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CHT Exam Prep Curriculum

Study Focus Area and HTCC Blueprint Content

 

Baseline Exam

 

Week 1: 

Anatomy and physiology of the hand and wrist, including kinematics of normal movement and features of the soft tissue and bony structures

  • Surface anatomy of the UE

  • Anatomy and Physiology of the skeletal system

  • Anatomy and Physiology of the muscular system

  • Anatomy and Physiology of the nervous system

  • Anatomy and physiology of the vascular and lymphatic system 

  • Kinesiology and biomechanics relative to the upper limb 

  • Diagnostic imaging of the upper limb

  • Tendon gliding

  • Adhesions or tightness (musculotendinous, capsular)

​

Week 2: 

Anatomy and physiology of the elbow and shoulder including kinematics of normal movement and features of the soft tissue and bony structures

  • Surface anatomy of the UE

  • Anatomy and Physiology of the skeletal system

  • Anatomy and Physiology of the muscular system

  • Anatomy and Physiology of the nervous system

  • Anatomy and Physiology of the vascular and lymphatic system 

  • Kinesiology and biomechanics relative to the upper limb 

  • Posture and its effects on the upper limb

  • Diagnostic imaging of the upper limb

​

Week 3:

Healing principles of soft tissue and bone injuries and the implications on therapeutic intervention

  • Histology of bone and soft tissue healing and repair 

  • Adhesions or tightness (musculotendinous, capsular)

​

Week 4: 

Evaluation, assessment, and special testing of the hand and wrist

  • Kinesiology and biomechanics relative to the upper limb 

  • Pathomechanics and pathophysiology relative to the UE

  • Psychological reactions to impairment 

  • Differential diagnosis

  • Assessment tools, tests, and measures and their psychometric properties 

  • Select, perform, and interpret assessment of:

    • Dexterity and coordination

    • Adhesions or tightness (musculotendinous, capsular)

    • Edema and swelling

    • Muscle function (MMT, tone, imbalance, atrophy)

    • Pain

    • Patient-reported outcomes

    • Sensibility

    • Dynamometry

    • Sympathetic status

    • ROM

    • Special signs and tests of the UE

​

Week 5: 

Peripheral nerve anatomy, acute and chronic injury, and nerve injury management

  • Anatomy and Physiology of the nervous system

  • Pathomechanics and pathophysiology relative to the UE

  • Posture and its effects on the upper limb

  • Differential diagnosis

  • Surgical, non-surgical, and medical management of hand and upper limb conditions, including expected outcomes and complications.

  • Post-surgical, non-surgical, and therapeutic intervention guidelines and protocols 

  • Assessment tools, tests, and measures and their psychometric properties 

  • Diagnostic imaging of the upper limb

  • Electro diagnostics of the upper limb

  • Anticipated outcomes of medical and/or therapeutic intervention

  • Rationale, indications, precautions, and contraindications for interventions 

  • Treatment techniques and tools:

    • Desensitization

    • Neuromuscular re-education 

    • Sensory re-education

    • Neural mobilization

  • Diagnoses, conditions, medical and surgical procedures:

    • Nerve injuries and conditions (neuropathies, palsies, nerve repairs, decompression, nerve grafts, transfers)

    • Neuromuscular diseases (ALS, MS, MD)

  • Select, perform, and interpret assessment of:

    • Dexterity and coordination

    • Muscle function (MMT, tone, imbalance, atrophy)

    • Sensibility

    • Dynamometry

    • Special signs and tests of the UE

​

Week 6:

Peripheral nerve anatomy, acute and chronic injury, and nerve injury management

  • Anatomy and Physiology of the nervous system

  • Pathomechanics and pathophysiology relative to the UE

  • Posture and its effects on the upper limb

  • Differential diagnosis

  • Surgical, non-surgical, and medical management of hand and upper limb conditions, including expected outcomes and complications.

