Hand therapist Anna-Lena Avenius treating a patient The last article in our series of expert interviews on the use of AnyHand in hand therapy practices . Since the CE certification in May, we have been able to carry out seven tests - fortunately before the second Corona wave currently prevents further product tests. Anna-Lena Avenius , a physiotherapist specialising in hand therapy, reports on the first patient applications, indications and cooperation between doctors and therapists.
A few weeks ago, a test setting with the AnyHand also took place in your hand therapy practice. What was your impression?
I was really looking forward to the appointment! During the development period, I was always able to follow the next steps piecemeal. The idea of a hand therapy robot was already very exciting, but the fact that it actually works in practice is impressive! With Pascal on site, the patients had the opportunity to speak directly with one of the AnyHand heads. They were really enthusiastic and also afterwards they received very positive feedback. Many asked, "So, do you have this in your practice now?" What else is on the market has never convinced me as a therapist, but your AnyHand is the implementation of what was previously developed as an ideal concept. I had also called in a patient with an amputation injury because I wanted to see the AnyHand especially for such complex injuries. And lo and behold, it worked perfectly! With this patient it would make particular sense to warm up his hand with the AnyHand and then work more intensively in hands-on therapy.
During the test placement in Anna-Lena Avenius' practice, a patient with an amputation injury also tested the AnyHand. Do you generally see the AnyHand being used as a warm-up before physiotherapy?
In physiotherapy we usually only have 20 minutes per session. If patients are moved through 10 minutes of AnyHand beforehand, I can use my 20 minutes much more effectively. This is very beneficial for the patients.
For which hand injuries did you use the AnyHand on this test day?
There was a wide spectrum: amputation and crush injuries, replantations, extensor tendon injuries.[1]
For which other indications can you imagine the AnyHand?
Since the AnyHand can be adjusted so individually, it is actually suitable for all injuries as soon as the wound conditions allow. However, it is also possible to leave out individual fingers that are not yet stable. The AnyHand thus makes it possible to decide very individually whether and how far each individual finger is moved.
Are there indications that particularly require continuous movement?
Tendon injuries are the most important of these. The sutured tendon is a sensitive structure that cannot be loaded again immediately. However, lack of movement often leads to the problem that the healing tendon sticks to the surrounding tissue. In such cases, the stuck tendon often has to be released surgically. This is called tenolysis. Patients who have undergone this type of surgery are encouraged to move their finger to move their finger all day. The AnyHand would be an excellent tool for this. Besides the passive movement, the assistive movement is a good therapy element, where the patients have to help with their own strength.
On your website you talk about the importance of working closely with hand surgeons. How can one imagine the communication with the doctors in everyday life?
I worked in a clinic for many years: there it was very easy to get in touch with the doctors. Consultation with the doctor is important for us therapists. If issues arise during a treatment series that can only be clarified with the doctor, we talk on the phone together. Hand surgery is like a big family because it is a niche in which people know each other. This makes for very good cooperation. All sides want to get the best possible results for the patients and that is only possible as a team.
We see it the same way! That is why LIME is working to build an integrated ecosystem that connects all actors in hand therapy. Your practice is physiotherapy. However, most hand therapy practices are classified as occupational therapy. What is the difference?
Whether physio or ergo, one takes an additional hand therapy training. One then imagines under the term "hand therapist" that one can completely care for hand injuries. So far, however, no prescription for hand therapy can be issued. Not yet - we wish we could. So either physiotherapy or occupational therapy is prescribed. Both professions have their specialities here. Let's take a craftsman with a hand injury as an example. With me as a physiotherapist, we work on the range of motion of his fingers, for example. In occupational therapy, he learns how to work with tools and how to turn a screw in the wall, despite the fact that his movement may be restricted. Occupational therapy is also responsible if he needs aids for this.
So the patient always goes through physiotherapy and occupational therapy?
This is decided by the attending doctors. Sometimes a patient can visit both professions, but by far not always. Occupational injuries generally receive more therapy, so this is more possible. Of course, it also depends on the complexity of the injury. In the case of a severe cut involving tendons, nerves, vessels and bones, both occupational groups are more often involved.
You were able to follow the development of AnyHand a little bit. How do you see the future of AnyHand?
I hope that AnyHand becomes well established, that many practices and clinics decide to use it and take this step. Because I believe it is an excellent way to support hand therapy. This way, hand-injured people can achieve even better results even faster. I was very happy to be able to accompany the whole development to some extent. As a therapist, you are inundated with advertising, but most things are not feasible or not applicable to all patients. That's why I have to say: you have succeeded in creating something outstanding that works fantastically and I am 100% convinced of AnyHand.
The person
Anna-Lena Avenius passed her exam to become a physiotherapist at the BG Unfallklinik Ludwigshafen in 2009. As the trauma clinic has a hand surgery department, she came into contact with hand therapy during her training. The accurate coordination of the fine structures of the hand fascinated her from the beginning. After completing her training, she worked in a practice for two years, but then came back to the clinic. In 2013, she completed her bachelor's degree in health management. She took over a practice specialising in hand therapy in 2017 and finally left the accident clinic last year to focus on her practice in Hockenheim. There, the successes of her patients motivate her: Special moments of happiness arise when everyday activities become possible again after a hand injury. Since 2016, she has been a hand therapist according to the guidelines of the German Association for Hand Therapy (DAHTH). She is also a member of the board and coordinates the specialist committee for further training.
Physiotherapist and hand therapist Anna-Lena Avenius © Physiotherapie Avenius [1] Surgical attachment of a finger previously amputated in an accident.
