CVA
An OT observes that a client's affected arm hangs loosely at the side with increased space between the acromion and humeral head during transfers. Which intervention is most appropriate to reduce shoulder sublaxation?
A. Positioning the affected arm in shoulder abduction and external rotation during rest
B. Using a sling continuously to prevent movement of the shoulder joint
C. Supporting the affected arm on a lap tray or arm through during sitting activities
D. Encouraging the client to allow the arm to dangle to promote proprioceptive input.
C. Supporting the affected arm on a lap tray or arm through during sitting activities
A client with hemiparesis reports sharp pain in the affected shoulder when the arm is moved above 90 degrees of flexion during dressing. Which factors are most likely contributing to this symptom?
A. Weakness of the scapular stabilizer causing abnormal scapulohumeral rhythm
B. Excessive use of a resting hand splint throughout the day
C. Increased muscle tone in the wrist and fingers, interfering with grasp.
D. Decreased trunk control, limiting the ability to sit upright during the reaching task
A. Weakness of the scapular stabilizer causing abnormal scapulohumeral rhythm
During upper-body dressing, a post-stroke client winces when the caregiver pulls the affected arm to assist with the sleeve. The OT determines that the pain results from the inferior glenohumeral subluxation and early impingement. What is the best immediate OT action?
A. Train the caregiver to support the humerus and guide the arm within a pain-free range during the dressing task
B. Recommend discontinuing use of the affected arm and completing all dressing with the unaffected arm
C. Applying resistance to the shoulder and deltoid muscles to facilitate the arm into forward flexion
D. Use high-frequency electrical stimulation before dressing to normalize muscle tone and decrease pain
A. Train the caregiver to support the humerus and guide the arm within a pain-free range during the dressing task
An OT notes that a client's affected shoulder is limited to 60 degrees of passive flexion and 30 degrees of abduction due to soft tissue shortening. Which intervention best addresses the prevention of further constriction?
A. Preform quick stretching before each therapy session
B. Apply prolonged LLSP in shoulder abduction and external rotation
C. Encourage strenthening of the deltoid and pectoralis mucles
D. Recommend resting the arm in full internal rotation to avoid overstretching
B. Apply prolonged LLSP in shoulder abduction and external rotation