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OT Toolkit

Treatment Guides

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OT Toolkit

Table of Contents
85 Treatment Guides
283 Handouts

ADLs and IADLs
Activities of Daily Living Training
Bathing and Showering
Clothing Care
Community Mobility
Dressing
Driving
Feeding
Functional Communication
Functional Mobility
Grooming and Oral Hygiene
Handwriting
Leisure, Recreation and Social Participation
Light Housework
Managing Finances and Mail
Meal Preparation
Medication and Health Management
Rest and Sleep
Shopping
Toileting
Interventions
Apraxia
Balance
Cognition
Fall Risk Assessment and Prevention
Home Safety and Modification
Therapeutic Exercise
Visual Perception
Conditions and Diseases
Adhesive Capsulitis
Alzheimer’s Disease and Related Disorders – Early Stage
Alzheimer’s Disease and Related Disorders – Mid Stage
Alzheimer’s Disease and Related Disorders – Late Stage
Amputation of the Lower Extremity
Amyotrophic Lateral Sclerosis
Biceps Tendinitis
Breast Cancer
Cancer
Cardiac Disease
Cardiac Surgery
Carpal Tunnel Syndrome - Conservative Management
Carpal Tunnel Syndrome - Surgical Management
Cervical Spine Surgery
Cervical Radiculopathy and Myelopathy
Chronic Kidney Disease
Chronic Pain
Complex Regional Pain Syndrome– Post-Stroke
Cubital Tunnel Syndrome (Ulnar Neuropathy)
Depression
De Quervain's Syndrome - Conservative Management
De Quervain's Syndrome - Surgical Management
Diabetes - Type 2
Dizziness
Epicondylitis
Essential Tremor
Extreme Obesity/Exceptionally Large Persons
Fracture of the Elbow (Olecranon and Radial Head)
Fracture of the Femur
Fracture of the Shoulder (Proximal Humerus and Humeral Shaft)
Fracture of the Wrist (Distal Radius)
Frail Elderly/Oldest Old +85
Guillain-Barré Syndrome
Hip Replacement (Arthoplasty)
Hospice
Joint Contractures
Knee Replacement (Arthoplasty)
Low Vision and Blindness
Lumbar Spine Surgery
Lumbar Radiculopathy
Mild Cognitive Impairment
Multiple Sclerosis
Myocardial Infarction
Osteoarthritis
Osteoporosis
Parkinson's Disease
Peripheral Neuropathy
Post-Poliomyelitis Syndrome
Pressure Ulcers
Pulmonary Disease
Rheumatoid Arthritis
Rotator Cuff Impingement, Tendonitis and Tears
Rotator Cuff Repair
Scleroderma/Systemic Sclerosis
Spinal Cord Injury
Stroke
Total Shoulder Replacement (Arthoplasty)
Urinary Incontinence
Vertebral Compression Fractures
ADL Handouts
Bathing and Showering

Adaptive Equipment for Bathing and Showering **
Bathing and Showering Tips
Placement of Grab Bars – Left Side
Placement of Grab Bars – Right Side
Dressing
Adaptive Equipment for Dressing
Dressing Tips
Putting on Open Front Garment Using a Dressing Stick
Putting on Pants and Underwear Using a Dressing Stick
Putting on Pullover Garment Using a Dressing Stick
Putting on/Removing Lower Body Clothing Method
Putting on/Removing Lower Body Clothing Method
Putting on/Removing Lower Body Clothing in Supine
Putting on/Removing Lower Body Clothing Using a Footstool
Putting on/Removing Open Front Garment Two Shoulder Drape
Putting on/Removing Open Front Garment One Shoulder Drape
Putting on/Removing Pullover Garment Arm-Head-Arm
Putting on/Removing Pullover Garment Head-Arm-Arm
Putting on/Removing Socks/Shoes with Adaptive Equipment
Putting on/Removing Support Stockings
Removing Pants and Underwear Using a Dressing Stick
Removing Pullover Garment Using a Dressing Stick
Using a Buttonhook
Dressing Using One-Handed Method – Left Side Affected
Putting on Open Front Garment
Putting on Pants and Underwear
Putting on Pullover Garment
Putting on/Removing Bra
Putting on Socks and Shoes
Removing Open Front Garment
Removing Pants and Underwear
Removing Pullover Garment
Shoe Tying
Dressing Using One-Handed Method – Right Side Affected
Putting on Open Front Garment
Putting on Pants and Underwear
Putting on Pullover Garment
Putting on/Removing Bra
Putting on Socks and Shoes
Dressing Using One-Handed Method – Right Side Affected
Removing Open Front Garment
Removing Pants and Underwear
Removing Pullover Garment
Shoe Tying
Feeding
Adaptive Equipment for Feeding
Functional Mobility
Adaptive Equipment for Mobility **
Assisted Sit Pivot Transfers Moving to the Left **
Assisted Sit Pivot Transfers Moving to the Right **
Assisted Stand Pivot Transfers Moving to the Left **
Assisted Stand Pivot Transfers Moving to the Right **
Bridging **
Getting Down On the Floor **
Getting In and Out of Bed Following Hip Surgery **
Getting In and Out of Bed – Left Hemiparesis **
Getting In and Out of Bed – Right Hemiparesis **
Getting In Bed towards Your Left Side **
Getting In Bed towards Your Right Side **
Getting In and Out of Bed with Help, Towards the Left Side **
Getting In and Out of Bed with Help, Towards the Right Side **
Getting Out of Bed towards Your Left Side **
Getting Out of Bed towards Your Right Side **
Getting Up From the Floor **
Moving Side-to-Side in Bed **
Rolling onto Your Side in Bed **
Scooting Up in Bed **
Sit Pivot Transfers Moving to the Left **
Sit Pivot Transfers Moving to the Right **
Sitting Down **
Sitting Down Following Hip Surgery **
Standing Up **
Standing Up Following Hip Surgery **
Standing Up with Help **
Transfer Board – Moving to the Left **
Transfer Board – Moving to the Right **
Transfer to Tub Using Bath Seat (back up, left) **
Transfer to Tub Using Bath Seat (back up, right) **
Transfer to Tub Using Bath Seat (left leg, right leg, sit) **
Transfer to Tub Using Bath Seat (right leg, left leg, sit) **
Transfer to Tub Using Bath Seat (left leg, sit, right leg) **
Transfer to Tub Using Bath Seat (right leg, sit, left leg) **
Transfer to Tub Using Bath Transfer Bench (left) **
Transfer to Tub Using Bath Transfer Bench (right) **
Transfers In and Out of a Car **
Wheelchair to Tub Using Bath Transfer Bench (left) **
Wheelchair to Tub Using Bath Transfer Bench (right) **
Wheelchair Mobility **
Grooming and Oral Hygiene
Adaptive Equipment for Grooming and Oral Hygiene
Toileting
Adaptive Equipment for Toileting **
Toileting Tips
Meal Preparation and Clean Up
Adaptive Equipment for One-Handed Meal Preparation
Managing Kitchen Tasks from a Walker
Managing Kitchen Tasks from a Wheelchair
One-Handed Meal Preparation
Medication Routine
Healthcare Providers Appointments
Medication Management Resources
Tips for Making and Keeping Healthcare Appointments

