The nerves that control the use of the hand are located in the brain and spinal cord. The brachial plexus, which originates in the neck or cervical region of the spinal cord, is the bundle of nerves that controls the strength and dexterity of the hands. Injuries that cause trauma to the brachial plexus can cause weakness and paralysis of the hand.
Causes of Spinal Cord Injuries That Affect the Hand
Injuries to the cervical spine that commonly affect the brachial plexus can occur during automobile accidents, contact sports such as wrestling or football, and the birth process. Injury occurs when the collar bone is pushed down while the head is pushed up. Shoulder trauma, tumors and inflammatory processes can also cause injury to the brachial plexus. Serious injuries in which the nerves of the brachial plexus are torn may require surgery. Lesser injuries may recover spontaneously. Therapy can be useful whether injuries are mild or severe.
Exercise to Strengthen the Wrist
Instructions for this exercise assume the presence of a therapist. A table, a block the length of the table, a straw, a cup, a small sand bag and paper tape are required.
The patient should sit with forearms pronated -- palms down -- and resting on a block on a table in front of him.
Place a sandbag on the forearm.
Tape a straw to the forearm and align the joint of the straw with the wrist.
Instruct the patient to move the wrist so that the back of the hand touches the straw, then relax the hand. Repeat five times and increase repetitions in increments of five as strength increases.
Exercise for Wrist Flexion and Extension
This exercise focuses on increasing the ability of the wrist to bend and straighten to a target. It improves the ability of the wrist to flex and extend. This exercise requires the use of a chair, table, sandbag and a small cylindrical object.
While the patient sits in a chair, place her arms on the table in front of her with the wrist in a vertical position, hand holding a small cylindrical object, thumb facing up and sandbag on the forearm.
Make a pencil mark on either side of the hand to mark the target for range of motion.
Move the wrist backwards and forwards so that the hand meets the target lines while holding onto the cylindrical object. Forearm motion is not allowed. Repeat five times and increase in increments of five as skill increases.
Exercises can be further advanced by using a cylindrical object with increased diameters, and by using an object than can be deformed.
Exercise to Increase the Ability to Hold a Cup
This exercise increases the ability to bend the wrist and hold a cup. Position is the same as in exercise number 2. Start with a cup that has a small diameter.
While holding the cup, move the wrist to the point where the cup is level with the table, then higher than the table. Repeat five times and increase in increments of five until the desired range and strength is achieved. Gradually increase the diameter of the cup, then add water to the cup.
Safety and Cooperation
Exercises for recovery from spinal cord injury should be done safely and, initially, with skilled supervision. Cooperation with your doctors and therapists optimizes the chances of recovery.
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