Hand Function Evaluation And Intervention Flashcards by Mateusz Marchut

Terminology of hand use what are they?

Visual Motor (eye hand coordination)
Fine Motor 
Reach 
Grasp 
Carry 
Voluntary Release 
In-Hand Manipulation
Biannual Skills

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What Factors contribute to the development of hand function?

Cultural Influence (Poverty, Utensils, View of Play)
Somatosensory Function (hepatic perception)
Visual Perception and Cognition
Musculoskeletal

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Cultural Influence How does it affect Developement of Hand function

Children learn to use tools by watching adults
Poverty- lack of objects to practice
Utensils - May not use
View of play - play may not be important

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Somatosensory functions How does it affect Developement of Hand function

Hectic perception
Accurate use of fingers movement
Sustaining grasp

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Somatosensory Limitations may cause?

Poor coordination
Problems with timing and speed of response
Clumsiness

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Visual Perception and cognition How does it affect Developement of Hand function

Vision is important for learning new motor skills (arching and manipulating)
Attention to objects
Problems solving with objects

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Musculoskeletal How does it affect Developement of Hand function

Joint, bone and muscle structure important
Hand Amomalis
Decreased ROM
And Musle power.

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Development of Hand Skills what are they?

Reach and carry 
Grasp patterns 
In-hand manipulation skills
Voluntary release 
Bimanual skills 
Throwing ball skills
Tool use 
Hand preference

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Reach and Carry 3 months

Bat at an object

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Reach and Carry 4 months

Hand Regard

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Reach and Carry 12 months

Optimal hand opening to reach and grasp an object

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True or False. Carrying - requires smooth body movement and stabilization of object in the hand

Ture

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Grasp Patterns Precision vs power ?

Precision - involves thumb opposition And small or medium objects
Power- Involves entire hand, medium or large objects

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Grasp Pattern 1-3 months

Grasp reflex

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Grasp Pattern 4 months

Voluntary grasp

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Grasp Pattern 7 months

Raking

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Grasp Pattern 9-12 months

Disk grasping
Cylindrical grasp
Spherical grasp

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Grasp Pattern 4-5 years with strength increasing until 12 years old

Lateral pinch

Tripod pinch

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What are types of In-Hand Manipulations?

Fingers to palm translation 
Palm to finger translation 
Shirt 
Simple rotation 
Complex rotation

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What are the requirements for development of in-hand manipulation skills ?

Supination
Wrist extension with stability
Controlled dynamic thumb opposition
Finger tip pretension
Isolated thumb and radial finger movements
Stability with mobility of transverse MCP arch
Dissociation of side of hand

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Voluntary Release requires what?

Precise coordination of fingertips forces and timing for predicting accurate object placement

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Voluntary Release 5-6 months

Transfers object from one hand to the other smoothly

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Voluntary Release 9 months

Release objects intentionally

Voluntary Release 7-13 months

Neat placement and release of objects of variety of size, weights and shapes.

Bimanual Skills infants move?

Arm/hand asymmetrically

Bimanual Skills 3 - 10 months

Symmetrical arm/hand movement. Allows hand to engage at midline

Bimanual Skills 9-10 months

Banged tow objects together

Bimanual Skills 10 months

Hold at object with one hand to explore it with the other

Bimanual Skills 17-18

One hand stabilizes object from the other to act on it

Bimanual Skills 30 months

Emerging differentiated use of arms/hands (cutting with scissors.

Ball throwing skills requires?

Shoulder strength and controls along with release skills

Ball Throwing Skills 2 years old ?

Can throw a ball foward and maintain balance

Ball Throwing Skills 3 years old

Projects ball towards target

Ball Throwing Skills 6 - 7 years

Throw a ball at target 12 feet.

Hand Preference infants ?

Should not demonstrate hand preference

Hand Preference 18-36 months old ?/

Show hand preference during activities that require two hands but not during simple grasp tasks

Relationship of Hand Skills to Children’s Occupations

ADL’s should be independent at the age of 8 Play School Function

School Function 1st and 2nd

FM most of the day

School Function 3rd grade

30% of the day

School Function FM 30 % of the day used on

Paper pencil tasks, cutting, folding paper, manage food containers and organizing belonging

Evaluation of Hand skills in children should be in ?

The context of play, self-care and school occupations

What includes in full evaluation of hand function ?

``` Fine motor Visual motor Hand functions performance Postural alignment and stability GM Cognition Perceptual skills Sensory processing Social0emotional skills ```

What are assessment tools used during evaluation of hand skills in children ?

``` Goniometer Observation Muscle test Grip and pinch strength test Tactile test And standardized tools ; Peabody,BOT, Purdue Pegboard, VMI, DTVP ```

Bio mechanical and Neurodevelopment Approaches Focus on?

``` ROM Strength Endurance Postural alignment Joint stability Often used with children with and other neuromuscular diseases ```

Wha are the PRINCIPALS of BPM?

Optimal alignment Optimal trunk control midline position Feel stable moving against gravity Relaxed tone

Strategies for BPM

Use various positions to enhance hand use

Neurodevelopmental therapy Goals are?

Inhibit spasticity Facilitate normal tone Guide normal movement patterns

Neurodevelopmental therapy Focus ?

Through sensory feedback children with Abnormal tone can learn how normal movement patterns feel and internalize them

Neurodevelopmental therapy Strategies?

Deep pressure UE weight bearing Hand line via key points of controle to encourage was and movement in different planes

True or False. Studies do not show that NDT improving functional outcome?

True

Occupational-Based Approaches emphasizes the relationship between?

Interactions of person, environment and occupation

What are consideration of occupation-based approaches ?

Child’s motivation Context of performance Child’s performance strength and limitations

What are the types of OBA/

Motor learning practice model | Pediatric constraint-induced movement therapy

Motor Learning Practice Model assist child in acquisition of ?

Motor skills through structured activities, practices of targeted skills and feedback using child’s interests

IN what population does MLP model work best on?

Those who follow directions, engage in repetitive practice and understand reinforcement NOT GOOD FOR INFANTS

Motor Learning practice model Principes and techniques + research

Meaningful activities keep the child engaged, repetitive practice, reinforcement. Research = Emerging and promising evidence that support the model

Pediatric Constraint-Induced Movement Therapy is a well researched and supports children with hemiparesis of ?

``` All ages May not help with dystopia may help with treating brachial plexus Older children work best Infant should be monitored closely ```