lecture 13: prehension and word Flashcards
what is keinbocks disease
avascular necrosis of the lunate
what is the definition of prehension
prehension is the ability of the fingers and thumb to grasp and pick up objects
what are the elements of prehension (5)
area of contact with hand
number of fingers involved
finger position
thumb position
wrist position
what are the 2 types of prehension
grip
pinch
what are the types of grip (5)
power grip
precision grip
hook grip
cylindrical grip
lumbrical grip
what are the types of pinch (3)
key pinch
tip pinch
3 point (palmar pinch)
stability and large force is associated with what grip
power grip
what is the wrist position in power grip
wrist extension and ulnar deviation
why is power grip associated with wrist extension and ulnar deviation
the flexion force is inferior because of active insufficiency
=the muscle tendinous unit crosses more than 1 joint therefore the long flexors are going to be in a flexed position (and not adequate muscle length )
describe the finger position in power grip
MP PIP and DIP in flexion
true or false: true power grip the wrist and fingers are in flexion
false only the fingers are but hthe wrist is in extension
what is the position of the thumb in power grip
thumb in abduction (around object)
give some examples of power grip activities
bat, stick, tennis, racket, hammer screwdriver
be able to recognize power grip
ex: holding a bat
delicate control is associated with what grip
precision grip
explain finger position of thumb and fingers in precision grip
thumb partially abductied and fingers partially flexed
true or false: in the precision grip, the fingers are fully flexed
false, partially
is the fore constant or variable in precision grip
variable
when does the grip get modified in precision grip
grip modified depending on object in hand
give examples of precision grip
hold a ball or egg with finger/thumb tips
finger grasp is associated with what grip
hook grip
explain the position of the fingers in hook grip
flexion of PIP and DIP joints (with MCP extension)
true or false: thumb does not contribute to grip in hook grip
true
what finger does not contribute to hook grip
thumb
give example of hook grip
holding a briefcase or purse
rock climbing
what grip is associated with graping a large cylinder
cylindrical grip
true or false: in cylindrical grip, the thumb touches fingers
false
thumb does not touch fingers
what is the position of thumbs in cylindrical grip
thumb does not touch fingers
thumb abduction and opposition
what is the finger position in cylindrical grip
finger flexion arounnd object
give example of cylindrical grip
holding a glass or water bottle
holding a glass or water bottle is an example of what grip
cylindrical grip
holding a briefcase ro purse, rock climbing is an example of what crip
hook grip
holdinga. ball or egg with finger/thumbs is an example of what grip
precision grip
holding a bat, racket or hammer is an example of what grip
power grip
there is greater contact with object in precision or cylindrical grip
cylindrical
what is the positions of the fingers in lumbrical grip
flexion of MPS
PIP and DIP extension
flexion of thumb MP with IP in extension
true or false: in lumbrical grip, there is extension of MPs and flexion of PIP and DIP
false, opposite
what is the position of the thumb in lumbrical grip
flexion of MP with IP in extension
give an example of lumbrical grip
pulling a car from deck
pulling a car from deck is an example of what grip
lumbrical grip
precision is associated with what grip
tip pinch
explain the finger position in tip pinch
opposition to fingertip
thumb MP and IP in slight flexion
finger flexed
give an example of tip pinch
holding a needle
true or false: in tip pinch, the thumb MP and IP are in slight flexion
true
key pinch is associated with what pinch
lateral pinch
explain thumb and finger position in lateral pinch
thumb adducted and index finger flexed
what muscle is mostly used in lateral pinch
adductor
what would happen if adductor is weak (with weak ulnar n) in lateral pinch
to compensate they would flex with flexor pollicus longus
what pinch is associated with pads of fingers-thumb
palmar pinch
explain the thumb and finger position in palmar pinch
thumb in opposition with IP in extension
finger DIP in extension
explain the thumb position in palmar pimch
thumb in opposition with IP in extension
explain the finger position in palmar pinch
finger DIP in extension
give examples of activities that use palmar pinch
turning scrwer/knob to adjust smt
turning scrwer/knob to adjust smt is associated with what grip
palmar pinch
to measure power grip
power grip is measured through dynamometer
how to measure lateral, palmar or tip pinch
pinch meter
a pinch meter can measure what grips
lateral, palmar or tip pinch
what is the most common pinch pattern
palmar pinch
in picking up and holding an object, what is the most common pinch pattern
palmar pinch
in picking up an object, what percentage of the test is done by palmar pinch
50
in holding an object, what percentage of the test is done by palmar pinch
88
study in functional prehension and autonomy looked at what the relative importance of prehension patterns wrt hand function and autonomy and found 3 most relevant, what were they
pad to pad pinch (both hands)
lumbrocal grasp (left hand)
cylindrical graps (right hand)
study in functional prehension and autonomy looked at what the relative importance of prehension patterns wrt hand function and autonomy, pad to pad pinch was associate with what hand
both hands
study in functional prehension and autonomy looked at what the relative importance of prehension patterns wrt hand function and autonomy, lumbrical grasp is associated with what hand
