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PT 632 Motor Control > Skill Acquisition - Reach, Grasp, Manipulation > Flashcards

Skill Acquisition - Reach, Grasp, Manipulation Flashcards

1
Q

process of learning to reach is one of

A

discovery

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2
Q

initial movement patterns for reaching are often

A

very unpredictable (flapping, uncontrolled bursts of movement) –> before becoming task specific

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3
Q

adult-like pattern of reaching does not evolved before ____ and may not be refined until ____

A
  • 2 y/o
  • 8-12 y/o
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4
Q

what are the two phases of reaching

A

Transport phase and grasp phase

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5
Q

occurs in the beginning of reach - brings hand toward target; visually trigged; controlled by proximal shoulder mm; present at birth

A

transport phase of reaching

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6
Q

last part of reach; directed by distal mm; position of arm is visually guided and defined

A

grasp phase

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7
Q

during grasp phase of reaching, the position of the arm is visually guided and defined but this does not develop until when and when does skill development peak

A
  • develop after 4th mo
  • peaks around 7 mo
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8
Q

at what age can we make movements without visual feedback

A

4-6 y/o

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9
Q

neural pathways controlling gross arm movements and those controlling fine movements of the hand and fingers develop

A

at different rates

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10
Q

_____ controlled by the brainstem develops earlier than _____ control mediated by the cortex

A

arm control
hand-finger control

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11
Q

anticipatory control of grip and lift forces begins to develop around when and matures around

A
  • 1-4 y/o
  • 11 y/o
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12
Q

at what age can children begin to show pre-reaching behaviors

A

1 week old

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13
Q

describe the first reaching attempts in infancy

A
  • both hands
  • symmetrical
  • meeting at midline to reach
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14
Q

at what age is an infant able to flex fingers as elbow and arm extend and head-arm movements become strongly coupled so that reaching is very segment-bound (non-fluid and accidental)

A

2 mo

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15
Q

when does head and trunk control develop –> essential for further development of reaching

A

2-4 months

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16
Q

the ability to what helps drive controlled reaching

A

locate objects, fix and shift gaze

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17
Q

_____ develops before smooth pursuit –> occurs in neonate

A

saccadic movements

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18
Q

the ability to disengage attention and examine new objects will occur at what age

A

about 4 mo

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19
Q

smooth pursuit is poorly developed when and begins to improve by

A
  • develops 1 mo
  • improves quickly by 6 weeks
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20
Q

eye-head coordination begins to develop when and is dependent on object size

A

2-5 mo

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21
Q

when does the coupling of head-arm movements allow for successful visually guided reaching

A

4 months

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22
Q

beyond 4 months, reaching becomes refined with what occurring

A

path straightening

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23
Q

arm trajectory moves from what to what as the child ages

A

rounded to linear (also seen in adults with neurological pathology)

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24
Q

describe how a child reaches in sitting

A
  • uses 1 hand to reach for toy
  • other hand used to support balance
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25
Q

when does mature reaching in sitting emerge

A

around 10 months

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26
Q

when does anticipatory control develop in sitting and describe

A

around 10 months - able to activate trunk mm BEFORE initiating reach

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27
Q

what is the initial type of grasp

A

palmar grasp reflex/reflexive palmar grasp
- involuntary

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28
Q

can voluntarily grasp and release appropriately sized objects but with poor control

A

4 months

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29
Q

at 4 mo, kids use what grasp to rake small objects into hand

A

ulnar palmar grasp – do NOT use thumb
(medial to lateral development principle)

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30
Q

can transfer objects from hand to hand, hold a bottle with 2 hands (bimanual)

A

4-5 months

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31
Q

type of grasp used up to 6 months but may be inconsistent

A

hand babbling

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32
Q

age of voluntary palmar grasp

A

6 months

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33
Q

age of radial palmar grasp

A

7 months

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34
Q

age of inconsistent controlled release

A

7-9 months

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35
Q

describe voluntary palmar grasp

A

do not use thumb, only use other 4 fingers

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36
Q

describe radial palmar grasp

A

thumb adduction

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37
Q

age at which radial distal grasp develops

A

9 months

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38
Q

beginning use of opposition of thumb

A

radial distal grasp

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39
Q

age inferior pincer grasp develops

A

9-12 months

40
Q

able to pick up small items using lateral index finger and thumb (pinch)