  • Post-surgical, non-surgical, and therapeutic intervention guidelines and protocols 

  • Assessment tools, tests, and measures and their psychometric properties 

  • Diagnostic imaging of the upper limb

  • Electro diagnostics of the upper limb

  • Anticipated outcomes of medical and/or therapeutic intervention

  • Rationale, indications, precautions, and contraindications for interventions 

  • Treatment techniques and tools:

    • Desensitization

    • Neuromuscular re-education 

    • Sensory re-education

    • Neural mobilization

  • Diagnoses, conditions, medical and surgical procedures:

    • Nerve injuries and conditions (neuropathies, palsies, nerve repairs, decompression, nerve grafts, transfers)

    • Neuromuscular diseases (ALS, MS, MD)

  • Select, perform, and interpret assessment of:

    • Dexterity and coordination

    • Muscle function (MMT, tone, imbalance, atrophy)

    • Sensibility

    • Dynamometry

    • Special signs and tests of the UE

​

Week 7:

Surgical and non-surgical management of hand fractures and associated soft tissue injuries.

  • Pathomechanics and pathophysiology relative to the UE

  • Histology of bone and soft tissue healing and repair 

  • Differential diagnosis

  • Surgical, non-surgical, and medical management of hand and upper limb conditions, including expected outcomes and complications.

  • Post-surgical, non-surgical, and therapeutic intervention guidelines and protocols 

  • Diagnostic imaging of the upper limb

  • Anticipated outcomes of medical and/or therapeutic intervention

  • Rationale, indications, precautions, and contraindications for interventions 

  • Treatment techniques and tools:

    • Orthotics

    • Mobility

    • Strengthening

    • Adhesions or tightness (musculotendinous, capsular)

  • Diagnoses, conditions, medical and surgical procedures:

    • Dislocations and subluxations 

    • Fractures

    • Ligamentous injury and instability 

    • Muscular strains, tears, avulsions

    • Arthrodesis

    • Arthroplasty

    • Fracture fixation

    • Ligament repair/reconstruction

  • Select, perform, and interpret assessment of:

    • Adhesions or tightness (musculotendinous, capsular)

    • Edema and swelling

    • Muscle function (MMT, tone, imbalance, atrophy)

    • ROM

    • Special signs and tests of the UE

​

Week 8:

Practice Exam 1

​

Week 9:

Surgical and non-surgical management of wrist fractures, dislocations, ulnar wrist pathology, and carpal instabilities and associated soft tissue injuries

  • Pathomechanics and pathophysiology relative to the UE

  • Histology of bone and soft tissue healing and repair 

  • Differential diagnosis

  • Surgical, non-surgical, and medical management of hand and upper limb conditions, including expected outcomes and complications.

  • Post-surgical, non-surgical, and therapeutic intervention guidelines and protocols 

  • Assessment tools, tests, and measures and their psychometric properties 

  • Diagnostic imaging of the upper limb

  • Anticipated outcomes of medical and/or therapeutic intervention

  • Rationale, indications, precautions, and contraindications for interventions 

  • Treatment techniques and tools:

    • Orthotics

    • Mobility

    • Strengthening

    • Proprioceptive training

  • Diagnoses, conditions, medical and surgical procedures:

    • Dislocations and subluxations 

    • Fractures

    • Ligamentous injury and instability 

    • Muscular strains, tears, avulsions

    • Arthrodesis

    • Arthroplasty

    • Fracture fixation

    • Ligament repair/reconstruction

  • Select, perform, and interpret assessment of:

    • Adhesions or tightness (musculotendinous, capsular

    • Edema and swelling

    • Muscle function (MMT, tone, imbalance, atrophy)

    • ROM

    • Special signs and tests of the UE

​

Week 10:

Evaluation and treatment of the elbow associated with fractures, dislocations, instabilities, and soft tissue injuries.

  • Pathomechanics and pathophysiology relative to the UE

  • Histology of bone and soft tissue healing and repair 

  • Differential diagnosis

  • Surgical, non-surgical, and medical management of hand and upper limb conditions, including expected outcomes and complications.

