SHTICON 2022 & ISSHCON 2022 Conference e-Souvenir

SHTICON 2022
th
9 Annual Conference of the
Society for Hand Therapy, India
7-8 October 2022, Hotel Marriott, Jaipur
ISSH
6-8 October 2022, Hotel Marriott, Jaipur
th
45 Annual Conference of the
Indian Society for Surgery of the Hand
In Collaboration with
THEME
EXPLORE THE POTENTIAL OF HAND
THERAPY TO THE FULLEST
e-SOUVENIR

Table of Contents
S. No. Content Page No.
Welcome Note
SHTICON 2022 Organizing Committee
Messages
About SHTI
Flyers & Brochures
Scientic Programe
Faculty Speakers
Abstracts: Faculty Talks, Oral Papers, E-Posters and Mini Movies; Essays
Award Winners
Gallery
Sponsors
Membership Form
Vote of Thanks
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
2
4
3
5
14
17
25
29
32
57
59
74
76
78
SHTICON 2022 e-SOUVENIR

Organising Committee SHTICON 2022, Jaipur, India
3
Shubhangi Lad
JT. Scientic Chairperson
MOTh
EC Member, SHTI
Afliation: Senior Clinical OT,
LTMMC &GH, Sion, Mumbai
Mobile: +91-9869445126
Email: suitshubu@gmail.com
Website: https://www.ltmgh.com/
JT. Organising Secretary
S K Meena
MOT, PGDHA
EC Member, SHTI
Afliation: Professor & Principal, MGOT
College, Jaipur
Mobile: +91-9414058796
Email: skmeena22@gmail.com
Website: https://mgumst.org
Organising Secretary
Yogita Shendge
MOTh, LLB
EC Member & Incharge Treasurer SHTI
Afliation: Founder Your Therapist Clinic
Tilak Nagar, Chembur, Mumbai, India
Mobile: +91 98207 94435
Email: yogitashendge2020@gmail.com
Web: www.yourtherapist.co.in
Dr Tejashree Dhabolkar
Scientic Chairperson
PhD PT
EC Member, SHTI
Afliation: Associate Professor, TMV
Lokmanya Tilak College of Physiotherapy,
Navi Mumbai,
Mobile:+91-9167047445
Email: tejashreedabholkar81@gmail.com
Dr Shovan Saha
Organising Chairman
PhD, FACOT
President, SHTI
Afliation: Associate Professor
(OT), MAHE, Manipal
Mobile: +91-9880059426
Email: shovanot@gmail.com
Website: https://manipal.edu/

4
WELCOME NOTE
Dear SHTICON Delegates,
On behalf of entire organizing committee of SHTICON 2022 and Society for Hand Therapy, India
we welcome one and all delegate to this mega academic feast. We are pleased to present this e-
souvenir the hallmark of SHTICON2022, to you as a memory album to be cherished upon. We
express our heartfelt gratitude to all the delegates without whom this event wouldn't have been
possible.
Thanks
SHTICON 2022
Organizing Committee

5
MESSAGES

Message from Organising Chairman, SHTICON 2022, Jaipur, India
Dr Shovan Saha
Greetings to all participants and the members from the fraternity of Indian Hand Therapist. It is a pleasure to pen
down these thoughts on the occasion of 9th Conference of Society for Hand Therapy, India and 45th Conference
of Indian Society for Surgery of the Hand on 7th & 8th Oct, 2022 at the pink city of Jaipur, the capital city of the
state of Rajasthan.
As the pandemic is receding, it has given us an opportunity to have the ofine conference, and everybody is
looking forward to that. But the virtual mode has created some wonderful opportunity, which we are
experimenting this conference. There will be video presentation by some of the world’s leading hand therapists,
which otherwise may not have been possible. This creates a great opportunity for Indian therapists to get an
international perspective, and this will be one of the highpoint of the conference.
We, the organizing committee did face challenges to get sufcient registration, but I am in full appreciation of my
team who demonstrated great team spirit to prepare an exciting basket of scientic and academic events. Also
we had a great support from ISSHCON’2022.
We are excited for this momentous occasion. This joint conference of surgeons and therapists will open up great
opportunity to get a perspective of surgical and rehabilitative management of various upper-extremity related
conditions under one roof.
SHTICON-2022 & President, SHT, India
MOT, PhD Organizing Chairman,
Keeping up with the theme of this conference Explore the potential of hand therapy to the fullest, Society for
Hand Therapy, India pledges to create a better and increased footprint of Hand Therapy in India.
Dr. Shovan Saha,
I would thank everybody who supported us in this endeavor and specially the participants.
Message
6

Honoured to be the organizing secretary of the 9th National Annual Conference of Society for Hand Therapy,
India, I extend my warm welcome to all the participants, students, professionals and delegates across the
country and the globe. We are excited to meet in person for the academic feast of 9th National Annual
conference of Society for Hand Therapy, India along with 45th National annual conference of Indian Society of
Hand Surgeons. .
Human nature is intrinsically RED TAPE. With the Pandemic, adapting and getting comfortable with virtual mode
had its own challenges and gestation period. Now, when the globe is working from home, having participation
for the physical meet itself has posed as a challenge. Nevertheless, limited registrations will provide an
opportunity to more intense brainstorming and interactions. Hence, with the spirit of "THE SHOW MUST GO ON"
we as a team, have worked to bring the best to the table .
My best wishes to all the incoming delegates and we look forward to great meeting, interaction and participation
especially after two years of social distancing and virtual meeting .
Yogita Shendge
In lines with the conference theme "Explore the potential of hand therapy to the fullest", as an entrepreneur,
practicing hand therapy in India, I would like to share that denitely there is immense scope and potential for the
branch of hand therapy to develop and grow in due course of time as a super-specialization. SHTICON along
with ISSHCON is one such unique platform where all the Hand therapists, Hand surgeons have an opportunity to
interact, share, discuss and network with like- minded and interested professionals from across the globe .
Organising Secretary SHTICON 2022
EC member & In-Charge Treasurer, SHT, India.
Message from Oraganising Secretary SHTICON 2022, Jaipur, India
Message
Yogita Shendge
7

Message from Scientic Chairperson SHTICON 2022, Jaipur, India
Message
Scientic Committee Chairperson SHTICON 2022
EC Member, Society for Hand Therapy (SHT), India
In capacity of scientic committee chairperson its always challenging to put up enriching scientic experience.
Blooming hand therapists are keen to present their best of the research work and it is a matter of great pleasure
for me to learn that Society for Hand Therapy India is organizing its 9th Annual National conference
SHTICON'2022 in collaboration with ISSHCON'2022 at JAIPUR .
Associate professor, TMV Lokmanya Tilak college of Physiotherapy, Navi Mumbai.
The theme of the 2022 conference "Explore the potential of hand therapy to the fullest" have been aptly chosen to
expand application of hand therapy in wider areas. This conference will have participation from national and
international faculty speakers, various research authors will be presenting their work in oral, E-Poster, Mini
movies, and Essay formats. Awards will be conferred in each category of presentation. Our best wishes to all the
presenters and looking forward to meeting you all on a positive note e .
Last year amidst the pandemic of covid our team has taken great effort to organise SHTICON 2021conference in
virtual mode. This year at Jaipur all delegates are eager to meet on common research platform and enjoy
educational feast. Society of Hand therapy, India has been proactive since the year 2009, in hosting diverse hand
therapy events: courses, workshops, annual conferences, hand therapy examinations etc .
Dr. Tejashree Ajit Dabholkar. MPT, PhD
EC Member, Navi Mumbai branch of Indian Association of Physiotherapy
8

On this 9th Annual National Conference of Society for Hand Therapy India i.e. SHTICON'2022 that is being
organized in collaboration with 45th Annual National Conference of Indian Society for Surgery of the Hand i.e.
ISSHCON'2022 on 7th and 8th October 2022 at Jaipur, I wish all the Organizing Committee Members, Heartfelt
Congratulations and Best Wishes for Successful Academic Feast.
Secretary, SHTI
With Warm Regards and Best Wishes
The Theme: "Explore the Potential of Hand Therapy to the Fullest" for SHTICON'2022 is aptly chosen during the
times of evidence-based clinical practices wherein there is an urge amongst Occupational Therapists and
Physiotherapists to offer best hand therapies to fullest potentials. Thereby, enabling their clients to return to their
pre-injury roles with optimal capabilities
I hope the Hand Therapists and Hand Surgeons take the best opportunities in professional networking and team
building during this national collaborative annual conference .
Executive Committee Member, AIOTA
Punita V. Solanki
Editor, The IJOT
Message from Secretary SHTI
Punita V Solanki
Message
9

Message from President IFSHT
Peggy
10

Message from President ISSH
Dr Mukund Thatte
Message
It is a privilege and an honour to be asked to write this message for the Indian Society of Hand Therapy . I write to you as
the incumbent President of the Indian Society of Surgery of the Hand .
I have always held that Hand therapy is an integral part of Hand Surgery. Without appropriate and timely therapy input
results are likely to be sub optimal. My association with hand therapy goes back to the mid-80s when we had a joint Hand
Injury Follow up Clinic (HIFC) held in the old barracks of the Lokmanya Tilak Municipal General hospital (sion hospital). It
was run by the Plastic Surgery Department along with both Physical and Occupational therapy teams seeing patients
simultaneously. Ms. Chhaya Rane who is now Prof. Chhaya Verma HOD PT in Nair and her friend and colleague Hemangi
were constant attendees. The HOD of OT Shri Oak used to attend and fabricate splints on the spot. It was an enriching
experience and deeply imprinted on my brain the need for constant collaboration.
The problem as I see it is of availability of Hand therapists outside larger cities and towns. Many people we operate live in
places where a surgeon may be available but not a Hand therapy professional. Currently our colleagues in Bombay
Hospital Shobha Atre and Mrunal Pandit keep tabs on such people via WhatsApp video. This is inadequate by their own
reckoning and needs to change. There is nothing like an actual physical contact with another human being who is caring
for your hand. That person can then communicate with the base unit for more effective implementation. I hope ISHT does
basic courses round the country to train therapists in Hand therapy. The ISSH Basic Hand Surgery course for General,
Orthopaedic, and Plastic surgeons held round the country can be a model for consideration.
Dr. Mukund Thatte
Bombay Hospital, Bai Jerbai Wadia Hospital for Children Mumbai India
Hand therapy has come a long way since and is very advanced in so many respects. Currently in our work in peripheral
nerve, Brachial plexus, and Tendon transfers; Hand Therapy plays a vital role in getting better results and superior
rehabilitation. Your organising secretary Ms. Yogita is a very vital part of the team particularly in splints for tendon transfers
and congenital hands.
I hope you have fruitful deliberations during this meeting and join us to participate in the ISSH meeting. My very best
wishes.
President ISSH 2022
Head Plastic Surgery
11

