Narrow Stance with Diagonal UB Pattern | Occupational Therapy Interventions

Dynamic Standing with Diagonal UB Pattern

Occupational Therapy Intervention: Dynamic Standing

Documentation and Activity Rationale

The patient engaged in dynamic standing activity in which they were tasked with completing repetitions of a UE diagonal pattern. Diagonal patterns have been researched in order to support claims that the brain recognizes rotational and diagonal patterns better than isolated movements during neuro-rehab. The patient was cued to maintain a narrow BOS in order to challenge and remediate noted balance deficits. The patient completed 2×15 repetitions utilizing intertwined hand-over-hand to support and facilitate movement from hypotonic LUE.

Grading Strategies

Grading Up:

stand in tandem stance
increased repetitions
switch between different stances each repetition

Grading Down:

slightly wider BOS
provide contact assistance

Appropriate Diagnoses / Deficits

Alzheimer’s
balance deficits
CVA
TBI

Multi-Modal Dynamic Seated Activity Posture | Occupational Therapy Interventions

OT Practitioners

Dynamic Seated Postural Activity

Occupational Therapy Intervention: Multi-Modal Dynamic Seated Postural Activity

Documentation and Activity Rationale

The patient engaged in a dynamic unsupported seated activity requiring him to toss a beanbag through a hoop approximately 6 feet off the ground suspended from the ceiling. The task utilized to encourage/elicit neck extension, strong posture, movement/task initiation, eye/hand coordination, modulation, and sustained attention to the task. The patient required moderate verbal cues through activity to complete the requirements of the task and was able to successfully accomplish an accurate toss 5 / 15 attempts

Grading Strategies

Grading Up:

complete standing
integrate midline crossing
have pt retrieve beanbags before tossing them through

Grading Down:

sit closer to hoola hoop
place hoola hoop on floor

Appropriate Diagnoses / Deficits

Dementias
Parkinsons
CVA
TBI
Kyphotic posturing

Functional Movement Pattern Strengthening | Occupational Therapy Interventions

OT Practitioners

Upper Body Functional Movement Pattern

Occupational Therapy Intervention: Functional Movement Patterns

Documentation and Activity Rationale

The patient engaged in functional movement pattern strengthening activity. The task required the patient to retrieve x9 16, 18, and 20 oz weighted balls from the middle of her back. The patient was given additional therapist provided resistance in order for a just-right challenge. The movement pattern invoked shoulder extension, internal rotation, and adduction, forearm flexion, pronation/supination, and wrist and digit flexion and extension. This activity is purposed to improve strength and activity tolerance through repetition and progressive overload in order to increase participation in daily activities such as UB dressing and decrease pain.

Grading Strategies

Grading Up:

begin with the balls at waist level
provide no therapist added resistance
given tactile cue as to where you are holding the ball
integrate duel tasking

Grading Down:

increase resistance
use only higher weight balls
do task seated

Appropriate Diagnoses / Deficits

Atrophy s/p wrist/hand surgery
Frozen shoulder (adhesive capsulitis)
Osteoarthritis
Decrease ROM
s/p rotator cuff injury

Forearm Strengthening with Forearm Flexor | Occupational Therapy Interventions

OT Practitioners

Forearm Strengthening

Occupational Therapy Intervention: Wrist and Hand Rehab

Documentation and Activity Rationale

The patient engaged in arm strengthening activity using a red forearm flexor with 10 reps with hands holding an object in pronation and 10 reps in supination. Resistance provides encouraged gross BUE strengthening and muscle stretching with the amplified purpose of wrist control and stability against resistance.

Grading Strategies

Grading Up:

Increased repetitions
Isometric hold at end range
Integrate duel tasking

Grading Down:

Decrease repetitions
Allow more time between sets

Appropriate Diagnoses / Deficits

TFCC injury
Muscle weakness
Atrophy s/p hand/wrist surgery

Additional Rationale:

Strengthening Forearm Muscles: Utilizing a forearm flexor with variable levels of resistance targets the forearm flexor muscles, which are crucial for many daily tasks. Strengthening these muscles improves grip strength and endurance.
Cylindrical Wrist Grasp: The cylindrical wrist grasp mimics functional hand positions used in daily activities, such as holding a cup, turning a doorknob, or using tools. This type of grip is essential for occupational performance.
Body Mechanics: Proper body mechanics during these exercises ensure that movements are safe and effective, reducing the risk of injury. It also promotes awareness and control over the body, which is crucial for functional tasks.
Pronation and Supination: Pronation (turning the palm down) and supination (turning the palm up) are fundamental movements required for many tasks. Resistance training in these movements enhances muscle strength, coordination, and control, which are essential for functional hand use.
Graded Resistance: The ability to adjust resistance allows for progressive overload, which is essential for muscle strengthening. It also enables the customization of the exercise to match the individual’s current functional level and gradually increase the challenge as their strength improves.
Concentric, Eccentric, and Isometric Contractions:
- Concentric Contractions: Strengthen muscles as they shorten, which is important for lifting and pulling activities.
- Eccentric Contractions: Strengthen muscles as they lengthen, improving control during lowering and decelerating movements.
- Isometric Contractions: Enhance muscle endurance and stabilization, which are necessary for holding objects and maintaining positions.

Occupational Performance Rationale

Functional Grip and Manipulation: Improved strength and control of the forearm flexors enhance the ability to grip and manipulate objects, which is essential for daily activities such as dressing, grooming, eating, and using tools.

Enhanced Coordination and Precision: Strengthening these muscles supports better coordination and precision in hand movements, contributing to tasks that require fine motor skills, like writing or buttoning a shirt.

Increased Endurance: Improved muscle endurance helps individuals sustain activities for longer periods without fatigue, which is important for both work and leisure activities.

Reduction of Pain and Injury: Strengthening the forearm muscles and improving body mechanics can reduce the risk of repetitive strain injuries and alleviate pain associated with conditions like tendinitis or carpal tunnel syndrome.

Improved Dexterity: Enhanced strength and control in pronation and supination movements support better dexterity, which is necessary for activities like turning keys, opening jars, or using a computer mouse.

Task-Specific Training: Engaging in exercises that mimic daily activities helps in the transfer of skills to real-life tasks. This functional approach ensures that the improvements in strength and coordination directly benefit the individual’s occupational performance.

Postural Stability and Balance: Proper body mechanics and the integration of upper extremity movements with postural control contribute to overall stability and balance, which is crucial for safe and effective task performance.

Using a forearm flexor with variable resistance and incorporating cylindrical wrist grasp, proper body mechanics, and pronation/supination against resistance addresses multiple dimensions of muscle function—strength, endurance, coordination, and control. These improvements directly enhance occupational performance by enabling individuals to perform daily activities more effectively, efficiently, and safely. Through progressive overload and specific movement patterns, this exercise regimen fosters the functional abilities necessary for independence and quality of life.