HISTORICAL OVERVIEW
JHT READ FOR CREDIT ARTICLE # 083
War, What is it Good for? Historical Contribution
of the Military and War to Occupational
Therapy and Hand Therapy
Sheila Catherine Yakobina, OTR/L, CHT
Stephanie Robin Yakobina, OTR/L, CHT
Hand Therapy Center at Capital Medical Center, Olympia,
Washington, USA
Sandra Harrison-Weaver, MHE, OTR/L, CHT
Madigan Army Medical Center, Tacoma, Washington, USA
‘‘War, what is it good for.absolutely nothing.’’
This anti-Vietnam protest song hit number one on the
Billboard Hot 100 in 1970. Though war is associated
with negative connotations, this article aims to high-
light some of the positive outcomes that have oc-
curred in the fields of occupational therapy (OT)
and hand therapy. This article will review the unique
history of war, individual military contributions, and
the establishment and development of OT and hand
therapy.
THE FOUNDERS OF OT
The founders of OT included William Dunton (a
psychiatrist), George Barton and Thomas Kidner
(architects), Eleanor Clarke Slagle (a social worker),
Susan Cox Johnson (an arts & crafts teacher), and
Susan Tracy (a nurse). These founders held the first
annual meeting of the National Society for the
Promotion of Occupational Therapy (NSPOT) in
1917. ‘‘Together they formed a profession, generated
Disclaimer: The opinions or assertions contained herein are the pri-
vate views of the authors and are not to be construed as official or
as reflecting the views of the Department of Defense.
Correspondence and reprint requests to Sheila Catherine Yakobina,
OTR/L, CHT, Hand Therapy Center at Capital Medical Center,
405-G Black Hills Lane SW, Olympia, WA 98502; e-mail:
<yakobina@msn.com>.
0894-1130/$ e see front matter Ó 2008 Hanley & Belfus, an imprint
of Elsevier Inc. All rights reserved.
doi:10.1197/j.jht.2007.07.022
106 JOURNAL OF HAND THERAPY
ABSTRACT: War has negative connotations; nevertheless, this ar-
ticle aims to highlight some of the positive outcomes that have oc-
curred in the fields of occupational therapy (OT) and hand therapy
due to war and war-related injuries. From the military background
of one of OT’s founders, Thomas Kidner, to the valiant efforts of the
reconstruction aides, to the origin of hand therapy during the Viet-
nam War, the military influence has been a powerful force in fur-
thering our profession. This article reviews the unique history of
war, the establishment and development of OT and hand therapy,
and the contributions from military service members.
J HAND THER. 2008;21:106–14.
a body of professional literature, and introduced a
new group of workers e the reconstruction aides of
World War I e into military medicine.’’1 The NSPOT
was later renamed the American Occupational
Therapy Association (AOTA) in 1921.
One of the founders, Thomas Kidner, served as
Vocational Secretary of the Canadian Military
Hospitals Commission in 1916. During this period,
he was responsible for the vocational training of
World War I (WWI) Canadian Soldiers after their war
wounds had healed.2 He was later appointed as a
special adviser to the U.S. government regarding re-
habilitation matters. Kidner’s primary objective was
to return Soldiers to productive employment. From
1923 to 1928, Kidner served as the president of the
AOTA.
WWI AND OT
In November 1917, the United States was called to
war by President Wilson. In anticipation of the influx
of war-injured Soldiers, two orthopedic surgeons,
Joel Goldthwait and Elliot Brackett, created the
Division of Orthopedic Surgery within the Medical
Department of the Army. They were responsible for
organizing the reconstruction program for wounded
Soldiers.3 Their recommendation to the U.S.