  • Post-surgical, non-surgical, and therapeutic intervention guidelines and protocols 

  • Assessment tools, tests, and measures and their psychometric properties 

  • Diagnostic imaging of the upper limb

  • Anticipated outcomes of medical and/or therapeutic intervention

  • Rationale, indications, precautions, and contraindications for interventions 

  • Treatment techniques and tools:

    • Mobility

    • Strengthening

  • Diagnoses, conditions, medical and surgical procedures:

    • Dislocations and subluxations 

    • Fractures

    • Ligamentous injury and instability 

    • Muscular strains, tears, avulsions

    • Arthroplasty

    • Fracture fixation

    • Ligament repair/reconstruction

  • Select, perform, and interpret assessment of:

    • Adhesions or tightness (musculotendinous, capsular)

    • Edema and swelling

    • Muscle function (MMT, tone, imbalance, atrophy)

    • ROM

    • Special signs and tests of the UE

​

Week 11:

Evaluation and treatment of the shoulder associated with fractures, dislocations, instabilities, and soft tissue injuries.

  • Kinesiology and biomechanics relative to the upper limb 

  • Pathomechanics and pathophysiology relative to the UE

  • Histology of bone and soft tissue healing and repair 

  • Posture and its effects on the upper limb

  • Differential diagnosis

  • Surgical, non-surgical, and medical management of hand and upper limb conditions, including expected outcomes and complications.

  • Post-surgical, non-surgical, and therapeutic intervention guidelines and protocols 

  • Assessment tools, tests, and measures and their psychometric properties 

  • Diagnostic imaging of the upper limb

  • Anticipated outcomes of medical and/or therapeutic intervention

  • Rationale, indications, precautions, and contraindications for interventions 

  • Treatment techniques and tools:

    • Mobility

    • Strengthening

  • Diagnoses, conditions, medical and surgical procedures:

    • Dislocations and subluxations 

    • Fractures

    • Ligamentous injury and instability 

    • Muscular strains, tears, avulsions

    • Arthroplasty

    • Fracture fixation

  • Select, perform, and interpret assessment of:

    • Adhesions or tightness (musculotendinous, capsular)

    • Edema and swelling

    • Muscle function (MMT, tone, imbalance, atrophy)

    • ROM

    • Special signs and tests of the UE

​

Week 12:

Treatment techniques, including physical agents and orthotic concepts

  • Properties of heat, water, light, electricity, and sound as they apply to PAMs and electrodiagnostic tools.

  • Physical properties of orthotic and prosthetic materials 

  • Concepts and principles of orthotic devices

  • Concepts and principles of prosthetic devices 

  • Rationale, indications, precautions, and contraindications for interventions 

  • Adaptive and assistive devices

  • Modalities

    • Cryotherapy

    • Fluidotherapy

    • Thermal/heat

    • Iontophoresis

    • Electrical stimulation

    • Paraffin

    • Ultrasound/phonophoresis

  • Biofeedback

  • Manual therapy techniques 

  • Neuromuscular re-education 

  • Orthotics

  • Taping

​

Week 13:

Flexor tendon injuries

  • Pathomechanics and pathophysiology relative to the UE

  • Differential diagnosis

  • Surgical, non-surgical, and medical management of hand and upper limb conditions, including expected outcomes and complications.

  • Post-surgical, non-surgical, and therapeutic intervention guidelines and protocols 

  • Anticipated outcomes of medical and/or therapeutic intervention

  • Rationale, indications, precautions, and contraindications for interventions 

  • Treatment techniques and tools:

    • Orthotics

    • Mobility

    • Strengthening

    • Tendon gliding

    • Adhesions or tightness (musculotendinous, capsular)

  • Diagnoses, conditions, medical and surgical procedures:

    • Tendon injuries and conditions (lacerations, repairs, transfers, tendonitis, ruptures)

    • Synovectomy/tenosynovectomy

    • Tenolysis

  • Select, perform, and interpret assessment of:

    • Adhesions or tightness (musculotendinous, capsular)

    • Edema and swelling

    • Muscle function (MMT, tone, imbalance, atrophy)

    • ROM

    • Special signs and tests of the UE

​

Week 14:

Extensor tendon injuries

  • Pathomechanics and pathophysiology relative to the UE

  • Differential diagnosis

  • Surgical, non-surgical, and medical management of conditions of the hand and upper limb, including expected outcomes and complications.

