Course Descriptions

Program Orientation Course and Resources: these are short introductory online modules and assignments that are completed prior to the Foundations in Upper Extremity course. Topics include:

• Tutorials in Learning Management System (Canvas) Navigation and program forms completion
• Introduction to Effective Technology and Online Learning
• Intro to Evidence-Based Practice in Hand Therapy
• Intro to Outcome Measures and Research Statistics in Hand Therapy
• Intro to Clinical Reasoning
• Case Studies and Scholarly Projects

Advanced Practice Concepts

This course runs ¾ length of the program, alongside the other courses, building your practice foundation by introducing an integrated orthopedic and hand therapy clinical reasoning model used throughout episodes of care, reviewing elements of an upper quarter medical screening, subjective exam, objective exam, assessment and treatment design. A review of tissue healing principles will be introduced prior to principles of various therapeutic intervention categories, including therapeutic exercise, manual therapy, taping, neurodynamics, sensorimotor, proprioception, therapeutic use of physical agent modalities. We will revisit tenets of clinical excellence as the course concludes.

Rationale: The hand and upper extremity rehabilitation specialty incorporates a blend of occupational and physical therapy principles, heavily influenced by orthopedics and neurology fields. Sound clinical reasoning, to include using a systematic patient-tailored approach to data gathering and forming early prioritized diagnostic hypotheses when appropriate, followed by a carefully selected interactive patient history taking and examination to test hypotheses, may reduce cognitive bias and lead to a greater understanding of the patient presentation. This greater understanding reduces the risk of diagnostic error and improper, overly aggressive, poorly tolerated hand therapy sessions. When clinical reasoning generates diagnostic hypotheses requiring medical management, incorporating best-evidence screening strategies may facilitate timely and appropriate medical care.

Foundations in Upper Extremity Practice

This course reviews upper quarter anatomy, biomechanics and current best evidence in clinical evaluation, including differential diagnosis of various common conditions. Introduction of pain science as related to clinical exam considerations, as well as the role of orthosis management for common conditions in hand therapy, will be introduced during this course. In addition, this course will take advantage of technology advancements including virtual web meetings for live discussions. The first of two weekend Orthosis Fabrication labs will occur during the course.

Instructional Methods: 13 week online course, 2-day hands-on lab, virtual case discussions

Common Conditions 1

This course reviews common upper quarter conditions and pathologies, with an emphasis on honing clinical evaluation, assessment and differential diagnosis skills, as well as therapeutic interventions to develop an effective plan of care. Current best evidence in clinical evaluation/assessment, conservative and post-surgical therapeutic interventions will be reviewed for commonly seen conditions in the hand and upper extremity specialty. This will include fractures and joint injuries, as well as soft tissue conditions including tendinopathies, peripheral nerve compression conditions, and edema and vascular management. The lab portion of this course focuses on skill acquisition of examination and intervention including manual therapy and therapeutic exercise/activities for the shoulder, elbow, wrist and hand. Each participant will be assessed via manual skills checks and online written assignments. Clinical reasoning and evidence-informed practice are underscored throughout both online and lab instruction. Learning is enhanced with the practical application of patient cases. Scholarly project selection will begin and include a partnered educational or patient case grand rounds presentation, as well as developing and taking action in a community outreach program to market yourself as an upper extremity/hand therapy-specialized clinician.

Instructional Methods: 13 week online course, 2-day hands-on lab, virtual case discussions

Common Conditions 2

This course reviews current best evidence in clinical evaluation/assessment, conservative and post-surgical therapeutic interventions for commonly seen complex conditions in the hand and upper extremity specialty, including: flexor and extensor tendon injuries; peripheral nerve injuries; tendon and nerve transfers; and arthritic and autoimmune conditions. A two-day weekend lab course emphasizing wrist and hand manual evaluation and treatment, as well as mobilization and restriction orthoses will occur during this course. Each participant will be assessed via manual skills checks and online written assignments. Clinical reasoning and evidence-informed practice are underscored throughout both online and lab instruction. Learning is enhanced with the practical application of patient cases.

Instructional Methods: 10 week online course, 2-day hands-on lab, virtual case discussions

Special Populations

This course addresses the nature and treatment of upper extremity disorders in special populations: hand and upper extremity pain conditions/CRPS. complex trauma and psychosocial adjustment disorders, the injured worker, musicians and athlete/sports injuries, Post-TBI or CVA hemiplegia /tetraplegia, and pediatric/congenital conditions. Scholarly projects will be completed during this course. A final two-day weekend lab course emphasizing orthosis problem-solving and fabrication skills will occur during this course. Clinical reasoning and evidence-informed practice are underscored throughout both online and lab instruction. Learning is enhanced with the practical application of patient cases. Finally, studies will culminate in a mock CHT-style exam. Ongoing orthosis fabrication skills will be evaluated and photos will be submitted/uploaded to the mentor’s Orthosis Fabrication Proficiency Evaluation in Canvas. Mentoring will continue with all associated forms completed at designated intervals per program Policies and Procedures.  

Instructional Methods: 8 week online course, 2-day hands-on lab, virtual case discussions

Four live, two-day Weekend Labs

Orthosis Fabrication and Management Labs (2)

Biomechanical and fitting principles, material selection, and assessment principles challenge the clinical reasoning skills of the clinician in custom orthosis fabrication, as well as in the selection and fitting of prefabricated orthoses. The orthoses reviewed coordinates with conditions studied throughout the program. Weekends 1 and 3: Orthosis Fabrication Lab 1 focuses on static/immobilization orthoses, and Lab 2 on dynamic/static progressive mobilization orthoses.

Upper Extremity Manual Therapy Evaluation Skills Lab (2)

Building upon concepts introduced in IAMT’s Upper Quarter Examination and Treatments course, this lab series coordinates with didactic material covered in the program. Live, hands-on review of special tests, and joint and soft tissue mobilization techniques, combine with practical assessment skills to prepare the clinician to effectively screen the cervicothoracic region, and treat the shoulder complex through hand. Weekends 2 and 4: Upper Extremity Manual Therapy Lab 1 reviews cervicothoracic screening and shoulder, and Lab 2 focuses on the elbow, wrist and hand. Each participant will be assessed via manual skills checks and online written assignments.