Session 9

Question 1

• grip that places an object in contact with the palm and palmar surface of the digits
• gross thumb and finger flexion and extension are needed to grasp and release large objects
• sustained finger flexion while holding object against palmar surface
• palm contours to object via palmar arches

Answer 1

gross grasp

Question 2

what is the position of the wrist during gross grasp?

Answer 2

30 degrees extension with ulnar deviation

Question 3

• hand position that allows for finger and thumb opposition and manipulation of objects
• fine manipulation of objects
• dexterity (speed) when manipulating objects
• skillful placement of an object btwn fingers and thumb

Answer 3

prehension patterns

Question 4

prehension patterns involve ____ rather than ____ muscle action

Answer 4

intrinsic, extrinsic

Question 5

• opposition of the pad/pulp of thumb to side of D2 with slight thumb IP flexion.
• wrist in neutral flexion/extension position
• least precise form of prehension (disability and tenodesis)

Answer 5

lateral prehension (key pinch)

Question 6

• opposition of the pad/pulp of thumb to pad/pulp of fingers
• used in precision handling of objects
• pincer grasp (cheerios)

Answer 6

pad-to-pad prehension/palmar prehension

Question 7

which palmar arch is fixed?

Answer 7

proximal transverse arch

Question 8

which palmar arches are mobile?

Answer 8

distal transverse arch and longitudinal arch

Question 9

describe the functional position of the hand.

Answer 9

• wrist extension
• ulnar deviation
• moderate flexion of MCP and IP joints of the finger and thumb

Question 10

moving from a state of dysfunction to function

Answer 10

change process

Question 11

why is the change process so important in treatment and for documenting reimbursement?

Answer 11

delineates observable behaviors for documentation

Question 12

name 5 general PRC for treatment planning.

Answer 12

• set up treatment environment
• rationalize to pt. why you are doing something in terms they get.
• devise meaningful tasks based on pt. definition and not always your own.
• prioritize UIAs most affecting safety and functional task performance
• determine how above affects discharge planning

Question 13

___ ___ to promote proximal shoulder stabilization via weight-bearing activities.

Answer 13

joint approximation

Question 14

name 3 aspects of stabilization/joint approximation treatment principles.

Answer 14

• weight bear on affected UE in elbow extension and supported by the therapist or by another support surface
• approximation can be used to facilitate shoulder/scapular stabilizers and elbow extensors.
• sufficient shoulder stability required before dynamic distal movement in space against gravity (required for all ADL tasks).

Question 15

describe 5 aspects of “reach” treatment principles.

Answer 15

• address reaching once shoulder stabilization established.
• facilitate with active scapular protraction, shoulder, flexion, and elbow extension.
• initially, slide the UE (gravity minimized) along gravity eliminated plane.
• may then begin practice of higher-level skill of reaching (against gravity) into space to grasp object.
• once lead-up skills have been performed, may guide in use of these skills to perform reaching movements in self-feeding, hygiene, and dressing activities.

Question 16

describe 1 aspect of neuromuscular facilitation and inhibition techniques treatment principles.

Answer 16

reduce flexor spasticity in wrist and fingers; required for facilitation of grasp/release and prehension patterns.