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  /Title (hand-assessments.pdf)
  /Creator (Cheatography)
  /Author (ts3414)
  /Subject (hand assessments Cheat Sheet)
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    \vspace{-2pt}\large{\bf{\textcolor{DarkBackground}{\textrm{hand assessments Cheat Sheet}}}} \\
    \normalsize{by \textcolor{DarkBackground}{ts3414} via \textcolor{DarkBackground}{\uline{cheatography.com/195341/cs/40915/}}}
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  \vspace{-2pt}ts3414 \\
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  \mymulticolumn{1}{p{5.377cm}}{\bf\textcolor{white}{Cheat Sheet}}  \\
   \vspace{-2pt}Not Yet Published.\\
   Updated 19th October, 2023.\\
   Page {\thepage} of \pageref{LastPage}.
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\mymulticolumn{2}{x{3.833cm}}{\bf\textcolor{white}{Neuropathies Conditions}}  \tn
% Row 0
\SetRowColor{LightBackground}
ulnar claw & ulnar nerve (hyperextension of 4/5th digits) \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
hand of benediction & high median nerve - only occurs when attempt to make a fist \tn 
% Row Count 5 (+ 3)
% Row 2
\SetRowColor{LightBackground}
ape hand & median nerve - injured hand at rest - thumb adducted, cannot abduct/oppose thumb \tn 
% Row Count 9 (+ 4)
% Row 3
\SetRowColor{white}
wrist drop & ulnar nerve issue \tn 
% Row Count 10 (+ 1)
% Row 4
\SetRowColor{LightBackground}
carpal tunnel & median nerve compression at wrist \tn 
% Row Count 12 (+ 2)
% Row 5
\SetRowColor{white}
cubital tunnel & ulnar nerve compression at elbow \tn 
% Row Count 14 (+ 2)
% Row 6
\SetRowColor{LightBackground}
ulnar tunnel - handle palsy & ulnar nerve compression at guyons canal \tn 
% Row Count 16 (+ 2)
% Row 7
\SetRowColor{white}
radial tunnel & radial tunnel compression \tn 
% Row Count 18 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
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\par\addvspace{1.3em}

\begin{tabularx}{3.833cm}{x{1.7165 cm} x{1.7165 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{3.833cm}}{\bf\textcolor{white}{Neuropathies testing}}  \tn
% Row 0
\SetRowColor{LightBackground}
carpal tunnel testing & tinel and phalens - prayer/reverse prayer sign \tn 
% Row Count 3 (+ 3)
% Row 1
\SetRowColor{white}
cubital tunnel testing & tinels \tn 
% Row Count 5 (+ 2)
% Row 2
\SetRowColor{LightBackground}
de quarvans & positive finkelstein "hook grip" \tn 
% Row Count 7 (+ 2)
% Row 3
\SetRowColor{white}
semmes wienstein - sensory & occlude pts eye; touch different areas of hand \tn 
% Row Count 10 (+ 3)
% Row 4
\SetRowColor{LightBackground}
guyons canal syndrome testing & testing over guyons canal \tn 
% Row Count 12 (+ 2)
% Row 5
\SetRowColor{white}
ulnar nerve testing motor innervation of thumb & positive froments test - flexion of IP joint of thumb \tn 
% Row Count 15 (+ 3)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
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\mymulticolumn{2}{x{3.833cm}}{\bf\textcolor{white}{Finger issues}}  \tn
% Row 0
\SetRowColor{LightBackground}
trigger finger & A1 pulley \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
swan neck deformity & proximal interphalangeal (PIP) joint hyperextension and the distal interphalangeal (DIP) joint flexion \tn 
% Row Count 6 (+ 4)
% Row 2
\SetRowColor{LightBackground}
boutonniere deformity & flexed at the proximal interphalangeal joint (PIP) and hyperextended at the distal interphalangeal joint (DIP) \tn 
% Row Count 11 (+ 5)
% Row 3
\SetRowColor{white}
ulnar drift & fingers shift towards ulnar side - RA \tn 
% Row Count 13 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
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\begin{tabularx}{3.833cm}{x{1.47619 cm} x{1.95681 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{3.833cm}}{\bf\textcolor{white}{tendon repairs}}  \tn
% Row 0
\SetRowColor{LightBackground}
kleinert & passive flexion using rubber band traction and active extension to the hood of the splint \tn 
% Row Count 5 (+ 5)
% Row 1
\SetRowColor{white}
- 0-4 weeks early phase & dorsal block splint \tn 
% Row Count 7 (+ 2)
% Row 2
\SetRowColor{LightBackground}
- 4-7 weeks intermediate phase & continue dorsal block splint, but adjust wrist to neutral \tn 
% Row Count 10 (+ 3)
% Row 3
\SetRowColor{white}
- 6-8 weeks AROM & no splint, AROM, light OT activities \tn 
% Row Count 12 (+ 2)
% Row 4
\SetRowColor{LightBackground}
