Rehabilitation of the upper limb after an stroke. Part 6. Dissociation to an "open" chain and hand treatment

Introduction: The treatment to get the best recovery of the hand stand in this article central. Last article part 5 had on the end also the hand therapy central. F.E.S and CIMT stand there as two possibilities to lay more pressure on the possibilities of the wrist and hand function. There are more treatments with the focus on the hand/wrist function. Some of this treatment is never proper investigated and others are treatment that has the origin out the sciences investigation. Especially the robotics or exoskeleton systems are solutions that come from the technic and with must be incorporated in the existed treatment program. Methods : Sometimes this are treatments were no other activity are use and that will have an effect on the system of the body. The building of your body through diagonals asked for an stability to get one point get his best stability and that part will always have influence on the outcome from each treatment. Sitting on chair an having an exoskeleton on the under arm and hand asked still for an activity of the shoulder. That activity must be controlled in the keypoint of the diagonal –back and front. When one of the diagonal is too dominant than is the movement in the affected shoulder not right. But look also under the table and observe the reaction of the legs or the not-affected arm and (on) the leg. There build the individual chain to get the best control over the affected keypoint and that is essential part of the treatment that also by the hand treatment must be watch and take care off. There they must also search for stabilization and often is that the affected arm/hand (upper trunk) and that will have an negative influence on the possibilities of this affected arm/hand. This part start with an observation paper. Here we focus on elements of the use of the hand/arm in the ADL . And this is an good start in the search for the exercise of that hand when there is some possibilities in the hand himself. Conclusion: Again is there always the possibility to make the exercise an task-specific resistance treatment that lead to an better coordination and more power in the muscles of the hand but that must be lead to an situation that the brain must search for an solution and that this function is incorporated in the ADL and IADL.