AIM:
To train shoulder abduction without excessive shoulder elevation in preparation for reaching.
Rationale:
Excessive shoulder elevation is a common adaptive strategy patients use when reaching. Task-related training is set up so the patient can practice with support from a plinth and/or manual guidance from the therapist (if necessary) without using this adaptive strategy.
Equipment:
- Adjustable height plinth
- Chair
Key Points:
- Patient is positioned in sitting, arm supported on plinth, arm positioned in 90° shoulder abduction and 90° elbow flexion
- Patient depresses the shoulder
- To progress this training, patient lifts elbow and/or hand off the plinth while maintaining shoulder depression
- Therapist is positioned to the side or behind the patient and provides manual guidance at the arm if necessary
Common Errors:
- Patient flexes trunk laterally
Progression and Variety:
- Decrease/remove manual guidance or support of plinth
- Increase amplitude of movement
- Increase speed of movement
- Sustain muscle contraction