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Repeat __ times.
Wk 2
Repeat __ times.
Wk 2
Picking up an object between the thumb and fingertips
Client's aim
To improve your ability to manipulate objects with your hand.
Client's instructions
Position yourself sitting with a small object, such as a pen lid, on a
table in front of you. Practice picking up the object using your thumb
and the tip of your first finger and placing it down again without
dropping it. Repeat using your second, third and fourth fingers to pick
up the object.
Repeat __ times.
Wk 2
Repeat __ times.
Wk 2
Picking up a coin
Client's aim
To improve your ability to pick up small objects with your hand.
Client's instructions
Position yourself sitting with a large coin on a table in front of you.
Practice picking up and placing down the coin.
Repeat __ times.
Wk 2
Repeat __ times.
Wk 2
Picking up coins and placing them in a jar
Client's aim
To improve your ability to pick up and put down small objects with
your hand.
Client's instructions
Position yourself sitting with some coins and a jar on a table in front of
you. Practice picking up the coins one at a time using your thumb and
index finger and placing them in the jar.
Repeat __ times.
Wk 2
Repeat __ times.
Wk 2
Pouring water from one cup to another
Client's aim
To improve your ability to manipulate objects with your hand.
Client's instructions
Position yourself sitting with two foam cups on a table in front of you.
Practice picking up the cups and pouring water from one cup to the
other without spilling it. Ensure that the cups do not deform.
Repeat __ times.
Wk 2
Repeat __ times.
Wk 2
Looking up and down in sitting
Client's aim
To improve your ability to sit unsupported.
Client's instructions
Position yourself sitting with your thighs supported on a bed, your feet
on the floor and your hands in your lap. Practice looking up and down.
Repeat __ times.
Wk 2
Repeat __ times.
Wk 2
Moving the shoulders forwards in sitting to a target
Client's aim
To improve your ability to stand up from sitting.
Client's instructions
Position yourself sitting with a table placed in front of you at chest
height. Practice bending your hips and moving your chest forwards to
touch the table. Ensure that your trunk does not bend, your toes are
aligned under your knees and you weight-bear through your affected
leg.
Repeat __ times.
Wk 2
Repeat __ times.
Wk 2
Transferring weight laterally in standing
Client's aim
To improve your ability to take weight from one foot to the other for
standing or walking.
Client's instructions
Position yourself standing with your feet slightly apart. Practice
transferring your weight from one leg to the other. Ensure that your
shoulders remain over your hips.
Repeat __ times.
Wk 2
Repeat __ times.
Wk 2
Walk heel to toe
Client's aim
To improve your ability to walk and balance.
Client's instructions
Position yourself standing on a line with one foot directly in front of the
other. Practice walking along the line by placing one foot straight in
front of the other, ie, heel to toe. Ensure that your feet do not step off
the line.
Repeat __ times.
Wk 2
Wk 2
Ankle dorsiflexor strengthening in long sitting
Client's aim
To strengthen the muscles at the front of your ankle.
Client's instructions
Position yourself sitting with your legs in front of you and a target held
above your toes. Practice bending your ankles to touch the target with
your toes.
Repeat __ times.
Wk 2
Repeat __ times.
Wk 2
Ankle dorsiflexor/plantarflexor strengthening in supine
Client's aim
To strengthen your ankle muscles.
Client's instructions
Position yourself lying on your back. Start with your toes pointing
down. Finish with your toes pointing up.
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Ankle plantarflexor strengthening in sitting without weights
Client's aim
To strengthen your calf muscles.
Client's instructions
Position yourself sitting with your knees together. Start with your feet
flat on the floor. Finish with your heels lifted off the floor. Ensure that
you keep your toes on the floor.
Wk 2
Wk 2
Elbow extensor strengthening in lying without weights
Client's aim
To strengthen the muscles that straighten your elbow.
Client's instructions
Position yourself lying on your back with your arm held vertically. Start
with your elbow straight. Finish with your elbow bent and your palm
touching your forehead. Ensure that your upper arm doesn`t move
and only your forearm moves.
