Hand Function Evaluation And Intervention Flashcards
Terminology of hand use what are they?
Visual Motor (eye hand coordination) Fine Motor Reach Grasp Carry Voluntary Release In-Hand Manipulation Biannual Skills
What Factors contribute to the development of hand function?
Cultural Influence (Poverty, Utensils, View of Play)
Somatosensory Function (hepatic perception)
Visual Perception and Cognition
Musculoskeletal
Cultural Influence How does it affect Developement of Hand function
Children learn to use tools by watching adults
Poverty- lack of objects to practice
Utensils - May not use
View of play - play may not be important
Somatosensory functions How does it affect Developement of Hand function
Hectic perception
Accurate use of fingers movement
Sustaining grasp
Somatosensory Limitations may cause?
Poor coordination
Problems with timing and speed of response
Clumsiness
Visual Perception and cognition How does it affect Developement of Hand function
Vision is important for learning new motor skills (arching and manipulating)
Attention to objects
Problems solving with objects
Musculoskeletal How does it affect Developement of Hand function
Joint, bone and muscle structure important
Hand Amomalis
Decreased ROM
And Musle power.
Development of Hand Skills what are they?
Reach and carry Grasp patterns In-hand manipulation skills Voluntary release Bimanual skills Throwing ball skills Tool use Hand preference
Reach and Carry 3 months
Bat at an object
Reach and Carry 4 months
Hand Regard
Reach and Carry 12 months
Optimal hand opening to reach and grasp an object
True or False. Carrying - requires smooth body movement and stabilization of object in the hand
Ture
Grasp Patterns Precision vs power ?
Precision - involves thumb opposition And small or medium objects
Power- Involves entire hand, medium or large objects
Grasp Pattern 1-3 months
Grasp reflex
Grasp Pattern 4 months
Voluntary grasp
Grasp Pattern 7 months
Raking
Grasp Pattern 9-12 months
Disk grasping
Cylindrical grasp
Spherical grasp
Grasp Pattern 4-5 years with strength increasing until 12 years old
Lateral pinch
Tripod pinch
What are types of In-Hand Manipulations?
Fingers to palm translation Palm to finger translation Shirt Simple rotation Complex rotation
What are the requirements for development of in-hand manipulation skills ?
Supination
Wrist extension with stability
Controlled dynamic thumb opposition
Finger tip pretension
Isolated thumb and radial finger movements
Stability with mobility of transverse MCP arch
Dissociation of side of hand
Voluntary Release requires what?
Precise coordination of fingertips forces and timing for predicting accurate object placement
Voluntary Release 5-6 months
Transfers object from one hand to the other smoothly
Voluntary Release 9 months
Release objects intentionally
Voluntary Release 7-13 months
Neat placement and release of objects of variety of size, weights and shapes.
Bimanual Skills infants move?
Arm/hand asymmetrically
Bimanual Skills 3 - 10 months
Symmetrical arm/hand movement. Allows hand to engage at midline
Bimanual Skills 9-10 months
Banged tow objects together
Bimanual Skills 10 months
Hold at object with one hand to explore it with the other
Bimanual Skills 17-18
One hand stabilizes object from the other to act on it
Bimanual Skills 30 months
Emerging differentiated use of arms/hands (cutting with scissors.
Ball throwing skills requires?
Shoulder strength and controls along with release skills
Ball Throwing Skills 2 years old ?
Can throw a ball foward and maintain balance
Ball Throwing Skills 3 years old
Projects ball towards target
Ball Throwing Skills 6 - 7 years
Throw a ball at target 12 feet.
Hand Preference infants ?
Should not demonstrate hand preference
Hand Preference 18-36 months old ?/
Show hand preference during activities that require two hands but not during simple grasp tasks
Relationship of Hand Skills to Children’s Occupations
ADL’s should be independent at the age of 8
Play
School Function
School Function 1st and 2nd
FM most of the day
School Function 3rd grade
30% of the day
School Function FM 30 % of the day used on
Paper pencil tasks, cutting, folding paper, manage food containers and organizing belonging
Evaluation of Hand skills in children should be in ?
The context of play, self-care and school occupations
What includes in full evaluation of hand function ?
Fine motor Visual motor Hand functions performance Postural alignment and stability GM Cognition Perceptual skills Sensory processing Social0emotional skills
What are assessment tools used during evaluation of hand skills in children ?
Goniometer Observation Muscle test Grip and pinch strength test Tactile test And standardized tools ; Peabody,BOT, Purdue Pegboard, VMI, DTVP
Bio mechanical and Neurodevelopment Approaches Focus on?
ROM Strength Endurance Postural alignment Joint stability Often used with children with and other neuromuscular diseases
Wha are the PRINCIPALS of BPM?
Optimal alignment
Optimal trunk control midline position
Feel stable moving against gravity
Relaxed tone
Strategies for BPM
Use various positions to enhance hand use
Neurodevelopmental therapy Goals are?
Inhibit spasticity
Facilitate normal tone
Guide normal movement patterns
Neurodevelopmental therapy Focus ?
Through sensory feedback children with Abnormal tone can learn how normal movement patterns feel and internalize them
Neurodevelopmental therapy Strategies?
Deep pressure
UE weight bearing
Hand line via key points of controle to encourage was and movement in different planes
True or False. Studies do not show that NDT improving functional outcome?
True
Occupational-Based Approaches emphasizes the relationship between?
Interactions of person, environment and occupation
What are consideration of occupation-based approaches ?
Child’s motivation
Context of performance
Child’s performance strength and limitations
What are the types of OBA/
Motor learning practice model
Pediatric constraint-induced movement therapy
Motor Learning Practice Model assist child in acquisition of ?
Motor skills through structured activities, practices of targeted skills and feedback using child’s interests
IN what population does MLP model work best on?
Those who follow directions, engage in repetitive practice and understand reinforcement
NOT GOOD FOR INFANTS
Motor Learning practice model Principes and techniques + research
Meaningful activities keep the child engaged, repetitive practice, reinforcement.
Research = Emerging and promising evidence that support the model
Pediatric Constraint-Induced Movement Therapy is a well researched and supports children with hemiparesis of ?
All ages May not help with dystopia may help with treating brachial plexus Older children work best Infant should be monitored closely
