Hand Therapy
Physical Rehabilitation
Lymphoedema Management
Work Rehabilitation
Work Assessments
Fitness to Drive Assessment

Hand Therapy

Hand Therapy is the rehabilitation of upper extremity injuries or persistent problems. It includes treatment before and after an operation to the fingers, hand or elbow.

Condition commonly treated by a hand therapist:
Fractures of the fingers, wrist or elbow; Arthritis of the hand, carpal tunnel disease, nerve injuries, tennis or golfers elbow, burns, ganglions excisions, abscesses, tendon lacerations, skin lesions on the hand or forearm, swollen and painful hands.

How is hand therapy performed?
Various treatment modalities like splinting, massaging, stretching and exercises are used to ensure that a patient can return to his or her work or hobbies.

Who can attend hand therapy?
You do not need a referral from a doctor to attend hand therapy. If you have any problems with pain, deformities or disability regarding your fingers, hands, wrist or elbow you can contact us directly for an appointment.

If you are booked for an elective surgery on your hand, the surgeon might refer you to us for post-op care. We will also be involved in the rehabilitation if you had an accident and sustained an injury to your hand at work or at home.

Physical Rehabilitation

Occupational, Physiotherapists and Biokineticits often work close together when providing physical rehabilitation, as a team approach results in better functional outcome. Physical rehabilitation is aimed at regaining functional movement after a stroke, brain injury, spinal cord injury, burns, or any other condition that may affect the body’s normal movement pattern. If normal movement cannot be regained, the therapist will be involved in identifying assistive devices and alternative methods to perform activities of daily living and regain quality of life. Occupational Therapists are more directed to regain upper limb functioning, attend to cognitive and emotional deficits and facilitated independence.

Conditions commonly treated by the occupational therapist in the field of Physical Rehabilitation:
Strokes, Traumatic brain injuries, Parkinson’s, Burns, Cancer, Spinal Cord Injuries, Multiple Sclerosis etc.

How is Physical Rehabilitation performed?
Therapist’s use special techniques to teach the body and brain to regain function. The therapist will mostly user herself as a therapeutic tool when assisting you with your rehab. The practice is equipped with various therapeutic equipment to assist with rehabilitation.

Who can attend Physical Rehabilitation?
Any person who sustained an injury to the body or brain and cannot move that body part in a normal way, can attend Physical Rehabilitation. Treatment within the first two years of an injury is most effective, and immediate treatment yields better results.



Lymphoedema, Lipoedema and Oedema Management

The lymphatic system plays a vital role in our immune system. An ineffective lymphatic system can result in many complications to the body and its functioning. These can include lymphoedema, recurrent cellulitis (infections), decreased range of motion, etc.

What is Lymphoedema?
Lymphoedema is any disruption of the normal flow of lymph fluid that causes excess accumulation of interstitial fluid and proteins resulting in oedema/swelling in the body. The proteins in the interstitial fluid act like sponges, and the skin then develops a chronic state of oedema/swelling. Lymphoedema can harm both your physical and psychological health. It is a chronic condition and will continue to cause discomfort until effectively managed.

Types of Lymphoedema:
There are many types of Lymphoedema, but to simplify it:

Primary Lymphoedema is a form of Lymphoedema with no direct attributable cause of trauma or medical condition resulting in the swelling. This may begin at ANY age.

Secondary Lymphoedema is Lymphoedema that occurs due to / is caused by a direct medical condition or trauma to the body. This may begin at ANY time, with no time limit after an injury/trauma.

What is lipoedema?
This is not Lymphoedema; it is an excessive accumulation of fatty deposits under the skin. It often involves the lower limbs.

When to receive treatment?
Early intervention is always best!
Identifying and treating Lymphoedema in the early stages will often decrease the negative impact lymphoedema has on the individual. Lymphoedema can result in larger body parts and more pain if left untreated. It may develop hard, tight fibrotic skin (hard pitting skin), thickened skin (hyperkeratosis), or bark-like warty projections (papillomatosis).

Conditions commonly known to cause Lymphoedema to include:
Any trauma to the lymphatic system, cancer, surgery, vein stripping, cellulitis, post-surgical scarring, sports injuries, CCF, Renal failure, Burns, obesity, etc.