Exercise Handouts
Balance

Balance Exercise Guidelines **
Core Exercise Guidelines **
Core Exercises – Back Muscles **
Core Exercises – Pelvic Muscles **
Core Exercise – Stomach Muscles **
Dynamic Balance Exercises **
Sitting Balance Exercises **
Stability Ball Exercise Guidelines **
Stability Ball Exercises – Back Muscles **
Stability Ball Exercises – Pelvic Muscles **
Stability Ball Exercises – Stomach Muscles **
Static Balance Exercises **
Elbow, Forearm, Wrist
Elbow, Forearm and Wrist Active ROM Exercises **
Elbow, Forearm and Wrist Strengthening Exercises **
Elbow, Forearm and Wrist Stretching Exercises **
Forearm and Wrist Active ROM Exercises **
Forearm and Wrist Strengthening Exercises **
Forearm and Wrist Stretching Exercises **
Cardiopulmonary
Arm Cycle Guidelines **
Pulmonary Exercises **
General
Active Movement of the Elbow, Wrist and Hand **
Active Movement of the Shoulder and Hand **
Active Movement of the Shoulder, Elbow and Hand **
Arm Exercises
Ball Exercises
Exercise Guidelines for Amyotrophic Lateral Sclerosis **
Exercise Guidelines for Arthritis **
Exercise Guidelines for Diabetes **
Exercise Guidelines for Multiple Sclerosis **
Exercise Guidelines for Orthopedic Conditions **
Exercise Guidelines for Post-Poliomyelitis Syndrome **
Exercise Guidelines for Renal Conditions **
Face and Neck Active ROM Exercises
Gross Motor Activities
Osteoporosis Extension Exercises **
Passive ROM Exercises **
Passive ROM Exercises – Left Hemiparesis **
Passive ROM Exercises - Right Hemiparesis **
Resistance Band Arm Exercises **
Upper Body Active ROM Exercises
Upper Body Strengthening Activities
Hand
Fine Motor Activities
Hand Strengthening Putty Exercises **
Hand Stretching and Active ROM **
Median Nerve Gliding Exercises
Tendon Gliding Exercises
Neck
Neck Active ROM Exercises **
Neck Isometric Exercises **
Neck Strengthening Exercises **
Neck Stretches **
Parkinson’s
Parkinson’s Exercises **
Shoulder
Dowel Exercises Lying **
Dowel Exercises Seated **
Mastectomy Exercises **
Pendulum Exercises – Left **
Pendulum Exercises – Right **
Shoulder Active Exercises – Left **
Shoulder Active Exercises – Right **
Shoulder Active ROM Exercises **
Shoulder Isometric Exercises Left – Seated **
Shoulder Isometric Exercises Right – Seated **
Shoulder Isometric Exercises Left – Standing **
Shoulder Isometric Exercises Right – Standing **
Shoulder Passive and Active-Assisted Exercises – Left **
Shoulder Passive and Active-Assisted Exercises – Right **
Shoulder Pulley Exercises - Left **
Shoulder Pulley Exercises - Right **
Shoulder Strengthening – Free Weights - Left **
Shoulder Strengthening – Free Weights - Right **
Shoulder Strengthening – Resistive Band - Left **
Shoulder Strengthening – Resistive Band - Right **
Shoulder Stretching Exercises – Left **
Shoulder Stretching Exercises – Right **
Stroke
Level 1 Activities - Getting Your Affected Arm to Move
Level 2 Activities - Passive Stabilizer
Level 3 Activities - Active Stabilizer
Level 4 Activities - Gross Motor Assist
Level 5 Activities - Fine Motor Assist
Using Your Arm as an Active Stabilizer
Using Your Arm as a Gross Motor Assist
Using Your Arm as a Passive Stabilizer
Using Your Arm with Caregiver Assisted Guiding
Using Your Arm with Self-Guiding
Stroke Left Hemiparesis
Scapular Mobilization and Strengthening Exercises – Left **
Self Range of Motion – Left Hemiparesis
Weight Bearing Exercises – Left Hemiparesis
Stroke Right Hemiparesis
Scapular Mobilization and Strengthening Exercises – Right **
Self Range of Motion – Right Hemiparesis
Weight Bearing Exercises – Right Hemiparesis

Educational Handouts
Amputation of the Lower Extremity

Care of Your Residual Limb **
Donning Your Prosthesis and Socks **
Equipment Care – Prosthesis and Socks **
Phantom Limb Pain **
Positioning Your Residual Limb **
Cardiopulmonary
Activity Guidelines Following Cardiac Surgery **
Activity Guidelines Following Heart Attack **
Cardiac Precautions for Exercise **
Causes of Respiratory Panic and Distress **
Coordinating Your Breathing with Activities
Deep Breathing Exercise
Diaphragmatic Breathing **
Energy Conservation **
Energy Conservation with Meal and Home Management
Energy Conservation with Self Care Activities
Levels of Shortness of Breath
Pursed Lip Breathing **
Respiratory Panic and Distress Control Technique **
Self-Monitoring Your Heart Rate **
Sternal Precautions **
Cognition and Visual Perception
Daily Planning Notebook-Setting Up a Daily Planning Notebook
Daily Planning Notebook-Using Your Daily Planning Notebook
Daily Planning Notebook-Daily Schedule/Things To Do
Daily Planning Notebook-Important Phone Numbers
Daily Planning Notebook-Important Things to Remember
Daily Planning Notebook-Personal Information
Daily Planning Notebook-Shopping List
Functional Cognitive Activities
Suggestions for Improving Attention
Suggestions for Improving Figure Ground Discrimination
Suggestions for Improving Form Constancy
Suggestions for Improving Left Side Awareness
Suggestions for Improving Memory
Suggestions for Improving Motor Planning (Apraxia)
Suggestions for Improving Right Side Awareness
Suggestions for Improving Thinking Skills
Suggestions for Improving Vision
Suggestions for Improving Visual-Motor Integration
Suggestions for Improving Visual Spatial Relations
Low Vision
Communication Tasks
Controlling Glare
Eating Techniques
Functional Reading
Functional Vision
Improving Your Other Senses
Kitchen Management
Labeling and Marking
Lighting Guidelines
Medication Tips
Mobility Tips
Money Management
Recreational Ideas
Safety Tips
Using Contrast
Neurological
Cognitive Strategies to Improve Movement **
Functional Use of Affected Upper Extremity after Stroke
Handwriting Techniques for Parkinson’s
Handwriting Component Exercises
Handwriting Cursive Exercises
Handwriting Pangrams
Positioning in Bed – Left Hemiparesis **
Positioning in Bed – Right Hemiparesis **
Proper Positioning When Sitting – Left Hemiparesis **
Proper Positioning When Sitting – Right Hemiparesis **
Protecting Your Arm – Left Hemiparesis **
Protecting Your Arm – Right Hemiparesis **
Strategies to Reduce Action Tremor
Orthopedic
Arthritic Joint Changes and Deformity
Body Mechanics **
Edema Control of the Arm **
Edema Control of the Leg(s) **
Everyday Activities after Cervical Surgery
Everyday Activities after Lumbar Surgery
Everyday Activities after Shoulder Surgery
Good Posture **
Hip Dislocation Precautions **
Joint Protection
Spinal Surgery Precautions **
Splint/Orthosis Instructions **
Splinting for Arthritis
Superficial Cold **
Superficial Heat **
Surgical Intervention in Arthritis
Other
Generously Sized Products
Good Sleep Habits
Healthy Bladder Habits **
Leisure Activities
Measuring Your Arm Following Mastectomy **
Pain Diary
Positioning in Bed to Minimize Pressure **
Pressure Relief **
Prevention and Control of Lower Extremity Lymphedema **
Prevention and Control of Upper Extremity Lymphedema **
Skin Inspection **
Stress Management and Relaxation Techniques
Safety
Daily Foot Care and Foot Safety **
Don’t Let a Fall Get You Down **
Home Safety and Performance Assessment
Personal Emergency Response Systems **
Post-Fall Questionnaire **
Using Your Walker Safely **
Using Your Wheelchair Safely **


