Certificate Program
Neurologic Hand Therapy
Enhance your skills with evaluation and treatment of the neurologically involved upper extremity!
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About this Certificate Program
Predicting outcomes, developing appropriate goals, and providing treatment strategies to address hand and upper extremity impairment following neurologic insult are critical for rehabilitation professionals working in a variety of clinical environments. This program is tailored to provide therapists with techniques to evaluate and predict recovery in the acute stage, as well as evidence-supported treatment techniques to address minimal to severe impairment for optimizing hand and upper extremity function. The Neurologic Hand Therapy Certificate prepares therapists to evaluate and treat neurologically involved upper extremity clients who present with a variety of clinical presentations. Therapists who successfully complete this 13-course program will enhance their clinical decision-making and improve the quality of care to optimize clinical outcomes.
Target audience
Therapists (OTs, COTAs, PTs, PTAs) practicing in an acute, rehabilitation, or outpatient environment who see patients with neurologic involvement in the upper extremity. For Certified Hand Therapists (CHTs), the combination of courses for this certificate qualifies for recertification through the Hand Therapy Certification Commission (HTCC) under Category A: formal courses in upper quarter therapy, greater than 3 hours in length.
Goals & objectives
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Apply evidence-based prediction models to estimate recovery and formulate appropriate upper extremity rehabilitation goals.
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Describe the clinical presentation of mild, moderate, and severe neurological involvement in the upper extremity and develop appropriate treatment plans to address each.
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Define neuroplasticity and learned nonuse and how these play an important role in creating appropriate treatment strategies for the patient with a neurologically involved upper extremity.
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Explain the nature of spasticity and its impact on movement, functional recovery, and the development of secondary impairments.
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Describe the basic principles of motor learning and repetitive, task-specific training and how they apply to patients with a wide range of impairments.
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Explain the rationale and components of modified constraint induced therapy.
What’s included in the Certificate Program
Accredited Online Courses*
19 hours of online video lectures and patient demonstrations.
Case Study Interviews
Recorded Q&A sessions between instructors and practice managers.
Interactive Learning Assessments
Case-based quizzes to evaluate and improve clinical reasoning.
Certificate Program overview
Section 1
Evaluation and Outcome Prediction Post-Stroke 3 ItemsPredicting Recovery and Setting Appropriate Upper Extremity Goals Post-Stroke Course
Chapter 1: Underlying Challenges in Upper Extremity Recovery Post-Stroke
This chapter will present the anatomical, biomechanical and patient-centered challenges that therapists are faced with when setting goals and designing rehabilitation interventions for the upper extremity.
Chapter 2: Using Evidence-Based Prediction Models to Tailor Upper Extremity Rehabilitation Goals
This chapter will present an evidence-based algorithm therapists can use to predict upper extremity recovery, establish an appropriate treatment plan and set appropriate goals. The algorithm will be applied to case examples along the recovery continuum.
Chapter 3: Using Evidence-Based Prediction Models to Drive Upper Extremity Intervention
This chapter will introduce an algorithm that can be used to design appropriate interventions for patients across the recovery continuum. Examples of intervention options will be provided.
Understanding Recovery and Evolution of Impairments in the Arm and Hand Course
Chapter 1: Recovery after a Stroke or Brain Injury
This chapter will cover the process of neurological and functional recovery for persons who have acquired brain injury or stroke and their implications on the rehabilitation process. Dr. Bondoc will also explain the nature of spasticity and its impact on movement, functional recovery, and the development of secondary impairments.
Chapter 2: Spasticity and Movement Impairment
This chapter will review neurophysiology of the motor unit and discuss the definition of spasticity and its impact on movement and posture of the arm and hand.
Chapter 3: Sensory Impairments
In this chapter Salvador Bondoc will review the somatosensory system and sub-modalities of somatosensation and describe pain and sensory impairments associated with the neurological UE following brain injury.
Evaluation and Outcome Assessment in the Neurological Upper Extremity Course
Chapter 1: Using the ICF Model and a Systems Approach to Assess the Neurological UE
This chapter will provide an overview of the ICF Model while integrating the ICF Model with a systems approach to assess the neurological upper extremity.
