AHTA News - Issue 107

Issue 107 Apr - Jun In this issue… Clinical Pearls

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Making the most of the AHTA National Conference

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Volunteering with Interplast

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AHTA PO Box 84 SOUTHEN CROSS WA 6426 AUSTRALIA P: +61 8 9049 1666 F: +61 8 9049 1677 E: info@ahta.com.au W: www.ahta.com.au

CONTENTS Regulars Message from the Editor

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Knowledge and Resources Report

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President Report

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Research and Scholarship

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Organisational Structure

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News Items

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Communications Report

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Professional Development

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Marketing and Promotions Report

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Mentor List

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Advocacy Report

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Library Resource List

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Accreditation Report

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IFSHT Update

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2016 Conference Report

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Journals

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State and Territories Reports

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Contact Us

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Membership Report

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AHTA Newsletter Advertising Rates

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Issue 107 Apr - Jun 2016 Clinical Pearls

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Therapist Led Clinic Implementation at Western Health Elizabeth Witherow & Nicole Byrne

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What a Joy: PreP22 appraised hand research direct to your inbox Lauren Miller

Announcement: Best Research Paper Catherine Reid and Vera Tse

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School of Occupational Therapy and Social Work Prize Giving Ceremony Curtain University

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Library Resource Review Sathish Kumar

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Zambia Visit Susan Dunn

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It was supposed to be a month off...

Hamish Anderson

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Functional and survival outcomes following a thumb replantation Jo Marsh

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AHTA AHTA Newsletter Newsletter Jul—Sep Apr - Jun 2015 2016 Issue Issue 104 107

A Message from the Editor Catherine Reid

Thanks once again to all the members who responded to requests to submit something to the newsletter, as a result of their generosity we have a jam packed edition. The management committee reports reflect how busy and dynamic the Association is and keep us in touch with what the manage-

ment committee have been So I hope you enjoy this edition up to on behalf of the mem- of the newsletter! bers.

The reports make for some interesting reading, espeKind regards cially prior to our upcoming AGM. Catherine Reid Communications Officer In addition to a review of Dr c o m m u n i c a t i o n s Don Lalonde’s talk on “Wide @ahta.com.au Awake Surgery”, an article on Therapist Led clinics, and an article on Volunteering with Interplast, some great Clinical Letters to the Editor Pearls have been submitted.

We also have a timely article are welcome and may be on how to get more from your emailed to: conference dollars. These sub- communications@ahta.com.au missions provide information you can’t always get in a peer Letters to the editor should be reviewed journal but which not more than 300 words and adds to our effectiveness as must be accompanied by the therapist’s name (published) therapists. and contact information.

REGISTRATIONS ARE NOW CLOSED FOR THIS COURSE

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AHTA AHTA Newsletter Newsletter Jul—Sep Apr - Jun 2015 2016 Issue Issue 104 107

Presidents Report Helen Burfield



The first five months of 2016 have been exceedingly busy for the management committee and we all continue to be productive and initiate exciting changes.

The committee met on the weekend of the 21st May in Melbourne for a whole committee face to face and strategic planning meeting to bring together an up to date and precise strategic plan. This process is being assisted and facilitated by John Peacock from Association’s Forum. Our strategic plan currently runs to 2018 but we have felt that it has become a little unwieldy and we are endeavouring with this meeting to refine the goals and strategic direction of the Association.

The current objectives from the strategic plan are still valid 

Increase executive support and programme management of AHTA portfolios to assist in deliv-

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ery of strategic objectives Restructure the Education subcommittee in line with AHTA Governance requirements Develop a draft proposal for Credentialing of AHTA full members Develop a white paper detailing member’s vision for “greater recognition” of practitioners of hand therapy

agement committee of volunteers their support is invaluable.

I am hoping all members will get behind Hand Therapy  Awareness Week coming up from the 6th till 12th June. Our marketing and promotions wiz  Amy Geach has been working hard to develop some wonderful professional marketing and promotional and materials for your practices,  websites and social media.

We are aiming to look at our Please make sure you take strategic goals and couple advantage of them to prothem with budgets and out- mote hand therapy and the c o m e AHTA to the measures to “I am hoping mem- wider commuensure the bers will get behind nity! long term via- Hand Therapy Awarebility and ness week—to pro- Last but not growth of the mote hand therapy least we have AHTA. annual and the AHTA to the our conference in wider community” S y d n e y The last four months has “Tendons – seen Kate Noller moving into moving to mastery” On Aua full time role and this has gust 26th – 28th where the NSW meant we have been able to organising committee have address many aspects and put together an inspiring and projects that have been just educational program. I enwaiting to be initiated and courage you all to register put into place coming to frui- and I look forward to seeing tion. Thankyou Kate for your you all there! knowledge and expertise!

Sarah is now able to put her considerable knowledge of Kind regards, the association into concentrating on the membership Helen Burfield and finance (and many other AHTA President areas!). This is just the beginning of the exciting expansion of the AHTA management team. This is vital as a man-

AHTA AHTA Newsletter Newsletter Jul—Sep Apr - Jun 2015 2016 Issue Issue 104 107

AHTA Executive Committee Organisational Structure

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AHTA AHTA Newsletter Newsletter Jul—Sep Apr - Jun 2015 2016 Issue Issue 104 107

Communications Report Recently, the AHTA conducted the AHTA Annual Member Survey, we received some excellent feedback on many aspects of the AHTA including Enews and Newsletter as well as feedback requesting further information in relation to undertaking a role on the AHTA Management Committee. I have outlined here, a description of and commitment required for the AHTA Management Committee role of Communications Officer, in the hope that this may offer some clarity to those who may be interested in nominating at the upcoming AGM. The Communications Officer ultimately runs the communications portfolio with the advice and support of the AHTA Executive Support. The Communications Subcommittee currently consists of the Communications Officer (myself), Vera Tse and Kate Noller and Sarah Dixon, being Executive Support. Vera Tse develops the Enews each month, and the Communications Officers develops newsletter content and oversee the google group. Kate Noller formats the newsletter and has recently taken on the role of formatting the Enews, previously undertaken by Sarah.

Enews—uses a Mail Chimp platform. Mail Chimp was adopted late last year and we think it produces a much crisper finish to the Enews. The Enews provides a monthly snapshot of what is going on in the Association. It is designed to be less formal than the newsletter and to let members know how to access information about current events, workshops or conferences. Contributions to Enews Page 6

Catherine Reid

should be brief and can be made via email to communications@ahta.com.au.

Newsletter—The process for development of the quarterly newsletter involves gathering management committee reports and submissions from the membership. Submissions to the newsletter can take the form of:  letters to the editor,  research articles,  literature review,  case study,  book/course/conference/website/app/you tube reviews  site profiles  news item  clinical pearls Member contribution guidelines can be accessed on the website (in the bylaws) http:// www.ahta.com.au/client_images/1802594.pdf (see page 80) and submissions can be sent to communications@ahta.com.au The Communications Officer, with the help of Executive Support are also responsible for approaching advertisers for the AHTA including advertising on the website, facebook, Enews and the newsletter.

This process has been improved since the AHTA advertising kit was updated earlier this year, a process largely completed by Kate Noller. The current advertising kit can be viewed on the website here: http://www.ahta.com.au/site/advertise-with-the-

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Communications Report

Catherine Reid

Continued ... ahta.

In addition to the above-mentioned duties the Communications Officer is also required to attend In addition to the advertising options that were premanagement committee meetings, strategic planviously available the AHTA now offers Corporate ning sessions and engage in discussion and deciPartnerships, Maida Learning is the first organisation sion making processes across all facets of the AHTA. to take up one of these partnerships, becoming a bronze partner in April this year. Welcome Maida Learning!

For further information, please contact me for a position description, if you have any questions please feel free to ask.

Google Groups—The AHTA now has two Google groups open to all members: the CHT exam Google study group and the members Google group. The Catherine Reid Google group is designed for sharing knowledge Communications Officer and queries regarding business, research or clinical Communications@ahta.com.au matters. These are both monitored for content by the Communications Officer, and inappropriate messages are removed or re-directed and the member who posted them is contacted privately.

As the membership of the group has grown, so too have the number of posts and it is important that with quantity of posts we don’t lose the quality of the Google group. If members find the number of August 12th 2016 posts they are receiving too overwhelming they November 11th 2016 can contact me via email and elect to have a daily summary of emails rather than have to read through each and every email. If you wish to be- Remember that contributions from Members to the come a member of the Google group you can newsletter earn valuable CPD points. So send in contact me via em a i l c om m u n i c a - your case studies, research articles, clinical pearls, tions@ahta.com.au. I am currently in the process book and App reviews, and DVD reports to comof designing a survey for members, to gather infor- munications@ahta.com.au. Please send your work mation on the type of content members want to as an attachment to your email, font Century Gothview on the Google group… so watch this space ic size 11. Try to avoid bullet points as these can be a little tricky to edit. and have your say.

Newsletter Contribution Deadlines for 2015

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AHTA AHTA Newsletter Newsletter Jul—Sep Apr - Jun 2015 2016 Issue Issue 104 107

Marketing and Promotions Report Amy Geach

The AHTA has started to collate information regarding visitors to the AHTA website, including locations visitors come from (Facebook, Google Things are gaining momentum and we are start- search), which pages they spend most time on, ing to get some great entries into our Hand and our bounce rate (how quickly people get Therapy Awareness Week competition, “I love back off without looking at any information). working in hand therapy because….”

This information will be used to help the AHTA review the current website set up and content.

Hi everyone,

I am also very pleased that we have now begun the AHTA blog, with Hamish Anderson being our first entry, with his video blog on mallet injuries. This can be viewed on the AHTA website under the ‘blog’ tab. The blog will be a monthly occurrence at this stage. If you are interested, please contact me at marketing@ahta.com.au for the guidelines on how to write a blog for the AHTA.

If you are on Facebook, remember to jump across and like the AHTA Conference 2016 Facebook page for updates on the conference.

For those on Twitter, the AHTA handle is @aushandtherapy We will be tweeting all about the conference and webinars to raise awareness of hand therapy across Australia.

This can only work if we do it collaboratively, so I encourage you all to join in the conversations and help spread the word. Hashtags to use are #handtherapy #htaw2016 #ahta2016 # t e n d o n m a s t e r y #guesswhoscomingtodinnerAHTA

The AHTA recently ran a Full Member webinar on how to promote hand therapy across social media sites. The webinar covered tip and tricks for developing a plan, as well as using Facebook, Twitter, LinkedIn and Instagram.

Full Members may access the recording from the webinar by contacting Sarah at the AHTA office. I am currently working on a social media guideline document to compliment the webi- Many Thanks nar. The document will contain similar inforAmy Geach mation to the webinar.

Marketing and Promotions Officer marketing@ahta.com.au Page 8

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Advocacy Report Tracey Clark

The Advocacy Committee met by teleconference on May 2, and had a very productive meeting during which we reviewed the committee’s achievements towards its strategic plan, in preparation for the annual report.

Did you know that the Advocacy Committee was established in 2008, following a recommendation from the inaugural AHTA strategic planning meeting of 2007? Its proposed objective was to inform the Management Committee about issues arising in the health care sector with potential to impact the practice of Hand Therapy. The Committee has struggled to get access to such information with adequate lead up time to contribute its voice. The issue was partly resolved through the engagement of a lobbyist, but the flow of information was still not ideal.

provide a vehicle for liaison and discussion between the professions themselves. This was seen as the ideal means through which to both access relevant information, and to contribute input.

to achieve this support. The APA CEO, Cris Massis, has provided an extremely positive letter of recommendation to the AHPA board, which I have attached for your interest. AHTA’s application will be proposed at the next AHPA board AHTA was not eligible to join AHPA meeting in June, and I will let you as a full member because full know the outcome. member organisations are required to represent a single discipline only. We were however, eligi- Thank you to the 76 members who ble to join as an affiliate or completed the annual member “friend”. This level of membership survey. The results of this survey required the support of an existing help the committee to prioritise its full member, and the Committee strategic objective for the coming has worked successfully with The year, and are summarised in the Australian Physiotherapy Associa- table below. tion (APA) over the past 12 months

During 2015, the Committee became aware of a national association of allied health professions (Allied Health Professions Australia – AHPA), who work to represent the interests of the allied health professions sector, particularly to the Federal Government; and to Page 9

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Advocacy Report Tracey Clark Continued ...

From the table on the previous page, we can see that members feel that the highest priority for the Advocacy Committee should be to be informed about State and National health policy issues with the potential to impact hand therapy practice, and to part of a National voice on issues of healthcare delivery in Australia.

This is closely followed by the desire to Formalise Relationships with Key Stakeholders.

