#11 Functional Activity Interventions for UE

What are typical characteristics and patterns of UE movements?

1. Proximal stabilization (trunk, shoulder...), including postural stability

2. Reach (stretch to touch/obtain), grasp (hand & fingers to embrace/ clasp), grip/, manipulate (strength to hold)

3. All reaching tasks begin at the trunk (postural adjustments to adjust for demands of the task)

4. Different types of grasp (spherical, hook, cylindrical, three-jaw chuck, power, lateral pinch, tip-to-tip pinch)

5. Functional position of wrist and hand

6. Eye-hand coordination

What are holistic considerations for UE interventions?

1. Severity of spastic tone

2. Lack of voluntary control

3. Ability to move around in and interact with objects in the environment

4. Visual and sensory function

5. ADLs, IADLs, education, work, play, leisure and social participation

What are common neuro impairments that affect UE function?

1. Decreased sensation

2. Paresis and paralysis

3. Hypertonicity

4. Impaired MC

5. Hypotonicity

6. Pain and CRPS

7. Decreased joint stability and/or muscle weakness

What are general safety considerations for UE?

1. Sensory loss: decreased awareness of pain and temperature, decreased protective responses

2. Hand deformities

3. Slings, splints, braces

4. Trunk support for hand function

5. Pain management and pain considerations

What can you perform during an examination for the UE?

1. Box and block test

2. Disabilities of the arm, shoulder, and hand (DASH)

3. Fugl-Meyer

4. Jebsen-Taylor hand function test

5. Nine hole peg test

6. Purdue peg board test

7. Wolf upper extremity motor function test

What are functional interventions for UE tasks?

1. Address underlying impairments

2. Positioning and postural control implications

3. Functional hand and reaching skills

4. Newer techniques

5. Splints/orthoses

What are newer techniques for functional interventions for UE tasks?

1. Robotics

2. Electrical stimulation

3. Mirror therapy

4. Constraint-induced therapy

What are splints/orthoses for functional interventions for UE tasks?

1. Wrist support

2. Pressure areas

3. Functional position of hand