Chapter 2: Tests and Measures
This chapter will continue the review of the ICF Model while demonstrating and explaining the use of certain physical tests and measures specific to the neurologic upper extremity.
Chapter 3: Patterns of Neurological Upper Extremity
Using assessment findings from a demonstration, this chapter will help the viewer recognize different patterns of the neurologic upper extremity and describe corresponding approaches to treatment.
Section 2
Treatment for the Minimally Involved Upper Extremity 2 ItemsNeurologic Upper Extremity Part 1: Assessment and Treatment of the Minimally Impaired UE Course
Chapter 1: Neuroplasticity
This chapter describes neuroplasticity, including basic physiologic mechanisms of cortical reorganization post-stroke. It will cover use-dependent plasticity, learned non-use, and their impact on UE function post-stroke.
Chapter 2: Treatment: Repetitive, Task-Specific Training
This chapter describes P.R.A.C.T.I.C.E. Principles and generally how they can be integrated into clinical therapies.
Chapter 3: Treatment: Adjunctive Strategies
This chapter covers transcranial direct current stimulation. Rationale for tDCS use in UE motor function will be briefly described, as well as tDCS mechanisms for anodal versus cathodal approach.
Evidence-Based Interventions for Mild-Moderate Impairments in the Neurological Upper Extremity Course
Chapter 1: Clinical Presentation
This chapter describes the clinical presentation of the neurological upper extremity classified as having mild tomoderate neuromotor impairments.
Chapter 2: Constraint-Induced Therapy and Task-Oriented Therapy
This chapter identifies various impairment-focused and function-based interventions appropriate for the mild to moderately impaired upper extremity and describes the indications and scientific and theoretical bases for specific interventions.
Chapter 3: Augmenting Task Practice Through Orthotics
This chapter describes the use of orthotics as a way to circumvent or support specific hand limitations to enable improved performance and increase engagement in task-oriented training.
Chapter 4: Bilateral Strategies
This chapter provides a description of the different levels of bilateral hand use and describes specific tasks for each level of bilateral functioning as a critical element of task-oriented training.
Section 3
Treatment for the Severely Involved Upper Extremity 4 ItemsUpper Extremity Strategies Along the Post-Stroke Recovery Continuum Course
Chapter 1: Care and Intervention for the Flaccid Upper Extremity
Participants will be presented with treatment approaches for the post-stroke upper extremity with little to no movement. Risk factors for shoulder pain will be discussed as well as appropriate range of motion and positioning techniques for this population.
Chapter 2: Intervention Strategies for the Not Yet Functional Upper Extremity
This chapter will present treatment approaches for the post-stroke upper extremity that presents with proximal movement, but which the patient considers “non-functional” secondary to lack of distal control.
Chapter 3: Designing Task-Oriented Functional Task Practice
This chapter will present treatment approaches for the post-stroke upper extremity that has regained movement but remains slow and poorly coordinated in daily living skills. Keys to developing skill in these patients, as well as the development of an independent practice program, will be presented.
Neurologic Upper Extremity Part 2: Adjunctive Treatment Strategies for Moderate to Severe Impairment Course
Chapter 1: Intro and Principles
This chapter will define neuroplasticity and learned non-use. It will describe the importance of neuroplasticity and reptitive, task-specific training to neurologic UE treatment.
Chapter 2: Electrical Stimulation (E-stim)
This chapter will cover the different kinds of electrical stimulation. The rationale and components of electrical stimulation in neurorehabilitation will be described.
Chapter 3: UE Robotics and Myoelectric Technology
This chapter explains the rationale and components of portable upper extremity robotics. The rationale and benefits of the Myomo myoelectric brace will be discussed.
Evidence-Based Interventions for Severe Impairments in the Neurological Upper Extremity Course
Chapter 1: Clinical Presentations
This chapter will describe the clinical presentation from the flaccid/ “non-assistive” upper extremity to emerging motor control.
Chapter 2: Interventions at Motor Recovery Levels One and Two
This chapter will identify various impairment-focused and function-based interventions appropriate for the flaccid/non-assistive upper extremity while discussing the indications and scientific and theoretical bases for specific interventions.
Chapter 3: Interventions at Motor Recovery Level Three
This chapter will identify and incorporate evidence-based strategies to address the painful and subluxed shoulder, with a particular view of interventions at motor recovery Level Three.