A

inferior pincer grasp

41
Q

age superior pincer grasp develops

A

12 months

42
Q

thumb and index finger are tip to tip

A

superior pincer grasp

43
Q

age 3-jaw chuck grasp

A

12 months

44
Q

distal pads of thumb with index and middle fingers; difficulty orienting spoon for feeding

A

three jaw chuck grasp

45
Q

age controlled release a small container without support develops

A

12 months

46
Q

age controlled release of a small pellet into a bottle develops

A

15 months

47
Q

around what age do kids begin to understand how to use objects such as spoon to hand and hand to mouth

A

~ 1 yr

48
Q

at what age do kids understand that certain objects go together (stacking blocks, items into a box)

A

13-21 months

49
Q

when does palmar supinated grasp develop

A

13-18 months

50
Q

imitation of scribbling with a large crayon with fisted hand, flexed and slightly supinated wrist

A

palmar supinated grasp

51
Q

when does digital pronate grasp develop

A

24-36 months

52
Q

can hold pencil or crayon with all fingers and straight pronated wrist

A

distal pronate grasp

53
Q

when does the development of tripod grasp of pencil develop (draws squares, triangles, begins writing, tying shoes)

A

4-6 years old

54
Q

all grasping patterns mature when

A

2nd year of life

55
Q

reaction times become ____ as children mature

A

faster (important for bouncing, catching, throwing activities

56
Q

______ depends on accuracy and distance requirements of the task

A

Movement time (Fitts’ law)

57
Q

reaction times develop most sharply by what age with continued but slower development until

A

8-9 y/o
16-17 y/o

58
Q

what is power grip and what are the different types

A

using the palm and palmar surfaces of the fingers with the reinforcement of the thumb

59
Q

what is precision grip and what are the different types

A
  • between terminal pads of the fingers and the thumb; requires independent movement of individual fingers
  • pad to pad, tip to tip, key, 3-jaw chuck
60
Q

decreased reaching, grasp, and manipulation associated with aging can be improved how and how long can it be transferrable to other UE tasks

A
  • improved with training
  • 1 month
61
Q

learning without consciously knowing (riding a bike)

A

implicit learning

62
Q

active or intentional learning (declarative knowledge - facts or figures is explicit learning) focused task with specific goal

A

explicit learning

63
Q

percent of reduction in velocity due to aging

A

30-90%

64
Q

what does time related changing in UE function depend on in aging

A

age, complexity of task

65
Q

slowing of UE reaction times most often occurs due to what - time it takes to make decision about next part in the movement sequence slows down

A

slowing of central processing

66
Q

coordination related changes with aging

A
  • decreased hand steadiness with reaching
  • little change in accuracy
  • need more time to monitor responses to initial movement and to process other simultaneously occurring tasks
67
Q

grasping changes related to age

A
  • decreased manual dexterity
  • diminished tactile sensation (unaware of how strongly they are holding objects)
  • takes older adults longer to adapt to final grasp force to changes in objects weight, slippery vs non-slippery (decreased reduction in skin-to-object friction properties)
68
Q

what neurological conditions affect UE Function

A
  • stroke/TBI: U/L plegia, paresis, dyscoordination
  • MS, PD, cerebellar disease: motor ataxia, resting/intention tremor, bimanual coordination dysfunction
  • SC injury: quadriplegia
  • Brachial plexus injury: klumpke’s/Erbs palsy, traction injuries
69
Q

what MSK conditional can affect UE function

A
  • RA/OA
  • tendinous injuries, Dupuytrens contracture, DeQuervains tenosynovitis
  • repetitive motion injuries: RTC, carpal tunnel
  • adhesive capsulitis
70
Q

effects neurological injury can have on reaching, grasping and manipulation

A
  • difficulty locating target and maintaining gaze prior to reaching –> occulomotor, vestibular, and cerebellar injuries
  • impaired coordination, timing, trajectory of movements
  • delayed movement times
  • sensory impairments
  • loss of hemispherically governed patterns of movement
71
Q

what is the test OT’s use to assess UE function

A

Wolf Motor Function Test

72
Q

task-oriented approach to examination of a pt with UE dysfunction

A
  • subjective interview focusing on impact of UE functional loss on social role
  • impact on self-care, work, leisure activities
  • current sx
  • what is family or cultural values impact task performance
  • pt primary concerns
73
Q

examination begins with what

A

observation

74
Q

what are some examples of functional scales that can be used to objectively measure impact of impairments

