Hand Therapy and Upper Limb Clinics

CRC specialist hand therapy and upper limb team offers a national consultative service aimed at maximising functional hand and arm use when this has been impacted by muscle tone difficulties. Our team of Occupational Therapists and Physiotherapists, Clinical Nurse, Consultant Paediatrician and Orthopaedic Surgeon work with the child or adult and family/carers to address your goals, in collaboration with your local team. The team provide specialist assessment and guidance on medical and surgical interventions combined with targeted therapy interventions and use of orthotics and dynamic splinting.

Hand Therapy Team: Occupational Therapist, Physiotherapist, OT Assistant

Upper limb full MDT Team: Consultant Pediatrician, Consultant Orthopaedic Surgeon, Clinical Nurse Specialist, Physiotherapist, Occupational Therapist

General Referral Criteria:

• Children with physical disability where atypical tone impacts upper limb and hand function
• Cerebral palsy GMFCS I-V

General Exclusion Criteria:

• Congenital Hand Disorders
• Children presenting with hypermobility
• Brachial Plexus Palsy

Hand Therapy Clinic Prioritisation Rationale

The Hand therapy team screen all referrals for the full UL MDT service as follows-

P1 Under 5 years old (prevention model)

Pre/post intervention evaluation (e.g., UL BoNT-A, Surgery)

Pain

New referral to ULOC (upper limb clinic)

P2 Advice / support for UL intervention options for local team

P3 Mild functional difficulties requiring specialist advice/input

HTC is inclusive of services of specialist orthosis / casting / advice on targeted therapy interventions such as modified constraint induced therapy / upper limb lycra garments and second skin garments, with continuous liaison, education and support to the child’s local primary therapists.

Upper limb orthopaedic and medical consultations take place as part of UL MDT service at CRC to plan and measure outcomes pre- and post-UL BoNT-A, Surgery.

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Contact Email:

upperlimb@crc.ie

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