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Left
0
80
60
15
25
30
30
WFL
Left
5/5
5/5
5/5
5/5
5/5
5/5
5/5
D1-D5:
5/5
Grip Strength
Dons grip strength test was conducted with the Jamar dynamometer and
measured in pounds. 3 trials were given for each hand and scores are indicated in the
table below.
Jamar
Dynamometer
Trial 1
Trial 2
Trial 3
Pinch Strength
Right
Left
30
15
5
100
80
80
Right
Left
2
2
5
18
20
18
Right
5
3
5
Left
25
25
25
Right
8
7
8
Left
22
21
21
Coordination
The Minnesota Rate of Manipulation (MRMT) was used to test Dons
coordination of the right and left extremity. The test was nonstandardized and only two
rows were used. Don completed the test with his right extremity in 52.96 seconds, while
with his left extremity he completed it in 8.17 seconds.
Daily Living Activities
As previously stated, Don was independent with all activities of daily living prior
to his injury. Don reported that he now has difficulty in a number of areas when
attempting to use the affected extremity, such as using silverware for eating, brushing his
teeth, and pulling up his pants for dressing. Driving is also difficult to do, as he is unable
Other than his current injury, Don is a physically healthy young adult.
Dons condition does not affect his sleep.
Don has support of family and friends available if needed.
Don does not experience pain or discomfort from his injury.
Don is involved in his community through school, his job, and participation in
activities such as bowling and volleyball.
Problems
Decreased pinch strength of the three functional pinches in the right hand
Decreased muscle strength and active range of motion in elbow extension and
supination, wrist extension and radial deviation, thumb extension, abduction, and
hand)
Decreased activities in daily living (Don is impacted in areas that include feeding
himself with silverware, personal hygiene such as brushing his teeth, and pulling
typing)
Presentation of wrist-drop deformity of the right hand
History of depression that may impact success of treatment for current injury
Goals
Don will perform the home exercise program when not wearing his dynamic
splint, consisting of AAROM/PROM at least 3 times per day to decrease the risk
1 week.
Don will demonstrate proper techniques to compensate for his decreased
sensation in his right hand during the activity of dressing within 1 week.
Current Treatment
Preparatory Methods
References
Earley, Donald. Peripheral Nerve Injuries. Powerpoint presentation. Saginaw Valley
State University, University Center, MI. March 2014.
Hannah, S.D, & Hudak, P.L. (2001). Splinting and radial nerve palsy: A single-subject
experiment. Journal of Hand Therapy, 14, 195-201.
Moscony, A. (2007). Common peripheral nerve problems. In C. Cooper (Ed.),
Fundamentals of Hand Therapy (pg. 201-250). St. Louis, Missouri: Mosby
Elsevier.
Reynolds, C. Christopher (2002). Preoperative and postoperative management of tendon
transfers after radial nerve injury. In Mackin, Callahan, Skirven, Schneider, and
Osterman (Ed.), Rehabilitation of the Hand and Upper Extremity, Fifth Edition
(pg. 821-831). Elsevier Health Sciences.