Week 1

Today i was asked to work on Patient d's right UL strength. Patient d had a stroke affecting his strength and muscle stimulation. He has poor hand function and difficulty with active movement against gravity. I began with passive ROM and then progressed to active ROM with gravity eliminated. I noticed he had compensatory movement patterns so i used tactile cues to prompt him to stabilise or relax unwanted contractions. After i had worked each major muscle group i decided to look more closely at intrinsic hand function. i gave patient d some basic finger extension/ flexion excercises with his arm resting on a desk for support. I then progressed this to a gripping excercise. I placed a tissue in patient d's hand and asked me to grip and release. I found duringf these excercises that my patient needed alot of prompting to minimise the compensatory movement and isolate the desired muscle. I found using the desk for support was very helpful.