Secretary of War included employing teachers and
medical aides in the reconstruction of the injured
soldier.2 According to Goldthwait and Brackett, this
curative phase would allow Soldiers to return to
active duty rather than ‘‘be discharged to live a life
reliant upon a pension, as an economic drain on the
country.’’3 Their suggestions were based on the
Canadian and English Forces’ curative workshops
in which recovering Soldiers were provided with oc-
cupations to promote both physical and mental
health.2
Initially, enlisted men unfit to return to full duty
were considered to fill the role of reconstruction aides;
however, few men were available due to the high
number already at war. Thus in March 1918, a call for
female reconstruction aides in OT and physical ther-
apy (PT) was issued.3 Volunteers were recruited from
the NSPOT, the American National Red Cross, and
from over 70 universities and colleges.4
In response to the growing need for reconstruction
aides and due to the increasing number of wounded
Soldiers, War Emergency training courses were
established at various OT schools across the nation.
A typical course outline from the year 1918 lasted
12e16 weeks and emphasized handcrafts such as
woodworking and bookbinding, and lectures such
as history of OT, psychology, problems of the hand-
icapped, kinesiology, and hospital etiquette.4 One
of the earliest educational programs was offered
at Walter Reed General Hospital (WRGH) in
Washington, DC; the OT Department at WRGH
became a model department for the profession.2
The first reconstruction aides were sent to France in
1918 and were stationed near the front lines.5 They
were responsible for returning Soldiers suffering
from ‘‘war neurosis,’’ battle fatigue, and war-related
injuries to duty expeditiously.1 Amputations, blind-
ness, head injuries, osteomyelitis, tuberculosis (TB),
and a variety of stress disorders were the conditions
most commonly treated.2 Upper extremity (UE) diag-
noses included fractures, peripheral nerve injuries,
and amputations. After evaluation, orthopedic sur-
geons selected therapeutic activities for the injured
Soldier. Treatment focused on improving function
of the wounded extremity. Soldiers were engaged in
light activities such as ‘‘woodcarving and general car-
pentry to maintain muscle tone and to prevent stiff-
ness and atrophy. Hand drills were used to improve
and strengthen grasp.Metal hammering on light-
weight brass provided flexion and extension for wrist
problems.’’4 The role of reconstruction aides was
‘‘.to hasten the recovery of patients.promote con-
tentment and make the atmosphere of the hospitals
such that the time spent in convalescence will pass
most pleasantly because the minds and hands of
the patients are properly occupied in profitable
pursuits’’2 (see Figure 1).
WWI and the employment of reconstruction aides
were credited in part for the rapid growth of OT. As a
result of the war effort, ‘‘schools of occupational
therapy were established, therapists were educated,
public awareness was achieved, and many policies
and procedures were developed as well as the
definition and description of OT services’’2 (see
Figure 2).
In the years following WWI, reconstruction aides
left the service without having been given military
status or benefits. During the Great Depression,
many OT departments and schools, including the
WRGH OT Department, were closed due to lack of
funding and personnel, and the focus of OT practice
returned to treating individuals with mental health
or psychiatric disorders. According to statistics from
1937, 59% of occupational therapists worked in
mental hospitals, 25% in general hospitals, 8% in TB
hospitals, 6% in other institutions, and only 2% in
orthopedics.2
WORLD WAR II AND OT
The military and OT profession were ill prepared
for World War II (WWII) having only eight OTs in the
U.S. Army and only five Army hospitals providing
OT services. Once again, War Emergency training
courses were established at various OT schools and a
total of 899 women were trained.4 The shortage of
OTs during WWII stressed the need for improved
planning in the training of personnel. Departments
of physical medicine were developed during WWII
that laid the foundation for OT practice in physical
disabilities and orthopedics.6
Under the Surgeon General’s Office, a
Reconditioning Division was established to oversee
an Army program for reconditioning Soldiers.
Winifred Kahmann was appointed as chief of the
newly established OT Branch, Reconditioning
Division, in 1943. Her duties included visiting
Army OT Departments to establish standards and
procedures, developing training activities, and pre-
paring manuals and directives. The success of the
Army’s OT program can be attributed to Kahmann’s
valuable contributions.4 The War Department, at
Kahmann’s insistence, requested reclassification of
OTs from civilian to military status. Through her per-
severance and an ensuing Act of Congress, OTs were
finally granted military designation in 1947.7 This
permitted the OT profession to apply for increased
financial support from the federal government to fur-
ther educate and train OTs.2 The Women’s Medical
Specialist Corps was established in 1947 and was
composed of OTs, physical therapists, and dietitians.