The AHTA strategic plan is being updated on May 21. Keep an eye out on the website for the new plan.

Tracey Clark Advocacy Committee Chair / Immediate Past President pastpresident@ahta.com.au Right: Page 1 of 2—Nomination of the AHTA as a friend of AHPA, written by Cris Massis, CEO, Australian Physioterapy Association.

Over page: Page 1 of 2— Nomination of the AHTA as a friend of AHPA, written by Cris Massis, CEO, Australian Physioterapy Association.

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Advocacy Report Tracey Clark Continued ...

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AHTA AHTA Newsletter Newsletter Jul—Sep Apr - Jun 2015 2016 Issue Issue 104 107

Accreditation Working Party Report Tracey Clark

The Accreditation Working Party continues working towards implementing the accreditation process by the start of 2018. As we work towards this, consultation with our membership base and other key stakeholders remains a key priority.

Again, the working party would like to stress that the aim of this process is to provide recognition as well as a robust benchmark for hand therapists to advocate for our profession to key stakeholders external to the association. It is definitely not to devalue or make it ‘hard’ for AHTA members to progress in their careers. Similarly, it is not a revenue raising exercise. We continue to welcome any and all feedback/ comments from the membership base around the AHT title and we will keep you informed as we move through the process. Continue to watch this space in the Newsletter as we will have updates for every publication.

additional quotes from consultants with experience in accreditation and are in the process of defining a scope that is fi nancia lly pru dent ye t achieves the needs of our association. Additionally, the working party have met with colleagues from the Australian College of Mental Health Nurses who have recently gone through a similar process with their Credentialed Mental Health Nurses (CMHN) title. This meeting was extremely fruitful and the advice received will be incorporated into the process moving forward.

The working party has received feedback around a number of issues related to the credentialing process and overall program and we hope to address these here. There was comment on the limited offering of AHTA courses and its impact on achieving the AHT title. The education team are working extremely hard to develop additional courses From a practical standpoint that therapists can do to enthe working party has sought deavour to achieve the rePage 12

quired level. Our aim is to offer more variety in courses that are tailored to therapist’s learning needs and professional goals. Additionally, there was some feedback in relation to the perceived difficulty in achieving the accreditation standard for a number of therapists. While we understand the life pressures of our members, as a professional association we need to find the right balance between achieving the required competence to become a titled AHT while making it realistic and achievable for our members to get there. Without a robust, transparent and measurable process to achieve accreditation, the title will become worthless and negate the intended purpose of that title. It was also raised that rural and remote therapists may find it even more difficult to achieve AHT than they currently do under the current Full Membership system. The accreditation party plans to take this issue back to the Management Commit-

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Accreditation Working Party Report Tracey Clark

tee for the consideration of possible scholarships to help alleviate some of the financial burden. Again, the aim is not the exclude, but to maintain a level of competence, so this is valid issue and one we think we can overcome to make it easier for our regional colleagues.

Secondly, there was some feedback related to the accreditation program and registration with our relevant prof e s s i o n a l b o a r d s (Occupational Therapy and Physiotherapy). The accreditation process does not replicate the Code of Conduct of these boards nor does the AHTA have any policing power for misconduct. Therapists will still require to adhere to the Code of Conduct of their respective professional board in addition to being an AHT titled therapist.

Thirdly, there has been a significant level of feedback in related to the CHT qualification and how it will interpreted in Page 13

achieving the AHT credential.

The CHT qualification does raise some interesting issues in relation to credentialing. While it is agreed that the CHT requires high levels of academic knowledge in the management of upper limb conditions, that knowledge does not necessarily translate into competence in practice. The driving force behind the AHT credentialing process is to ensure that clinicians with the AHT title have demonstrated theoretical and practical competence across the key practice areas of hand therapy. We aim to achieve this by ensuring AHT titled therapists complete a suite of both theoretical and practical courses with assessable items that is coupled with a robust mentoring component. The working party will take this feedback on board in relation to the CHT and its weighting in relation to the title however there will still be a requirement for hand therapists wanting the AHT title to demonstrate competence in

the practical aspect of hand therapy practice.

Finally, the AHTA will continue to work tirelessly for its members regardless of whether they elect to pursue the AHT title or not. The Association will continue to espouse its mission “To maintain and promote high standards of Hand Therapy practice in Australia” for all members whether the member is an AHT or not. The AHT title is just the next step as Hand Therapy matures as a health profession and seeks professional recognition in the broader landscape of healthcare.

As always we welcome feedback and will continue to consult the membership throughout the process.

Tracey Clark Accreditation Working Party Chair / Immediate Past President pastpresident@ahta.com.au

AHTA AHTA Newsletter Newsletter Jul—Sep Apr - Jun 2015 2016 Issue Issue 104 107

2016 Conference Report The 2016 AHTA Conference in Sydney is fast approaching. Registrations have been coming in thick and fast with over 300 hand therapists, physiotherapists and occupational therapists from Australia and New Zealand set to enjoy a dynamic program focusing on the management of tendon injuries.

Fiona Peck from the UK is our keynote speaker but she is well supported by local therapists such as Erica Elliott, Ben Cunningham, Joy Hanna, Amy Geach, Ray Jongs, Hannah Munro and Sarah Baxter. There will also be papers from Karen Ginn and Leanne Bisset.

Anne Wajon will give the Founders lecture.

Members have submitted some exciting abstracts for free papers and posters.

Tim Sprague will present the first ever Members only Masterclass on the Thursday afternoon. The topic will be using Positive Psychology Principles to Practice Management and Patient Care.

The social events include the welcome drinks on the Friday evening. The dinner on the Saturday evening is being held at a secret location with hints to come over the next few weeks.

Looking forward to catching up with everybody on the 26th August.

Rebecca Crowley 2016 Conference Convener

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REGISTRATIONS ARE NOW CLOSED FOR THIS COURSE REGISTRATIONS ARE NOW CLOSED FOR THIS COURSE REGISTRATIONS ARE NOW CLOSED FOR THIS COURSE

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AHTA AHTA Newsletter Newsletter Jul—Sep Apr - Jun 2015 2016 Issue Issue 104 107

State and Territory Affairs Report Jennifer Kaess

Fabulous news…

CHT Exam Feedback-

Your AHTA has purchased a ZOOM account. This is a simple conference and web meeting program that will allow remote and rural access to our fabulous SIG meetings! We have only one license so we can only run one meeting at a time and have up to 50 people sign in on the program.

Zoom was used successfully as a first trail, to run a CHT exam feedback gathering of 12 interested members. Fiona Orton (Member AHTA and CHT) offered her insights into sitting the CHT exam. A wonderful team of therapists attended and gained some fabulous pearls to assist them with their prep for taking the exam.

This can be used for AHTA gatherings but it is specifically for SIG meetingsIt will be a first in priority basis (but SIG will trump other gatherings such as the CHT special group gathering organized via google which will have to be bumped to allow SIGs to have the platform)

Our next gathering for this will be on Wednesday June 8, at 8 pm by Jane Sandhurst (Member AHTA and CHT). Details on how to attend will be on Google group.

Western Australia will continue to use their Public Hospital free service for as long as possible, but if the We have several other recent CHT exam passers coordinators are not linked in with the public hospital lined up to offer the same support, so if you missed in future, this might change. the first, can’t make the next one, or want to find out Currently Victoria is using the account located at about how different people found the exam, pop in, the site and this will continue for the near future too. we would love to see you.

The program is so simple to use, if you are intending to attend a SIG via Zoom, you will need to let the organizers know with a few days’ notice, you will receive an email with log in details, all you do is click the link from any online computer or smart device and you will be taken to the meeting! In rare case of failure there is a phone in system too!

Thank you and Help Needed!

I would like to take this opportunity to personally thank the terrific team of the State and Territory sub committee. They work so hard to keep the flow of info going between what is going on in the coal face and the strategic direction of the profession. It is a wonderful way to contribute back to the profesThis has been a huge project by the State and Terri- sion we all love, and to be part of the direction gotory team and we finally feel like we have a solid ing forward. solution to rolling out more equivalent services to our If you find you have a little extra time, would like to fellow ‘non metro’ members. dip your toe into the workings of the professional Page 16

AHTA AHTA Newsletter Newsletter Jul—Sep Apr - Jun 2015 2016 Issue Issue 104 107

State and Territories Reports body, a sub committee appointment may be something you would like to consider. I am stepping down from being the State and Territory Affairs Officer after 6 years on the Management committee. I have worked with some of the most inspirational and dedicated professionals and have learned more than I imagined possible. It is an exciting time to be involved with so much in the pipeline with the move to Accreditation. I urge all of you to consider how you might be able to contribute to this process, including taking on a Management committee role or a sub committee portfolio.

The AHTA cannot work without volunteers to do their bit. I know many of you are busy, have other commitments or volunteer elsewhere, and maybe right now is not the right time, but keep it in mind as your lifestyle and commitments evolve, and remember your profession needs you!

NSW was very lucky to host the 2016 Combined Meeting of the Australian Hand Surgery Society and American Society for Surgery of the Hand, under the direction of Dr Anthony Beard from Royal North Shore Hospital. There was a great mixed international delegation of close to 300 people and a number of Therapists were in attendance which was great to see.

The conference was varied in its content, with lots of interesting topics presented and discussed. There were notable sessions on sports injuries, complex PIPJs, wrist injuries, Dupuytrens - prolonged static stretch & collagenase injections, paediatrics, and some big and very interesting sessions on microsurgery and composite allograft transplantation (hand transplants to you and I) and lots of other topics too broad to mention here. Dr Scott Levin, who led the team that performed the first bilateral paediatric hand transplant, presented the Bernie O'Brien Oration, and a session on the ethical and selection conJen Kaess siderations for these amazing and challenging operState and Territory Affairs Officer ations (and the lifelong management thereafter). A stateaffairs@ahta.com.au fascinating 3 days and very lucky to be able to access such great information on our doorstep.

The rest of the year in NSW is busy being planned and will include a talk by Dr Anthony Beard from Royal North Shore as well as a talk about pain in the upWe will be holding an asso- per limb. ciates only event to help our associate members up- If anyone has any suggestions of topics (the more grade to full membership. specific the better), presenters you would like to hear This will be help on Thursday from or locations for the meetings please feel free to 16th June at 7pm. For further details and to RSVP email us on nswigmeeting@gmail.com. please contact Cathy Merry at cathymmerBy Nadia Jenkins, Nicola Cook, Michele Chim and ry@hotmail.com Victoria Tricardos

New South Wales / ACT

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State and Territories Reports Tasmania No Report received

Western Australia

is being held on 30th July, and the call for abstracts has opened. Abstracts are due by 3 rd June, and must be submitted to Mr Jeff Ecker at samantha.desport@ecker.com.au (via the email that has been circulated). If you or your clinic has completed any research or pilot trials, it may be worth presenting! It would be great to see more hand therapy presentations this year.

Finally, the time will soon be approaching for Yvette, Stuart, and Lani to pass the baton to the next WA subcommittee representatives for the next 2 year term (2017-2018). Please consider if you would like to nominate yourself for this role. It really isn’t difficult, and anyone can do it! Having a group of 3 has made this role very manageable over the last 2 years, so why not get a few friends together and do it as a group? Being a subcommittee representative allows you to give back to the AHTA and your profession. If you have any questions about what the role would entail, please don’t hesitate to contact us on stuart.wilson@handworks.net.au or lani.mcauliffe@handworks.net.au.

Our next interest group meeting will be June 11th, with presentations by Sir Charles Gairdner Hospital and Fremantle Hospital. As usual, the meeting will be held from 9am-12noon in the Occupational Therapy Department of SCGH, Lower ground, G Block. Topics and presenters will be announced closer to the date. Telehealth will be available for any rural and remote therapists to attend also. The WA meetings always have at least a few people attend via telehealth, and this system has been working very well over the past 2 years.

We encourage any rural or remote therapists who Look forward to seeing you all at the next meeting treat hand and upper limb conditions to attend our in June! meetings via telehealth to keep up to date with PD, extend learning into specific hand and upper limb conditions and treatment modalities, and to net- By Lani McAuliffe work with peers.

The WA Society of Hand Surgeons Annual Meeting Page 18

AHTA AHTA Newsletter Newsletter Jul—Sep Apr - Jun 2015 2016 Issue Issue 104 107

State and Territories reports Northern Territory No report received

from the Body and Mind Institute (UniSA). Dr Bellan will be sharing her preliminary findings of her upper limb CRPS research currently being conducted in Adelaide, here is a link to her Bio: (http:// www.bodyinmind.org/who-are-we/bim-researchgroups/). Looking forward to seeing those who attend in June.