A
  • barthel, FIM: measures low level UE skills - basic ADL
  • Assessment of motor and processing skills: measures higher level UE skills - IADLs (phone, shopping, preparing meals, housework)
  • Motor Activity Log: developed to determine amount and quality of hemiparetic UE activity following stroke
  • Pediatric Scales: weefim, school functional assessment, manual abilities classification scheme (CP)
  • Jebsen-Taylor hand function test: stimulates hand functions associated with everyday ADLs
75
Q

what are other elements that can be assessed during UE examination

A
  • handwriting
  • eye-head or eye-head-hand coordination
  • reach and grasp
  • manipulate and release objects
  • fine motor/dexterity activities
  • in-hand manipulation
  • B/L coordination
76
Q

what to look at during handwriting analysis

A
  • wrist stabilization
  • ability to secure paper
  • legibility
  • writing speed
  • implement mangament
77
Q

what to look at when assessing reach and grasp

A
  • have pt point/reach for objects of both involved and uninvolved side (randomize objects shape, size, textures, reaching distance)
  • may see increased trajectory movement time and inefficient hand trajectory
  • not problems with grip formation (closure, unstable grasp, orientation of hand to the object)
  • observe trunk for postural stability (trunk rot in opposite direction to glenohumeral abduction and scapular retraction to keep hand moving in a straight path)
78
Q

what to assess with eye-head coordination

A
  • saccades and smooth pursuits in near and far central and peripheral vision fields (intact, diminished, absent)
  • test in sitting, standing and walking
79
Q

hold 2 objects 12 inches apart and 3 feet away from pt and have pt look back and forth between the 2

A

saccades

80
Q

H and J patterns

A

smooth pursuits

81
Q

assessing reach and grasp

A

if pt has difficulty with anticipatory control you will see:
- repeated knocking over of objects
- contact of objects with web spaces instead of finger tips
- denting or crushing lightweight objects after first grasping
- difficulty raising heavy but liftable objects off table

82
Q

once an object is grasped it can either be

A
  • manipulated
  • stabilized
83
Q

is the movement of an object in space or in reference to another object

A

manipulation

84
Q

requires sustained isometric mm force to prevent object slippage

A

stabilizataion

85
Q

_____ of grip force is impaired in individuals with neurological injury

A

modulation

86
Q

pediatric outcomes measures of UE assessment

A
  • BOT 2: fine manual coordination and manual coordination subscale
  • Peabody: objective manipulation, fine motor and visual motor integration subscale
87
Q

outcome measure to assess UE function in adults post stroke/TBI

A
  • Fugl-Meyer UE Gross motor and fine motor coordination scales
  • Wolf motor function test (OT)
  • rivermead motor assessment
88
Q

fine motor and dexterity tests

A
  • perdue peg board
  • minnesota rate of manipulation test
  • box and block test
  • peabody fine motor scale (up to 7 y/o)
89
Q

what can you use to assess B/L Coordination

A

fold towels, toss a back back and forth between two hands, hold a cup in one hand and pour from a pitcher with the other

90
Q

move a coin from fingers to palm of hand and back

A

translation in-hand manipulation

91
Q

adjust your pencil from between your fingers to the palm of your hand and back

A

shift in-hand manipulation

92
Q

turn a fork so that you can put it in your mouth after picking up food

A

rotation in-hand manipulation

93
Q

difficulty with multiple tasks, cannot do it involuntary, cannot tell you what they want to do

A

ideational apraxia

94
Q

cannot perform task for someone telling them to do something; pt can do it subconsciously; can tell you what they want to do but cannot do it

A

ideomotor apraxia

95
Q

apraxia

A

difficulty with motor planning

96
Q

how to assess strength using dynanomometer

A
  • elbow 90 flex, FA/wrist between sup/pro
  • mean of 3 trials

PT 632 Motor Control (9 decks)

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