Hand is one of the important parts of body. Without hand we cannot do our daily work. We use our hands for almost everything we do from morning until night. Because of their constant use, hands and wrists are often injured. Any direct trauma or laceration to the hand can result in serious consequences if one or more tissues are damaged. An injury to the area will therefore affect a person’s ability to do simple and complex tasks. Ensuring appropriate diagnosis, assessment and rehabilitation for injuries to hands and wrists is essential to preventing long-term adverse effects and possible disability.

Hand therapy is a type of rehabilitation provided by an occupational therapist for patients suffering from a condition affecting their hands and upper limbs.

Occupational therapy is the healthcare profession that aims to restore a patient’s functional capacity. Using specific assessment and treatments skills, occupational therapists specializing in hand therapy offer therapeutic approaches to restore function, limit the progression of pathology or prevent upper limb dysfunction in order to help patients resume their everyday tasks at home and at work, and their recreational activities.

Occupational Therapist works for following conditions:

Fractures

Tendinitis

Lacerations (lesions) or tears: skin / nerve / tendon / muscle / ligament

Sprains / trauma

Wounds

Hyposensitivity or hypersensitivity

Complex regional pain syndrome (CRPS)

Amputation (finger)

Arthrosis / arthritis

Burn

Role of occupational therapy

Occupational therapists are major contributors to the multi-professional approach that is required in the delivery of specialist rehabilitation to people with conditions affecting the hands or upper limbs (IFSHT 2010)

In studies undertaken to establish the benefits of occupation-based interventions in hand therapy, Colaianni and Provident (2010) found that occupation-based hand therapy interventions increased client motivation, satisfaction and adherence, and promoted a faster functional recovery due to the relevance of the activities to the individual’s daily life and interests. Such activities also addressed psychological factors such as fear, pain and confidence. Furthermore, Jack and Estes (2010) identified that a holistic, client-centred and occupation-based approach to the treatment of hand injuries resulted in improved patient outcomes through facilitating adaptation and improved performance of functional activities.

Such specialist occupational therapy interventions require advanced post-graduate education and clinical experience but benefits to the client include a return to a productive lifestyle following injury, disease or deformity (BAHT 2013). For example, an occupational therapy-led service for people with conditions such as carpal tunnel syndrome demonstrated effective early diagnosis and management without increasing the demand for surgical procedures or opinion (Rose and Probert 2009).

Hand injuries are the second most frequent incidence of workplace injury; Amini (2011) considered the effectiveness of occupational therapy interventions with people who had a range of work-related injuries or conditions of the forearm, wrist and hand by means of a systematic review. The findings supported the effectiveness of occupation-based activities and interventions through techniques such as early mobilization, splinting, pain control techniques and workplace interventions.

The use of orthotics in the conservative management of people with rheumatoid arthritis is commonplace and effective. Occupational therapists regularly use splinting as part of their intervention with this client group in order to decrease hand and wrist pain and to improve function; the most commonly used splints are the resting splint and the thumb post splint (Henderson and McMillan 2002).

Benefits of occupational therapy

Occupational therapy-led hand therapy services can improve the patient pathway by providing early access to a specialist opinion for diagnosis and management of specified hand conditions, thus improving access to care and service delivery. The implementation of this patient pathway is intended to support cost efficiencies (Rose and Probert 2009).For people with work-related injuries and conditions, occupational therapy interventions such as early mobilization, splinting, pain control and workplace interventions have been found to have positive effects (Amini 2011).

In a study of upper limb injuries or surgery, where occupational therapy was the only rehabilitation service provided, functional performance gains were found to be significant following client-centered intervention when measured by the Canadian Occupation Performance Measure, the Disability of Arm, Shoulder and Hand questionnaire and the Short Form 36 (Case-Smith 2003). This study also demonstrated that a period of six to eight weeks of occupational therapy produced an 80% success rate in return of full function to patients with significant hand injuries or following hand surgery.

Occupation-focused hand therapy interventions can increase client motivation, satisfaction and participation, and promote faster functional recovery.