Hand therapist Anna-Lena Avenius training with a patient at her parctice.
© Physioavenius

The final part of our series of expert interviews on AnyHand’s application in hand therapy practices. Since the CE certification in May, we carried out seven product trials - fortunately before the second corona wave currently prevents further appointments. Anna-Lena Avenius, physiotherapist with a focus on hand therapy, talks about the first treatments with AnyHand, possible indications and the cooperation between the medical and therapeutic side.

A few weeks ago, you tested AnyHand in your hand therapy practice. What was your impression?

I was really excited about the appointment! During the development time I always got an insight about the current status. The idea of a hand therapy robot was already very interesting, but the practical realization is impressive! As Pascal was present during the product trial, the patients had one of the AnyHand’s developers to directly ask questions. They were quite enthusiastic and gave very positive feedback. Many asked me afterwards: “So, do you have this in your practice now?" Other hand therapy devices available on the market have never convinced me, but AnyHand is the implementation of what was previously meant to be an ideal concept. I had also called in a patient with an amputation injury because I wanted to see AnyHand especially for such complex injuries. And lo and behold: it worked perfectly! It would make sense for this particular patient to warm up his hand with AnyHand and then work more intensively in hands-on therapy.

A patient with finger amputations trained with AnyHand during the product trial.

Do you generally see AnyHand as a warm-up device before physiotherapy?

Physiotherapy sessions in Germany usually only last 20 minutes. If the patient has already been moved with AnyHand for 10 minutes before starting the actual session, I can use these 20 minutes much more effectively. This is very beneficial for the patients.

For which hand injuries did you use AnyHand during the product trial?

There was a wide range of injuries: amputation and crush injuries, replantations, extensor tendon injuries. Replantation is a very complex matter, because all structures from soft tissue to tendons, vessels, nerves and bones are affected. 

What other indications could AnyHand be used for?

Since AnyHand can be adjusted so individually, it is actually suitable for all injuries as soon as the wound conditions allow it. However, it is also possible to leave out individual fingers that are not stable yet. AnyHand thus allows to determine very individually whether and how far each individual finger is being moved.

Are there any indications that particularly require continuous movement?

Tendon injuries are the most common. The sutured tendon is a sensitive structure that shouldn’t put at any risk. However, lack of movement often results in the following problem: the healing tendon sticks to the surrounding tissue. In such a case, the stuck tendon often must be surgically loosened. This operation is called tenolysis. Patients after such an operation are encouraged to move their finger all day long if possible. AnyHand would be an excellent tool for this. In addition to the passive movement, the assistive set-up is a good therapeutic element: Patients use their own strength to move their fingers and are supported by AnyHand. 

On your website you mention the importance of close cooperation with hand surgeons. How is the everyday communication with the doctors like?

I worked in a clinic for many years: there it was very easy to get in touch with the doctors. It is important for us therapists to consult with the doctors. If issues arise during a treatment series that can only be clarified with the doctor, we just call him or her. Hand surgery is like a big family, because it is a niche where you know each other. This creates a very good cooperation. All sides want to achieve the best possible result for the patient and that can only be achieved as a team.

We totally agree! That is why LIME is working on building an integrated ecosystem in which all actors in hand therapy are connected with each other. Your practice works physiotherapeutically. Most hand therapy practices, however, can be classified as occupational therapy. What is the difference?

Whether physio- or occupational therapist, you take an additional training in hand therapy. Under the term "hand therapist", one then imagines to be able to provide complete care for hand injured people. However, there is no prescription for hand therapy so far. Not yet - we would appreciate that. So, either physiotherapy or occupational therapy is prescribed. Both professional groups have their specialities here. Let us take a craftsman with a hand injury as an example. As a physiotherapist, I work on the range of motion of his fingers. In occupational therapy, he learns how to work with tools again, even though his movement may still be restricted. Occupational therapy is also responsible for him if he needs any aids for his everyday life.

So, does the patient always undergo physiotherapy and occupational therapy?

That is up to the doctors treating the patient. Sometimes a patient can visit both professions, but by no means always. Occupational accidents generally receive more therapy, so that is more likely to happen. Of course, it also depends on the injury’s complexity. In the case of a severe cut injury involving tendons, nerves, vessels, and bones, both professions are involved.

You had some insight into AnyHand’s development. How do you see its future?

I hope that many practices and clinics will decide to take this step to apply AnyHand. I believe it is an excellent opportunity to support hand therapy. Patients can achieve even better results even faster. I was very pleased to be able to accompany the whole development to a certain extent. As a therapist, you are inundated with advertising, but most devices are not feasible or not applicable to all patients. That is why I have to underline: You have succeeded in doing something excellent, which works fantastically. I am 100% convinced of AnyHand.

About Anna-Lena

Anna-Lena Avenius passed her exams as physiotherapist at the BG Unfallklinik Ludwigshafen in 2009. As the 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 right from the start. After completing the training, she worked in a practice for two years, but then returned to the clinic. In 2013 she completed her Bachelor's degree in health management. Then, in 2017, she took over a practice with a focus on hand therapy and finally left the clinic last year to concentrate on her practice in Hockenheim. It is there that the success of her patients motivates her: There are special moments of happiness when everyday activities become possible again after a hand injury. Since 2016 she became a hand therapist according to the guidelines of the German Association for Hand Therapy (DAHTH). She is a board member in the association and coordinates the expert committee for further education.  

Hand therapist Anna-Lena Avenius © Physioavenius