** these handouts are also in the Physical Therapy Toolkit
Table of Contents
85 Treatment Guides
283 Handouts

ADLs and IADLs
Activities of Daily Living Training
Bathing and Showering
Clothing Care
Community Mobility
Dressing
Driving
Feeding
Functional Communication
Functional Mobility
Grooming and Oral Hygiene
Handwriting
Leisure, Recreation and Social Participation
Light Housework
Managing Finances and Mail
Meal Preparation
Medication and Health Management
Rest and Sleep
Shopping
Toileting
Interventions
Apraxia
Balance
Cognition
Fall Risk Assessment and Prevention
Home Safety and Modification
Therapeutic Exercise
Visual Perception
Conditions and Diseases
Adhesive Capsulitis
Alzheimer’s Disease and Related Disorders – Early Stage
Alzheimer’s Disease and Related Disorders – Mid Stage
Alzheimer’s Disease and Related Disorders – Late Stage
Amputation of the Lower Extremity
Amyotrophic Lateral Sclerosis
Biceps Tendinitis
Breast Cancer
Cancer
Cardiac Disease
Cardiac Surgery
Carpal Tunnel Syndrome - Conservative Management
Carpal Tunnel Syndrome - Surgical Management
Cervical Spine Surgery
Cervical Radiculopathy and Myelopathy
Chronic Kidney Disease
Chronic Pain
Complex Regional Pain Syndrome– Post-Stroke
Cubital Tunnel Syndrome (Ulnar Neuropathy)
Depression
De Quervain's Syndrome - Conservative Management
De Quervain's Syndrome - Surgical Management
Diabetes - Type 2
Dizziness
Epicondylitis
Essential Tremor
Extreme Obesity/Exceptionally Large Persons
Fracture of the Elbow (Olecranon and Radial Head)
Fracture of the Femur
Fracture of the Shoulder (Proximal Humerus and Humeral Shaft)
Fracture of the Wrist (Distal Radius)
Frail Elderly/Oldest Old +85
Guillain-Barré Syndrome
Hip Replacement (Arthoplasty)
Hospice
Joint Contractures
Knee Replacement (Arthoplasty)
Low Vision and Blindness
Lumbar Spine Surgery
Lumbar Radiculopathy
Mild Cognitive Impairment
Multiple Sclerosis
Myocardial Infarction
Osteoarthritis
Osteoporosis
Parkinson's Disease
Peripheral Neuropathy
Post-Poliomyelitis Syndrome
Pressure Ulcers
Pulmonary Disease
Rheumatoid Arthritis
Rotator Cuff Impingement, Tendonitis and Tears
Rotator Cuff Repair
Scleroderma/Systemic Sclerosis
Spinal Cord Injury
Stroke
Total Shoulder Replacement (Arthoplasty)
Urinary Incontinence
Vertebral Compression Fractures
ADL Handouts
Bathing and Showering

Adaptive Equipment for Bathing and Showering **
Bathing and Showering Tips
Placement of Grab Bars – Left Side
Placement of Grab Bars – Right Side
Dressing
Adaptive Equipment for Dressing
Dressing Tips
Putting on Open Front Garment Using a Dressing Stick
Putting on Pants and Underwear Using a Dressing Stick
Putting on Pullover Garment Using a Dressing Stick
Putting on/Removing Lower Body Clothing Method
Putting on/Removing Lower Body Clothing Method
Putting on/Removing Lower Body Clothing in Supine
Putting on/Removing Lower Body Clothing Using a Footstool
Putting on/Removing Open Front Garment Two Shoulder Drape
Putting on/Removing Open Front Garment One Shoulder Drape
Putting on/Removing Pullover Garment Arm-Head-Arm
Putting on/Removing Pullover Garment Head-Arm-Arm
Putting on/Removing Socks/Shoes with Adaptive Equipment
Putting on/Removing Support Stockings
Removing Pants and Underwear Using a Dressing Stick
Removing Pullover Garment Using a Dressing Stick
Using a Buttonhook
Dressing Using One-Handed Method – Left Side Affected
Putting on Open Front Garment
Putting on Pants and Underwear
Putting on Pullover Garment
Putting on/Removing Bra
Putting on Socks and Shoes
Removing Open Front Garment
Removing Pants and Underwear
Removing Pullover Garment
Shoe Tying
Dressing Using One-Handed Method – Right Side Affected
Putting on Open Front Garment
Putting on Pants and Underwear
Putting on Pullover Garment
Putting on/Removing Bra
Putting on Socks and Shoes
Dressing Using One-Handed Method – Right Side Affected
Removing Open Front Garment
Removing Pants and Underwear
Removing Pullover Garment
Shoe Tying
Feeding
Adaptive Equipment for Feeding
Functional Mobility
Adaptive Equipment for Mobility **
Assisted Sit Pivot Transfers Moving to the Left **
Assisted Sit Pivot Transfers Moving to the Right **
Assisted Stand Pivot Transfers Moving to the Left **
Assisted Stand Pivot Transfers Moving to the Right **
Bridging **
Getting Down On the Floor **
Getting In and Out of Bed Following Hip Surgery **
Getting In and Out of Bed – Left Hemiparesis **
Getting In and Out of Bed – Right Hemiparesis **
Getting In Bed towards Your Left Side **
Getting In Bed towards Your Right Side **
Getting In and Out of Bed with Help, Towards the Left Side **
Getting In and Out of Bed with Help, Towards the Right Side **
Getting Out of Bed towards Your Left Side **
Getting Out of Bed towards Your Right Side **
Getting Up From the Floor **
Moving Side-to-Side in Bed **
Rolling onto Your Side in Bed **
Scooting Up in Bed **
Sit Pivot Transfers Moving to the Left **
Sit Pivot Transfers Moving to the Right **
Sitting Down **
Sitting Down Following Hip Surgery **
Standing Up **
Standing Up Following Hip Surgery **
Standing Up with Help **
Transfer Board – Moving to the Left **
Transfer Board – Moving to the Right **
Transfer to Tub Using Bath Seat (back up, left) **
Transfer to Tub Using Bath Seat (back up, right) **
Transfer to Tub Using Bath Seat (left leg, right leg, sit) **
Transfer to Tub Using Bath Seat (right leg, left leg, sit) **
Transfer to Tub Using Bath Seat (left leg, sit, right leg) **
Transfer to Tub Using Bath Seat (right leg, sit, left leg) **
Transfer to Tub Using Bath Transfer Bench (left) **
Transfer to Tub Using Bath Transfer Bench (right) **
Transfers In and Out of a Car **
Wheelchair to Tub Using Bath Transfer Bench (left) **
Wheelchair to Tub Using Bath Transfer Bench (right) **
Wheelchair Mobility **
Grooming and Oral Hygiene
Adaptive Equipment for Grooming and Oral Hygiene
Toileting
Adaptive Equipment for Toileting **
Toileting Tips
Meal Preparation and Clean Up
Adaptive Equipment for One-Handed Meal Preparation
Managing Kitchen Tasks from a Walker
Managing Kitchen Tasks from a Wheelchair
One-Handed Meal Preparation
Medication Routine
Healthcare Providers Appointments
Medication Management Resources
Tips for Making and Keeping Healthcare Appointments