Kaveeta Deut

South Australia The last quarter has been relatively quiet in South Australia. In April we had our second IG meeting for the year which provided a great overview of basic shoulder assessment and common pathology.

April also saw Professor Don Lalonde visit Adelaide and several of our members were lucky enough to hear his wonderful presentation on ‘Wide Awake Hand Surgery’.

We’ve had two new Associate Members join our group. We’d like to extend a huge welcome to; Darcy O’Neil and Davide Zerillo.

The next IG meeting will be held on Wednesday June 15th, 7:00pm at Waverly House (Wakefield Hospital). We will have researcher Dr Valeria Bellan

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Victoria It’s been a busy first half of 2016 for us here in Victoria.

We have conducted very interesting Interest Group Meetings in February and April, with great attendance rates. The April topic was looking at outcome measures in the 21st Century, and was presented by PhD candidate Bridget Hill.

Our next meeting is scheduled for Wednesday 1st June 2016. The topic will be” The Wrist” by Lauren Young, and “Wound Management” by Fiona Orton. We hope to see you at The Monash Clinical School (regular venue) at 6:30pm.

Many of our therapists were fortunate to attend a seminar organised by the VHSS on April 21st. The speaker was Professor Don Lalonde, who is the Chief of Plastic and Reconstructive Surgery in New Brunswick, Canada. It was a very informative evening.

AHTA AHTA Newsletter Newsletter Jul—Sep Apr - Jun 2015 2016 Issue Issue 104 107

State and Territories reports We’d like to welcome our new associates in the last quarter: Yvonne Fellner and Cherie Smith. We’d also like to congratulate Kelly Papatolicas on her successful application to upgrade to full Membership.

We know that Karen Fitt once again volunteered with Interplast in April. If any members are also volunteering, or doing anything of interest relating to hand therapy we’d love to know about it.

service will replace Skype as our avenue for enabling out of area therapists to link into meetings. We apologise for the difficulties encountered using Skype and hope that Zoom will be a much positive experience for our members.

Amanda, Frances, Margo and Charlotte

By Virginia Wise and Lisa O’Brien

Queensland Queensland AHTA members have enjoyed a fabulous array of special interest group topics this year. We are very grateful to all our members who have helped plan, coordinate and present at these meetings.

We endeavour to hold monthly special interest group meetings, with the hosting responsibility spread between both remote and central members. Please continue to check the AHTA webpage to see when your workplace is nominated to contribute.

There is much excitement about the recent AHTA purchase of Zoom online video conferencing. This

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AHTA AHTA Newsletter Newsletter Jul—Sep Apr - Jun 2015 2016 Issue Issue 104 107

Membership Report Kylie Flynn Congratulations & Welcome to Lauren Jensen our new AHTA Members: Estee Hartnett

QLD contact your state mentor.

Alison Butcher

WA

Cherie Smith

VIC

Lisa Browne

WA

Juliet Milne

QLD

Kelly Papatolicas

VIC

Amy Dobby

VIC

Greg Sullivan

NSW Davide Zerillo Bethany Butler

Welcome also to all our new Sarah Fairthorne Associate Members: Felicia Lim Christine Do VIC Darcy O’Neill

SA

Penelope Barratt

NSW

Emma Sayle

QLD

Renae Lim

ACT

Marnie Oliver

WA

Yvonne Fellner

VIC

Liz Koruga

NSW

Hayley Dymock

QLD

Sheree Colquhoun

NSW

Lara Condon

QLD

Clare Fortescue

WA

Paula O’Connor

WA

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WA

SA QLD WA NSW

The membership subcommittee has been busy reviewing associate member’s applications for upgrading their membership. Applicants please be aware that applications must include soft copy evidence for CPD points and these must be in reasonable order and saved in one file, before they will be accepted and reviewed by your State mentor. A reminder to all associate members that courses must have been completed in the past 5 years to be included in the 300 hours required for membership. If you have any questions, please

The membership subcommittee has also been considering requests for CPD point allocation for maintaining membership activities, under contributions to the profession, that have been raised by members, such as writing blogs and overseas volunteer work. If you think there is an activity that you do which is directly related to Hand Therapy and should be included in the requirements for maintaining membership please send me an email membership@ahta.com.au Regards Kylie Flynn Membership Secretary, AHTA membership@ahta.com.au

AHTA AHTA Newsletter Newsletter Jul—Sep Apr - Jun 2015 2016 Issue Issue 104 107

Knowledge and Resources Dion Sandos

There has been a lot going on in the Knowledge and Resources portfolio over the past month or 2.

I’m excited to announce 3 new resources that AHTA Members can now access. We have purchased a subscription to the Journal of Hand Surgery (European Volume) that is available online. We have also completed a bulk order of Everyday Upper Extremity Anatomy and Evidence Based Hand and Upper Limb Protocols. For more information about these resources see below: The Journal of Hand Surgery (European Volume) is essential reading for everyone involved in restoring the function to the hand and upper limb. Dedicated to the needs of hand, plastic, reconstructive and orthopaedic surgeons, it publishes the best selection of current papers on hand surgery.

The journal regularly highlights key developments in a range of original, authoritative and highly informative articles written by distinguished experts from around the world. Rapid coverage of the latest research, techniques, trends and ideas to make sure you stay up-to-date. You will also find editorials, book reviews, conference Page 22

dates, case studies, detailed cov- mation better. This resource is a erage of new techniques and full- great way to teach students and length reviews articles. patients.

The AHTA has access to the complete back catalogue of journals.

To access this journal log on to the Members section of the website and follow the links to the Sage Journals.

Everyday Upper Extremity Anatomy is a desk reference anatomy book. Learn through creative techniques such as layering the muscles on templates with colourful re-usable vinyl clings, tracing dermatomes and cutaneous pathways, and drawing the brachial plexus using the DVD tutorial provided. Everyday Anatomy is a fun and interactive book focusing on an array of topics including skeletal, muscular, peripheral nerves, and vascular anatomy.

Upon completion of the study, the participant is left with an excellent everyday reference that will be a helpful tool for any clinician. Activity tips and guidelines are provided to help make the most of the learning experience. Regardless of whether you are a visual, kinaesthetic, or auditory learner, when you add a learn-by-doing component, you will retain the infor-

Evidence Based Hand and Upper Extremity Protocols is a comprehensive manual with over 70 therapy treatment protocols for the most common surgical and nonsurgical diagnoses of the upper extremity. This manual is in a weekby-week format that is easy to use.

Each protocol is based on the most current medical evidence and is uniformly outlined with indications, contraindications, recommended weekly therapy visits, and surgical outcome limitations. Many of the diagnoses have more than one protocol to choose from.

Thank you to everyone who expressed their interest in purchasing one or both of these resources. To purchase either of these books visit the Online Store of the website.

For any loan requests, resource suggestions or general enquiries please contact me at resources@ahta.com.au.

Dion Sandoz Knowledge and Resources Officer resources@ahta.com.au

AHTA AHTA Newsletter Newsletter Jul—Sep Apr - Jun 2015 2016 Issue Issue 104 107

Research and Scholarship Evidence based practice - What is it all about?

By Andrea Bialocerkowski Evidence based practice is a term which is frequently used to describe an approach to practice in addition to justifying the management provided to clients. But what does this phrase really mean?

Evidence based practiced started in the field of medicine in the 1990s .Sacket et al (1996) defined evidence based medicine as the “…conscious, explicit and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence based medicine means integrating individual clinician expertise with the best available external clinical evidence from systematic research.” This means that clinicians need to use the best, evidence-based assessments and treatment during client care. To enable this to occur, clinicians need to keep up to date with the published research literature and use it in their everyday decision-making processes.

Although research evidence and clinical findings (and diagnoses) are important pieces of information to use in clinical decision-making, evidence based practice also involves sharing and discussing this information with the client, and valuing and using client choice in the decision-making process. This principle is in line with client-centred care and potentially increases client compliance, and thus the effectiveness of the treatment delivered. Evidence based practice also involves the evaluation of the effectiveness of the intervention. The advantages of practicing in an evidence-based manner is that the best possible care is provided to our clients and that ineffective, traditional or unsafe practices are ceased in lieu of those which have evidence to support their effectiveness. Evidence based practice also means that we have a sound justification for the treatments that we provide which can be expressed in terms of research evidence.

As hand therapists we are experts undertaking assessments on our clients and ascertaining the client’s choice regarding treatment. However, with the expanding research based, keeping up to date with the evidence base can be challenging. In addition, how can we determine what is considered the “best available evidence”? Below is a process which is recommended to follow to perform evidence based practice: ->

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AHTA AHTA Newsletter Newsletter Jul—Sep Apr - Jun 2015 2016 Issue Issue 104 107

Research and Scholarship Evidence based practice - What is it all about?

By Andrea Bialocerkowski Continued ... 

Step 1: Assess the client - A clinical problem or question often arises from the assessment or care of the client

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Step 2: As the question – Construct a well-built clinical question that pertains to the client

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Step 3: Acquire the evidence – select the appreciate databases or other resources, construct and implement a search strategy and gather the evidence

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Step 4: Appraise the evidence – appraise the evidence for its validity and bias (using a hierarchy of evidence and a critical appraisal tool) as well as its applicability to clinical practice in your setting and your client

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Step 5: Apply the evidence - Discuss this treatment approach with your client and use this information in your decision making processes

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Step 6: Evaluate the outcome of your treatment approach

There are a number of excellent resources available at no cost on the Internet, that provide further explanation regarding each of these steps. These include, but are not limited to, Central Queensland University: http://libguides.library.cqu.edu.au/ebp Duke University: http://guides.mclibrary.duke.edu/c.php?g=158201&p=1036021 OT Seeker: http://www.otseeker.com/resources/evidencebasedpractice.aspx The University of Notre Dame: http://libraryonline.nd.edu.au/evidencebasedpractice University of Canberra: http://canberra.libguides.com/evidence Andrea Bialocerkowski

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AHTA AHTA Newsletter Newsletter Jul—Sep Apr - Jun 2015 2016 Issue Issue 104 107

News Items

Above and below: Images from a recent AHTA Fundamentals of Hand Therapy Course. The course was held in Melbourne over 2.5 days and was presented by Vicki Strelan. To view all available AHTA Courses you can visit our online store: http://ahta.com.au/site/index.cfm?display=160933 and register for any one

Dear Members, The AHTA is undertaking a conversion to our new Accounting Software, which we hope will streamline our current office procedures and allow a more user friendly system, DATE has been changed to the 2nd June. I envisage that this will cause some minor disruptions to the office and service provided as the conversion is taking place and during my training in the use of the new software. (Duration: approx 2 weeks) During this time I will not be able to record any financial transactions.

I have been advised to inform you that under the new system I will only be able to reproduce records up to 2 years old. (Receipts/Tax Invoices etc) Therefore I strongly urge you to maintain these records when they are produced for your Taxation purposes in the future.

Further to this: Please be advised that the office will also be experiencing some changes for the next few months. As a result I may have limited access to internet/email services. If you haven't received a reply to an email in 48 hours I would encourage you to contact the office by telephone. or email Kate at executiveadmin@ahta.com.au My apologies for any inconvenience this may cause you and I appreciate your patience and understanding during this time.

Please contact me at the office by Tel 08 9049 1666 or email info@ahta.com.au if you wish to discuss this matter further or have any questions Sarah Dixon Page 25

AHTA AHTA Newsletter Newsletter Jul—Sep Apr - Jun 2015 2016 Issue Issue 104 107

News Items In Memoriam: Dr. Alfred Swanson Posted by Jeanine A. Beasley, EdD, OTR, CHT, FAOTA on 05/03/2016 Dr. Alfred Swanson, hand surgeon, scientist humanitarian educator and pioneer in the field of orthopedic and hand surgery passed away April 27, 2016, at the age of 9 3 .

His passion and dedication to the field is known worldwide, especially for his work in the development and application of silicone finger joint implants in the treatment of arthritis. He received his medical doctorate from the University of Illinois in 1947, and training in orthopedics at the Universities of Illinois, Northwestern and Indiana. During the Korean War, Captain Swanson served two years in the US Army Medical Corps in Fort Lewis, WA, before establishing his practice in Grand Rapids, MI, in March 1954.

In 1962, Dr. Swanson founded the Orthopedic Research Department at Blodgett Hospital where he pioneered the concept of using flexible implants for small joint reconstruction and performed the first ever biocompatibility studies of silicone in bone. In 1963, he performed the first human implantation of silicone in the humerus of a juvenile amputee to control bone overgrowth. After extensive testing, he established the feasibility of using silicone elastomer for finger joint implants and operated the first patient in 1964. Prior to their release in 1969, the implants were further evaluated in worldwide Field Clinic Trials. He went on to develop silicone, titanium and other implants for the wrist, elbow, shoulder and great toe.

