It is not everyday that we have the opportunity to interview such renowned and also special colleague in the field of Hand Therapy as Tom Lattré. By way of background, Tom is one of 24 European Certified Hand Therapists who currently hold this certificate. He is indeed an European expert in Hand Therapy!
Who is Tom Lattré?
Tom works as a physiotherapist in Belgium and specialises in hand therapy since 2004. He works in his private clinic “Tom Lattré – Handcentrum leper“. Furthermore, Tom has been president of the Belgian Society of Hand Therapists from 2009 to 2014.
A few months ago, we had the opportunity to accompany Tom to the Annual Symposium of the Belgian Hand Therapists Association in Brussels. Tom presented the work “Road to ReHand. A story” in which he talked about the work we have been doing together for years.
He also performs his clinical work of physiotherapist specialised in musicians. We have already discussed about the need for adequately treat these patients with such specific needs.
Apart from his clinical profile, he also carries out significant contributions in hand therapy research, having published in journals such as “Muscle & Nerve“, “Hand Surgery and Rehabilitation” or “The Journal of Hand Surgery (Asian-Pacific Volume)“. One of them was recently published in our social networks due to it´s clinical relevance. Tom Lattré et al asked themselves if the Boston Carpal Tunnel Questionnaire (BCTQ) needs a an update to keep up with current times:
In 2022, Tom Lattré et al published a new article! They performed an in-depth analysis using the Boston questionnaire (BCTQ) in preoperative patients with Severe and Recurrent Carpal Tunnel Syndrome. They argued with their results the need to analyse the scoring of all sections of the BCTQ, not only in its global score.
Here are some of the answers Tom gave us in our interview:
Many studies have reported how hand-wrist pathology has a direct impact on the somatosensory cortex. How important do you think it is to approach the post-surgical patient from a sensorimotor point of view?
“The impact of the somatosensory cortex, disturbance after trauma and training is very important. During my fellowship in university hospital in Leuven (Belgium,2004) I read an article about people who suffered a flexor tendon injury. After repair they could not move their finger, echographic findings were negative for adhesions or re-rupture. Functional MRI of the cortex suggested that they “forgot” to move.
“Next to this research, the articles from Rosèn Birgitta about sensory rehab, the mirror therapy form Ramachandran and the beautiful work of Elisabeth Hagert regarding the wrist proprioception were key stones in my awareness of the impact of the somatosensory system in the rehabilitation.”
“As a therapists, you must use all available senses to treat a hand. Hands are designed to be one of the main receptors in the human body. They deserve the best treatment, also from a sensomotoric point of view. The hand and fingers are hungry to stimulus.”
Why should I go to a Hand Therapist?
“If you have got a highly specialised tool that got broke, it’s obvious that you go to a specialist for the repair. It is the same thing for an injury in the hands. They are a very sophisticated parts of our body, making us able to “handle” something. For that reason, people should go to a specialized and experienced hand therapist.”
In which cases have you been able to use ReHand?
“In every case where I see the advantage of this tool. Stiffness, fear of mobilization/movement, early rehabilitation after surgery etc. It is an amazing tool that I can offer. It’s like good advice… you can use it or not… My patients are free to use it… it’s their responsibility and “they must take their rehabilitation in their own hands”.
The latest evidence advocates the use of adherence promotion strategies when prescribing exercise programmes. How do you think the possibility of monitoring your patients remotely has impacted?
“Very important. The monitoring and the ability to adapt the programme is important as a therapist. You are the pilot, the guide of the rehabilitation. The control is the stick behind the door, you can check how motivated your patient is.”
“When I am telling my patients that I can monitor their activities on ReHand, it’s always fun to see their reactions 🙂 “
Does telerehabilitation contribute to your therapist-patient relationship?
“Yes, they see that you are up to date as a therapist by using the newest technology in a fast changing (digital) world. However, the human contact and touch by the therapist stays important. No machine can feel or interpret this feeling like an experienced hand therapist. So this is a good combination as there can be treatment at home and in my practice.”
What value has ReHand brought to your clinical practice?
“In my first experience with ReHand, I had a case, a severe hand trauma complicated with CRPS with a young lady. For that case I had to look for something extra because she was not able to press in a very soft ball. Thanks to ReHand she made a big progress in that difficult period.”
Do you think it is important to be able to monitor and obtain accurate data on the patient’s recovery process?
“Yes, absolutely. In my lectures I always end with a quote from Mr. Deming: “In God we trust, the others must find data.”
“Thanks to the reports of ReHand I can see the progress that my patient is making by training with ReHand. Next to my clinical measurement it gives a good view of the progress. Gathering all this data is a good source for further scientific research and development.”
What do patients think and report to you about this?
“The patients are pleased and stimulated with ReHand. They are happy if I show them the graphics with the progress. It is a confirmation that they are training well.”
Would you recommend the use of the ReHand tool?
Such an amazing interview that we may sum up with this cite:
“The hand and fingers are hungry to stimulus.”Tom Lattré