Message from President AIOTA
Dr Anil K. Srivastava
All India Occupational Therapist' Association (AIOTA) will be happy to provide necessary assistance as and when
required by SHT to further promote the area of hand rehabilitation in clinical practice throughout the country.
I am condent that the 9th Annual National Conference of the Society for Hand Therapy (SHT), India would promote
excellence in the practice and enhance research for multifaceted growth of the occupational therapy in the area of
hand rehabilitation. My best wishes to all who are working hard for making this event a great success.
Executive Chairman- Academic Council of OT
Executive Chairman/Editor-in-Chief – The Indian Journal of OT
President- AIOTA & WFOT Delegate
Dr. Anil K. Srivastava
I congratulate Dr. Yogita Shendge for taking over this huge responsibility to organize 9th SHITCON. I am aware that
Society for Hand Therapy (SHT) is doing excellent work under the potential leadership of Dr. Shovan Saha and his
dedicated team since last decade in promoting Hand Therapy as a specialty area of occupational therapy practice in
India.
Occupational therapy encircles a very signicant role in hand therapy to optimize the functional use of the hand and
arm.. Its pivotal role is to improve and maintain functionality in order to restore independence in self-care and
occupations. Much of our lives are spent using our hands hence hand therapy treatment in occupational therapy
cannot be overlooked or ignored in our clinical practice.
I feel immense pleasure to know that 9th Annual National Conference of the Society for Hand Therapy (SHT), India, is
a being organized on 7th & 8th October, 2022 at the pink city of Rajasthan -Jaipur .
Message
12

Message from IAP President
It gives me immense pleasure to learn that Society for Hand Therapy, India (SHTI] is organizing a conference 9th
SHTICON'2022 along with 45th ISSHCON on 7th & 8thOctober, 2022. It is a matter of pride that they are trying to
spread the message of hand therapy across 55 countries of the globe. It is our responsibility that our services
should help the patients in remote area also and they should get beneted from a collaborative team approach.
As one of the important health streams, Hand Therapy should be promoted equally at all levels of health care i.e.
for prevention, for treatment and for rehabilitation equally. As the need and awareness of Hand therapy is
growing day by day in our society, I am sure this conference will prove a milestone in journey of Hand Therapy
and will help Physiotherapists, Occupational therapists to learn new horizon, and many patients will also be
benetted by this event. I wish all the best to Dr. Shovan Saha, the organizing committee and everyone
associated with this conference a great success.
Prof. Sanjiv K Jha, Masters in Physiotherapy (Sports)
Professor and Principal, RD Gardi Medical College, Indore, Madhya Pradesh, India
President, Indian Association of Physiotherapists (IAP)
Owner, Centre for Chronic Diseases & Research (CCDR).
Prof. Sanjiv K Jha
Message
13

14
Current Ofce Bearers of SHTI
Shubhangi Lad
MOTh
Mobile: +91-9869445126
Website: https://www.ltmgh.com/
S K Meena
MOT, PGDHA
Afliation: Professor & Principal, MGOT
College, Jaipur
Mobile: +91-9414058796
Email: skmeena22@gmail.com
Website: https://mgumst.org
Yogita Shendge
MOTh, LLB
Afliation: Founder Your Therapist Clinic
Tilak Nagar, Chembur, Mumbai, India
Mobile: +91 98207 94435
PhD PT
Navi Mumbai,
Mobile:+91-9167047445
Dr Shovan Saha
PhD, FACOT
(OT), MAHE, Manipal
Mobile: +91-9880059426
Website: https://manipal.edu/
Punita V Solanki
Msc (OT), FACOT, ADCR
Afliation: Freelance Private Practice
Mumbai
Mobile: +91-9167180215
Email:orthorehab.punita@gmail.com
Website: www.orthorehab.in
President SHTI Secretary SHTI
EC Member &
In-charge Treasurer
SHTI
EC Member SHTI
EC Member SHTI EC Member SHTI

Past and Present SHTICON
th
9 Dr. Shovan Saha Yogita Shendge 7th & 8th October
2022
Jaipur Rajasthan
15

PROMOTIONAL
CONTENT
16

Flyers and Brochures
17

Flyer Design by: Dr. Shovan Saha
18

19

20

21

22

23

SCIENTIFIC
PROGRAM
24

Scientic Schedule, SHTICON 2022
9.00am-11.00 am
11.00am-11.10am
11.10am-11.30am
11.40am-12.00pm
12.00pm-12.20pm
2.00pm-2.20pm
2.20pm-2.40pm
2.40pm-3.00pm
3.00pm-3.10pm
3.10pm-4.00pm
4.00pm-5.00pm
4.00pm-4.10pm
4.10pm-4.20pm
4.20pm-4.30pm
4.30pm-4.40pm
25
Mrs. Shubhangi Lad
Mrs. Shubhangi Lad

4.40pm-4.50pm
4.50pm-5.00pm
5.00pm-5.10pm
5.10pm-5.30pm
26

8.00am-8.20am
8.20am-8.40am
8.40am-9.00am
9.00am-10.20am
9.00am-9.08am
9.08am-9.16am
9.16am-9.24am
9.24am-9.32am
9.32am-9.40am
9.40am-9.48am
9.48am-9.56am
9.56am-10.04am
10.04am-10.12am
10.12am-10.20am
10.30am-10.50am
10.50am-11.10am
27
Mrs. Yogita Shendge
Mrs. Yogita Shendge
Mrs. Yogita Shendge
Mrs. Yogita Shendge
Mrs. Yogita Shendge
Mrs. Shubhangi Lad

28
11.10am-11.30am
11.30am-11.50am
11.50am-12.00pm
12.00pm-12.10pm
12.10pm-12.30pm
12.10pm-12.20pm
12.20pm-12.30pm
12.30pm-12.50pm
12.50pm-1.10pm
Mrs. Yogita Shendge
Mrs. Shubhangi Lad
Mrs. Shubhangi Lad

Dr Shovan Saha
PhD, FACOT
President, SHTI
(OT), MAHE, Manipal
Mobile: +91-9880059426
https://manipal.edu/
Website:
Title of Presentation:
1.Workshop on: Basics of Low
temperature thermoplastic splinting
2.Splinting management of Upper
Extremity Spasticity
Analysis of Surgical hand
Shubhangi Lad
MOTh
EC Member, SHTI
Mobile: +91-9869445126
http://www.ltmgh.com/
Website:
Extensor Tendon Injuries of Hand and
its management
Shilpshree Palsule
MOTh
Assistant Professor,
Seth GSMC & KEMH Mumbai
Mobile : +91 7021249575
Email : sppalsule@gmail.com
Title of presentation:
Adult Brachial Plexus Injuries: Rehab
Process and Challenge
Shrikant J. Chinchalkar
MThO, BSc OT, OTR, CHT, OT Reg. (On)
Afliation: Ex-Senior Hand Therapist,
Roth-McFarlane Hand & Upper Limb
Centre, St. Joseph's Health Centre in
London, Ontario, Canada
Mobile: +1 (519) 854-5028
Email: schinchalkar@hotmail.com
Title of Presentation
1.Anatomy of elbow and its implications
2.Therapeutic management of Elbow Fracture
Yogita Shendge
1.Keynote: Explore the potential of
Hand therapy to the Fullest
2.Challenges Post Hand
Transplant –Therapist’s Perspective
MOTh, LLB
EC Member & In-charge Treasurer SHTI
Afliation: Founder Your Therapist Cinic
Tilak Nagar Chembur, Mumbai India
Mobile: +91 98207 94435
PhD PT
EC Member, SHTI
Navi Mumbai,
Mobile:+91-9167047445
Faculty Speakers
29

Faculty Speakers
Dr Anil Bhat
Associate Dean,
Professor & Head
Dept of Hand Surgery
MAHE, Manipal, India
Mobile:9008419336
Email:anil.bhat@manipal.edu
RA Hand-Surgeon's Perspective
Dr Ashwath Acharya
Associate Professor,
Department of Hand Surgery
Kasturba Medical College,
MAHE, Manipal, India
Email:anm.acharya@manipal.edu
Peripheral Nerve Injuries:
Surgeon's Perspectives
Gráinne Bourke
Consultant in Plastic Reconstructive
and Hand Surgery,
Leeds Teaching Hospital Trust
Honorary Senior Lecturer University of
Leeds
President British Association of
Hand Therapists ,UK
Email: grainnebourke@nhs.net
Congenital Hands: Considerations,
Decision making and options for the
child and Family
Rashmi Yeradkar
MOTh
Associate Professor & In - charge
(From 2010 till date)
Occupational Therapy Department LTMMC,
Sion, Mumbai
Mobile: + 91 9820954156
Email otrashmi@gmail.com
:
A Role of an Occupational Therapy in
hand rehabilitation in public healthcare
system- An overview
Cindy Weinberger
OT/L, CHT
Owner & Clinical Director: Mobile
Therapy Group Occupational Therapist and
Certied Hand Therapist College,
Phone: +1 561-461-5343
Email: cindy@mobiletherapygroup.com
Hand therapy Journey
Sarah G Ewald
Bsc, OTR,
European Certied Hand Therapist
Founder City Handtherapie, Zurich,
Switzerland
Past President of IFSHT
Mobile: +1 (519) 854-5028
Email: sgewald@city-handtherapie.ch
Patient Education in Hand Therapy:
Perspectives, Tools, Tips, and Tricks
Dr Nilesh Satbhai
Dr Binoy P
. S.
Consultant Hand Surgery & Microsurgery
ST James Hospital, Chalakudy, Kerala
Email:handmicro@outlook.com
Extensor Tendon Reconstruction
Senior Consultant and Head
Dept. Of Plastic, Hand & Reconstructive Microsurgery
Global Hospital, Parel, Mumbai Hon. Consultant in Pediatric
Plastic Surgery BJ Wadia Hospital for Children, Mumbai
Mobile: +91-9769271549
Email: satbhainilesh@gmail.com
nileshhand@gmail.com
Hand Transplant: Surgical and Rehabilitation Perspective
30

ABSTRACTS
31

Faculty Speakers
Yogita Shendge . MOTh, LLB
Founder of Your therapist…An advanced mobility care clinic at Tilak Nagar
Chembur, Mumbai
Email address: yogitashendge2020@gmail.com
Contact: +91 98207 94435
Key note Abstract:
Hand therapy has its existence since more than seven decades in India. Hand therapy benets
right from a new born to an elderly. It benets patients with traumatic injury to cumulative trauma
disorder. Workers both from industries and corporate sector forms the clientele of Hand clinics.
However, there are certain on eld challenges that provides a room for exploring the potential for
hand therapy. Unavailability, Inaccessibility, Unaffordability, Resilience and Resistance of team
members, Governance, enactment of statutes are the various factors that affects the potential of
hand therapy in India. There is a gap between the potential of the hand therapy and possibility of
exploring. Society of Hand Therapy, India aims to work to bridge this gap through various means
such as organising and conducting annual congress, website and certicate courses
Shrikant Chinchalkar- M.Th.O, B.Sc.OT, OTR, CHT,
worked as a Senior hand therapist at the Roth-McFarlane Hand & Upper Limb
Centre, St. Joseph's Health Centre in London, Ontario, Canada.
Abstract – Anatomy of the Elbow
The elbow is a complex joint, acting as a link in the lever arm system to provide mobility and
stability and function. The distal humerus, proximal ulna, and the radial head form the three
major articulations of the elbow joint. A single and continuous joint capsule covers these
articulations. The lateral and medial collateral ligaments act as important stabilizers of the
elbow joint. The radial collateral ligament merges with the annular ligament. These two
ligaments are primarily responsible for providing stability to the radial head. Motion of the
elbow joint is controlled by a variety of muscles. These muscles are supplied by the
musculocutaneous, median, ulnar, and radial nerves. The vascular supply of the elbow joint
consists of the brachial, radial, and ulnar arteries. An understanding of the elbow anatomy and
biomechanics is crucial in designing a post trauma rehabilitation
SHTICON 2022 e-SOUVENIR 32
“Holding hands to heal hands”- Dr Mukund Thatte, Consultant Plastic Surgeon, Bombay Hospital, Mumbai

