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Neuro Science > UE Reaching > Flashcards

UE Reaching Flashcards

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1
Q

Eye-head-hand Coordination Series of Events

A

Typically…
Eyes reach target first
Then head
Then hand

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2
Q

Eye-head-hand Coordination

A

-entire reach is guided by vision
-need to “vaguely” know the target or object location in order to plan/execute reach direction and distance (peripheral vision)
-last part of the reach is vision dependent (foval vision)
“Foviate” your eyes on the object
Must know the object characteristics in order to successfully grasp the object

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3
Q

Eye-head-hand Coordination: Encourage…

A

Encourage our patients to find target with their eyes first in order to locate and facilitate an accurate reach

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4
Q

Smooth pursuit

A

Track a slow moving object smoothly
Can only be done to a certain speed -> saccades
CN 3, 4, and 6

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5
Q

Saccades

A
  • rapid eye movements

- Don’t process on what’s in between-just focusing on each vocation

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6
Q

Cerebellar trauma (or stroke) Issues

A
  • Gaze-evoked nstagmus
  • disrupted smooth pursuit
  • Ocular dysmetria when performing saccades
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7
Q

Gaze-evoked nystagmus

A
  • Slow nystagmus in same direction of the spin
  • Fast nystagmus in opposite direction of spin
  • **Caused by a quick saccade! Just looking at target, their eyes cannot focus
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8
Q

Disrupted Smooth Pursuit

A

Cannot keep tracking an object

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9
Q

Ocular Dysmetria when performing saccades

A
  • Dysmetric= poor measurements
  • Hypometric- falling short of object, undershooting
  • Hypermetric- falling past object, overshooting
  • Can’t pick up object until eyes target object
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10
Q

Dorsal pathway (superior) “spatial vision”

A
  • parietal lobe
  • processing of spatial relationships between you/objects
  • Have pt move objects around in space to work on the “spatial vision”
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11
Q

Ventral pathway (interior) “object vision”

A
  • temporal lobe

- processing physical qualities of an object

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12
Q

Transport

A
  • primarily the proximal joints moving the hand where it needs to be
  • Scapula, shoulder, elbow and forearm if within arm length reach (trunk stable)
  • if reach is beyond arm’s length include trunk:
  • Sitting: includes the trunk (trunk dynamic)
  • Standing: may include the trunk and LEs (e.g. hip or ankle strategy)
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13
Q

Reaching from the Sitting Position: Within Arm’s Length

A

Stable Trunk:

Facilitation of abdominal and lumber co-contraction for reach within arm’s length (to avoid falling)

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14
Q

Reaching from the Sitting Position: Beyond Arm’s Length

A

Dynamic trunk

  • Facilitate weight shift from centered to over ischial tuberosity, same side as reach (diagonal is lateral and anterior)
  • Facilitate Pelvic Tilt (posterior -> anterior) & Lumbar (flexion -> extension)
  • Facilitation of trunk lateral elongation (reach side) and contraction/lateral flexion (contralateral side)
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15
Q

Dynamic trunk reach

A

The more angular (on a diagonal) the reach, the more you observe the previous patterns. Plus encourage a “high” reach by placing an object.

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16
Q

Reaching from the Sitting Position: Scapula

A

-Scapular protraction (upward rotation/ER) (abduction, external rotation, elevation)-reach forward
-Scapular retraction (downward rotation/IR)
(adduction, internal rotation, depression) –come back

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17
Q

Reaching from the Standing Position: Within Arm’s Length

A

Trunk & body fairly stable:
Facilitation of abdominal and lumber co-contraction for reach within arm’s length…need to stabilize more for heavier objects

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18
Q

Reaching from the Standing Position: Beyond Arm’s Length [Trunk and Ankle]

A
  • Dynamic trunk and body & LEs
  • Facilitate weight shift to ipsilateral foot and trunk elongation
  • Ankle strategy – relative DF to weight shift (rocking)– just a little beyond’s arms length
19
Q

Reaching from the Standing Position: Beyond Arm’s Length [Hip]

A
  • Dynamic trunk and body & LEs
  • Facilitate trunk/hip flexion & relative ankle plantarflexion
  • COM of pelvis must shift posterior
  • COM of chest must shift anterior, elevate and lateral (ipsilateral)
20
Q

Reaching from the Standing Position: Beyond Arm’s Length [Stepping]

A

-Facilitate through pelvis to encourage step
(diagonal lateral and anterior shift)
-Facilitate through upper (chest) & lower trunk elongation

21
Q

UE Reaching: Scapula, Shoulder and Elbow

A

-Facilitate scapula protraction,
shoulder elevation and elbow extension
-you could say forearm is pronating and wrist moves into flexion

