Happppyyyyy Thursday y’all!! I am excited for today’s guest in this new series I’ve been working on called sp{OT}light – where you get to hear from students and professionals in the field of OT (because we know there is a LOT we can do).
Today’s interview is with Jessica Henry, OTD, she just completed her residency/doctoral capstone experience in Hand Therapy and had such a wonderful experience! Butttt I’ll let her do the talking:
Tell us a about your residency/doctoral capstone experience and the ACOTE pillars/standards you chose to pursue.
I chose clinical practice skills and education as my residency pillars. I had an interest in developing my knowledge of conditions and interventions seen in a hand therapy setting. In addition, I have experience in mentoring and have always had a passion for life-long learning. After participating in a splinting class taught by Laura Conway and hearing Chemaine Crane’s presentation on hand therapy conditions at NSU I decided that I wanted to do this for residency. I have always had an interest in orthopedics and chose Select Medical so I could study under Laura and Chemaine, two amazing Hand therapists based out of Florida.
What client population are you working with?
Young- Older Adults (20s-70s).With Various Conditions: Lateral epicondylitis, Dequervians, Wartenburgs syndrome, Cubital Tunnel, Carpal Tunnel, Trigger Finger, Fractures (PIP, Metacarpal, Colles, Smiths, Elbow), Dupetrens, Extensor Tendon Injury, Flexor Tendon injury, Medial Epicondylitis, Mallet finger, Boutonniere deformity, Swann neck, Arthritis, CVA, Brachial Plexus Injury, Digital Nerve Lacerations, Muscular Dystrophy, Reynaud’s, Breast Cancer (post lat. dorsi flap), ALS.
What type of setting were you in?
Outpatient Hand Therapy
What does a typical day look like?
I arrive at the facility at 6:50 A.M, 10 minutes before my first patient. If I have not already planned for my first scheduled patient the day before, I review the previous note to familiarize myself on their condition, precautions, goals, progress, and areas of concern (I also check to see if they are due for measurements so I can send a note to the MD on their progress).
After I have reviewed the previous note, I invite the patient back and usually start their session with a physical agent modality or aerobic conditioning to prep the body for participation in therapy. I often use Fluidotherapy, Paraffin, moist heat pack, or the arm bike depending on the condition. After they are warmed up I usually take measurements if needed or begin manual therapy, therapeutic activities, neuromuscular re-education, or therapeutic exercise to promote functional use of the injured body part for improved performance with daily occupations or work related tasks.
This setting uses the biomechanical approach. I usually see 1-2 patients an hour and my days can be 8-12 hours long (including lunch). I document throughout the day, and usually do not leave with any outstanding or incomplete documentation unless the day is super busy. Patients who require splints were often seen by my CI, however, I did get to construct several splints during down time, including a trigger finger splint for a patient during my last month at Select. If we do have cancellations, that down time is used for practice with manual techniques, splinting, studying, my capstone, or prepping for the following day or patient.
Where is your site located/name if you want to share?
Select Medical or Select Physical Therapy
Were there any programs/presentations you completed while as a resident?
Presentation: Graded Motor Imagery Effectiveness and Practical Application in a Hand Therapy Setting
This is planned for a future AOTA poster presentation submission. Graded Motor Imagery is a graded treatment approach based out of neuroscience that is effective with individuals suffering from pain limiting motion. It uses left-right discrimination (body alteration changes), explicit motor imagery (imagination), and mirror therapy (retraining brain on movement).
What is the most challenging part in this setting?
ANATOMY. Knowing the anatomy in the upper extremity was imperative when treatment planning, splinting, explaining the condition to patient’s, and when performing provocative testing during evaluations. I needed to spend extra time reviewing the anatomy to accurately perform differential diagnosis testing during evals.
Most memorable experience/impactful experience?
Honestly, the patients were amazing. All of them made my heart smile. It was tough leaving such a wonderful place with such great people, it makes you want to give them all that you got. The patient’s showed me how important therapeutic use of self is and really helped by giving me feedback on how I was doing and where I can improve (for example, applying more pressure during PROM). Every day I woke up happy because of my opportunity to work with them.
Advice for students interested in hands?
Books for Reference: Rehab of the Hand and Upper extremity
Things to Study: UE anatomy, ROM/MMT testing, common conditions (fractures, cumulative trauma), Healing time for structures (bone, tendon, muscle ligament).
Be open, creative, and willing to learn. You must be receptive to feedback and be a people person, because you will have to speak to people for at a minimum 30 minutes to an hour.
If you would like to learn more about the hand therapy setting or have questions for Jessica she can be contacted at Jesshenry2615@gmail.com
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