2. To strengthen Muscles :
                          In paraplegics we overstrengthen upper extremity and strengthen the lower extremity. The overstrengthening of arms along with shoulder gridle is essential so that during crutch walking whole of the body weight is borne by the upper extremity. The lower extremity is to be strengthen in order to make the patient walk with or without assistance. The patient can be given for strengthening upper extremity :-

A. Cord knotting : It is good to strengthen grip, and other muscles. It is said that it involves all those muscle groups, which are very essential for crutch walking. It is also known as pre-crutch activity.

B. wire work : Good to improve finer finger dexterity, pinch, opponence and eye-hand co-ordination if impaired due to prolonged disuse

C. Braid Weaving : This is also very good for paraplegics. This can be given as prevocational and vocational activity.

D. Woodcarving : this craft is also very laborious and requires good muscle power in arms. The constant use of upper extremity will prevent stiffness at any joint and will keep the required R.O.M at every joint.

E. Ivory Work : This can be given to the paraplegics and it has proved to be a very successful as vocational craft.

F. Fret Work : This is also very good for upper extremity when Fret-Saw machine is operated electrically or with lower extremity to improve concentration and eye-hand and leg co-ordination.

G. Stuff Toy making : This craft is also very good for improve strength of the hand muscles of the patient.

H. Metal Beating : This can be given in case of chronic patients who can take black-smithy as profession later on.

                     Like these there are many other activities, which strengthen the upper extremity e.g., Basketry, Sanding, chair caning, hammering and carpentry.

                           The activities for the lower extremity are :

1.    Fret Saw machine : This can be given only in the cases when there is paresis only in the legs. But if the ankle has fairly good power, then also this can be used in making shuttle and gauge and doing fret work.

2.    Kicking the Medicinal Ball : This can be done when patient stands with calipers or without calipers if power is fair. The therapist can assist this so that patient does not feel helpless to do it.

3. Bicycling : This can be encouraged when the power in legs is 3 or more than 3 so that the muscles can work against gravity. This should be performed without calipers if the control of the muscles around each joint is fairly good.

4. Bicycle Fret-Saw machine : This can be used by the patient with or without calipers can use this with the assistance of the therapist. The patient can develop reciprocal pattern of movement in the legs, which is very essential for walking.

5. Multipurpose wheel : This is adjustable equipment so that it can be used for upper and lower extremity both. This will help to improve both strength and range of movement in the legs.

3. To increase / maintain range of motion :
                           The legs of the paraplegics are the main brunt of the disease. In case of stiffness due to arthritis or due to spasticity may affect the normal range of movement. All the activities like :

          A. Bicycling
          B. Paddling
          C. Tailoring
          D. Fret work
          E. Ball - Kicking etc., prove to be beneficial.

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