Instructional Concurrent Session VIII
Applying Self-Management Support in Hand and Upper Extremity Therapy: Considering Excellence and Equity to Co-Produce Health
Self-management support involves fostering knowledge, attitudes, confidence, and skills to enable patients’ active engagement in the co-production of their health. It extends beyond physiological remediation and traditional patient education to emphasize partnership and cognitive and behavioral principles of care. While self-management support is traditionally discussed for chronic conditions, it has relevance for a broad spectrum of hand and upper extremity conditions. Routinely integrating principles of self-management support into daily practice can increase the value of hand and upper extremity therapy by preventing or managing persistent pain or disability and decreasing the costs and utilization of health care services. Supporting self-management is timely and may be the future of excellence in hand and upper extremity therapy with shifts to value-based payment models and virtual service delivery models. While self-management models can increase equity by reducing barriers to access posed by extended in-person care, they must be thoughtfully applied to prevent inequities related to health literacy, numeracy, and technology. This intermediate session will present an evidence-informed perspective of self-management support for hand and upper extremity conditions. Case studies will be used as a teaching mechanism to engage learners and accelerate knowledge translation.
- Contrast self-management support with traditional approaches to musculoskeletal care.
- Describe three benefits of incorporating self-management support principles into the care of patients with hand and upper extremity conditions
- Identify three health equity considerations when incorporating self-management support into hand and upper extremity therapy programs
- Discuss three case examples of applying self-management support principles for high-value hand and upper extremity therapy
Rotator Cuff Pathology - Current Evidence and Clinical Tips for an Effective Assessment and Management of the Non-Surgical Shoulder
Rotator cuff pathology is a common cause of pain in the shoulder that presents as a clinical spectrum, ranging from subacromial impingement syndrome, bursitis, cuff tendinopathy and partial to full thickness rotator cuff tear, all associated with a specific set of etiology. Current evidence has shown enhanced efficacy of conservative treatment that is contingent on shoulder specific symptom assessment, cortical changes, central sensitization, postural analysis, scapular and RC mechanics. The instructional course will look at all these factors and current evidence that points at inconsistent validity of provocative tests in identifying a pathoanatomical source of pain in RC pathology. Scientific literature will be reviewed to determine the clinical effectiveness of multimodal rehabilitation as the mainstay of conservative intervention. We will address novel treatment strategies and tips based on patient assessment and clinical presentation.
- Identify the three broad pathoetiological factors that contributed to rotator cuff related shoulder pain (RCRSP)
- Develop an understanding of a sequential patient specific evaluation paradigm.
- Identify efficacious treatment interventions prevalent in the current literature, as part of conservative management of RCRSP.
- Identify as least four clinical tips and tricks, based on the assessment model, in managing pain, improving function, and optimizing outcomes.
We Are What We Eat—Nutrition and Wound Care: Implications for the Hand Therapist in Promoting Wellness
Hand therapists routinely manage wound care in the treatment of upper extremity pathology. Traditionally, the focus of wound care intervention has included dressings, PAMs, and orthotics. While these interventions are critical, consideration of additional lifestyle factors including nutritional status and diet are vital for holistic wound care, and for optimal wound healing. Physiological processes such as wound healing are intrinsically occurring processes, but are influenced both externally and internally. “We are what we eat” rings true in consideration of external influence on these internal physiological processes. Our micro and macro nutrient statuses play a key role in wound healing time, tissue integrity, and even pain. Other extrinsic factors include culture, socioeconomic status, and neighborhood environment, influencing what or how an individual may eat. In addition to these extrinsic factors, intrinsic states including age or presence of comorbidities such as diabetes, obesity, or stress also influence an individual’s capacity for wound healing. This session will detail the role of nutrition in wound care with consideration of both internal and external factors, providing goals, evaluation recommendations, and intervention strategies related to nutrition to enhance the hand therapist’s management of wounds.
- Describe the importance of nutrition in wound care.
- Identify 2 goals of nutritional intervention.
- Identify the impact age, social factors, and comorbidities may have on nutritional status and implications for wound healing.
- Implement basic nutritional screening and education into practice within the scope of their parent profession.