Updated: Sep 10, 2020
Therapy putty is a great resource. It provides almost all the criteria a busy therapist needs: convenience, built-in grading, and adaptability. Honestly, therapy putty is one of my go-to resources for my orthopedic patients. But remember: with neuro-rehab, function trumps mundane exercise. If we can make our therapeutic exercises and activities simulate a functional task or a part of task-specific training, we will have better outcomes. AND reaching into our creative pockets to achieve functional but directed therapy is what makes part of being an occupational therapist fun...and what makes OT the best T. :)
Okay. Broad category. But so many possibilities for hand strengthening are included in the cookie-making task..
Exhibit A: stirring the cookie dough. For simple prep, have all of the ingredients added to the bowl prior to beginning your session, and then have your patient stir away. Repetitive, task-specific, and built-in resistance! Exhibit B: rolling cookie dough.
For sugar cookies: roll out the dough with a rolling pin. For drop cookies, use a cookie scoop for repetitive grasp/release. For rolled cookies: coordination combined with strength training.
Pro-Tip: For the low level arm, use a cookie scoop sans the dough for functional, repetitive grasp/release.
For the busy therapist: catch the "ready-to-bake" cookie dough tubes on sale and stash them in a freezer for a go-to intervention when the right patient comes.
2. Squeeze Bottle
I stock up on the empty shampoo/conditioner bottles from the travel section of the store. To work on hand strength and coordination of grasp/release, I fill the bottle with water (or to upgrade: a thicker liquid like conditioner) and have the patient squeeze all of the liquid out. I find my clients really like this because the goal is apparent: empty the bottle and they're done! So much better than "3 sets of 20."
Larger squeeze bottles such as dish soap containers or (empty) condiment containers would work well for the hand progressing out of the flexion synergy stage.
3. Spray bottle
This activity is very similar to the squeeze bottle. I grab one of the spray bottles found in the hair-care section of the drug store and fill it with water. The repetitive activity is to empty the spray bottle by pulling the trigger to the sprayer over and over again until the bottle is empty. Again, simple grasp/release and power grip strengthening.
Pro-tip: For the higher-level arm, use this for the bilateral task of cleaning--spray and wipe down counters or windows. (OR the therapy equipment you need cleaned :)...only kidding. Kind of.)
4. Kneading Bread Dough
Y'all. This is such a good task for hand strengthening but also for hand and arm coordination, activity tolerance, and core strength. For many, kneading dough can be an easy way to achieve flow. I also find that for many of my patients, anything to do with making bread is a source of emotional connection to their childhoods and their families.
Pro-tip: Making dough is a good way to 'kill two birds with one stone.' With a little forward thinking, this can be an intervention for multiple patients in one day. If you have someone on your caseload who needs to work on standing balance/tolerance, sequencing, or activity tolerance, have them do the initial measuring and mixing of the dough. Then, the dough will be ready for the next patient to knead.
For the busy therapist: Dough can be made ahead of time and then frozen! When you want to use kneading as an intervention, pull the dough out of the freezer and let it thaw.
5. Squeeze toothpaste Squeezing toothpaste out of the tube is a good activity for strength and coordination of lateral prehension. Before you think this is wasteful: have your patient squeeze the toothpaste into a reusable container (like a denture bath). If your patient has difficulty with the functional task of squeezing toothpaste onto a toothbrush, you can then velcro that dental bath to their bathroom sink and they can "scoop" the toothpaste onto their toothbrush. Boom. Remedial intervention one day, adaptive compensation the next.
Pro-tip: If you work in an inpatient facility like a SNF or an inpatient rehab, with some easy convincing and permission of the purchasing department, you can take a stash of the facilities' toothpaste to store in the rehab-department for "cheap" and easy access.
I LOVE working with other occupational therapy practitioners to brainstorm ways to better serve our clients. What are some of your go-to interventions for hand strengthening?
Be encouraged today to continued to guide your clients to Live today. Live better tomorrow. And inspire others to do the same.
Your (fellow) OT,