Abstract
Following the success of ‘Under The Skin’ the HandLab have produced yet another invaluable teaching tool for the hand therapist. Comprising two parts, this DVD/CD provides a comprehensive educational module on the thumb, spanning six hours of video instruction linked to self-study materials.
This production assumes some basic knowledge of anatomy and has been reviewed in its entirety by a large team of hand therapists comprising both occupational therapists and physiotherapists at all levels, from student to clinical specialist. All members of the team reported the format to be clear and concise and extremely well presented with clear illustrations and helpful summaries after each section. It has proved an excellent educational reference for all grades of therapist and a first-class revision tool even for the specialists among us!
Each part can be purchased separately and includes two separate DVD/CDs. The first comprises printable self-study notes of summary points, references and useful articles and clinical pearls. It is helpful to download these in Adobe PDF format and read these before watching the videos. The second CD of each part contains the instructional video.
Part I examines the anatomy of all joints of the thumb, joint structure, biomechanics and testing of ligaments and muscles, all presented by Judy herself and clearly illustrated with a PowerPoint-type presentation. This part concludes with details of carpometacarpal joint arthritis looking at all aspects of the disease from incidence and symptoms to pathogenesis. X-rays are also included to assist with diagnosis, disease staging and clinical examination. Part I concludes with self-study exercises which are helpful to include in group teaching sessions. Also, if one wishes to examine the knowledge gained from this there are 100 self-study questions recommended before attempting an optional online examination included in the price.
Part II begins by examining the role of the physician and the non-operative treatment of carpometacarpal joint arthritis, including injection and drug therapies. It also looks at the latest research into non-operative management and leads to a comprehensive and lengthy instructional session on therapy management at all stages of the disease. Judy recommends her own exercise regimens, for different degrees of articular destruction and disease stages. There are details of both functional aids and joint protection regimens and of particular note in Part II are the descriptions of different pinch patterns under load.
A large proportion of Part II is dedicated to the roles and goals of splintage. There are eight splint demonstrations: four for the carpometacarpal joint, two for the metacarpophalangeal joint and two for the interphalangeal joint. Each demonstration is carefully orchestrated and illustrated. This section is to be recommended to any hand therapist wishing to improve knowledge on the principles of splint construction and decision-making based on different types of thumb deformity, joint involvement and stage of the disease. Our team found this part of the module to be particularly useful as Judy's wealth of experience in this field is clearly demonstrated.
There is a large amount of downloadable information and video instruction on all aspects of the thumb and carpometacarpal joint arthritis in this collection, which takes considerable time to absorb. We found that as a team it was helpful to break this down into manageable sessions giving time for discussion after each section.
We would highly recommend this production to other hand therapy units managing arthritic conditions of the thumb. It can be purchased online by visiting