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Finger and thumb extensor strengthening using an elastic band
Client's aim
To strengthen the muscles that straighten your fingers and thumb.
Client's instructions
Position yourself sitting with the tips of your fingers and thumb held
together and an elastic band placed around them. Practice opening
your fingers and thumb outwards against the resistance of the elastic
band.
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Bridging
Client's aim
To strengthen the muscles at the back of your hip.
Client's instructions
Position yourself lying on your back with your knees bent. Lift your
bottom off the bed.
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Hip flexor strengthening in supine
Client's aim
To strengthen the muscles at the front of your hip.
Client's instructions
Position yourself lying on your back with your legs straight. Lift your
knee towards your shoulder.
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Straight leg raise
Client's aim
To strengthen the muscles at the front of your hip and knee.
Client's instructions
Position yourself lying on your back with your legs straight. Start with
your leg straight and your heel on the bed. Finish with your leg
straight and your heel above the bed.
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Wk 2
Bilateral squat in standing
Client's aim
To strengthen the muscles that straighten your leg.
Client's instructions
Position yourself standing with your knees straight. Bend your knees
and then stand up straight again.
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Passive ankle movements
Client's aim
To stretch or maintain range in your ankle.
Client's instructions
Position yourself sitting with one foot up on your opposite knee. Move
your ankle up and down and around in circles.
Precautions
1. Ensure that the chair does not tip backwards.
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Hand stretch of the MCP joints
Client's aim
To stretch or maintain range in your knuckle joints.
Client's instructions
Position yourself sitting with your hand on a table nearby. Push your
hand down with your knuckle joints bent and your finger joints straight.
Precautions
1. Preserve tenodesis grasp.
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Neck lateral flexor stretch
Client's aim
To stretch or maintain length in the muscles at the side of your neck.
Client's instructions
Position yourself with your head facing forwards. Move your neck to
the side to bring your ear towards your shoulder. Ensure that your
head faces forwards.
Precautions
1. Only administer after attaining medical approval.
2. Stop with first signs of pain.
3. Impaired or absent sensation of stretch.
Hold for __ minutes.
Wk 2
Wk 2
Passive wrist flexion and extension
Client's aim
To stretch or maintain range in your wrist.
Client's instructions
Position yourself lying down with your forearm supported. Instruct a
carer/therapist to passively move your wrist up and down.
Precautions
1. Impaired or absent sensation of stretch. 2. Preserve tenodesis
grasp.
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Wk 2
Finger and wrist flexor stretch in sitting by weight-bearing through hands
Client's aim
To stretch or maintain range in your wrists.
Client's instructions
Position yourself sitting on a plinth with your arms out straight behind
you. Ensure that your fingers are kept straight.
Precautions
1. Impaired or absent sensation of stretch.
Wk 2
Wk 2
Calf stretch in long sitting
Client's aim
To stretch your calf muscles.
Client's instructions
Position yourself in long sitting with your knee straight. Place a towel
around your foot and gently pull your foot towards your head until you
feel a stretch in your calf muscle.
Wk 2
Wk 2
Finger adduction resisted by an elastic band
Client's aim
To strengthen the muscles that bring your fingers together.
Client's instructions
Position yourself with an elastic band around your finger. Hold one
end of the elastic band with your unaffected hand. Pull your finger
inwards against the resistance of the elastic band.
Wk 2
Wk 2
Finger and thumb adductor stretch
Client's aim
To stretch or maintain range in your finger and thumb.
Client's instructions
Position yourself with your fingers and thumb on the table. Attempt to
stretch your fingers and thumb apart. Ensure that your fingers and
thumb are kept straight.
Wk 2
Finger extension
Client's aim
To strengthen the muscles that straighten your fingers.
Client's instructions
Position yourself with your palm down on the table. Lift your finger off
the table.
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Hand behind the back
Client's aim
To stretch or maintain range in your shoulder muscles.
Client's instructions
Position yourself holding on to a towel behind your back. Straighten
your top arm. Pull on the towel to bring your bottom arm higher up
your back.