In 1955, the Women’s Medical Specialist Corps was
renamed the Army Medical Specialist Corps when
legislation authorized the commissioning of male
therapists and dietitians. From 1947 to 1952,
Kahmann served as president of the AOTA.
The number of OTs employed in the United States
grew from 2,132 OTs in 1941 to 3,244 OTs in 1945.
AprileJune 2008 107
FIGURE 1. Occupational therapy ward and workshop activities, 1918e1920. Ward patients working with occupational
therapists on the porch, Walter Reed General Hospital, Washington, DC (Top). Ambulatory patients in woodworking
and basket weaving room, Fitzsimmons General Hospital, Denver Colorado (Bottom).

According to statistics from 1953, 54% of OTs worked
in mental health, 27% in general medicine and sur-
gery, 10% in TB hospitals, and 3% in physical
rehabilitation.2
WWII AND HAND SURGERY
A large number of Soldiers survived combat en-
gagements with UE injuries during WWII as a result
of improved transport systems, emergency medical
treatment, and management of infection. It was
estimated that out of 592,000 injured U.S. and allied
Soldiers, 148,000 sustained UE injuries and 89,000
incurred hand injuries8 (see Figure 3). As a result of
this unprecedented number of UE injuries, the re-
nowned hand surgeon Sterling Bunnell, MD, was
appointed by the U.S. Surgeon General as civilian
consultant to the Secretary of War and established
nine U.S. Army Hand Centers.9 ‘‘The surgeons in
the military services during World War II became
the nucleus of the American Society for Surgery of
the Hand (ASSH).’’10
In 1944, Bunnell published the first edition of
Surgery of the Hand and became the first President of
ASSH in 1946. He has been referred to as the

108 JOURNAL OF HAND THERAPY


FIGURE 2. Street uniform worn by physical and occupa-
tional therapists, World War I.
‘‘founding father’’ of the specialty of hand surgery in
the United States.10 According to Bunnell, ‘‘In the re-
habilitation of the injured hand, OT played an ex-
tremely important role. The patient was assigned a
job on the basis of his needs, not just to keep him
working. The OT knew the results desired and de-
voted her efforts to restoration of the special function
which had been lost’’6 (see Figures 4 and 5).
VIETNAM WAR AND HAND
SPECIALIZATION
There was a major shift from generalized surgery
to specialization after WWII and the Korean War. The
advancement of hand surgery as a subspecialty
paralleled this movement.9 During the Vietnam War
(1965e1973), hand and UE surgeons developed new
procedures to manage high-velocity missile wounds
and land mine injuries. These innovations included
passive tendon implants (Hunter rod), improved
flexor tendon surgeries, UE prosthetics, thumb
lengthening procedures, and microsurgical neuro-
vascular techniques11 (see Figure 6). In contrast to
previous wartime surgical protocols, the Vietnam
FIGURE 3. Retraining for the upper extremity amputee.
Working with tools to increase ability to operate
prosthesis.
War demonstrated that selective debridement and
delayed closure resulted in lower infection rates
and were more effective than primary closure when
managing war wounds of the hand.12
Aero-medical evacuation from Vietnam allowed
for the prompt return of Soldiers to the United States;
injured Soldiers were transported to Valley Forge
General Hospital (VFGH), the orthopedic hospital
center for the Eastern US. Numerous surgeons, who
had been trained in hand surgery, were assigned to
VFGH. This Army hospital grew to 1,100 orthopedic
beds, with 150 beds being dedicated to Soldiers with
hand and UE injuries.11 In 1964, James Hunter, MD,
was appointed as Hand Surgery Consultant at
VFGH. Hunter eloquently stated, ‘‘This epic period
at VFGH during the Vietnam conflict, in my opinion,
heralded the beginning of hand therapy, and that is a
gold nugget to be cherished from the winds of
Vietnam.’’11 With advancements in surgical tech-
niques and expansion of the field of hand surgery
came the need for specialization in rehabilitation of
the hand. It was during this time that hand therapy
partnered with hand surgery.
