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Invited Review: All hands on deck: The multidisciplinary rehabilitation assessment and management of hand function in persons with NM disorders
Invited Review: All hands on deck: The multidisciplinary rehabilitation assessment and management of hand function in persons with NM disorders
FREE MEMBER CME!

Abstract

Hand function is important in every aspect of our lives. Across a wide range of neuromuscular disorders—inherited ataxias, motor neuron diseases, polyneuropathies, and myopathies—people can experience losses in hand strength, tone, movement, dexterity, joint range, and sensation. Such changes can adversely affect function and independence in daily activities, reducing participation and quality of life. People with neuromuscular disorders (pwNMD) known to involve the hand should be assessed at regular intervals for changes both clinically and using impairment, performance, function, and patient-reported outcome measures as appropriate. A patient-centered approach to management is recommended, with clinicians partnering with the individual, their caregivers and the interprofessional teams to create personalized solutions, that can overcome barriers to participation and best meet the goals of individuals affected by neuromuscular disorders. Management strategies should be multifaceted, and may include exercise, orthoses, assistive devices, technological solutions, environmental or task adaptations, medications, and/or surgery. Exercise recommendations and orthoses should be individualized and evolve based on disease progression, impairments, and functional limitations. While medications and surgery have a small role for specific clinical situations, there is a plethora of assistive and technological solutions to assist with basic and instrumental activities of daily living, work/education, and leisure for pwNMD with reduced hand function. In addition, clinicians should advocate for appropriate accommodations for reduced hand function at work/school, and the development of and adherence to legislation supporting accessibility and inclusion.

Objectives: The objectives of this activity are to: 1) Be able to properly integrate exercise into a hand rehabilitation program; 2) Be able to properly integrate orthoses and other assistive devices into a hand rehabilitation program; 3) Be able to properly integrate equipment and instruction to facilitate the use of technology into a hand rehabilitation program.


ACCREDITATION STATEMENT
The AANEM is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.


CREDIT DESIGNATION
The AANEM is accredited by the American Council for Continuing Medical Education (ACCME) to providing continuing education for physicians. AANEM designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

DISCLOSURE INFORMATION
The authors had no financial conflicts of interest.


FORMAT
PDF
Authors
Colleen O'Connell MD, FRCPC; Meiqi Guo MD, FRCPC; Béatrice Soucy MD, FRCPC; Marla Calder BScOT; Jeff Sparks CPHR; Stephanie Plamondon MD, FRCPC.
Summary
Availability: On-Demand
Expires on Jun 06, 2027
Cost: Member: $0.00
Non-Member: $25.00
Credit Offered:
1 CME Credit
1 CEU Credit


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