Rehabilitation
At Home Rehabilitation Exercises
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9- Nuts and Bolts
LEVEL 1 - Using 100 nuts and 100 matching bolts approximately one to two inches long and three empty shoeboxes or plastic food keepers. If nuts and bolts are not available, any two small items could be used (for example: buttons, paperclips, coins, toothpicks). Place the nuts in one box and place an empty box approximately 12 inches away. Using the right hand, ask the student to place nuts, one at a time, into the empty box. After some practice, assess speed by allowing 10 seconds to transfer. Switch hands when tired.
LEVEL 2 - Place all the nuts in one box. Arrange two empty boxes on each side of the full box, about 12 inches away. Ask the student to place individual nuts in the empty boxes, alternating between the two. If the student stops alternating, provide a reminder. When one hand tires, switch to the other hand.
LEVEL 3 - Place three boxes in a row with the box full of nuts in the middle. Ask the student to transfer the nuts using both hands simultaneously. The left hand is to fill the box on the left, the right hand the box on the right. With the 3 boxes in a row, as above, place both nuts and bolts in the center box. Using the left hand, the student is to place the nuts in the box on the left, and using the right hand place the bolts in the box on the right. Encourage the use of both hands simultaneously and look for approximately equal numbers of items in each box.
LEVEL 4 - Place nuts in one box and bolts in the others. Instruct the student to pick up a bolt with one hand and a nut with the other and screw the nut on the bolt in a few turns. The completed assembly is to be placed in the remaining empty box. Increase difficulty by putting a time constraint on the activity.
LEVEL 5 - Allow the student to turn screws and bolts into scrap wood. This might involve drilling holes into the wood as a guide for the screws and bolts. Under close supervision, allow the student to drill the holes. Also using scrap wood, allow the student to hammer nails. Initially, this will likely require that the trainer start the nail and the student should hammer without holding the nail (to avoid striking their hand with the hammer). Use of a hand-held saw (not a power tool) could also be considered.
LEVEL 6 - Do small construction projects together, such as building a simple bench, birdhouse, or shelf. This provides the student with a sense of purpose and accomplishment, in addition to good cognitive and physical stimulation.
Taken from Tasks for Home-Based Cognitive Stimulation Program, the Traumatic Brain Injury Model System at the University of Alabama at Birmingham, Dept. of P M & R, Birmingham, AL. © 1998-2003 University of Alabama at Birmingham