Binder Clips and Coins | Occupational Therapy Interventions

Fine Motor Strength Intervention

Occupational Therapy Intervention : Fine Motor Strength

Documentation and Activity Rationale

The patient engaged in a seated fine motor activity requiring patient to use alternating tip pinch and lateral pinch prehension skills to secure clips [varying levels of resistance] to small objects 25x with right hand in order to increase intrinsic hand strength, thumb strength, pinch strength, fine motor coordination, and general pain-free mobility. Good challenge. Fatigue noted and observe by end of task. No discomfort noted.

Grading Strategies

Grading Up:

greater resistance
smaller items to secure clips on

Grading Down:

lesser resistance
begin with clothespins
clip onto theraband

Appropriate Diagnoses / Deficits

s/p hand and/or wrist injury
s/p ulnar collateral ligament injury
fine motor strength deficits
CVA
TBI

Functional Grasp and Forearm Strength | Occupational Therapy Interventions

OT Practitioners

Functional Grasp and Forearm Strength

Occupational Therapy Intervention : Functional forearm strength

Documentation and Activity Rationale

The patient engaged in arm strengthening activity using functional household items with 10 reps focusing on forearm flexion and extension, radial and ulnar deviation. Resistance provides encouraged gross UE strengthening and muscle stretching with the amplified purpose of wrist control and stability against resistance. x2 VC were given for proper form and muscle isolation.

Grading Strategies

Grading Up:

involve a greater number of heavy functional items (e.g. a gallon of water)
have the patient complete the task with 4-5 step instructions (e.g. “pick up and move the gallon of water and place on the book, then, pick them both up and move them to…”)

Grading Down:

begin with lighter items
use BUE

Appropriate Diagnoses / Deficits

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

In hand Manipulation | Occupational Therapy Interventions

OT Practitioners

In-Hand Manipulation

Occupational Therapy Intervention: In-Hand Manipulation

Documentation and Activity Rationale

The patient engaged in a kinetic-based therapeutic activity requiring the gathering of 20 beads into the palm of the right hand (and then left in separate repetition) with subsequent placement of each bead into a small target. The task elicited fine motor coordination, in-hand manipulation, and mm endurance of the intrinsic muscles of the hand. Task requires translation, shift, rotation, and stabilization of the objects within the palm space by eliciting mm involvement of the ring and pinky fingers while isolating movement of the beads with the thumb, index, and middle fingers.

Grading Strategies

Grading Up:

more beads
timed activity

Grading Down:

use larger objects
decrease amount

Appropriate Diagnoses / Deficits

muscle weakness
atrophy s/p hand and/or wrist injury

Pitch Back with Kinesiology Tape | Occupational Therapy Interventions

OT Practitioners

Pitch Back with Kinesiology Tape

Occupational Therapy Intervention: Pitch Back

Documentation and Activity Rationale

The patient engaged in a 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.

(Kinesiology tape application prior to pitch back) The patient engaged in approximately 12 minutes of neuromuscular re-education through proprioceptive manipulation, muscle elongation, and application of dermal material to provide ongoing proprioceptive input and support to the patient between sessions thus promoting the brain’s awareness of the RUE and muscle recruitment for wrist support and decreased pain.

Grading Strategies

Grading Up:

incorporate directional changes
increase activity demands

Grading Down:

use a larger ball
catch with both hands

Appropriate Diagnoses / Deficits

muscle weakness
atrophy s/p hand and/or wrist injury
CVA
TBI

Work Hardening and Fine Motor Strength | Occupational Therapy Interventions

OT Practitioners

Work Hardening and UB Strength

Occupational Therapy Intervention: Work Hardening and UB Strength

Documentation and Activity Rationale

The patient engaged in a work hardening task in which she was tasked with shoulder (adduction and abduction), forearm, wrist, and intrinsic hand strengthening. The task required the patient to manipulate <50lbs for x10 repetitions in order to prepare the patient for return to work s/p hand injury.

Grading Strategies

Grading Up:

increased repetitions
increased weight

Grading Down:

less weight
begin with the movement pattern

Appropriate Diagnoses / Deficits

Atrophy s/p hand and/or wrist injury
muscle weakness
hypo/hypertonicity
TBI
CVA

Narrow Stance with Diagonal UB Pattern | Occupational Therapy Interventions

OT Practitioners

Dynamic Standing with Diagonal UB Pattern

Occupational Therapy Intervention: Dynamic Standing

Documentation and Activity Rationale

The patient engaged in dynamic standing activity in which they were tasked with completing repetitions of a UE diagonal pattern. Diagonal patterns have been researched in order to support claims that the brain recognizes rotational and diagonal patterns better than isolated movements during neuro-rehab. The patient was cued to maintain a narrow BOS in order to challenge and remediate noted balance deficits. The patient completed 2×15 repetitions utilizing intertwined hand-over-hand to support and facilitate movement from hypotonic LUE.

Grading Strategies

Grading Up:

stand in tandem stance
increased repetitions
switch between different stances each repetition

Grading Down:

slightly wider BOS
provide contact assistance

Appropriate Diagnoses / Deficits

Alzheimer’s
balance deficits
CVA
TBI