AIM:

To train the regulation of flexor force in preparation for manipulating objects.

Rationale:

An important component for manipulating objects is the ability to regulate the amount of flexor force at the fingertips. Task-related training is set up so the patient can practice with manual guidance from the therapist if necessary.

Equipment:

  • Table
  • Chairs
  • Pegs
  • Comb
  • Plastic container

Key Points:

  • Patient is positioned in sitting in front of a table
  • Patient picks up an object (eg, peg or ruler) and holds it, horizontal to the table, between thumb and index finger. Patient reduces the flexor force applied to the object so it moves into the vertical position
  • To progress this training, patient attaches the peg to a container after completing the sequence above or completes the sequence while holding other objects in the hand (as shown in video).
  • Therapist is positioned to the side of the patient and provides manual guidance at the hand if necessary

Common Errors:

  • Patient abducts and internally rotates shoulder
  • Patient holds object too tightly
  • Patient holds object too loosely so it drops out of the hand

Progression and Variety:

  • Vary shape and weight of objects
  • Increase speed of movement
  • Increase complexity of task components