Developed by Peter G Levine author of Stronger After Stroke (book), and blog by the same name. 

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ArmTran: Precautions

Exercise is not without its risks and this or any other exercise program may result in injury. Any person who undertakes any exercises does so at their own risk. To reduce the risk of injury you should consult your doctor before beginning this or any other exercise program. 

As with any exercise program, if at any point during your workout you believe conditions to be unsafe or begin to feel faint or dizzy, have physical discomfort, or pain, you should stop immediately and consult a physician.

Precautions for the ArmTran are the same precautions for the upper extremity. Special care, and the advice of an appropriate therapist, should be sought regarding the hemiplegic shoulder. 

1. Do not perform passive range of motion/ stretching exercises without instructions from your healthcare provider

2. The ArmTran can be used to both exercise and stretch. If any exercise/ stretch causes  pain, discontinue immediately and consult the appropriate healthcare worker.
3. Patients with subluxation (dislocation) of the shoulder should consult the appropriate healthcare worker prior to beginning using the ArmTran.

As is true with any exercise routine, start slow. For instance, if you are using the ArmTran to repeat the movement of reaching forward, do a few minutes to start. Then increase the number of repetitions as you get stronger and more coordinated.

After stroke exercise should be done with caution because the shoulder is susceptible to...
• Hemiplegia/hemiparesis
• Spasticity (uncontrollably tight muscles)
• Flaccidity (no contraction of any muscles)
• Subluxation (dislocation)
• Impingement ("pinching" of the soft tissue of the shoulder by hard surfaces like bone)
• Soft tissue injury
• Brachial Plexus or peripheral nerve injury
• Shoulder - hand syndrome

A great overview of shoulder problems and recommendations can be found here.