UNIVERSITY OF SOUTHERN CALIFORNIA



UNIVERSITYUniversity OF SOUTHERN CALIFORNIAof Southern California OT 57300A, B, C

Department of Occupational Science and Occupational Therapy Fall, 20045689

Instructor: Lisa Deshaies, OTR/L, CHT

Clinical Pathway: Hand Rehabilitation

Class Time and Location:

6:00-98:050pm, Center for Occupation and Lifestyle RedesignVKC 102

Instructor Contact:

Work E-mail ldeshaies@laddhs.; .co.la.ca.us; Work Phone (562) 401-7425

Home E-mail lddeshaies@

Please e-mail to both addresses for the most immediate response.

Course Purpose:

This introductory course is an elective and can be applied toward the 12-unit elective requirement for the Master of Arts in Occupational Therapy. This elective course will explore occupation-based evaluation and treatment for individuals with common hand disorders. Through lecture, lab, small group work, and class discussions, this course will emphasize functional anatomy of the hand and will promote sound clinical reasoning skills based on consideration of key anatomical principles and patients’ occupational goals.

The course will begin with reflective exercises and discussion related to the beauty and complexity of hand function and the symbolic nature of hands. A strong foundation of forearm, wrist, and hand anatomy, kinesiology, and physiology will be built over the course of several weeks utilizing lecture, videos, cadaver specimens, labs, and study cards. This will be followed by diagnostic-specific sessions where anatomy will be integrated along with evaluation and treatment techniques. Throughout the course, occupation-based, patient-centered, and evidence-based approaches will be emphasized.

The student will appreciate that, although quite specialized, hand therapy is not a discipline unto itself. It is through a balance of science (tissue-specific treatment) and art (core occupational therapy premises) that Occupational Therapists provide effective hand rehabilitation.

Course Objectives:

1. Understand anatomy, kinesiology, and physiology of the forearm, wrist, and hand.

2. Recognize a variety of evaluation and treatment modalities commonly used in hand

rehabilitation.

3. Demonstrate clinical reasoning skills based on key anatomical principles and patient

factors when planning evaluation and treatment for commonly seen hand conditions.

4. Understand the value of a patient-centered and occupation-based approach and identify

means to apply it in hand rehabilitation.

5. Identify resources for future reference and further study.

Accommodations for Disability:

Any student requiring academic accommodation based on a disability is required to register with Disability Services and Programs (DSP) each semester. A letter of verification for approved accommodations can be obtained from DSP. Please be sure the letter is delivered to me (or to TA) as early in the semester as possible. DSP is located in STU 301 and is open 8:30am-5:00pm, Mondays through Friday. The phone number for DSP is (213) 740-0776.

Required Readings:

Course Reader,Fundamentals of Hand Therapy: Clinical Reasoning and Treatment Guidelines for Common Diagnoses of the Upper Extremity, by C. Cooper, 2007, Elsevier, ISBN: 0323033865, available from USC Bookstore, main campus. See attached reference list for reader content. Additional handouts to be provided.distributed in class. as needed.

Expectations for Readings:

The syllabus clearly identifies required readings. Readings are due prior to class and are viewed as a support for in-class material. In many cases, the student will NOT be able to participate in class without completing the required readings.

Required Readings:

Course Reader, available from USC Bookstore, main campus. See attached reference list for reader content.

Additional handouts to be distributed in class as needed.

Assignments:

The syllabus clearly identifies assignments. Assignments are due the following class unless otherwise instructed.

Expectations for Participation:

Class participation is required. It is expected that all students will actively participate in and attend each class unless there is an excused absence or illness.

Instructor’s Role:

The role of the instructor is to present course material, lead discussions, be available to answers questions, and provide a supportive environment to facilitate student learning.

Class Schedule:

ClassWeek 1 August 26432185

Course Overview

Introduction to Hand Rehabilitation

Introduction to Occupation-Based and Patient-Centered Care in Hand Rehabilitation

Required Reading: None

Assignment: None

Week 2 HOLIDAY 9/1/08September 1- HOLIDAY- No Class

Clinical and Occupation-Based Evaluation of the Hand

Required Reading:

• Advance for Occupational Therapy Practitioners, “The Art of the First Impression”

• Fundamentals of Hand Therapy, Chapter 8, “Fundamentals of Client-Therapist Rapport”

• Rehabilitation of the Hand and Upper Extremity, Chapter 8, “Clinical Examination of the Hand”

