Hand Therapy Certification Examination study guide
CHT · Work through your exam, one topic at a time.
The Certified Hand Therapist (CHT) credential is awarded by the Hand Therapy Certification Commission to occupational therapists and physical therapists who meet advanced experience requirements and pass a comprehensive examination of advanced clinical skills and theory in upper limb rehabilitation. According to HTCC, a CHT has a minimum of three years of clinical experience, including 4,000 hours or more in direct practice in hand therapy. The CHT study guide has 5 sections and about 1,627 words.
01Upper Limb Assessment and Evaluation
Assessment of the upper limb is a hypothesis-driven process, not a checklist. Be able to describe observation (posture, swelling, wasting, skin changes), active and passive range of motion (AROM/PROM) , manual muscle testing (MMT, 0–5 scale) , goniometry landmarks, sensation testing (light touch, two-point discrimination, monofilament), grip and pinch dynamometry , and functional/outcome measures (e.g., DASH, QuickDASH, PRWE, Michigan Hand Questionnaire).
347 words, about 2 min02Treatment Planning and Intervention
Treatment planning links assessment findings to measurable goals , dose , and progression criteria . Understand tissue healing phases (hemostasis/inflammation, proliferation, remodeling) and how they set loading parameters.
321 words, about 2 min03Anatomy and Pathology of the Upper Limb
Know the brachial plexus (roots C5–T1, trunks, divisions, cords, terminal branches) and key peripheral nerves: median (carpal tunnel, pronator teres, anterior interosseous), ulnar (cubital tunnel, Guyon's canal), and radial (spiral groove, posterior interosseous). Understand myotomes and dermatomes , the rotator cuff (supraspinatus, infraspinatus, subscapularis, teres minor) and its actions, ligament and capsule anatomy of the wrist and hand, and common pathologies: rotator cuff tendinopathy/tear, adhesive capsulitis, lateral/medial epicondylalgia, carpal tunnel syndrome, De Quervain tenosynovitis, Dupuytren contracture, trigger finger, and complex regional pain syndrome .
330 words, about 2 min04Wound Care and Scar Management
Understand wound healing phases and the factors that delay healing (infection, ischemia, diabetes, smoking, steroids, malnutrition). Know wound assessment - size, depth, tissue type, exudate, periwound skin, and signs of infection - and moist wound healing principles.
312 words, about 2 min05Professional Practice and Evidence
This domain tests evidence-based practice (ask, acquire, appraise, apply, assess), levels of evidence (systematic reviews/RCTs above cohort/case studies/expert opinion), and critical appraisal concepts: validity, reliability, sensitivity/specificity, likelihood ratios, confidence intervals, and effect size . Know outcome measure properties (reliability, validity, responsiveness, MCID) and how to select a measure.
317 words, about 2 min