Abstract – Management of Elbow Trauma
Successful rehabilitation following elbow trauma relies on communication between the treating
physician and therapist. Therapists must be aware of the rigidity of bony xation achieved, the
ligamentous stability, and the status of the other soft tissues surrounding the joint. Reection
and reattachment of the triceps muscle, repair of the lateral ulnar collateral ligament, or
anterior transposition of the ulnar nerve are just a few of the important details that must be
known before implementing any treatment program. These surgical details guide treatment
because they determine the type of motion allowed, the safe arc of motion, and the limitations
for functional use of the upper extremity by the patient following surgery.
Sarah G. Ewald
Occupational Therapist and Hand Therapist,
Past President International Federation of Societies for Hand Therapy
Email ID: sgewald@city-handtherapie.ch
Title of presentation: Patient Education: Improving patient uptake of information
Abstract: A patient's active participation in the therapeutic process is essential to obtain the best
outcome. A substantial component of hand therapy treatment is teaching the patient about their
injury or disease and their specic home program for care and recovery of their hand. Therefore,
therapists should consider themselves instructors as well as health care providers. In turn, patient
education should be approached with the same professionalism as all other aspects of treatment.
This requires knowledge about how adults learn, knowledge of the different learning styles, and the
ability to use multi-dimensional teaching styles and materials and methods to instruct the patient
and ensure that they learn the new information and apply it. Godwin (2000) found that patients
remembered 25% of the information conveyed in an initial consultation! Providing patients with
customized written information about their health condition improved patient recall by 28%
(Patterson & Teal 1997). Orkun and Rice (2001). noted that medical information conrming
existing beliefs was remembered better than information contradicting these beliefs. Finally, Guise
et al. (2012) found that patient education specic to a patients' learning style signicantly
improved information uptake and retention. The information gained from these and other studies
can help us optimize patient instruction in the practice of hand therapy and thus optimize patient
outcomes. This presentation will focus on:
1. the characteristics of adult learners and how these apply in the therapy setting
2. the different types of learning styles (visual, auditory, read-write, and kinesthetic)
3. identication of a patient's preferred learning style within the context of therapy
4. strategies for tailoring the instructional method to a patient's preferred learning style.
Enhanced delivery of patient instruction improves patient adherence and outcomes
Faculty Speakers
33
“Hand Therapist can sort out the function from dysfunction”- JOSE MARY. X(OT), JIPMER, Puducherry, India.

Grainne Bourke
Consultant in Plastic Reconstructive and Hand Surgery, Leeds Teaching
Hospital Trust Honorary Senior Lecturer University of Leeds
President British Association of Hand Therapists (2020-2023)
Email:grainnebourke@nhs.net
Title of presentation: Congenital Hands: Considerations, Decision making and
options for the child and family
Abstract
Congenital hands: considerations, decision making and options for the child and family
There is a broad spectrum of congenital hand conditions both in classication and severity.
Some are genetic and families are familiar with the conditions and have options about the
management strategies. For others these are sporadic conditions or syndromes and decision
making is more challenging and stressful .
Hand Surgeons and therapists need to work together with psychologist to support these
families and children in making the right decisions to enable them to have the best
functionality and quality of life both in childhood and in later adult life. Therapist play an
important role in developing relationships with the families and supporting them
throughout these early years.
Consulting with the family and supporting them in their decision making is a recurrent
process for all children with complex limb anomalies. This talk will navigate through meeting
with children and families and working with them to share knowledge and support them
Cindy Weinberger
OT/L, CHT, Owner & Clinical Director: Mobile
Therapy Group Occupational Therapist and
Certied Hand Therapist College,
Phone: +1 561-461-5343
Email: cindy@mobiletherapygroup.com
Hand therapy Journey
Faculty Speakers
Abstract
Mobile Therapy Group provides certied hand therapy, physical therapy and occupational therapy in
the home or in our boutique therapy clinic in West Palm Beach, FL. The practice has grown from
one provider to eight in a two and a half year period and continues to expand.Cynthia will share her
story of starting and running a therapy practice in Palm Beach County, Florida
34
“The hand is an epitome of harmony, harmony between 29 bones, 29 joints, 123 ligaments,
34 muscles, 48 named nerves, and 30 named arteries”- Dr. Shovan Saha, PhD, OT, Manipal, India

Rashmi Yeradkar
(MOTh, Musculoskeletal sciences)
Afliation: Associate Professor, Department of Occupational Therapy, LTMMC,
Sion,Mumbai,Maharashtra, India.
Mobile: +91- 9820954156
Email: otrashmi@gmail.com
Title of presentation: A role of an Occupational Therapy in hand rehabilitation in public
healthcare system-An overview.
Abstract: A normal working hand is one of the most important features for independence in an
individual's life. The loss of hand function results in a severe compromise of the ability to care
for oneself, and limits one's participation in work, social and family life. Multi- disciplinary
approach in treating hand injurie helps to improve functioning and reduce disability
in individuals. Therefore, providing a collaborative and exible rehabilitation program to clients is
the aim of public health system. The purpose of this presentation is to dene the role of
occupational therapy in hand rehabilitation and to give an overview about the services provided
by occupational therapy departments in public healthcare system.
Shubhangi Mandar Lad , MOTh (MSK)
Afliation: - Senior Occupational Therapist
Lokmanya Tilak Municipal Medical College & Hospital, Mumbai,
Maharashtra, India
Mobile: - +91 9869445126
Email id: - suitshubu@gmail.com
Title of Presentation: Extensor Tendon Injuries of Hand and Its Management
Abstract: Normal hand function mirriors the integrity of the extensor tendons. The extensor
muscles to the digits are weaker, and their capacity for work and their amplitude of glide are less
than their exor antagonist, yet they require a latitude of motion that is not necessary for exor
function. The extensor tendon distal to the extensor retinaculum are relatively thin, broad
structures that present a disproportionately large surface vulnerable to injury and susceptible to
the formation of restraining scar. Any violation of the extensor tendon or their investments
introduces the potential for a functional deciency. The outcome is often better when the injury is
a clean cut to the tendon , rather than one that involves crushing or damage to the bones and
joints.
Faculty Speakers
35
“Brain directs, Hand Acts”- Yogita Shengde, MOTh, Mumbai, India

Shilpshree Palsule
MOTh
Afliation: Assistant Professor, Dept. of Occupational Therapy, Seth GSMC,
Mumbai
Email id : shilpshreepalsule@kem.edu
Contact details: 9987798660
Title of presentation: “Adult Brachial Plexus Injuries: Rehab process and challenge”.
Abstract: Brachial plexus injuries are devastating upper extremity injuries, affecting patients
physically, mentally and psychologically. Some physical improvement may be achieved through
recent surgical techniques; however, recovery process is prolonged, challenging and often
incomplete. The therapist, who works in close association with the patient during this
rehabilitation process is required to understand the patient holistically, to enable the patient to
adjust back into the society to perform meaningful occupations. Knowledge regarding presenting
symptoms, surgical procedures used, and rehabilitation methods helps better management of
the affected patients in their prolonged recovery process.
Dr. Shovan Saha
MOTh, PhD
Afliation: Associate Professor, Dept of Occupational Therapy
MCHP
, MAHE, Manipal
Contact: +91 98800 59426
Title of presentation: Splinting management of spastic upper-extremity
Abstract: In India, there is rapid industrialization and motorization often leading to injuries, which an be
musculoskeletal and neurological in nature. Neurological problems may also arise due to degenerative conditions, age
related issues or birth related issues. Thus, leading to major impact on individual's work capacity, daily living tasks and
leisure pursuits. To minimize the negative impact of a dysfunction, the process of creating, crafting and delivering low
technology devices in the form of splints (remedial, functional and preventive in nature) is undertaken, facilitating them
to meet the requirements of basic and instrumental activities of daily living. The splinting interventions in neurological
conditions has several challenges, it has to take into account som very fundamental aspects like spasticity, spasticity
and contracture, accidity, low tone, uctuating tone and synergy patterns. Any form of technological solutions needs
to accommodate all these variations. The signicance of splinting in spastic condition is also in facilitating clients to
express their needs, and also ensuring client's preference of functional independence is paramount. Splinting as a
modality is effective in stretching muscles which may not be sufciently stretched by therapy alone. It also helps in
reducing tone, improve mobility, reduce contracture, and redirect the pattern of neuronal ring. Therapists use either
static or dynamic splints to achieve these aims of therapy. It can aid in overcoming physical and functional problems
and live to their fullest potentials.
Faculty Speakers
36
Miracles are blessed by God, Functional hand independence is the crown of our efforts"- Shubhangi Mandar Lad (OT) ,Mumbai

Abstract: Advancements in science and technology is growing leaps and bounces. Hand
transplants are medical miracles for amputees provided they go through extensive rehabilitation
program to regain functional outcome. Various factors affect the outcome of hand transplants.
Pre-operative stump, donor organ structure, general conditioning of the patients, side effects of
immuno-suppressants. Post Hand-transplant, clients are required to undergo extensive
therapeutic rehabilitation including customized series of splinting and self-help devices to
facilitate the functional outcome in their activities of daily living. However, in the process of
rehabilitation, various challenges are encountered by the therapists, patients and their families
that impacts their active vigorous involvement in therapy thereby affecting the outcome. Hence,
it is of utmost importance that these challenges are recorded, documented and worked upon in
addition to therapeutic needs and goals.
Yogita Shendge- MOTh,LLB
Founder of Your therapist…An advanced mobility care clinic at Tilak Nagar
Chembur, Mumbai
Contact: +91 98207 94435
Dr. Tejashree Dabholkar, MPT.PhD
Associate Professor & Head of department of kinesiotherapy & Physical Diagnosis.
Co-founder AT Advance Physiotherapy clinic and education center. Kharghar Navi Mumbai.
Ex -Associate professor, School of Physiotherapy, D.Y.Patil University, Nerul ,Navi Mumbai.
Ex-Professor, MGM school pf Physiotherapy, Navi Mumbai.
Mobile: +91- 9167047445.
Email: tejashreedabholkar81@gmail.com.
Title of presentation: Analysis of surgical hand.
Abstract: Hand is an essential sensory organ. Surgeons need ne dexterous hand for performing
very skilful surgical procedures. Distal hand function essentially gets affected by various factors
like proximal muscle strength, Biomechanical risk factors, Anthropometric dimensions of wrist
and hand etc. Strength of forearm muscles and contractions are components for wrist stability
and ne hand function. Fatigue due to long term repetitive tasks and handling of surgical tools,
instruments does affect grip strength, pinch strength and hand dexterity. Abnormal ergonomic
considerations affect distal functions. hence it is vital to consider and work on theses parameters
for optimisation of surgical work performance. This presentation aims at highlighting important
aspects related to hand performance pertaining to surgical eld. Research presented in
presentation is unique and targeting surgical specialities.
Faculty Speakers
37
Topic of presentation: Challenges post Hand Transplant-Therapist Perspective.
“Hands mould, create, and mirror the future”- Ms. Dola Saha, Dept. of Health Information Management, MCHP, Manipal