Wk 2
Head rotation
Client's aim
To improve your head rotation.
Client's instructions
Position yourself in sitting or standing with a good posture. Gently turn
your head to one side, back to neutral and then to the other side. Try
to rotate a little further each time so that you can see over your
shoulder.
Precautions
1. This exercise may cause discomfort but it should not increase your
pain or symptoms. 2. Perform the exercise in a slow and controlled
manner.
Hold for __ seconds.
Repeat __ times.
Wk 2
Neck extension
Client's aim
To improve your ability to extend your neck.
Client's instructions
Position yourself in sitting or standing with a good posture. Gently look
up towards the sky and return to the upright position. Ensure that your
chin is tucked in prior to carrying out the exercise.
Precautions
1. This exercise may cause discomfort but it should not increase your
pain or symptoms. 2. Perform the exercise in a slow and controlled
manner.
Hold for __ seconds.
Repeat __ times.
Wk 2
Neck flexion
Client's aim
To improve your ability to bend your neck.
Client's instructions
Position yourself in sitting or standing with a good posture. Gently look
down towards your chest and then return to the neutral position.
Precautions
1. This exercise may cause discomfort but it should not increase your
pain or symptoms. 2. Perform the exercise in a slow and controlled
manner.
Wk 2
Neck lateral flexion
Client's aim
To improve side bending of your neck.
Client's instructions
Position yourself in sitting or standing with a good posture. Centre
your neck. Gently bring your ear down towards your shoulder. Return
to the centre. You should feel a gentle stretch in the side of your neck.
Precautions
1. This exercise may cause discomfort but it should not increase your
pain or symptoms. 2. Perform the exercise in a slow controlled
manner.
Hold for __ seconds.
Repeat __ times.
Wk 2
Wk 2
Opposition of thumb to little finger
Client's aim
To improve your ability to manipulate objects with your hand.
Client's instructions
Position yourself with your hand resting in front of you. Practice
touching the tip of your little finger to the tip of your thumb.
Wk 2
Wk 2
Opposition of thumb to ring finger
Client's aim
To improve your ability to manipulate objects with your hand.
Client's instructions
Position yourself with your hand resting in front of you. Practice
touching the tip of your ring finger to the tip of your thumb.
Wk 2
Palmar abduction
Client's aim
To improve your ability to stretch your webspace.
Client's instructions
Position yourself with your hand resting in front of you. Position your
thumb so that it moves perpendicular to your palm.
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Passive wrist flexion
Client's aim
To stretch or maintain range of your wrist.
Client's instructions
Position your wrist in a bent position. Use your other hand to maintain
the position.
Wk 2
Wk 2
Place and hold the finger
Client's aim
To improve your ability to maintain a bent finger.
Client's instructions
Position yourself with your hand resting in front of you. Push your
fingers into a fist with your other hand. Hold your fingers in a bent
position once the pressure is released.
Wk 2
Wk 2
Tendon gliding - full fist
Client's aim
To improve your ability to bend your fingers.
Client's instructions
Position yourself with your wrist extended. Make a fist and keep your
finger joints bent.
Wk 2
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Tendon gliding - straight
Client's aim
To improve your ability to straighten your fingers.
Client's instructions
Position yourself with your wrist in extension. Straighten your fingers
at all joints. Avoid hyperextending at the knuckles.
Wk 2
Wk 2
Tendon gliding - table top
Client's aim
To improve your ability to bend your fingers at your large knuckles.
Client's instructions
Position yourself with your wrist extended. Bend at your knuckle
joints. Ensure that your fingers are kept straight maintaining a table
top position.
Wk 2
Wk 2
Thumb abduction
Client's aim
To improve your ability to open your thumb.
Client's instructions
Position yourself with your hand resting on a table in front of you.
Slide your thumb away from your finger. Ensure that you keep your
thumb on the table.
Wk 2
Wk 2
Thumb flexion to metacarpophalangeal joint of the little finger
Client's aim
To improve your ability to bend your thumb.
Client's instructions
Position yourself with your hand resting in front of you. Touch the tip
of your thumb to the base of your little finger.
