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RUTH MAY DE VILLA BSPT IV

MANAGEMENT FOR THE RHEUMATOID OF THE ® THUMB

1. Paraffin over the ® thumb including thenar eminence x 20 min; to aid

relaxation

2. US x 3 MHz x 1.5W/cm2 x 5 min over the ® thumb and thenar eminence;

to aid tissue healing;

3. Gentle massage on the ® thumb and thenar eminence; effleurage; to aid

good circulation of the blood, relaxation and prevent atrophy

4. Static Splint – Thumb Spica Splint on the ® hand; to immobilize the

thumb

5. AROM exercises for the ® thumb x 10 reps for 2 sets within the limit of

pain, gradual progression as tolerated; to maintain available motion

a. flexion – extension of IP joint and MCP joint

b. abduction, adduction, flexion, extension and opposition of the CMC

joint

6. Gentle joint technique grade I or II oscillations on the ® thumb; IP, MCP

and CMC joints; for pain management and to minimize joint stiffness.

7. Gentle isometrics for the ® thumb in pain free position; to minimize

atrophy

8. Good positioning oh the ® hand and thumb to prevent deformities.

9. Lessen activities that may stress the joints.

10. Refer back to physiatrist for counseling on prognosis.