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Over-the-Door Pulley System

Gather the following equipment from stores such as Home Depot and Walmart.

• One single pulley at least three-fourths-inch to one and a quarter-inch in size. (swivel pulley is good but not necessary).
• Solid braid nylon rope to fit the pulley. Make sure the rope will fit the groove of the pulley you buy. Buy 12 feet of rope.
• PVC piping – buy two approximately ½ inches in diameter and five inches long.
• One over-the-door garment hanger (found in the housewares department with the regular coat hangers)

Fabrication
 1. With a pair of scissors, cut 12 to 16 inches from one end of the nylon rope.

 2. Thread the shorter nylon rope though the eye of the pulley. Then tie the rope to the over-door garment hanger with the pulley hanging below the hanger approximately 4 to 6 inches. (make sure the knots are secured since the pulley will hang above patient's head).

 3. Thread the larger nylon rope through the pulley wheel, and leave it hanging evenly loose (do not tie off).

 4. Thread one loose end of the nylon rope through the PVC piping until 6 inches are exposed at opposite end. Tie a tight knot allowing your hand to grip the piping with the rope loose on the back of your hand. This will be handle #1.

 5. Have the patient sit in the chair designated for the pulley exercise.

 6. Have the patient hold handle #1 in the hand of the weakest upper extremity. Thread the other end of the nylon rope through the last PVC pipe and have patient hold handle #2 in the non-injured hand.

 7. Instruct the patient to hold both handles in her or his hands and to raise the injured (or weakest) upper extremity as high as possible and hold it there. Then the patient will raise the non-injured upper extremity to the same height as the injured one. Take up the slack rope and tie to the hanging rope from the pulley wheel.

Fabrication Precautions
Use caution with scissors to prevent cuts.
Use caution with the nylon rope to prevent rope burns.
Make sure all knots are tight and secure to prevent them from slipping under pressure.
Make sure over-the-door garment hanger is secure on door.
Instruct the patient never to sit directly under the pulley mechanism.

 

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