Wk 2
Wk 2
Thumb interphalangeal joint flexion and extension in opposition.
Client's aim
To improve your ability to bend and straighten the tip of your thumb.
Client's instructions
Position yourself with your hand resting in front of you. Touch the tip
of your thumb to the base of your little finger. Slide your thumb up
your little finger. Slide your thumb down your little finger.
Wk 2
Wk 2
Thumb movements resisted by an elastic band
Client's aim
To strengthen the muscles that move your thumb.
Client's instructions
Position yourself with an elastic band around your thumb. Place an
elastic band around your thumb and first finger. Move the thumb
against the resistance of the elastic band as if you opening their and
to grasp a cup.
Wk 2
Thumb retropulsion
Client's aim
To improve your ability to lift your thumb.
Client's instructions
Position yourself with your hand resting in front of you. Lift your thumb
off the table.
Wk 2
Walk backwards with big steps
Client's aim
To improve your ability to walk backwards and balance.
Client's instructions
Position yourself in standing. Practice walking backwards taking big
steps. Ensure you check that the path is clear behind you.
Repeat __ times.
Wk 2
Wk 2
Wringing a towel in pronation
Client's aim
To strengthen your hand grip.
Client's instructions
Position yourself with a rolled up towel in your hands and palms facing
up. Grip the towel and move your hands in a wringing motion.
Wk 2
Wk 2
Wringing putty
Client's aim
To strengthen your hand grip.
Client's instructions
Position yourself with putty in your hands. Grip the putty and move
their hands in a wringing motion.
Wk 2
Wk 2
Wrist flexion and extension
Client's aim
To improve your ability to bend and straighten your wrist.
Client's instructions
Position yourself with your hand resting in front of you. Bend your
wrist letting the fingers straighten and straighten your wrist letting the
fingers bend.
Wk 2
Wk 2
Wrist radial and ulnar deviation
Client's aim
To improve your ability to move your wrist from side to side.
Client's instructions
Position yourself with your hand resting in front of you. Move your
wrist from side to side. Ensure that you keep your wrist in line with
your forearm.
Wk 2
Wk 2
Controlling finger flexor force by lowering peg from horizontal to vertical
Client's aim
To improve your ability to manipulate objects with your hand.
Client's instructions
Position yourself sitting while holding onto the end of a peg between
your index finger and thumb. Hold the peg horizontally. Practice
reducing the pressure on the peg to allow the peg to lower slowly to a
vertical position. Ensure that you don`t let go of the peg.
Repeat __ times.
Wk 2
Opening a container
Client's aim
To improve your ability to manipulate objects with your hand.
Client's instructions
Position yourself sitting while holding a plastic container with the lid
closed in your unaffected hand. Practice opening and closing the lid
with your affected hand.
Repeat __ times.
Wk 2
Connecting a plug and socket
Client's aim
To improve your ability to manipulate objects with your hand.
Client's instructions
Position yourself sitting in front of a table with a socket in your
unaffected hand. Practice connecting and disconnecting the plug from
the socket.
Precautions
1. Ensure that the socket is not connected to the power supply.
Repeat __ times.
Wk 2
Repeat __ times.
Wk 2
Turning nuts and bolts
Client's aim
To improve your ability to manipulate objects with your hand.
Client's instructions
Position yourself sitting with some nuts and bolts on a table in front of
you. Practice picking up a nut with your affected hand and threading it
onto a bolt using your thumb and index finger.
Repeat __ times.
Wk 2
Repeat __ times.
Wk 2
Threading macaroni
Client's aim
To improve your ability to manipulate objects with your hand.
Client's instructions
Position yourself sitting with some nylon line and some macaroni in a
container on a table in front of you. Practice picking up the macaroni
one at a time using your affected thumb and index finger and
threading it onto the nylon line held in your unaffected hand.
Repeat __ times.
Wk 2
Repeat __ times.
Wk 2
Marching on the spot
Client's aim
To improve your ability to walk.
Client's instructions
Position yourself standing with a table nearby for support. Practice
marching on the spot. Ensure that your legs lift up an equal amount.
