Assessment of the CMC Joint and Proprioception Interventions
Presented by Kristin Valdes
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It can be difficult to keep up with the latest evidence for the conservative management of carpometacarpal osteoarthritis (CMC OA) because new evidence is constantly being generated. Some assessments that are used in clinical practice in the evaluation of the CMC joint are not reliable. The most reliable assessments for determining range of motion, strength, and joint position can include errors. There are new provocative tests that can rule out or rule in the presence of CMC OA. This course outlines the evidence that can guide best practice regarding the assessment of the CMC joint and proprioception limitations. Evidence regarding a specific program of proprioception interventions for the thumb will be described and demonstrated. This course is designed for the advanced hand therapist.
Meet your instructor
Kristin Valdes
Kristin Valdes was previously the owner of Hand Works Therapy in Sarasota, Florida, and was in private practice for more than 30 years. Currently, she is a full professor at Touro University in Henderson, Nevada. Her clinical expertise includes treatment of the hand, wrist, elbow, and shoulder; splinting; and arthritis. Dr.…
Chapters & learning objectives
1. Evidence for Assessment of the CMC Joint
The provocative tests that are the most reliable to determine the presence of carpometacarpal osteoarthritis will be demonstrated. Reliable measures for addressing thumb ROM limitations will be addressed. The joint position sense assessment technique will be demonstrated to determine the presence of proprioception deficits.
2. Proprioception Deficits of the CMC Joint
The patient demonstration of neuromuscular deficits will be discussed to enable the therapist to understand the functional consequences of impaired sensorimotor control. The important role of the thumb muscles and ligaments will be reviewed to ensure the therapist can implement a treatment plan that takes into consideration the biomechanics of the thumb.
3. Proprioception Interventions
An evidence-based proprioception exercise protocol that consists of three phases will be provided, with specific exercises provided for each phase. The three-phase active program consists of position reproduction, force sense, and activities of daily living. The evidence regarding the effects of proprioception training on pain will be shared.