  • Post-surgical, non-surgical, and therapeutic intervention guidelines and protocols 

  • Anticipated outcomes of medical and/or therapeutic intervention

  • Rationale, indications, precautions, and contraindications for interventions 

  • Orthotics

  • Mobility

  • Strengthening

  • Tendon Gliding

  • Adhesions or tightness (musculotendinous, capsular)

  • Diagnoses, conditions, medical and surgical procedures:

    • Tendon injuries and conditions (lacerations, repairs, transfers, tendonitis, ruptures)

    • Synovectomy/tenosynovectomy 

    • Tenolysis

  • Select, perform, and interpret assessment of:

    • Adhesions or tightness (musculotendinous, capsular)

    • Edema and swelling

    • Muscle function (MMT, tone, imbalance, atrophy)

    • ROM

    • Special signs and tests of the UE

​

Week 15:

Practice Exam 2

​

Week 16:

Anatomical features, presentation, and intervention associated with Dupuytren’s disease, infections of the hand, tumors, and burns.

  • Pathomechanics and pathophysiology relative to the UE

  • Etiology and pathology of medical conditions that may manifest with signs or symptoms in the hand or UE.

  • Differential diagnosis

  • Surgical, non-surgical, and medical management of hand and upper limb conditions, including expected outcomes and complications.

  • Post-surgical, non-surgical, and therapeutic intervention guidelines and protocols 

  • Pharmacology as it relates to the scope of hand therapy practice. 

  • Anticipated outcomes of medical and/or therapeutic intervention

  • Rationale, indications, precautions, and contraindications for interventions 

  • Diagnoses, conditions, medical and surgical procedures:

    • Cysts and tumors

    • Dupuytren’s disease

    • Infections

    • Fasciectomy/fasciotomy

    • Ganglionectomy 

    • Injections

    • Nailbed repair

    • Amputations

    • Crush injuries/mutilating trauma

    • Replantation and revascularization

    • Skin grafts/flaps

  • Select, perform, and interpret assessment of:

    • Adhesions or tightness (musculotendinous, capsular)

    • Edema and swelling

    • Muscle function (MMT, tone, imbalance, atrophy)

    • ROM

    • Special signs and tests of the UE 

  • Treatment techniques and tools:

    • Desensitization

    • Sensory re-education

    • Wound care

      • Debridement

      • Suture or staple removal

      • Cleansing

      • Application of topical medications 

      • Selection and application of dressings

      • Scar management 

​

Week 17:

Anatomical features, presentation, and intervention associated with amputations, transplants, and complex traumas

  • Pathomechanics and pathophysiology relative to the UE

  • Etiology and pathology of medical conditions that may manifest with signs or symptoms in the hand or UE.

  • Differential diagnosis

  • Surgical, non-surgical, and medical management of hand and upper limb conditions, including expected outcomes and complications.

  • Post-surgical, non-surgical, and therapeutic intervention guidelines and protocols 

  • Pharmacology as it relates to the scope of hand therapy practice. 

  • Anticipated outcomes of medical and/or therapeutic intervention

  • Rationale, indications, precautions, and contraindications for interventions 

  • Diagnoses, conditions, medical and surgical procedures

  • Differential tissue assessment

  • Treatment & Interventions

​

Week 18:

Anatomical features, presentation, evaluation, surgical and conservative management of arthritis affecting the elbow, wrist, and hand. 

Ergonomics and joint mechanics, worksite injuries

  • Etiology and pathology of medical conditions that may manifest with signs or symptoms in the hand or UE.

  • Differential diagnosis

  • Surgical, non-surgical, and medical management of hand and upper limb conditions, including expected outcomes and complications.

  • Post-surgical, non-surgical, and therapeutic intervention guidelines and protocols 

  • Assessment tools, tests, and measures and their psychometric properties 

  • Pharmacology as it relates to the scope of hand therapy practice. 

