AIM:
To train thumb and little finger opposition in preparation for manipulating objects
Rationale:
An important component for manipulating objects is the ability to use thumb and little finger opposition to ”cup” the hand. Task-related training is set up so the patient can practice with manual guidance from the therapist if necessary.
Equipment:
- Table
- Chairs
- Beans
- Targets, eg, tape
Key Points:
- Patient is positioned in sitting, arm supported on table, shoulder slightly flexed, elbow flexed and forearm pronated
- Patient slides fingers upwards so MCP joint flexes and IP joints maintain extension
- Ensure forearm and fingertips remain in contact with the table
- To progress this training, patient supinates forearm, “cups” the hand to hold some beans and maintains “cupping” while the hand is moved towards targets on the table
- Therapist is positioned to the side of the patient and provides manual guidance at the hand if necessary
Common Errors:
- Patient flexes IP joints excessively
Progression and Variety:
- Decrease/remove manual guidance
- Increase amplitude of movement
- Increase speed of movement
- Increase fluidity of the material placed in the hand