A hand injury can be a devastating experience. Not only does it result in physical pain and functional limitations, it affects a person’s interaction with his natural world. Our upper limbs are critical to completing basic activities of daily living, such as feeding, dressing and toileting and a loss of function in the hand can have a significant impact on a person’s level of independence and quality of life. In addition, dexterity is most often an essential work demand and compensating for upper limb impairment in the workplace can be challenging.

The human hand is the most developed prehensile organ among all living creatures.
– Ulrich Mennen –

Tracey Buchanan (Proclaim Care) and Anne Byrne (Obair) at a recent presentation to QBE claims handlers on the hand and upper limb services offered by Obair.

Tracey Buchanan (Proclaim Care) and Anne Byrne (Obair) at a recent presentation to QBE claims handlers on the hand and upper limb services offered by Obair.

Hand therapists are attuned to the needs of individuals who have sustained hand and upper limb injuries and geared for guiding them towards improved independence and function through a period of rehabilitation. Obair has identified the need for hand and upper limb rehabilitation, focused on improving residual function following a hand injury. Through improving range of motion, strength and functional use of the hand, the opportunity for a quicker return to work and productive lifestyle is provided.

Occupational therapists are particularly well equipped to provide this service, as they are dual trained in mental and physical health and can therefore make use of activities to improve function, as well as assist the client with processing the psychological impact of the injury. These activities typically include tasks that are familiar to the client, such as activities of daily living around the home and at work. Therapeutic goals aim to enhance performance, improve and maintain function and workability, and therapists seek to adapt activities to improve independence. As the client views therapy in relation to occupational abilities and roles, this further improves the client’s motivation to participate in rehabilitation.

Lara Wood (Rehabilitation Consultant, QBE) looking at a pain scale used during the evaluation.

Lara Wood (Rehabilitation Consultant, QBE) looking at a pain scale used during the evaluation.

A rigorous evaluation proceeds rehabilitation, with the aim of establishing a functional baseline and rehabilitation potential.  Clients may present with protective behaviour, as well as a fear or avoidance of using the upper limb in functional tasks. Furthermore, hypersensitivity or increased pain responses may be identified. The evaluation seeks to establish goals for intervention and also determine any psychosocial factors that may impact on hand function at home and at work.

Early identification of barriers that might prolong disability or absence from work is key in ensuring a successful rehabilitation outcome. In the case of hand therapy, early intervention is critical and may prevent secondary complications such as chronic regional pain syndrome, contractures and hypersensitivity, with subsequent non-use of the hand.

Anne Byrne demonstrating the use of equipment used during the hand and upper limb evaluation.

Anne Byrne demonstrating the use of equipment used during the hand and upper limb evaluation.

The training delivered was interactive and professional. The presenter was both knowledgeable and passionate about the subject and this was clear in her delivery of the training. Positive feedback was received from adjusters stating that the training was relevant and insightful.
– QBE rehab team –

Obair works along with a national network of occupational therapists with expertise in hand and upper limb rehabilitation to provide this service. If you are a hand therapist and interested in working along with us, please get in touch.

Written by Lezanne Fieuw

The Hand Book-A practical approach to common hand problems. Editors: U Mennen and C van Velze. (2008)