Exercise Handouts
Balance

Balance Exercise Guidelines **
Core Exercise Guidelines **
Core Exercises – Back Muscles **
Core Exercises – Pelvic Muscles **
Core Exercise – Stomach Muscles **
Dynamic Balance Exercises **
Sitting Balance Exercises **
Stability Ball Exercise Guidelines **
Stability Ball Exercises – Back Muscles **
Stability Ball Exercises – Pelvic Muscles **
Stability Ball Exercises – Stomach Muscles **
Static Balance Exercises **
Elbow, Forearm, Wrist
Elbow, Forearm and Wrist Active ROM Exercises **
Elbow, Forearm and Wrist Strengthening Exercises **
Elbow, Forearm and Wrist Stretching Exercises **
Forearm and Wrist Active ROM Exercises **
Forearm and Wrist Strengthening Exercises **
Forearm and Wrist Stretching Exercises **
Cardiopulmonary
Arm Cycle Guidelines **
Pulmonary Exercises **
General
Active Movement of the Elbow, Wrist and Hand **
Active Movement of the Shoulder and Hand **
Active Movement of the Shoulder, Elbow and Hand **
Arm Exercises
Ball Exercises
Exercise Guidelines for Amyotrophic Lateral Sclerosis **
Exercise Guidelines for Arthritis **
Exercise Guidelines for Diabetes **
Exercise Guidelines for Multiple Sclerosis **
Exercise Guidelines for Orthopedic Conditions **
Exercise Guidelines for Post-Poliomyelitis Syndrome **
Exercise Guidelines for Renal Conditions **
Face and Neck Active ROM Exercises
Gross Motor Activities
Osteoporosis Extension Exercises **
Passive ROM Exercises **
Passive ROM Exercises – Left Hemiparesis **
Passive ROM Exercises - Right Hemiparesis **
Resistance Band Arm Exercises **
Upper Body Active ROM Exercises
Upper Body Strengthening Activities
Hand
Fine Motor Activities
Hand Strengthening Putty Exercises **
Hand Stretching and Active ROM **
Median Nerve Gliding Exercises
Tendon Gliding Exercises
Neck
Neck Active ROM Exercises **
Neck Isometric Exercises **
Neck Strengthening Exercises **
Neck Stretches **
Parkinson’s
Parkinson’s Exercises **
Shoulder
Dowel Exercises Lying **
Dowel Exercises Seated **
Mastectomy Exercises **
Pendulum Exercises – Left **
Pendulum Exercises – Right **
Shoulder Active Exercises – Left **
Shoulder Active Exercises – Right **
Shoulder Active ROM Exercises **
Shoulder Isometric Exercises Left – Seated **
Shoulder Isometric Exercises Right – Seated **
Shoulder Isometric Exercises Left – Standing **
Shoulder Isometric Exercises Right – Standing **
Shoulder Passive and Active-Assisted Exercises – Left **
Shoulder Passive and Active-Assisted Exercises – Right **
Shoulder Pulley Exercises - Left **
Shoulder Pulley Exercises - Right **
Shoulder Strengthening – Free Weights - Left **
Shoulder Strengthening – Free Weights - Right **
Shoulder Strengthening – Resistive Band - Left **
Shoulder Strengthening – Resistive Band - Right **
Shoulder Stretching Exercises – Left **
Shoulder Stretching Exercises – Right **
Stroke
Level 1 Activities - Getting Your Affected Arm to Move
Level 2 Activities - Passive Stabilizer
Level 3 Activities - Active Stabilizer
Level 4 Activities - Gross Motor Assist
Level 5 Activities - Fine Motor Assist
Using Your Arm as an Active Stabilizer
Using Your Arm as a Gross Motor Assist
Using Your Arm as a Passive Stabilizer
Using Your Arm with Caregiver Assisted Guiding
Using Your Arm with Self-Guiding
Stroke Left Hemiparesis
Scapular Mobilization and Strengthening Exercises – Left **
Self Range of Motion – Left Hemiparesis
Weight Bearing Exercises – Left Hemiparesis
Stroke Right Hemiparesis
Scapular Mobilization and Strengthening Exercises – Right **
Self Range of Motion – Right Hemiparesis
Weight Bearing Exercises – Right Hemiparesis

Educational Handouts
Amputation of the Lower Extremity

Care of Your Residual Limb **
Donning Your Prosthesis and Socks **
Equipment Care – Prosthesis and Socks **
Phantom Limb Pain **
Positioning Your Residual Limb **
Cardiopulmonary
Activity Guidelines Following Cardiac Surgery **
Activity Guidelines Following Heart Attack **
Cardiac Precautions for Exercise **
Causes of Respiratory Panic and Distress **
Coordinating Your Breathing with Activities
Deep Breathing Exercise
Diaphragmatic Breathing **
Energy Conservation **
Energy Conservation with Meal and Home Management
Energy Conservation with Self Care Activities
Levels of Shortness of Breath
Pursed Lip Breathing **
Respiratory Panic and Distress Control Technique **
Self-Monitoring Your Heart Rate **
Sternal Precautions **
Cognition and Visual Perception
Daily Planning Notebook-Setting Up a Daily Planning Notebook
Daily Planning Notebook-Using Your Daily Planning Notebook
Daily Planning Notebook-Daily Schedule/Things To Do
Daily Planning Notebook-Important Phone Numbers
Daily Planning Notebook-Important Things to Remember
Daily Planning Notebook-Personal Information
Daily Planning Notebook-Shopping List
Functional Cognitive Activities
Suggestions for Improving Attention
Suggestions for Improving Figure Ground Discrimination
Suggestions for Improving Form Constancy
Suggestions for Improving Left Side Awareness
Suggestions for Improving Memory
Suggestions for Improving Motor Planning (Apraxia)
Suggestions for Improving Right Side Awareness
Suggestions for Improving Thinking Skills
Suggestions for Improving Vision
Suggestions for Improving Visual-Motor Integration
Suggestions for Improving Visual Spatial Relations
Low Vision
Communication Tasks
Controlling Glare
Eating Techniques
Functional Reading
Functional Vision
Improving Your Other Senses
Kitchen Management
Labeling and Marking
Lighting Guidelines
Medication Tips
Mobility Tips
Money Management
Recreational Ideas
Safety Tips
Using Contrast
Neurological
Cognitive Strategies to Improve Movement **
Functional Use of Affected Upper Extremity after Stroke
Handwriting Techniques for Parkinson’s
Handwriting Component Exercises
Handwriting Cursive Exercises
Handwriting Pangrams
Positioning in Bed – Left Hemiparesis **
Positioning in Bed – Right Hemiparesis **
Proper Positioning When Sitting – Left Hemiparesis **
Proper Positioning When Sitting – Right Hemiparesis **
Protecting Your Arm – Left Hemiparesis **
Protecting Your Arm – Right Hemiparesis **
Strategies to Reduce Action Tremor
Orthopedic
Arthritic Joint Changes and Deformity
Body Mechanics **
Edema Control of the Arm **
Edema Control of the Leg(s) **
Everyday Activities after Cervical Surgery
Everyday Activities after Lumbar Surgery
Everyday Activities after Shoulder Surgery
Good Posture **
Hip Dislocation Precautions **
Joint Protection
Spinal Surgery Precautions **
Splint/Orthosis Instructions **
Splinting for Arthritis
Superficial Cold **
Superficial Heat **
Surgical Intervention in Arthritis
Other
Generously Sized Products
Good Sleep Habits
Healthy Bladder Habits **
Leisure Activities
Measuring Your Arm Following Mastectomy **
Pain Diary
Positioning in Bed to Minimize Pressure **
Pressure Relief **
Prevention and Control of Lower Extremity Lymphedema **
Prevention and Control of Upper Extremity Lymphedema **
Skin Inspection **
Stress Management and Relaxation Techniques
Safety
Daily Foot Care and Foot Safety **
Don’t Let a Fall Get You Down **
Home Safety and Performance Assessment
Personal Emergency Response Systems **
Post-Fall Questionnaire **
Using Your Walker Safely **
Using Your Wheelchair Safely **


** these handouts are also in the Physical Therapy Toolkit
Dressing

Dressing includes selecting appropriate clothing for the time of day, weather and occasion; obtaining clothing from closets and drawers; dressing and undressing of openfront garments; pullover garments, bra, pants, underwear, socks, panty hose, nylons, shoes, slippers, support and anti-embolism stockings; opening and closing fasteners; personal devices (hearing aids, eyeglasses, AFO, hand splint, back brace, slings, prosthetics).