Oral Paper
1. Dr. Chhaya V. Verma PT, PhD
Hospital, Mumbai Central, Mumbai, Maharashtra, India.
Title: Correlation of Implicit Motor Imagery and Hand Function in Adults with
Chronic Shoulder Pain –A Pilot Study
Author: Aditi Parekh (PT)
Instuition:
Professor and Head of Department,Physiotherapy School and Centre, Topiwala
National Medical College and B.Y.L Nair Charitable
Post Graduate Student,
Email address: adi.030297@gmail.com
Methodology:
Contact Details: +91 8082681599
Results:
Aim: To assess the impairments in the implicit motor imagery of the shoulder in
individuals with chronic shoulder pain and correlate it with the gross motor
dexterity of the hand.
A significant difference was found in the accuracy and reaction time of the right
side and the box and block test scores between participants with and without
shoulder pain. A significant difference was also found between the right and left
side of the individuals with pain. A significant weak negative correlation was
found between accuracy and SRQ scores in participants with pain. No
significant correlation was found among the other outcome measures.
Hospital, Mumbai Central, Mumbai, Maharashtra, India.
Physiotherapy School and Centre, Topiwala National Medical College and
B.Y.L Nair Charitable
Chronic musculoskeletal pain conditions lead to the alterations in the cortical
representation of the affected body part in the primary somatosensory cortex.
Graded Motor Imagery (GMI) involves the cortical neural engagement to
activate different motor areas without actually performing any movement. It has
been noted that a smooth functioning of the distal joints in the kinematic chain
requires a good dynamic stabilization at the proximal joint.
We conducted a cross sectional, observational study consisting of 30
participants with chronic shoulder pain and 30 age, gender and dominance
matched participants. The participants were assessed for the laterality
judgement task for the shoulder for the implicit motor imagery assessment
(accuracy and reaction time), box and block test for the gross motor dexterity.
Shoulder Rating Questionnaire (SRQ) was also taken.
2. Aditi Parekh (PT)
Gross Motor Dexterity has been observed to be affected in individuals with
chronic shoulder pain. No correlation was found between the implicit motor
imagery outcomes and hand function.
Background:
Key words: Hand dexterity, Shoulder, Graded Motor Imagery, Laterality Task,
Chronic pain.
Conclusion:
38
“Hands are the most incredible tools we have, when we align them with our creative minds and
empathetic hearts, anything is possible"- Lisa Kozden MOT, OTR/L, CHT, COMTUSA

Title: use of intermittent pneumatic compression along with conventional
therapy in edema of hand in patients with upper extremity injury.
Institution: PG Student: III MOTh (Musculoskeletal Sciences), OT School and
Training Centre, L.T.M. Medical college and General Hospital, Sion, Mumbai,
Maharashtra, India.
Contact details– 9324527518
Author : Harshada Gadekar (OT)
Objective of the study to find out the efficacy of IPC in reduction of edema in
patients with upper extremity injury.
Email address- harshu13gadekar@gmail.com
Study design: Experimental study
In this Experimental study 10 patients were included with edema of hand. Out
of which 5 patients received with IPC (30 min compression of 40 to 120 mm
hg) along with conventional therapy and another 5 patients received only
conventional therapy. Outcome measure like ROM using(goniometer), grip and
pinch strength using (pinchometer and dynamometer), functional dependency
using (Michigan questionnaire) were assessed 3 weeks post intervention .
Conclusion: In this study we observed that IPC is effective adjunctive modality
which can be used along with conventional therapy.
Materials & Methods
Background: Hand is a major organ of expression and function. Edema is
swelling caused by excess fluid trapped in our body's tissues. Hand edema
(swelling) is a common consequence of hand trauma or surgery and it affects
ranges, strength and function of hand. Intermittent pneumatic compression
(IPC) is effective tool for reducing edema.
Results: A significant change was observed in pre and post management ROM -
MCP joint (73±4.8/85±3.5) PIP joint (78±2.9/±4.8) DIP joint (72±2.8/79±4.9),
grip strength (0.3±0.5/3.3±1.5), pinch strength (0.3±0.6/3.3±1.5) , reduction in
edema and also decreased functional dependency on MICHIGAN questionnaire.
Keywords: intermittent pneumatic compression, conventional therapy, edema.
User satisfaction is of considerable importance as an outcome measurement in
evidence-based healthcare and the client-centered approach.
#MOTH(Masters in musculoskeletal conditions) , currently , pvt. Practice
Occupational Therapy Department, Seth GSMC and KEMH
Purpose: To formulate a questionnaire based on available literature for clients
prescribed orthotic devices.
**MOTH (Masters in musculoskeletal conditions), currently, Asst. Prof., SRM
Title: SUEO ( Satisfaction with Upper Extremity Orthosis) – A Pilot Study.
Contact Details: 9987798660
Author: Shilpshree Palsule* , Ashwini Chauhan**, Ankita Shetye#.
Objectives: 1. Formulate a questionnaire evaluating satisfaction and difficulty
with a given hand orthosis and compare this questionnaire with existing
evaluation measures, namely Quebec user evaluation of satisfaction with
assistive technology (QUEST)
Email address: shilpshreepalsule@kem.edu
Institution: *Assistant professor, Department of Occupational therapy, Seth
G.S.M.C & K.E.M.H,Mumbai, India.
Background: Orthosis is as “an externally applied device used to modify the
structural and functional characteristics of the neuromuscular and skeletal
system.
39
“The hand is one of nature's best gift to mankind”- Dr. Shovan Saha, PhD, OT, Manipal, India

Conclusion: Preliminary finding of our pilot study show that the SUEO scale
can be used as a method for evaluation of satisfaction & level of difficulty of
use of upper extremity
College and General Hospital, Sion, Mumbai.
5) Dr Chhaya Verma (PT, PhD) – Professor & Head, Physiotherapy School and
Centre, TNMC & BYL Nair Ch. Hospital, Mumbai Central, Mumbai
orthosis.
Results: The SUEO scale had a good content validity with a CVI of 0.94. The
scale also showed a good internal consistency with cronbachs alpha value above
0.8 for all items on satisfaction domain. Difficulty & satisfaction domains were
negatively correlated with Pearson Correlation value of -.229, however was not
statistically significant with P value of .172. Both the scales, namely SUEO and
Quebec, had a moderate degree of correlation (with the correlation coefficient of
.662 of satisfaction domain and -.445 of difficulty domain) & overall correlation
of both the scale was .439, thus stating that our scale was a valid and reliable
scale for evaluation of satisfaction with upper extremity orthosis.
Title: Evaluation of Functional Outcomes in Primary Repair of Zone V Flexor
Tendon Injury: A Systematic Review.
Contact Details: +91 9920407576/ 8850290653
Methods: A questionnaire SUEO (satisfaction with upper extremity orthosis)
scale was prepared based on existing literature and validated by experts from of
Occupational therapy (OT). Final questionnaire consist of 15 items (8
(satisfaction) +7(difficulty) domain.After ethical permission, 37 participants
above 18 years of age, provided with hand splint for unilateral upper extremity
impairment in OT department were recruited for the study. Patients with nerve
injuries were excluded. SUEO scale with QUEST scale was administered on
above patients. Responses on both scales were compared.
Study design: Cross-sectional study.
Keywords: Occupational therapy, Orthosis, Quebec, Satisfaction, Upper
extremity
Email Address: sonali.manek1996@gmail.com
Ch. Hospital, Mumbai Central, Mumbai.
1) Sonali Manek (PT) – Post Graduate Student, Physiotherapy School and
Centre, TNMC & BYL Nair
Ch. Hospital, Mumbai Central, Mumbai.
Author: Sonali Sunil Manek (PT)
3) Dr Iris Cardoz Lobo – Bonded Assistant Professor, Department of Plastic
Surgery, Lokmanya Tilak
Attempt and establish scoring for the same based on the existing validated scale
(QUEST)
Institution:
2) Krutika Bhosale (PT) – Junior Physiotherapist, Physiotherapy School and
Centre, TNMC & BYL Nair
Municipal Medical College and General Hospital, Sion, Mumbai.
4) Dr Maksud Devale – Professor, Department of Plastic Surgery, Lokmanya
Tilak Municipal Medical
40
“Opportunities and dreams are protected and moulded by our hands”- Ms. Dola Saha, Dept. of
Health Information Management, MCHP, Manipal

41
6)Dr Priyanka Kerketta – Bonded Assistant Professor, Department of Plastic
Surgery, Lokmanya Tilak Municipal Medical College and General Hospital,
Sion, Mumbai.
Flexor Zone V is the compact region extending from proximal row of transverse
carpal ligament till musculotendinous junction in forearm, with arrangement of
tendons, nerves and vessels in a relatively narrow region. Injury in this zone is
also termed as “Spaghetti Wrist”. Extrinsic adhesions and neurovascular injuries
are one of the common complications of zone V Flexor Tendon Injury (FTI).
Trauma to any or all of these structures will cumulatively influence the
Functional Outcome. Therefore, it is crucial to judiciously select appropriate
functional outcome in primary repair of Zone V FTI. Need for this review is
driven by lack of consensus on use of any specific functional outcome measure
available in literature that prove to be most appropriate for Zone V.
Methodology: A protocol is registered prospectively on PROSPERO
(CRD42022329391). Using appropriate search strategy, a total of 3778 articles
were retrieved from four databases (PubMed, ProQuest, Google Scholar,
Cochrane CENTRAL). The databases were searched from inception of database
till June 2022. Studies exclusively on primary repair of Zone V flexor tendon
injury, with clinician rated functional outcome measure and articles in English
and German languages were included in the review. 15 articles, including 1
Randomized Controlled Trial, 3 Observational studies, 11 Case Series are
included. The methodological quality for risk of bias assessment using The
Joanna Brigg Institute Checklist (JBI) and Data extraction was done by 2
independent reviewers, respectively.
1. IIIrd Year MOTh Student Department of Occupational Therapy Seth GSMC
& KEMH,Mumbai.
Results & Observation: A total of 7 evaluation systems were found to be used
in 15 included studies. Kleinert and Verdan's Criteria (13.33%), Total Active
Motion – ASSH (20%), Buck-Gramcko criteria (13.33%) Noaman's Criteria
(20%), Lister's Criteria (6.66%), Strickland/ Adjusted Strickland's Criteria
(20%), Modified Strickland's Criteria (6.66%). Since these evaluation systems
have varied scoring system, comparison of these systems is difficult. However,
it was observed that Noaman's criteria assessed wider aspect of the injury like
tendon function, opposition, intrinsic function, deformity and sensations which
is congruent to the structures injured in Zone V.
2. Assistant Professor at Department of Occupational Therapy Seth GSMC &
KEMH,Mumbai.
Background:
Title: Outcome measures used for assessment and evaluation in adults with
traumatic brachial plexus injury: A Systematic Review.
Authors: Tejal Talankar1 , Shilpshree Palsule2 , Dr Shubham Dakhode3
3. Senior Resident at Department of Orthopedics TNMC & BYL Ch. Nair
Hospital.
Keywords: Zone V, Flexor Tendon Injury, Flexor Tendon Repair, Spaghetti
Wrist, Functional Outcome
Conclusion: Various evaluation systems exist in literature; hence, judicious
choice of outcome should be made in order to get a holistic picture of function
in Zone V flexor tendon repair.
7) Aditi Parekh - Post Graduate Student
“Haste makes waste in hand therapy, scientic the rapeutic exercise progression is the key to
favourable outcome”- JOSE MARY. X (OT), JIPMER, Puducherry, India.

