Instructions for stretching exercises, either self-stretching or assisted stretching by a family member or caretaker, will help maintain flexibility and reduce cramping. Range of motion should be performed and include all the major joints of the body. Muscle weakness leads to decreased joint mobility which can, in turn, impair mobility and activities of daily living. Patients are instructed to perform range of motion in different positions and to use the mechanical advantage that some positions provide. For example, some patients may not be able to raise their arms over their head while sitting, but they can do so in a supine position.
Therapy consists of joint mobilization to restore joint alignment and to free adhesions.
Ultrasound and diathermy may also help, as will proper positioning to prevent progression of the shoulder joint problems. Proper equipment is the key to independent living. Recommendations are made based on each patient's specific needs. There are a multitude of devices and equipment available to help in maintaining mobility and independence. Safety issues include prevention of fatigue and changes that may need to be made in the work or home environment.