Ataxia-reaching & grasping (D3)

AIM:

To improve spatial accuracy of reaching and grasping tasks

Rationale:

Practice is set up so that excessive movements are constrained and feedback about accuracy is implicit in the task.

Equipment:

  • 4 cylindrical objects, e.g. bottles or cups
  • Table
  • 2 chairs

Key Points:

  • Ensure patient is sitting upright with the feet supported on the floor
  • Arrange objects on the table so that excessive hand aperture is constrained during grasp and release
  • Encourage the patient to grasp, move and release the objects, without touching the other objects and without resting the arm on the table

Common Errors:

  • Patient supports forearm on the table
  • Objects are spaced too wide apart, so the patient is not challenged to decrease the excessive aperture of the hand during grasp and release
  • Objects are positioned so close together that it is not possible to complete the task without touching the other objects (even for a person without ataxia)

Progression and Variety:

  • Place objects closer together
  • Increase reach distance
  • Increase speed
  • Decrease thigh support in sitting
  • Add variety by using other tasks to constrain excessive movements, e.g. picking up a pen lid from within a sticky tape roll, reaching for a object through a hoop