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In 2018, a major review of upper limb interventions following stroke found significant positive effects for constraint and task specific-therapies and the supplementary use of biofeedback and electrical stimulation. However, they concluded that the use of Bobath therapy was not supported. [19]
Closed kinetic chain exercises or closed chain exercises (CKC) are physical exercises performed where the hand (for arm movement) or foot (for leg movement) is fixed in space and cannot move. The extremity remains in constant contact with the immobile surface, usually the ground or the base of a machine.
Monoplegia of the upper limb is sometimes referred to as brachial monoplegia, and that of the lower limb is called crural monoplegia. Monoplegia in the lower extremities is not as common of an occurrence as in the upper extremities. Monoparesis is a similar, but less severe, condition because one limb is very weak, not paralyzed.
In the majority of cases, spinal cord injury leaves the lower limbs either entirely paralyzed, or with insufficient strength, endurance, or motor control to support safe and effective physical training. Therefore, most exercise training employs the use of arm crank ergometry, wheelchair ergometry, and swimming. [21]
Exercises that strengthen the back muscles include rows, pull-ups, and shoulder blade squeezes. Exercises like doorway stretches for the chest can help stretch out tension that contributes to rounded shoulders. Synergistically implementing muscle strengthening and stretching can effectively prevent the development of rounded shoulders. [47] [48]
Exercises that will help improve the strength of the muscles in the back include rows and leg and arm extensions. [21] Elastic resistance exercise may also be able to sustain the progression of spinal curvature. [22] This type of exercise is able to sustain progression by equalizing the strength of the torso muscles found on each side of the body.
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