Full Length Article| Volume 35, ISSUE 3, P339-345, July 2022

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Beyond the hand and upper extremity: The role of hand therapists in care of people with rheumatic diseases

Published:August 16, 2022DOI:


      • Functional and work disability in people with rheumatic diseases remain high despite advances in medical and pharmacological management
      • Hand therapists can play a vital role in chronic rheumatic disease management to improve self-management and increase participation in meaningful activities.
      • Patients, primary care, and rheumatology providers need to be educated about the scope of services occupational and physical therapy provide beyond the hand impairments.


      Study design

      Invited Clinical Commentary


      Arthritis is one of the most frequently reported causes of disability in the United States and the prevalence is expected to increase in the coming decades. While many rheumatic diseases involve hand impairments, most are systemic and involve more than the musculoskeletal system. Functional and work disability are high and people would benefit from the services of occupational and physical therapists.

      Purpose of study

      This paper reviews concepts of self-management, and symptoms that contribute to limitations and restrictions to participation in daily life in people with rheumatic diseases and suggests roles for hand therapists beyond the immediate hand impairments.


      The impact of selected rheumatic diseases on functional and work disability are reviewed along with strategies for symptom management and self-management. Upper extremity impairments of selected rheumatic diseases are also discussed.


      The role for hand therapists in evaluating and addressing the complex needs of persons with rheumatic diseases, including less common diseases, is discussed. Outcome measures for fatigue, muscle involvement, ergonomics and computer use, and work disability are introduced. Finally, strategies for self-management and prevention of work and functional disability, along with symptom management for fatigue and pain are presented.


      Hand therapists can play a vital role in chronic rheumatic disease management to improve self-management and increase participation in meaningful activities. Patients, primary care and rheumatology providers need to be educated about the scope of services occupational and physical therapists provide beyond the hand impairments.


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      JHT Read for Credit

      Quiz: # 870

      Record your answers on the Return Answer Form found on the tear-out coupon at the back of this issue or to complete online and use a credit card, go to There is only one best answer for each question.
      • # 1.
        The authors emphasize the role of
        • a.
        • b.
          caretaker efficiency
        • c.
        • d.
          proper use of orthotic devices
      • # 2.
        A National Health Survey found that approximately
        • a.
          2/3 of patients were women
        • b.
          2/3 of patients were male
        • c.
          50% were female and 50% were male
        • d.
          70% were left handed
      • # 3.
        Well recognized is the existence of ______________ along with the rheumatoid disease
        • a.
        • b.
        • c.
        • d.
          all of the above
      • # 4.
        The typical hand deformity accompanying scleroderma is
        • a.
          claw hand
        • b.
          swan neck
        • c.
          reduced PIP extension and reduced MP flexion
        • d.
          mallet finger
      • # 5.
        The authors emphasize the need for therapists to be more aware and concerned about the far-reaching effects of rheumatoid disease beyond the obvious effects on hands
        • a.
          not true
        • b.
      When submitting to the HTCC for re-certification, please batch your JHT RFC certificates in groups of 3 or more to get full credit.