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Our user asked: "I work at a habilitation center for adults with developmental disabilities. My current project is to improve the arm coordination of a woman, mid 30s, who is wheelchair bound and has extensive brain damage from infancy. She favors the use of her right arm and I am supposed to help her to do exercises which require the use of both arms at the same time, to prepare her for her next challenge which will be to eventually get her using both hands to push herself in her wheelchair (instead of going in circles.) She has almost no individual finger dexterity but does have a strong grip. She cannot speak and knows very minimal sign language (hungry, eat, angry, etc.) She understands more than she can communicate, but doesn't follow instructions well or focus on one thing for very long. She has $300 which I can use to purchase tools/equipment. It can be new or used. What products should I buy?"
Ask a PT Response: "Does your patient have any contractures (stiffening of the joint, causing it to shorten and stay bent) at her upper extremities and wrist/hands? If so, stretching & ROM exercises along with splinting/bracing may be beneficial. Restricting the upper extremity which is favored and encouraging the increase use of the less favored upper extremity for various functional exercises such as reaching, grabbing, lifting, etc. has been found beneficial in therapy. Some of the equipment which may be utilized in the PT clinic can include and isn't limited to shoulder pulleys, hand dynamometers, putty, hand weights, cones, tubing, etc. From what you describe it appears your patient would be appropriate for PT given she has potential for increasing her functional status (independent with wheelchair mobility) and it may be a good ideal to look into this as the PT would be able to develop a plan of care specific to her needs."
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