• Fundamentals of Hand Therapy, Chapter 5, “Evaluation of the Hand and Upper Extremity”

Assignment: None

ClassWeek 23 September SeptemberAugust 23109848

• Functional Anatomy of the Wrist and Hand

Required Reading:

• Rehabilitation of the Hand and Upper Extremity, Chapter 3, “Anatomy and Kinesiology of the Hand”

• Fundamentals of Hand Therapy, Chapter 2, “Upper Extremity Anatomy”

Assignment: None

Clinical Examination of the Hand

Required Reading: “Clinical Examination” section of course reader

• Advance for Occupational Therapy Practitioners, “The Art of the First Impression”

• Fundamentals of Hand Therapy, Chapter 8, “Fundamentals of Client-Therapist Rapport”

• Rehabilitation of the Hand and Upper Extremity, Chapter 8, “Clinical Examination of the Hand”

• Fundamentals of Hand Therapy, Chapter 5, “Evaluation of the Hand and Upper Extremity”

Assignment: None

ClassWeek 34 September 15197645

• Functional Anatomy of the Wrist and Hand

Required Reading:

• “Rancho Los Amigos Functional Anatomy of the Wrist and Hand” sheets

Assignment: “Functional Anatomy Study Questions I”, 1-5

• Functional Anatomy of the Wrist and Hand

Required Reading: “Anatomy” section of course reader

• Rehabilitation of the Hand and Upper Extremity, Chapter 2, “Surface Anatomy of the Upper Extremity”

• Rehabilitation of the Hand and Upper Extremity, Chapter 3, “Anatomy and Kinesiology of the Hand”

• Fundamentals of Hand Therapy, Chapter 2, “Upper Extremity Anatomy”Rehabilitation of the Hand and Upper Extremity, Chapter 4, “Anatomy and Kinesiology of the Wrist”

Assignment: None

ClassWeek 45 September 164321822

• Functional Anatomy of the Wrist and Hand

Required Reading:

• Fundamentals of Hand Therapy, Chapter 1, “Fundamentals of Clinical Reasoning: Hand Therapy Concepts and Treatment Techniques”

Assignment: “Functional Anatomy Study Questions I”, 6-10

• Functional Anatomy of the Wrist and Hand

• Functional Anatomy of the Wrist and Hand

Required Reading:

• “Rancho Los Amigos Functional Anatomy of the Wrist and Hand” sheets

Assignment: “Functional Anatomy Study Questions I”, 1-5None

ClassWeek 56 September 231098259

• Functional Anatomy of the Wrist and Hand

Required Reading:

• Fundamentals of Hand Therapy, Chapter 23, “Preventing and Treating Stiffness”

Assignment: None

• Functional Anatomy of the Wrist and Hand

Required Reading:

• Fundamentals of Hand Therapy, Chapter 1, “Fundamentals of Clinical Reasoning: Hand Therapy Concepts and Treatment Techniques”

None

Assignment: “Functional Anatomy Study Questions I”, 16-510

ClassWeek 67 SeptemOctober 30268765

• Peripheral Nerve Problems

• Sensation/Sensibility

Required Reading:

• Fundamentals of Hand Therapy, Chapter 12, “Common Peripheral Nerve Problems”

• Fundamentals of Hand Therapy, Chapter 5, “Evaluation of the Hand and Upper Extremity”

Assignment: “Fight On Study Questions”

• Functional Anatomy of the Wrist and Hand

Functional Anatomy of the Wrist and Hand

Required Reading:

• Fundamentals of Hand Therapy, Chapter 23, “Preventing and Treating Stiffness”

None

Assignment: “Functional Anatomy Study Questions I”, 6-10None

ClassWeek 78 October 13 975423

• Arthritis

Required Reading:

• Fundamentals of Hand Therapy, Chapter 17, “Arthritis”

• Peripheral Nerve Injuries

• Sensation/Sensibility

Required Reading: “Nerve Injuries” section of course reader

• Rehabilitation of the Hand and Upper Extremity, Chapter 33, “Therapist’s Management of Peripheral Nerve Injuries”

• Rehabilitation of the Hand and Upper Extremity, Chapter 34, “Splinting the Hand with a Peripheral Nerve Injury”

• Hand Rehabilitation: A Practical Guide, Chapter 6, “Nerve Repair”

Manual on Management of Specific Hand Problems, Chapter 1, “Nerve Injuries in the Upper Extremity”