In 1962, the University of North Carolina Hand
Rehabilitation Center was established in Chapel Hill,
NC. The first of its kind in the United States,
the center was founded by L. Irene Hollis, OTR, a
legend in the world of hand therapy, along with Erle
Peacock, MD, and John Madden, MD.13 Interestingly,
Hollis had volunteered as a reconstruction aide
AprileJune 2008 109

FIGURE 4. Occupational therapy after plastic surgery.
Woodworking. Bilateral activity needed to regain flexion
in hands and fingers after application of skin grafts to dor-
sal surfaces.
during WWII at an Army hospital.7 Over the next de-
cade, an increasing number of therapists began spe-
cializing in hand rehabilitation; however, there was
no central organization.
The creators of the American Society of Hand
Therapists (ASHTs) first met at the ASSH Annual
Meeting in 1975 when they discovered that there
were several therapists in the audience; this visionary
group of OTs and PTs realized that they were a
stronger force together than apart.14 The ASHT be-
came incorporated on March 28, 1977.15 Its ‘‘original
six’’ members included Bonnie Olivett, Karen
Pendergast Lauckhardt, Evelyn Mackin-Henry,
Judith Bell-Krotoski, Mary Kasch, and Pegge
Carter-Wilson.14
A shortage of military physicians as a result of the
Vietnam conflict was nowhere more evident than in
the Army; for this reason, military OTs became relied
upon for their skills in the area of neuromusculoske-
letal evaluation and treatment.16 Recognizing the
need for more therapists with specialized skills, the
senior leaders within the Army OT Section devel-
oped an intensive training course to allow therapists
to function in the role of physician extenders. With
this training, Army OTs could evaluate the UE, order
and interpret X-rays, order laboratory tests, make re-
ferrals to other services, prescribe medications, and
110 JOURNAL OF HAND THERAPY
FIGURE 5. Lapidary. Partial amputation of thumb and
fingers necessitates activity to increase motion, strength,
dexterity, and coordination in the remaining digital
portions.
determine treatment programs. By providing these
services, OTs lessened the burden on the orthopedic
physician’s workload especially during times of
mobilization.
MILITARY CONTRIBUTIONS TO
HAND THERAPY KNOWLEDGE
Over the past 35 years, military OTs have made
valuable contributions to hand therapy literature.
Kilulu Von Prince and Mary Yeakel, who both served
as U.S. Army Colonels, coauthored The Splinting of
Burn Patients in 1974. Kilulu Von Prince also re-
searched Semmes-Weinstein Monofilament testing
and developed a scale of interpretation for levels
of function for individuals with peripheral nerve in-
juries (K. Von Prince, personal communication,
February 16, 2007).
Judith Bell-Krotoski, a founding member of the
ASHT, served as a commissioned officer in the U.S.
Public Health Service. She authored several chapters
for the first edition of Rehabilitation of the Hand and also
served as one of its editors; she has continued to write
for subsequent editions. She has authored numerous
other book chapters and journal articles (J. Bell-
Krotoski, personal communication, January 24,
2007). In 1984, Lopez described a splint modification
to the Kleinert orthosis for flexor tendon repairs.17
During the 1980s, Dovelle et al. generated several arti-
cles on the therapeutic management of extensor and
 terrorism, and advancements in UE rehabilitation
and assistive technology.36e44
The citations and presentations listed above repre-
sent only a small portion of the multitude of contri-
butions that military members have made to the body
of knowledge in hand therapy. Although only regis-
tered OTs and PTs may become hand therapists, it
would be remiss not to mention that military OT
assistants have also made great contributions within
the field.

