Improving Fine Motor Skills after a stroke

The movements produced by the body’s small muscle groups are the fine motor skills inherent in an individual. Examples of these are tasks such as drawing, using scissors, engraving, tying the shoelace, writing, and others which require fine measures of focus and skill. Fine motor skills require precision of movement and accurate control by the brain.

Aside from loss of gross motor function, fine motor skills of the stroke victim may be affected after a stroke. While recovery of gross motor functions helps patients regain mobility and function to a certain extent, recovery of fine motor skills may spell the difference between complete independence and need for assistance in performing activities of daily living.  It is, thus essential to include therapies for fine movements in the overall rehabilitation program of stroke victims.

 

Certain factors which causes dysfunction in Fine Motor Skills

Fine motor skills of a stroke victim may be hampered due to:

Paralysis

Paralysis causes a person lose motor skills overall, including fine movements. The stroke patient’s muscle movements are affected due to paralysis.  But apart from simple paralysis, a stroke patient may also suffer from loss of co-ordination and balance control. In such cases, carrying out any task which requires use of fine motor skills becomes tedious.

Spasticity

After an initial stage of flaccidity, the paralyzed limb often develops muscle stiffness or tightness ,termed as spasticity, which may also interfere with Fine motor movements Spasticity needs to be treated so as to prevent muscle or joint contractures.

Perceptual Disorders

A stroke may cause a patient to lose his skills in judging distances. This may make it difficult for patients to control fine motor movements and ought to be corrected by using measures to improve depth perception.

 

Improving fine motor skills after a stroke

Physical therapy, in general, helps a stroke patient improve his overall musculo skeletal functions.  Occupational therapy, on the other hand, emphasizes improving fine motor skills involved in the performance of specific tasks.

One technique used in rehabilitation of stroke patients is called‘Constraint-Induced movement therapy’. In this technique, the unaffected limb is restrained, forcing the use of the affected limb in executing tasks. Another technique is the use of‘Functional Tone Management (FTM)’ device to assist in enabling ‘grasp and release’ movement of the hand, by holding of the hand in its resting state. Often techniques are used in combination with one another or other sort of physical training.

Exercises to improve fine motor skills after a stroke can also be carried out at home, keeping in mind the magnitude of the deficit from the stroke.  Examples of such exercises that can be carried out at home are:

  • A cardboard box is placed at the corner of a room and the patient tries to shoot in marbles
  • Use of weightless resistance inducing rubber (elastic) bands to smoothly stretch muscles
  • Squeezing a crazy ball or a rubber ball to stimulate strength in fingers
  • Repeatedly putting in and removing pegs from a peg board
  • Performing finger movements and forcing affected fingers and hands against mattress or a pillow to stretch tight muscles
  • Simple routine movement of throwing and picking up coin from the floor.

 

Conclusion

Fine motor skill in a stroke victim is often affected with the overall paralysis and may take longer and be more difficult to recover. It is, however, very important in the overall quality of life and functional independence of the patient.  Rehabilitation of fine motor skills after a stroke could be carried out using some techniques and with the aid of professional therapists.  Nevertheless, a few simple techniques can be performed at home to help improve fine motor movements.

 

References

http://www.strokeassociation.org

http://www.stroke-rehab.com