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OBJECTIVES

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At the end of this chapter, all students are expected to:

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  1. Describe the types and functions of upper extremity orthoses.

  2. Identify and describe the parts of upper extremity orthoses, including the materials, componentry, and orthotic designs used in these appliances.

  3. Describe the impairments and functional activities that may be improved by the use of an upper extremity orthosis.

  4. Discuss the ways in which an upper extremity orthosis may affect the wearer's ability to perform his or her activities of daily living.

  5. Discuss applications for upper extremity orthoses to improve function.

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Physical Therapy students are expected to:

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  1. Determine the need for an upper extremity orthosis for a client based on examination findings.

    1. Evaluate examination findings, including those from preorthotic prescription examinations, upper quarter biomechanical assessment, and functional analysis, to diagnose impairments that may be improved by use of an upper extremity orthosis.

  2. Develop appropriate goals for an upper extremity orthosis based on a client's impairments and functional limitations.

  3. Describe the biomechanical methods employed in upper extremity orthoses to achieve the orthotic goals.

  4. Develop and execute a search strategy to identify research evidence for the effects and effectiveness of upper limb orthoses and to identify best practices for upper extremity orthotic prescription.

  5. Name an upper extremity orthosis using both biomechanical terminology and the Splint Classification System (SCS) developed by the American Society for Hand Therapists.

  6. Recommend an orthosis to improve and optimize function as part of a plan of care for an individual with impairments in the upper extremity.

  7. Examine and evaluate upper extremity orthoses for acceptable fit, function, comfort, and cosmesis.

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CASE STUDIES

Harry Green is a 67-year-old African American widower who suffered a thrombotic cerebral vascular accident (stroke) with right hemiparesis. His history and chief complaints are described in Chapter 2. Mr. Green's acute care hospitalization progressed without complication, and he was discharged to a rehabilitation facility for intensive therapies. From that facility he was discharged to home, where he received some continued home care therapy for several weeks. It is now 6 months after his stroke, and Mr. Green is living alone in his own home with community services. He walks safely with a lower extremity orthosis and an ambulatory aid, but his upper extremity function has not improved very much, and he uses his hand only to hold things down. He has also developed shoulder pain that is not incapacitating but definitely impedes functional activities. He realizes that to continue to be independent at home, he needs to have more use of his upper extremity.

Marjorie Harris is a 40-year-old owner of a music school and violinist in the community symphony orchestra. Marjorie is an active mother of three sons. She teaches violin to children in her music school, plays violin in various community orchestra and theater performances, and also fills in as needed as a musician at her synagogue. Marjorie has experienced lateral elbow pain in ...

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