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Positioning the Hand to Encourage Function
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