Repeat __ times.
Wk 2
Wk 2
Heel raise
Client's aim
To strengthen your calf muscles.
Client's instructions
Position yourself standing. Start with your heels on the ground. Push
up on your toes.
Wk 2
Wk 2
Hip abduction in standing
Client's aim
To strengthen the muscles on the outside of your hip.
Client's instructions
Position yourself standing with their feet together. Start with your leg
beside your body. Lift your leg out to the side. Ensure that you keep
your body upright and your toes pointing forward.
Wk 2
Wk 2
Hip external rotator strengthening standing beside a wall - 2
Client's aim
To strengthen the muscles that rotate your hip.
Client's instructions
Position yourself standing beside a wall. Bend the knee closest to the
wall and rest it on the wall. Push your knee into the wall while keeping
your other leg straight.
Wk 2
Wk 2
Dynamic knee control with hip extension
Client's aim
To strengthen the muscles that straighten your leg.
Client's instructions
Position yourself standing. Practice sliding back and forwards with
your unaffected leg. Ensure that both feet point forwards and the
weight is mostly on the front leg. Ensure your front knee bends in line
with the foot and you keep your pelvis level.
Wk 2
Wk 2
Active assisted knee flexion and extension
Client's aim
To strengthen the muscles at the front and back of your thigh and to
stretch or maintain range in your knee.
Client's instructions
Position yourself sitting with your knees bent. Practice straightening
your affected knee as much as possible while assisting with your
unaffected leg, then bending your affected knee as much as possible
while assisting with your unaffected leg.
Repeat __ times.
Wk 2
Wk 2
Walking fingers up the wall
Client's aim
To strengthen the muscles at the front of your shoulder and stretch or
maintain length of the muscles at the back of your shoulder.
Client's instructions
Position yourself standing facing the wall. Place the palm of your hand
against the wall and slowly `walk` your fingers up the wall.
Wk 2
Wk 2
Anterior deltoid strengthening - stage 3
Client's aim
To strengthen your shoulder muscles.
Client's instructions
Position yourself lying on your back with your arm by your side. Flex
your shoulder to 90 degrees. Move your arm in an arc above and
below shoulder height. Ensure that the movement is slow and
controlled.
Wk 2
Wk 2
Bending the knee in sitting
Client's aim
To stretch or maintain range in your knee.
Client's instructions
Position yourself sitting with a towel underneath your foot. Slide your
foot backwards along the floor to bend your knee.
Precautions
1. Impaired or absent sensation of stretch.
Wk 2
Wk 2
Active assisted shoulder flexion 90 degrees
Client's aim
To improve range of motion of your shoulder.
Client's instructions
Position yourself in supine and hold a walking stick with both of your
hands. Raise both hands over your head so that you feel a stretch in
your shoulder.
Wk 2
Wk 2
Posterior capsule stretch in standing
Client's aim
To stretch or maintain length in the muscles behind your shoulder.
Client's instructions
Position yourself in standing. Use one hand to stretch your opposite
shoulder by pulling your arm across your body.
Wk 2
Wk 2
Wrist and finger extensor stretch in standing
Client's aim
To stretch or maintain length of your wrist and finger extensors.
Client's instructions
Position yourself in standing with your arm outstretched and your
palm facing down. Bend your fingers and your wrist with your other
hand. Ensure that your elbow remains straight.
Wk 2
Wk 2
Pouring water between cups
Client's aim
To improve your ability to rotate your forearm.
Client's instructions
Position yourself sitting with two cups on a table and holding onto a
third cup filled with water. Practice pouring water into each cup on the
table by rotating your forearm one way and then the other. Ensure
that you keep your elbow bent.
Repeat __ times.
Wk 2
Repeat __ times.
Wk 2
Bending the wrist while holding a cup
Client's aim
To improve your ability to bend your wrist.
Client's instructions
Position yourself sitting with your hand grasping a cup and hanging
over the edge of a table. Practice tilting the cup up by bending your
wrist to a point level with, or higher than the table.
Repeat __ times.
Wk 2