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DPT 752 - Neurological Rehab I > Normal and Abnormal Reach, Grasp and Manipulation > Flashcards

Normal and Abnormal Reach, Grasp and Manipulation Flashcards

1
Q

Why is upper limb function important for ADLs?

A

Upper limb function is essential for fine motor skills needed for ADLs such as feeding, donning/doffing clothes.

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2
Q

What gross motor skills are related to upper limb function?

A

Gross motor skills such as crawling, walking, regaining balance, and protecting the body from injury during a fall.

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3
Q

Why is retraining upper extremity (UE) function important?

A

Due to the interrelation of UE control with both fine and gross motor skills, retraining UE function is crucial for PTs and OTs.

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4
Q

How do reach, grasp, and manipulation fit into the ICF framework?

A

They fit into the ICF under body structure and function (neuromusculoskeletal and movement-related functions), activities and participation (mobility, carrying, moving, and handling objects), and self-care.

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5
Q

What are the motor control principles involved in reach, grasp, and manipulation?

A

Control of reach, grasp, and manipulation requires both reflexive and voluntary movements and both feedback and feedforward processing.

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6
Q

What is the role of feedforward processing in motor control?

A

Feedforward processing uses vision to anticipate where to move the hand to catch a ball, activating biceps, triceps, and wrist muscles.

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7
Q

What is the role of feedback processing in motor control?

A

Feedback responses occur after the ball hits the hand, providing sensory information from the hand and eyes to compare planned and actual outputs.

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8
Q

What are the basic requirements of reach, grasp, and manipulation?

A

Visual regard, reaching, grasping, and manipulation.

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9
Q

What is visual regard?

A

Visual regard is locating the object in space and includes eye-head-trunk coordination.

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10
Q

What are smooth pursuits?

A

Smooth pursuits are following a slowly moving target with the eyes only.

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11
Q

What are saccades?

A

Saccades are rapid eye movements between two targets with the head stationary.

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12
Q

What is the Vestibulo-ocular Reflex (VOR)?

A

VOR is keeping an object visually stable while moving the head and body.

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13
Q

What is reaching?

A

Reaching is the transportation of the arm and hand in space, requiring postural support.

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14
Q

How do postural support demands vary in reaching?

A

Seated reaching requires less postural support than standing, which may require extensive activation of muscles in legs and trunk.

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15
Q

What is grasping?

A

Grasping is making contact with an object, including grip formation, grasp, and release.

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16
Q

What are the types of grips?

A

Power grip and precision grip.

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17
Q

What is a power grip?

A

A power grip involves finger and thumb pads directed toward the palm to transfer force to the object, using basic synergies of the arm.

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18
Q

What is a precision grip?

A

A precision grip involves forces directed between the fingers and thumb, allowing manipulation of the object relative to the hand and within the hand.

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19
Q

What is manipulation?

A

Manipulation is moving the object with grip-dependent dexterity and power.

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20
Q

What are musculoskeletal components contributing to reach, grasp, and manipulation?

A

Joint ROM, spinal flexibility, and postural support.

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21
Q

What are neural components contributing to reach, grasp, and manipulation?

A

Motor processes (coordination of eyes, head, and trunk), muscle strength, and coordination of reach and grasp phases.

22
Q

What are sensory processes contributing to reach, grasp, and manipulation?

A

Coordination of vestibular, visual, and somatosensory systems.

23
Q

What is the impact of abnormal reach, grasp, and manipulation?

A

It significantly impacts independence with ADLs and gross motor skills, contributing to increased healthcare costs.

24
Q

What are common problems with visual regard?

A

Eye movement problems (slow/inaccurate smooth pursuits or saccades), gaze stability problems, and visual field deficits.

25
Q

What are common problems with eye-head-hand coordination?

A

Coordination problems often seen with cerebral palsy, developmental coordination deficits, stroke, and cerebellar pathology.

26
Q

What are common problems with reach?

A

Sensory contributions (visual and somatosensory deficits), cognitive contributions (alertness, memory, attention), and motor contributions (timing problems, inter-joint coordination, abnormal synergies).

27
Q

What are common problems with grasp and manipulation?

A

Altered grip position, slower movements, less accuracy, altered forces, and problems with in-hand manipulation and release.

28
Q

How can target location problems be managed?

A

Training focus on eye movements while the head is stationary, progressing to gaze stability, and combining eye, head, and trunk movements.

29
Q

How can reach problems be managed?

A

Providing postural support, facilitating UE movement, using targets, and retraining task-dependent characteristics of reach.

30
Q

How can grasp and manipulation problems be managed?

A

Starting with simple grip patterns, progressing to more precision grips, using diverse objects in various positions, and working on release.

31
Q

What is Constraint-Induced Movement Therapy (CIMT)?

A

CIMT is a form of massed practice designed to improve function in patients with hemiplegia by constraining the less-affected limb.

32
Q

What are the benefits of CIMT?

A

Improved hand function, greater pinch strength, and less variability during precision grip tasks.

33
Q

What is bimanual training?

A

Bimanual training uses both upper extremities simultaneously to encourage interlimb coordination and is functional and recreational.

34
Q

What are smooth pursuits and their role in visual regard?

A

Smooth pursuits are following a slowly moving target with the eyes only, essential for visual regard.

35
Q

What is the significance of postural support in reaching?

A

Postural support is crucial for stabilizing the body while reaching, varying in demand based on the task.

36
Q

How does anticipatory shaping occur during reach?

A

Pre-shaping of the hand occurs during the transportation component of the reach, under visual control.

37
Q

What are the classifications of grasp patterns?

A

Grasp patterns are classified as power grips and precision grips.

38
Q

What are examples of power grips?

A

Hook grasp, spherical grasp, and cylindrical grasp.

39
Q

What is the role of tactile sensation in grasp?

A

Tactile sensation is important to adjust the forces during grasp.

40
Q

What are common motor contributions to reach problems?

A

Timing problems, over/undershooting the target, and inter-joint coordination issues.

41
Q

What are visual feedback deficits in reach?

A

Visual feedback deficits affect the accuracy of reaching movements.

42
Q

What are proprioception deficits in reach?

A

Proprioception deficits lead to less accurate reaching movements involving multiple joints.

43
Q

What is the impact of abnormal synergies on reach?

A

Abnormal synergies involve fixed patterns of movement, impacting reach accuracy.

44
Q

How can external trunk support improve reaching?

A

External trunk support can improve reaching kinematics for individuals with neurological pathology.

45
Q

What is the clinical implication of visual regard problems?

A

Lack of coordination of eye-head movements needed for visual regard may affect functional grasp.

46
Q

What are cognitive contributions to reach problems?

A

Cognitive contributions include difficulties with alertness, memory, attention, and dual tasking.

47
Q

What are common release problems in grasp?

A

Slower and less accurate/timely release of objects.

48
Q

How can visual modeling aid in reach training?

A

Visual modeling prior to active movement can improve proprioception and reaching accuracy.

49
Q

What is the importance of high repetition in grasp training?

A

High repetition helps in developing and refining grip patterns and manipulation skills.

50
Q

What is the role of CIMT in brain reorganization?

A

CIMT helps rewire the brain following neurological injury through intensive task-oriented training.

DPT 752 - Neurological Rehab I (22 decks)

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