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F - Reaching, Grasping and Manipulation

Reaching, Grasping and Manipulation | Body Structure and Function MC Verrier, MHSc; S Kalsi-Ryan, PhD; N Desai, MSc; and the E-Scan Investigative Team Upper limb function is vital to everyone. The ability to lean over a table, to grasp a pen and position it in order to sign one’s name, is critical to one’s independence – and a great challenge to individuals with spinal cord injury (SCI). Reaching, grasping and manipulation are the important components of upper limb function that allow individuals to use the sensorimotor integrity of their arm and hand, to perform activities that meet their personal needs, and to explore and participate in their external environment, in meaningful ways. For those with tetraplegia, how to optimize upper limb recovery, or replace function by an alternative means, is a major rehabilitation focus. Even small gains in function are extremely critical for these individuals, because they translate into some degree of independence. Individuals with tetraplegia use their upper limbs to perform functions that able-bodied individuals would do with their hands. Often, these upper limbs also replace functions of other body parts. For example, leg function for walking is often replaced by wheelchair propulsion and weight bearing activities, such as transfers in and out of bed or on and off the toilet. In some instances, use or overuse of the upper limbs, causes secondary complications, such as degeneration of the rotator cuff, which leads to shoulder pain, restriction in movements and, ultimately, decreased function longitudinally. Therefore, improvement and maintenance of upper limb function, across an individual’s lifespan is a priority and, according to individuals with tetraplegia,1 one of the most significant factors in improving quality of life. Best practices in rehabilitation for upper limb function must be robust and encompass both primary rehabilitation and secondary prevention. Many factors require consideration, when providing best practices in assessment and therapeutic interventions for upper limb rehabilitation for individuals with SCI, beyond the neurological their status (Figure 1.0). Reaching, grasping and manipulation are inherently complex and exquisite movements, and integration of many determinants ensures that movements result in improved quality of life. Figure 1.0 A model of factors that require consideration when implementing upper limb rehabilitation . FIGURE 1.0 . A MODEL OF FACTORS THAT REQUIRE CONSIDERATION WHEN IMPLEMENTING UPPER LIMB REHABILITATION. Sensorimotor control and learning Task specificity and meaningfulness External context goal orientation Central nervous system adaptation Sensorimotor ability Performance Behaviour Spinal cord pathology recovery and compensation REACHING, GRASPING AND MANIPULATION | BODY STRUCTURE AND FNUCTION 69


F - Reaching, Grasping and Manipulation
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