Patient Information: Male, Age 94

Diagnosis: Chronic Kidney Disease / Generalized Weakness

History: Following hospitalization related to chronic kidney disease, this gentleman, a long-term skilled nursing facility resident, was referred to occupational therapy to address severely decreased range of motion (ROM) in his right hand which limited his ability to feed himself. Prior to the hospitalization, he was able to feed himself independently.

Pre-Therapy Status:
•Feeding: Maximal (>75%) assistance.
•Right Hand ROM: Severely limited; hand rests in fisted position.
•Orthotic Management: Unable to tolerate wearing resting hand splint.

Therapy Information:
•Modality: OmniStim^® FX² Pro Patterned Electrical Neuromuscular Stimulation (PENS).
•Frequency: 3x per week.
•Protocol Specifics: Upper extremity triphasic PENS to the right wrist flexor and extensor
muscles for neuro re-education and strengthening.
•Duration: Six weeks.
•Other Therapy Services Provided: Upper extremity active range of motion exercises, orthotic management, and caregiver education.

Outcome:
•Feeding: Independent.
•Right Hand ROM: No limitation; able to open hand completely.
• Orthotic Management: Resting hand splint worn at night.

This gentleman, family members and nursing staff are thrilled with his accomplishments in therapy! With his increased right hand range of motion, he is now able to feed himself a snack, use a washcloth to clean his face and even use a tissue to blow his nose.