- 8-12 weeks & strengthening, work, leisure \tn 
% Row Count 14 (+ 2)
% Row 5
\SetRowColor{white}
duran & passive flexion and extension of digit \tn 
% Row Count 16 (+ 2)
% Row 6
\SetRowColor{LightBackground}
- 0-4.5 weeks & dorsal blocking splint, exercises in splint include flexion of PIP joint, DIP joint \tn 
% Row Count 20 (+ 4)
% Row 7
\SetRowColor{white}
- 4.5-6 weeks & active flexion and extension within limits of splint \tn 
% Row Count 23 (+ 3)
% Row 8
\SetRowColor{LightBackground}
- 6-8 weeks & tendon glides, differential tendon gliding, scar management \tn 
% Row Count 26 (+ 3)
% Row 9
\SetRowColor{white}
- 8-12 weeks & strengthening/work activities \tn 
% Row Count 28 (+ 2)
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\mymulticolumn{2}{x{3.833cm}}{\bf\textcolor{white}{Splints}}  \tn
% Row 0
\SetRowColor{LightBackground}
brachial plexus injury & flail arm splint - for positioning \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
radial nerve injury & colditz or radial nerve splint -for function \tn 
% Row Count 5 (+ 3)
% Row 2
\SetRowColor{LightBackground}
medial nerve injury & opponens splint (for functional activities), Cbar, thumb post \tn 
% Row Count 9 (+ 4)
% Row 3
\SetRowColor{white}
ulnar nerve injury & anticlaw splint, lumbrical bar splint - prevent clawing \tn 
% Row Count 12 (+ 3)
% Row 4
\SetRowColor{LightBackground}
spinal cord - C6-C7 & tenodesis splint - facilitate grasp and release \tn 
% Row Count 15 (+ 3)
% Row 5
\SetRowColor{white}
carpal tunnel syndrome & wrist splint positioned in neutral - decrease carpal canal pressure \tn 
% Row Count 19 (+ 4)
% Row 6
\SetRowColor{LightBackground}
cubital tunnel syndrome & elbow splint position at 30 degrees of flexion - prevent elbow flexion at night \tn 
% Row Count 23 (+ 4)
% Row 7
\SetRowColor{white}
de quervains & thumb splint, includes wrist, IP joints free \tn 
% Row Count 26 (+ 3)
% Row 8
\SetRowColor{LightBackground}
skiers thumb & UCL hand based thumb splint - protect the ulnar collateral ligament of MCP \tn 
% Row Count 30 (+ 4)
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\mymulticolumn{2}{x{3.833cm}}{\bf\textcolor{white}{Splints (cont)}}  \tn
% Row 9
\SetRowColor{LightBackground}
CMC arthritis & hand based thumb splint - for hand to be at rest to decrease inflammation \tn 
% Row Count 4 (+ 4)
% Row 10
\SetRowColor{white}
ulnar drift & ulnar wrist/deviation splint - decrease pain, provide stability, realign MCP \tn 
% Row Count 8 (+ 4)
% Row 11
\SetRowColor{LightBackground}
flexor tendon injury & dorsal protection splint - for protection of site \tn 
% Row Count 11 (+ 3)
% Row 12
\SetRowColor{white}
swan neck & silver rings, \seqsplit{buttonhole/hyperextension} block splint - prevent further deformity \tn 
% Row Count 15 (+ 4)
% Row 13
\SetRowColor{LightBackground}
boutonniere deformity & silver ring or PIP extension \tn 
% Row Count 17 (+ 2)
% Row 14
\SetRowColor{white}
arthritis & functional splint or safe splint - decrease inflammation \tn 
% Row Count 20 (+ 3)
% Row 15
\SetRowColor{LightBackground}
flaccidity & resting/functional hand splint - prevent joint contracture, common wearing and at night then on off during the day \tn 
% Row Count 26 (+ 6)
% Row 16
\SetRowColor{white}
spasticity & spasticity splint or cone splint - prevent joint contracture \tn 
% Row Count 29 (+ 3)
% Row 17
\SetRowColor{LightBackground}
muscle weakness - ALS, SCI, guillain barre & balanced forearm orthosis (BFO), deltoid sling/suspension sling - supports \tn 
% Row Count 33 (+ 4)
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\begin{tabularx}{3.833cm}{x{1.7165 cm} x{1.7165 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{3.833cm}}{\bf\textcolor{white}{Splints (cont)}}  \tn
% Row 18
\SetRowColor{LightBackground}
hand burns & wrist 15-30 degrees extension, MCP 50-70 degrees flexion, IPs in full extension \tn 
% Row Count 4 (+ 4)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
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\mymulticolumn{2}{x{3.833cm}}{\bf\textcolor{white}{Range of motion}}  \tn
% Row 0
\SetRowColor{LightBackground}
goniometer & measurement tool \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
functional ROM & rom needed to perform functional movements - reaching to top of head, small of back \tn 
% Row Count 6 (+ 5)
% Row 2
\SetRowColor{LightBackground}
active ROM - AROM & contractile structures - movement produced by ones own muscle \tn 
