Stroke with dense hemiplegia

[The therapist]

hiiiii dear
here i will give you some guid lines to add it to your rehab. programm

1-Regardin the shoulder apply electric stimulation for posterion fibers of deltoid + the supraspinatus to reduce the chance of sublaxation and pain

2-Encourage the TURNNING ACTIVITIES as early as possible

3-Focus On stretching of Latissmus dorsi mucsle as it tend to get tight affecting trunk stability and gait pattern

Regarding locking of knee joint i have a point of view here ,, the spastisty have positive feature in locking the knee joint and it will appear sooner ar later . ..But u can stimulate the locking action by:

1-try to apply approximation from knelling Position as it stimulat the locking by quadriceps muscle

2-Also try to teach the patient how to stand from sitting to stimulat the knee locking

3-Apply electric stimulation for the VMO (Vustus Medialis Oblicus) muscle on the medial aspect of thigh

finally you can use the knee orthosis for locking the knee during gait training


I HOPE U GET GOOD RESULT
my regards
THE THERAPIST ('',)

[clarett]

You can also get him doing self-assisted shoulder flexion if you teach him how to do it correctly.
Try active- assisted movements rather than passive movements. As he has no activity get him to imagine the muscles contracting as you're doing the movement. If he finds this difficult get him to move his right arm simultaneously so he can use the sensation of the movement in his right to imagine how it would feel in the left.
How is his sensation? If his sensation is good - assist him to handle different objects with his hand to provide stimulation.

Let us know how you're getting on.