Kinesiology Functional Use Of Upper Extremity In Prehension

Front 1

List the 6 components of functional use of the upper extremity

Back 1

- reach
- grasp
- in-hand manipulation
- carry
- voluntary release
- bilateral coordination

Front 2

What is the goal of reaching?

Back 2

to transport the hand to the target with precision in both SPACE and TIME (goal directed movements)

Front 3

List important elements locating on object in space for UE functional use

Back 3

- coordinated movements of eyes head and trunk depending on distance of the object
- range of head and eye movements
- locating the object in the fovea for precision tasks

Front 4

Describe the general ROM of head vs. eyes for locating objects in functional tasks of the UE

Back 4

- Head accounts for 60-70% of movement
- Eye movement depends on level of detail

Front 5

List the typical positions of each joint of the UE in a mature reach to object at about table height

Back 5

- shoulder flexion
- external rotation
- elbow extention
- forarm supination towards neutral
- slight wrist extension
- trunk extension
- lateral weight shift towards object

Front 6

Describe how saccadic eye movements are important in functional activities of the upper extremity

Back 6

Allow scanning of objects to find what is needed for the next step (like making a sandwhich)

Front 7

Describe how the two streams of visual procssing play a role in the functional use of the upper extremity

Back 7

(there are vental and dorsal streams)
- processing in parietal lobe: how to act on an object
- processing in temporal lobe: identification of an object

Front 8

How does lack of somatosensory information change the functional use of the upper extremity

Back 8

Changes speed and quality and requires visual compensation

Front 9

Describe how reach and grasp are related/paired

Back 9

They occur TOGETHER is space and time

Front 10

Describe the sequence of reach and grasp

Back 10

- arm moves quickly initially
- hand opens
- arm slows
- hand closes

Front 11

When does maximum hand opening occur during reach/grasp?

Back 11

At 2/3-3/4 of total movement TIME the hand reaches maximum apperature

Front 12

Describe how reach/grasp changes overall when object is smaller

Back 12

- total movement time is longer
- hand opens sooner
- more time is spend slowing the arm down and positioning the hand

Front 13

How do you decide how much grip to give an object?

Back 13

- experience
- afferent information

Front 14

Describe how decreased roughness of an object influences grip

Back 14

Decreased roughness leads to tighter grip and slower movement

Front 15

Describe what happens to adjust when on object you are holding slips

Back 15

- Increases grip strength within 30ms
- decreases elbow flexor force to decrease the rate of lifting

Front 16

Define prehensive movements

Back 16

movements in which an object is seized and held paritally or wholly within the boundary of the hand

Front 17

List three examples of non-prehensive movements of the upper extremity

Back 17

push, lift, poke

Front 18

List 2 anatomic categories of prehension

Back 18

- palmar grip
- digital prehension

Front 19

Define palmar grip

Back 19

palm and fingers, usually thumb involvement

Front 20

Define digital prehension

Back 20

thumb and one or two fingers (pads)

Front 21

List 2 purpose-based categories of prehension

Back 21

- power grip
- precision grip

Front 22

Define power grip

Back 22

used for moving an object immobilized within the hand through space (to TRANSPORT, not necessarily a lot of force)

Front 23

Define precision grip

Back 23

Used in moving an object within the hand in preparation for USE

Front 24

Why is a palmar grip for power purposes sometime useful?

Back 24

Sustained force, counterforce with thumb, move hand as a whole
* less freedom but greater stability

Front 25

Why is digital prehension for precision handling sometimes useful?

Back 25

the rest of the fingers are available to move within the hand

Front 26

Give a major functional example of prehension with power grip

Back 26

bringing food to the mouth

Front 27

List the 4 major types of power grips

Back 27

- cylindrical grasp
- spherical grasp
- hook grasp
- lateral prehension

Front 28

Key features of the cylindrical grasp

Back 28

- a power grip
- often with ulnar deviation (heavier = more deviation)

Front 29

Key features of the spherical grasp

Back 29

- a power grip
- each finger has a force from a different direction towards center
- fingers more spread than cylindrical grasp

Front 30

Key feature of the hook grasp

Back 30

- a power grip
- IP flexes
- in pure hook the thumb does very little
- can be sustained a long time without fatigue

