Assessment of the CMC Joint and Proprioception Interventions

presented by Kristin Valdes, OTD, OT, CHT

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Financial: Kristin Valdes receives compensation from MedBridge for this course. There is no financial interest beyond the production of this course.

Nonfinancial: Kristin Valdes has no competing nonfinancial interests or relationships with regard to the content presented in this course.

Satisfactory completion requirements: All disciplines must complete learning assessments to be awarded credit, no minimum score required unless otherwise specified within the course.

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Video Runtime: 47 Minutes; Learning Assessment Time: 31 Minutes

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, OTD, OT, CHT

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. Valdes has published articles…

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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.

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