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In-Hand Manipulation

Occupational Therapy Intervention : Fine Motor Coordination

Documentation and Activity Rationale

The patient engaged in a fine motor activity using right hand (left hand to assist prn) to retrieve coin using thumb abduction and/or tip pinch, maintain grip and place into a slightly resistive target. The patient was very challenged by this activity requiring frequent adaptations. Patient was unable to retrieve independently requiring max ax1/and placement of coin in webspace of thumb x10 coins. The activity seeks to elicit fine motor active range of motion, coordination, pinch strength, translation, and skills of prehension.

Grading Strategies

Grading Up: 

  • smaller coins
  • more coins

Grading Down: 

  • larger opening to release into 
  • less coins at one time

Appropriate Diagnoses / Deficits

  • coordination deficits 
  • atrophy s/p hand and/or wrist surgery
  • CVA
  • TBI