Dr. Swanson served as Chief of Orthopaedic Surgery, Director of the Grand Rapids Orthopaedic Residency (1954-2000) and Hand Surgery Fellowship (1962-2000). He was Professor of Surgery at Michigan State University and Chief of Staff at Mary Free Bed. His scholarship includes more than 300 publications and 700 presentations worldwide. He was President of the American Society for Surgery of the Hand (1979-1980) and International Federation of Societies for Surgery of the Hand (1983-1989). He received numerous prestigious awards as listed in his full obituary. In cooperation with Evelyn Mackin, he helped promote hand therapy as a specialty in the United States and initiate the American Society of Hand Therapists (1977), International Federation of Societies of Hand Therapists (1980), Journal of Hand Therapy (1987) and its International Issues (1993). He gave the Keynote Address, “Opportunities for Medical Statesmanship in our Society,” at the 6th ASHT Annual Meeting, March 6, 1983, Anaheim, CA. In 2004, he received the ASHT Honorary Membership Award in recognition for his long-term contributions.

He was a great educator of surgeons and therapists. More than 3,000 physicians and therapists attended the series of 22 annual International Symposia on Implant Arthroplasty in the Hand, Upper Extremity and Foot held at Blodgett Hospital.

He is remembered by many therapists, including Elaine Fess, who said, “The Philadelphia meetings, the international meetings -- he was a larger-than-life presence, a great teacher and always supportive of therapists.”

Linda Klein said, “I attended a course early in my career in Grand Rapids that he taught, mostly for physicians.

I learned so much.”

Donna Breger-Stanton said, “He was important to the founding of ASHT -- a great friend to the therapists.”

Dr. Swanson held a yearly Christmas party for children at Mary Free Bed Hospital where, dressed as “Cowboy Al” and accompanied by his residents and therapists in character costumes, he sang and played his guitar (1954-2004). Amiably dubbed “skin and bones” team by colleagues, Geneviève de Groot Swanson, MD, surgeon, his wife of 47 years, and mother of their son Eric Alfred, was an integral part of his career. He will be remembered and missed by his “life” Geneviève, his children, grandchildren and great grandchildren, as well as friends and colleagues from around the world.

To view the original post go to: https://www.asht.org/about/blog/memoriam-dr-alfred-swanson You can access the full Obituary here: http://obits.mlive.com/obituaries/grandrapids/obituary.aspx?n=alfredswanson&pid=179766921&fhid=5484

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AHTA AHTA Newsletter Newsletter Jul—Sep Apr - Jun 2015 2016 Issue Issue 104 107

Clinical Pearls

From Fellow Members...

1. Splint Socks

A patient put me onto purchasing women’s knee high socks from Kmart in packs of 3 pairs for $3. The have come in white, grey and black but not always available. It used to be a rollover top but now has a band which can be too tight for larger forearm which I then cut off. They are warmer for winter, wash well, last longer and don't unravel like tibigrip/tubifast. I give patients 2 and they never need any more generally so very cost effective!! I cut then and use the leg portion of the sock for a forearm length and the foot for a hand based splint. I am told there are similar ones at big W but I have n o t f o u n d t h e m a s o f y e t .

Beth McNeish

2. Polymer Pearls Are water soluble gel beads which are generally used in flower vases for colour and support for the arrangement. They are great for desensitisation for severely hypersensitive digits/hands. They can be used over and over and just rehydrate when they start to dry out after a number of weeks. Great for your clinic or patients to use at home.

Beth McNeish

AHTA Official Corporate Partner

Bronze Partner Profile

The AHTA would like to welcome Maida Learning on board as the AHTA’s first official Bronze Corporate Partner. This month we are profiling Maida Learning to give our readers some insight into this exciting and innovative company.

Maida Learning provides business education, resources and support for allied health professionals and private practice owners. Maida Learnings director, Amy Geach has been practicing in the Hand Therapy industry for 15 years, therefore Maida Learning’s education is highly relevant for other therapists. Amy has been a member of the AHTA for many years and believes in the values of the AHTA and it’s vision for it’s members. Maida Learning relishes in the opportunity to be part of that vision, by helping therapists improve their business acumen.

Operating since 2013, Maida Learning, takes pride in it’s focus on practical, affordable business education, that is relevant to the allied health sector and believes that a partnership with the AHTA will assist Maida Learning to provide education that supports the AHTA mission, to promote high standards of hand therapy practice in Australia.

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AHTA AHTA Newsletter Newsletter Jul—Sep Apr - Jun 2015 2016 Issue Issue 104 107

Member Contributions Therapist Led Clinic Implementation at Western Health Elizabeth Witherow & Nicole Byrne Following some discussions on the Google group regarding Therapist Led Clinics, we were asked to share our experience of recently implementing a Therapist Led Clinic including how it was implemented and how staff were credentialed.

Introduction of a Therapist Led Clinic at Western Health was a high priority for Allied Health as well as the Plastic Surgery Team at the time of this funding round which greatly assisted in implementing the service. Some of the existing issues with the system prior to introduction How it began….. of the clinic which we attempted In 2015 the Department of Health to address included: and Human Services requested applications from Victorian Public Hos-  Delay in referral of high priority pitals for Advanced Practice Role conditions i.e. patient who had Development as part of the Allied a high risk of complication Health Workforce Grant Program. (adhesion/rupture/corrective Occupational Therapy at Western surgery) if therapy was delayed Health were fortunate to receive a or change in therapy regime grant to implement a Therapist Led due to delay Clinic which involved accepting  Where referred to an appropripatients directly from theatre folate medical clinic, due to clinic lowing surgery for tendon repair, sizes, the patient was unable to fracture ORIF and volar plate open be seen in therapy repair. A number of other Hand  Demand of appointments in Therapy Services also received medical clinics (overbookings) grants and formed a group which  Patient waiting times and satismet bimonthly along with a reprefaction sentative from the Department of  “Double handling” where bulky Health and Human Services to disdressings applied in clinic and cuss progression of the projects and plaster re-applied were reproblem shoot issues which ocmoved in order to facilitated curred. early active mobilisation  Suboptimal education of paMelbourne Health, Eastern Health, tients due to busy and loud clinMonash Health, Bendigo Health ic environment and St Vincents Health all received  Multiple points of contact for grants - with the majority of services the patient, risk of varying educhoosing to focus on acquired cation provision i.e. “splint can conditions (attempt to remove pabe removed for showering” tients from the waiting list through  Whilst clinicians had worked in a conservative management of OA, similar clinic within another MelCTS etc.) or accepting patients dibourne Hospital, the Governrectly from ED. ance structure of Western Health required an outpatient

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Plastic Surgery review of all patients prior to an assessment by Hand Therapy What we did…..

Baseline data was collected prior to implementation of the clinic for 11 weeks and 10 weeks following the clinic with a total of 120 patients recruited.

A credentialing package (assessment) was developed by two Occupational Therapy senior clinicians which incorporated: a written competency related to each injury type/additional responsibilities of an advanced scope clinician, a verbal questionnaire, observation checklist and a documentation audit tool and a red-flag checklist. This package was developed using a structure recommended by the Occupational Therapy Department and was reviewed by the Western Health Allied Health and Care Coordination Credentialing and Professional Advisory Committee (CPAC) to ensure it met a satisfactory standard for Western Health Governance. Once approved, senior clinicians underwent the credentialing process assessed by the Head of Plastic Surgery. Subsequent experienced Grade 2 clinicians were assessed by the credentialed senior clinicians.

Identification of a referral method which did not increase the workload, require significant change in practice/new learning for the surgeons and permitted early referral was key. For Western Health an electronic referral method via the medical record system was adopted. Two appointments were allocated daily to ensure the ability to meet early appointment demands.

Education of key stakeholders was key for implementation. One of the aims of the clinic was to remove any Plastic Surgery outpatient follow-up and initially to allay concerns regarding this; a brief case summary of patients referred via

AHTA AHTA Newsletter Newsletter Jul—Sep Apr - Jun 2015 2016 Issue Issue 104 107

Member Contributions

Continued ...

the clinic was presented through The Therapist Led Clinic continues the Plastics audit meeting. to run. On introduction of the clinic, the surgeons were keen to refer Supporting policy and procedure other conditions which were not documents were also developed included within the credentialing to support the referral process and process for example tenolysis and implementation of the Therapist pilon fractures. We were fortunate Led Clinic. In addition, updated to receive a further funding patient education handouts were through the Western Health Allied developed for each condition.

Health Foundation Grant to develop additional credentialing docuSummary of the outcomes to help ments. justify the service…..  The number of Plastic Surgery Challenges/key learnings/things of outpatient appointments was interest……..  Consider the terms advanced reduced by 34% versus extended scope practi 37% reduction in Plastic Surgery tioner roles. Including having Outpatient FTAs these roles recognised and ap 14% reduction in Hand Therapy propri at e l y re mune rat e d/ appointments maintaining career structure  43% increase in patients attendwithin the scope of your role ing initial Occupational Therapy (AHPRA) Assessment within 4 days of sur Consider what is a core skill set gery versus advanced skill set  8% reduction in change to ther Consider state based and serapy regime as a result of earlier vice based differences in these initial assessment roles – particularly regarding  Improved QuickDASH, range of credentialing motion, strength and return to  Consider governing bodies and goal timeframes tools that already exist to  Increased Medical and Patient demonstrate competency satisfaction  Last year the AHTA met with OT  Reduced therapist satisfaction – Australia to commence work which reflected other demands on a position paper for Adon the service at this time as vanced Scope roles in OT/Hand well as reduced exposure of Therapy, however also consider complex conditions to junior differences that may impact therapists impacting on educabetween OT and PT hand thertion and learning opportunities apists  Overall increase in demand on Plastic Surgery and Occupa-  Every service will have it’s own requirements about implementtional Therapy appointments ing these types of clinics as well despite the clinic, demonstratas the type of credentialing ing overall service growth that is required  Cost saving over 10 weeks related to provision of Initial assess-  Consider who is the most appropriate person to complete ments and more significant cost credentialing in the first insavings incurred due to reducstance. tion of ongoing medical and  Ensure the system you set up is therapy appointments sustainable  Cost of the credentialing process for each therapist was  Some useful credentialing resources – there are many availquickly outweighed by the cost able through various governsaving of service provision ment websites, each state varies regarding where they are up Where to now……

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

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to with advanced scope roles and credentialing:  Department of Health and Human Services Credentialing resource kit: h t t p s : / / www2.health.vic.gov.au/ about/publications/ policiesandguidelines/ R e s o u r c e % 2 0k i t % 2 0 1% 20credentialling%20and% 2 0 s c o pe % 20 o f% 2 0 p r a ct i ce % 2 0 al l i e d% 20health  Advanced musculoskeletal physiotherapy clinical education framework supporting an emerging new workforce* Paula Harding A C, Jonathan Prescott A, James Sayer A and Andrea Pearce.

Australian Health Review 39(3) 271-282  h t t p s : / / www2.health.vic.gov.au/ Api/downloadmedia/% 7BA5561FB0-66A1-47EC8E51-8B28D32481CD%7D Developing and evaluating a clinic/credentialing process requires a large amount of time, without funding for backfill this project would have seemed unachievable or taken many years rather than 6 months Timing of projects can be important as organisation wide changes can impact on time availability i.e. Hospital accreditation Shifting the responsibility of triage and booking patients post operatively from outpatient bookings to therapy created additional time burdens, particularly given this service has no administration support Involve key stakeholders to ensure full support; otherwise introducing something new can be very challenging. Ongoing education may be required to prevent confusion, even for areas not directly impacted i.e. day procedure unit, admin.

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Making the most out of the AHTA National Conference Amy Geach

food!). The best way to be remarkable and be remembered by someone, or form a relationship, is to ask the other person questions “where do you work, what do you like about it, did you enjoy that session, have you always lived in ???” etc. When you get home, you can still stalk people from the conference: 

With the AHTA annual conference not far away, it is a good time to talk about networking!

Hopefully many of you will be attending this year’s conference.

The first conference I attended was many years ago at the Sheraton Mirage on the Goldcoast and I remember being only new to the conference scene – I knew one person – Adrian Jollow, and tried my best not to annoy him all conference! You will have to ask Adrian whether I succeeded in that or not! If this is you, don’t despair, there are many lovely people at the conference probably really looking forward to hearing your story and introducing you to other people as well. The other thing that happens to me at conferences is I write the most incredible to do lists – ideas I think of as I am sitting in the audience, tips from speakers, things to email to people that I promised I would send them, and if the topic is really dry, I might write down a list of non-hand therapy things to do, like what party food I might have at my daughter’s birthday (admit it, we all drift off at some stage in the conference!?). It is common to get home though and get busy again and either run out of time, or forget all those things I wanted to do.

