D1 and D2 Upper Extremity Patterns

Summary

The video covers upper extremity movement patterns, focusing on flexion, adduction, external rotation, and their opposites. The instructor reviews classic hand holds, guiding through rhythmic initiation and resistance techniques. Key points include proper hand positioning, patient engagement, and the use of isometric contractions to strengthen the shoulder at its end range. Additionally, irradiation techniques and dowels are demonstrated to enhance shoulder mobility and strength, especially for rehabilitation scenarios like frozen shoulder or post-op recovery. The video emphasizes body alignment, weight shifting, and coordinated resistance for effective patient support.

Takeaways

• 👐 The first pattern reviewed is the flexion-adduction-external rotation for the upper extremity, starting from the pinky side leading with wrist and finger flexion.
• 💪 Opposite to the first pattern is the wrist and finger extension, moving into shoulder extension-abduction-internal rotation.
• 🔁 Rhythmic initiation is used to guide the patient through the pattern, keeping the arm relaxed while demonstrating the movement.
• 👌 Specific hand holds are required when resisting motion, particularly on the lateral aspect of the hand, depending on the desired pattern.
• 🦾 The weight shift of the instructor's body is crucial when providing resistance, reducing the effort required by their arms.
• 🔄 Introducing traction in the wrist extension pattern provides additional resistance and helps to engage wrist muscles more effectively.
• 👍 A flexion-abduction-external rotation pattern can be led with the thumb side of the hand, emphasizing end-range positions that align with the body's midline.
• 🎯 Proper end-range positioning helps target strength improvements in shoulder mobility, especially for post-operative or frozen shoulder patients.
• 🔄 Irradiation techniques using the opposite arm can improve overall strength in the targeted area by creating overflow effects from the opposite extremity.
• 💡 Reversals and partial-range movements in the patterns are used to develop end-range strength and coordination in the upper extremities.

Q & A

What is the primary focus of the exercise pattern discussed in the script?

The primary focus is on the flexion, adduction, and external rotation pattern for the upper extremity, emphasizing rhythmic initiation, wrist and finger movements, and proper hand holds to assist the patient in moving through the pattern.

Why is rhythmic initiation used in these exercises?

Rhythmic initiation helps the patient understand the movement pattern and relax their muscles. It is a method of passively guiding the patient through the motion before adding resistance.

What are the key points to remember when performing the flexion adduction external rotation pattern?

The arm should stay close to the body, the elbow should come towards the nose, and the movement should lead with the pinky side of the hand.

How does the trainer provide resistance during the exercises?

The trainer provides resistance by weight shifting rather than using arm strength. Hand holds are placed on the lateral aspect of the patient's hand or wrist, and the trainer guides the patient through the movement while applying resistance.

What is the purpose of providing traction during the exercises?

Traction is introduced to assist with wrist extension and to provide gentle pull or separation of the joints, helping the patient maintain correct positioning and engage more effectively in the movement.

What is the difference between the two hand holds demonstrated in the script?

The first hand hold is on the lateral aspect of the hand for pulling the arm up, while the second hand hold emphasizes wrist and finger flexion by holding the hand in a way that allows the trainer to rotate their body with the patient during the motion.

How is the second pattern, involving flexion abduction and external rotation, different from the first pattern?

The second pattern leads with the thumb side of the hand, focusing on flexion, abduction, and external rotation with wrist and finger extension, whereas the first pattern focuses on flexion, adduction, and external rotation.

What is the importance of midrange and end range in these patterns?

Maintaining a fist-width distance from the head at end range is crucial to ensure correct alignment and avoid overstretching. It also helps in retraining end-range strength, especially for conditions like frozen shoulder or post-operative recovery.

How does the trainer work on strengthening end range motions?

The trainer uses isometric contractions and isotonic movements to strengthen end-range motion, providing resistance as the patient holds or moves through partial or full ranges.

How are dowels or canes incorporated into the exercises?

Dowels or canes are used to assist the patient in performing end-range movements, allowing them to use their opposite arm for additional support and engage their trunk strength to enhance the movement.