OTS AND CERTIFIED HAND

THERAPISTS IN THE MILITARY:
CURRENT DEMOGRAPHICS

FIGURE 6. Occupational therapist works with an upper There are approximately 80 Army OTs, of which 17
extremity Vietnam War amputee on using his prosthesis. are certified hand therapists (CHTs). Sixty-five percent
Walter Reed General Hospital, circa 1968. of Army OTs are now functioning in the role of
physician extender. Many Army OTs, including
CHTs, have been deployed in a variety of roles
flexor tendon injuries including the Washington
including physician extenders and mental health of-
Regimen.18e20 They also coauthored articles on dy-
ficers in combat stress control detachments (Harrison-
namic splinting for extrinsic tendon tightness and
Weaver, personal communication, September 25,
joint stiffness.21,22 McPhee described an extension
2006). The Navy employs 22 military OTs, five of
blocking splint for the proximal interphalangeal joint,
which are CHTs (Ferland, personal communication,
and reviewed and analyzed the merits of 11 functional
October 18, 2006). They are all stationed in fixed
hand evaluations.23,24 Luster et al. discussed the crea-
medical facilities primarily in the United States; no
tive application of dental technology to hand rehabil-
Navy OTs have been deployed (Harrison-Weaver,
itation when splinting Soldiers and researched an
personal communication, September 25, 2006). There
electronic device for measuring joint stiffness in the
are 21 OTs in the Air Force, 16 of them function
burned hand.25,26 Cancio and Cashman demonstrated
primarily as hand therapists. Currently, five Air Force
the usefulness of a self-reported UE symptom survey
OTs are CHTs. To date, seven Air Force OTs have been
in assessing cumulative trauma disorders.27
deployed in support of Operation Iraqi Freedom; of
The new millennium has proven to be a prolific
these, three are CHTs (see Figure 7). These therapists
period for military therapists who have demon-
are deployed exclusively as hand therapists and serve
strated continued dedication to broadening the base
as physician extenders in support of the orthopedic
of UE knowledge. Fabrizio analyzed the prevalence,
surgery service (DaLomba, personal communication,
cost, and risk factors of work-related UE injuries in
October 16, 2006).
military and civilian populations.28 Yeager high-
lighted low-tech adaptive devices developed for UE
amputees.29 Greer and Miklos-Essenberg presented
a case report on early mobilization using dynamic
splinting for a triceps tendon avulsion.30 Greer et al.
reviewed UE war injuries and protective gear worn
during Operation Enduring Freedom and
Operation Iraqi Freedom.31
Military OTs have coauthored publications de-
scribing nerve and tendon gliding exercises in the
conservative management of carpal tunnel syn-
drome, work-related UE musculoskeletal disorders,
current OT processes for battle casualties at Walter
Reed Army Medical Center (WRAMC), and motion
enslaving among multiple fingers of the hand.32e35
Many military OTs have presented their research at
local, state, and national conferences over the years.
Within the past three years, numerous therapists FIGURE 7. Air Force Captain John DaLomba, OTR/L,
have presented poster and/or paper presentations CHT fitting a resting hand splint on a burn patient
featuring war-related injuries, the global war on (U.S. Marine) in the ICU during deployment to Iraq.

AprileJune 2008 111

MEDICAL AND TECHNOLOGICAL
ADVANCES
Advances in the fields of science, technology, and
medicine have improved the military’s ability to
protect and treat injured Soldiers. Though Soldiers’
cores are protected with Kevlar helmets and flak
vests during battle, their extremities remain vulner-
able to injury.45 Deltoid and Axillary Protectors have
been issued to Soldiers to protect their axillas and up-
per arms from blast fragments; however, the UE
remains unshielded.31 Researchers at the National
Nuclear Security Administration’s Sandia National
Laboratories have created gauntlets to protect the
arms of Soldiers in combat. The shoulder-length
gauntlets are made of Kevlar with carbon-composite
inserts that protect the hand, wrist, and elbow from
blunt trauma, blast fragments, and heat.45
According to 2004 statistics, OTs and CHTs in the
U.S. military have treated over 1,000 UE injured
Soldiers and over 100 UE amputees since 2001
(Amaker, personal communication, April 21, 2005)
(see Figure 8). The evolving needs of this growing
population have prompted the establishment of two
Amputee Centers of Excellence at WRAMC and
Brooke Army Medical Center; innovative prosthetic
technologies are being implemented at these centers.