So, for conferencing people this year, I have put together a three key points about making the most  of the conference experience whilst you are there, and ensuring the benefits last when you get back home.  1.Get connected: You will have no doubt caught up with friends and other colleagues as well as met new people at the conference. It is a great idea to stay in touch for support, and building your network. Firstly, BRING YOUR BUSINESS CARDS – you might not hand out many, but it is a great way to share your contact details with people. You can also connect with people using a social media platform such as LinkedIn, Facebook or Twitter. When you are connecting with people on social media, remember to customise the message – write something they will remember you by.

LinkedIn has a pre-written message when you want to connect with someone, and it is pretty boring and un-original. Get rid of that and write your own little introduction when connecting.

When you are meeting people in person for the first time, don’t just talk about yourself, or the weather, or the food (unless they are a foodie lover, THEN talk about the

Write a card to your favourite speaker – As a speaker, it is good to hear people enjoyed what you had to say Send an email to individual people that you met, or send a post conference email to someone you know, but didn’t get to talk to much Find the practices and services that are on Facebook and follow them. They will love the engagement!

2. Spread the #handtherapy love: I recently attended the Speech Pathology Australia conference in Perth and it was fantastic to watch the Twitter feed at the conference. There was so much excitement and so many posts firing off, making Speech Pathology reach number 2 of most popular topics on Twitter on day one of the conference – wouldn’t that be great awareness of hand therapy if we could do the same thing! Make sure you get on your phone in the sessions, during the breaks and in the evenings and write some inspiring hand therapy tweets, re-tweet others, and connect with one another. I saw many people at the Speech Pathology Australia conference connect on Twitter in a session from across the room and then randomly run into one another a

Caption Page 30

AHTA AHTA Newsletter Newsletter Jul—Sep Apr - Jun 2015 2016 Issue Issue 104 107

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lunch. Make sure you follow the AHTA on Twitter at @aushandtherapy, and use hashtags when you tweet #handtherapy #ahta2016 # t e n d o n m a s t e r y #guesswhoscomingtodinnerAHTA If you are going to Tweet or Facebook about the content of the conference or the wonderful things you are learning, make sure you have permission from the presenter to upload pictures of their slides onto social media.

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I can share a to do list with a and you feel lost, head to the colleague or friend if we both AHTA booth and ask to be introneed to work on the tasks duced to someone – or you could just lurk around and find Adrian I can send emails I need to Jollow, he is a great conference work on straight from my inbox buddy to have! into Trello Trello will sync my list as I go, so Amy Geach when I get back to work onto Life Member AHTA my office computer, it is all Director Riverina Hand Therapy & Maida Learning there.

Wagga Wagga NSW

Hope to see you at the conference. If you haven’t been to many or don’t know many people

3. Keep a handle on the to do list: There are so many ways of creating a to do list. Some off us love pen and paper, whilst some of us love electronic lists. For those who love to hand write down ideas and reminders, make sure that when you go back home you get out that paper list and schedule things to do into the diary. I think this is one of most common ways we don’t get things done, because we don’t find time when we get back home to make it happen. If they are schedules into the diary, you are more likely to be accountable to yourself to get things completed. Trello is a great place to start. Trello is an online tool that allows you to great to do lists easily and have them available when you get back home from the conference.

Trello is available for smartphones, tablets and desktop computers.

Whilst you are sitting at the conference you can be creating your to do list as you go. I love Trello for the following reasons: 

I can add deadlines to my tasks as I create them

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I can have multiple to do lists in the one screen (yes, I love to categorise them!)

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on a stamp; 4. shuttle and deal playing cards; 5. put a scarf around one ’s neck.

TEMPA (Test d’Evaluation des Membres Supé ueurs de Personnes Âgées)

4-point scale, task analysis.

References Desrosiers J, Hébert R, Dutil É, Bravo G. Development and reliability of an upper extremity function test for the elderly: the TEMPA. Can J Occup Ther 1993;60:9-16.

Birgit Svens

Desrosiers J, Hébert R, Dutil É, Bravo G. Upper extremity performance patient’s upper limb limitations than test for the elderly (TEMPA): normative data and correlates with senour other functional assessments. sorimotor parameters. Arch Phys Med Rehabil1995;76:1125-9.

The total cost for TEMPA and transport at the end of 2015 was Desrosiers J, Hebert R, Dutil É, Bravo A$1323.00. Delivery time from the G, Mercier L. Validity of the TEMPA: time of ordering was approximately a measuremet instrument for upper extremity performance. Occup Ther one month.

J Res 1994;14:267-81.

A few years ago I submitted a short article to this newsletter asking if anyone had an interest in obtaining the TEMPA. The aim was to obtain a group of people to show interest so that we could then engage an Australian supplier to import it. The outcome was that only one person showed interest and the idea was Unilateral tasks put on hold.

In November last year we presented on Functional Assessments currently in use at Royal Adelaide Hospital to the Plastic and Reconstruction Surgery Department in their weekly inservice. We mentioned that the TEMPA was included as something we would like to use to replace our existing ones (Upper Extremity Function Test, Sollerman’s Hand Grip Test and a few others). The ‘Plastics’ department kindly offered to purchase the TEMPA for the OT department for use on their patients.

As it is an overseas supplier the hospital could not order it and therefore we had to use one of our own personal credit cards to purchase it and then seek re-imbursement.

Janelle Hill has so far used it with major upper limb trauma, and reconstruction. The TEMPA provides better details and overview of the

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Nedelec B, Dion K, Correa JA, Desrosiers J. Upper Extremity Perfor1. pick up and move a jar; 2. pick up a pitcher and pour water mance test for the elderly (TEMPA): Normative data for young adults. J into a glass; 3. handle coins; Hand Ther 2011;24:31-43.

4. pick up and move small objects Platz T, Winter T, Müller N, Pinkowski Bilateral tasks C, Eickhof C, Mauritz K-H. Arm ability training for stroke and traumatic 1. open a jar and take a spoonful brain injury patients with mild arm of coffee; 2. unlock a lock and open a pill paresis: a single-blind, randomised, controlled trial. Arch Phys Med Recontainer; 3. write on an envelope and stick habil 2001;82:961-8.

Right: This picture is copied from the Physipro website: http:// www.physipro.com/en/ product/tempa/ For more information about this product you can contact Physipro by emailing: info@physipro.com

AHTA AHTA Newsletter Newsletter Jul—Sep Apr - Jun 2015 2016 Issue Issue 104 107

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The ‘Scissor Splint’ Rose Gospel

fortable and natural to use (above) For several years I experienced thumb CMC joint pain from using scissors with poor thumb posture and I know I’m not alone! Even after I learnt the importance of not “collapsing” my thumb into the MCP joint hyperextension posture, if I was too busy, or the scissors were too stiff for my thumb strength, my attempt at good thumb posture would vanish (see below).

plastics including Orfit Eco, Taylor and Aquaplast T. I think any plastic of this thickness is fine. I prefer non-perforated for infection control reasons (hard to get the disinfectant wipe into those little holes).

Pattern (below)

Instructions I tried working with a thumb splint that kept my MCP joint in flexion but found it awkward and could- 1. Mould the thermoplastic circumferentially around your n’t use it with scissors. I had the thumb, extending from the idea of having my splint built into MCP joint to the tip of the my scissors. I have been using this thumb. ‘scissor splint’ for several years and the only time I now get thumb 2. Place your thermoplastic enpain is when I demonstrate poor cased thumb through the top thumb posture to my patients. hole of the scissor handle at approximately a 45° angle.

Position your thumb in the scisI have made the ‘scissor splint’ sors where it would feel comwith a variety of 3.2mm thermoPage 33

3. Fold the wider section of the thermoplastic back around the top scissor handle.

4. Before the thermoplastic has fully hardened, ensure you can slide your thumb in and out, remembering that the scissor splint works best if it is snug. If you accidentally get your thumb IP joint stuck, gently heat the thermoplastic with a hair dryer to soften.

Improving thumb stability I find it physically impossible to hyperextend my thumb MCP joint when cutting with the ‘scissor splint’ insitu. I believe this is preventing further laxity of my already lax thumb ligaments (ie. Volar oblique “beak” ligament). Using the ‘scissor splint’ also seems to have a strengthening effect in particular to my first dorsal interos-

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Member Contributions

Continued ...

sei, extensor pollicis brevis and flexor pollicis brevis. To a lesser extent it contracts abductor pollicis longus (isometric type contraction). Adductor Pollicis Brevis is active when using the ‘scissor splint’ and I regularly release and stretch this muscle to maintain an open first web space. Since using the ‘scissor splint’ regularly at work, I have noticed that my thumb doesn’t collapse like it used to in other tasks. It appears that my regular scissor use is now strengthening and providing dynamic stability to my thumb, rather than pain and deformity.

Good scissors I would like to credit Elizabeth Lomax for writing our department’s scissor policy. This includes maintaining, sharpening or replacing scissors regularly and using different scissors for cutting different materials. In our department we

use Kinesio scissors for cutting strapping and fabrics, metal scissors for thermoplastics, curved scissors for those hard to get into spots (a must have in my opinion) and spring opening shears for sticky backed Velcro.

Some therapists prefer the spring opening lever style scissors to look after their thumbs, but I’ve never found any of great quality. For me I credit my ‘scissor splints’, made on good quality sharp scissors for my strong and pain free thumb.

Lets do what we tell our patients AND LOOK AFTER OUR THUMBS! I would love to hear any feedback from therapists who try this.

Rose Gospel BAppSc (OT)/CHT The Queen Elizabeth Hospital Rosemary.Gospel@sa.gov.au

Top right: Spring opening level style scissors from Spotlight, Bottom Left: Spring opening shears for sticky backed Velcro.

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Volunteering with Interplast Sharon Goldby

Interplast Australia & New Zealand (Interplast) was founded in 1983 and is a not-for-profit organisation that provides volunteer plastic and reconstructive and capacity building programs to countries in the Asia Pacific region.

Interplast works to improve the lives of people in developing countries who are disabled as a result of congenital and acquired medical conditions. Volunteer plastic and reconstructive surgeons, anaesthetists, nurses and allied health professionals provide free medical treatment for those who would otherwise not be able to afford access to services.

Interplast works closely with local health services to build their capacity to deliver surgical and other related health care interventions.

Interplast Hand Therapy Coordinators (Asia and Pacific) are voluntary positions responsible for assisting Interplast staff, with oversight and advice for Interplast hand therapy program activities.

The Hand Therapy Coordinator for each region provides a focal point for all programs in that region and assists in identifying appropriate volunteers for program activities and reviews activity reports. Current coordinators are Sharon Goldby Occupational Therapist (Asia) and Jenny Ball, Physiotherapist representing activities in the Pacific region The Interplast hand therapy working group consists of members of the AHTA and aims to support surgical programs by providing postopera-

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tive hand therapy follow up by local therapists trained and mentored by our members.

Most activities are aimed at reducing the severity of burn scar contracture both acutely and long term by providing appropriate training programs where possible to local staff.

In 2015 the AHTA provided a grant for an Occupational Therapist to attend this program to provide splinting and post operative management to surgical patients and to assess potential areas for capacity building. Jane Aarons pioneered the hand therapy component of this program and in 2016 this program was expanded to provide a small assessment, fitting and manufacturing service of pressure garments for keloid and hypertrophic scarring with the support of The Women’s international group. Opportunities were investigated as to the potential for local tailors or garment companies to manufacture these garments, as materials are available in Thailand as are some splinting materials. This program made use of donated garments, fabric and new and pre-used pressure garments from Therapist support laboratories and the Alfred hospital. Post operative care was provided to program participants with mentoring to local therapists and surgeons. .Jane Aarons and Sharon Goldby have been the principle therapists involved in this program with ongoing capacity building activities planned for 2017.

Programs in the Asia/Pacific region vary from country to country in terms of allied health development but most involve training as well as working alongside surgical teams The working group is represented by clinicians from all major hospitals in Melbourne, many private practices Bhutan: and Monash University.

Recent programs in the Asia and pacific region 2015-16 have included Laos and Bhutan, Fiji, Vanuatu, Tonga and Samoa. Hand Therapists will also be participating in programs in Mongolia, Bangladesh and the Solomon islands in 2016-17. An overview of these programs provides an insight into the scope and development of hand therapy services across our region and the benefit to local counterparts by involvement of our members.

Laos Since 2008 Interplast has provided plastic surgery training at Mahosot hospital in Vientiane with a focus on burns management.

Up to this point no hand therapist had been included on this program.

A long standing combined surgical and allied health program has been running in Bhutan for 6 years under the guidance and expertise of Suzanne Caragianis. This program came under partnership with Interplast in 2015.