• Fundamentals of Hand Therapy, Chapter 12, “Common Peripheral Nerve Problems”

• Fundamentals of Hand Therapy, Chapter 5, “Evaluation of the Hand and Upper Extremity”

Assignment: “Fight On Study Questions”?????????????????“Peripheral Nerve Case Study”

Assignment: “Arthritis Case Studies”

ClassWeek 89 October 2016914210

• Arthritis

• Physical Agent Modalities

Sensation/Sensibility Testing

Hand Function Tests

Required Reading:

• Fundamentals of Hand Therapy, Chapter 17, “Arthritis”

• Rehabilitation of the Hand and Upper Extremity, Chapter 107, “Ultrasound and Selected Physical Agent Modalities in Upper Extremity Rehabilitation”

• Thermal Agents in Modalities for Therapeutic InterventionRehabilitation, Chapter 13, “Heat and Cold Therapy Modalities: in Hand RehabilitationFrozen Peas and More”

• Modalities for Therapeutic Intervention, Chapter 4, “Heat Therapy Modalities: Beyond Fake and Bake”

• American Journal of Occupational Therapy, “Physical Agent Modalities: Developing a Framework for Clinical Application in Occupational Therapy Practice”

“Sensation” and “Hand Function Tests” sections of course reader

Hand Rehabilitation: A Practical Guide, Chapter 7, “Sensory Evaluation”

Hand Rehabilitation: A Practical Guide, Chapter 8, “Desensitization”

• Hand Rehabilitation: A Practical Guide, Chapter 9, “Sensory Re-education”

• Clinical Assessment Recommendations, Chapter 9, “Dexterity”

• Clinical Assessment Recommendations, Chapter 11, “Hand Function”

Assignment: “Arthritis Case Studies”NoneNone

ClassWeek 910 October 2732119867

• Tendon Injuries

• Arthritis

• Physical Agent Modalities

Required Reading:

• Fundamentals of Hand Therapy, Chapter 16, “Tendon Injury”

“Arthritis” and “Physical Agent Modalities” sections of course reader

• Rehabilitation of the Hand and Upper Extremity, Chapter 95, “Therapist’s Evaluation and Conservative Management of Rheumatoid Arthritis in the Hand and Wrist”

• Rehabilitation of the Hand and Upper Extremity, Chapter 101, “Therapist’s Management of Osteoarthritis in the Hand”

• Hand Rehabilitation: A Practical Guide, Chapter 46, “Conservative Treatment of Arthritis”

• Rehabilitation of the Hand and Upper Extremity, Chapter 107, “Ultrasound and Selected Physical Agent Modalities in Upper Extremity Rehabilitation”

• Thermal Agents in Rehabilitation, Chapter 3, “Heat and Cold in Hand Rehabilitation”

Assignment: None

“Arthritis Case Studies”

ClassWeek 101 OctoNovember 28653

• Wound Healing

• Scar Management

• Edema Management

04

• Tendon Injuries

Required Reading:

• Rehabilitation of the Hand and Upper Extremity, Chapter 20, “Care of the Hand Wound”

• Clinical Assessment Recommendations, Chapter 3, “Wound/Scar Assessment”

• Fundamentals of Hand Therapy, Chapter 3, “Edema Reduction Techniques”

• Fundamentals of Hand Therapy, Chapter 19, “Burns”

“Tendon Injuries” section of course reader

• Rehabilitation of the Hand and Upper Extremity, Chapter 27, “Postoperative Management of Flexor Tendon Injuries”

• Rehabilitation of the Hand and Upper Extremity, Chapter 31, “Clinical Management of Extensor Tendon Injuries”

• Hand Rehabilitation: A Practical Guide, Chapter 10, “Extensor Tendon Repair”

• Hand Rehabilitation: A Practical Guide, Chapter 11, “Flexor Tendon Repair”

Assignment: “Functional Anatomy Study Questions II”, 1-5 None

ClassWeek 112 NovembNovember 1064201

• Hand Splinting

Wound Healing

Scar Management

Edema Management

Required Reading: “Wounds” and “Edema” sections of course reader

• Splinting the Hand and Upper Extremity: Principles and Process, Chapter 6,

“Process of Splinting”

• Rehabilitation of the Hand and Upper Extremity, Chapter 19, “Wound Classification and Management”

• Rehabilitation of the Hand and Upper Extremity, Chapter 20, “Care of the Hand Wound”