This new technology uses digital lasers to scan the
stump and computer driven milling machines to
shape the socket. Advantages of this system include
speed, accuracy, improved fit, and lower cost.46
Air Force OTs have recently developed splint
protocols using Johnson & Johnson Delta Cast
Focused Rigidity Casting (FRC) Tape. This material
was selected because it is more suitable than ther-
moplastics for Soldiers working in hot, desert envi-
ronments (DaLomba, personal communication,
September 25, 2006). FRC is also currently used in
FIGURE 8. Adaptive splint designed by 1LT Erik John-
son, OTR/L to assist a patient with severe upper extremity
nerve injuries (due to explosive device) with shifting gears
when driving.
112 JOURNAL OF HAND THERAPY
numerous Army OT clinics (Harrison-Weaver, per-
sonal communication, October 7, 2006).
CONCLUSION
The goal of this article was to shed a different light
on the phrase, ‘‘War, what is it good for?’’ War has
provided the impetus for individuals in the fields of
hand surgery and hand therapy to devise innovative
surgical procedures and treatment techniques thus
ensuring that our courageous Soldiers receive unpar-
alleled care and return to healthy, productive lives.
Military contributions have not only aided Soldiers
but have been incorporated into the civilian world
where their benefits can shared by all.
Acknowledgments
The authors would like to thank Colonel Robinette Amaker
for inspiring them and for giving them the opportunity to
share their profession’s fascinating history with their col-
leagues. They would like to thank Colonel William Howard
III for his guidance and assistance. They would also like to
acknowledge Captain John DaLomba’s valuable contribu-
tions. Finally, they are grateful to all Soldiers for their brave
and selfless service.
REFERENCES
1. Trombly CA. Occupational Therapy for Physical Dysfunction.
4th ed. Baltimore, MD: Williams & Wilkins, 1995.
2. Hopkins HL, Smith HD (eds). Willard and Spackman’s Occu-
pational Therapy. 8th ed. Philadelphia, PA: J.B. Lippincott
Company, 1993.
3. Gutman SA. Influence of the US military and occupational
therapy reconstruction aides in World War I on the develop-
ment of occupational therapy. Am J Occup Ther. 1995;49(3):
256–62.
4. Office of Medical History: Office of Surgeon General [Internet].
Fort Detrick: MD. [cited 2006 Oct 1]. Available at: http://history.
amedd.army.mil/booksdocs/histories/ArmyMedicalSpecialist
Corps/frameindex.html. (accessed Oct 1, 2006).
5. Low JF. The reconstruction aides. Am J Occup Ther. 1992;46(1):
38–43.
6. Dillingham TR. Physiatry, physical medicine, and rehabilita-
tion: historical development and military roles. Phys Med
Rehabil Clin N Am. 2002;13(1):1–16.
7. Hollis LI. The 1979 Eleanor Clarke Slagle lecture: remember?
Am J Occup Ther. 1979;33(8):329–41.
8. Burkhalter WE. Care of war injuries of the hand and upper ex-
tremity: report of the war injury committee. J Hand Surg [Am].
1983;8(5 Pt 2):810–3.
9. Omer GE. Development of hand surgery: education of hand
surgeons. J Hand Surg [Am]. 2000;25:616–28.
10. Newmeyer WL, Sterling Bunnell MD. The founding father.
J Hand Surg [Am]. 2003;28:161–4.
11. Hunter JM, Mackin EJ, Callahan AD. Rehabilitation of the
Hand: Surgery and Therapy. 5th ed. St. Louis, MO: Mosby,
2002.
12. Brown PW, Fairfield CT. War wounds of the hand revisited.
J Hand Surg [Am]. 1995;20(3 Pt 2):61–7.