What must I do to get therapy?
Give us a call! We will schedule your first appointment to gain information and begin equipping and preparing you for your lymphoedema journey.

Work Rehabilitation

Work rehabilitation closely links with hand therapy and physical rehabilitation. It bridges acute rehabilitation with preparation of physical abilities required to perform specific work demands.

Work hardening
Continuation of care, to ensure that a patient can return to his previous occupation, is facilitated through scientific analysis of the job requirements and the persons overall functioning. Work rehabilitation prepares patients to endure a full working day after being on sick leave, and allows them to tolerate intensive physical work after illness or surgery. At Richter Therapy we have a work hardening centre, where patients are exposed to simulated work tasks to ensure they are fit for work.

Case management
Work rehabilitation does not only address a client’s tolerance to perform physical and other work demands, but can also include interaction with the workplace. A team approach to successfully re-integrate an employee to work is followed. Case management ensures that a patient follows a scientific programme to address physical, psychosocial and emotional problems that prevents them from going back to work.

The Progressive Goal Attainment Programme (PGAP)
The Progressive Goal Attainment Program is an intervention that has been developed to target psychosocial risk factors for delayed recovery. PGAP has been shown to reduce psychosocial risk factors and promote successful return-to-work in individuals suffering from a wide range of debilitating health or mental health conditions. PGAP has been included in the 13th Edition of the Official Disability Guidelines as an evidenced-based intervention for work-disability. For more information please click here.

Chronic Pain Management
Patients who presents with persistent pain after acute management of a condition will benefit from occupational therapy. An holistic approach is followed where the following aspects are addressed: education regarding pain physiology, coping mechanisms, group work, relaxation therapy etc. This is a comprehensive programme where the focus shifts from ‘pain’ to ‘functionality’.


Work Assessments

Short Return to Work Assessments
This type of assessment is aimed to review a specific diagnosis and how it impacts the person’s ability to work. The assessment is limited to one diagnosis and two hours. A short report outlines the physical, cognitive or emotional capacity to meet job demands.

Functional Capacity Evaluations
In depth functional capacity evaluations are performed to determine the persons ability to perform his own, an accommodated or alternative job. Physical, cognitive and psychosocial components are assessed and matched to the job requirements. The assessment time ranges from two to three hours, and a comprehensive report and assessment results are sent to the referrer after ten working days. Standardises assessment used are the WorkWell FCE protocol, and various MODAPTS tests. A quote to perform an FCE is based on the diagnosis and invoices according to time spent on the assessment.

Job site assessments
On site assessments can be conducted to determine the job requirements (physical and cognitive demands) of a job.

Medico-legal Assessments
Leandi Daling (Richter) received special training in performance of high quality Independent Medical Evaluations by the American Board of Independent Medical Examiners (ABIME). Apart from this prestigious certification she has over ten years of clinical experience in performing Functional Capacity Evaluations and independent assessments. Continued clinical exposure to the fields of hand therapy, physical rehabilitation and vocational rehabilitation with adults allows for better understanding and interpretation of disability on an individual’s ability to work and engage in activities of daily living. Assessments are performed on behalf of the plaintiff. Expert opinion after independent assessment is provided in report form within ten working days to inform the legal process regarding the impact of disability on a person’s functional capacity.

The practice has the following standardised assessment tools, ensuring that all assessments hold clinical value and provide reliable and valid results:

  • Developmental Test of Visual Perception – Adults (DTVP-A).
  • Test of Visual Perceptual Skills (TVPS).
  • Beery: Visual Motor Integration, Visual Perception, Motor Coordination.
  • Loewenstein Occupational Therapy Cognitive Assessment (LOTCA).
  • WorkWell.
  • Various Modular Arrangement of Predetermined Time Standards (MODAPTS) assessments.

Fitness to Drive Assessment

We can assess your ability to return to driving safely after you have been diagnosed with a medical conditions.

A drivers assessment is conducted by first performing an office based assessment followed by a on-road assessment, the next day, in collaboration with a qualified driving instructor.

Treatment for Specific Conditions

Please click any image below to view a larger version:

You may also download the PDF copy of each here:

OT in COVID and Long COVID
OT in chronic pain management
OT in mental health
OT for the elderly
What role does an OT play in a patient who has sustained an injury on duty

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