Bobath principles...

I had the opportunity to be taught some upper limb techniques this week which I applied to a pt who suffered a Left TACI FIVE WEEKS AGO.He is stage 3 upper limb and has quite a significant subluxation and severe left shoulder and hand pain. He is hypersensitive in left hand and has lots of tone. His GHJ adductors are also very tight and is therefore restricted into external rotation. His Prom is 90 degrees flxn/abd before pain inhibits further mvt. I put the patient in long sitting with a large cushion behind him. I started on his unaffected hand/forearm and shoulder and performed SIMMS/transverse soft tissue mobilisation . This lasted abouttwenty minutes. I then moved onto the affected side and performed the same techniques. Because I had started on the good side the affected side was more relaxed although still very tight. Howevere I was able to get the GHJ further into abd and ext rotation than everbefore and the pt was more relaxed and in less pain. It also translated into better responses later in the session when I began to get the pt to weight bear trough the upper limb.