• Rehabilitation of the Hand and Upper Extremity, Chapter 21, “Management of Skin Grafts and Flaps”

• Hand Rehabilitation: A Practical Guide, Chapter 1, “Wounds”

• Hand Rehabilitation: A Practical Guide, Chapter 2, “Skin Grafts and Flaps”

• Clinical Assessment Recommendations, Chapter 3, “Wound/Scar Assessment”

• Rehabilitation of the Hand and Upper Extremity, Chapter 12, “Edema: Therapist’s Management”

Assignment: “Functional Anatomy Study Questions II”, 1-5

Assignment: Complete fabrication of thermoplastic “lumbrical bar splint”

Assignment: “Functional Anatomy Study Questions II”, 6-10

ClassWeek 123 November 173119867

• Digital Splinting/Casting

• Hand Splinting

Required Reading: “Splinting” section of course reader

• Rehabilitation of the Hand and Upper Extremity, Chapter 114, “Plaster Cylinder Casting for Contractures of the Interphalangeal Joints”

• Introduction to Splinting, Chapter 12, “Splinting for the Fingers”

• Hand Splinting: Principles of Design and Fabrication, Chapter 1, “Splint Prescription: Clinical Reasoning Issues”

• Hand Splinting: Principles of Design and Fabrication, Chapter 2, “Biomechanical Principles of Design, Fabrication, and Application ”

• Hand Splinting: Principles of Design and Fabrication, Chapter 3, “Resources, Materials, and Methods”

Splinting the Hand and Upper Extremity: Principles and Process, CChapter 6,

6,

“Process of Splinting”

Assignment: Complete fabrication of thermoplastic “gutter splint” and plaster “digital cast”

Assignment: Complete thermoplastic “lumbrical bar splint”

Assignment: Complete “Hand Observation Log”

“Functional Anatomy Study Questions II”, 6-10

ClassWeek 134 November 240186534

• Digital Splinting/Casting

Required Reading: “Digital Casting” section of course reader

• Rehabilitation of the Hand and Upper Extremity, Chapter 114, “Plaster Cylinder Casting for Contractures of the Interphalangeal Joints”

Assignment: Complete thermoplastic “gutter splint” and plaster “digital cast”

Class 14 December 1November 25320

• Occupation-Based Practice in Hand Therapy

• Required Reading: “Occupation-Based Practice” section of course reader

• Advance for Occupational Therapy Practitioners, “It’s Time to Choose Which Path You Take”

• Advance for Occupational Therapy Practitioners, “The Integration of Occupation-Based Treatment Into Hand Therapy”

• OT Practice, “Occupation-Based Practice in Physical Disabilities”

• OT Practice, “Hand Rehabilitation: Matching Patient Priorities and Performance with Pathology and Tissue Healing”

• OT Practice, “Occupation-Based Practice in Physical Disabilities”

• OT Practice, “SymboloicSymbolic Aspects of Hand Therapy”

• OT Practice, “Clinical Reasoning and Occupation-Based Practice: Changing Habits”

• OT Practice, “Renaissance Occupational Therapy and Occupation-Based Hand Therapy”OT Practice, “Measuring Occupational Performance”

Assignment: Complete “Hand Observation Log”

Assignment: Internet exploration of one to two “professional resource” web sites Required Reading:

• AOTA Fact Sheet, “Occupation-Based Hand Therapy

• Advance for Occupational Therapy Practitioners, “It’s Time to Choose Which Path You Take”

• Advance for Occupational Therapy Practitioners, “The Integration of Occupation-Based Treatment Into Hand Therapy”

• Advance for Occupational Therapy Practitioners, “Where We Are and Where We’re Going”

• Advance for Occupational Therapy Practitioners, “Peers Will Spread Occupational Approach”

• Advance for Occupational Therapy Practitioners, “Occupation Starts on Day One”

• Advance for Occupational Therapy Practitioners, “Practicing OT to its Fullest”

• OT Practice, “Hand Rehabilitation: Matching Patient Priorities and Performance with Pathology and Tissue Healing”

• OT Practice, “Occupation-Based Treatment in Physical Disabilities”

• OT Practice, “Symbolic Aspects of Hand Therapy”

• OT Practice, “Clinical Reasoning and Occupation-Based Practice: Changing Habits”

• OT Practice, “Renaissance Occupational Therapy and Occupation-Based Hand Therapy”

