Lab 3: UE & Trunk Control

________ is essential for UE movement and distal manipulation

Proximal stability

UE movement is dependent on:

• Postural alignment

• Trunk stability

• Proximal control

• Scapular positioning

Trunk control supports:

• Selective UE movement

• Efficient and coordinated reaching

• Force production

• Adaptable movement strategies

Need to ensure ________ is addressed prior to reaching

Posture/ trunk control

What are common impairments after ABI?

• Weakness

• Hypertonicity/ Spasticity

• Hypotonia

• Sensory loss/ Proprioceptive deficits

• Poor trunk control

• Scapular weakness/ Poor scapular control

• Coordination deficits/ Ataxia

• Neglect/ Inattention

• Decreased ROM/ Contractures

• Pain/ Subluxation

Effect of weakness on sitting/posture

• Difficulty maintaining upright posture

• Decreased trunk stability

• Fatigue

Effect of weakness on UE Function

• Decreased reach distance

• Reduced grasp force

• Difficulty lifting/ manipulating objects

Effect of hypertonicity/ spasticity on sitting/posture

• Asymmetrical posture

• Trunk stiffness

• Flexed posture patterns

Effect of hypertonicity/ spasticity on UE function

• UE flexion synergy

• Decreased selective movement

• Difficulty with hand opening/release

Effect of hypotonia on sitting/posture

• Collapse into posture

• Decreased proximal stability

• Reliance on external support

Effect of hypotonia on UE function

• Poor proximal fixation

• Difficulty sustaining UE position against gravity

Effect of sensory loss/ proprioceptive deficits on sitting/posture

• Poor midline orientation

• Increased reliance on vision

• Impaired balance reactions

Effect of sensory loss/ proprioceptive deficits on UE function

• Poor force grading

• Inaccurate reaching

• Visual fixation on UE

• Impaired grasp modulation

Effect of poor trunk control on sitting/posture

• Lateral trunk lean

• Instability

• Decreased anticipatory postural adjustment

Effect of poor trunk control on UE function

• Compensatory reaching

• Reduced distal control

• Decreased movement efficiency

Effect of scapular weakness/ poor scapular control on sitting/posture

• Poor shoulder girdle alignment

• Decreased proximal support

Effect of scapular weakness/ poor scapular control on UE function

• Shoulder hiking

• Decreased shoulder flexion

• Inefficient reach patterns

Effect of coordination deficits/ ataxia on sitting/posture

• Instability during sitting

• Excessive corrective movements

Effect of coordination deficits/ ataxia on UE function

• Dysmetria

• Poor timing/sequencing

• Overshooting or undershooting targets

Effect of neglect/ inattention on sitting/posture

• Asymmetrical posture

• Decreased awareness of one side

Effect of neglect/ inattention on UE function

• Reduced spontaneous use of involved UE

• Collisions/missed targets

Effect of decreased ROM/ contractures on sitting/posture

• Limited postural adaptability

• Restricted trunk or shoulder positioning

Effect of decreased ROM/ contractures on UE function

• Limited reach

• Inability to achieve functional positions

• Compensatory trunk movement

• Altered grasp patterns

Effect of pain/ subluxation on sitting/posture

• Guarded posture

• Decreased weight shifting

• Protective positioning

Effect of pain/ subluxation on UE function

• Reduced UE use

• Decreased active movement

• Compensatory movement patterns due to pain avoidance

Task oriented treatment technique includes doing:

• Practicing meaningful functional tasks (task-specific)

• Repetition & intensity

• Active problem solving

• Task/ environmental modification

• Movement adaptability

• Motor learning/ neuroplasticity

Constraint-induced movement therapy (CIMT) treatment technique includes doing:

• Forced use of affected UE

• High repetition/ intensity

• Massed practice

• Neuroplasticity

• Reducing learned non-use

Bimanual treatment technique includes doing:

• Both hands participate

• Affected UE may stabilize/ assist hands

  • Do NOT need symmetrical roles

• Functional task practice promotes participation & use