AIM:
To train forearm supination and pronation in preparation for reaching and manipulation
Rationale:
An important component of reaching and manipulation is forearm supination and pronation. Task-related training is set up so the patient can practice with manual guidance from the therapist if necessary.
Equipment:
- Table
- Chairs
- Ruler
- Targets, eg, cups, tissue boxes
Key Points:
- Patient is positioned in sitting, arm supported on table, shoulder slightly flexed, elbow flexed and forearm neutral
- Patient holds a ruler, supinates and pronates forearm.
- It may be necessary to tape the ruler into the hand if the patient is unable to grasp objects (shown in video)
- Ensure forearm remains in contact with the table
- Therapist is positioned to the side of the patient and provides manual guidance at the forearm if necessary
- Therapist provides cues for range of movement using targets
Common Errors:
- Patient flexes and extends wrist
- Patient laterally flexes trunk
Progression and Variety:
- Decrease/remove manual guidance
- Remove support from table
- Increase amplitude of movement
- Increase speed of movement
- Sustain muscle contraction