tools into treatment, mentorship, interdisciplinary collaboration, and advocacy with no formal art training required.

Level: Entry, Intermediate, Advanced

Load progression is a foundational principle of upper extremity rehabilitation, essential for restoring muscular strength, tendon capacity, neuromuscular control, and functional tolerance. This session explores evidence-informed strategies for progressively increasing load across phases of recovery, emphasizing safe implementation, dosing, exercise selection, and clinical reasoning. Progressive overload will be explored, along with how to determine when to progress patients to higher levels of strength-based activities to support their appropriate progression. Various treatment methodologies and modalities will be presented to the upper-extremity therapist. The session will explore various clinical and case scenarios, including how patients have been appropriately progressed and how the best course of progression was determined. They will learn how to apply load progressions to conditions such as rotator cuff injuries, instability, tendinopathy, and post-operative cases of the elbow and hand.

Level: Entry

Functional neurological disorder (FND) is a frequently misunderstood condition that presents in both adult and pediatric hand therapy settings. Referrals may list “tremor,” “weakness,” or “abnormal upper extremity movement,” yet FND demonstrates distinctive clinical features that differentiate it from structural neurological or orthopedic pathology.

This presentation will define FND with the current diagnostic framework and neurobiological model underlying the functional symptoms. Case examples will be used to compare FND presentations with peripheral nerve injury, movement disorders, and other upper limb pathologies commonly encountered in hand therapy.

Attendees will explore the typical medical journey patients experience prior to referral to occupational or physical therapy, including the role of the multidisciplinary team in diagnosis and management. Practical evaluation strategies will be reviewed that support recognition of FND in the upper limb. The session will emphasize how assessment findings can directly inform treatment planning, with a focus on restoring functional movement. Treatment principles grounded in motor retraining, graded exposure, attention redirection, and neuroscience education will be reviewed. Practical demonstrations will illustrate strategies to reduce symptom reinforcement and promote normalized movement patterns.

FND is a condition that clinicians may not immediately recognize–but one they are likely already encountering. Increased awareness and clinical confidence are essential for upper extremity providers to identify FND and implement appropriate, function-focused interventions. By shifting the lens from structural impairment to functional retraining, therapists can help patients move from disabling symptoms toward restored independence.

Level: Intermediate

This session will explore physician non operative and surgical management, and therapist management of digital dislocation / fracture dislocations as well as strategies to restore range of motion and functional use

Level: Intermediate