There have been significant advances in training of hospital physiotherapists and technicians and mentoring from a hand therapy perspective with substantial resources, and equipment provided.

Through independent fund raising

by Suzanne Caragianis hand therapy rooms have been established and fitted out in three areas, the main hospital in Thimpu, and two regional areas, Mongar and

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Punkha. Suzanne has also generously committed personal funds to the establishment of hand Therapy services in Bhutan, without which these services would not exist.

Two hand and upper limb courses have been run and significant mentoring and training of the local therapists is ongoing. Suzanne has been supported on many of these programs by Megan Fitzgerald. In 2015 courses were run on neuro physio treatment for head injuries, stroke and CP. A physiotherapist and doctor from Bhutan were sponsored by Suzanne to attend a month of training in hand therapy in India and ongoing sponsorship for local training and equipment continues to occur. Suzanne has also been involved with promoting government awareness of the value of hand therapy and rehabilitation post injury. She is to be congratulated for her efforts.

From Jenny’s perspective: Physiotherapists provide all Allied health treatment in the Pacific.

Generally there are no Speech pathologists or Occupational Therapists. They are also poorly resourced in terms of consumables, relying solely on donations, which are an issue requiring at some point, discussion with local ministries of health.

In many places there may be only one or two staff who do everything.

What they do depends on their knowledge and experience and what opportunities they have had for extra training in more specialised areas.

This precedent gives us hope that with the right education and support we can up-skill the current and future workforce in the basics of burns treatment, scar management, hand therapy and speech intervention in cleft lip and palate.

The Pacific region has the advantage of the centralisation of Medical, Nursing and Physiotherapy degree courses at the Fiji National

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University. As the educational hub, students from all other countries in the region attend university in Suva for undergraduate and postgraduate studies.

We now have a foot in the door and have presented our first week long course in Burn and Hand therapy, splinting, pressure garment design and sewing, and Speech pathology for Cleft lip to the final year Physiotherapy students. We have the full support of the head of school, who also attended the whole week last year and has placed our course in the 4th year curriculum. We see this as a cost effective and opportune method of ensuring that the future workforce across the Pacific will view treatment of these patients as a part of their everyday work and not something that other people from outside will come in and do. We also hope to bring key staff from outlying areas to the course this year to up-skill the current workforce.

Also, in the absence of local professional development opportunities, ongoing professional development in the form of access to the online resources of Australian organisations such as the APA, AHTA, ANZBA and OT Australia is being sought and negotiated.

I hope that in the years to come surgical teams will notice a difference and an overall improvement in outcomes across hands, burns and cleft lip and palate.

grams, there is a lack of local resources for allied health in terms of people, equipment, supplies and local training opportunities. The working party is looking to develop resources that can be made available to teams in the absence of allied health input in the form of basic positioning, exercise, and scar information kits.

The hand therapy working group has provided substantial resources to an Interplast educational portal to support therapists attending programs and with a view to enabling access to local therapists.

Monash 4th year students are contributing to the organization of this resource which has recently been launched. The portal consists of educational resources for volunteers, including presentations, patient resources and educational materials for in country therapists.

The provision of pressure garments and scar management education is significantly lacking across the regions and has been identified, as a major need. It has been proposed that pressure garment manufacturers in Australia be approached to provide a course in the fundamentals of pressure garment construction. Interplast volunteers will then be equipped to provide basic training in this area to all regions where applicable.

The working group meets on a monthly basis to review and to assist with the ongoing planning and development of programs.

Main issues for the Hand Therapy working group.

Volunteer applications can be submitted via the Interplast website.

There has been an increase in re- Interplast is a highly organised and quests for allied health support for respected organisation with which Interplast programs. Many programs to partner, and to raise the profile of do not have local personnel to sub- Australian allied health representastantiate training programs but as tives both at home and overseas. the clinical focus of surgical programs becomes more specific and hand surgery becomes a focus, the inclusion of hand therapists on these programs becomes essential.

As is the case with most surgical pro-

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Wide Awake Hand Surgery & Clinical Pearls for Hand Surgeons and Hand Therapists Alanna O’Brien On Friday 6th May 2016, Prof Don Lalonde, New Brunswick Canada, presented at the Queensland Hand Surgeons Society Members and Associates Dinner at the Gold Coast Arts Centre.

I was eager to attend as I heard great reviews about Dr. Lalonde’s talks and I was interested on how clients manage Wide Awake Surgery and the implications from a therapy point of view. There were many of us that trekked down from Brisbane to the Goldy and we were treated with an amazing 3 course dinner sponsored by Integra and enjoyed not only a talk on Wide Awake Hand Surgery, but also his Pearls of Hand Surgery and Hand Therapy.

Dr. Lalonde is an engaging speaker, the presentation was full of video clips and he was determined to share his pearls whilst we were eating. The first topic was around intrinsic muscle function; whereby he nicely described the lateral bands mimic a noose. i.e. When the MCPJ flexes this increases the tension on the long extensors pulling the lateral bands dorsally and tighten like a noose around the PIPJ. Dr. Lalonde uses the

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simple “pencil test” in rooms or a sterile tongue depressor in surgery to assess function and pain/stiffness with a change of the MCPJ flexion/extension relative to the adjacent fingers, which results in a change of pain/stiffness at the PIPJ or other contributing structures. He terms it the relative motion exercise splint (RMES), a thermoplastic version of the pencil configuration that applies the principle is the same as the Merritt bar/Yoke splint/reverse Merritt bar.

tion, VP# on a background of diffuse OA. Dr. Lalonde reports great success for managing Boutonniere deformities in this type of splint, which clearly allows patient to continue to function as opposed to traditional splints.

He spends a long time educating his patients. One of his mantra’s/ clinical pearls is: “You can move it, but you can’t use it.

You can move it, but you can’t use it.

You can move it, but you can’t use it.”

He is keen for his patients to “live and function” not be bogged down in exercise regimes. It seems like a great simple analogy for those clients that just don’t quite get it.

A Plastics and Reconstructive Surgeon, he is an advocate of healing by secondary intention, and a favorite wound dressing is He advocated use of the RMES Vaseline and Coban™. in conservative management of Interosseous tears, which are He talked about his personal excharacterized by pain in be- perience of having a carpal tuntween the MCPJ, reduced intrin- nel release, then having ongosic function and swelling over ing mild symptoms which didn’t the interosseous muscle. I have resolve as expected. Through a been fortunate to be treating a conference he met with Elisabet few clients with similar conditions Hagert who demonstrated to since the talk, where I hadn’t him he had unresolved Pronator previously thought of using this syndrome. Specifically, had type of splint. Instantaneously proximal median nerve entrapwith an interosseous tear, I had ment at the lacetus fibrosus increased function (gripping) which is characterised by weakand less pain and the client was ness of FPL, FDP2, FCR, pain over able to return to sailing and their compression at lacertus level. hobbies. I had a similar great He also reported symptoms may outcome reducing pain, swelling include palm numbness or paand increase in function for a tient complains of generalized client 11/52post painful and weakness. poorly managed PIPJ disloca-

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The evening topic changed to  Wide Awake Surgery or WALANT (Wide Awake Local Anaesthesia No Tourniquet) techniques.

Dr. Lalonde reports using this technique since 2007 and advocates in many surgeries and those that do not need observation of the blood tissue supply in the hand.

Some of surgeries that he has been using the technique for include:

as surgery is conducted with field sterilization (in a room no different to your GP procedure suite), it was really easy for the Hand Therapist to view the surgery or see the outcomes or splint post operatively. No more “how did you get 0-100 for that PIPJ on the table”

He is an advocate for initial hand therapy review on Day 3.

He operates on Friday, and therapy starts Monday for his clients including Flexor tendon repairs and tenolysis. It is all related to normal tissue healing and that a tendon is unlikely to be adhered in this time frame, and allows those post operative vascular changes to occur without further trauma.

tendon excursion with this limited movement, which reduces the tension on the repair but ensures enough glide. He advocates stopping Place and Hold exercises, which he calls “Buckle and Jerk”. After seeing the video’s of this (flexor tendon buckling on the pulley and jerking through with the hold– I’m a little scared too.

It was an incredibly enjoyable evening and presentation. I am sure the clinicians around the country that were able to hear him were as equally impressed as I.

Tendon transfer surgery Primary flexor and extensor tendon repairs  Carpal Tunnel, Cubital tunnel, Alanna O’Brien Lacertus compression releasIpswich Hand Therapy es  Tenolysis  K-wire insertion of finger fractures.

On a final note on flexor tendon repairs; Dr. Lalonde strongly adDr. Lalonde’s technique uses an vocated using half fists to 45 deanesthetic comprised of Lido- grees for the first 3-4 weeks as he caine with epinephrine. He de- has demonstrated 0.5cm to 1cm scribed a particular serial progression of injecting to achieve suitable anaesthesia, so patients only feel the first injection. He reported high safety rates, eliminating anaesthesia induced complications.  

The biggest advantages I could see from hand therapist’s point of view: 

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the surgeon can spend time with the patient educating them (how wonderful for a flexion tendon repair!) the patient can see/feel the outcome of the surgery. Fantastic for empowering them. the patient can move the affected area if needed check AROM i.e. tenolysis and tendon repair.

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AHTA AHTA Newsletter Newsletter Jul—Sep Apr - Jun 2015 2016 Issue Issue 104 107

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AHTA AHTA Newsletter Newsletter Jul—Sep Apr - Jun 2015 2016 Issue Issue 104 107

AHTA Google Group   

Would you like to discuss ideas and issues with other hand therapists?

Do you love the idea of having access to an entire network of like-minded individuals?

Would you love to access a wide range of topics relative to your industry and even create your own topics?

You can! And all from the comfort of your computer!

If you are a member of the AHTA you can Join our exclusive google group, giving hand therapists access to Australia’s largest online forum of Hand Therapists.

Share and access exciting clinical and professional information now!!

Contact communications@ahta.com.au for further information

Just can’t get enough of us?

There are lots of ways to access exclusive AHTA content!

Visit us:

www.ahta.com.au

or click one of the links below:

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AHTA AHTA Newsletter Newsletter Jul—Sep Apr - Jun 2015 2016 Issue Issue 104 107

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AHTA AHTA Newsletter Newsletter Jul—Sep Apr - Jun 2015 2016 Issue Issue 104 107

Professional Development International Conferences 2016 22nd—25th June 2016 Federation of European Societies for Surgery of the Hand Santander, Spain http://www.fessh2016.com/

13th—15th July 2016 New Zealand Hand Society Meeting Queenstown, NZ http://handsociety.nzoa.org.nz/home

15th-18th September, 2016 American Society of Hand Therapists 2016 Conference Washington DC https://www.asht.org/education/asht -annualmeeting

6th—9th October 2016 American Society of Shoulder and Elbow Therapists Annual Conference Boston, USA http://www.asset-usa.org/Conferences.html

13th—14th October 2016 British Society for Surgery of the Hand and British Association of Hand Therapist Combined Autumn Scientific Meeting Cardiff, UK http://www.bssh.ac.uk/education/ scientificmeetings

24th—28th October, 2016 IFSSH-IFSHT 2016 Joint Congress Buenos Aires, Argentina

Australian Meetings 2016 26th-28th August, 2016 Australian Hand Therapy Association 2016 National Conference: “Tendons, Injuries / Conditions” Rydges, World Square, Sydney http://ahtaconference.com.au/

Don’t forget! You can view upcoming events on the AHTA website. Simply go to: http:// www.ahta.com.au/site/ australian-meetingsconferences-2016

http://www.ifssh-ifsht2016.com/ifsht.php Page 42

AHTA AHTA Newsletter Newsletter Jul—Sep Apr - Jun 2015 2016 Issue Issue 104 107

Mentor List A number of AHTA Members have made themselves available to act as mentors to hand therapists wishing to apply for Full Membership of the AHTA. Please contact one of the mentors in your state or territory for assistance with your application.

Contact should be established 3-6 months prior to submitting the application to ensure adequate time frames for professional dialogue between the therapist and mentor. The purpose of this is to: Help you locate a mentor (or be a mentor) if you do not already have one; and Review your application to ensure it is complete and accurate before submitting

AHTA Mentors 2015

QLD Katie Whittle

secretary@ahta.com.au

Phone: (07) 3139 4259

hamish@andersonhandtherapy.com.au

Phone: 0413 426 474

hfitzgerald@inhand.net.au emmatstaples@gmail.com

Phone: 0412 288 593 Phone: (08) 9272 1424

suzanne_caragianis@bigpond.com

Phone: (08) 8277 9667

cathymerry@hotmail.com naomiw@sapphirephysio.com.au

Phone: (02) 4626 1333 Phone: (02) 6492 0023

VIC Hamish Anderson

WA Helen Fitzgerald Emma Staples

SA Suzanne Caragiannis

NSW Cathy Merry Naomi White Page 43

AHTA AHTA Newsletter Newsletter Jul—Sep Apr - Jun 2015 2016 Issue Issue 104 107

Library Resource List Pollicization: Educating The AHTA’s DVD content is available through the website. Simply log  Hand Surgeons: Making a in as a Member and click on the Videos link on the top right side of Thumb: The story of pollicithe page. Please email Dion Sandoz (AHTA Knowledge & Resources zation Officer) on resources@ahta.com.au if you have any issues viewing the AHTA DVD’s.

