Mrs. Richards is a 79 year old widow who is in the skilled nursing facility secondary to a falling incident which injured her left shoulder. she has a history of rheumatoid arthritis which also impacts her active range of motion in bilateral upper extremity secondary to pain at the end of range. although she can be ranged to WFL passively , she complains of pain when performing active range of motion and all tasks which require that she raise her arms to >100degrees for shoulder flexion. the strength in her affected upper extremity is 3+/5 and in the right upper extremity 4/5. she enjoys learning crafts and crossword puzzles, gardens, cooks and watches TV. She doesn't mind trying new things but they have to be therapeutic.
Activity:
Create an activity that addresses her left upper extremity strength using an isometric contraction to prevent pain upon movement beyond 100degrees
create an activity that addresses her left upper extremity decreasing strength using an eccentric contraction
create an activity that addresses her right upper extremity strength using a concentric contraction
create an activity that addresses her left upper extremity range of motion using a closed kinetic chain