Impairments and Functional Limitations:
Impaired shoulder strength and/or ROM
Impaired hand strength, ROM, sensation and/or coordination
Impaired LE function
Limited activity tolerance and endurance
Impaired sitting balance
Impaired standing balance
Visual perceptual impairment
Cognitive impairment

Occupational Therapy Intervention:
Apply different approaches for solving difficulties with dressing. Including but not limited to…

  • Treat underlying limitations to safety and independence
    Physical (strength, hand function, ROM, coordination, balance, endurance, abnormal tone), sensory (tactile, vision, hearing, vestibular, pain), behavioral, cognition and/or perception.
  • Train in compensatory strategies.
    Safety techniques; one-handed techniques; energy conservation; low vision techniques; cognitive/perceptual compensation; task segmentation; joint protection; step-by-step instructions; hand-over-hand guiding
  • Train in the use of adaptive equipment and assistive devices such as.
    Buttonhook; Velcro closures on shoes; elastic shoelaces; long handled shoehorn; dressing stick; reacher; sock aid; zipper pull; walker tray or basket; labeling system for identifying clothes.
  • Provide environmental modifications and adaptations such as.
    Avoid storing items on the floor; lower closet poles; organize clothes within easy reach; label drawers of contents using picture or words
  • Instruct in activity modification
    • Change the task - Place the weaker extremity into the garment first. Dress in a supine position
    • Eliminate part or all of the task – Choose garments that are easy to put on and remove such as: elastic waist pants, loose fitting tops, pullover tops, suspenders instead of a belt, Velcro or slip on shoes, front hook bra, sports bra, camisole.
    • Have someone else do part or all of the task

Train in safe and efficient functional mobility (sit to stand; bed mobility skills; transfers; ambulation and wheelchair mobility) as it relates to dressing.

Provide caregiver/family education and training.

Patient and Caregiver Handouts:

  1. Adaptive Equipment for Dressing
  2. Dressing Tips
  3. Energy Conservation with Self Care Activities
  4. Putting on Open Front Garment Using a Dressing Stick
  5. Putting on Pants and Underwear Using a Dressing Stick
  6. Putting on Pullover Garment Using a Dressing Stick
  7. Putting on/Removing Lower Body Clothing Method 1
  8. Putting on/Removing Lower Body Clothing Method 2
  9. Putting on/Removing Lower Body Clothing in Supine
  10. Putting on/Removing Lower Body Clothing Using a Footstool
  11. Putting on/Removing Open Front Garment Two Shoulder Drape
  12. Putting on/Removing Open Front Garment One Shoulder Drape
  13. Putting on/Removing Pullover Garment Arm-Head-Arm
  14. Putting on/Removing Pullover Garment Head-Arm-Arm
  15. Putting on/Removing Socks/Shoes with Adaptive Equipment
  16. Putting on/Removing Support Stockings
  17. Removing Pants and Underwear Using a Dressing Stick
  18. Removing Pullover Garment Using a Dressing Stick
  19. Using a Buttonhook

Dressing Using One-Handed Method – Left Side Affected

  1. Putting on Open Front Garment
  2. Putting on Pants and Underwear
  3. Putting on Pullover Garment
  4. Putting on/Removing Bra
  5. Putting on Socks and Shoes
  6. Removing Open Front Garment
  7. Removing Pants and Underwear
  8. Removing Pullover Garment
  9. Shoe Tying

Dressing Using One-Handed Method – Right Side Affected

  1. Putting on Open Front Garment
  2. Putting on Pants and Underwear
  3. Putting on Pullover Garment
  4. Putting on/Removing Bra
  5. Putting on Socks and Shoes
  6. Removing Open Front Garment
  7. Removing Pants and Underwear
  8. Removing Pullover Garment
  9. Shoe Tying

Resources:

  1. American Health Care Apparel - Adaptive Clothing - www.clothesforseniors.com
  2. Silvert’s Adaptive Clothing and Footwear - www.silverts.com
  3. Spec L Clothing Solutions - Adaptive Clothing - www.clothingsolutions.com
Breast Cancer

Impairments and Functional Limitations:
ADL, IADL, work and leisure impairment
Limited activity tolerance and endurance
Limited ROM of shoulder
Depression
Impaired body image
Other symptoms and conditions – pathologic fractures, lymphedema, chemotherapy induced peripheral neuropathy, adhesive capsulitis, weight loss, fatigue

Occupational Therapy Intervention:

ADL, IADL, work and leisure training including but not limited to…

  • Recommend and/or provide adaptive equipment.
  • Encourage use of affected extremity during tasks.

Education on strategies to manage fatigue and conserve energy.

  • Assess using the Modified Fatigue Impact Scale (Fisk 1994).
  • Instruct in pacing and energy conservation strategies.
  • Encourage performance of activities during medication peak times.
  • Instruct in activity balancing for self-care, work, play and rest.
  • Instruct in good sleep hygiene.
  • Encourage keeping a diary to record tasks that increase fatigue and times of the day when fatigue is more of a problem.

Provide graded UE therapeutic activities and exercises to improve ROM and strength. Follow the referring surgeon’s specific guidelines for ROM and lifting restrictions, and for progression of exercises. Instruct in home program with verbal and written instructions

Instruct in diaphragmatic breathing and proper posture during exercise and activities.

Prevent and control of lymphedema.

  • Education on lymphedema prevention or risk factor reduction
  • Obtain baseline measurements of both arms: mid-hand, wrist, 10 cm below the lateral epicondyle, elbow, 10 cm above the lateral epicondyle, and the upper arm just below the axilla.
  • Measure arm periodically.
  • Classifications using the American system: Mild 1.5-3.0 cm; Moderate 3.1-5.0 cm; Severe > 5.0 cm

Manage lymphedema using complete decongestive therapy/decongestive lymphatic therapy (only performed by a qualified therapist).

  • Manual lymph drainage/massage
  • Compression pump therapy
  • Compression bandaging and compression garments
  • Lymphedema exercises while wearing compression garments
  • Scar tissue management including cross friction massage, scar pads, kinesiotape
  • Home program for exercises, self massage, compression wrapping

Teach stress management and relaxation techniques such as progressive muscle relaxation, controlled breathing, self-hypnosis, guided imagery, autogenic training, tai chi, yoga and meditation.

Assist in developing effective communication skills, positive coping strategies (seek out information and support, find strength through spiritual practices, verbalize feelings and concerns, set realistic goals and express positive thoughts); and making informed decisions about medical and alternative treatments.

Educate patient and caregivers about breast cancer, the availability of community resources and encourage participation in support groups.

Patient and Caregiver Handouts:

  1. Deep Breathing Exercise
  2. Energy Conservation
  3. Mastectomy Exercises
  4. Measuring Your Arm Following Mastectomy
  5. Prevention and Control of Upper Extremity Lymphedema
  6. Good Posture
  7. Shoulder Isometric Exercises
  8. Stress Management and Relaxation Techniques
Frail Elderly / Oldest Old 85+

Impairments and Functional Limitations:
ADL, IADL, work and leisure impairment
Functional mobility impairment
Muscle weakness
Limited activity tolerance and endurance
Impaired balance
At risk for – functional decline, falls, dementia, delirium, depression, incontinence, sleep disorders, malnutrition, dehydration, pressure sores, sarcopenia and hypothermia

Occupational Therapy Intervention: ADL, IADL, work and leisure training including but not limited to…

  • Treat underlying limitations to safety and independence - physical (strength, hand function, ROM, coordination, balance, endurance, abnormal tone), sensory (tactile, vision, hearing, vestibular, pain), behavioral, cognition and/or perception.
  • Address ability to shop, access kitchen, prepare nutritious meals and get adequate hydration.
  • Encourage to eat with others.
  • Address ability to drive safely. Provide referral to driving rehab specialist and/or explore alternative transportation options.

