'Man in a Barrel syndrome' -need help

[git z red]

Hi everyone Im a 3rd year phsio student working with a patient who suffers from this condition. Im looking for some upper limb limb excercises with a gym ball I could use.

thanks in advance

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[irishneurohead]

What is the cause of his MIB syndrome?

What grading does he have on MMT currently?

Stay away from shoulder pullies!!!!! never use them on a neurological patient (or perhaps any patient im undecided!!!)

[gcoe]

Hi Git Zi Red

I think Man-in-a-Barrel syndrome just refers to to a bilateral brachial diplegia and is a vivid description of the inability to elevate the arms. There a multiple aetiologies - most being upper motor neurone syndromes but it can also be due to brachial plexus lesions.

Have you conducted a really thorough assessment to base a rational management plan on? - rather than providing prescriptive exercises. Irishneurohead suggests starting with MMT and that sounds a good idea. You could also have a good look at a task-based level. See if you can make a really rational basis for your treatment: use progressive resistance training (PRT) if at higher grades, Low resistance techniques (polish boards, sling suspension, low grade theraband etc) and possibly FES (if UMN in nature) for lower MMT grades. PRT and FES have good evidence for them. Task based practice may be highly motivating and may be worth including rather than just doing impairment based exercises.

What are you going to use to measure progress?

Hope that is of help