Positioning the Hand to Encourage Function
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As soon as my patient begins to get any tone or movement in their hand, I encourage using it during functional tasks. I try to avoid activities that require a tight, closed fist. The size of the hand and any ROM limitations will influence the object you use. Sometimes it may be necessary to first prepare the hand. Weightbearing or slow stretching can be helpful.

When selecting a task, choose objects, which fit the contour of the hand, keeping it open but not flat. A glass is perfect.

Hard surfaces work best, especially for patients that have increased tone in finger flexion. Objects that are soft can be less beneficial. Paper or Styrofoam cups don't provide a rigid surface to keep the hand in a good position.

A jar is slightly larger, encouraging more extension of the MCP, PIP and DIP joints and still keeps the hand in a good position.

When choosing activities, think of other objects with round contours. A flowerpot is also a good choice for positioning the hand.

Placing the hand in these positions during functional tasks encourages more normal movement patterns.

For more treatment ideas see
Functional Treatment Ideas
& Strategies in Adult Hemiplegia

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I have begun work on my third video series in the Stroke Education Training Series. I will be focusing on the lower level patient.

I welcome your feedback re: what would be helpful and where you have experienced difficulties related the treatment of stroke and adult hemiplegia.

See our January Newsletter.

CEU Approval
Our programs are approved by PT Boards in 9 states, with 10 more states pending approval. See list.

For Colleges & Universities
A College & University Edition of Functional Treatment Ideas & Strategies is now available on DVD for PT, OT, PTA and OTA programs at a special student rate.

Perfect for in-class teaching or used as an independent learning module. Contact us for more information.

International
I will be presenting (in English) a 5 day workshop at the Rehab Centre Hoensbroeck in the Netherlands.

The focus of the workshop will be on functional treatment ideas in the application of NDT/Bobath principles for the adult hemiplegic patient. Contact information.

If you have something you would like to share related to the treatment of stroke and adult hemiplegia, or if there are suggestions for future topics, please contact Jan Davis.

International Clinical Educators, inc.