% Row Count 10 (+ 4)
% Row 3
\SetRowColor{white}
passive ROM - PROM & noncontractile structures - movement produced by an external force \tn 
% Row Count 14 (+ 4)
% Row 4
\SetRowColor{LightBackground}
active assisted range of motion - AAROM & movement produced by ones own muscles and assisted by an external force \tn 
% Row Count 18 (+ 4)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
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\par\addvspace{1.3em}

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\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{3.833cm}}{\bf\textcolor{white}{muscle strength testing and interventions}}  \tn
% Row 0
\SetRowColor{LightBackground}
MMT & break test is most common \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
5 normal & Complete ROM against gravity and maximal resistance. Resistive exercise is used to increase strength.  Example: Tossing a medicine ball while standing. \tn 
% Row Count 7 (+ 6)
% Row 2
\SetRowColor{LightBackground}
4 good & Complete ROM against gravity and moderate resistance. Resistive exercise is used to increase strength.  Example: Tossing a beach ball with weighted cuffs strapped to the patient's wrists. Tossing a therapy ball. \tn 
% Row Count 15 (+ 8)
% Row 3
\SetRowColor{white}
3+ fair plus & Complete ROM against gravity and slight resistance. Resistive exercise is used to increase strength.  Example: Tossing a beach ball. \tn 
% Row Count 20 (+ 5)
% Row 4
\SetRowColor{LightBackground}
3 fair & Complete ROM against gravity. When a grade of 3 is reached, the activity can be structured to move against gravity.  Example: Balloon volleyball / throwing a balloon at a target, which requires the patient to lift their arm up against gravity.  Adapted volleyball type game. \tn 
% Row Count 30 (+ 10)
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\begin{tabularx}{3.833cm}{x{0.92691 cm} x{2.50609 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{3.833cm}}{\bf\textcolor{white}{muscle strength testing and interventions (cont)}}  \tn
% Row 5
\SetRowColor{LightBackground}
3- / fair minus & More than 50\% ROM against gravity. Example: Structure an activity to encourage the patient to lift his arm up in a vertical plane, against gravity. As the patient will not be able to achieve a complete ROM, place the goal at the highest level which the patient is able to reach. \tn 
% Row Count 10 (+ 10)
% Row 6
\SetRowColor{white}
2+ poor plus & Less than 50\% ROM against gravity / complete ROM gravity eliminated slight resistance. Example: Place the patient's arm on top of a table. Structure a table top activity which requires the patient to slide their arm along the surface of the table, through a complete ROM (in a gravity eliminated plane). Using a regular surface and introducing weighted game pieces, will add resistance to the movement. \tn 
% Row Count 24 (+ 14)
% Row 7
\SetRowColor{LightBackground}
2 poor & Complete ROM with gravity eliminated. For exercises/activities performed in a gravity-reduced plane, use a powdered surface or skateboard to reduce the resistance produced by friction on a supporting surface.  Example: Place the patient's arm on top of a table which has been covered with powder. Structure a table top activity which requires the patient to slide their arm along the surface of the table, through a complete ROM (in a gravity eliminated plane). Play a board game with light game pieces, or table cricket. \tn 
% Row Count 43 (+ 19)
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\par\addvspace{1.3em}

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\begin{tabularx}{3.833cm}{x{0.92691 cm} x{2.50609 cm} }
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\mymulticolumn{2}{x{3.833cm}}{\bf\textcolor{white}{muscle strength testing and interventions (cont)}}  \tn
% Row 8
\SetRowColor{LightBackground}
2- / poor minus & Incomplete ROM with gravity eliminated. Patient moves the joint through partial ROM and the therapist or mechanical device completes the ROM.  Example: Support the patient's arm and allow the patient to actively move through as much range as is possible, in a gravity eliminated plane. As soon as the therapist feels/observes that the patient has stopped actively moving, the therapist continues to support and move the patient's arm through the complete ROM. Incorporate a goal into the exercise e.g. incorporate using a suspension mobile arm support with a meaningful activity. \tn 