left hand
study in functional prehension and autonomy looked at what the relative importance of prehension patterns wrt hand function and autonomy, cylindrical grasp was associate with what hand
right hand
why was lumbrical grasp more common in left hand
used right hand for finger movements
claw hand is associated with what palsy
ulnar nerve palsy
what is the position of hands in ulnar n palsy
MP hyperextension
PIP and DIP flexion
true or false, in claw hand, MP PIP and DIP are all in flexion
false, MP is in hyperextension
explain what happens to grip with claw hand position
contact surface is greatly reduced is there is decreased hand grip force
wrist level median n injury results in inability to do what
oppose thumb
what compensatory movement is done if you have median nerve palsy
compensatory movement with thumb adductor
to do a normal okay sign, what is the position of thumb
thumb abduction and opposition
how can a pt compensate to do the ok sign with median n palsy
client will compensate and rely on adductor (ulnar)
in work analysis, what is the biomechanimal frame of reference
evaluation of the tasks, duties of the workplace and tools and working conditions necessary to perform the job in a satisfactory manner
explain the professional roles of OT, PT and kinesiology and ergonomists for work analysis
may assess the physical demands of a clients job, help to reintegrate a client back to work and suggest modification of equipment/methids used at work (ex: modify office chair)
explain the professional roles of biomechanics researchers for work analysis
can perform experiments in a more controlled lab setting with more sophisticated equipment.
Results can then be applied to work setting (ex: spine loads during lifting)
explain the professional roles of governmental agencies/epidemilogist for work analysis
identify and study risk factors, incidence, prevention methods as well as providing work related regulations and norms
ex: CNESST, IRSST (canadian centre for occupational health and safety
work related musculoskeletal disorders risk factors are a function of what 2 things
exposure to risk factors vs workers capacity (physical, mental, anthropometrics)
give an example of how psychological factors can be a risk factor for work related muscle disorders
increased pressure due to increasing demands
ex: increased isolation after covid
give an example of how work organization and technological can impact work related musculosketlated disorders
may be at risk of working in home (bad ergonomics)
assembly lines
what are some examples of worksite evaluation methods (4)
kinematic assessment
questionnaries
force evalutiation
surface EMG
explain kinematic assessment as a worksite evaluation
task analysis from interview and observation, range of motion
video analysis
give an example of a worksite evaluation method in terms of questionnarie
occupation self assessment
give an example of force evaluation as a worksite evaluation method
chatillon dynamometer (force needed to push/pull/lift)
what are the 5 variables assessed in the “revised strain index”
intensity of exercution
frequency of exertion
duration per extertion
hand/wrist position
duration of the task per day
what is a Dartfish
movement analysis software using important video images to look at ROM
protocols for utilization recommended to optimize reliability and interpretability
what are the 3 biomechanimcal risk factors
posture
movement and repetition
force
explain extreme posture
flexed, extended or twisting posture rather than neutral position
give an example of extreme posture
overhead work
what is the US department of labor definition of extreme posture
task carried out with joint at 90-100% of ROM amplitude
what is prolonged static posture
muscles do no t relax, posture help for greater than 1 min
true or false: extreme position can only be in flexed or extended positions
false, also twisting
how long is prolonged static posture need to be held for
greater than 1 min
what is an example of prolonged static posture
seat with no arm rests
the amount of time working with arms in elevation about 90 degrees is associated with what
shoulder and neck pain
the amount of time working with arms in elevation about BLANK degrees is associated with shoulder and neck pain
90 degrees
number of months with arms in elevation above 90 degrees associated with what
alterations in supraspinatus tendon
number of months with arms in elevation above BLACK degrees associated with supraspinatus tendon
90
what are the two types of movements in movement and repetition category
extreme movements
repetitive movements
explain extreme movements and give example
work fast carried out with extreme movement
ex: reaching on an assembly line
ex: twisting neck to look at computer
explain repetitive movements and give example
number of cycles of the work carried out in the same day and cadence must be considered
what industry is bad for repetive
food industry
according to the dictionary of occupational titles, what does repetitive mean
greater than 2/3 of work dat
according to the dictionary of occupational titles, what does frequent mean
1/3-2/3 of work day
according to the dictionary of occupational titles, what does occasional mean
1/3 or less of work day
true or false: occasional work is defined as taking up 1/3 to 2/3 of work day
false, 1/3 or less
what is force (biomechanics work analysis)
exertion required to carry out the task
true or false: if the task is repetitive, a small increase in the required course may cause physical symptoms
true
give an example of how if the task is repetitive, a small increase in the required course may cause physical symptoms
