HAND REHABILITATION
The hand has a key role in all upper extremity functions. The hand has two main functions, sensation and movement. It performs the 'sensory function' with touching and feeling, and the 'movement function' with grasping and hand movements. In addition, the hand takes part in self-expression, showing emotions, nutrition, body care, defense and attack, temperature regulation, and sexual functions. Paul Valery said, "The hand is a device that can strike, take, give, feed, swear, read for the blind, speak for the mute, reach out to the friend, hold a rhythm, and is used like hammer tongs.". Therefore, the extent of the loss caused by hand diseases is much more than the mechanical work done by the hand. The aim of hand rehabilitation is to regain the loss of movement and sensory functions of the hand and to increase the quality of life of the individual.
WHO IS APPLICABLE TO HAND REHABILITATION?
Patients who have;
- Tendon and nerve injuries of hand and forearm
- Hand and/or wrist fractures
- Hand and wrist surgeries
- Tendon transfer surgeries
- Breaks (amputations) in the hand and forearm
- Lymphedema
- Complex Regional Pain Syndrome
- Hand involvement of endocrine and metabolic diseases (such as diabetes, thyroid diseases, hemochromatosis)
- Burns
- Hand osteoarthritis
- Hand involvement of inflammatory rheumatic diseases (such as rheumatoid arthritis, psoriatic arthritis, gut)
- A vascular necrosis of the hand bones (such as Kienböck's disease)
- Nerve entrapments such as carpal tunnel syndrome, cubital tunnel syndrome, Guyon's canal syndrome
- Ligament injuries of the hand(especially the triangular fibrocartilage complex injuries)
- In cases where hand functions are affected in neurological diseases such as parkinsonism, spinal cordinjuries, stroke
- Trigger finger
- Dupuytren's contracture
- Overuse syndrome ssuch as De Quervain's tenosynovitis
-
PATIENT EVALUATION FOR HAND REHABILITATION
When you apply to Fatih Sultan Mehmet Training and Research Hospital Physical Medicine and Rehabilitation Clinic Hand Rehabilitation private branch polyclinic, first, your complaints are recorded along with a detailed history. If there is trauma, the time, mechanism and severity of the trauma are questioned. For problems not related to trauma, the duration of the complaints, the factors that increase them, whether they are progressive, the relationship with professional activities, nocturnal complaints, and the presence of similar complaints in the hand and body are questioned. The treatments applied so far are recorded. Inpatients that have undergone surgery, detailed information about surgery is provided in written form. In the first examination, the range of motion of the wrist and hand joints, muscle strength, loss of sensation, circulatory system abnormalities, and functional status are evaluated. Special diagnostic tests related to hand diseases are applied. In measurements; “Jamar dynamometer” will be used for hand grip strength, “Pinch meter” for finger lateral grip strength, “Semmes-Weinstein monofilament” for sensory loss, and “Forktuning” for vibration sense. The functional state of the hand is determined by the "Sollerman Hand Function test". These evaluations are made before and after treatment.
CONTENTS OF HAND REHABILITATION APPLICATIONS
The main goal of hand rehabilitation is to regain the past movement and sensory functions of the hand. In our clinic, a personalized rehabilitation program is planned after the evaluation. For this purpose, exercise approaches for pain and edema control, sensory retraining, regaining muscle strength, increasing aerobic condition, regaining joint range of motion, muscle strength and fine motor skills; soft tissue mobilization techniques; proprioceptive neuro muscular facilitation techniques; motor learning and planning strategies; taping methods (Kinesio Tape®); desensitization applications; distinctive sensory training; return to work, daily life and sports training; therapeutic ultrasound applications; and electrical stimulation methods are applied.
INJECTION TREATMENTS AND USE OF ULTRASONOGRAPHY IN HAND REHABILITATION
Injections are applied to deliver therapeutic drugs directly to the diseased area. Injections are used in diseases such as osteoarthritis, rheumatic diseases, nerve entrapments, trigger finger, De Quervain's tenosynovitis. In our hand rehabilitation clinic, we use ultrasonography both as a guide to increase the efficiency and safety of injections and to evaluate nerve and tendon morphology for diagnostic purposes. In addition, ultrasonography is used to evaluate the upper and lower nerve endings in nerve injuries, fracture healing and bone fragments, nerve compression areas, and changes in the nerve and surrounding tissues in cases of nerve compressions.
DURATION OF HAND REHABILITATION
In our clinic, the hand rehabilitation program is adjusted according to patient-specific evaluations, the severity of the disease, and the expectations of the patients. Therefore, the content and duration of treatment varies from patient to patient.