Question: Edi Paragraph Styles 2. Mr. Gold Is A 26 Y/o Male With Complaints Of Difficulty Using His (R) Hand. He Reports That The Onset Of Hand Difficulty Was Approximately 2 Weeks Ago, And States That His Condition Is Worsening. Mr. Gold Works As A Landscape Designer And Primarily Performs Computerized Drawings During His Work Day. Outside Of Work, He Enjoys …

Edi Paragraph Styles 2. Mr. Gold is a 26 y/o male with complaints of difficulty using his (R) hand. He reports that the onset of hand difficulty was approximately 2 weeks ago, and states that his condition is worsening. Mr. Gold works as a landscape designer and primarily performs computerized drawings during his work day. Outside of work, he enjoys golfing and runs approximately 3 miles/day. He has also been working with an organization that builds homes for a low- income population on the weekend. Mr. Gold noticed the onset of his hand complaint after working nearly nonstop during one weekend. He states that he has difficulty picking things up with his (R) hand and has become “clumsy” when using his drawing tools. He denies any numbness or tingling in his hand and states that picking up change from the counter at the coffee shop is nearly impossible. His problem is beginning to affect his effectiveness at work and he fears that he is not helping as much as he could at the home site he has been volunteering at Clinical Findings: Mr. Gold presents with a symmetrical posture in sitting, AROM of the UE is WNL with the exception of thumb and index finger flexion is slightly limited. PROM of these structures is WNL. Muscle performance testing reveals shoulder and elbow strength to be WFL. Supination strength is WFL, however, he is weak and painful with pronation. Wrist strength is normal. Mr. Gold demonstrates some (R) handed weakness with use of a dynamometer, however this strength issues appear to be most significant for thumb flexion and second digit DIP flexion, which are 3+/5 for both. Palpation reveals some soreness over the medial aspect of the forearm just inferior to the medial epicondyle. Mr. Gold demonstrates good prehension with all pinch grips with the exception of tip-to-tip prehension of the first two digits. 1 Plan of Care: He will perform exercises to restore grip strength to the lateral aspect of the hand. He will also receive instruction on stretching activities for the forearm and be evaluated for proper use of tools on the work site. What is the rationale for this plan?