22
Q

Grasp

A
  • primarily the distal joints of the wrist and hand performing manipulation
  • Fine motor control
  • Some reference the forearm as part of transport and some state the forearm is part of manipulation or grasp
23
Q

Spatial Trajectory

A
  • Reaching is a multi-joint movement accomplished by a straight line trajectory
  • Essentially a straight line from start to target locations
24
Q

Spatial Trajectory: Force and Direction

A
  • had variability in trajectory and end point
  • Pt needs to accurately plan and execute the movement
  • Essentially straight spatial hand path or trajectory
  • Effector - index finger – reach and point
  • try to figure out if pt has problem with force OR direction and help you configure a strate
25
Q

Spatial Trajectory: Effector

A

can differ [what pt can get on target]
Pointing – tip of index finger
Grasp – tips of thumb and index fingers
Punch – knuckles

26
Q

Joints involved in Transport Changes with Movement Direction : Simple

A
  • relatively single joint movement

- “relatively a simple movement”

27
Q

Joints involved in Transport Changes with Movement Direction : Horizontal

A
  • relatively two-joint movement

- Horizontal adduction and elbow extension (opposite coming back)

28
Q

Joints involved in Transport Changes with Movement Direction : Straight line across page

A
  • joint reversal movement

- Horizontal adduction and elbow flexion then extends [joint reversal]

29
Q

Spatial Trajectory: Purpose

A

An individual must correctly plan and execute both the proper direction and distance of the trajectory

30
Q

Spatial Trajectory: Accuracy

A

-Direction versus Distance (force) Error
-distance error > direction error
[Distance = force]
[Direction = multi-joint]
-increased both types of error with distance
-This is done on a moradum, where the elbow and shoulder are free to move BUT the motion is restricted to a 2D movement

31
Q

Constant error (CE)

A

distance from the mean end point location to the center of the target

32
Q

Variable error (VE)

A
  • a measure of error dispersion
  • one standard deviation in the X & Y directions
  • “The Scatter” of the 6 dots
  • How variable are they in their reaches/end point
33
Q

Speed-Accuracy Tradeoff

A
  • Increase movement speed, decrease accuracy

- Decrease movement speed, increase accuracy

34
Q

Fitt’s Law

A

MT = a + b log2 (2A/W)

A = amplitude (distance start to target)
–As A increases, MT will increase bc it takes more time to each the target [directly related]

W = width of target
–as W decreases, the MT increases to hit target [inversely proportioned]

MT=movement time (varies with distance of A and with W)

35
Q

Transport: Clearance

A
  • Movements around obstacle
  • Forces curvilinear trajectories
  • Minimum clearance – closest approach to obstacle
  • Move fast over obstacle, increase minimum clearance
  • Move slow over obstacle, decreases minimum clearance
36
Q

Hand Grasp

A
  • Spatial hand path or trajectory
  • Maximum aperture – 60-80% of reach distance or time
  • Maximum aperture is relative to object width
  • pre-shaping as reach
  • finalize shape at end of reach
37
Q

Maximum Aperture

A
  • Width of fingers spread apart
  • Maximum aperture is 2.5 – 3 times larger than object width
  • Finger start to match shape of object at end of reach trajectory
  • When they “mold” around the object as you touch the object
38
Q

Grip Force

A
  • Must match grip force to object weight (grip to load ratio)
  • Must match grip force to texture of object (grip to texture ratio)
39
Q

In-hand Manipulation

A
  • Translation - move object to fingers, to palm and back
  • Shifting - moving a “pen” closer and further from tip
  • Rotation - rotating and stabilizing an object
40
Q

Clinical Application: Grasp

A 
Vary:
size and shape of object
weight and texture of object
orientation of object
use of object
“slipperiness”
fragility of object
vary functional use 
stationary versus moving objects/person (taxonomy)
41
Q

Interlimb Timing Constraints and Phase Characteristics

A

The two hands are temporally and spatial linked
-Ex 1: finger abduction-adduction
-Ex 2: tap two hands at different rates
-example three: spatial/timing constraints
Draw simultaneously

42
Q

In Clients post-CVA or TBI…

A
  • use non-involved UE to impose temporal and spatial constraints upon involved UE
  • Perform bi-manual movements (rolling pin, etc.), mirrored movements, & reciprocal movements
  • This will train both the movement pattern (muscles sequencing) and timing
43
Q

Take Home Message: UE Reaching

A
  • Do not use a haphazard approach when setting up tasks for your patient(s) to perform
  • Methodically plan to expose your clients to a wide variety of functional tasks in multiple environments

Neuro Science (6 decks)

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