Strengthening ActivitiesThis is a featured page

STRENGTHENING ACTIVITIES

Strengthening exercises and activities are performed to improve the
performance of weakened muscles. Most patients who have lost muscle
power and developed weakness are candidates for strengthening
therapy. The exception is found with patients who may have changes
in their muscle tone, such as spasticity, which is increased tension in a
muscle, following a stroke or head injury. Patients with cerebral palsy
may not be candidates for strengthening activities because strengthening
may increase their spasticity.

The goal of strengthening is to improve a patient’s muscle power and
endurance so that he can adequately perform routine tasks. In formulating
a strengthening program, it’s important to know the lifestyle of
each patient. For example, a patient may be a laborer who will be returning
to a physically challenging job, an elderly man who needs to
climb 10 steps to get to his bedroom, or a mother of three who needs
to return to homemaking activities.
Strengthening activities cover a broad spectrum. The most familiar
strengthening activities include the use of weights, dumbbells, and
hand grippers. These are very effective tools for improving
muscle power, strength, and endurance. They’re often referred to as
progressive resistive exercises (PREs), and are often graded to the patient’s
tolerance.
Patients who engage in this type of strengthening program include
those with tendonitis, fractures, carpal tunnel syndrome, nerve injuries,
or those persons who have become weak after a long illness or
hospital stay. Strengthening exercises are initiated when indicated by
a physician.
Many functional activities are recommended for patients to improve
strength and endurance. For example, a patient can work on sitting
upright in a chair to strengthen weak trunk muscles. Another patient
can lift his leg to put on a sock or shoe to strengthen leg muscles,
while another patient can stand and prepare a meal at the stove or
counter to improve upper and lower body strength and endurance.
Patients who generally engage in this type of strengthening are those
who have developed generalized weakness and deconditioning from
a diagnosis such as multiple sclerosis, stroke, or rheumatoid arthritis.
Strengthening programs for patients who have a CNS or
systemic disorder must be tailored to each individual’s needs to prevent
fatigue. Games and leisure activities are also ways to provide a strengthening
program. Games are a very effective way to treat children. A child
with upper body weakness may benefit from throwing a ball, pushing
himself on a scooter board, or playing wheelbarrow. The O.T. aide
is very helpful in activities when a second person is needed to complete
the task, such as playing catch.
As with all activities and exercises, they should be meaningful along
with effective in achieving the desired end result.

Gross Motor Activities
Gross motor skills refer to coordinated movements of large muscle
groups, such as throwing a ball, climbing stairs, or pulling up pants.
Patients who have suffered trauma to the brain or spinal cord, or
some type of progressive disease of the central nervous system may
have impaired gross motor skills. Such patients may have difficulty
performing many basic daily tasks that require movement by large
muscle groups.

This type of patient needs to work on coordination. If a patient displays
difficulty throwing a ball or pulling a shirt over her head, the
O.T. aide may help the patient raise her shoulder. Once the patient
has mastered this movement, she would then add elbow movement
along with the shoulder motion. This would be followed with movement
of the forearm, wrist, and hand.

Gross motor activities go from simple to more complex movements.
The following is a list of gross motor activities beginning with the basic
and moving to the more advanced.
_ Pushing a towel back and forth on a table top
_ Rolling a ball across the table
_ Sitting down in a chair
_ Combing hair
_ Putting on a jacket
_ Running a vacuum
_ Throwing a ball
_ Climbing a ladder
_ Using a shovel
Most of what we do throughout our daily lives involves a significant
amount of gross motor activity: getting out of bed, taking a shower,
getting dressed, driving a car, cooking a meal, child care, and many
hobbies and sporting activities. It’s important to be creative when
planning and implementing gross motor tasks. They should be challenging
and meaningful to the patient, but they shouldn’t be overwhelming.

Fine Motor Activities
Fine motor skills are the opposite of gross motor skills. Fine motor
skills use a person’s hands to manipulate objects. Examples
of fine motor activities are
_ Picking up small objects such as blocks, buttons, coils, and pegs
_ Using a fork and knife
_ Counting money
_ Shuffling cards
_ Turning a key
_ Zipping a zipper
_ Opening a package
_ Tying a bow
_ Turning a page


There are many diagnoses that impair a person’s ability to perform
fine motor activities. Some of these diagnoses include hand trauma,
nerve injury, stroke, spinal cord injury, head injury, and multiple sclerosis
and other degenerative diseases of the central nervous system.
An individual with decreased fine motor skill can become frustrated
when performing some of the most basic daily tasks. Sometimes assistive
devices can help accomplish these tasks—for example, using a
button hook for buttoning, padding the handles of eating utensils to
enable a better grasp, and wearing hand splints to improve hand
functioning.
These devices may be temporary or can be used long-term if the patient’s fine motor skills don’t improve to the point of independent functioning.

The cause for impaired fine motor skills varies depending on the diagnosis;
however, the end result is decreased functional performance.
Therefore, it’s important to understand that the goal for all patients
who have lost fine motor function is to restore their ability through
retraining, adaptive devices, and education to allow them to regain
their maximum function.

Range of Motion Activities
Range of motion refers to the ability of a joint to move in certain directions
to given limits. The two types of range of motion are active and
passive.
Active range of motion is the ability of a joint to move through its available
range on its own, without assistance.
Passive range of motion is the movement of a joint through its available
range when manipulated by another individual, a device, or by the
patient using a device. With passive range of motion,
there’s no active participation.

Range of motion measurements are performed by a therapist for
evaluation purposes. The device used to perform these measurements
is a goniometer.
Range of motion exercises and activities are indicated for patients
who display decreased motion due to their injury or disability. The
goal is to obtain maximum motion to allow the patient to perform
functional tasks that are required for the performance of their work,
leisure, and daily living tasks.
Range of motion activities include any task that moves a joint through
a particular range. Examples include tasks such as
_ Combing hair if an individual has limited motion at the shoulder
_ Bringing a utensil to the mouth if there’s limited elbow motion
_ Squeezing a sponge if there’s restricted finger motion.


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