Front 31

Describe lateral prehension and give an example of when it's used

Back 31

- power grip with 2 adjacent fingers
- example: smoking a cigarette

Front 32

List 3 major types of precision grips

Back 32

- palmar pinch
- lateral pinch
- tip to tip pinch

Front 33

Synonyms for palmar pinch

Back 33

pad to pad; 3 jaw chuck

Front 34

Synonyms for lateral pinch

Back 34

key pinch, pad to side

Front 35

Features of the palmar pinch

Back 35

- most common pinch for holding small objects
- can be 2 or 3 fingers

Front 36

Define precision grips

Back 36

static grips with the object stabilizaed between fingers and thumb

Front 37

Features of the lateral pinch

Back 37

- useful to hold flat objects and turn

Front 38

Features of the tip to tip pinch

Back 38

- more circular than other pinches
- pick up very small objects

Front 39

Pounds of functional pinch needed to pull on a sock

Back 39

7.7# of pinch

Front 40

Pounds of functional pinch needed to hold a soup spoon

Back 40

1.6# on pinch

Front 41

List 3 types of pecision handling

Back 41

- translation
- rotation
- shift

Front 42

Define the general concept of precision handling

Back 42

these are types of IN-HAND manipulation of an object

Front 43

Define translation (precision handling)

Back 43

moving from finger to palm or palm to finger

Front 44

Define simple rotation (precision handling)

Back 44

- object held at finger pads
- turned 90 degrees or less
- object often held in other hand
- example: opening a jar lid

Front 45

Define complex roation (precision handling)

Back 45

- movement of an object around one or more of its axes 180-360 degrees
- example: turning a pencil around to use the eraser

Front 46

Average force (rounded) in males and females (age 30) for cylindrical grasp

Back 46

- men: 120 pounds
- women: 80 pounds

Front 47

Average force (rounded) in males and females (age 30) for palmar pinch

Back 47

- men: 25 pounds
- women: 20 pounds

Front 48

Average force (rounded) in males and females (age 30) for lateral pinch

Back 48

- men: 25 pounds
- women: 20 pounds

Front 49

Average force (rounded) in males and females (age 30) for tip to tip pinch

Back 49

men: 20 pounds
women: 15 pounds

Front 50

Define shift (precision handling)

Back 50

linear movement of an object on the finger surface to allow repositioning the object on the pads of the fingers
- example: sorting through cards
- example: shifting pens down to fingertips

Front 51

Describe stabilization (precision handling)

Back 51

- use ulnar hand with 4th and 5th finger to stabilize or store an object
- makes further tasks with the hand more difficult

Front 52

Why is it unlikely that we would create a separate motor program for each type of grasping action we need?

Back 52

- too many degrees of freedom...need to coordinate joints in real time
- it would be too many motor programs to store
- we would not suceed with novel situations (but we do)

Front 53

What is the propsed solution to us not being able to have a motor program for each reach/grasp activity?

Back 53

***self-organizing system***
- prefered patterns of movement with small adaptations
- organized for most effecient movement
- when an adjustment needs to be made, usually a little change happens in each component

Front 54

Describe the importance of complexity and automaticity of functional UE movements

Back 54

- give goal oriented directions: people do better with "touch my hand" rather than "straighten your elbow"

Front 55

How can we use the relationship of reach and grasp in retraining movement?

Back 55

Pair them. If trying to work on writst extension, use reaching movements not just isolated wrist extension, because the wrist automatically extends a bit when you reach

Front 56

Why should we train grasp with reach in retraining (such as in stroke)?

Back 56

- patterns more easily relearned than isolated movements
- uses entire limbe as soon as possible after injury

Front 57

If you are training someone with grasp, be such to also train _______

Back 57

voluntary release

Front 58

List the limitations of static grasps in relation to the importance of in-hand manipulation

Back 58

- not a lot you can do functionally with just holding an object
- in hand manipulation hard early in injuries
- in hand manipulation hard with UE prosthesis
- individual finger movements are important
- training in-hand manipulation tends to generalize easily to functional activities

Front 59

Describe the importance of using real objects in training reach and grasp

Back 59

- studies done in MS and stroke
- with real objects also get anticipatory movements of trunk and other body parts
- real objects provide important feedback about weight, etc.