During sensory facilitation in neuro rehabilitation we use tapping, weight bearing, and joint compression to facilitate the motor control in upper limb. Most of the time therapist use weight bearing through upper limb either in prone on elbows, quadruped, or in sitting weight bearing through upper limb with hand kept either sideways or backward. Most of the time we don’t even think what is our objective of this exercise and which purpose it is used. Even we don’t plan that, are we trying to do heavy joint compression or light joint compression. What is the purpose of the joint? Is it heavy joint compression or light joint compression? Wrist and elbows are not meant for heavy joint compression. Wrist and elbows are for the purpose is for light activity and skillful activity. By doing this heavy joint compression in the lengthened range of ling flexors, we overstretch the long flexors. This increases the movement arm of flexor tendons and this cause’s excessive flexion force and flexion attitude of the flexors in every movement of wrist and hand and skillful movements. Already it is difficult to activate finger flexors and teach release of fist and this over action of flexors makes it more difficult. So we should avoid weight bearing through hand in fully extended fingers.
Instead of giving sensory stimulation in functional positions we need to give sensory feedback during functional activity & task specific position. This helps in sensory integration of sensory feedback with motor control in given task, given task parameters and contextual factors.

Published by GajananBhalerao

DR. GAJANAN BHALERAO (PT) MPTh Neuro, NDT Adult (USA), Motor relearning (Australia), Aquatic therapist (Switzerland). Associate professor at Sancheti Institute College of physiotherapy, Shivajinagar, Pune. Founder Director of "School of neuro rehab and aquatic therapy" , speciality centre for neuro rehabilitation of stroke, brain and spinal cord injury. Mobile : 9822623701,

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