Despite the growing amount of scientific evidence supporting exercise as an effective rehabilitation intervention for clients, translating that research into practice has proven challenging for clinicians. The result is that clients aren’t having their impairments appropriately assesses for the best object outcomes. Rather, clients often guide the progress based solely on their subjective biases. In more extreme cases, we see individuals who need intervention to assist with their impairment who are turning solely to exercise and attempting to rehabilitate without the guidance and skill or a licensed therapists.

It is time for a reset.

We must translate evidence-based rehabilitation into daily clinical practice to ensure that all clients receive adequate, intense, and progressive exercise rehabilitation.

Course Content

The main objective of Precision Design for the Hand and Wrist is to provide clinicians with the skillset to implement dosing, design and implementation strategies for the hand and wrist related therapeutic exercises. The course will help the clinician to perform a functional assessment and be able to design therapeutic exercises based on the functional biomechanics of the hand and wrist. Special attention is paid to functional integration of wrist and hand therapeutic exercises using the “Local – Semi-global – Global METhodology approach. With a balanced mix of lecture and lab practice, this course enables clinicians to immediately implement therapeutic exercises with high specificity of dose, design and delivery for the hand and wrist.


  • Direct therapeutic exercise design and dosing based on the knowledge of demographics, prevalence, prognosis of hand and wrist pathology, impairment and dysfunction.
  • Direct therapeutic exercise design and dosing based on the knowledge of wrist and hand functional biomechanics.
  • Recognize the components of therapeutic exercise prescription for the wrist and hand.
  • Operate dynamometry to facilitate the Clinical Fatigue Test for wrist and hand related therapeutic exercises.
  • Execute a Clinical Fatigue Test for wrist and hand related therapeutic exercises.
  • Formulate an exercise prescription with high specificity.
  • Dose therapeutic exercises utilizing different resistance equipment.
  • Dose therapeutic exercises for strength, strength/endurance, endurance, power, symptom reduction, mobilization and stabilization.


All modules are a combination of lecture and lab.

Day 1

08:00 AM Registration
08:15AM The M.E.T. METhodology: Dosing – Design – Delivery
08:30 AM Case Studies
09:30 AM Biomechanics of the Wrist and Hand: Considerations for Therapeutic Exercise Design
10:30 AM Break
10:45 PM Symptom Reduction Exercises for the Wrist and Hand
11:15 PM Mobilization Exercises for the Wrist and Hand: Manual Therapy Alignment, Design and Dosing
12:45 PM Lunch
01:30 PM Stabilization and Functional Integration: Therapeutic Exercise design considerations
02:30 PM Strength Exercises for the Wrist and Hand
03:30 PM Break
03:45 PM Strength Exercises for the Wrist and Hand – Continued
04:30 PM Case-studies and Theoretical Post – Course Interaction
05:30PM Adjourn

Required Readings

Course reading materials provided by MET following registration. 

  1. Altman E. The ulnar side of the wrist: Clinically relevant anatomy and biomechanics. J Hand Ther. 2016 Apr-Jun;29(2):111-22.
  2. Berger RA. The anatomy and basic biomechanics of the wrist joint. J Hand Ther. 1996 AprJun;9(2):84-93.
  3. Valdes K, von der Heyde R. An exercise program for carpometacarpal osteoarthritis based on biomechanical principles. J Hand Ther. 2012 Jul-Sep;25(3):251-62.