stiffer keyboard for data entry operators can increase insertion
what can determine a workers risk for injury
the combination of required force and number of muscle contractions can determine workers risk for injury
the combination of required force and BLANK can determine workers risk for injury
number of muscle contractions
when is worker at risk for low back pain in terms of lifting
if there is imbalance between their actual lifting strength and the lifting requirements of the job
in terms of exposure and risk graph, what is the lowest (green level)
1 factor and less frequent
(repetition, or force, or posture)
in terms of exposure and risk graph, what is the mid (yellow level)
2 factors and moderate frequency
(repetition and force or posture)
in terms of exposure and risk graph, what is the highest (red level)
3 factors and frequent exposure
what are the mechanical risk factors
tool use
local pressure
impact vibration
true or false, tools can be used for tests they’re not necessarily made form
false, according to the general principles, the tools should effectively perform the intended function
what is important in terms of the size of tool use and body of user
appropriate portion to body size
(ex: small hand gripping large pliers is bad)
what are the 4 general principles for tool use
1) tools should effectively perform the intended function
2) appropriate proportion to body size
3) appropriate for strength and capacity of worer
4) design should minimize fatigue `
what are some hand tool considerations
handle she, handle length, handle diapers, texture, grip span, right or left hand, glove use, vibration
what is the problem with the current plier shape if its too big
can develop dequervains tendonitis
what are some risk factors for dental hygienist
hunched over
neck flexion (extreme posture)
might have to increase holding force to hold
receptive vibration
what is local pressure
sustained pressure or friction during work task
give an example of local pressure
manual therapy techniques and therapists
give 2 examples of the supporting evidence for effect of pressure
wagon and ada: evaluated 155 physiotherapists who perform spinal manual techniques and 83% complained of thumb pain
crime et al: lifetime prevalence of work related musculoskeletal disorders was 91% in a sample of 824 physios
in wagon and ada: evaluated 155 physiotherapists who perform spinal manual techniques what percentage complained of thumb pain
and 83% complained of thumb pain
what are the 7 evidence based interventions
1) modify work station componets
2) modification of work method
3) exercise programs
4) education program
5) work hardening
6) modification of work wear
7) reduce exposure
give examples of modifying work station components
ex: hand tools, keyboard design, assistive devices
give examples of modification of work method
mini breaks, lower weight loads, alternating sitting and standing posture, set up with lean principles
give example of education programs
back posture during lifting
give examples of work hardening programs after injury
task simulation and duration of workday
give example of modification of work wear
shock absorbing insoles
how many hours per day does the average canadian undergrad student spend sitting
12
what can help reduce disc pressure during sitting
use of lumbar support, inclining back rest and arm rests
when is EMG activity reduced during sitting
when back rest inclination is closer to seat
when back rest inclination is closer to seat, is EMG activity reduced or icnreased
reduced
what is the ideal posture for sitting
feet flat (or on stool)
knees 90
buttock to back of seat (back rest)
elbow 90 and supported
head straight
in the study of impact of office chair features, what improved seated posture
seat pan tilt and lumbar support
in the study of impact of office chair features, what improved seated posture, sitting uses what
near end range of flexion of the spine
in the study by madras evaluating the low back biomectrics of 3 different worstations (seated, stnading and perched), what was the conclusion
perching method beneficial since moderate support and moderate mvement
helped to reduce spinal load and discomfort
true or false: there is a 16% reducion in disc pressure when arms are comfortably supported
true
does arms being supported affect disc pressure
yes
there is a 16% reducion in disc pressure when arms are comfortably supported
what can cause lower EMG activity during sitting
if arm and wrists are supported
when is there an increased keystroke ability
when wrists are supported
in the study of hand rest and wrist support during typing by CAllegari, what was the results of EDC and biceps
EDC fatigue after one hour of type
biceps fatigue reduced by use of wrist support with keyboard (EMG)
how far should the screen be
should be face to face, approx 60-70 cm from worker (arm length)
where should eyes be in terms of screen
top of screen eye level
what is the ideal angle of keyboard
0-25 degrees
what facilitated typing performancy
dished (indented) keys with light resistance facilitated typing performance
keyboards leads to risk of waht
excessive pronation and ulnar deviation
what percentage of computers users requrie a mouse
33-66
what percent of mouse users keep their fingers in extension
48
what is a factor for discomfort in terms fo the mouse
mouse placement far from keyboard risk
mouse is potential for repetitive BLANK deviation
WRIST
true or false and explain: cellphones have no effect on ergonomcis
false, a study found that 84% reported pain in at least one body part and right hand pain was most comon at the base of the thumb
s=
