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Home Health Policy and Procedure Manual - Fine Motor Exercises

Posted by Steven Steggles on Feb 17, 2015

Fine Motor Exercises to Improve Hand Strength, Dexterity & Coordination

Include the following evidence-based best clinical practices in your home health policy and procedure 15-02-17-Hand-Exercisesmanual:

What are Fine Motor Exercises?

Fine motor skills are small, precise, coordinated movements, like using your fingers to pick up a coin. Fine motor skills require integrating muscular, skeletal and neurological functions. Physical and occupational therapists can work with you to practice these skills after stroke.

“The theory is that you can create new pathways in the brain to compensate for injured areas,” says occupational therapist Rondi Blackburn. “The key is to use your affected side as much as possible and to repeat activities several times each day.“At Baylor Institute of Rehabilitation in Dallas, we have great success with constraint-induced movement therapy. A survivor will work with me for two weeks, six hours a day performing functional activities like grooming, putting on makeup, handwriting and feeding themselves. We also use putty and practice putting pegs in a pegboard.”

Sharon and John Anderson weren’t willing to settle for the prognosis that John would never use his right hand or arm again. “We read about constraint therapy,” Sharon says, “but to qualify you have to be able to extend your fingers and release them. John had the twenty degrees of wrist extension required but not the finger release.

“Fortunately, I happened to search the Web for stroke and found information on the Functional Tone Management (FTM) device. This is a custom-made, glove-like device that holds the hand in a functional resting position and assists hand opening so that grasp-and-release is possible. They combine the FTM device with intensive training,” Sharon says.

You can also do exercises to improve fine motor skills at home. Stroke survivor James Bradley created his own version of rehab. Like exercises in occupational therapy, James’ exercises are based on using the affected hand often and repeating activities every day. Some activities include:

  • Time yourself putting pegs in a pegboard and taking them out.
  • Shoot marbles into a cardboard box several times a day.
  • Use rubber bands to exercise your fingers. For example, place your affected hand on a table and loop a rubber band around one of your fingers. With your unaffected hand, pull the rubber band up and down to exercise the affected finger.
  • Squeeze a rubber ball to strengthen your affected hand.

Like James, survivor John Moore created a program for himself at home. After his stroke in April 1998 he could not move his affected left side. Now he can type with his left hand, although slowly, so he usually types with only his right hand to keep up with his workload. He suggests:

  • Start with range-of-motion exercises. Each day, raise your affected arm up and down with your unaffected hand or with the help of your caregiver.
  • Think about moving one finger at a time. (He was able to create slight twitches in his fingers by focusing on moving one finger at a time.)
  • Push your affected fingers and hand against the mattress to strengthen them.
  • Fan out your fingers every day.
  • Practice making a fist.
  • Celebrate every little gain, even if it’s just a twitch in your fingers.

The effects of practice are cumulative and can’t be measured by the results on a single day. Do something to stretch yourself every day and eventually you will see results!

Excerpted from "Fine Tuning: Tips for Improving Fine Motor Skills", Stroke Connection Magazine, September/October 2003 (Last science update March 2013)

Download Patient Teaching Sheet for  Fine Motor Exercises