AHTA History: All other library items can be borrowed on request by emailing the On AHTA website AHTA Knowledge and Resources officer. Library loans are for 1 week only. There is no hire fee. Members are responsible for return Books: postage to Dion Sandoz.  Clinical Assessment Recommendations 3rd.

2 CPD points are awarded to members who complete a short reEdiition: Impairment Based view of a resource item by answering a few questions for the newsConditions (2015) letter. A certificate will be emailed to members on receipt of the  Organising academic conreview. ferences. Amy and Lynn Exploring Hand Therapy  Office Ergonomics: Take Zelmer. Green Guide No ( T r e a tm e n t 2 G o ) D V D s Control!

11. (1991) (Available Online):  Physical Agent Modalities:  Therapeutic Hand Splints Occupation based impleVol 1 by Paul Van Lede &  A Royal Pain in the Thumb mentation of electrical and Griet Van Veldhoven  Basics and Beyond: Part 1 thermal agents (donated 2000) and 2 everything you need  RSD: Tips, tricks, trends and Online Journals (Available through Science Direct via the to know- Shoulder to finger trivia (For loan)  Shoulder Pathology: A de- AHTA website):  Burns: Stop, Drop and Retailed approach to examihab nation and treatment  American Journal of Hand  Clinical Activities Made  Sports Injuries: Off the SideTherapy (1995 Onwards) Simple lines and into the game  American Journal of Hand  Cervical exam: The Physi-  Stiff Hand: Explanations Surgery (1995 Onwards) cian’s approach and MP and Solutions  Hand Clinics (2002 OnArthroplasty  Stiff Joints: Tips, tricks and wards)  Distal Radius Fractures: Slip, trivia  Hand Therapy (complete fall broken wrist  Wound Healing for the back catalogue)  Elbow: Unlocking the hinge Hand Specialist: Heal ‘em  Journal of Hand Surgery to function up Quickly!

(European Volume)  Ergonomics: tips, tricks and  Wrist Secrets: Parts 1, 2 and (complete back catatrivia 3 logue)  Hand Therapy Boot Camp  X-Rays: Basics and beyond Journals (For Loan):  Intrinsics: Unravel the mysOther Educational CD/DVD’S: tery  Joint Mobilization of the  American Journal of Hand Upper Extremity  Explain Pain Audio (NOI) Therapy (Oct 1987 to 2008  Lateral Epicondylitis: A ther-  Interactive Hand (PCs not but missing 1994 no 3 and apists approach to conMACs)- Therapy edition 1996, no 2). quering pain DVD by Judy Colditz, D  British Journal of Hand Ther Mirror Mirror on the Wall: Mcgrouther, J Harris apy (Jan 2005 to 2008): Motor Imagery Program  The Neurodynamic Tech* Up to August 2007  Myofascial Therapy: With niques DVD plus handbook available from librariemphasis on trigger points (NOI) an of the upper extremity  Oedema Management in * Summer 2007 Vol Oedema: Here today, Hand Therapy: K erry ume 12, Nos 2, 3 and 4 gone tomorrow Stingel: 2013 (Flash drive) * Summer 2008 VolPage 44

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Library Resource List ume

13, Nos 2, 3 and 4 * Winter 2008 Volume  No 4. from the AHTA office manager

13,

AHTA Interest Group Meetings:  DVD’S /CD’S: 

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AHTA National Conference (Adelaide 2006): Level 1 splint workshop (photo’s) and How to make a leather splint by Emily Myers NSW IG Meeting (February 2003): CRPS by Lorimer Moseley NSW IG Meeting (2004): Principles of Tissue Healing

by Tracey Clark, Lara Phillips, Julia Wild, Sue Shaw NSW IG Meeting (August 2005): Musculoskeletal Ultrasound by Dr John Korber NSW IG Meeting (August 2006): Wrist Anatomy Workshop by Dr Alok Jhamb NSW IG Meeting (February 2007): PIP Joint by NSW IG Member Presentations NSW IG Meeting (March 2007): Focal Dystonia by Bronwyn Ackerman NSW IG Meeting (July 2007): Review of International Conference, Sydney NSW IG Meeting (July 2007): Nerve gliding for CTS and Review of IFSHT paper

by Michel Coppieters NSW IG Meeting (September 2007): Leather Splinting by Penny Barrett NSW IG Meeting (February 2008): Various NSW IG Member Presentation NSW IG Meeting (June 2008): Hand Therapy Products & Casting by 3M & Ausmedic NSW IG Meeting (2008) Extensor Tendons by Emma Carr (No DVD, available for download on pdf from the

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library AHTA Website) NSW IG Meeting (April 2009): Developing Country Projects by Dr Grace Warren NSW IG Meeting (June 2009): Ultrasound of the Hand by Dr John Korber NSW IG Meeting (October 2009): The TFCC- Surgery and Therapy by David Yee NSW IG Meeting (February 2010): WorkCover and Hand Therapy by Dr Rob Boland NSW IG Meeting (May 2010): Kinesiotape in Hand Therapy by Alison Taylor NSW IG Meeting (June 2010): Carpal Tunnel Syndrome by Dr Rob Boland NSW IG Meeting (October 2010): Neuropathic Pain and CRPS by Dr Robert Adler NSW IG Meetings (February 2013 onwards): Available at: www.handgroup.net Qld IG Meeting (March 2004): The Wrist and Hand in Sport- Taping, Active Stability and Fine Motor Acquisition by Chris Brady (x 2 DVD’s) Qld IG Meeting (July 2004): The Psychological Components of Pain Management and Adjustment to Injury by Mandy Vance and Louise Williams (Summary in Powerpoint format available via email) Qld IG Meeting (March 2005): Mirror Therapy for Acute CRPS- Graded Motor Imagery by Mark Cruickshank Qld IG Meeting (February 2006): Plaster of Paris: The forgotten splinting material

by Vanda Carius Qld IG (May 2006): Anaesthetics Perspective on CRPS

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management by Dr Mark Walden Qld IG Meeting (2008): Manual Oedema Mobilisation by Angela Thynne Qld IG Meeting (December 2010) Multi-Trauma by Cherie Aceto & Emma Taylor Qld IG Meeting (2011): Throwing Injuries by Dr Matt Hislop SA IG Meeting (February 2014) Examination of the Wrist by Malcolm Wicks WA IG Meeting (2007): Manual Oedema Mobilisation by Sandy Artzberger WA IG Meeting (February 2010): Anatomy of the Extensor Tendons- Clinical reasoning strategies, plus quiz questions by Specialised Hand Therapy WA IG Meeting (May, 2010): Pain WA IG Meeting (May 2012): CRPS- Handout only, also available via webinar format by Jeannie Davis

Birgitta Rosen Papers on the one CD: 

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AHTA 0401 A New Model Instrument for outcomes after nerve repair. Birgitta Rosen and Goran Lundborg (2003) AHTA 0402 Behavioural treatment of post traumatic and vibration- induced digital cold sensitivity. Ingela Carlsson, Ragnhild Cederlund, Jan Holmberg and Goran Lundborg (2002) AHTA 0403 Early use of artificial sensibility in hand transplantation. Marco Lanzetta et al (2003) AHTA 0404 ASHT Clinical Assessment Recommenda-

AHTA AHTA Newsletter Newsletter Jul—Sep Apr - Jun 2015 2016 Issue Issue 104 107

Library Resource List 

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tions: Sensibility Testing.

Janet Stone (undated) AHTA 0405 A new tactile gnosis instrument in sensibility testing. Birgitta Rosen and Goran Lundborg (1998) AHTA 0406 Sensory reeducation today and tomorrow: A review of evolving Concepts. Birgitta Rosen, Christian Balkenius and Goran Lundborg (2003) AHTA 0407 Early use of artificial sensibility to improve sensory recovery after repair of the median and ulna nerve. Birgitta Rosen, Goran Lundborg (2002) AHTA 0408 Outcome assessments in hand surgery: When are they meaningful?

Robert Szabo (2001) AHTA 0409 Sensory relearning after nerve repair. Bigitta Rosen and Goran Lundborg (2001) AHTA 0410 Inter-tester reliability of a tactile gnosis test: The STI Test. Bigitta Rosen (2003) AHTA 0411 Sollerman hand function test: A standardised method and its use in tetraplegic patients. Christer Sollerman and Arvis Ejeskar (1994)

Cochrane Reviews:

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Silicon gel sheeting for preventing and treating hypertrophic and keloid scars (Review). O’Brien & Pandit.

2008, issue 3.

Journal Articles: (Can be photo-  copied, faxed/posted, emailed from librarian) 

A walk through the anatomy of the hand and fore-

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arm. Daniel C. Riordan.

Journal of Hand Therapy 1995; April-June: 68-79.

Achieving a successful and sustainable return to the workforce after ABI: A client-centred approach. Lisa O’Brien. Brain Injury 2007; 21(5): 465-478.

Adherence to therapeutic splint wear in adults with acute upper limb injuries: a systematic review. Lisa O’Brien. Hand Therapy 2010; 15(1): 3-12.

An advice and exercise program has some benefits over natural recovery after distal radius fracture: a randomised control trial. Sandra Kay, Margaret McMahon and Kathy Stiller. Australian Journal of Physiotherapy 2008; 54: 253-259.

Assessment of the severity of hand injuries using hand injury severity score, and its correlation with the functional outcome. Saxena P., Cutler L., Feldberg L., Injury: International Journal of the Care of the Injured, 2004, 35, 511-516.

Biologic Aspects of Flexor Tendon Laceration and Repair. Beredjiklian, Pedro.

JBJS,

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Current Concepts Review, 2003.

Casting, Splinting and Physical and Occupational Therapy of Hand Deformity and Dysfunction in Cere-  bral Palsy. Judith Wilton, Hand Clinics, 19 (2003) 573584.

Clinical Care Update.

Technique addresses computer related RSI. Kahan, N.  J. Occupational Medicine, Vol 8, No17. 2002 Part 1.

Part 2: Vol 8, No 18 2002.

Clinical examination of the wrist. Terri Skirven. Journal of Hand Therapy 1996; 9: 96 -107.

Clinical provocative tests used in wrist pain. LaStayo and Howell. Journal of Hand Therapy 1995; 1: 1017.

Comparing Three Post Operative Treatment Protocols for Extensor Tendon Repairs in Zones 5 and 6 of the Hand. Hall, Lee, Page, Rosenwax and Lee. The American Journal of Occupational Therapy 2010; 64 (5): 682-688.

Consensus statement Describes Dressings for Acute and Chronic wound Management. Barclay,L. Archives of Dermatology 2007, 43: 1291-1294, 12971304.

Determinants of compliance with hand splinting in an acute brain injured population. O’Brien & Bailey. Brain Injury 2008; 22(5): 411-418.

Early return to work and improved range of motion with modified relative motion splinting: a retrospective comparison with immobilization splinting for zones 5 and 6 extensor tendon repairs. Hirth, Bennett, Mah, Farrow, Cavallo, Ritz and Findlay. Journal of Hand Therapy 2011; 16: 8694.

Effects of Stress Healing on Wounds: Intermittent Noncyclical Tension. Arem, A., Madden, J., Journal of Surgical Research, Vol 20, No2, 1976.

Extensor Retinaculum Impingement in the Athlete: A New Diagnosis. Van Heest A, Luger N, House J, Vener

AHTA AHTA Newsletter Newsletter Jul—Sep Apr - Jun 2015 2016 Issue Issue 104 107

Library Resource List 

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M AJSM Preview 2007.

Immediate Cotrolled Active Motion Following Zone 4-7 Extensor Tendon Repair.

Howell, Merritt and Robinson. Journal of Hand Therapy 2005; 18: 182-190.

Impact of Taping After Finger Flexor Tendon Pulley Ruptures in Rock Climbers.

Isabelle Schöffl, Frank Einwag, Wolf Strecker, Friedrich Hennig, and Volker Schoffl. Journal of Applied Biomechanics, 2007; 23:5262 2007.

It’s Not Just a Finger.