The Hemiplegic Shoulder: Pain & Subluxation Course
Chapter 1: Assessment of the Hemplegic Shoulder
This chapter discusses the mechanics of impairment in the hemiplegic shoulder and reviews of the healthy shoulder anatomy and pathomechanics associated with hemiplegia.
Chapter 2: Special Treatment Considerations
This chapter identifies and incorporates evidence-based strategies to address the painful and subluxed shoulder.
Section 4
Additional interventions 7 ItemsUsing Neuroplasticity Principles to Guide Therapeutic Intervention Post-Stroke Course
Chapter 1: Designing Interventions to Improve and Not Lose Motor Ability Post-Stroke
This chapter will provide an operational definition of neuroplasticity and present the principles of “Use it or Lose It,” “Use it and Improve It,” and “Specificity.” These will be presented using examples from animal and human research with clinical examples on their implementation for patients post-stroke.
Chapter 2: Right Practice: Repetition Without Repetition
This chapter will present the principles of repetition and intensity using evidence from clinical trials. Examples from trials that can be translated into clinical practice will be provided.
Chapter 3: Considerations of Age, Time, and Salience in Goal-Setting
This chapter will discuss the role patient-specific factors, such as age and time post-stroke play in recovery. Clinical interventions that may interfere with neuroplasticity will also be discussed.
Noninvasive Brain Stimulation in Neurologic Diagnoses Course
Chapter 1: Overview of Brain Stimulation Techniques
This chapter provides an overview of neuroplasticity, learned non-use, basic mechanisms of TMS, and how TMS is used for assessment and treatment. There is a brief introduction to tDCS and how to differentiate between tDCS and TMS.
Chapter 2: tDCS Mechanisms and Safety
This chapter summarizes the physiological basis for tDCS, including interhemispheric imbalance, long-term potentiation, and long-term depression. Mechanisms for both anodal and cathodal stimulation techniques are described, as well as the established tDCS safety guidelines.
Chapter 3: Evidence for tDCS
This chapter covers tDCS evidence and use in various diagnoses, including neurodegenerative diseases, spinal cord injury, and stroke. tDCS evidence and use in post-stroke upper and lower extremity motor function is also discussed.
Chapter 4: How to Use tDCS
This chapter covers the supplies needed to administer tDCS, including electrodes, electrode sponges, and machine. A demonstration shows the electrode placement for both anodal and cathodal stimulation, as well as usage of the tDCS device.
The EXCITE Stroke Trial: Comparing Early and Delayed Constraint-Induced Movement Therapy File
Infusing Motor Learning Research into Neurorehabilitation Practice: A Historical Perspective with Case Exemplar from the Accelerated Skill Acquisition Program File
Effect of a Task-Oriented Rehabilitation Program on Upper Extremity Recovery Following Motor Stroke: The ICARE Randomized Clinical Trial File
Mental Practice: Applying Motor PRACTICE and Neuroplasticity Principles to Increase Upper Extremity Function File
Post-Test Quiz
Instructors
Dorian Rose
PT, PhD
Salvador Bondoc
OTD, OTR/L, BCPR, CHT, FAOTA
Heather T. Peters
PhD (cand.), MOT, OTR/L
CEU approved
19
total hours*
of accredited coursework.
Medbridge accredits each course individually so you can earn CEUs as you progress.
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Browse PlansFrequently asked questions
Everything you need to know about Certificate Programs.
Accreditation Hours
Each course is individually accredited and exact hours will vary by state and discipline. Check each course for specific accreditation for your license.
When do I get my certificate?
You will receive accredited certificates of completion for each course as you complete them. Once you have completed the entire Certificate Program you will receive your certificate for the program.
Do I get CEU credit?
Each course is individually accredited. Please check each course for your state and discipline. You can receive CEU credit after each course is completed.
Do I have to complete the courses in order?
It is not required that you complete the courses in order. Each Certificate Program's content is built to be completed sequentially but it is not forced to be completed this way.
How long do I have access to the Certificate Program?
You will have access to this Certificate Program for as long as you are a subscriber. Your initial subscription will last for one year from the date you purchase.
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