UE Function Flashcards
4 Components of UE function:
- Locate target
- reach
- grasp
- manipulate
(fine and gross motor)
Location of Target
- Coordinated eye and head movement important
- vision: info pertaining to distance of object
Reach
- role of arm
- postural control also important
- transportation: hand moves quickly to vicinity of object
Movements in Reach
- hand begins to open early in movement
- grasp aperature increases gradually throughout movement
- Trajectories are straight and smooth with bell-shaped velocity profiles
Grasp
- role of hand
- importance of vision
- final movement adjustments just before grasp
- many hand configurations possible
2 grip types
- Power: whole hand
- Precision: primarily pads of fingers/thumb
Manipulate
-fractionated movement: well coordinated movements of individual fingers, working independently of one another
Locating Target Problems
- Vision–central lesions, visual field deficits, visual neglect, visual extinction
- Eye-Head-Hand Coordination–cerebellar/vestibular disorders
Problems with reach
- timing problems (slow, less accurate, poor coordination)
- -Stroke: compensate with trunk movement
- -Cerebellar: slowed reaction and movement times
- -PD: slower reaching times
Decomposition
-moving one joint at a time
Reach Problems with Stroke
-Compensate with trunk movement
Reach problems with Cerebellar Lesions
- -slowed reaction and movement time
- -dysmetria
- -decomposition
- -Hypo/hypermetric
- -perform better with trunk support
Reach problems with PD
- slower reaching times
- fine motor control problems
- reduced ability to coord wrist and hand movement, perform movements involving the trunk
Sensation important for:
- adapting movements
- correcting errors
- ensuring accuracy of reach, especially in final phases
Sensory Impairments
- Optic Ataxia
- Poor somatosensation
Optic Ataxia
- inability to reach in space despite intact motor function, vision, somatosensation
- poor visual control of hand
Problems with Grasp: Stroke
- Slower and less accurate movements
- Poorly modulated fingertip forces (scaling)
- reduced ability to fractionate movement
Problems with Grasp: PD
- Slowed reach and grasp
- smaller max aperature
- Longer time to max aperature
- Increased variability in aperature and scaling
Problems with Manipulation and release: Stroke
- prob with fractionation affect manipulation
- Poor extensor muscle control/activity affect relsease
Problems with Manipulation and release: PD
-slower release especially when trying to move fast
Motor control problems with Stroke
- visual field deficits limit reach into space
- poor UE control–>compensatory trunk rotation
- synergistic movements leads to poor fractionation
- poor scaling of forces
Motor control problems with Cerebellar Dysfunction
- Problems with visual tracking
- poor inter-limb coordinatoin
Motor control problems with PD
-problems with speed and initiation of movement affects quick reach/grasp
Grasp Treatment
- start with power grip
- then precision (lateral pinch, 3 draw chuck, pincer grasp)
