Many of the patients I treat on a routine basis have some degree of osteoarthritis throughout their hands. This is why joint protection training is essential in maximizing functional use of the hands while assisting with pain management.
A gross grasp is the best way to protect the joints within the hands.
This means that we as the OT work to teach the patient to use large, wide grasp patterns when completing daily tasks.
In some instances, certain tasks require painful, fine motor movements. This is where adaptive equipment comes into play. Items like button hooks, zipper pulls, and pump activated soap bottles can assist with self care task completion, while can opens, jar openers, and adaptive utensils can assist with IADL task completion.
When it comes to larger joints such as shoulders, hips, and knees, adaptive techniques are the best way to maximize protection and integrity of the joints. The use of button down shirts can help to minimize excessive shoulder range of motion during upper body dressing, while dressing sticks or reachers can decrease excessive bending of the hips and knees during lower body dressing.
The shoulders can be further protected by moving commonly used household items to shelves and counters that are below shoulder height but above waist height.
Hips and knees can be further protected by encouraging the patient to sit on surfaces that are high enough to keep the knees at 90 degrees when seated.
What are some ways that you incorporate joint protection into your treatment sessions and patient education?
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