Hello all ,
i really appreciate all ur feedbacks, regarding how the upper limb looks like i tried to attach a picture but the file is too big.Let me describe u the condition of the upper extremity,Starting from shoulder , no shoulder control,limited passive flexion and extension , almost no external rotation ,produces pain in an attempt to move (so cant move), trying scapular mobilization and pectoral stretch.... Elbow severe flexion contracture (may be spastic also but contracture is a bigger problem)with pronation ,wrist flexed,fingers curled in ..attempts to move the wrist/fingers in passive extension impossible....elbow cannot be extended beyond about(full flexion to 30 extension) ..... .so what i m asking is , if the arm is completely non functional and in such a bad shape what can be done...the patient is not interested for serial casting...

Regarding the lower extremity, there is not limitation in hip/knee flexion and extesion(passive) anlke (limited dorsiflexion) end range... patient is M/52 ,well build.......
Regards