Combs, J. Journal of Athletic Training 2000, 35: (1681782).

Moon Socks for Mallets.

Thomas C. American Journal of Hand Therapy 2006; 19 (13): 365-367.

Patient Experience of Distraction Splinting for Complex Finger Fracture Dislocations. O’Brien & Presnell.

Journal of Hand Therapy 2010; 23: 249-260.

Pre and post surgical therapy and management of a patient with intrinsic minus hands. Donna Breger. Journal of Hand Therapy 1989; July-September: 177-185.

Prevocational Group Intervention Program for Building Motivation in Mature Aged Unemployed People with a Disability. Lisa O’Brien. Journal of Rehabilitation 2007; 73(1): 22-28.

Prospective Analysis of splinting the first carpometacarpal joint: an objective, subjective, and radiographic assessment. Weiss, LaStayo, Mills,and Bramlet.

Journal of Hand Therapy 2000; 13(3): 218-227.

Provocative wrist tests and MRI are of limited diagnos-

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tic value for suspected wrist ligament injuries: a cross sectional study. Prosser, H a r v e y , L a S t a yo , H a r greaves, Scougall and Herbert. Journal of Physiotherapy 2011; 57: 247-253.

Reliability and validation properties of the Malaysian language version of the Occupational Self assessment version 2.2 for injured workers with musculoskeletal disorders. Murad, Farnworth & O’Brien. British Journal of Occupational Therapy 2011; 74(5): 226232.

Secondary defects of the hand with intrinsic paralysis: prevention, assessment and treatment. J. Wil Brandsma. Journal of Hand Therapy 1990; January – March: 14-19.

Sensible manual muscle strength testing to evaluate and monitor strength of the intrinsic muscles of the hand. Brandsma and Schreuders. Journal of Hand Therapy 2001; 14: 273 -278.

Shoulder muscle recruitment patterns during a kayak stroke performed on a paddling ergometer. Trevithick B., Ginn K., Halaki M., Balnave R. Journal of Electromyography and Kinesiology 17 (2007) 74-79.

Shoulder Pain and Disability Index. Breckenridge and McAuley. Journal of Physiotherapy 2011; Vol 57: 197.

Single blind, prospective, randomized controlled trial comparing dorsal aluminium and custom thermoplastic splints to stack splint for acute mallet finger.

O’Brien and Bailey. Archives Phys Medical Reha-

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bilitation 2011; 92: 191-198.

Strength measurements of the intrinsic hand muscles: a review of the development and evaluation of the Rotterdam intrinsic hand myometer. Schreuders et al. Journal of Hand Therapy 2006; 19: 393-402.

The Distal Radioulnar Joint: anatomy and management of disorders. Jaffe, Chidgey, and LeStayo.

Journal of Hand Therapy 1996; 9: 129-38.

The Effect of Passive Mobilisation following Fractures involving the Distal Radius: a randomised study. Sandra Kay, Naomi Haensel and Kathy Stiller. Australian Journal of Physiotherapy.

The Efficacy of Ultrasound in the Evaluation of Dynamic Scapholunate Ligamentous Instability. (2004) Journal of Bone and Joint Surgery (Am) 86: 1473-1478.

The Thumb “Strap Splint” for Dynamic Instability of the Trapeziometacarpal Joint.

Anne Wajon. Journal of Hand Therapy 2000; JulySept: 236-237.

Twelve weeks of nightly stretch does not reduce thumb web space contractures in people with neurological condition: a randomised controlled trial. L Harvey, L., De Jong, I., Goehl, G., Marwedal, S. Australian Journal of Physiotherapy, Vol. 52, 2006.

Abstracts of Interest: 

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Biomechanical Comparison of Ulnar Collateral Ligament reconstruction techniques Ruland, R et al AJSM 36:1560-1570 2008 Closed Treatment of non

AHTA AHTA Newsletter Newsletter Jul—Sep Apr - Jun 2015 2016 Issue Issue 104 107

Library Resource List rheumatoid extensor tendon dislocation at the MCP  joint. Catalano L. et al JHS 31:2;242-245 2006 Theses: 

Adherance Behaviour in an Acute Paediatric Hand Trauma Population: A pilot study investigating parental report of adherence levels and influencing factors Tanya Cole (Masters Thesis) 2014

Course Notes: AHTA National conference March 2002 Jane Fedorczyk (international speaker) (P/P presentations): * Examination and Intervention for lateral epicondylitis * Management of neurogenic pain in the hand and upper quadrant * Overview of CTD: Epidemiology and Evidence of Tissue Changes * The Use of Physical Agents in the Management of CTD: Reflections on * Evidence and Neuroscience * Evidence of Neuroplastic Changes in the Dorsal Horn of the Spinal Cord in * An In Vivo Voluntary Repetitive Motion Injury Model  “Welcome to Explain Pain” Sydney 2007 by David Butler  Current Concepts in Diagnosis and Management of CRPS. Damien Finniss.

Memorabilia:     

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AHTA Newsletters: Page 48

All newsletters are accessible on the AHTA Website: 1993 to Oct 2007 2007 to current (located at AHTA Office)

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Photos from conferences IFSHT opening ceremony DVD Sydney 2007/photos Notes/ photo’s for AHTA poster Poster on ‘Do you want to know more that the basics History of American Society of hand Therapists pre certification ASHT Newsletters 1986

Conferences: Abstract proceedings/notes:

books/

1984: 1986: Combined Australian Hand Club/AHTA: Ten don repairs & manage ment. Sydney NSW. 1987: Management of small joint injuries. Melbourne VIC. 1987: RA and wrist instability. Ade laide, SA. 1988: Anatomy and General hands.

Brisbane QLD. 1990: Wrist and soft splinting.

Glenelg, SA 1991 May: Update hand injuries and dynamic splinting. Sydney, NSW 1991 Nov: The Stiff Hand/RA Hand.

Judy Colditz. Sydney, NSW 1992 1993: Combined AHSS/AHTA: Flexor Tendons & Mutilating InjuriesBlue Mountains, Sydney.

1994: Comprehensive approach to the wrist. Noosa, QLD. 1995: Joint replacements in the up per limb. Melbourne VIC 1996: Nerve and the Upper

Quad rant. Cairns QLD. 1997: Wrist Functional Capacity Eval uation, Shoulder & research Sydney 1998: Biomechanics of the Upper Limb – Perth WA 1999: Sporting Injuries of the Hand and Upper Limb Sydney 2000: Acute Upper Limb Trauma – Melbourne VIC 2001: Pain M anag em ent – Glenelg, SA 2002: Cumulative Trauma – Main Beach QLD 2002: Jane Fedorczyk workshops Gold Coast, Qld 2003: Combined NZHT/AHTA – Queenstown, NZ 2004: Nerve Injury and Repair – Fre mantle, WA 2005: Hands On Trauma – Coogee Beach, NSW 2006: Get A Grip on Arthritis Ade laide SA 2007: IFSHT/IFSHS - Sydney International Proceedings: 1992: Paris 2nd IFSHT 1995: IFSHT Helsinki 3rd IFSHT 2007: IFSHT/IFSHS Sydney Hand In Hand: with opening ceremony disc Tapes: 2004: Nerve Injury and Repair – Fre mantle, WA: 5/11/04: session2, 3, 4.

6/11/04: session 1, 2, 3, +workshop 7/11/04: session 1

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AHTA AHTA Newsletter Newsletter Jul—Sep Apr - Jun 2015 2016 Issue Issue 104 107

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AHTA AHTA Newsletter Newsletter Jul—Sep Apr - Jun 2015 2016 Issue Issue 104 107

Contact us Office Contacts

Australian Hand Therapy Association National Office Address: Email: Phone:

PO Box 84 SOUTHERN CROSS WA 6426 info@ahta.com.au (08) 9049 1666

DIXON

SARAH

Executive Support Manager (Operations)

NOLLER

KATE

Executive Support Manager (Strategy)

Management Committee HELEN President

BURFIELD

(SA) president@ahta.com.au

Phone: (08) 8211 800

presidentelect@ahta.com.au

Phone: (03) 9458 5166

TRACEY CLARK (NSW) Immediate Past President

pastpresident@ahta.com.au

Phone: (02) 8080 4362

DAVID Treasurer

PARSONS

treasurer@ahta.com.au

Phone: (08) 9266 3970

KATIE Secretary

WHITTLE

secretary@ahta.com.au

Phone: (07) 5443 5474

communications@ahta.com.au

Phone: (03) 5562 4442

education@ahta.com.au

Phone: 0417 760 970

DION SANDOZ (NSW) Knowledge and Resources

resources@ahta.com.au

Phone: (02) 4922 3059

AMY GEACH (NSW) Marketing and Promotions

marketing@ahta.com.au

Phone: (02) 6925 0157

KYLIE FLYNN Membership

membership@ahta.com.au

Phone: (02) 9845 6500

stateaffairs@ahta.com.au

Phone: (03) 5331 3066

KAREN FITT President Elect

(VIC)

(WA)

(QLD)

CATHERINE REID Communications

(VIC)

JULIE CONDON Education

(QLD)

(NSW)

JENNIFER KAESS (VIC) State and Territories Affairs Page 59

AHTA AHTA Newsletter Newsletter Jul—Sep Apr - Jun 2015 2016 Issue Issue 104 107

Divisional Coordinators 2014 - 2015 ACT ELIZABETH (Main Contact)

DALLA - POZZA

The Canberra Hospital Yamba Drive GARRAN ACT 2605

Phone: (07) 3139 4259

NICOLA (Main Contact)

COOK

MGS Hand Therapy 1 Whistler Street MANLY NSW 2095

Phone: (02) 9976 2666

MICHELLE

CHIM (YUEN)

North Shore Hand Therapy Level 4, Suite 2, Westbourne Street ST LEONARDS NSW 2065

Phone: (02) 9460 7788

NADIA

SMIT

Macquarie Hand Therapy Suite 403, Macquarie University Clinic 2 Technology Place MACQUARIE UNIVERSITY NSW 2109

Phone: (02) 9812 3982

VICTORIA

TRICARDOS

South Western Sydney Hand Centre Fairfield Hospital Cnr Polding Street and Prairievale Rd PRAIRIEWOOD NSW 2168

Phone: (02) 9616 8713

VIRGINIA (Main Contact)

WISE

The Alfred Hospital 55 Commercial Road PRAHRAN VIC 3004

Phone: (03) 9076 2920

TANYA

COLE

The Alfred Commercial Road PRAHRAN VIC 3181

Phone: (03) 9076 3526

LISA

O’BRIEN

N/A

Phone: N/A

LUKE

ROBINSON

The Royal Melbourne Hospital Gratan Street PARKVILLE VIC 3050

Phone: (03) 9342 7400

DONOVAN

Alice Springs Hospital Gap Road ALICE SPRINGS NT 0870

Phone: (08) 8951 7789

NSW

VIC

NT JAYNE (Main Contact)

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AHTA AHTA Newsletter Newsletter Jul—Sep Apr - Jun 2015 2016 Issue Issue 104 107

Divisional Coordinators 2014 - 2015 Continued

QLD FRANCES (Main Contact)

BLACK

QLD Health 45 Richmond Street GORDON PARK QLD 4031

Phone: (07) 3636 7100

AMANDA

MCKILLOP

Advance Therapy Solutions Suite 8 1407 Logan Road MT GRAVATT QLD 4122

Phone: 1300 420 556

MARGO

COFFEY

QLD Health 3/119 Baringa Street MORNINGSIDE QLD 4170

Phone: N/A

CHARLOTTE

NASH

EKCO 5 Tees Street YEERONGPILLY QLD 4105

Phone: N/A

DEUT

Flinders Medical Centre Bedford Park ADELAIDE SA 5048

Phone: (08) 8204 5498

CAROLYN (Main Contact)

ASMAN

Launceston General Hospital Charles Street LAUNCESTON TAS 7250

Phone: (03) 6348 7216

MARLENE

KALIS

In Balance Physiotherapy 18-20 Paterson Street LAUNCESTON TAS 7259

Phone: (03) 6334 4766

STUART (Main Contact)

WILSON

Hand Works Occupational Therapy Suite 16, Lvl 1, Wexford Medical Centre 3 Barry Marshall Pde MURDOCH WA 6150

Phone: 1300 887 798

LANI

MCAULIFFE

Hand Works Occupational Therapy Suite 16, Lvl 1, Wexford Medical Centre 3 Barry Marshall Pde

Phone: 1300 887 978

YVETTE

ROBERT

Inhand Occupational Therapy Princess Margaret Hospital 4/44 Barnfield Road CLAREMONT WA 6010

Phone: (08) 9284 5885

SA KAVEETA (Main Contact)

TAS

WA

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