  • Diagnostic imaging of the upper limb

  • Anticipated outcomes of medical and/or therapeutic intervention

  • Rationale, indications, precautions, and contraindications for interventions 

  • Treatment techniques and tools:

    • Ergonomic modification

    • Joint protection

    • Orthotics 

    • Mobility

    • Strengthening

  • Diagnoses, conditions, medical and surgical procedures:

    • Arthritis and rheumatic diseases

    • Arthrodesis

    • Arthroplasty

    • Injections

  • Select, perform, and interpret assessment of:

    • Adhesions or tightness (musculotendinous, capsular)

    • Edema and swelling

    • Muscle function (MMT, tone, imbalance, atrophy)

    • ROM

    • Special signs and tests of the UE

  • Concepts and principles of ergonomics

  • Treatment techniques and tools:

    • Ergonomic modification

    • Joint protection 

    • Posture awareness, modification, and adjustment

  • Work conditioning and return to work programs

​

Week 19:

Tendinopathies affecting the upper extremity

  • Pathomechanics and pathophysiology relative to the UE

  • Etiology and pathology of medical conditions that may manifest with signs or symptoms in the hand or UE.

  • Differential diagnosis

  • Surgical, non-surgical, and medical management of conditions of the hand and upper limb including expected outcomes and complications.

  • Post-surgical, non-surgical, and therapeutic intervention guidelines and protocols 

  • Assessment tools, tests, and measures and their psychometric properties

  •  Diagnostic imaging of the upper limb

  • Anticipated outcomes of medical and/or therapeutic intervention

  • Rationale, indications, precautions, and contraindications for interventions 

  • Treatment techniques and tools:

    • Ergonomic modification

    • Joint protection

    • Mobility

    • Strengthening

  • Diagnoses, conditions, medical and surgical procedures:

    • Cumulative trauma disorders

    • Tendonitis 

    • Muscular strains, tears, avulsions

    • Injections

    • Synovectomy/tenosynovectomy

  • Select, perform, and interpret assessment of:

    • Adhesions or tightness (musculotendinous, capsular)

    • Edema and swelling

    • Muscle function (MMT, tone, imbalance, atrophy)

    • ROM

    • Special signs and tests of the UE

​

Week 20:

Anatomy, classification, presentation, and management of brachial plexus injuries

  • Anatomy and physiology of the nervous system

  • Etiology and pathology of medical conditions that may manifest with signs or symptoms in the hand or UE.

  • Posture and its effects on the upper limb

  • Differential diagnosis

  • Surgical, non-surgical, and medical management of hand and upper limb conditions, including expected outcomes and complications.

  • Post-surgical, non-surgical, and therapeutic intervention guidelines and protocols 

  • Anticipated outcomes of medical and/or therapeutic intervention

  • Rationale, indications, precautions, and contraindications for interventions 

  • Treatment techniques and tools:

    • Adaptive and assistive devices

    • Desensitization

    • Biofeedback

    • Sensory re-education

  • Diagnoses, conditions, medical and surgical procedures:

    • Nerve blocks/sympathectomies 

    • Tendon transfers 

  • Select, perform, and interpret assessment of:

    • Dexterity and coordination

    • Muscle function (MMT, tone, imbalance, atrophy)

    • Pain

    • Sensibility

    • Dynamometry

    • Sympathetic status

    • ROM

    • Special signs and tests of the UE

​

Week 21:

Vascular and lymphatic disorders affecting the upper extremity; Concepts relating to pain

  • Anatomy and physiology of the vascular and lymphatic system 

  • Etiology and pathology of medical conditions that may manifest with signs or symptoms in the hand or UE.

  • Rationale, indications, precautions, and contraindications for interventions 

  • Treatment techniques and tools:

    • Edema management

    • Lymphedema management 

  • Diagnoses, conditions, medical and surgical procedures:

    • Thermal and electrical injuries 

    • Vascular disorders

    • Edema

    • Lymphedema

  • Select, perform, and interpret assessment of:

    • Edema and swelling

    • Sensibility

    • Sympathetic status

    • ROM

    • Special signs and tests of the UE

  • Pathomechanics and pathophysiology relative to the UE

  • Physiology and psychology of pain

  • Pharmacology as it relates to the scope of hand therapy practice 

  • Anticipated outcomes of medical and/or therapeutic intervention

  • Treatment techniques and tools:

    • Desensitization

    • Biofeedback

    • Neuromuscular re-education 

    • Pain management

    • Graded motor imagery

    • Stress loading

    • Relaxation techniques 

    • Sensory re-education

  • Diagnoses, conditions, medical and surgical procedures:

