Exercise, Strengthening and Rehabilitation for Hand Therapy · of exercise? •Assess •Establish...
Transcript of Exercise, Strengthening and Rehabilitation for Hand Therapy · of exercise? •Assess •Establish...
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Exercise, Strengthening and Rehabilitation for Hand Therapy
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WHY?
To reduce pain
To maintain and increase range in joints
To maintain and improve tendon excursion /gliding
To maintain and improve strength
To reduce swelling
To mobilise scar tissue
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How do you know which type of exercise?
•Assess
• Establish clear goals
• Set clear short and long term objectives.
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Which type of exercise?• Passive?
• Active assisted?
• Against resistance?
• Through range?
• Composite or isolated?
• Active?
• Concentric?
• Eccentric?
• Isometric?
• Isotonic?
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What makes a good exercise programme?
•Purposeful
•Why are they doing theses particular activities or exercises? How do they relate to the end goal?
• Easily incorporated into daily life
•Achievable
• Fun
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A progressive sequence
• Passive IPJs and MCPJs
• Composite IPJs and MCPJs
• Place and hold
• Active ROM
• Resisted Isotonic, isometric.
• Activities to stimulate and strengthen component muscles.
• Activities to improve proprioception, stereognosis and speed.
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Activities for ROM
• Tendon gliding sequence
• Place and hold
• Splints – block or TERT
• Rice/beans span and grip pass from one bowl to another
• Flicking cotton wool ball/ ping/pong ball/pom-pom for extension
• Scraping wet rice/lentils off hand ( no help from the opposite one)
• Pen walking
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Activities for Dexterity• Scissor work – hold scrap in little and ring fingers.
• Crumpling newspaper into a ball
• Walking a ball up leg, across tummy and down leg
• Twirl bean bag/ sock full of corn through the air
• Turning coins or cards
• Stacking coins/buttons
• Cats cradle
• Play dough
• Marbles
• paperclips
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Activities
Ideas for ROM span and full fist ideas for interossei strength
These can be timed, they can be counted, you can use different sizes of objects in the bowl.
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Activities
You can create blocking splints with pencils, extension blocking for improving PIPJ extension, flexion blocking to improve PIPJ flexion.
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More Activities
Elastic bands are great for strengthening extensor, cards for dexterity, lumbricals, pinch.
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Pencil Walking and Rolling
• Great for individual tendon work – loosen those rusty cables!
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Activities for StrengthPegging Pro/supination
• Tennis ball monster
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Summary• Try to make it fun
• Try to make it purposeful
• Think of progression
• Think about the patient’s needs.
My Dad’s holding my youngest