C6/7-passive movements (S19)

Patients with C6 and C7 tetraplegia are dependent on an effective tenodesis grip for crude hand function. The effectiveness of the tenodesis grip is dependent on full passive joint mobility in the MCP and IP joints of the fingers and slight loss of extensibility in the long finger flexor muscles.

Equipment:

• Nil

Key Points:

• Patient may be positioned in lying (shown on video clip) or sitting
• Position the MCP and IP joints in flexion while passively moving the wrist
• Position the wrist and IP joints in flexion while passively moving the MCP joints
• Position the wrist and MCP joints in flexion while passively moving the IP joints

Common Errors:

• The IP joints are not moved into full extension
• The MCP joints are not moved into full flexion
• Inadvertent stretching of the long finger flexors but inappropriate stabilization of adjacent joints

Progression and Variety:

• Teach patients to self-administer flexion stretches for the MCP joint and extension stretches for the IP joints