Functional Grasp [Reach. Grasp, Place] | Occupational Therapy Interventions

Functional Grasp Training

Occupational Therapy Intervention : Functional Grasp

Documentation and Activity Rationale

The patient engaged in reach, grasp, and release activity in which he was challenged with midline crossing, movement intention, grasp release, gross grasp, and modulation of movement. x20 cones were completed within 7m 37s with moderate difficulty and x5 tactile cueing for proper form.

Grading Strategies

Grading Up:

use larger cylindrical objects
use a combination of objects
complete while standing
set up to facilitate trunk rotation
complete seated
decrease amount of cones

Grading Down:

complete seated
decrease amount of cones

Appropriate Diagnoses / Deficits

s/p hand and/or wrist surgery
muscle weakness
CVA
TBI

Dealing Cards | Occupational Therapy Interventions

OT Practitioners

Fine Motor Coordination – Card Dealing

Occupational Therapy Intervention : Fine Motor Coordination

Documentation and Activity Rationale

Patient engaged in a card activity in order to address fine motor control and functional use of the wrist. Patient required modification of larger cards to independently shuffle cards for 5 trials and deal for 3 trials with use of a lateral pinch grasp.

Grading Strategies

Grading Up:

regular-sized deck of cards
combine cognitive tasks such as addition and subtraction

Grading Down:

fewer cards
smaller-sized deck of cards

Appropriate Diagnoses / Deficits

CVA
TBI
decreased fine motor coordination
muscle weakness of intrinsic hand muscles

Pitch Back | Occupational Therapy Intervention

OT Practitioners

Pitch Back

Occupational Therapy Intervention : Pitch Back

Documentation and Activity Rationale

The patient engaged in dynamic standing activity requiring the propulsion of weighted balls [ 16oz, 18oz, 20oz] from 8ft away to a pitchback altering between objects for recognition and enhancement of modulation ability. The task was performed 2×25 reps while alternating between right and left extremity enhancing BUE strength and range of motion, forearm strength, functional grasp/intrinsic strength, reaction time, force absorption through palm and wrist joint, balance, postural alignment, gross muscle stamina, and endurance for activity.

Grading Strategies

Grading Up:

switch throwing and catching hand
involve changes in head positioning (vestibular)

Grading Down:

use a larger ball
stand closer to the pitch back

Appropriate Diagnoses / Deficits

decreased coordination
s/p hand and/or wrist surgery
CVA
TBI

Upper Body Strengthening | Occupational Therapy Interventions

OT Practitioners

Work Hardening UB Strengthening

Occupational Therapy Intervention : Work Hardening

Documentation and Activity Rationale

The patient engaged in a work conditioning activity facilitating synergistic movement patterns of gross upper body mobility, grasp, and pinch combined with core stability, trunk rotation, weight shift, and awareness of proper body mechanics. The patient was required to use chuck and 5 point pinch as well as gross grasp to displace a 5lb weighted sheet from outside BOS on the right to outside BOS on the left simulating work-related tasks. The patient performed 2×15 repetitions without s/s of pain or mm exhaustion. Future sessions will require integration of these movement patterns to changes of elevation from high to low and shallow to deep, toleration of varying mass up to 20lbs, and continued education on proper body mechanics to avoid maladaptive compensatory movement responses.

Grading Strategies

Grading Up:

heavier weight

Grading Down:

decreased weight
move through ROM before adding weight

Appropriate Diagnoses / Deficits

muscle weakness
s/p hand and/or wrist surgery
CVA
TBI

Dual Tasking and Arithmetic | Occupational Therapy Intervention

OT Practitioners

Dual Tasking and Arithmetic

Occupational Therapy Intervention : Dual Tasking

Documentation and Activity Rationale

The patient engaged in a dual-tasking activity with an emphasis on arithmetic and intentional movements. The task required the patient to receive a specified number or addition/subtraction calculations and ambulate the amount given. This activity is purposed to focus on intentional movements, logical reasoning, and working memory. The patient demonstrated no evidence of LOB or instability. She required between 2-3 repetitions of each math calculation given.

Grading Strategies

Grading Up:

more complex math computations
more challenging hurdles/activity

Grading Down:

label the pieces of tape with coordinating numbers

Appropriate Diagnoses / Deficits

Alzheimer’s
Dementias
Memory Changes
Attention deficits [alternating/divided]
CVA
TBI

Shuffle Cards | Occupational Therapy Intervention

OT Practitioners

Card Shuffling – Fine Motor Coordination

Occupational Therapy Intervention : Functional Fine Motor Coordination

Documentation and Activity Rationale

Patient engaged in a card activity in order to address fine motor control and functional use of the wrist. Patient required modification of larger cards to independently shuffle cards for 5 trials and deal for 3 trials with use of a lateral pinch grasp.

Grading Strategies

Grading Up:

regular-sized deck of cards
combine cognitive tasks such as addition and subtraction

Grading Down:

fewer cards
smaller-sized deck of cards

Appropriate Diagnoses / Deficits

CVA
TBI
decreased fine motor coordination
muscle weakness of intrinsic hand muscles