Train in safe and efficient functional mobility (sit to stand; bed mobility skills; transfers; ambulation and wheelchair mobility) during ADL and IADL tasks.

Provide functional balance activities to increase balance confidence with ADL tasks.

Provide UE therapeutic activities and exercises to improve strength and endurance.

  • Instruct in home program with verbal and written instructions

Provide a fall prevention program that includes balance, coordination and agility training and education about fall risk and prevention strategies.

Complete a comprehensive, performance-based home assessment. Recommend and/or provide home and activity modifications.

Educate regarding hypothermia prevention.

  • Eat well and dress warmly.
  • Dry off if you get wet.
  • Wear a hat and scarves and gloves when it is cold.
  • Avoid alcohol before going out in the cold.

Patient and Caregiver Handouts:

  1. Arm Exercises
  2. Balance Exercise Guidelines
  3. Dynamic Balance Exercises
  4. Hand Strengthening Putty Exercises
  5. Resistance Band Arm Exercises
  6. Static Balance Exercises

Resources:

  1. Geriatric Care Manager Association - www.caremanager.org
  2. National Institute on Aging - www.nia.nih.gov
  3. Remote monitoring systems; E-Neighbor, Grand Care
Osteoarthritis

Impairments and Functional Limitations:
ADL, IADL, work and leisure impairment
Functional mobility impairment
Limited ROM (typically seen in shoulder abduction and external rotation, elbow extension, forearm pronation and supination wrist flexion and extension, radial ulna deviation, and thumb and finger flexion and extension).
Impaired grip and pinch strength
Hand deformities due to osteophyte formation in the DIP (Heberden nodes) and at the PIP (Bouchard nodes).
Impaired strength
Limited activity tolerance and endurance
Joint pain, stiffness and inflammation that increase with activity
Impaired fine motor control
Impaired hand function
Fall risk

Assessments: Manual Ability Measure (MAM) (Chen 2010)

Occupational Therapy Intervention: ADL, IADL, work and leisure training including but not limited to…

  • Train in the use of adaptive equipment to improve grasp (built-ups), improve ease of performance (electric can opener), compensate for range of motion loss (dress stick), compensate for weak/absent muscle (universal cuff, jar opener), prevent stress on joints (lever door handle), prevent prolonged grasp (book holder, Dycem), prevent accidents (bath seat, nonskid rugs).
  • Instruct in energy conservation strategies and joint protection.
  • Instruct in activity balancing (balancing self-care, work, play and rest)

Train in safe and efficient functional mobility (sit to stand; bed mobility skills; transfers; ambulation and wheelchair mobility) during ADL and IADL tasks.

Provide UE, neck and trunk therapeutic activities and exercises to improve ROM and strength.

  • Acute flare-ups – instruct in performing gentle range of motion exercises 3-4 times daily followed by icing for 15 minutes.
  • For non-acute joints – instruct in the use of superficial heat, gentle selfstretching techniques and strengthening in pain free range.
  • Instruct in home program with verbal and written instructions

Provide splints to rest inflamed joints, maintain proper joint alignment, improve functional control and support weak or painful joints.

  • Resting hand splint, wrist cock-up, finger splints, ulnar deviation splint, tri-point proximal interphalangeal joint splint, and thumb spica splint.

Instruct in pain management techniques to improve participation in ADL tasks.

  • Teach stress management and relaxation techniques.
  • Coordinate medication peak with exercise and activity.
  • Educate in use of superficial heat and cold.
  • Teach self-massage techniques.
  • Provide positioning support devices (back supports, pillows, and splints).

Complete a comprehensive, performance-based home assessment. Recommend and/or provide home and activity modifications.

Provide education about fall risk and prevention strategies.

Patient and Caregiver Handouts:

  1. Deep Breathing Exercise
  2. Energy Conservation
  3. Exercise Guidelines for Arthritis
  4. Joint Protection
  5. Splint/Orthosis InstructionsvSuperficial Cold
  6. Superficial Heat
  7. Upper Body Active ROM Exercises

Resources:

  1. Arthritis Foundation - www.arthritis.org
  2. Arthritis Helpbook - www.afstore.org
  3. Arthritis Today magazine - www.arthritistoday.org
Stroke

Impairments and Functional Limitations:
ADL, IADL, work and leisure impairment
Impaired sit-to-stand, transfers, bed mobility and gait
Hemiparesis, hemiplegia
Impaired postural control
Impaired coordination
Limited activity tolerance and endurancev Fall risk
Sensory deficit
Central post-stroke pain
Language disorders (aphasia, dysarthria, dyspraxia)
Dysphasia
Visual and perceptual impairment
Cognitive impairment
Behavioral disorders (depression, lability, low frustration tolerance, impulsivity)
Bladder and bowel dysfunction
Secondary complications - bio-mechanical shoulder pain (biceps tendonitis, rotator cuff impingement, adhesive capsulitis, tendonitis, shoulder-hand syndrome or subluxation); edema (upper and lower extremity); pressure sores; joint contractures; depression; DVT’s; aspiration pneumonia.

Assessments:
Arnadottir OT-ADL Neurobehavioral Evaluation (A-ONE) (Arnadottir 1990)
Assessment of Motor and Process Skills (AMPS) (Fisher et al 1993)
Chedoke-McMaster Stroke Assessment Scale (Gowland 1993)
Modified Ashworth Scale (Bohannon & Smith 1987)
Stroke Impact Scale (Duncan 1999)

Occupational Therapy Intervention:
ADL, IADL, work and leisure training including but not limited to…

  • Use of compensatory techniques (task modification; one-handed techniques; hand-over-hand guiding; task segmentation; end chaining).
  • Recommend and/or provide adaptive equipment (rocker knife, inner lip plates, holders for books or playing cards, stabilizing devices for activities that traditionally require two-handed performance (e.g., cutting vegetables, cleaning dentures), and keyboards adapted for one-handed computer use.
  • Safely incorporate affected extremity with all activities.
  • Instruct in pacing and energy conservation strategies.

Train in safe and efficient functional mobility (sit to stand; bed mobility skills; transfers; ambulation and wheelchair mobility) during ADL and IADL tasks.

Improve postural control

  • Focus on stability, weight shifting, body awareness, trunk rotation & elongation.
  • Have patient turn toward affected side when reaching.
  • Set up room so the patient must physically move to their affected side.
  • Provide reach-grasp-hold-carry-place activities; in standing and sitting; with and without support.

Provide functional balance activities to increase balance confidence with ADL tasks.

  • Graded activities in sitting and standing, supported and unsupported.

Improve upper extremity function

  • Use a variety of approaches according to the needs of the patient
  • Provide early mobilization and positioning.
  • Incorporate task-oriented training.
  • Provide opportunities to use and move the arm all day (use of ball bearing feeder, mobile arm support, overhead suspension sling).
  • Provide constraint-induced movement therapy (CIMT) for patients who demonstrate at least 20 degrees of wrist extension and 10 degrees of finger extension, and have minimal sensory or cognitive deficits.
  • Provide an arm and hand strengthening exercise program (spasticity is not a contraindication)
  • Provide weight bearing exercises and activities.
  • Functional electrical stimulation
  • Electromechanical/robotic devices.
  • Mirror therapy

Provide activities and exercises to uninvolved side to prevent loss of ROM and strength.