Email Address: tejtalankar@gmail.com
Background: To review the available literature for assessment and
evaluation tools used in assessment of outcomes after traumatic Brachial
plexus (TBPI) injury in adults. Design: Systematic Review.
Methodology: A comprehensive search of the publications available
between 1st January 2012 & 30th August 2022 was reviewed on Medline,
Embase, Pubmed, Cochrane & Google Scholar data base. Specific key
words & their combinations related to TBPI outcomes were used. Results:
We identified 597 citations; 532 texts were excluded & 65 texts were
screened for eligibility. Only full text articles published in the English
language were included. 50 studies including 32 different Outcome
measures were extracted.These included sensorimotor assessments,
functional outcomes, patient reported outcomes, specific evaluations etc.
Medical Research Council grading for assessment of muscle strength was
the commonest assessment measure and was used in 30.6% studies, whereas
DASH score was the most common outcome used for assessment of
functional outcome (28.5%). 18.3% studies mentioned ROM as a outcome
measure but did not clearly state whether ROM was taken actively or
passively. Pain was evaluated by Visual analogue score in most of the
studies. Studies addressing psychosocial domain were limited; the most
common assessment used was SF 36 & these authors had stressed upon
need of psychosocial assessment in TBPI patient. None of the reviewed
papers mentioned the use performance-based assessment measures.
Contact details: 7022132071
Author: LOUIS SUNNY. MOT
Institution: Consultant OT Hand Therapists, St. James Hospital,
Chalakudy, Kerala
Background: Leisure is an important factor which has an influence on
occupational balance. Participation in leisure has a positive impact on
leisure satisfaction which can ultimately impact on the life satisfaction and
over-all quality of life. Hand injury can compromise the leisure
participation.
Conclusion: Methods used for assessments should be stated clearly with
details of instruments and methods used. DASH remains the most
commonly used functional assessment measure, however need of
assessment by brachial plexus specific measures are needed. Evaluations
should also stress on the psychosocial domain in view of the chronicity of
the condition.
Email Address: louissunny715@gmail.com
Keywords: Traumatic Brachial plexus injury, Outcome measures,
Functional Outcome
Aim: The aim of the study is to analyze the correlation between disability
severity and leisure satisfaction in people with hand injury.
Title: Correlation between disability severity and leisure satisfaction in
people with hand injury.
42
"Happy Mind = Happy Hand"- Shubhangi Mandar Lad (OT), LTMMC& GH, Sion,Mumbai

43
Dr. Angayarkanni, Retd. Admin. Ofcer, LIC of India, Tamil Nadu, India .
“Beauty of mind can be known only through the dexterity of hand”- Dr. AGK Sinha, PT, PhD
Statistical analysis:
Conclusion: This study found out the correlation between leisure
satisfaction and disability severity in people with hand injury. The result
concluded that more the disability less the leisure satisfaction level in
individuals with hand injury.
SPSS version- 16 was used for data analysis. Descriptive statistics was used
to summarize participant related factors. Spearman's rank correlation test
was used to correlate the independent and dependent variables, based on the
normality of the data.
Result: The DASH score is strongly negatively correlated with Leisure
Satisfaction Measure which indicates that more the disability less the leisure
satisfaction.
Keywords: Leisure activity, hand injury, hand fracture, disability severity,
leisure satisfaction
Methods: The observational and cross-sectional study include 47
participants with hand injury. Disability of the Arm, Shoulder, and Hand
(DASH) scale and Leisure Satisfaction Measure were used as outcome
measures.

E-Poster
Background:
quadriga of the flexor tendons to his benefit.
Email Address: adi.030297@gmail.com
Title: Multistage management of hand crush injury: Link between Staged surgeries
and Rehabilitation – A Case Report
Background:
He has reported significant improvements in his PSFS, PRWHE and QOL scores. He
is also regaining active movements in the affected muscles.
Keywords: Median Nerve, Quadriga, Deca Durabolin, Vicarious Movements,
Rehabilitation
Contact Details: +917303695726
Conclusion: In chronic cases, adaptations to use trick movements in benefit of
required movement will improve the patients' functions.
Email Address: drdivyarangwani@gmail.com
before surgery reported Right sensory-motor median neuropathy above the elbow
(severe axon degeneration). Weakness was demonstrated in the FDS ad FDP of index
finger, FPL, 1st lumbrical and pronator quadratus. Tinel's sign was present just distal
to the scar. He was assessed for various outcome measures at baseline and fixed
intervals. Patient Specific Functional scale (PSFS), Patient Rated Wrist/Hand
Evaluation (PRWHE) and Quality of Life (QOL) scale was taken. He was treated
with various approaches involving muscle activations, IG stimulation, PNF
techniques, GMI etc. Post 8 months he was prescribed 3 doses of deca durabolin IM
injections in view of his persistent impairments. Along with this he was trained to use
the rebound phenomenon and
Title: Vicarious Movements: Bane or Boon in a traumatic Median nerve injury? - A
Case Report.
Author: Aditi Parekh (PT)
Institution: Physiotherapy School and Centre, Topiwala National Medical College
and B.Y.L Nair Charitable Hospital, Mumbai Central, Mumbai, Maharashtra, India
The Median nerve is commonly injured by trauma, iatrogenic, sling and dressing.
Sometimes symptoms of median nerve injury mimic the ligamentous injury of the
finger, hence injury to median nerve or its branches is clinically a challenging task.
This becomes even more challenging when a primary repair has not been done.
Material /Method:
A 25/M graduate, aspiring for further education was operated for repair of the median
nerve (8cm defect) with sural nerve cable graft. He presented to the physiotherapy
department 3 weeks post operatively, with complaints of lack of sensation in the right
median nerve distribution, inability to move the thumb, grip objects, make a fist and
write. He also complained inability to perform his BADLs such as eating and
bathing. Adhered Scar was observed around the elbow on the medial aspect. EMG
conducted
Results:
Author: Divya Atmaram Rangwani (PT)
Institution: Junior Physiotherapist, Physiotherapy School and Centre, Topiwala
National Medical College and BYL Nair Charitable Hospital, Mumbai Central,
Mumbai – 400008
Crush injuries to the hand are catastrophic, with substandard end-results. These
injuries cause damage to the multiple tissues due to rise in tissue pressure
44
"Four Aces of Hand therapy are Adequate splintage, Appropriate mobilisation , Augment
activity, and Achieve functional independence ."- Anuradha Pai , A. Professor,(OT), LTMMC& GH, Sion

Immediate debridement of non-viable tissues, revascularization of middle and ring
finger and fracture fixation with K-wire was done. After 3weeks split-thickness skin
grafting was performed. After removal of K-wire, i.e., 6weeks, patient was referred for
physiotherapy. Mobilization of metacarpophalangeal (MCP) and interphalangeal (IP)
joints and stretching of intrinsic flexors of the hand was done to prevent contractures.
Unstable Fracture of phalanx was again stabilised by plating, after 2 weeks. (8weeks
post-injury). After 2weeks of plating patient was re-referred for physiotherapy, which
included Maitland Mobilization to reduce pain and improve range of motion, Bunnell
block exercises for strengthening flexors and extensors of hand and Scar mobilization.
Patient was evaluated at regular intervals every month.
Result: Substantial improvement has been noted in ranges of MCP and IP joints, pain
and grip strength. The total active motion (TAM) has improved for all fingers.
Disability of Arm Shoulder and Hand (DASH) scores showed regression in disability
from 35% to 16.7% (lower the better). On Patient Specific Functional Scale (PSFS)
patient had difficulty in gripping and holding smaller objects, which has improved from
3.6 to 6.1(more the better). The patient has been vocationally rehabilitated.
Conclusion: An imbalance between finger flexion-extension force impairs hand
function. IP joint stiffness significantly reduces grip strength. For optimum recovery of
the hand, normalizing the relationship between finger flexor and extensor forces is
important.
Author: Sonal Amrut Vichare (PT)
Keywords: Crush injury, Joint stiffness, Hand Rehabilitation, Return to Work, Total
Active Motion baseline and fixed intervals. Patient Specific Functional scale (PSFS),
Patient Rated Wrist/Hand Evaluation (PRWHE) and Quality of Life (QOL) scale was
taken. He was treated with various approaches involving muscle activations, IG
stimulation, PNF techniques, GMI etc. Post 8 months he was prescribed 3 doses of deca
durabolin IM injections in view of his persistent impairments. Along with this he was
trained to use the rebound phenomenon and quadriga of the flexor tendons to his
benefit.
Institution: Junior Physiotherapist, Physiotherapy School and Centre, Topiwala
National Medical College and B.Y.L Nair Charitable Hospital, Mumbai, Maharashtra,
India
Email Address: sonalrk_11@yahoo.co.in
Background: The successful outcome of tendon injuries can be attributed to surgical
management & adherence to rehabilitation protocol. Extensor tendon injuries have
made advancements with advent of early mobilization post-surgical repair, resulting in
better functional outcomes.
Material/Methods: Our case series describes outcomes of 3 different scenarios.
1: 30/M labourer sustained accidental trauma by ply-cutter in zone 4 of non-dominant
hand. Index & middle finger involvement with amputation of middle phalanx of index
finger was managed with primary repair of EDC.
Material/Method: A 21-year-old boy, right-hand dominant, sustained a left-hand work-
related crush injury. There was loss of dorsal and volar skin, an exposed fracture of
middle phalanx 4th finger, injury to digital vessels and lacerated tendons. A multi-
staged reconstruction in conjunction was done with hand rehabilitation.
Title: Know-how of post-operative rehabilitation of extensor tendon injury repair: a
case series
hairline fracture of 5th MC. Delayed primary repair of ECRL, ECRB, EI, EDC of all 4
digits & EDM was done.
2: 25/M garage supervisor met with road traffic accident & injured zone 6 of dominant
hand along with
45
“The best tool of creation- our hands”- Sandhya Khatri (OT), Vadodara

