Normal and Abnormal Reach, Grasp and Manipulation Flashcards
Why is upper limb function important for ADLs?
Upper limb function is essential for fine motor skills needed for ADLs such as feeding, donning/doffing clothes.
What gross motor skills are related to upper limb function?
Gross motor skills such as crawling, walking, regaining balance, and protecting the body from injury during a fall.
Why is retraining upper extremity (UE) function important?
Due to the interrelation of UE control with both fine and gross motor skills, retraining UE function is crucial for PTs and OTs.
How do reach, grasp, and manipulation fit into the ICF framework?
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.
What are the motor control principles involved in reach, grasp, and manipulation?
Control of reach, grasp, and manipulation requires both reflexive and voluntary movements and both feedback and feedforward processing.
What is the role of feedforward processing in motor control?
Feedforward processing uses vision to anticipate where to move the hand to catch a ball, activating biceps, triceps, and wrist muscles.
What is the role of feedback processing in motor control?
Feedback responses occur after the ball hits the hand, providing sensory information from the hand and eyes to compare planned and actual outputs.
What are the basic requirements of reach, grasp, and manipulation?
Visual regard, reaching, grasping, and manipulation.
What is visual regard?
Visual regard is locating the object in space and includes eye-head-trunk coordination.
What are smooth pursuits?
Smooth pursuits are following a slowly moving target with the eyes only.
What are saccades?
Saccades are rapid eye movements between two targets with the head stationary.
What is the Vestibulo-ocular Reflex (VOR)?
VOR is keeping an object visually stable while moving the head and body.
What is reaching?
Reaching is the transportation of the arm and hand in space, requiring postural support.
How do postural support demands vary in reaching?
Seated reaching requires less postural support than standing, which may require extensive activation of muscles in legs and trunk.
What is grasping?
Grasping is making contact with an object, including grip formation, grasp, and release.
What are the types of grips?
Power grip and precision grip.
What is a power grip?
A power grip involves finger and thumb pads directed toward the palm to transfer force to the object, using basic synergies of the arm.
What is a precision grip?
A precision grip involves forces directed between the fingers and thumb, allowing manipulation of the object relative to the hand and within the hand.
What is manipulation?
Manipulation is moving the object with grip-dependent dexterity and power.
What are musculoskeletal components contributing to reach, grasp, and manipulation?
Joint ROM, spinal flexibility, and postural support.
What are neural components contributing to reach, grasp, and manipulation?
Motor processes (coordination of eyes, head, and trunk), muscle strength, and coordination of reach and grasp phases.
What are sensory processes contributing to reach, grasp, and manipulation?
Coordination of vestibular, visual, and somatosensory systems.
What is the impact of abnormal reach, grasp, and manipulation?
It significantly impacts independence with ADLs and gross motor skills, contributing to increased healthcare costs.
What are common problems with visual regard?
Eye movement problems (slow/inaccurate smooth pursuits or saccades), gaze stability problems, and visual field deficits.
What are common problems with eye-head-hand coordination?
Coordination problems often seen with cerebral palsy, developmental coordination deficits, stroke, and cerebellar pathology.
What are common problems with reach?
Sensory contributions (visual and somatosensory deficits), cognitive contributions (alertness, memory, attention), and motor contributions (timing problems, inter-joint coordination, abnormal synergies).
What are common problems with grasp and manipulation?
Altered grip position, slower movements, less accuracy, altered forces, and problems with in-hand manipulation and release.
How can target location problems be managed?
Training focus on eye movements while the head is stationary, progressing to gaze stability, and combining eye, head, and trunk movements.
How can reach problems be managed?
Providing postural support, facilitating UE movement, using targets, and retraining task-dependent characteristics of reach.
How can grasp and manipulation problems be managed?
Starting with simple grip patterns, progressing to more precision grips, using diverse objects in various positions, and working on release.
What is Constraint-Induced Movement Therapy (CIMT)?
CIMT is a form of massed practice designed to improve function in patients with hemiplegia by constraining the less-affected limb.
What are the benefits of CIMT?
Improved hand function, greater pinch strength, and less variability during precision grip tasks.
What is bimanual training?
Bimanual training uses both upper extremities simultaneously to encourage interlimb coordination and is functional and recreational.
What are smooth pursuits and their role in visual regard?
Smooth pursuits are following a slowly moving target with the eyes only, essential for visual regard.
What is the significance of postural support in reaching?
Postural support is crucial for stabilizing the body while reaching, varying in demand based on the task.
How does anticipatory shaping occur during reach?
Pre-shaping of the hand occurs during the transportation component of the reach, under visual control.
What are the classifications of grasp patterns?
Grasp patterns are classified as power grips and precision grips.
What are examples of power grips?
Hook grasp, spherical grasp, and cylindrical grasp.
What is the role of tactile sensation in grasp?
Tactile sensation is important to adjust the forces during grasp.
What are common motor contributions to reach problems?
Timing problems, over/undershooting the target, and inter-joint coordination issues.
What are visual feedback deficits in reach?
Visual feedback deficits affect the accuracy of reaching movements.
What are proprioception deficits in reach?
Proprioception deficits lead to less accurate reaching movements involving multiple joints.
What is the impact of abnormal synergies on reach?
Abnormal synergies involve fixed patterns of movement, impacting reach accuracy.
How can external trunk support improve reaching?
External trunk support can improve reaching kinematics for individuals with neurological pathology.
What is the clinical implication of visual regard problems?
Lack of coordination of eye-head movements needed for visual regard may affect functional grasp.
What are cognitive contributions to reach problems?
Cognitive contributions include difficulties with alertness, memory, attention, and dual tasking.
What are common release problems in grasp?
Slower and less accurate/timely release of objects.
How can visual modeling aid in reach training?
Visual modeling prior to active movement can improve proprioception and reaching accuracy.
What is the importance of high repetition in grasp training?
High repetition helps in developing and refining grip patterns and manipulation skills.
What is the role of CIMT in brain reorganization?
CIMT helps rewire the brain following neurological injury through intensive task-oriented training.