Manage spasticity

  • Prevent contractures (specifically shoulder external rotation, ankle dorsiflexion and hip internal rotation)
  • Provide PROM, SROM and stretching exercises.
  • Proper positioning in bed, chair and during mobility.
  • Provide splinting to protect hand/wrist. Resting hand splint for flaccid to mild tone. Spasticity splint for moderate to high tone.

Prevent or manage hand edema

  • Active self-range of motion exercises in elevation
  • Positioning to elevate hand
  • Retrograde massage

Prevent or manage hand edema

  • Gentle grade 1-2 mobilizations for the hand and fingers
  • Compression garment

Prevent or manage shoulder pain

  • Avoid overaggressive therapy, avoid overhead pulleys
  • Mobilize and strengthen the scapula.
  • Position arm with cubital fossa facing up, 45º abduction and comfortable external rotation.
  • Provide firm support devices such as lap trays and arm troughs
  • Range of motion exercises should not move the shoulder beyond 90 degrees of flexion and abduction unless there is upward rotation of the scapula and external rotation of the humeral head.
  • Manage orthopedic conditions (biceps tendonitis, impingement syndrome, adhesive capsulitis, rotator cuff tendonitis, shoulder-hand syndrome).
  • Functional Electrical Stimulation

Instruct patient and caregivers in proper care of the affected extremity.

  • Prevention and control of edema.
  • Passive ROM exercises.
  • Self-ROM exercises.
  • Protection and support of the affected arm during bed mobility, transfers and ambulation using slings, pocket, or by therapist and during wheelchair use by using hemi tray or arm troughs.
  • Proper positioning in bed and chair.
  • Care and use of positioning splints.

Teach compensatory strategies for perceptual deficits.

Provide cognitive retraining and training in the use of compensatory strategies.

Provide education about fall risk and prevention strategies.

Community Integration

  • Address ability to drive safely. Provide referral to driving rehab specialist and/or explore alternative transportation options.
  • Vocational rehabilitation strategies to assist the return to work if appropriate
  • Leisure and social participation intervention
  • Complete a comprehensive, performance-based home assessment. Recommend and/or provide home and activity modifications.

Educate patient and caregivers about stroke, availability of community resources and encourage participation in support groups.

Assist in developing self-management skills (effective communication, positive coping strategies, stress reduction, physical activity and exercise, medication management, healthy eating, good sleep habits and making informed decisions about medical and alternative treatments, prevention of secondary complications).

Patient and Caregiver Education Handouts: English Spanish

  1. Edema Control Techniques
  2. Energy Conservation
  3. Functional Use of Affected Upper Extremity after Stroke
  4. Getting In and Out of Bed – Left Hemiparesis
  5. Getting In and Out of Bed – Right Hemiparesis
  6. Positioning in Bed - Left Hemiparesis
  7. Positioning in Bed - Right Hemiparesis
  8. Proper Positioning When Sitting – Left Hemiparesis
  9. Proper Positioning When Sitting – Right Hemiparesis
  10. Protecting Your Arm – Left Hemiparesis
  11. Protecting Your Arm – Right Hemiparesis
  12. Splint/Orthosis Instructions
  13. Stress Management and Relaxation Techniques
  14. Using Your Walker Safely
  15. Using Your Wheelchair Safely

Patient and Caregiver Exercise Handouts:

  1. Arm Exercises
  2. Ball Exercises
  3. Dynamic Balance Exercise
  4. Fine Motor Activities
  5. Gross Motor Activities
  6. Hand Strengthening Putty Exercises
  7. Level 1 Activities - Getting Your Affected Arm to Move
  8. Level 2 Activities - Passive Stabilizer
  9. Level 3 Activities - Active Stabilizer
  10. Level 4 Activities - Gross Motor Assist
  11. Level 5 Activities - Fine Motor Assist
  12. Passive ROM Exercises – Left Hemiparesis
  13. Passive ROM Exercises - Right Hemiparesis
  14. Resistance Band Arm Exercises
  15. Scapular Mobilization and Strengthening Exercises - Left
  16. Scapular Mobilization and Strengthening Exercises - Right
  17. Self Range of Motion - Left Hemiparesis
  18. Self Range of Motion - Right Hemiparesis
  19. Sitting Balance Exercises
  20. Static Balance Exercise
  21. Upper Body Active ROM Exercises
  22. Upper Body Strengthening Activities
  23. Using Your Left Arm as an Active Stabilizer
  24. Using Your Left Arm as a Gross Motor Assist
  25. Using Your Left Arm as a Passive Stabilizer
  26. Using Your Left Arm with Caregiver Assisted Guiding
  27. Using Your Left Arm with Self-Guiding
  28. Using Your Right Arm as an Active Stabilizer
  29. Using Your Right Arm as a Gross Motor Assist
  30. Using Your Right Arm as a Passive Stabilizer
  31. Using Your Right Arm with Caregiver Assisted Guiding
  32. Using Your Right Arm with Self-Guiding
  33. Weight Bearing Exercises - Left Hemiparesis
  34. Weight Bearing Exercises - Right Hemiparesis

Additional Treatment Guides:

  1. Activities of Daily Living Training
  2. Apraxia
  3. Balance
  4. Cognition
  5. Complex Regional Pain Syndrome – Post-Stroke
  6. Fall Risk Assessment and Prevention
  7. Functional Mobility
  8. Handwriting
  9. Home Safety and Modification
  10. Joint Contractures
  11. Pressure Ulcers
  12. Therapeutic Exercise
  13. Urinary Incontinence
  14. Visual Perception
    Transfer to Tub Using Bath Seat (left leg, right leg, sit)

    Step 1
    Face the wall and hold onto the grab bar.

    Step 2
    Step into the tub with your left leg.

    Step 3
    Lift your right leg into the tub.

    Step 4
    Sit down on the shower chair.
    Reverse the steps to transfer out.

    Putting on Pullover Garment
    Using One-Handed Method - Left Side Affected

    Step 1
    Position your shirt face down on your lap with the collar at your knees.

    Step 2
    Gather the opening of the left shirtsleeve and place on your lap.

    Step 3
    Lean forward and place your left arm into the sleeve opening.

    Step 4
    Pull the sleeve up your arm and over your elbow.

    Step 5
    Place your right arm into the right sleeve opening.

    Step 6
    Grasp the fabric and pull the shirt over your head.

    Step 7
    Push the shirt fabric over your left shoulder.

    Step 8
    Adjust the shirt, pulling it down in the front and the back.

    Energy Conservation with Self Care Activities

    Remember to use your pursed lip breathing.
    Pace yourself and rest frequently.

    Eating

    1. Eat slowly and completely chew your food.
    2. Eat six small meals a day instead of three big meals. This will cut down on the energy you need to chew and digest your food.
    3. Avoid gas-forming foods that bloat your abdomen and make it more difficult to breathe, such as peas, melons, turnips, onions, cauliflower, apples, corn, broccoli, cucumbers, cabbage, beans, and Brussels sprouts.
    4. Grooming

      1. Sit to shave, comb your hair and brush your teeth.
      2. Support your elbows on the counter while grooming or shaving.
      3. Use an electric toothbrush and an electric razor.
      4. Wash your hair in the shower. Keep your elbows low and your chin tucked.
      5. Avoid aerosols and strong scents.

      Bathing and Showering

      1. If your doctor has prescribed oxygen to be use during exercise, then use it when you take a shower.
      2. Make certain your bathroom is well-ventilated.
      3. Consider taking your shower in the evening to allow plenty of time.
      4. Gather all the necessary items you will need, including your clothes.
      5. Sit to undress, bathe, dry and dress. Use a bath chair in your shower.
      6. Avoid over reaching. Use a long-handled brush to wash your back and feet. Use a hand-held showerhead to rinse.
      7. Use a shower caddy and soap on a rope or place soap in a nylon stocking and tie the stocking to the shower seat or soap dish.
      8. Have a towel or robe near by. Consider using hand towels because they are not as heavy. Avoid the task of drying by putting on a terry cloth robe.

