In October, the AnyHand was tested in the practice of hand therapist Beate Jung and her team in Munich. In our interview, she discusses the importance of patient education and the possible applications of AnyHand .
The AnyHand in the field test First of all, a question about your choice of profession: Why are you a hand therapist?
When I took my exam as an occupational therapist in 1992, hand therapy was just being established in Germany. In the USA, hand therapy had already been a separate discipline within occupational and physiotherapy since 1977, which was my orientation in the first years. I have always found hands exciting because they are highly specialised and incredibly versatile. We all need our hands to be able to cope with our everyday lives. The range of people affected is enormous, all age groups are represented with a wide variety of diagnoses; illnesses as well as injuries. The professions range from construction worker to pianist to surgeon, but sports injuries and childhood hand dysfunctions also play a major role. For further specialisation, I took the exam in 2012 to become a certified hand therapist according to the guidelines of the German Working Group for Hand Therapy(DAHTH ).
How do you feel about working with the patients?
I attach great importance to intensive and individual cooperation with the patients. Thebetter the information, the more I as a hand therapist involve the person and explain to them which structures are affected and what measures we can take, the more I motivate people because they realise: they can actively contribute to improvement themselves. I think it is very important that the patients know the exact diagnosis and the problem of their hand. I am of the opinion: "The patient must become an expert for his or her hand". The more the patient knows about the dysfunction and the hand therapy techniques that can improve it, the more adequately they can cooperate. That's why I think it's important not to say: "I'll be moved for half an hour and then I'll go home again.
How did the contact with LIME come about?
Pascal got in touch with me at the DAHTH therapy congresses and visited my practice several times to discuss the requirements such a device has to fulfil in terms of functionality and handling. It quickly became clear: the operation must be as simple and intuitive as possible and require little time. Through the early involvement of experienced hand therapists, the device was constantly further developed by the committed team according to the therapy needs.
What was your impression of the test position?
The AnyHand met almost all requirements in the practical test : A hand template helps to read off the size of the hand and to adjust the device correctly. The lateral guidance of each individual finger is anatomically favourable, the pivot point is close to the joint and thus the load on the respective joint is very low. In the case of a rotational malposition of a finger or after an amputation, individual fingers can be left out of the adjustment. The AnyHand was tested by patients with different diagnoses and from different age groups. The unanimous feedback was that the device was easy to handle and that they could well imagine using it at home. In a conversation with a patient, Pascal and I also found out that the movement plane of the thumb in external rotation could be a useful extension in the future.
What applications do you see for the AnyHand?
I can imagine AnyHand as a very good addition and extension to therapy. It is important that the hand therapist carries out an exact needs analysis, taking into account temporary arthrodesis or healing phases of the affected structures, e.g. after osteosynthesis.[1] [2] [3]
In my practice, I often experience that some patients are unsure at the beginning of the therapy how far they can exercise their affected fingers. Therefore, it is extremely important that the therapists adjust the AnyHand exactly and try this out together with the patients. This makes it easier for the patients to relax their hands, because they know that the movement of the device ends exactly where the range of motion was previously set.
Could the AnyHand also be used for warming up before and after manual therapy?
Before therapy, I always carry out a visual examination: Especially in the morning after getting up, the hand is still stiff and less mobile than it was perhaps the day before. Therefore, I would use the AnyHand especially if a higher degree of mobility has already been achieved with manual therapy and this new degree of movement should then be trained further.
Would you recommend independent use of the device at home to maintain range of motion?
Yes, but only in combination with the therapy in the practice or to secure the result after completion of the therapy. Therapy in the practice must be carried out at least once or twice a week. The hand therapists can always vary the individual treatment and adapt the range of motion to the respective condition. The setting of the AnyHand can then be adapted accordingly. One thing is certain: Those who train at home also ensure the success of the treatment between therapy sessions and thus prevent relapses.
What role does the documentation of therapy progress play for you?
We use standardised measuring devices, for example the dynamometer for hand strength or the goniometer for joint angle measurement. In this way, we not only document treatment progress, we also set measurable therapy goals. This is very motivating for the patients: they see the success and can better assess where they are on the road to recovery and what road still lies ahead of them. The documentation of the measurement data from AnyHand would be an optimal addition.
The person
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Beate Jung completed her training as a certified occupational therapist at the state vocational school in Munich in 1992. She is a founding member of the German Association for Hand Therapy (DAHTH), which she chaired for two years. In 1999 she took up a "Handtherapy Fellowship" in Houston, Texas, and subsequently completed internships in Sacramento and San Francisco.
She was able to expand the contacts she made there during her work as an international delegate of the DAHTH and thus win renowned speakers for the international congress of the IFSHT/DAHTH 2019 in Berlin, among other things. Beate Jung is a specialist book author and speaker at national and international congresses. Eight years ago, she founded her own practice in Munich, which specialises in hand therapy. As a lecturer for the DAHTH, it is her concern to promote education and training in hand therapy.
1] Temporary surgical fixation of a joint, e.g. by Kirchner wire.
2] Surgical joining of a broken bone, e.g. by means of screws or plates.
[3] Surgical release of tendon adhesions to restore tendon gliding.
