Certified Hand Therapist (CHT) Examination key terms

Measurement of joint range of motion using a protractor-like device aligned with bony landmarks. Clinicians record active and passive arcs in degrees to document baseline motion, track progress, and guide treatment decisions.

Standardized measurement of maximal grip force using a calibrated hand dynamometer, usually reported in kilograms or pounds. Three trials are averaged and compared with normative values adjusted for age, sex, and hand dominance.

Threshold test of light touch using calibrated nylon filaments applied with enough force to bend the monofilament. It grades sensory impairment from normal to loss of protective sensation and helps identify patients at risk for skin injury.

Test of innervation density in which two points are applied to the skin and the smallest distance perceived as two separate points is recorded. Static and moving versions assess different receptor populations, and normal values differ by digit and age.

A tingling or electric sensation produced by percussing over a regenerating or compressed nerve. It helps localize the level of nerve involvement and track sensory recovery over time, though findings are not highly specific.

A provocative test for carpal tunnel syndrome in which the wrists are held in full flexion for about one minute. Numbness or tingling in the median nerve distribution is considered a positive result.

The sum of active metacarpophalangeal, proximal interphalangeal, and distal interphalangeal joint flexion minus any extension deficit. Expressed as a composite score, it summarizes digital motion after tendon injury or repair.

A water displacement method for measuring hand or limb edema. The hand is lowered into a volumeter and displaced water is read from a graduated scale; serial measurements track swelling and response to edema control interventions.

An eleven-item self-report questionnaire derived from the Disabilities of the Arm, Shoulder and Hand outcome measure. It scores upper-limb disability and symptoms from 0 to 100, with higher scores indicating greater limitation.

A sequenced set of finger and wrist positions that move the flexor tendons through their full excursion within the sheath. The exercises reduce adhesion formation and restore differential glide after tendon repair or in tenosynovitis.

Gentle, controlled movements that slide and elongate a peripheral nerve along its bed without stretching it to the point of tension. They aim to restore neural mobility and reduce symptoms of nerve compression or adhesion.

A set of energy-conservation and body-mechanics strategies that reduce stress on painful or deformed joints. Techniques include using larger joints, avoiding prolonged gripping, respecting pain, and modifying tools and daily tasks.

Techniques such as elevation, compression garments, retrograde massage, and active exercise used to reduce excess fluid in the hand. Controlling edema preserves joint mobility, reduces pain, and limits fibrosis after injury or surgery.

A splint that applies low-load, prolonged tension to a joint and can be adjusted to progressively increase stretch as tissue lengthens. It is used to regain motion in stiff joints such as the elbow or finger.

A splint with elastic or spring components that applies continuous passive force to assist or resist motion. It is commonly used to maintain or gain range after tendon injury, nerve injury, or joint stiffness.

A graded program of progressively less tolerable textures and stimuli applied to a hypersensitive area. The goal is to reduce pain and hypersensitivity after nerve injury so the patient can tolerate normal touch and use the hand.

Structured training that helps patients reinterpret altered sensory input after nerve repair or injury. It progresses from protective awareness to localization, discrimination, and object recognition using graded tactile tasks.

A treatment in which the patient views the reflection of the unaffected limb in a mirror placed at midline, creating the illusion of movement in the affected limb. It is used for pain, phantom sensations, and motor recovery.

Peripheral nerve formed from the medial and lateral cords of the brachial plexus that supplies sensation to the palmar thumb, index, middle, and radial half of the ring finger and motor control of the thenar muscles.

Peripheral nerve arising from the medial cord that supplies most intrinsic hand muscles and sensation to the little finger and ulnar half of the ring finger. It passes through Guyon canal at the wrist.

Anatomic passage at the wrist formed by the carpal bones and the transverse carpal ligament. The median nerve and flexor tendons pass through it, and narrowing here causes carpal tunnel syndrome.

A fibro-osseous tunnel at the ulnar side of the wrist through which the ulnar nerve and artery pass. Compression here produces ulnar neuropathy with sensory and intrinsic motor deficits.

A ligamentous and cartilaginous structure on the ulnar side of the wrist that cushions the ulnar carpus and stabilizes the distal radioulnar joint. Tears cause ulnar-sided wrist pain and instability.

Tendon of the extensor mechanism inserting at the base of the middle phalanx. Its disruption allows the proximal interphalangeal joint to flex, producing a boutonnière deformity over time.

A thick ligament at the palmar aspect of the proximal interphalangeal joint that prevents hyperextension. Injury can lead to joint instability, swelling, and a flexion contracture or swan neck deformity.

Four intrinsic muscles that originate from the flexor digitorum profundus tendons and insert into the extensor mechanism. They flex the metacarpophalangeal joints and extend the interphalangeal joints during coordinated finger movement.

A finger deformity with proximal interphalangeal joint flexion and distal interphalangeal joint hyperextension, caused by disruption of the central slip. It impairs extension and requires splinting and targeted exercise.

A finger deformity with proximal interphalangeal joint hyperextension and distal interphalangeal joint flexion. It results from imbalance of the extensor mechanism, as in rheumatoid arthritis or after volar plate injury.

A chronic pain condition, usually after trauma, characterized by disproportionate pain, swelling, temperature and color changes, and motor or trophic changes. Early recognition and graded movement are important to limit disability.

A progressive fibroproliferative disorder of the palmar fascia that produces nodules and cords, causing flexion contractures of the fingers. Treatment options include observation, needle aponeurotomy, collagenase injection, and surgery.

Painful inflammation of the abductor pollicis longus and extensor pollicis brevis tendons in the first dorsal compartment at the radial wrist. It is provoked by thumb and wrist motion and treated with splinting, activity modification, or injection.

The range of professional activities a clinician is legally and ethically permitted to perform, defined by licensure, law, and professional standards. Practitioners must recognize when a case exceeds their competence or authority.

The process of explaining a proposed evaluation or treatment, its risks, benefits, and alternatives, so the patient can voluntarily agree. It requires decision-making capacity, comprehension, and documentation of the discussion.

A structured documentation format with Subjective, Objective, Assessment, and Plan sections. It records patient reports, measurable findings, clinical interpretation, and the planned course of care in a consistent, reviewable way.

The smallest change in an outcome score that patients perceive as meaningful. It helps clinicians decide whether an improvement exceeds measurement error and is clinically worthwhile.

A study in which participants are randomly assigned to intervention or control groups, reducing selection bias. It is a strong design for testing treatment effectiveness and supports causal inference.

Sensitivity is the proportion of people with a condition who test positive; specificity is the proportion without the condition who test negative. Together they describe how well a test rules in or rules out a diagnosis.

A framework for building a clinical question from Patient or population, Intervention, Comparison, and Outcome. It focuses literature searches and makes evidence appraisal more efficient.