AIM:
To train wrist extension with radial deviation in preparation for reaching and manipulation
Rationale:
An important component of reaching and manipulation is wrist extension with radial deviation. Task-related training is set up so the patient can practice with manual guidance from the therapist if necessary.
Equipment:
- Table
- Chairs
- Small cylindrical object
- Plate
Key Points:
- Patient is positioned in sitting, arm supported on table, shoulder slightly flexed, elbow flexed and forearm neutral
- Patient holds a cylindrical objects and extends wrist
- It may be necessary to tape the cylinder into the hand if the patient is unable to grasp objects
- To progress this training, patient extends then radially deviates at the wrist.
- Ensure forearm remains in contact with the table
- Therapist is positioned to the side of the patient and provides manual guidance at the wrist if necessary
- Therapist provides cues for range of movement using a plate
Common Errors:
- Patient flexes elbow
- Patient abducts shoulder
- Patient fails to maintain radial deviation while extending the wrist
Progression and Variety:
- Decrease/remove manual guidance
- Remove support from plinth
- Increase amplitude of movement
- Increase speed of movement
- Increase circumference and/or weight of object in hand
- Sustain muscle contraction