Transcript
josh MacDonald: Hi, I'm Josh McDonald.
Miranda Materi: And I'm Miranda Macerri and we are Ham Therapy Academy.
josh MacDonald: Let's talk about technology and some of the apps we use in our clinics, whether it's on a phone or an iPad or whatever it is, what are some apps that we use? Miranda, do you have a favorite? Do you have a go-to?
Miranda Materi: um I think there's like, this is really a simple one, but the patient's camera on their phone to do videos of their exercises. So recording them doing the exercises or even taking a picture of their HEP paper, because I don't know about you, but that paper always seems to be sitting on that desk after they leave.
Miranda Materi: Yeah.
josh MacDonald: Yep, yep. I tell them, you can't tell me your dog needs your homework if it's on your phone. So you can take a picture of it.
Miranda Materi: Yeah.
josh MacDonald: Yep.
Miranda Materi: So it's either having them do a video of their exercises and I like hold their phone. Of course, you have to be careful that if there's other people in the clinic that you're not recording them, but recording them doing their exercises or just taking that picture.
josh MacDonald: yeah
Miranda Materi: So that's not really an app, but it is, I guess it kind of is.
josh MacDonald: yeah
Miranda Materi: It's an application on their phone. So that would be one thing. There is some other ones I like to use, which is Orientate, which is for the, um, graded motor imagery type stuff. So I might have them download the app where they can do right left discrimination.
Miranda Materi: When I first started working as an o t we had we made like these little, you know, like the index cards. So we would cut out pictures in a magazine of hands and we would like glue them on the index card.
josh MacDonald: Yeah, yeah.
Miranda Materi: And so of course you can't like, you know, you're making all these index cards for patients, but I, So when that app came out, it was like, oh yeah, this is amazing, right? We're not like making these silly or having interns cut up hand pictures from a magazine and putting them on an index card.
josh MacDonald: That was a great task for interns and and level one students, but nice to have you at.
Miranda Materi: Yeah, it's really nice. So basically it's an app where the patient has to look through and say, is this their right or their left hand? Because with conditions like CRPS or even some of our patients that maybe have amputees or amputations where they have a hypersensitivity, um discriminating between right, left has been shown to help reorientate them and help with some of their pain symptoms.
Miranda Materi: So basically this app goes through and you look at a hand and you say, is this the right or the left hand? And then at the end, it gives you a score of how well you did.
josh MacDonald: Yeah. Yeah. And it's pretty darn useful. They can keep track of their progress on their phone. It tracks one episode to the next and or exercise session to the next.
Miranda Materi: Yeah, I think it is pretty helpful too.
josh MacDonald: Yeah.
Miranda Materi: What about you?
josh MacDonald: um We've got a couple that we use like for proprioceptive or thumb mobility exercises. If you've got an iPhone. There's, um, there's an app called measure and it's like standard on your phone.
josh MacDonald: And if you, if you open it up and you click on the level, like a bubble level, like you would hang a picture with and you hold your phone flat, like screen to the ceiling, you can rest that on your thumb and index finger over that first web space. Like you're holding a cup.
josh MacDonald: And then you have to move your phone to get these two circles to line up and turn green, but it's a lot of CMC stability stuff. So that's a good one. That's standard on an iPhone. um There's another one. I've actually got my phone open because I don't remember these necessarily off the top my head the names of them.
josh MacDonald: One is tall called Tenku, T-E-N-K-Y-U. um And it's a labyrinth game, right? There's a bunch of these that are available. I've got one that's called Labyrinth 2 Light.
josh MacDonald: but this 10Q one is like it's levels like Candy Crush and you work your way up levels, but you're using your thumb to navigate around on the screen to move the maze under the ball.
josh MacDonald: And it's just good thumb stability. If you're working on an FPL adhesion after a flexor tendon injury or, you know, those kinds of things, it's just good to get your thumb moving. Like we do too much scrolling and swiping and texting, but this is maybe a little bit dynamic left, right, circular up and down movement. So good thumb mobility kind of things.
Miranda Materi: Very cool. And then the labyrinth one you can use for the wrist as well, right? So you could use it for a phone or an iPad, or sometimes we'll put the iPad on like a Bosu ball and have them in a prone position with their core stabilized where they have to, it's kind of more of shoulder proprioception where they have to hold the Bosu ball and get the balls to go through the maze on the iPad.
