Conservative and Surgical Management of the Osteoarthritic Hand and Wrist: A Physical Therapy Perspective

Teri Bielefeld Fagan, PT, CHT, is a graduate of the Program in Physical Therapy at Marquette University, Milwaukee. She has recently retired from the Zablocki VA Medical Center in Milwaukee after holding the position of PT clinical hand specialist in the Outpatient Physical Therapy Clinic for the past 35 years. Teri is a clinical instructor in the physical therapy programs at Marquette University, Carroll University, Concordia University, and the University of Wisconsin-Madison. She has been a certified hand therapist since 1991 and has lectured nationally and internationally on numerous hand rehabilitation topics. Her publications include “The Unstable Metacarpophalangeal Joint in Rheumatoid Arthritis: Anatomy, Pathomechanics, and Physical Rehabilitation Considerations,” in the Journal of Orthopaedic & Sports Physical Therapy (2005), “The Carpometacarpal Joint of the Thumb: Stability, Deformity, and Therapeutic Intervention,” published in the same journal (2003), a monologue titled Hand Splinting for the APTA (Orthopaedic Section), and a chapter in Rehabilitation of the Hand and Upper Extremity, 6th edition, titled “Therapist’s Management of the Thumb Carpometacarpal Joint with Osteoarthritis.” Teri has twice served as president of the Hand Rehabilitation Section of the American Physical Therapy Association and is currently serving as their treasurer. Teri received the Marquette University 2000 Merit Award for distinguished professional achievement and the American Physical Therapy Association Henry O. and Florence P. Kendall Award for Clinical Excellence in 1998. She was named the Marquette University Physical Therapy Alumna of the Year in 1995 and received an Outstanding Service Award from the National Kidney Foundation of Wisconsin in 1992 and the M. P. Murray Award for Excellence in Clinical Practice from the Wisconsin Physical Therapy Association in 1987.

Debbie Amini, EdD, OTR/L, CHT, FAOTA, is the director of professional development for the American Occupational Therapy Association (AOTA). She received her bachelor of science degree in occupational therapy from Quinnipiac University, her master’s degree in education from the University of North Carolina at Wilmington, and her doctorate in education from North Carolina State University. A certified hand therapist since 1991, Dr. Amini worked as the director of an occupational therapy assistant program for 14 years before becoming an assistant professor of occupational therapy at East Carolina University in Greenville, North Carolina. She served for 3 years as chair of AOTA’s Commission on Practice and is the author of several AOTA official documents. For several years, Dr. Amini wrote bimonthly print columns in Advance for Occupational Therapy Practitioners, including “Hands On” and “Inside Occupation.” Her articles have appeared in Advance for Directors in Rehabilitation, the PD-SIS quarterly newsletter, OT Practice magazine, and AJOT. In addition to authoring online courses and textbook chapters, she has contributed the hand, wrist, and forearm component of the Occupational Therapy Practice Guidelines for Individuals with Work-Related Injuries and Illnesses published by AOTA. Dr. Amini has presented at the AOTA, NCOTA, and ASHT annual conferences and has conducted regional 2-day workshops on the topics of hand therapy and authentic OT practice.