Treatment for the arm and hand

Treatment for the arm and hand (fine / gross motor skills)

You have difficulty performing tasks such as buttoning, cutting, writing, opening boxes, tying your shoes, etc. You need to improve your fine motor skills or dexterity. It is defined by the agility of the hand and fingers when executing fine, precise and meticulous movements that call for muscular control. In certain neurological or musculoskeletal conditions, it is then necessary to develop or relearn how to grasp objects, how to dissociate the fingers and how to make precise movements. Significant dexterity deficits can be observed when the hands are in significant spasticity. This spasticity should then be worked on in the rehabilitation program.

When gross motor skills are affected, treatments will focus on balance, general coordination of the limbs, laterality and tone. When the affected functions are mainly strength and mobility, the cause may be musculoskeletal with problems at the joint (lack of amplitude) and/or muscle (muscle weakness) level. These cases may be observed following an accident, surgery, or be caused by an inflammatory pathology such as arthritis.

When the control and coordination functions are affected, the cause is more generally associated with a neurological disorder. Movements are jerky, brutal, asymmetrical, cause uncontrolled tremors, bimanual tasks are difficult. These behaviours may be observed after a stroke, a craniocerebral trauma, in the course of advanced multiple sclerosis, etc.

At the Neuro-Concept centre, our physiotherapists and occupational therapists can help you work on the strength and mobility of your upper limbs (arms and hands), but also on the coordination in daily life tasks or in sports activities. Proprioception work is also important in order to have a good perception of the positions of the hands and upper limbs. The control of the trunk is important in stabilizing movement. A complete evaluation of your condition by our experts will allow us to target your needs and build a personalized program with you.

Our rehabilitation technologies such as the Amadeo complement the therapists’ work for strength and finger range of motion while having fun with the game interface1. The Jintronix targets gross motor skills, including coordination and range of motion of the upper limbs while sitting or standing using virtual reality2.

In cases where only one hand is affected (such as after a stroke), mirror therapy and motor imaging are effective techniques for gaining fine motor skills3. By looking in the mirror at movements of the hand and the strong, unaffected arm, our visual information deceives the brain into believing that it is the weak arm that is moving, helping to stimulate the areas of the brain that control the movement of the affected arm. Finally, when a minimum of motor control is present, constraint induced movement therapy also increases the use of the affected limb. All these therapies are available at the Neuro-Concept centre. We also offer an intensive Neuro-Program for the upper limb over periods of 3 to 6 weeks at a rate of 15 to 25 hours per week. Don’t wait any longer, make an appointment for your evaluation.

References :

1 – Dimkić Tomić, T. J., Savić, A. M., Vidaković, A. S., Rodić, S. Z., Isaković, M. S., Rodríguez-de-Pablo, C., & … Konstantinović, L. M. (2017). ArmAssist Robotic System versus Matched Conventional Therapy for Poststroke Upper Limb Rehabilitation: A Randomized Clinical Trial. Biomed Research International, 1-7. doi:10.1155/2017/7659893

2 – Rathinam, C., Mohan, V., Peirson, J., Skinner, J., Nethaji, K. S., & Kuhn, I. (2018). Effectiveness of virtual reality in the treatment of hand function in children with cerebral palsy: A systematic review. Journal Of Hand Therapy: Official Journal Of The American Society Of Hand Therapists.

3 – Thieme H, et al. (2019), Mirror Therapy for Improving Motor Function After Stroke, Stroke, vol 50, no 2, p.e26-e27