R&G Scenario 1

• Loss of wrist extension and radial deviation

  • Main Analysis Findings
  • impairment likely in stabilisation phase - holding onto object
  • lack of wrist extension - weak extensors/lack rom
  • lack of radial deviation - weak radial deviator/lack rom

  
• Loss of wrist extension and radial deviation

  • Further tests/investigations you would like to do
  • could be distal radial fracture - xray
  • wrist extensor strength/rom - oxford scale/goniometer
  • radial deviation strength/rom - oxford scale/goniometer
  • does their impairment depend on texture/surface of the object their holding
• Loss of wrist extension and radial deviation

  • suitable outcome measure
  • wrist extensor strength/rom - oxford scale/goniometer
  • radial deviation strength/rom - oxford scale/goniometer
  • aim to have at least 2 outcome measures - 1 impairment based measure, 1 activity based measure (more important)
  • grip strength - dynamometer and oxford scale - handheld dynamometer may be limiting as it only measure strength of power grip, not precision grip
  • handwriting
• Loss of wrist extension and radial deviation

  • Justification for selection of treatment
  • wrist strengthening exercise - using cue point wrist from 12 oclock to 1 oclock, then mimic handshake in that position, then back to 12 oclock
  • strengthen/increase rom of wrist flexors and radial deviators
• Loss of wrist extension and radial deviation

  • Justification of approaches to facilitated learning
  • imagery
  • cues point wrist from 12 oclock to 1 oclock, then mimic handshake in that position, then back to 12 oclock
  • part practice to whole practice
  • distributed better than massed
  • constant then variable
  • blocked then random
  • depends on stage of learning
  • fade feedback and use bandwidths, self-selected frequency?
  • KP then KF
• Loss of wrist extension and radial deviation

  • Potential progression
  • progress to hold items - start by using something thats light and easy to hold - then progress to heavier objects with different textures/shapes
  • progress onto doing whole movement / every phase