• OT Practice, “Occupation-Based Hand Therapy and the Occupational Therapy Practice Framework”

• American Journal of Occupational Therapy, “Embracing Our Ethos, Reclaiming Our Heart”

Assignment: Internet exploration of one to two “professional resource” web sites

ClassWeek 15 DecemNoveDecember 12304298

• Evidence-Based Practice/Outcomes in Hand Therapy

• Professional Resources

• Hand Therapy Certification

• California Licensure Regulations for Advanced Practice Certification

Required Reading: “Evidence-Based Practice” section of course reader

• Journal of Hand Therapy, “Evidence-Based Practice: Worthy Pursuit or Passing Trend?”

• Journal of Hand Therapy, “An Introduction to Evidence-Based Practice for Hand Therapists”

• OT Practice, “Evidence-Based Practice: What Can It Mean for Me?”

• OT Practice, “Measuring Occupational Performance”

• Advance for Occupational Therapy Practitioners, “Research and the Hand Therapist”

• American Journal of Occupational Therapy, “Outcomes in Hand Rehabilitation Using Occupational Therapy Services”

• American Journal of Occupational Therapy, “Adaptation to Hand Injury: An Evolving Experience”

• Journal of Hand TherapyFundamentals of Hand Therapy, Chapter 6, “Compliance with Hand Therapy Programs: Therapists’ and Patients’ PerspectivesAssessment of Functional Outcomes”

Assignment: Internet exploration of one to two “professional resource” web sites

Assignment Descriptions: Need to add 1 more

“Functional Anatomy Study Questions I”: Each student will answer all ten questions in as much detail as possible, including references to justify your answers. This assignment is worth 10% of the overall grade.

“Fight On Study Questions”: Each student will answer both questions in as much detail as possible, including references to justify your answers. This assignment is worth 10% of the overall grade.

“Peripheral Nerve Injury Case Study”: Each student will complete with as much detail as possible, including rationale and references to justify your answers. This assignment is worth 10% of the overall grade.

“Arthritis Case Studies”: Each student will complete with as much detail as possible, including rationale and references to justify your answers. This assignment is worth 10% of the overall grade.

“Functional Anatomy Study Questions II”: Each student will answer all ten questions in as much detail as possible, including references to justify your answers. This assignment is worth 10% of the overall grade.

“Lumbrical Bar Splint”: Each student will complete fabrication, be able to describe how the splint works, and be prepared to state two clinical indications for using this splint. This assignment is worth 20% of the overall grade.

“Gutter Splint” and “Digital Cast”: Each student will complete fabrication, be able to describe how the splint and the cast work, and be prepared to state two clinical indications for using this splint and cast. This assignment is worth 20% of the overall grade.

“Professional Resource”: Each student will be assigned one to two web sites to explore and will prepare a three to five minute summary of each site and what it has to offer related to hand rehabilitation. This assignment is worth 10% of the overall grade.

“Hand Observation Log”: Each student will observe ten persons of varying age performing an occupation. Impressions related to hand function will be recorded and a verbal summary may be shared with the class. This assignment is worth 10% of the overall grade.

“Professional Resource”: Each student will be assigned one to two web sites to explore, will print the home page, and will prepare a threetwo to fivethree minute summary of each site and what it has to offer related to hand rehabilitation. This assignment is worth 10% of the overall grade.

All assignment materials will be distributed in class by course instructor.

The syllabus and assignment dates may change. Notice will be given if needed.

Assignment Grading:

Each aAssignments will be graded. Students must earn a grade of 80% or better to get credit for the course. A grade of below 80% will earchn a “Credit” or “No Credit” grade. Missing assignments will not be awarded points. Late assignments will be marked down 5 points for each day late. Students are expected to complete all assignments with a grade of “Credit”.

Key References in Course Reader and Additional References:

Acland, R.D. (1996). The Video Atlas of Human Anatomy, Tape 1: The Upper Extremity.

Baltimore, MD: Williams & Wilkins.

Bracciano, A.G. (2008). Physical Agent Modalities: Theory and Application for the

Occupational Therapist (2nd ed.). Thorofare, NJ: Slack.

Brand, P.W., & Hollister, A.M. (19939). Clinical Mechanics of the Hand (32ndrd ed.). St. Louis,

MO: Mosby.

