Practice analysis of hand therapy.

In 1994, a practice analysis (role delineation study) was conducted on the profession of hand therapy. This study was conducted as a follow-up to the original study conducted by the American Society of Hand Therapists (ASHT) in 1985. A representative group of content experts developed a description of hand-therapy practice, and this description was validated using a questionnaire. The questionnaire was distributed to a random sample of 400 certified hand therapists (CHTs), of whom 50% responded. The respondents provided confirmation of the accuracy of the description of hand therapy. The survey results were used to update the test specifications for the Hand Therapy Certification Examination. The results enabled the Hand Therapy Certification Commission to improve upon its certification program by clarifying and expanding the definition of hand therapy. The 1994 findings were also compared with the results of the 1985 study.

The hand therapy certification examination: results of the first five years.

In 1991, the first Hand Therapy Certification Examination was administered to candidates throughout the United States. Since then, the examination has been given annually. The purpose of this paper is to summarize the processes that have been used to develop the examination as well as to report demographic data about the examination and certification candidates. Overall, the results of test administration have been very good. Twenty-two hundred therapists have become certified hand therapists. Eighty-five percent are occupational therapists, and 88% are female. Most candidates have practiced for ten years or less and have maintained caseloads of upper-extremity patients for three to six years. The examination has performed well. Reliability coefficients have been 0.91 or greater for each administration. The mean scores on the examination have decreased each year, from 148.4 in 1991 to 129.4 in 1995.

Clinical management of scar tissue.

This paper will review the physiology of scar formation including the properties of wound healing and scar remodeling. A clinical scar management program that includes evaluation of scar adhesions and use of a variety of therapy interventions to minimize the formation of scar will be described. Use of compression, massage, splints and functional activities is included in this program. The information is applicable for the general occupational therapist who sees patients with hand dysfunction as well as a therapist specializing in hand rehabilitation. Every therapist who treats hand trauma must be familiar with the sequence and the properties of scar formation in order to reestablish tendon gliding and facilitate early remodeling of scar tissue. Many treatment techniques can be directed toward scar adhesions and no one method is totally effective when used alone; used together, these techniques can positively influence scar formation and restore maximal hand function.