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Occupational Therapy for Dupuytren's Contracture- Lucy Bailey

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Lucy Bailey

on 3 June 2013

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Transcript of Occupational Therapy for Dupuytren's Contracture- Lucy Bailey

Dupuytren's contracture disease Your Journey to recovery Occupational Therapy interventions Scar management The Occupational Therapist will educate you on exercises to promote range of movements in your hands and fingers.
They will recommended that you take off your day or night splint when carrying out your finger and hand exercises.
Exercises can include:
- stretching the finger(s) away from the palm (Extension) to increase range of movements.
-playing with putty/play dough to increase strength.
The exercise can gradually get harder as your range of movement and strength increases. Hand and finger exercises By the end of Rehabilitation (6-12weeks) you
will be advised to continue wearing the splints
provided.

You will also be advised to
- continue to gain strength through exercises
-continue increasing ADL's
-continue with scar management Occupational performance Diagnosis of Dupuytren's
contracture 1- Bent Finger
2- Abnormal nodes in the connective tissue beneath the skin
3- Normal connective tissue Start of your journey Tests for diagnosis
Table Top Test The doctor or therapist may do a table top test which is a simple movement that can determine whether you have dupuytren's contracture.

You will be asked to place your hand palm down on a table top and attempt to flatten the hand.

Being able to flatten the hand means that no contracture is present. Dupuytren's Contracture Information Illustration of Dupuytrens contracture Dupuytren's contracture is a condition
that effects the hands and fingers. This is caused by a small growths or lumps
of tissue called nodules that develop on
the palm of the hand.
It causes one or more fingers
on one or both hands, to bend into
the palm of the hand.
This commonly happens in the little and ring
fingers. You may therefore have difficulties
carrying out everyday activities such as
writing, dressing or hobbies.
If the symptoms of Dupuytren's contracture is affecting your hand function you may benefit from surgery.

It involves cutting open the skin in the palm of your affected hands and fingers and removing the underlying tissue that has become thickened and tight, which is causing your fingers to bend inwards.

The surgery aims to improve the position of the fingers which should allow you to move your hand and fingers move easily. Following diagnosis Surgery post op When leaving hospital you may have heavy bandages
on your hand. These will be removed when you attend a
clinic appointment in approximately one week.
Here your wound will be checked and a light dressing
will be fitted and your stitches will be removed.

At the clinic you will also see an Occupational Therapist. Thermoplastic Splints The occupational therapist will provide you with a splint to make your operated finger(s) as straight as possible.

A night splint should also be worn, which will help straighten the affected fingers whilst you are asleep preventing your fingers from curling back into the palm and the scar from tightening.

As the finger (s) gets straighter the occupational therapist will adjust the splint. Evidence has demonstrated that the post operative
rehabilitation stage is as important as the surgery itself Occupational therapists can advise you how to manage your scars effectively.

When the wound is dry and closed you will be advised to use an appropriate cream to rehydrate and mobilize the scar.

This will improve the appearance of the scar and improve flexibility and movements of the hand and fingers. Assessment of your hand and finger function and how this is affecting your occupational performance The Occupational Therapist will measure your range of movement (ROM) in your hands and fingers before and after surgery and rehabilitation to determine any improvements in your function.

They may set short term and long term goals with you, these are individualized to meet your needs and will allow the therapist to understand what you would like to gain out of rehabilitation. A Goniometer measurement can show the range of movement in your fingers and hand. Night resting splint Day splint Splints will also help reduce
any swelling (edema)
The OT can also educate you on Edema
control techniques. Assessment The Occupational Therapy assessment process begins with gathering information about you.
You may discuss:
-hand dominance
-how you use your affected hands to carry out activities of daily living such as eating, dressing.
-The OT may want to understand how the hand condition is affecting engagement with your leisure life (valued occupations)
-your present level of functioning
-your personal aims of treatment
A volumeter is commonly used to measure for any edema in your hands or fingers. The interventions provided by the Occupational Therapist will be designed for you to successfully gain your overall goals.

whether it will be, to be able to play golf again or to be able to do go shopping independently the Occupational Therapist will work with you to ensure this goal is met.
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