Who is a Certified Hand Therapist?
A Certified Hand Therapist (CHT) is an occupational therapist or physical therapist who has a minimum of five years of clinical experience, including 4,000 hours or more in direct practice in hand therapy. In addition, the Certified Hand Therapist has successfully passed a comprehensive test of advanced clinical skills and theory in upper quarter rehabilitaion. Because of changes in the profession, every CHT is required to demonstrate continued professional development and competency by recertifying every five years.
Benefits of Working with a Certified Hand Therapist
People value the use of their hands and any loss of function through injury or accident may have a devastating effect on their lives. Anyone with an injury wants the very best of treatment to assure maximal recovery. The Certified Hand Therapist credential offers assurance to the public that the therapist has achieved the highest level of competency in the profession and stays up to date with practice within the field.
The intricate anatomy of the arm and hand frequently requres very delicate surgery, often with microscopic techniques. The technical complexity of these kinds of surgeries necessitates a high level of competence by therapists with advanced skills in upper quarter rehabilitation during postoperative recovery. Therapists must be knowledgeable about these advanced surgical techniques and postoperative therapy programs to become CHTs. They must also remain current with changes in hand therapy practice.
Certification is voluntary and difficult to attain. It involves meeting rigorous standards, developing a long-range career path, and acquiring the advanced study and training required to pass the certification examination. CHTs are therapists who demonstrated a personal dedication to the profession of hand therapy a desire for advanced competency; they bring to their work a commitment and dedication to reach and maintain the highest standards in their profession. The CHT credential is recognized by many professional organizations as a benchmark for excellence in advanced specialty credentialing in health care.
Scope of Practice
Theoretical knowledge and technical skills are applied, using sound clinical judgement, in assessment and treatement of individuals with diagnoses related to the upper quarter (hand, wrist, elbow, shoulder girdle, cervical area or multiple joints). These may include but are not limited to:
- Amputations
- Central nervous system disorders as they relate to the upper quarter
- Congenital differences/anomalies
- Cumulative trauma disorders/repetitive stress injuries
- Dupuytren's contracture
- Flexor/extensor tendon injuries
- Infections
- Infammatory and degenerative arthritis
- Multiple system trauma
- Nail bed injuries
- Pain-related syndromes
- Peripheral nerve compression and disease
- Peripheral nerve injuries
- Physchogenic disorders involving the upper quarter
- Soft tissue injuries
- Thermal injuries
- Tumors and cysts
- Vascular disorders
Such patients may be referred to a hand therapist following a variety of medical or surgical interventions including:
- Amputation revision
- Arthoplasty
- Arthrodesis
- Fasciectomy/fasciotomy
- Fracture fixation/bone graft
- Ganglionectomy
- Injections
- Joint reconstruction
- Joint releases
- Joint synovectomy
- Ligament repair
- Nail bed repair
- Nerve blocks/sympathectomies
- Nerve decompressions
- Nerve grafts/nerve repairs
- Neurolysis
- Replantation/revascularization
- Scar revisions
- Skin grafts/flaps
- Soft tissue releases
- Tendon grafts/tendon repairs
- Tendon transfer
- Tenolysis
- Tenosynovectomy
- Tissue transfers
- Use of pharmaceutical agents
A variety of techniques and tools may be used in therapeutic intervention with hand and upper quarter patients, including but not limited to:
- Activity
- Adaptive/assistive devices
- Training in activities of daily living (ADLs)
- Behavior management
- Compressive therapy
- Desensitization
- Electrical modalities
- Ergonomic modification
- Excercise
- Manual therapy
- Patient and family education
- Prosthetics
- Sensory re-education
- Splinting
- Standardized and non-standardized assessment tools
- Strengthening
- Thermal modalities
- Work hardening/retraining
- Wound care/dressings/topical agents