Bilateral arm work allows you to use irradiation from the patient's strong arm to facilitate weak motions or muscles in the involved arm. You can use any combination of patterns in any position. Work with those that give you and the patient the greatest advantage in strength and control.
When you exercise both arms at the same time there is always more demand on the trunk muscles than when only one arm is exercising. You can in crease this demand on the trunk by putting your patient in less supported positions such as sitting, kneeling, or standing. Bilateral combinations are very effective way to use the strong arm to reinforce the weaker arm.
Here we picture all the bilateral arm patterns with the patient supine to show the therapist's body position and grips more clearly.
Bilateral Symmetrical. Flexion-abduction-external rotation (O Fig. 7.19).
D Fig. 7.21a,b. Bilateral symmetrical reciprocal patterns, flexion-abduction on the right arm and extension-adduction on the left arm
D Fig. 7.21a,b. Bilateral symmetrical reciprocal patterns, flexion-abduction on the right arm and extension-adduction on the left arm b a
Bilateral Asymmetrical. Flexion-abduction-external rotation with the right arm, flexion-adduction-external rotation with the left arm (O Fig. 7.20).
Bilateral Symmetrical Reciprocal. Flexion-abduction-external rotation with the right arm, extension-adduction-internal rotation with the left arm (O Fig. 7.21).
Bilateral Asymmetrical Reciprocal. Extension-adduction-internal rotation with the right arm, flexion-adduction-external rotation with the left arm (O Fig. 7.22).
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