% Row Count 21 (+ 21)
% Row 9
\SetRowColor{white}
1 trace & No movement but can contract muscle. Facilitate muscle contraction – Tap, rub, vibrate muscle to facilitate a stronger contraction.  Active-Assisted Exercise. The patient contracts their muscle, and the therapist or a mechanical device completes the entire ROM. Slings, pulleys, weights, springs, or elastic bands may be used to provide mechanical assistance. This exercise is graded by decreasing the amount of assistance until the patient can perform active exercises.  Example: Supporting and moving the patient's arm through a full ROM in a gravity eliminated plane. Incorporate a goal into the exercise e.g. support the patient's arm on a large ball and assist the patient in rolling the ball through a full ROM, to play a variation of traditional ten-pin bowling. \tn 
% Row Count 48 (+ 27)
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\mymulticolumn{2}{x{3.833cm}}{\bf\textcolor{white}{muscle strength testing and interventions (cont)}}  \tn
% Row 10
\SetRowColor{LightBackground}
0 zero & No muscle contraction. Paralysis. Maintain PROM. The purpose of passive exercise is to prevent contractures, adhesions, and deformity by maintaining ROM. \tn 
% Row Count 6 (+ 6)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
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\mymulticolumn{2}{x{3.833cm}}{\bf\textcolor{white}{simple interventions}}  \tn
% Row 0
\SetRowColor{LightBackground}
increasing strength & high resistance, low reps \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
increasing endurance & increase reps, low weight/resistance \tn 
% Row Count 4 (+ 2)
% Row 2
\SetRowColor{LightBackground}
edema reduction & elevation, retrograde massage, compression, contrast baths \tn 
% Row Count 7 (+ 3)
% Row 3
\SetRowColor{white}
scar mgt & ROM, massage, compression, scar pad with compression, splinting, edema control \tn 
% Row Count 11 (+ 4)
% Row 4
\SetRowColor{LightBackground}
sensory training - desensitization for hypersensitivity & massage, textures, vibration, fluidotherapy \tn 
% Row Count 14 (+ 3)
% Row 5
\SetRowColor{white}
sensory training - re-education & massage, textures, vibration, fluidotherapy *high risk for injury since they are not feeling \tn 
% Row Count 19 (+ 5)
% Row 6
\SetRowColor{LightBackground}
joint protection & use hips/knees, push large items with full body, carry bags on forearm \tn 
% Row Count 23 (+ 4)
% Row 7
\SetRowColor{white}
body mechanics & do not move items that are too heavy, keep objects close to the body during lifting, hold object centered at waist level \tn 
% Row Count 29 (+ 6)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
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\mymulticolumn{3}{x{3.833cm}}{\bf\textcolor{white}{PAMS}}  \tn
% Row 0
\SetRowColor{LightBackground}
pam & indication & \seqsplit{precautions/contraindication} \tn 
% Row Count 3 (+ 3)
% Row 1
\SetRowColor{white}
cold pack & pain management, anti inflammation, edema control, decrease of muscle guarding, spasm. & \seqsplit{Hypersensitivity} or poor tolerance to cold • Raynaud's disease and phenomenon{\bf{ • Circulatory impairment – e.g. hemorrhaging tissue or untreated hemorrhagic disorders • Peripheral vascular disease • Active DVT • Impaired sensation (neuropathy) • Open wounds, near chronic wounds • Cryoglobulinemia}}* • Over regenerating nerves • Impaired cognition and/or ability to communicate \tn 
% Row Count 34 (+ 31)
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\begin{tabularx}{3.833cm}{x{1.03122 cm} x{1.00089 cm} x{1.00089 cm} }
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\mymulticolumn{3}{x{3.833cm}}{\bf\textcolor{white}{PAMS (cont)}}  \tn
% Row 2
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hot pack & subacute and chronic conditions. Relieves pain, increases soft tissue \seqsplit{extensibility}, reduces muscle spasm, relaxes skeletal muscles, decreases joint stiffness, and promotes wound healing. & Peripheral vascular disease • Impaired circulation, bleeding disorder, DVT or \seqsplit{thrombophlebitis} • Local malignancy and recently radiated areas • Acute inflammation or trauma, edema, infection • Open wounds • Over large scars • Impaired sensation (neuropathy) • Large areas, or at sufficient intensity to raise core temperature- pregnancy, severe cardiac disease/in cardiac failure • Impaired ability to communicate- cognition or \seqsplit{communication} impairments sufficient to prevent patient from giving accurate and timely feedback • Areas affected by \seqsplit{heat-sensitive} skin diseases (e.g., eczema) • Areas of skin breakdown or damage producing uneven heat conduction across the skin • Reproductive organs (testes) \tn 
