Chapter 1: Conservative and Surgical Management of the Osteoarthritic Hand and Wrist, 3rd Edition 2 Contact Hours
By: Erin K. Peterson, DHSc, OTR, CH Learning objectives After completing this course, the learner will be able to: Recognize the etiology and pathophysiology of osteoarthritis (OA) of the hand and wrist. Explain the process and criteria for reaching a clinical diagnosis of OA. Identify the goals and treatment options for managing OA. Course overview This intermediate-level course provides rehabilitation practitioners with a detailed overview of the pathophysiology and mechanics of the joints of the hand of those diagnosed with osteoarthritis (OA). Both occupational therapists (OTs) and physical therapists (PT) are trained initially as generalists in understanding the signs and symptoms of OA, the functional implications of the condition, and basic methods of intervention. An intimate knowledge of this condition and its treatment, typically reserved for those who specialize in hand therapy, will become paramount for generalists, too. With an aging American population, and based on the percentage of older adults affected, will come an increase in the number of individuals Implicit bias in healthcare Implicit bias significantly affects how healthcare professionals perceive and make treatment decisions, ultimately resulting in disparities in health outcomes. These biases, often unconscious and unintentional, can shape behavior and produce differences in medical care along various lines, including race, ethnicity, gender identity, sexual orientation, age, and socioeconomic status. Healthcare disparities stemming from implicit bias can manifest in several ways. For example, a healthcare provider might unconsciously give less attention to a patient or make assumptions about their medical needs based on race, gender, or age. The unconscious assumptions can lead to delayed or inadequate care, misdiagnoses, or inappropriate treatments, all of which can adversely impact health outcomes. Addressing
Determine an occupational therapy intervention plan for management and treatment of OA of the proximal and distal finger joints. Differentiate an occupational therapy intervention plan for the management and treatment of OA of the carpometacarpal thumb joint. Construct an occupational therapy intervention plan for the management and treatment of OA of the wrist. experiencing the signs, symptoms, and occupational disruptions associated with OA. The focused content on hand and wrist OA offered in this course provides the practitioner with the tools needed to assist clients in decreasing pain and deformity, while enhancing function. The course offers practitioners in-depth knowledge of several of the most common medical and evidence-based treatments, and it provides instruction for the application of techniques in evaluation and intervention. These include specific interventions, physical agent modalities, orthoses (splints), adaptive equipment, and joint protection to allow clients to engage in meaningful daily occupations. implicit bias in healthcare is crucial for achieving equity in medical treatment. Strategies to combat these biases involve education and awareness programs for healthcare professionals. These programs help individuals recognize and acknowledge their biases, fostering a more empathetic and unbiased approach to patient care. Additionally, implementing policies and procedures prioritizing equitable treatment for all patients can play a pivotal role in reducing healthcare disparities. Ultimately, confronting implicit bias in healthcare is essential to creating a more just and equitable healthcare system where everyone receives fair and equal treatment regardless of their background or characteristics.
INTRODUCTION
Osteoarthritis (OA), also known as degenerative joint disease (DJD), is the most common form of arthritis found in the hand and upper extremity (Arthritis Foundation, n.d.; Lubahn et al., 2011). As many as 54.4 million Americans—or approximately 28% of the adult population—are affected, most of whom are over the age of 45 (Guglielmo et al., 2019). Characterized by loss of the articular cartilage of a joint, OA can lead to stiffness, bony sclerosis, capsular thickening, pain, and disability. Impaired movement of the joints, as well as disuse and weakness resulting from pain, can lead to significant limitations in occupations such as self-care, work, leisure, and social participation (Taylor et al., 2011). Physical and occupational therapy (PT/OT) practitioners are instrumental members of any healthcare team seeking to facilitate quality of life for individuals experiencing the signs and symptoms of OA. Offering a holistic approach to client care, OT is concerned with the ability of the client to engage in all desired life occupations, including self-care, care of others, work, play, leisure, social participation, rest, and sleep (American Occupational Therapy Association [AOTA], 2020), similarly,
PT is focused on improving quality of life through prescribed exercise, hands-on care, and patient education. (American Physical Therapy Association [APTA], n.d.). To help clients with OA achieve their highest level of function within these areas of occupation, practitioners use a range of treatment approaches that affect a variety of underlying factors and skills. Both physical/occupational therapists (PT/OTs) and physical/ occupational therapy assistants (PTA/OTAs) are trained initially as generalists in understanding the signs and symptoms of OA, the functional implications of the condition, and basic methods of intervention. An intimate knowledge of this condition and its treatment, typically reserved for those who specialize in hand therapy, will become paramount for generalists, too. With an aging American population, and based on the percentage of older adults affected, there will be an increase in the number of individuals experiencing the signs, symptoms, and occupational disruptions associated with OA. The focused content on hand and wrist OA offered in this course provides the practitioner with the tools needed to assist clients in decreasing pain and deformity, while enhancing function.
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Book Code: PTOH1324
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