Burke,

S.L., Higgins, J., McClinton, M.A., Saunders, R., & Valdata, L. (2006). Hand and

Upper Extremity Rehabilitation (3rd ed.). New York, NY: Churchill Livingstone.

Cailliet, R. (1994). Hand Pain and Impairment (4th ed.). Philadelphia, PA: F.A. Davis.

Cannon, N.M. (Ed.). (2001). Diagnosis and Treatment Manual for Physicians and

Therapists (4th ed.). Indianapolis, IN: Hand Rehabilitation Center of Indiana.

Casanova, J.S. (Ed.). (1992). Clinical Assessment Recommendations (2nd ed.). Chicago,

IL: American Society of Hand Therapists, Inc.

Clark, G.L., Wilgis, E.F., Aiello, B., Eckhaus, D., & Eddington, L.V. (1998). Hand

Rehabilitation: A Practical Guide (2nd ed.). New York, NY: Churchill Livingstone.

Colditz, J.C. (2001). The Hand: An Interactive Study for Therapists. Bethesda, MD:

American Occupational Therapy Association.

Cooper, C. (Ed.). (2007). Fundamentals of Hand Therapy: Clinical Reasoning and

Treatment Guidelines for Common Diagnoses of the Upper Extremity. St. Louis,

MO: Elsevier.

Coppard, B.M., & Lohman, H. (20018). Introduction to Splinting: A Clinical Reasoning and

Problem-Solving Approach (3rd 2nd ed.). St. Louis, MO: Mosby.

Fess, E.E, Gettle, K.S., Philips, C.A., & Janson, J.R. (Eds.). (2005). Hand and Upper

Extremity Splinting: Principles and Methods (3rd ed.). St. Louis, MO: Mosby.

Jacobs, M.A., & Austin, N.M. (Eds.). (2003). Splinting the Hand and Upper Extremity:

Principles and Process. Baltimore, MD: Lippincott Williams & Wilkins.

Green, D.P., Hotchkiss, R.N., Pederson, W.C., & Wolfe, S.W. (Eds.). (2005). Green’s

Operative Hand Surgery (5th ed.). Philadelphia, PA: Churchill Livingstone.

Hentz, V.R., & Chase, R.A. (2001). Hand Surgery: A Clinical Atlas. Philadelphia, PA:

W.B. Saunders.

Jacobs, M.A., & Austin, N.M. (Eds.). (2003). Splinting the Hand and Upper Extremity:

Principles and Process. Baltimore, MD: Lippincott Williams & Wilkins.

Mackin, E.J., Callahan, A.D., Skirven, T.M., Schneider, L.H., & Osterman, A.L. (Eds.). (2002).

(2002). Rehabilitation of the Hand and Upper Extremity (5th ed.). St. Louis, MO: Mosby.

Mosby.

Malick, M.H., & Kasch, M.C. (Eds.). (1984). Manual on Management of Specific Hand

Problems. Pittsburgh, PA: AREN Publications.

McKee, P., & Morgan, L. (1998). Orthotics in Rehabilitation: Splinting the Hand and Body.

Philadelphia, PA: F.A. Davis.

McMinn, R.M.H., Hutchings, R.T., Pegington, J., & Abrahams, P.H. (1993). Color

Atlas of Human Anatomy, (3rd ed.). St. Louis, MO: Mosby.

Michlovitz, S.L., & Nolan, T. (Eds.). (19962005). Thermal Agents in RehabilitationModalities for Therapeutic Intervention

( (34rd ed.). Philadelphia,

PA: F. A. Davis.

Prosser, R., & Conolly, W.B. (Eds.). (2003). Rehabilitation of the Hand and Upper Limb.

Edinburgh: Butterworth-Heinemann.

Tubiana, R., Thomine, J., & Mackin, E. (1996). Examination of the Hand and Wrist.

St. Louis, MO: Mosby.

Weiss, S., & Falkenstein, N. (2005). Hand Rehabilitation: A Quick Reference Guide and

Review (2nd ed.). St. Louis, MO: Elsevier.

Wilton, J.C. (1997). Hand Splinting: Principles of Design and Fabrication. Philadelphia,

PA: W.B. Saunders.

Advance for Occupational Therapy Practitioners. King of Prussia, PA: Merion.

American Journal of Occupational Therapy. Bethesda, MD: American Occupational

Therapy Association.

Journal of Hand Therapy. Philadelphia, PA: Hanley and Belfus.

OT Practice. Bethesda, MD: American Occupational Therapy Association.

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