of motion.
Title: Multidisciplinary Approach to Complications Post Flexor Tendon Repair in Zone
V: A Case Report
Results:
Contact Details: +91 9920407576/ 8850290653
Early controlled mobilization protocol was incorporated in addition to dynamic
splintage. Mobilization of digits within the splint was done under supervision. Range of
motion was stepped up gradually & splint was taken off after 5-6 weeks. Stretching &
strengthening for finger flexors & extensors were commenced at 6-8 weeks. Pre and Post
outcome assessment was done.
Email Address: sonali.manek1996@gmail.com
Key words: Extensor tendon injury, Dargan's criteria, early controlled mobilization,
Rehabilitation, Range
Multicomponent injuries on the forearm can lead to varying levels of disability and pose
a challenge to Plastic & Microvascular Surgeon and Hand Rehabilitation Team.
Advancements in newer and stronger techniques pave ways for early mobilization post
repair of tendons and nerves. This in-turn will prevent common complications
like adhesion formation and rupture of primarily repaired structures, which tend to pose a
great challenge in long run.
Background:
3: 35/M small scale businessman had accidental trauma in zone 7 of dominant hand.
Distal 1/3rd of shaft of radius was fractured with injury to radial artery & sensory branch
of radial nerve. Primary repair of ECRL, ECRB, APL & EPB was performed with repair
of radial artery & radial nerve. First 2 patients reported within 3 weeks whereas third
patient reported 2 months post-op.
Author: Sonali Sunil Manek (PT)
Institution: Post Graduate Student, Physiotherapy School and Centre, Topiwala National
Medical College and B.Y.L Nair Charitable Hospital, Mumbai Central, Mumbai - 400008
Total active motion of affected digits & quantitative evaluation of grip strength, patient
rated wrist & hand evaluation (PRWHE) & patient specific functional scale (PSFS) have
shown good functional outcome. Assessment of progress at regular intervals done by
Dargan's criteria has been found to be good. All 3 patients were rehabilitated vocationally
for return to work.
Conclusion: Early holistic rehabilitation approach can prove to be beneficial in terms of
functional outcomes and early return to work in patients with Extensor Tendon Repair
nerve course in the hand, difficulty in ADLs. Due to prolonged immobilization and delay
in early rehabilitation, patient presented, with severe extrinsic adhesion formation
leading to restricted finger mobility and no recovery in ulnar nerve 4 months post
primary surgery. Informed Consent was taken from the Patient. Patient underwent
vigorous physiotherapy regime for 6 months. With satisfactory results she underwent
secondary exploration and tenolysis of the adhered tendons. Intraoperatively a gap of 5.2
cm in the ulnar nerve was managed with sensory sural nerve cable graft. Vigorous
Presenting a case of 17/F, right-handed dominant, with an accidental glass cut injury to
right forearm involving Ulnar Nerve and Tendons (2nd,3rd,4th,5th FDS*,
2nd,3rd,4th,5th FDP*, FCU*), for which primary repair was performed. Patient came
with complaints of inability to straighten her fingers, reduced sensation along the ulnar
Material/Methods:
46
“Connecting hands for quality lives”- Shashikant Chandanshive, Assistant professor (OT), TNMC and BYL Nair hospital.

factors to compliance to hand therapy.
reported are stated. Few research papers related to the topic were found. Some
Results and Conclusion: Patient was assessed Pre-Operatively and Post Operatively at
fixed Intervals. Multidisciplinary approach has benefited our patient with significant
improvement 8 weeks Post-Operatively in Range of Motion (ROM), Assisted –
Unassisted angle at PIP (Bouviers maneuver), Patient Specific Functional
scale (PSFS) (1.6→6.6) **, Patient Rated Wrist/Hand Evaluation (PRWHE) (53→39)
***, Sensory Recovery (50% →60%).
occupations. Both physical and occupational therapists perform an important role in
and patient based may affect the therapy needs of the patient. In a country like India,
awareness, training opportunities and support from various institutions including
Occupation in Hand therapy.
Keywords: Flexor Tendon Injury, Deca- Durabolin, Nerve Repair, Outcomes,
Rehabilitation, *FDS – Flexor Digitorum Superficialis, FDP – Flexor Digitorum
Profundus, FCU – Flexor Carpi Ulnaris.
Result & Observation: Challenges identified were therapist and patient factors, which
included factors such as addressing barriers through research and education,
Conclusion: Various factors, both therapist and patient related contribute to
Keywords: Challenges, hand therapy, resources, barriers, perceptions stretching.
Email Address: vrushalijadhav52@gmail.com
meaningful occupations, teamwork, spreading awareness and bridging the gap
between patient's expectations and therapeutic outcome were concerns identified.
Conclusion: We conclude that multidisciplinary approach to tackle complications post
flexor tendon repair can prove to be beneficial in terms of functional outcomes.
Authors: Vrushali Jadhav1, Shilpshree Palsule2
Poor socio- economic conditions, non-availability of therapists and resources, lack of
***Less Score = Better OutcomeRepair
Title: Challenges in Hand Therapy - A Narrative review
rehabilitation was started 4 weeks post-immobilization, which included serial splinting,
stretching exercises, scar tissue mobilization, interrupted galvanic current for intrinsic
muscles, Ultrasound for the scar tissue. To enhance the recovery, patient received 3 doses
of deca-durabolin 25 mg intramuscularly at an interval of 15 days.
1.MOTH student,2. Assistant Professor.
Institution: Department of Occupational Therapy, SETH GSMC and KEMH
Background: Hand injuries impact an individual's ability to perform daily
rehabilitation of the patients reporting with hand injuries. Many factors, both therapist
** High Score = Better Outcome
awareness, restricted budgets available in the health care sector may be contributing
Methods: Published papers related to the research topic were identified and issues
topics covered were the experience of Being a Hand therapist, Benefits of use of
restricted resources and lack of standardized outcome measures is reported. Use of
Use of a top-down approach was also suggested in management of these injuries.
Patient factors included failure to identify their participation goals, return to work,
rehabilitation concerns in patients needing hand therapy should be holistically
evaluated. The opinions noted from hand therapists highlighted the importance of
roles from being a breadwinner to a dependent were also stated.
government and work in unity after coming together for the growth of hand therapy
Psychosocial implications of hand injuries were highlighted. Shift in occupational
as a specialty. Patient and occupational therapist experiences of that approach, and
the impact of that approach compared to other approaches to hand therapy.
47
“Hand therapist making surgeon's hand work best”- Ms Grainne Bourke, Consultant in Hand and Plastic Surgery, UK

Author: Tejal Talankar
Title: Occupational Therapy Intervention in Total Elbow Arthroplasty: A case report
Institution: 3rd Year MOTh Student Department of Occupational Therapy Seth GSMC
&KEMH, Mumbai.
Email Address: tejtalankar@gmail.com
Background:
Comminuted distal humerus fractures especially in elderly which cannot be managed by
fixation can be well managed by total elbow arthroplasty. Functional outcomes in such
cases mainly depend on post-surgical rehabilitation. Occupational therapy intervention
can help to achieve good outcomes.
Materials & Methods: Case study. Follow up for 6 months.
Case Report:
We report a case of a 65-year male, Right hand dominant, retired service man, who had a
history of RTA in February 2022. The clinical and radiological examination showed a
comminuted intra-articular left distal humerus fracture, AO type 13-C3 with ulnar nerve
palsy. Patient was subsequently planned for total elbow replacement, and a
semiconstrained type of linked implant was used.Occupational therapy intervention was
started immediately after surgery. Patient was examined and assessed on the basis of
Occupational Therapy Performance Framework 4 (OTPF 4) &Patient rated elbow
evaluation (PREE), Modified Barthel Index, Mayo Elbow Performance
Occupational therapy interventions can help in making patients independent in ADL's
with help of exercise, splinting, functional activities, physical agent modalities, providing
modifications & adaptations wherever needed and providing care for one's psychosocial
well-being. All these areas are very important in holistic treatment and help an individual
to achieve his pre-injury status.
A custom-tailored program was specifically designed for the patient with taking
consideration of geriatric problems. Patient education regarding do's and don'ts after
TEA, elbow exercises, functional activities, splinting, ADL retraining, lifestyle
modification, family education, stress management was included in this program. Patient
was assessed every month for 6 months on above mentioned outcomes.
Score and Visual Analogue Scale (VAS).
Conclusion:
There was significant improvement in elbow ranges [Elbow flexion 0°-135°, supination
& pronation 0°-80°]. Also, there was a remarkable reduction in pain on VAS Score.
Modified Barthel Index showed a score of 100/100 by the end of 6th month. MAYO
score showed significant improvement [85/100] by 3rd month which was persistent by
the end of 6th month. PREE scores reduced from 61.6 to 32.8 by the end of 6th month
[lower scores are associated with better functional outcome].
After 6 months of occupational therapy intervention, the patient is now independent in all
his basic ADL's like self-care, leisure activity as well as most of his instrumental ADL's
like taking care of grandchildren, riding non geared bike for shorter distances in non-
crowded areas etc.
Keywords: Total Elbow Replacement, Occupational Therapy, Rehabilitation.
Results:
48
“Hand is a classical presentation of team work and unity in diversity”- Yogita Shengde, MOTh, Mumbai, India

Keywords: Spasticity, ADL, PROMIS, and Duruoz Hand Index
Conclusion: A rational approach is therefore based on a clear understanding of the
pathophysiology of spasticity and the localization of injuries that cause it. A multi-
disciplinary team is valuable to form an individualized treatment protocol for each
patient.
Background: A compressive force, acts on blood in the vasculature and causes
Objective: The objective of the study is to assess the effect of traction splint and OT
BACKGROUND: Traumatic brain injury is a common cause of disability worldwide.
Six year old TBI case came with upper limb spasticity specifically wrist and fingers,
difficulty in doing ADL and severe pain in the hand.
Result: PROMIS questionnaires and Duruoz Hand Index both improved for the patient.
PROMIS Upper extremity function (fine motor, ADL) score improved from 19 to 40.
Physical function improved from 12 to 20. Anxiety, Depression, Fatigue decreased from
12 to 5, 15 to 4 and 13 to 5 respectively. Ability to participate in social roles and
activities improved from 4 to 20. Pain assessed using NAS marked 10 and recorded as
preoperative whereas 0 post surgery. Duruoz Hand Index improved from a preoperative
value of 77(out of 90) to 2 postoperative.
Institution: PG Student: III MOTh (Musculoskeletal Sciences), OT School and Training
Centre, L.T.M.Medical college and General Hospital, Sion, Mumbai, Maharashtra,India.
Email Address: drishanichiniwar@gmail.com
Outcome Measures: PROMIS and Duruoz Hand Index
PROMIS and Duruoz Hand Index value measured before the surgery and recorded as Pre
value. Selective Ulnar Neurectomy Surgery was performed to address spasticity and
post-surgical rehabilitation (Physiotherapy and Occupational Therapy) performed for 10
months and re-assessed in tenth month with PROMIS and Duruoz Hand Index value and
recorded as post value.
OBJECTIVE: To evaluate the effectiveness of Selective Ulnar Neurectomy and post
Rehabilitation on Spasticity and ADL.
injury using traction splint (sugarcane)- A case series.
Methodology:
injuries of the hand sustained from sugarcane juice extracting machines.
damage to multiple tissue, bones, blood vessels, nerves, and soft tissues in crush
Author: Ishani B. Chiniwar (OT)
Email Address: shafeeqpp1995@icloud.com
Design: Case Study
Contact Details : +91-8424852020
Title: Occupational Therapy (OT) Management in patient with sugarcane machine
Mohammed Shafeeq1 , Dr. Ajeesh Sankaran2, Fazal Gafoor3
Institution:
Title: Effectiveness of selective ulnar neurectomy and post rehabilitation on spasticity
and ADL – a case study
1.Consulting Physiotherapist, Department of Physical Medicine Rehabilitation
2.Consultant hand and microvascular surgeon
Department of Microvascular Surgery and Rehabilitation
3.Consulting Physiotherapist
Department of Microvascular Surgery and Rehabilitation,
KIMS Al-Shifa Super Speciality Hospital, Perinthalmanna, Kerala
49
“Our Hands holds our future”- Ms. Dola Saha, Dept. of Health Information Management, MCHP, Manipal