% Row Count 56 (+ 56)
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\begin{tabularx}{3.833cm}{x{1.03122 cm} x{1.00089 cm} x{1.00089 cm} }
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% Row 3
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\seqsplit{fluidotherapy} - heat & help patients with their hands and wrists. Arthritis, chronic tendonitis, \seqsplit{postoperative} conditions, post fracture management, and Raynaud's syndrome. & open wounds \tn 
% Row Count 12 (+ 12)
% Row 4
\SetRowColor{white}
\seqsplit{neuromuscular} electrical stimulation NMES - muscle stimulation & stimulate paralyzed, paretic muscle, muscle weakness, peripheral neuropathy, and muscle spasm. & Pregnancy • Cancer • Presence of a cardiac pacemaker, or any other electrical simulators. Precautions include obesity, impaired sensation, and over relatively superficial metal implants. \tn 
% Row Count 27 (+ 15)
% Row 5
\SetRowColor{LightBackground}
paraffin & useful for contractures due to rheumatoid arthritis, burns, and progressive systemic sclerosis \seqsplit{(scleroderma)}. Used to treat chronic arthritis of the hand, various distal extremity conditions to increase ROM, manages pain, and assists in wound healing. & if patient has open wounds, abrasions or skin infections. \tn 
% Row Count 47 (+ 20)
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% Row 6
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\seqsplit{transcutaneous} electrical nerve stimulation - TENS - used for PAIN & Stimulates nerve fibers and provides symptomatic relief of pain. Used to treat chronic pain syndrome, spinal \seqsplit{radiculopathy}, low back pain, reflex sympathetic dystrophy, etc. & Pregnancy  • Pacemakers  • Prone to seizures- Tens "pulses" have the ppotential to trigger a seizure. \tn 
% Row Count 14 (+ 14)
% Row 7
\SetRowColor{white}
ultrasound & Penetrates deep into the musculature and joint tissues. • Increase the \seqsplit{extensibility} of collagen fibers in tendons and joint capsules • Reduce muscle spasms • Aids tissue healing – speeds up the rate of healing \& enhance the quality of the repair • Modulate pain, goes to the deepest layer for pain & Pacemaker • Areas of decreased circulation • Impaired sensation • Pregnancy • Along the cervical sympathetic ganglion (or over the \seqsplit{anterolateral} neck) • Directly over the spinal column after laminectomy • Severe arterial disease or DVT • Bleeding disorders • Over a bony prominence • Over epiphyseal plates • Any surgically implanted artificial product (e.g., Gortex or mesh) may build up heat in an area. \tn 
% Row Count 47 (+ 33)
\end{tabularx}
\par\addvspace{1.3em}

\vfill
\columnbreak
\begin{tabularx}{3.833cm}{x{1.03122 cm} x{1.00089 cm} x{1.00089 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{3}{x{3.833cm}}{\bf\textcolor{white}{PAMS (cont)}}  \tn
% Row 8
\SetRowColor{LightBackground}
whirlpool & Pain management • Wound management, particularly in the management of burn patients • To facilitate debridement in infected wounds, non-draining wounds, wounds with thick eschar, and on wounds with loosely adherent necrotic tissue • Helps dressings to be removed slowly and gently, reducing the pain of dressing changes. • ROM exercises • Promoting muscular relaxation & Fever • Recent skin grafts • Circulatory impairment • Active bleeding/ hemorrhaging • Open wounds • Sensory or vascular impairment \tn 
% Row Count 30 (+ 30)
\end{tabularx}
\par\addvspace{1.3em}

\vfill
\columnbreak
\begin{tabularx}{3.833cm}{x{1.03122 cm} x{1.00089 cm} x{1.00089 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{3}{x{3.833cm}}{\bf\textcolor{white}{PAMS (cont)}}  \tn
% Row 9
\SetRowColor{LightBackground}
contrast baths & Hot/cold immersion therapy is a method of treating: • Muscle soreness • Swelling • \seqsplit{Inflammation.} • Joint injuries, mild sprains, • Symptoms of chronic pain and repetitive strain injuries • Edema & Same as Superficial Heat and Cold \tn 
% Row Count 16 (+ 16)
\hhline{>{\arrayrulecolor{DarkBackground}}---}
\end{tabularx}
\par\addvspace{1.3em}


% That's all folks
\end{multicols*}

\end{document}