Amy, the stroke liaison nurse, re-visits the family to see how they are getting on. Jimmy continues to attend the gym three times a week where he meets friends and describes the visits as enjoyable. Jimmy is delighted to be doing more with the family and has noticed that he is feeling less tired and is sleeping better. He is thinking about returning to work but Debbie is concerned about him going back too soon.
Jimmy continues to practice his hand coordination exercises at home. However he is concerned that he can’t use a computer keyboard effectively and writing remains difficult.
Select the items on Jimmy’s desk below to identify which tasks he may find difficult at work and see what the community rehabilitation team may recommend.
Select the items on Jimmy’s desk below to identify which tasks he may find difficult and see what the community rehabilitation team may recommend.
Phone
Task analysis:
- Sustained holding of the phone to the ear demands upper limb control and strength
- Finger fine motor control is required to operate phone buttons
- Bilateral arm co-ordination is required for taking notes whilst on the phone
Suggested therapeutic activities:
- Arm exercise programme to improve control, strength an co-ordination
- Practice fine motor and hand precision skills (e.g. picking up small objects etc)
- Consider provision of an earpiece or speakerphone to make the phone hands free
- Consider use of a phone with larger buttons
Computer keyboard and mouse
Task analysis:
- Using a keyboard demands bilateral hand co-ordination, isolated finger movement and learning of motor patterns
- Use of a mouse requires control of movement and eye hand co-ordination
Suggested therapeutic activities:
- Use online keyboard training programmes for task specific training
- Practice fine motor and hand precision skills (e.g. picking up small objects etc)
- Play computer console or board games (e.g. Jenga) with the children that demand upper limb co-ordination and dexterity
Writing
Task analysis:
- Shoulder and elbow joints need to be stable
- The wrist needs to be held in extension
- There needs to be good control and strength of movement in the hand to hold the pen
- A smooth co-ordinated movement of the arm and hand is needed to write clearly
Suggested therapeutic activities:
- Provide ergonomic advice on seating posture and desk position to optimise the working posture and ensure arm stability
- Practice fine motor and hand precision skills (e.g. picking up small objects etc)
- Graded handwriting practice sheets
- Provision of an adapted pen grip to assist with writing stamina and quality
- Give consideration to the use of voice recognition software to record information.
Page last reviewed: 25 May 2021