weeks in OT department post K-wire removal. Outcome measures included Range of
4th week: Interchanging of traction forces in vertical and horizontal directions for 2
management in patients with sugarcane machine injury.
Study Design: Experimental study, Case series.
machine with skin lacerations and phalangeal fractures were followed up for six
motion (Goniometer), grip & pinch strength (Dynamometer & Pinchometer),
Material & Methods: Three patients with crush injury due to sugarcane juicing
composite flexion (measuring tape). Functional outcome measure was assessed
using Patient Rated Wrist/Hand Evaluation (PRWHE) questionnaire. Six weeks
program of OT management included application of static progressive traction splint
nail bed for exerting tension on joints and soft tissues. The tension of rubber bands in
(sugarcane) on volar aspect. Splint has rubber bands which are attached to patient's
splint was equal for all fingers. In 1st and 2nd week: Rubber bands are applied to
fingers in extended position so that traction force is in vertical direction. In 3rd and
hours along with passive stretch exercises. In 5th and 6th week: Hinge is removed
Results: The significant change was observed pre and post OT management in ROM (37
± 21.11/66 ± 21.11), Grip strength (5 ± 5.03/12 ± 5.03), Pinch strength (4.3 ± 6.8/8.3 ±
6.8) & composite flexion (3.8 ±1.5/1.6 ±1.5), also patient showed decreased functional
disability and pain on PRWHE questionnaire.
Keywords: Functional disability, Passive stretch, Sugarcane machine injury, Traction
splint
Author: Jose Mary Sangeetha. X
Email Address: getotrehab@gmail.com
Background: Complex regional pain syndrome (CRPS) is a complex and difficult
condition not only to diagnosis but also to treat. As CRPS onset is likely influenced by
alterations in the brain's somatosensory region, a rehabilitation intervention, Graded
Motor Imagery (GMI), aims to restore cortical representation, including sensory and
motor function, of the affected limb. This case study design used a 4-week graded motor
imagery program used as an adjunct in Occupational Therapy for Type 1 CRPS of upper
limb, applying the concepts of International Classification of Functioning, Disability &
Health (ICF).
Purpose: The purposes of this case report are (i) to use graded motor imagery program
as an adjunct in Occupational Therapy for Type 1 CRPS, (ii) to document ICF level
changes after 4 weeks of GMI program.
Case Description: The patient is a 52-year-old female with Type 1 CRPS (Stage 1)
following Right Distal Radius Fracture. The report describes the integration of the ICF
and documentation into the patient's evaluation, prognosis and intervention while she
participated Graded Motor Imagery Program. Measures were chosen to document
changes at different levels of ICF including Visual Analogue Scale, Quick Dash,
Michigan Hand Questionnaire, Grip & Pinch Strength, Canadian Occupational
Performance Measure & Barthel Index.
Conclusion: Traction splint and OT management was found effective in patients with
sugarcane machine injury.
Title: “ICF level changes in a patient with type 1CRPS after graded motor imagery
intervention– a case report”
Institution: Occupational Therapy Section, PMR Department, PMRC Block, JIPMER
Hospital, Dhanvantri Nagar, Puducherry - 605006, India.
and adding flexion outriggers for maintaining MP's in maximum flexion.
50
“What the hand doesn't know the brain can not know”- Dr Maksud Devale Professor, Plastic surgery, LTMMC & GH, Mumbai

Result & Observation: ICF level changes in the patient's overall functioning status at
the beginning of the program and her improvements in functioning following
intervention and the goal achievement were documented. Potential implications of
implementing Graded Motor Imagery in Type 1 CRPS also addressed.
Outcomes: Changes were documented in self- care, hand function and grip strength and
increased independence along with marked reduction in pain.
Keywords: ICF, Type 1 CRPS, Graded Motor Imagery
Mohammed Shafeeq, Ajeesh Sankaran, Fazal Gafoor
Email Address: shafeeqpp1995@icloud.com
Results: Results showed that Chronaxie and Rheobase curve significantly lowered after
immediate mobilization.
Objective: To find out immediate effect on neural mobilization in upper limb nerves on
Chronaxie and Rheobase.
Conclusion: Chronaxie and Rheobase can be used as an alternative to check the nerve
excitability. So, study also concludes that neural mobilization significantly alters the
nerve excitability.
Methodology: A 19 year old healthy adult was recruited for the study. SD curve was
plotted; Chronaxie & Rheobase was calculated for each nerve i.e., Median, Radial and
Ulnar Nerves before and after the mobilization.
Keywords: Chronaxie, Rheobase, Neural Mobilization
Title: Immediate effect of neural mobilization on nerve excitability in a normal subject -
a case study
1.Consulting Physiotherapist, Department of Physical Medicine Rehabilitation
Background: Neural mobilization has shown to increase the nerve conduction velocity
and has an effect on H reflex. H reflex measures the nerve excitability which can also be
measured by Chronaxie and Rheobase. They are easy to administer and less painful.
Institution:
51
“A healing hand touches the body, calms the mind and heals the Spirit”- Dr Ajit Dabholkar, MPT, PhD, Dr. D.Y. Patil University, Nerul , Navi Mumbai

Mini Movie
Department Of Physical Medicine Rehabilitation
Author: Harshada Gadekar
A working hand is one of the most important features for independence in an
individual's life. The loss of hand function results in a severe compromise of
the ability to feed and care for oneself, and limits one's participation in work,
social and family life. The film depicts the journey of recovery of an
individual traumatic hand injury through occupational therapy in becoming a
functional individual of the society. occupational therapy addressing client-
centered and Occupation based approaches which invigorate individual to
participate in meaningful functional activities and return back to work
Author: Fazal Gafoor1 BPT1, Dr. Ajeesh Sankaran2, Mohammed Shafeeq
3BPT, MPT, Sahal Abdurahman 4BPT.
Email Address: fazalgfr@gmail.com
Title: Occupational therapy: healing hands
Institution: Occupational therapy department, LTMMC & GH Sion, Mumbai
Keywords: Flexor Tendon Rehabilitation, Wide Awake Hand Surgery,
Tendon repair
Contact Details– 9324527518
Email Address- harshu13gadekar@gmail.com
Title: Use of early active mobilization with Dorsal short splint for zone II
flexor repair rehabilitation.
Flexor tendon injuries continue to be common, yet complex, injuries
managed by hand therapists. The flexor tendon mechanism plays a key role in
the functionality of the hand and zone II injuries have been associated with
disabling restriction of motion.Rehabilitation following flexor tendon repair is
still an active topic for debate. Regimens have evolved from passive motion
protocols to active extension with passive flexion and then to early active
motion. Early active motion is being recognized for providing greater
excursion and is often employed with controlled joint isolation for better
results. We are at present using an early active protocol for flexor repair
rehabilitation, combined with early conversion to a short dorsal splint and
rapid institution of passive extension exercises. This regimen has allowed the
faster achievement of full flexion along with minimizing joint
contractures.This mini movie aims to present our current treatment practice
for a zone II flexor tendon injury from surgery to complete return to ADL
activities.
52
“Hand in hand - restoring handling abilities”- Ms. Dola Saha, Dept. of Health Information Management, MCHP, Manipal

Essay
“Explore the potential of Hand Therapy to the fullest”
Author: Ishani B. Chiniwar
Institution: PG Student: III MOTh (Musculoskeletal Sciences), OT School and
Training
Centre, L.T.M.Medical college and General Hospital, Sion, Mumbai, Maharashtra,
India.
Contact Details: +91-8424852020
Email Address: drishanichiniwar@gmail.com
'Hands build or destroy, compliment or insult, heal or even hurt'. The hand is an
amazing, complex part of the human body, essential for all of our daily activities like
self-care, work, and Instrumental activities of daily living. From writing with a pen,
typing on a computer, or turning a screwdriver, our hands are important tools in our
daily lives. From an infant's need to satisfy his need to mouthing objects with hands to
an old person walking with a cane, hands are important tools in our lives. Musicians,
sportsmen, doctors, writers, artists, and all active people cherish their hands. Repetitive
stress, trauma, accidents, congenital defects, or syndromes may lead to dysfunction of
the hands and here arises the need for the most important approach of 'Hand therapy'
Hand therapy is the art and science of rehabilitation of the upper extremity that is
Shoulder girdle, elbow, wrist and hand. It offers effective, client centered services that
enable people to engage in occupations of life. It focuses on rehabilitation of the hand
and upper limbs and is a merging of occupational therapy and physical therapy theory
and practice. It is provided by the entire rehabilitation team which includes physicians,
surgeons, Occupational therapists, physiotherapists, prosthetics, orthotics,
psychologists and medical social workers. According to history, India has been a
pioneer in the field of hand therapy. Dr Paul Brand worked with leprosy patients and
this work led to the development of hand surgery and hand therapy, but this was 50
years back.
Hand therapists work in Industrial rehabilitation and educate the employees and
employers regarding the prevention of accidents at the workplace and cumulative
trauma disorders, they advise protective techniques and suggest adaptive devices for
computer operators like ergonomic keyboards, ergonomic mouse like Logitech
trackman marble trackball, USB optical finger mouse, legtrack trackball and desk
accessory wrist rice bag.
Hand therapy has extended to Rural areas through Tele-rehabilitation, home
visits, and awareness programs to inform them regarding the injuries and their
disabilities and how to overcome them with the use of splints and adaptive devices.
Also, a few online websites and social media like Facebook, Instagram, and WhatsApp
help patients from rural areas to solve queries, update their functional status and discuss
further planning regarding their occupational performances. Therapists publish journals
and magazines to provide hand rehabilitation information to other professionals at rural
hospitals. Handouts in simple languages are given to patients to understand the
importance of hand therapy. Web conferences and online seminars that have helped to
discuss various cases with medical professionals not only in India but we have shared
and exchanged our knowledge with other professionals staying abroad. Thus, Hand
therapy has outstretched from Rural to Overseas.
Hand therapy also focuses on vocational rehabilitation and functional abilities for an
individual and aims at functional capacity evaluations, work conditioning and work
hardening programs that help patients regain their independence in activities. Driving
53
“ThemorehandsIholdthemoreIinvokethestrengthinmine”-DrTwinkleDabholkar,MPT,PhD,Professor&HeadDepartmentofMusculoskeletalPhysiotherapy