    • Factitious disorders

    • Pain syndromes (CRPS, Fibromyalgia)

    • Nerve blocks/sympathectomies 

  • Select, perform, and interpret assessment of:

    • Dexterity and coordination

    • Adhesions or tightness (musculotendinous, capsular)

    • Edema and swelling

    • Muscle function (MMT, tone, imbalance, atrophy)

    • Pain

    • Patient-reported outcomes

    • Sensibility

    • Dynamometry

    • Sympathetic status

    • ROM

    • Special signs and tests of the UE

​

Week 22:

Practice Exam 3

​

Week 23:

Conditions associated with the pediatric population

  • Age-specific upper limb function 

  • Etiology and pathology of medical conditions that may manifest with signs or symptoms in the hand or UE.

  • Diagnoses, conditions, medical and surgical procedures:

    • Congenital anomalies/differences

    • Developmental disabilities

​

Week 24:

Spinal Cord and CNS disorders

Pathomechanics and pathophysiology relative to the UE

  • Etiology and pathology of medical conditions that may manifest with signs or symptoms in the hand or UE.

  • Differential diagnosis

  • Treatment techniques and tools:

    • Adaptive and assistive devices

    • Biofeedback

    • Orthotics

  • Diagnoses, conditions, medical and surgical procedures:

    • Spinal cord and CNS injuries

    • Tendon transfers

​

​

Retake missed questions on Practice Exams 

Final full Practice Exam and review 

​

Learning Objectives:

​

Upon full participation in the curriculum, participants that meet the HTCC CHT Exam criteria of 3 years in clinical practice and 4,000 practice hours in upper limb & hand therapy will:

​

Demonstrate advanced expertise in upper limb and hand anatomy and biomechanics, including related neuroanatomy & physiology, and the physiology of healing as evidenced in a weekly quiz and case study participation and by completion of (4) CHT practice exams.

 

Demonstrate advanced expertise in upper limb and hand pathology, pathomechanics, and the resultant sequelae, including impairment and occupational dysfunction, as evidenced in the weekly quiz and case study participation and by completion of (4) CHT practice exams.

 

Demonstrate advanced expertise in occupation-based examination, evaluation, diagnosis, prognosis, intervention, and management of patients with upper extremity, hand impairment, and disability as evidenced in a weekly quiz and case study participation and by completion of (4) CHT practice exams.

 

Demonstrate expertise in the use of tests and measures for the upper quarter, including identifying red flags that necessitate referral to the appropriate professional, as evidenced in the weekly quiz and case study participation, and by completing the (4) CHT Practice Exams.

 

Demonstrate the appropriate use of preparatory and occupation-based interventions for the upper extremity and hand to improve patient outcomes, as evidenced in the weekly quiz and case study participation and by completing the (4) CHT Practice Exams.

 

Demonstrate expertise in knowledge of medical management of upper limb and hand conditions (i.e., medications, injection,  surgical management...) and how that informs OT intervention as evidenced in the weekly quiz and case study participation and by completing the (4) CHT Practice Exams.

 

Demonstrate advanced expertise in common interventions used in upper limb and hand therapy interventions, such as manual techniques, orthotic fabrication, modalities, therapeutic exercise, and occupation-based activity, as evidenced in a weekly quiz and case study participation and by completion of (4) CHT practice exams.

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ACCESSIBILITY ACCOMMODATIONS: 

This program is delivered virtually using PowerPoint presentations and audio. Closed captioning is available if you choose to enable it. If you need special accommodations to improve accessibility of contact, please email Mirella Deisher at: info@virtualhandfellowship.com

 

CANCELLATION POLICY: 

The program can be discontinued at any time by canceling your monthly subscription through your enrollment & learning platform account.

 

You will not be reimbursed for any attended sessions, or content you have had access to, such as that provided with discounted bundles. 

 

CONTACT HOURS: 

VHSF is an AOTA Approved Provider; the CHT Exam Prep curriculum has been submitted for approval to AOTA as a PD activity of 52 contact hours delivered as a distance learning, independent, interactive, or hybrid.

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In order to be awarded the certificate of completion, all sessions must be attended, independent or interactive, and all quizzes and exams must be completed.

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