The NDIS (National Disability Insurance Scheme) is rolling out around Australia, and with it brings changes to the way people with a disability access services. The vision is great; fostering inclusion and breaking down the barriers which stigmitise disability in our country.
Although these changes may seem overwhelming at first; they will inevitably bring positive change to individuals, families and the wider community.
People with a disability will have more choice and control about how they live their life. And which services they engage to best help them reach their own goals.
Over time, with increased access, participation and contribution, the barriers faced by people with a disability will decrease. Enabling greater understanding and acceptance from the wider community.
Hand Therapists offer a unique set of skills to those who suffer from a hand or upper limb disability.
They are Occupational Therapists and Physiotherapist who specialise in rehabilitation from injury, condition or disease to the hand & upper limb (finger tips to shoulder). Hand Therapists understand the complex anatomy of the upper limb, and how disease and disability can result in impairment and dysfunction. And have specilaist skills in helping to improve position, coordination, strength and maximise function in the hands and arms. To find the closest Accredited Hand Therapist to you search the web site www.ahta.com.au.
Some Hand Therapists are registered with the NDIS to provide services to all NDIS participants, including Agency Managed Participants.
At Adelaide Hills HAND THERAPY we are currently a fully registered NDIS provider.
As the scheme is rolling out, and Certification is required for health professionals, it is anticipated that many Hand Therapists will opt to not be registered with the NDIS. This is due to the complex and expensive process involved to Certify for ongoing registration. These therapists will continue to be able to work with Plan Managed, Self Managed and combination managed participants, but not those managed by the NDIS.
Services that Hand Therapists will offer to NDIS participants will vary depending upon the individual provider, at Adelaide & Hills HAND THERAPY some of the services that we offer participants include;
At Adelaide & Hills HAND THERAPY we are excited about the possibilities that the NDIS will bring for participants, their families and the community in general. And we look forward to being involved in this positive change. Contact us if you'd like to discuss how we can help you reach your goals! 08 8339 HAND, 08 8339 4263.
The term Accredited Hand Therapist (AHT) is the name given to a practitioner of Hand Therapy who meets specific criterial listed below;
The AHTA is the professional association in Australia which represents Practitioners of Hand Therapy. The association supports it's members by building upon public awareness of the speciality of Hand Therapy through netowrking and representation. And provides professional development oportunities through education and courses and mentorship support.
A Certified Hand Therapist (CHT) has internally recognised specialist hand & upper limb rehabilitation skills. To be titled as a CHT an individual must;
There are almost 6600 CHT's world wide, and over 180 in Australia and New Zealand.
85% of CHT's are Occupational Therapists.
Choosing a CHT means you are chosing a professional who has demonstrated a high level of knowledge about how the hand & upper limb (fingertip to shoulder) usually are, and how injuries and conditions impact upon the upper limb and how it functions.
1 in 3-4 women over 50 years of age will get osteoarthrtitis (OA) at the base of their thumb. The incidence is less for men, however the symtoms & cause are the same.
OA is a degenerative joint condition which commonly results is pain, sometimes swelling and decreased movement at a joint. It can result from previous trauma to the joint, or due to chemical changes in the joint, which change the joint surface and surrounding tissues over time. Painful OA is particularly common at the base of the thumb.
The joint at the base of the thumb (at the thumb side of the wrist) is called the first carpometacarpal joint (CMCJ). This joint is affected by OA as the joint allows for a complex and wide degree of movements. It is the joint responsible for opposition, where by our thumb pulp (fleshy surface) can face and pinch the finger tip pulps. Because it allows for a great degree of movment, the joint relies on the soft tissues around it to give it stability. However when OA is present, the stability of these structures is often compromised.
Throughout our lives the first CMCJ certainly gets a work out! The joint positions the thumb so we can use it in almost all activities involving our hands. And it also absorbes and transfers pressure associated with the forces involved in pinch. These shearing and loading forces are generally well tolerated. This is because the soft tissues (ligaments, tendons, muscles) aroud the joint stabilise it- that is until they are damaged.
OA effects change on the bone as well as soft tissues around the involved joint. With loosening and deterioration of the capsule and ligaments around the joint- the bones can shift out of alignment. And this is the process of the development of joint deformities in thumb osteoarthritis. There are different patterns of joint deformity which result from imbalances in muscle and ligament strength and the way the bones line up during different activities.
How we can help you, is be assessing the pattern of deformity, seeing which structures are loose and which are tight, and how the bone is shifting during use and sitting at rest. Hand Therapy can help to reposition the joint, and bring balance to the structures which destabilise the thumb. Please call us today so we can help you get the most out of your thumb 08 8339 HAND (8339 4263).
Following hand injury sensitivity to cold, or cold intolerance is not uncommon. In fact around 40% of those suffering hand trauma will experience cold intolerance (Novak & McCabe, 2015).
Cold intolerance is more than the usual feelings of chill. Symptoms include ache or pain in and around the injured part. The feeling is excessive to what would usually be expected following exposure to the cold. And in some cases can be severe and result in stiffness. Change in colour of the finger or hand to blue, red or whiter can also occur. Symptoms usually persist until or after the hand is warmed.
The exact cause of cold intolerance is unknown. Some research suggests it is more likely following injury to a nerve in the hand (Median or combination Median and Ulnar nerves), +/- damage to a blood vessel. This same research concluded that blunt injury was also more likely to cause issues tolerating the cold (Irwin et al 1997). Other studies have researched cold intolerance following tendon and bone injuries in the hand.
Exposure to cold air is the usual trigger, which makes those living and working in cold environments more susceptible. And most research conculdes that those who smoke and injury severity are the main predictors of a poor outcome.
What can I do to stop cold intolerance?
Preventing the fingers / hands getting cold seems to be the only real way of managing cold intolerance. Avoiding exposure to cold air appears to be the best solution for minimising the impact of cold intolerance. And where the temperature can not be controlled using good quality gloves made of natural materials can help. Donning the gloves before leaving the house or car, of before entering the cold environment can help - as warming hands once cold can take time and be painful.
A hand therapist or occupational therapist can provide advice about tool handles / grips and other tricks to minimise exposure and the onset of symptoms. In the first instance- avoid cold and don good quality gloves!