13. Flowers K. The legacy of Irene Hollis. J Hand Ther. 2005;18:321.
14. American Society of Hand Therapists [Internet]. The spirit of
our creators. Chicago: IL. [updated 2006; cited 2006 Oct 1].
Available at: http://www.asht.org/about/history.cfm. (accessed
Oct 1, 2006).
15. American Society of Hand Therapists [Internet]. ASHT mem-
bership application process is developed. Chicago: IL. [updated
2006; cited 2006 Oct 1]. Available at: http://www.asht.org/
about/25th_spirit3.cfm. (accessed Oct 1, 2006).
16. Jenik CA, Protzman RR, McKennett D. The army occupational
therapist as an orthopedic health care extender. Mil Med. 1984;
149:383–8.
17. Lopez MS. Splint modification for flexor tendon repairs. Am J
Occup Ther. 1984;38(6):398–405.
18. Dovelle S, Heeter PK. The Washington regimen: rehabilitation
of the hand following flexor tendon injuries. Phys Ther. 1989;
69:1034–40.
19. Dovelle S, Heeter PK, Fischer DR, Chow JA. Early controlled
motion following flexor tendon graft. Am J Occup Ther. 1988;
42(7):457–63.
20. Dovelle S, Heeter PK, Fischer DR, Chow JA. Rehabilitation of
extensor tendon injury of the hand by means of early con-
trolled motion. Am J Occup Ther. 1989;43(2):115–9.
21. Dovelle S, Heeter PK, Phillips PD. A dynamic traction splint
for the management of extrinsic tendon tightness. Am J Occup
Ther. 1987;41(2):123–5.
22. Dovelle S, Heeter PK, McFaul TV. A dynamic finger flexion
loop. Am J Occup Ther. 1988;42(8):535–7.
23. McPhee SD. Extension block splinting for the proximal inter-
phalangeal joint. Am J Occup Ther. 1987;41(6):389–90.
24. McPhee SD. Functional hand evaluations: a review. Am J
Occup Ther. 1987;41(3):158–63.
25. Luster SH, Hughbanks JC. From mouth to hand: applying dental
technology to hand rehabilitation. Mil Med. 1995;160(8):420–1.
26. Luster SH, Patterson PE, Cioffi WG, Mason AD, McManus WF,
Pruitt BA. An evaluation device for quantifying joint stiffness
in the burned hand. J Burn Care Rehabil. 1990;11(4):312–7.
27. Cancio LI, Cashman TM. Self-reported cumulative trauma
symptoms among hospital employees: analysis of an upper-
extremity symptom survey. Am J Occup Ther. 1999;53:227–30.
28. Fabrizio AJ. Work-related upper extremity injuries: prevalence,
cost, and risk factors in military and civilian populations.
Work. 2002;18:115–21.
29. Yeager AF. Low tech adaptive devices for upper extremity
amputees. OT Pract. 2004:12–5.
30. Greer MA, Miklos-Essenberg ME. Early mobilization using
dynamic splinting with acute triceps tendon avulsion: a case
report. J Hand Ther. 2005;18:365–70.
31. Greer, Miklos-Essenberg, Harrison-Weaver. A review of 41 up-
per extremity war injuries and the protective gear worn during
operation enduring freedom and operation Iraqi Freedom. Mil
Med. 2006;171:595–7.
32. Rozmaryn LM, Dovelle S, Rothman ER, Gorman K, Olvey KM,
Bartko JJ. Nerve and tendon gliding exercises and the conser-
vative management of carpal tunnel syndrome. J Hand Ther.
1998;11:171–9.
33. Ruess L, O’Connor SC, Cho KH, et al. Carpal tunnel syndrome
and cubital tunnel syndrome: work-related musculoskeletal
disorders in four symptomatic radiologists. Am J Roentgenol.
2003;181:37–42.
34. Doukas WC, Howard WJ. Process of care for battle casualties at
Walter Reed Army Medical Center: Part IV. Occupational ther-
apy service. Mil Med. 2006;171:209–10.
35. Li ZM, Dun S, Harkness D, Brininger T. Motion enslaving
among multiple fingers of the human hand. Motor Control.
