Fine Motor Function Flashcards
What are isolated movements of the hand?
Wrist: Flexion, Extension, Ulnar deviation, Radial deviation
Fingers/Thumb: Flexion, Extension, opposition, abduction, adduction
What are movement patterns of the hand?
Power grips, precision grips, release, dexterity and manipulation
What are the names of the power grasps? Give an example of each.
Power grasps typically engage D4–D5 with lots of ulnar deviation.
Plate PG: Hand relatively flat, DIP joints slightly flex towards an object (holding a plate)
Spherical PG: Palm is engaged to surround an object (picking up a ball)
Cylindrical: Min–max ulnar deviation, MCP, PIP, DIP flexion, wrist neutral or slightly extended. (Grabbing a carton of milk)
Hook PG: MCP neutral or slight flexion, PIP and DIP joints flexed. (carrying a grocery bag)
What are the names of the precision grasps? Give an example for each.
Two–point pinch (pad–pad): MCP and PIP slightly flexed, thumb abducted, DIP extended to bring finger and thumb pads together (coin into vending machine)
Two–point pinch (tip–tip)– brings the tip of the thumb and finger together. (picking up a small pin)
Lateral Pinch: slight ulnar deviation, thumb and D2 together, strongest precision grip. (Key pinch)
Tripod Grasp: Holding a pencil, involves thumb, palm, D2–D3.
Lumbrical grip: Holding the edges of a plate
Side–to–side grip: Weakest grip, like holding a cigarette
What is release dependent on?
Release is dependent on Lumbricals for IP extension, Dorsal interossei to abduct the fingers, Extensor digitorum muscles for MCPs to extend, Coordination of flexors and extensors of the hand and wrist.
What’s the difference between controlled and automatic release?
Controlled release is more focused and requires a lot more hand and wrist stability, for example when building a house of cards. Automatic release is less focused and typically follows an existing motor plan such as throwing a ball.
What are in hand manipulation skills?
Rotation: being able to change the orientation of an object (flipping a pencil around from the led side to the eraser)
Translation: being able to move an object from fingers to palm and vice versa. (rolling a pencil from palm to fingers and vice versa)
Shift: move the object between finger and thumbs opposed. (taking dice and moving it from thumb to D5 and vice versa)
What are the 3 types of bilateral hand activities?
Symmetrical: Both hands doing the same thing (clapping)
Differential: Both hands follow the same motor plan but are doing different things such as one stabilizing an object while the other does the main task. (Cutting vegetables)
Asymmetrical: There are 2 different motor plans, both hands are engaged in their own task that is not related to the other. An example would be one hand holding a purse while the other is holding a cell phone up to your ear.
What’s the difference between the dominant hand being affected vs. the non-dominant in regards to unilateral control?
The dominant hand has many strong unilateral and bilateral motor plans to choose from whereas the non-dominant hand has weak unilateral motor plans but can do bilateral symmetrical activities
Explain the purpose of the Minnesota Rate Test
Is a standardized assessment that assesses a person’s gross motor dexterity speed and accuracy, through repetitive reaching, picking up, manipulation, and placing. Can be done unilaterally or bilaterally involving a 3ft board with 60 red and black checkers.
Explain the purpose of the Perdu assessment?
A standardized assessment assessing the speed and accuracy with pinch, picking up, manipulating, and placing small objects in a localized place within 30 seconds
Explain the purpose of the Box and Blocks Test?
Standardized assessment that assesses gross motor dexterity, reaching, and unilateral dexterity. A client must transfer blocks from one side to the other for 1 minute for each hand where their fingers must cross the partition as quickly as they can.
What is the FDT test?
The functional dexterity test is used to assess hand manipulation skills as the client uses their injured dominant hand to turn pegs over in a zig-zag pattern within 16-25 seconds.
Why are standardized assessments used?
To improve the validity and reliability of outcomes.
What does the dynamometer measure?
The dynamometer measures a person’s grip strength. The client will be seated with their arm slightly adducted with slight internal rotation, elbow at 90 degrees, forearm in neutral, wrist 15-30 degrees, and 0-15 degrees of ulnar deviation. The client will perform the test three times and the clinician will calculate the average of the three trials.
What does the pinch gage measure?
Used to measure pinch strength (three-point, two-point pad-to-pad, lateral pinch) Client is seated in the same position as the dynamometer. 3 trials, average of the three.
What is D.A.S.H?
Disabilities of the Arm, Shoulder, and Hand. Since you cannot function properly with one without the other, clinicians came up with an assessment tool that has a series of questions
What is the BOT 2?
The Bot 2 is an assessment kit that can assess many areas of fine motor and gross motor skills for people ages 4-21. This kit has 8 subsets that include assessments of Fine manual control, manual coordination, body coordination, or strength and agility.
What are some hand therapy activities used in OT?
PROM, ROM, massage, building strength, applying resistance, AROM, AAROM, Dexterity, Fine motor function. Functional tasks such as dressing, writing, and eating.
What is the recovery pattern?
Trunk, reach, grasp, release, manipulate
(Gross motor into fine motor tasks)
What is needed for Fine Motor Coordination?
Range of Motion
Postural Control
Shoulder, scapular, elbow, wrist stabilization
Normal muscle tone
Sensation (Motor plan ability)
Coordination of Gross and Fine motor abilities
Finger Movement
How would you grade activities up or down?
Trunk stability: start pelvis and move distally
Reach: Start with scapular control, move into UE control
Grasp: Start with power and move towards precision
Release: Start with automatic, move into controlled non-precision release, move to controlled precision release
Where do you start when treating/assessing a client with fine motor deficits?
Proximal to Distal