Hand therapy brings together techniques of occupational therapy like scar
management, retraining, splinting, advice on activities of daily living preventing
stiffness, and help to get back to work, sports, or hobbies. Various hand function tests
like the Purdue pegboard manual dexterity test and the Jebson Taylor hand function
test are used for assessment. The rehabilitation team works together in a well-
organized therapeutic program and a collaborative learning environment. Therapists
set SMART goals that meet the expectations of patients and their caregivers as it is
essential to deliver effective and good quality care in our community. Thus, hand
therapy plays an important role in community rehabilitation as well.
strengthening and mobilizing exercises with advice on joint protection improves hand
function and grip strength. In Autism, a kid experiences handwriting issues which are
improved by proximal muscle strengthening exercises given by the therapists. In
NICU, infants with cortical thumb, a cortical thumb splint is given and Obstetric
brachial plexus injury (OBPI), a orfit moulded aeroplane splint is given for
positioning. In breast cancer patient's, post-mastectomy, hand therapy includes
lymphoedema management. Thus hand therapy not only plays a major role in
orthopaedic conditions but also in neurological, paediatric, child psychiatry, NICU,
and cancer patients.
Hand therapy can improve the quality of life for children with Congenital
Hand Anomalies like Congenital constriction ring syndrome, Brachydactyly,
Camptodactyly, Clinodactyly, Mirror hand, Constriction ring, etc. For the Geriatric
population, therapy includes energy conservation techniques, adaptive devices (build-
up handles, jar openers, long scrubber, dispensers. Etc) task and work simplification
techniques, caregiver education, and facilitating performance in basic ADL and IADL.
Thus, hand therapy has its roots in the Congenital to Geriatric population.
We also have an official website that will contain information about hand therapy and
upcoming meetings, its progress, and current details, and also an e-newsletter that
helps to increase awareness among other professionals. Thus, hosting the conferences
and discussing research studies, case series, innovative devices, posters, street play
Etc. helps in improving the quality of care of patients.
In the era of Hand transplants advances in immunosuppressive drugs for
transplantation have now allowed for non-life-threatening types of transplants to be
performed including hand transplants. News from Hindustan times dated 12th August
2022, A young man from Madhya Pradesh underwent a hand transplant, which became
the first public-run institution to carry out the procedure. Following the 14-hour-long
Splints have enhanced hand rehabilitation, so various certification courses and
workshops on learning splints and their advances are organized by AIOTA (All India
Occupational Therapists' Association). Orfit moulded figure of '8' splint for median and
ulnar nerve palsies maintain the functional position of the hand. Adjunct techniques
like Kinesiotaping, myofascial release, TENS, etc. have magnified the importance of
hand rehabilitation. Inventions in Prosthetic and robotic hands have flourished hand
therapy to a greater extent. Innovations like MusicGlove (sensorized glove) which is
used to make functional gripping movements to play a customized version of the open-
source music game also, the SaeboFlex a dynamic custom fabricated wrist, hand, and
finger orthosis that allows stroke survivors the ability to incorporate the involved hand
functionally. Thus, advances from splinting to robotics, and hand therapy have
achieved the greatest potential.
Increased training opportunities for the professionals, certification and professional
guidelines have improved patient care and professional standards. So for continuing
the exchange of ideas and maintaining the quality of hand rehabilitation, 'knowledge
exchange programs' between different institutes have taken place.
54
“Working hand in hand, to make the hand work”- Ms. Malavika Saha, Vth BOT Student, MCHP, Manipal

Not only effective and creative therapy should be taken care of. But most
importantly the right “dosage” of a particular individualized therapy program is more
important. Scientific Therapeutic Exercise Progressions (STEP) developed by The Ola
Grimsby Institute, which is a concept of dosing exercises according to the specific
pathological condition and tissue tolerance of each client.
The core moto of hand therapy is bring back the function of hands as far as
possible like prior to injury/ disorder. After the initial evaluation, the therapist will note
down the baseline function of the client and then sets realistic goals and schedules
therapy session with graded protocol for that particular problem. Timeline is another
vital factor which has to set on. All the above-mentioned things will help reach the
desired occupational function.
Through years hand therapy has grown, re-shaped, modified, updated and made
known itself as vital for any client with upper extremity impairment. Therefore, therapist
working in this field should have a sound clinical and therapeutic knowledge of hand
therapy and should update themselves with the latest developments. Through research,
book reviews, journal meet, case studies and discussions, knowledge sharing and
upgrading can be done in order to explore the potential of hand therapy to the fullest.
Hand is a man's best friend. It is visible, potent and vulnerable to various injuries
and disorders. Hand therapy is an advanced area of practice within Occupational
Therapy which requires therapists to have a wide knowledge base of upper extremities
conditions and effective intervention methods to assist clients in occupational
performance. It is the responsibility of the therapist to restore hand functions, re-engage
the patient in his routine life and occupation.
Email Address: getotrehab@gmail.com
Along with the therapy visits, a detailed home program is also usually scheduled with
some set of exercises, dos and don'ts to carry out at home. Patients are directed to keep
up with the hand therapy, as skipping session would result in deterioration of functions
gained. Also, making it harder to move forward with successive therapy. Recovery
depends on sticking on to the therapy schedule with consistent effort by the client. Lack
of which might prolong recovery. Hand therapy focuses in improvement of range of
motion, muscle strength, edema/ scar, management, hastening tissue healing, pain
reduction, provision of appropriate splints and adaptive devices all together leading to
client's independence in in activities of daily living and effective performance in
occupation and
As quoted by Mc Evan, “the more you know about something in detail the less you
know about it in general”. This implies well in hand therapy. Good clinical reasoning
skills are required in order for therapists to move beyond therapy protocol, to think
critically about their client's needs and to provide safe and creative treatment. Therapists
should enable themselves to treat their clients as people with unique needs and to apply
appropriate and effective therapy.
surgery of the hand transplant procedure, intensive hand therapy was given to regain
hand and arm function.
In this way, right from hand surgeries and repairs to Hand transplants, hand therapy has
come a long way and is helping in improving the quality of life of patients with hand
injuries.
will flourish more, as the sky's the limit…………
Hand therapy has grown as a banyan tree from a seed, and hand therapy
Explore the Potential of Hand therapy to the Fullest
Author: Jose Mary Sangeetha. X
Institution: Occupational Therapy Section, PMR Department, PMRC Block, JIPMER
Hospital, Dhanvantri Nagar, Puducherry - 605006, India.
55
“Hands are the best means to greet the almighty and everyone with Namaste or Namaskar posture”
Vivek kulkarni (PT), Sancheti College of Physiotherapy, Pune, India

To summarize, by providing a holistic therapeutic management for upper extremity
dysfunction using the most appropriate and best recent evidences, according to the needs
of a client in order to make him or her participate in all life roles and occupational
performances effectively is to explore the potential of hand therapy to the fullest.
Impairments in hand often impact on activities of daily living, person's ability to
participate in occupation and societal roles. ICF frameworks considers these issues in
context. Consideration of the target level whether an impairment, activity or
participation issue, ensures that hand therapy meets the current status and needs of the
individual. This use of bio-psychosocial approach in hand therapy is key to achieving
person-centered management. Therefore, when it comes to exploration of hand therapy
to the fullest, all the latest advancements in therapeutic methods, treatment options, and
latest technological inventions needs to be incorporated accordingly. Also, the latest
professional frameworks have to be considered and used then and there as appropriate in
order to address a wider perspective of the individual client's needs and necessities.
Also, the International Classification of Functioning, Disability & Health known
more commonly as ICF, a WHO framework for description of health and health related
status can be considered to be incorporated in hand therapy. There are specific Core-sets
for Hand Conditions in ICF. In hand therapy, ICF offers a model for consideration of
multiple impairments, relating them to guide domains that guide assessment, goal
setting and treatment planning and also in re – evaluation.
leisure. Tissue specific exercise progressions are used in hand rehab. Years before
bottom up approach was used, but nowadays many therapists prefer using top down
approach, but anyways it highly depends on the expert decision of the therapist based on
the individual client's needs and the therapists discernment.
Recently the fourth edition of Occupational Therapy Practice Framework (OTPF-4)
has been published which serves to describe the common core of the profession. It
provides a structure or base on which to build a system or concept. This framework can
also be incorporated in the hand rehabilitation by occupational therapists thereby
exploring the hand therapy to the fullest in addressing client's values, beliefs,
occupational performances and environmental and personal factors.
Moreover, Evidence based practice is the current best trend which would help to
explore the full potential of hand rehabilitation. It can be used to review, analyse, and
translate the latest scientific evidence. The goal is to quickly incorporate the best
available research, along with clinical experience and client preference, into clinical
practice.
Evidence based practice in hand therapy can be considered as the corner stone in
which the best therapeutic method can be selected accordingly to fulfil the needs of the
client. By this the hand therapist can be up to date giving the right and best of treatment
option available to address a particular functional problem. Selection of appropriate
outcome measure is essential to form a baseline of functional potential of a client. By
which, it helps to address the impact of the hand therapy, the range of improvement and
to evaluate the success of therapy.
57
56
“Accurate assessment, timely treatment and right rehabilitation form pillars of complete functional recovery for the HAND to be back in action”-
Dr Anjali Puntambekar MPT, PhD, SIA College of Health Sciences, College of Physiotherapy, Dombivli.

Award Winners
SHTICON 2022 Best Essay
Jawaharlal Nehru Institute of Post Graduate Medical Education & Research (JIPMER),
Puducherry. India
Tittle: Explore the potential of Hand therapy to the fullest
Jose Mary Sangeetha. X
Ishani Chiniwar
SHTICON 2022 Best E-poster
PG student, OT School & centre, Lokmanya Municipal Medical College, Sion Mumbai,
India
Tittle: Occupational therapy (OT) management in patient with sugarcane machine
injury using traction splint - a case series
Fazal Gafoor
SHTICON 2022 Best Mini Movie
KIMS AL -Shifa Super speciality hospital Perinthalmann, Kerala, India
Tittle: Use of Early Active mobilization with Dorsal short splint for zone II exor repair
rehabilitation
SHTICON 2022 Best Oral Paper Award
Physiotherapy School and Centre, Topiwala National Medical College and BYL Nair
Charitable Hospital. Mumbai, India
Title : Evaluation of Functional Outcomes in Primary Repair of Zone V Flexor Tendon
Injury: A Systematic Review.
Sonali Sunil Manek
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57
“Hand Therapy is giving a helping hand, to a struggling hand, to move itself to function”
Jose Mary, Occupational Therapist, JIPMER, Puducherry, India.

GALLERY
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Pre-Conference Preparation
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Preparation in Full Swing

ISSHCON 2022 INAUGURAL
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SPLINT WORKSHOP
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LEARNING HANDS-ON
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Key Note Address
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SHTICON 2022 INAUGURAL
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FACULTY SPEAKERS
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PRESENTERS
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SHTICON 2022 & ISSHCON 2022 Conference e-Souvenir

SHTICON 2022 & ISSHCON 2022 Conference e-Souvenir

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SHTICON 2022 & ISSHCON 2022 Conference e-Souvenir