Upper limb fx

Question 1

Fine motor Ax

Answer 1

Purdue pegboard

Jebson Taylor Hand Function Test (JHFT): more occupation-based
writing, simulated page-turning, lifting small objects, simulated feeding, stacking, and lifting large, lightweight, and heavy objects

Functional Dexterity Test: dexterity and in-hand manipulation skills

Question 2

UL assessment (stroke)

Answer 2

Functional Test of the Hemiparetic Upper Extremity (FTHUE):
-Stabilize a jar
-Simulate wringing a rag
-Blocks and Box
-Eat with a spoon
-Box on shelf
-Drink from glass
-Key turning
-Clip cloth peg

Question 3

UL assessment (Median nerve injury)

Answer 3

• Phalen’s test (wrist flexion 60sec max.)
• Tinel’s sign (tapping over transverse carpal ligament–> feel tingling –> nerve damage or irritation at that site)

Question 4

UL assessment (Ulnar nerve injury)

Answer 4

• Froment sign (ask the patient to keep a pincer grip position and hold a piece of paper in place)
  SSx: paper slip out / make an “OK” sign
  (due to injured adductor pollicis muscle)
• Tinel’s sign (tapping over transverse carpal ligament–> feel tingling –> nerve damage or irritation at that site)

Question 5

UL assessment (Tennis elbow)

Answer 5

Cozen’s Test
SSx: weakness/pain over lateral epicondyle of humerus

Question 6

UL assessment (De Quervain’s Tenosynovitis)

Answer 6

Finkelstein’s test:
flex thumb into palm of hand –> ulnar deviate the wrist

Question 7

Principle of UL treatment (fine motor dysfunction)

Answer 7

• Provide arm supports to increase proximal stability
• Fine motor remedial activity

Question 8

UL treatment (Tremor)

Answer 8

• Putting hands in position close to the body rather than handling at a distance
• Both hands grasp while propping the elbow on a sink or countertop
• Shoulder could be adducted and elbow flexed or the forearms supported on a table to provide arm support

Question 9

UL treatment (Ataxia)

Answer 9

• impaired coordination
• Encourage proximal stabilization for improved distal movements
• Modify tasks by promoting hand-over-hand techniques for fine motor tasks (e.g., using the unaffected extremity over the hand with tremor when dialing a phone

Question 10

UL treatment (Stroke)

Answer 10

Include the affected upper extremity in functional tasks to promote awareness and use
e.g. weight bearing, moving objects across a work surface, and reaching and manipulating objects