Physiotherapy Hand Exercises

Can any of you guys tell me about physiotherapy exercises for arms?

I'm required to research on these but have no idea about them apart from what I've seen in videos.

Can you list out some of the most commonly prescribed exercises for the arm? I do not require exercises for wrist injuries (more on shoulder and lower arm). We are targeting primarily the elderly for this research and would like to know exercises prescribed for them primarily and the number of repetitions as well as any time range (hold hand in position), if any.

Thanks a bunch

Hi,
your question is very unspecific, therefore difficult to answer. There is a huge range of exercises that can be prescribed and the amount of repititions, concentric versus excentric, isokinetic versus isometric, etc. varies from patient to patient.

Could you please tell us more about your actual research question, e.g. what's the target population in regards to presentation/ problem, are you looking at one-on-one treatment or group sessions, what is the purpose of the exercises (ROM?, strengthening?, functional activation?, etc.), where is the therapy delivered (home?, hospital?, outpatients?, rehab centre?).

Have you checked the general online Physiotherapy journals and Geriatric journals?
Also PEDRO is very good.
PEDro

Regards,
Fyzzio

Hi.

We are researching on home physiotherapy solutions targeted primarily towards the elderly population with issues requiring exercises to the arm.

By arm exercises I mean for example:
--Hold hand straight ahead, palm down --> move the arm anticlockwise to the left 90 degrees --> return to original position --> Repeat 10 times-->etc..etc..
--Hold hand straight down, as if at rest --> keeping elbow fixed, raise the lower arm to a horizontal position, palm down.-->etc.. etc..

As far as physiotherapic exercises go, I'm completely ignorant (You probably guessed as much from my description of exercises). But our focus is on the exercises itself, not the cause. It is currently targeted for a per-patient basis and all kinds of exercises apply as long as it requires the movement of the arm (for now. We would like to extend it to other parts of the body, but we are currently tackling hand exercises).

I'm looking for well established physiotherapic exercises as opposed to research on new exercises, hence PEDro is not much helpful for me, thanks for the link anyway.

Is there a place which documents the different kinds of physiotherapic exercises for me to refer to?

Thanks

I haven't had a reply for quite a while. Anyone?
--Ignore the rest of the message--
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Hi Hercules13

I too find your research question quite perplexing and I wonder if that is why you are not getting many responses. Knowing that you are intending to do is not clear at all. At one moment you are talking about hand exs then the next minute you are talking about arm exercises. At least it is more clear about the patient group

Perhaps I could explain where we are coming from. As physios I think you will find us a bit cautious (even paranoid!) about the use of exercise therapy as it is much abused, often exercises are prescribed indiscriminately often resulting in poor match to the patient - resulting in ineffectiveness and at worst causing patients harm. So when you say you are researching hand exercises and then you start talking about arm exercises and now you are talking about home programmes for the elderly to be honest it sets off warning bells in my head that you may not have a clue what you are doing or undertaking. Here are a few comments I would make:

*The elderly upper limb is likely be getting weak. So effective strengthening programmes are often desirable

*the elderly upper limb may have osteoarthritis and so addressing the impairments such as joint stiffness and weakness may be require

*Some elderly patients could be harmed by inappropriate exercise prescription. For example the patient with rheumatoid arthritis in the hand ( a relatively comon condition in this age group, particularly among women) - certain exercises may be contraindicated where a healthy counterpart there would be no issue and the exercise may be beneficial.

*If you develop a programme that is inappropriate for your consumer have you considered the ethical and legal issues involved? if someone believes they have been harmed by a particular exercise that can and do take legal recourse.

*Exercise Aim - physios don't just issue an exercise. There always has to be a clearly defined goal behind the exercise

*Dosage In the examples you give:

Quote:

---

--Hold hand straight ahead, palm down --> move the arm anticlockwise to the left 90 degrees --> return to original position --> Repeat 10 times-->etc..etc..

---

the repeat 10 time is an example of the dosage. However this is woefuly inadequate if it is being set for a population or an idividual. Dosage should be set individually to a patient's response. For example if it is a strengthening exercise the number of sets and repetitions and the load usually with the overload principle (work the number of repetitions to fatigue) should follow something like the ACSM guidelines on progressive resistance training and should all be described and set for an individual patient.

*Exercises should be evidence-based where possible - that is it should be informed by the research into a particular patient group or patient problem where specific exercise was shown to be effective

So the context of the exercise is really important. exercise prescription follows on from a good assessment of the patient's condition and factors, exercise goals. Can you see why your question leaves us a bit confused and uncomfortable with what you so far have said you are setting out to do? here is an analogy: what do you think the response would be from GPs if you approached them and said you are researching drugs. Please provide a list of drugs you commonly prescribe? I imagine the response would not be very forthcoming to say the least. And while this analogy is more extreme issues such as contraindications and precautions for individual patients and potential for harm in prescription, and disregard for effective and safe dosage are all the same.

What is your aim here - is it setting up a commercial product? or is it some sort of observational research?

On a more positive note you could have a look at some of the exercise software packages that are discussed on this site such as Physiotools. These packages would give you databases of exercises. Another thing you could do is look at some of the larger clinical trials into exercise for community dwelling elderly and see what programmes they used and how they set the programmes. another alternative is you could look at some hand therapy textbooks - although this speciality tends to deal more with acute injuries and post surgical care which is not what you may be looking for.

However I really have to ask do you really know what you are undertaking?