Hand Therapy Evaluation

[YOUR COMPANY NAME]

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Date: March 19, 2050

Patient's Information:

Name:

Age:

Gender:

Date of Birth:

Contact Information:

Introduction: This evaluation form is specifically designed for the assessment of hand therapy patients. It aims to objectively evaluate their functional abilities, strength, and range of motion.

Overview: This comprehensive Hand Therapy Evaluation contributes to the rehabilitation process of individuals with hand injuries or conditions. It systematically monitors progress and pinpoints areas requiring additional therapy interventions.

Evaluation Criteria:

1. Functional Abilities: This criterion assesses the patient's capability to perform everyday tasks using their hands. It includes activities such as gripping objects, writing, buttoning clothes, and handling utensils.

2. Range of Motion: Evaluate the extent of movement in the patient's hand joints, including fingers, wrist, and thumb. Use a goniometer or visually estimate the range of motion to provide an accurate assessment.

3. Strength: Measure the power exerted by the patient's hand without discomfort or injury. This involves testing grip strength and pinch strength using dynamometry or manual muscle testing techniques.

4. Dexterity: Assess the patient's precision, coordination, and fine motor skills in hand movements. Tasks such as picking up small objects, threading a needle, or manipulating small tools can be used to evaluate dexterity.

Instructions:

Rate each criterion on a scale from 1 to 5 according to the provided definitions:

1 - Severe impairment - Indicates significant limitation or inability to perform tasks.

2 - Significant impairment - This signifies notable difficulty or restriction in function.

3 - Moderate impairment - Suggests some limitations but with the ability to perform tasks with effort.

4 - Mild impairment - Denotes slight difficulty or restriction in function.

5 - No impairment - Indicates full capability with no limitations in function.

Assessment:

Criteria	Description	Rating Scale (1-5)
Functional Abilities	The ability of the patient to perform day-to-day tasks using their hands.
Range of Motion	The degree of movement available in the patient's hand joints.
Strength	The power is exertable by the patient's hand without discomfort or injury.
Dexterity	The skill and ease with which the patient can use their hand and fingers.

Additional Comments

Comments

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