Fine Motor:
- Reaching
- Grasping
- Manipulating
- important in activities of daily living (dress, feed)
Gross Motor:
- Stabilising
- Crawling
- Walking
- Moving a wheelchair
- Running
- Swimming
Communication
- speaking
- sign language
UL role in balance
- Upper limbs can play a role in ability to recover
balance and to protect body from harm when recovery not possible.
kinematics components of normal reach, grasp
& manipulation
Visual regard- Eye / head coordination to locate
target and guide the hand
Postural control- Ability to control the bodies
position for stability or mobility when the arms are moved
Reaching- Transport of the hand towards an object
Grasping- Formation of a grip, grasp & release
In-hand manipulation- Moving objects within the palm of the hand
The 4 functions of the upper limb can be grouped as:
▪ Support / Stabilization
▪ Reach
▪ Grasp and release
▪ Manipulation
REACH essential components
– Scap protraction
– Sh F or Abd
– Trunk ext in hip flex
– Elbow ext
– Forearm – midprone; pronated; supinated
– Finger position
– Wrist position – ext or flex
SUPPORT- (Sitting leaning on hands on bed with hands placed behind body)
– Sh ER & Ext
– Elbow ext
– Supination
– Wrist ext, ulnar dev
– Finger ext
– Palm in contact with bed
GRASP essential components
– Wrist ext & rad deviation
– Finger flex
– Opposition
– Mid-prone
– Elbow, Sh
– Finger abd, ext
release
– forearm mid-prone
– Wrist ext or flex
MANIPULATION essential components
Thumb pad to index or 3rd finger - opposition
Power Grasp and Release
finger and thumb pads directed towards palm to transmit force to an object
Precision Grasp and Release
forces directed between thumb and fingers – allows movements of object relative to the hand and within the hand
Manipulation definition
- Manipulation is defined as movement of an
object in space or with reference to another
object.
Upper limb outcome measures
impairment
9 hole peg test (dexterity), grip dynamometry (strength)
Upper limb outcome measures
activity
Motor Activity Log, Action Research Arm test
Upper limb outcome measures
participation
Canadian Occupation Performance Measure, DASH
