Joint protection program for the upper limb
- Maureen R Gecht-Silver, OTD, MPH, OTR/L
Maureen R Gecht-Silver, OTD, MPH, OTR/L
- Assistant Professor of Clinical Family Medicine
- Clinical Assistant Professor of Occupational Therapy
- University of Illinois at Chicago
Joint protection should be introduced to every patient with a chronic rheumatologic disorder in order to prevent recurrent sprains and strains which can add to inflammation and degeneration . Conservative care includes preventive care, and joint protection is a fundamental way to provide preventive joint care.
Joint protection for the upper limb is reviewed here. An overview of joint protection and the application of the principles of joint protection to the neck and lower limb are presented separately. (See "Overview of joint protection" and "Joint protection program for the neck" and "Joint protection program for the lower limb".)
PRINCIPLES OF JOINT PROTECTION
These principles are derived from the simple, practical application of proper body mechanics, posture, and positioning of joints. Joint protection reduces local joint stress and preserves joint integrity. Joint protection is achieved through patient education, self-management, and problem-solving to promote behavior modification; energy conservation; exercise; and selective use of splints, adaptive devices, and modalities. Guiding patients to perform tasks in a manner that reduces stress on joints is generally preferred to prohibiting the task. (See "Overview of joint protection".)
Principles of joint protection include:
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- PRINCIPLES OF JOINT PROTECTION
- IDENTIFYING AGGRAVATING FACTORS
- General questions
- Questions regarding specific regions
- GUIDELINES FOR UPPER LIMB PROTECTION
- Elbow and forearm
- Hand and wrist
- EFFICACY OF JOINT PROTECTION AND EXERCISE
- Upper limb exercise
- Hand and wrist interventions
- - Tool design for minimum force
- - Hand splinting
- - Joint protection education
- Rheumatoid arthritis
- Ergonomic interventions
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS