Arm Elevation

Question 1

Lowering/Elevation Objectives

Answer 1

Normal glenohum rythm
Glenohum joint stabil/mobil
Scap stabil/mobil
Trunk stabil

Question 2

Post-stroke issue meeting glenohum stabil/mobil

Answer 2

Inferior Subluxation: take up part of hemaperatic arm to maintain shoulder joint ex: sling/pocket

Anterior subluxation: abducts more, sag and lengthened on hemaparetic side, pull arm across body to add glenohum

Question 3

Flexor Synergy post stroke

Answer 3

During reach:
shoulder abd
shoulder ER
elbow flexion
frearm supination

Question 4

Post-stroke initiating with scapular elevation

Answer 4

NEVER a normal reach pattern-shows compensating

don’t meet obj of scapular stability/mobility
Predisposes them to move with flexor synergy

Work with patients in scap stabilized position to get shoulder flexion/elbow extension

Question 5

Arm elevation

Phases

Answer 5

Elevation: dependant on position of arm to full elevation
Lowering: full elevation to dependant position of arm

Question 6

OBJ:

Normal glenohum rythm

Answer 6

2:1 ration
Maintains GHJ stability when arm overhead
Maintains normal length-tension of rotator cuff
Minimizes subacromial impingment

Question 7

OBJ:

Glenohum stability and mobility

Answer 7

Stability: via compression
rotator cuff stabilizes

Mobility: via force couple action
Supraspinatus helps spin clockwise in line of pull and rotates down; counterbalances upward pull of delt

Question 8

OBJ:

Scapular stability and mobility

Answer 8

Up/Mid/Lower trap, serratus, delt all work together to allow functional movement with upward rotation

Weakness: lose stability

ex: scapular winging if serratus weak
ex: weak lower trap- translates upward

Question 9

OBJ:

Trunk stability

Answer 9

As trunk goes scapula goes with it

One leg tasks: throwing
palvis stability becomes critical, can compensate with trunk

Changing orientation of arm to aim changes torque at shoulder and elbow

Question 10

Possible compensatory patterns of arm elevation

Answer 10

Shrug using upper trap- cuff weakness, lacks inf glid (tight caps), gives pseudo abduction

Trunk lean: further pseudo abd/elevation

Elbow flexion: shortens lever arm if weakness

Overuse levator scap: if lack stability, gives 30 degrees of abd

Question 11

MOST COMMON compensatory patterns

Answer 11

Scapular elevation: induces pseudo shoulder abduction

Lateral trunk lean: induces pseudo shoulder abduction

Elbow flexion: reduces gravitational lever arm