EXERCISES

BENDING THE WRIST TO A TARGET:
Physiotherapist`s aim:
To improve the ability to extend the wrist.
Client`s aim:
To improve your ability to straighten your wrist.
Physiotherapist`s instructions:
Position the patient in sitting with their forearm pronated and resting on a block on a table in front of them.
Place a cup in their hand, a sandbag on their forearm and tape a flexible straw to the dorsal surface of their forearm with the joint of the straw aligned with their wrist joint.
Instruct the patient to extend their wrist to touch the tip of the straw and then relax their wrist back into flexion.
Client`s instructions:
Position yourself sitting with your forearm resting on a block on a table in front of you and your palm facing down.
Place a cup in your hand, a sandbag on your forearm and tape a flexible straw to the top of your forearm so that the bend of the straw is over your wrist.
Practice straightening your wrist so that your hand touches the tip of the straw then relaxing your hand back down again.
Progressions and variations:
Less advanced: 1. Bend the straw down to decrease the range that the wrist needs to move through. 2. Hold a cup with a smaller diameter.
More advanced: 1. Bend the straw up to increase the range that the wrist needs to move through. 2. Hold a cup with a larger diameter. 3. Hold a cup that can deform.


BENDING THE WRIST WHILE HOLDING A CUP:
Physiotherapist`s aim:
To improve the ability to radially deviate the wrist.
Client`s aim:
To improve your ability to bend your wrist.
Physiotherapist`s instructions:
Position the patient in sitting with their hand grasping a cup and hanging over the edge of a table.
Instruct the patient to tilt the cup up by radially deviating their 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.
Progressions and variations:
Less advanced: 1. Move the cup through a smaller range of motion. 2. Use a cup with a smaller diameter.
More advanced: 1. Move the cup through a larger range of motion. 2. Use a cup with a larger diameter. 3. Use a cup that can deform. 4. Add water to the cup.


BICEPS ELECTRICAL STIMULATION:
Physiotherapist`s aim:
To strengthen the elbow flexors.
Client`s aim:
To strengthen your biceps.
Physiotherapist`s instructions:
Place the electrodes over the muscle belly of the elbow flexors.
Client`s instructions:
Place the two electrodes over the muscle belly as shown.
Precautions:
1. Perform skin tests.


BILATERAL ANKLE PLANTORFLEXOR STRETCH USING A WEDGE WHILE STANDING AGAINST A WALL:
Physiotherapist`s aim:
To stretch or maintain length of the ankle plantarflexors.
Client`s aim:
To stretch or maintain range in your ankles.
Physiotherapist`s instructions:
Position the patient in standing with their back against a wall and both feet on a wedge.
Ensure that their knees are kept straight and both feet point forwards.
Client`s instructions:
Position yourself standing with your back against a wall and both feet on a wedge.
Ensure that you keep your knees straight and both feet point forwards.
Progressions and variations:
Less advanced: 1. Decrease the angle of the wedge.
More advanced: 1. Increase the angle of the wedge.
Precautions:
1. Impaired or absent sensation of stretch.


BILATERAL ANKLE PLANTORFLEXOR STRETCH USING A WEDGE WHILE STANDING AT A TABLE:
Physiotherapist`s aim:
To stretch or maintain length of the ankle plantarflexors.
Client`s aim:
To stretch or maintain range in your ankles.
Physiotherapist`s instructions:
Position the patient in standing with both feet on a wedge and a table in front.
Ensure that their knees are kept straight and both feet point forwards.
Client`s instructions:
Position yourself standing with both feet on a wedge and a table in front.
Ensure that you keep your knees straight and both feet point forwards.
Progressions and variations:
Less advanced: 1. Decrease the angle of the wedge.
More advanced: 1. Increase the angle of the wedge.
Precautions:
1. Impaired or absent sensation of stretch.


BILATERAL CALF RAISES:
Physiotherapist`s aim:
To strengthen the ankle plantarflexors.
Client`s aim:
To strengthen your calf muscles.
Physiotherapist`s instructions:
Position the patient in standing.
Instruct the patient to plantarflex their ankles.
Client`s instructions:
Position yourself standing with your feet together.
Start with your heels on the ground.
Finish with your heels off the ground.
Progressions and variations:
Less advanced: 1. Provide hand support for balance.
More advanced: 1. Progress using strength training principles.


BILATERAL CALF RAISES ON A BLOCK:
Physiotherapist`s aim:
To strengthen the ankle plantarflexors.
Client`s aim:
To strengthen your calf muscles.
Physiotherapist`s instructions:
Position the patient in standing on a step with their heels off the edge.
Instruct the patient to plantarflex their ankle.
Client`s instructions:
Position yourself standing on a step with your heels off the edge.
Lift your body weight up onto your toes.
Progressions and variations:
Less advanced: 1. Provide hand support for balance.
More advanced: 1. Wear a backpack with weights in it. 2. Progress using strength training principles.