Susan, what to expect?

[KoKo]

Hi Susan

I have had PPMS for 12 years. My right arm and hand have been gradually losing function over the years.

I did pulley/resistance arm exercises on my Nordic chair for several years after DX. Unfortunately my arm strength has been gradually declining over the years, and using the exercise chair became more and more difficult, even with less reps, to the point where I could no longer use it.

I have been using an arm cycle for the past few years (table top), which is doable. I also have someone come over to do range of motion, and stretches on my arm.

At my recent appointment with my neurologist, I was diagnosed with having "wrist drop", and was given a written order for Occupational Therapy.

I haven't called to get the ball rolling yet.

Could you possibly give me an idea of what to expect with Occupational Therapy for my arm? Does the OT always come to the house? How often are the sessions?

Thanks much!

Take care,
KoKo

[SusanD]

Hi KoKo....
Occupational Therapy can provide several different approaches to address the issue.
After a full assessment, different exercises are provided. Please note that not all exercises mean weights will be added.
Gravity itself causes resistance especially as muscles get affected. Moving the hand up and down can be tiring as the gravity provides resistance.

An example of what I would do is to allow the hand to move in different planes so that the muscles graded so that the amount of muscle strength varies. I would start with no gravity meaning the moving the hand up and down while resting on the side of the hand. Then gradually changing the position to find the position/point it is most challenging.

The therapeutic approach of each therapist is clearly different. Different types of exercises and activities are provided to help strengthen wrist and should also incorporate the hand and fingers. As you already do, ROM and stretching is important.

An additional treatment would be the use of electrical stimulation modality. The electrodes are placed on the muscles of the top of forearm used to generate contractions. As those muscles contract, the wrist will be brought up. This is used along with your abilities of movement and used to prevent atrophy if movement is very limited or non existent.

I would always recommend getting treatment in a clinic as they have far more to work with than a traveling therapist. However, if you do get home health, make sure they are not only moving your fingers, hand and wrist but also incorporate activities to help you with your activities of daily living (dressing, grooming, things in the kitchen.. etc).

I hope this helps. Let me know if you need more information.

[KoKo]

Thanks Susan!

I was hesitant to pursue this as I didn't think that there would be much benefit. (Don't need to waste precious energy and stamina, if I don't have to)

After your explanation, it sounds like it might be worth the effort.

Take care,
KoKo

[SusanD]

Definitely worth it and please let me know how things go.

Best Regards,
Susan