2004;8(1):1–15.
36. Amaker RJ. Upper extremity splinting: nerve injuries in the
war casualty. Paper presented at the 27th American Society
of Hand Therapists Annual Conference, Charlotte, NC; 2004.
37. Amaker RJ. Traction splinting phalanx fractures. Paper pre-
sented at the 27th American Society of Hand Therapists
Annual Conference, Charlotte, NC; 2004.
38. Quick CD. Occupational therapy in a theater of operations. Pa-
per presented at the 28th American Society of Hand Therapists
Pre-Conference Military Meeting, San Antonio, TX; 2005.
39. Chapman T. Management of the burned hand: OIF outcomes.
Paper presented at the Joint Meeting of the American Society
for Surgery of the Hand and the American Society of Hand
Therapists Pre-Conference Military Meeting, San Antonio,
TX; 2005.
40. Chapman T, Cancio LC, Hedman TL, Wolf SE, Holcomb JB.
Outcomes of combat casualties with hand burns: detecting
clinical change by measuring physical impairment and disabil-
ity after discharge. Paper presented at the American Associa-
tion for the Surgery of Trauma, Atlanta, GA; 2005.
41. Chapman T. Outcomes of combat casualties with hand burns:
detecting clinical change by measuring physical impairment
and disability after discharge. Paper presented at 6th Interna-
tional Congress of Kuwait Society of Plastic Surgery for Burns
& War Trauma, Kuwait City, Kuwait; 2005.
42. Amaker RJ. Upper extremity injuries in the global war on
terrorism. Poster session presented at the 29th American
Society of Hand Therapists Annual Conference, Atlanta, GA;
2006.
43. Slater KM. Role of navy occupational therapy in support of op-
eration Iraqi freedom. Poster session presented at the 29th
American Society of Hand Therapists Annual Conference,
Atlanta, GA; 2006.
44. Smurr LM. War related injuries, limb salvage: recent experi-
ence at Walter Reed Army Medical Center. Paper presented
at Philadelphia Meeting: Surgery and Rehabilitation of the
Hand with Emphasis on the Wrist, Philadelphia, PA; 2006.
45. Sandia National Laboratories [Internet]. Albuquerque: NM.
United States Department of Energy, Lockheed Martin Com-
pany; c2006 [cited 2006 Oct 1]. Available at: http://www.
sandia.gov/LabNews/ln02-18-05/labnews02-18-05.pdf. (ac-
cessed Oct 1, 2006).
46. US Medicine [Internet]. Prosthetics technology evolution helps
patients adjust At Walter Reed [cited 2006 Oct 1]. Available
at: http://www.usmedicine.com/article.cfm?articleID¼804&;
issueID¼58. (accessed Oct 1, 2006).
AprileJune 2008 113
 JHT Read for Credit
Quiz: Article # 083

Record your answers on the Return Answer Form c. WWII

found on the tear-out coupon at the back of this d. the Spanish American War
issue. There is only one best answer for each #4. The first hand rehabilitation center was estab-
question. lished at
a. the Valley Forge General Hospital
#1. The profession of Occupational Therapy origi- b. the University of North Carolina in Chapel
nated on or about the time of Hill
a. Desert Storm c. University of Pcnnsylvania Hospital in
b. the Vietnam conflict Philadelphia
c. WWII d. Johns Hopkins University Hospital in
D. WWI Baltimore
#2. As late as 1937 almosteeee% of OTs worked in #5. The authors stress the fact that innovations in
mental hospital facilities hand surgery and hand therapy coming from
a. 40 war-time experience are almost exclusively appli-
b. 50 cable to military personnel only.
c. 60 a. true
d. 70 b. false
#3. According to James Hunter, MD what period her-
alded the beginning of hand therapy? When submitting to the HTCC for re-certification,
a. the Vietnam conflict please batch your JHT RFC certificates in groups
b. WWI of 3 or more to get full credit.

114 JOURNAL OF HAND THERAPY