Hand and wrist strengthening exercises during rehabilitation of a patient with hereditary distal myopathy.

Abstract

The effects of isometric and resistive strengthening exercises on myopathic distal muscles were examined by implementing a program of hand and wrist exercises during the rehabilitation of a patient with adult-onset hereditary distal myopathy. A 78-year-old man with this diagnosis for 18 years entered the hospital after a lumbar laminectomy and complete bedrest for seven weeks. After a three-week course of twice-daily Velcro board, therapeutic putty, and table-side isometric exercises, his hand and wrist manual muscle testing score, hand grasp and pinch strength, and nine-hole peg test times had all improved. In addition, the patient had moved from minimum-moderate assist in dressing and hygiene, and maximum assist in homemaking, to stand-by assist in both areas. The outcome demonstrates the feasibility and functional value of isometric and resistive strengthening exercises in muscles severely affected by a myopathic process.