Miranda Materi: I think that's a fun one. It's obviously a more higher level exercise for our patients. And also it helps for the wrist as well.
josh MacDonald: Yes.
josh MacDonald: yes Yeah. Yeah. There's also some apps out there for us as therapists that are helpful, that are things we can use as tools. Um, a S S H has something called hand.e.
josh MacDonald: Um, and it's got a lot of good, like articles on things and little, um, quick, like quick things you can watch and lessons on things. It's just one of those, you can like, it's for surgeons, but it's good information for us. And you can read, uh, like what's newest in their journal. And some of those things, they just kind of keep updating it with things on,
josh MacDonald: certain specific topics, but good it's a good learning source.
Miranda Materi: Yeah, that's awesome. A couple other ones that we'll recommend, and there's a bunch of these, but there's some for mindfulness and meditation. um I think this is more a part of, you know, maybe our OT background, trying to be a holistic practitioner, but where they have, if you have a patient that's having a lot of pain management or maybe a lot of anxiety and stress, maybe it's due to their recent injury, or maybe that's kind of an overriding theme for them.
Miranda Materi: I think some of those can be helpful too, because we know it all impacts their recovery and their injury.
josh MacDonald: Yeah, yeah, definitely. We've got a couple of tools in our clinic that rely on an app that we have to use. um We've got both the Squag and the M-Trigger. Both of them are kind of biofeedback-like devices. The M-Trigger is definitely biofeedback, um but they've got several different games you can download. Basically, you're putting um motor point receptor um adhesive dots on the patient's muscle and just distal. You've got wires that go to this base unit and then a Bluetooth connects to typically your tablet or a phone.
josh MacDonald: And then you're just tracking how many microamps of force they're applying and they apply that to games you can play and whatnot. um And then Squag is a similar thing where how much they're squeezing, how much force they're squeezing, the repetition, coordinating it is all based on, it's a gamification on the app that they've got as well. So you have to kind of have a device to do that, um to use the app, but those can be kind of fun, different ways to engage patients with like gamifying the same exercises we're always doing anyway.
Miranda Materi: especially if it's a kid too. I feel like the kids love the squag. And what I like about the squag is you just clean it and you can use it each time. I think what's harder about the M trigger is the electrodes, right? Like there's only there's very specific electrodes you have to buy.
josh MacDonald: Yeah.
Miranda Materi: And so each patient has their own electrodes. So if you just want to try it one time, you're like, oh, I have to give you these electrodes. You know, like you you want to make sure you're going to get it be committed to using it more than once.
josh MacDonald: Yeah, yeah.
Miranda Materi: um But i I do like it because it does give you like kind of some EMG type feedback where you can see how the muscle is actually firing or if you don't want it to fire, right? Like, so sometimes where we have these exercise induced compartment syndromes and things like that, where you're like trying to be like, oh no, we don't actually want that muscle to fire when you're doing this type of exercise. So then the patient can really see like, oh, it's not firing or, oh, it's really firing way too much.
josh MacDonald: Yeah. Yeah. We typically reserve that for, in our case, more of the neuro patients, like radial palsy patients, trying to get things to turn back on again, tendon transfer patients, prosthetic training patients to try to get them to like, Hey, if I can,
josh MacDonald: initiate scapular retractors for before they get their device, or if they're getting a myoelectric, what motor points are going to be effective and maybe training those even working with a prosthetician to say like, Hey, this is, we've got really good like biceps, but brachioradialis is not really doing much or whatever the case is. And, and give them some feedback and say like, Hey, we can get good responses out of one group or another.
Miranda Materi: Right. And I think what is also helpful with that is you can, the electrodes is you can like kind of change your size a little bit. So if you're doing a smaller muscle group, you can cut them down a little bit. You just kind of have to know that that's going to impact your data a little bit on the screen.
Miranda Materi: But I think you have to know your anatomy well with the trigger.
josh MacDonald: Yeah.
Miranda Materi: So which we all should know well, but I think that's another reason we need to know anatomy well.
josh MacDonald: Yeah.
josh MacDonald: Yeah. yeah So lots of good technology out there to be had. If you have any other favorite apps that you use either as a, as a clinician to help educate you or with your patients to have some fun with and kind of take it in a different direction and and use the technology around us, let us know.
josh MacDonald: um Send us an email at info at hand therapy, academy.com or reach out to us on social media at hand therapy, academy.