      Dressing

      1. Gather all the necessary items you will need.
      2. Sit to dress.
      3. Minimize bending by bringing your foot to the opposite knee, use a step stool or use long-handled equipment to put on pants, shoes and socks.
      4. Wear easy-to-put-on, comfortable clothes such as slip-on shoes; elastic waistbands and one sized larger shirts
      5. Avoid restrictive clothes such as belts, ties, tight socks, girdles and bras. Use suspenders if belts are too restricting.
    Hand Strengthening Putty Exercises

    Perform the checked exercises _____ time(s) per day, _____ days a week
    Repeat _____ times
    Perform these exercises with   right   left   both   hands (circle one)

    Finger Flexion
    Shape the putty into a ball. Squeeze the putty with your whole hand.
    Thumb Flexion
    Shape the putty into a ball. Hold the putty in your closed hand. Press your thumb into the putty.
    Lateral or Key Pinch
    Shape the putty into a ball. Pinch the putty between your thumb and the side of your index finger.
    Lumbrical Pinch
    Shape the putty into a ball. Hold your fingers straight and your knuckles bent. Squeeze the putty between your fingers and thumb.
    Finger Extension
    Flatten the putty into a pancake. Place your fingertips together on the putty and spread the putty outward.
    Finger Abduction
    Flatten the putty into a pancake. Spread the putty apart using two fingers at a time.
    Finger Adduction
    Reshape the putty into a sausage. Squeeze the putty between the insides of your fingers.
    Finger Tip Pinch
    Reshape the putty into a sausage. Pinch the putty between your thumb and each of fingers individually.
    Using Your Right Arm as a Passive Stabilizer

    It is important that you use your affected your arm as much as possible during daily activities. Here are a few examples of how you can do that.

    Use you right hand to stabilize your plate while eating.

    Stabilize a sheet of paper with your right hand while writing with your left hand.

    Stabilize a washcloth with your right hand while applying soap with your left hand.

    Stabilize your toothbrush with the right hand while your left hand applies the toothpaste.

    Transferirse a la Tina Usando una Silla de Baño
    (pierna izquierda, derecha, sentarse)

    Paso 1
    Mirando la pared, agarre el asidero.

    Paso 2
    Entre a la tina con su pierna izquierda.

    Paso 3
    Suba su pierna derecha a la tina.

    Paso 4
    Siéntese en la silla de baño.
    Invierta el órden de los pasos para salir.

    Ponerse una Prenda de Vestir sin Botones
    Usado el Método de un Mano - Lado Izquierdo Afectado

    Paso 1
    Posicione su camiseta hacia abajo en sus piernas con el cuello de la camisa en las rodillas.

    Paso 2
    Agarre la apertura de la manga izquierda y coloque en su regazo.

    Paso 3
    Incline hacia adelante y coloque el brazo izquierdo en la apertura.

    Paso 4
    Suba la manga sobre el brazo y sobre el codo.

    Paso 5
    Coloque el brazo derecho en la manga derecha.

    Paso 6
    Agarre la fábrica y traiga la camiseta sobre la cabeza.

    Paso 7
    Empuje la fábrica sobre el hombro izquierdo.

    Paso 8
    Ajuste la camiseta, jalando en el frente y detrás.

    Conservación de Energía con Actividades de Cuidado Propio

    Recuerde usar buena técnica para respirar.
    Descanse frecuentemente para evitar demasiado esfuerzo.

    Comer

    1. Coma seis comidas pequeñas durante el día en lugar de tres comidas grandes. Esto disminuye la energía necesaria para comer y digerir la comida.
    2. Coma lentamente y mastique completamente la comida.
    3. Evite comidas que forman gases que pueden hinchar el abdomen y hacerlo más difícil para respirar, como arvejas, melón, nabo, cebollas, coliflor, manzanas, maíz, brócoli, pepinos, repollo, frijoles, coles de bruselas.
    4. Higiene y arreglo

      1. Siéntese para afeitarse, peinarse y cepillar los dientes
      2. Evite el aerosol y la fragancia fuerte.
      3. Lávese el cabello en la ducha. Mantenga los codos bajos y la barbilla hacia abajo.
      4. Soporte sus codos en una superficie mientras se arregla o se afeita.
      5. Use un cepillo de dientes eléctrico y una máquina de afeitar.

      Bañarse y tomar una ducha

      1. Considera tomarse la ducha en la noche para tener suficiente tiempo.
      2. Colecte todos los artículos que necesita, incluyendo la ropa.
      3. Use una silla de baño en la ducha.
      4. Siéntese para quitarse la ropa, bañarse, secarse y vestirse.
      5. Evite alcanzar demasiado. Use una esponja con mano larga para lavarse la espalda y los pies.
      6. Use una manga de ducha.
      7. Si su doctor le prescribió oxígeno para uso durante ejercicio, úsalo durante la ducha.
      8. Este seguro que su baño está bien ventilado.
      9. Tenga una toalla o bata cerca. Considera usar toallas de mano porque no son muy pesados. Póngase una bata de felpa para evitar la necesidad de secarse.
      10. Use un caddie para la ducha y jabón en una cuerda o coloque el jabón en una media de nylon y amárralo a la silla de baño o al plato de jabón.

      Vestirse

      1. Antes de comenzar, colecte toda la ropa, zapatos, etc.
      2. Siéntese para vestirse.
      3. Reduzca doblar mientras se viste cruzando una pierna sobre la otra, o use un escabel para ponerse las medias, los pantalones, y los zapatos, o use equipo con manos largas.
      4. Calce zapatos sin cordones; use un calzador de mano larga.
      5. Evite la ropa restrictiva, las medias apretadas, las fajas, y los brasieles. Use portaligas en lugar de cinturones demasiado restrictivos.
    Ejercicios para Fortalecer la Mano

    Haga los ejercicios _____ veces al día, _____ veces a la semana.
    Repita _____ veces
    Haga estos ejercicios con la mano   derecha   izquierda   los dos   (circula uno).

    Flexión de los dedos
    Apriete la masilla con la mano completa.
    Extensión del pulgar
    Apriete la plastilina y forme una bola. Haga una forma con la plastilina. Agarre la plastilina en su mano cerrada. Presione su pulgar adentro de la plastilina.
    Pellizcar lateralmente
    Pellizque la masilla entre el pulgar y el lado del dedo índice.
    Pellizco para los lumbricales
    Apriete la plastilina y forme una bola. Agarre sus dedos estirados y sus nudillos doblados. Apriete la plastilina entre sus dedos y pulgar.
    Extensión de los dedos
    Aplana la plastilina cómo una tortita. Coloque la punta de los dedos juntos en la plastilina y separe la plastilina hacia fuera.
    Abducción de los dedos
    Aplana la plastilina cómo una tortita. Separa la plastilina usando dos dedos a la vez.
    Aducción de los dedos
    Apriete la masilla entre los dedos.
    Pellizcar desde la punta de los dedos
    Pellizque la masilla entre el pulgar y cada uno de los dedos.
    Uso de la Mano Derecha como un Estabilizador Pasivo

    Es muy importante que use la mano afectado lo más posible durante actividades diarias. Aquí hay algunos ejemplos de como puede hacerlo.

    Use la mano derecha para estabilizar el plato mientras come.

    Estabilice un papel con la mano derecha mientras escribe con la mano izquierda.

    Estabilice una toallita con la mano derecha mientras aplica jabón con la mano izquierda.

    Estabilice su cepillo de dientes con la mano derecha mientras la mano izquierda aplica la pasta de dientes.

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