Table 3.
Exercises and exercise measures for each movement component (A) and functional combinations of movement components (B).
| Movement variation | Measures |
|||
|---|---|---|---|---|
| Must have | Should have | Could have | ||
| A. Movement components | ||||
| Reach | ||||
| Reach to a cylinder object and touch it. The object can be in different positions; the patient can reach in different directions: vertical ‘high’ (90–160 degrees shoulder flexion), vertical ‘low’ (< 90 degrees shoulder flexion), horizontal abduction (0–90 degrees horizontal shoulder abduction), horizontal adduction (90–130 degrees shoulder adduction). | reach distance; reach direction; velocity |
trunk and shoulder compensatory movements; reach distance |
touch accuracy; smoothness | ROM shoulder, (anteflexion, abduction, adduction); ROM elbow (flexion-extension) |
| Reach to a point and touch it. (Moving) targets are shown (on a digital screen). The patient touches the targets with preferably the index finger. Targets can appear and disappear in different sizes and speeds. | velocity; target size | trunk and shoulder compensatory movements; reach distance |
touch accuracy; smoothness | ROM shoulder, (anteflexion, abduction, adduction); ROM elbow (flexion-extension) |
| Grasp | ||||
| Grasp a cylinder (cylinder grasp). | position of the object; dosage of grip strength | timing of hand opening and closing; grip strength | ROM index finger and thumb; trunk and shoulder compensatory movements | |
| Grasp a small cube (three-point grasp). | position of the object; dosage of grip strength | timing of hand opening and closing; grip strength | ROM index finger and thumb; trunk and shoulder compensatory movements | |
| Hold & release | ||||
| Hold and release a cylinder (cylinder grasp) on the system-indicated moments, durations and force. | position of the object; velocity; dosage of grip strength | timing of hand opening; grip strength | trunk and shoulder compensatory movements | |
| Hold and release a small cube (three-point grasp) on the system-indicated moments, durations and force. | position of the object; velocity; dosage of grip strength | timing of hand opening; grip strength | trunk and shoulder compensatory movements | |
| Displace, lift & positioning | ||||
| Lifting a cylinder, transport it in different directions (< 90 degrees shoulder flexion, horizontal 0–90 degrees horizontal shoulder adduction, horizontal 90–130 degrees shoulder adduction) while keeping it in an upright position | transport direction; transport distance; velocity; dosage of grip strength | object tilt (in degrees); transport distance; smoothness; grip strength; trunk and shoulder compensatory movements | ROM shoulder, (anteflexion, abduction, adduction); ROM elbow (flexion-extension) | Velocity |
| Lifting a cylinder object, transport it in different directions (< 90 degrees shoulder flexion, horizontal 0–90 degrees horizontal shoulder abduction, horizontal 90–130 degrees shoulder adduction) while keeping it in an upright position and tilting the object on the by the tablet indicated place, moment and speed. | transport direction; transport distance; velocity; dosage grip strength; object tilt degrees; object tilt timing | object tilt (in degrees); transport distance; accuracy of object tilt; smoothness; grip strength; trunk and shoulder compensatory movements | ROM shoulder (anteflexion, abduction, adduction); ROM elbow (flexion-extension); ROM wrist (pronation-supination) | Velocity |
| Push/pull/shove | ||||
| Moving the palmar side of the hand over the back of the head | velocity | trunk and shoulder compensatory movements; smoothness | ROM shoulder (anteflexion, abduction, adduction); ROM elbow (flexion-extension); velocity of the hand | |
| Moving the palmar side of the hand over the back | velocity | trunk and shoulder compensatory movements smoothness | ROM shoulder (anteflexion, abduction, adduction); ROM elbow (flexion-extension); velocity of the hand | |
| Manipulate | ||||
| Hold a pen in hand and perform 'writing’ exercises: following lines straight and curled, writing the alphabet in block letters. | velocity, size of the lines and letters | smoothness; grip strength | Velocity | ROM index finger and thumb |
| Grasp small objects (small pegs) between fingers (optional: turn the pegs around) and put each of them separately in a small container | velocity | smoothness; grip strength | Velocity | ROM wrist (pronation- supination); ROM index finger and thumb |
| B. Combination Exercises | ||||
| Reach + grasp (cylinder or 3-point grasp) | ||||
| Reach to the object (cylinder or cube) and grasp it (cylinder or 3-point grasp). The object can be placed in different positions; the patient should reach in different directions (high (90–160 degrees shoulder flexion), low (< 90 degrees shoulder flexion), horizontal 0–90 degrees horizontal shoulder abduction), horizontal 90–130 degrees shoulder adduction) | reach distance; reach direction; dosage of grip strength |
timing of hand opening and closing, smoothness; grip strength; trunk and shoulder compensatory movements; reach distance | ROM shoulder (anteflexion, abduction, adduction); ROM elbow (flexion-extension) | ROM index finger and thumb |
| Reach + grasp + hold & release | ||||
| Reach to the object (cylinder or cube) and grasp it (cylinder or 3-point grasp). The object can be placed in different positions; the patient should reach in different directions (high (90–160 degrees shoulder flexion), low (< 90 degrees shoulder flexion), horizontal 0–90 degrees horizontal shoulder abduction), horizontal 90–130 degrees shoulder adduction). Hold and release a cylinder object on the tablet indicated moments, durations and force. | reach distance; reach direction; dosage of grip strength; velocity | timing of hand opening and closing; smoothness; grip strength; trunk and shoulder compensatory movements; reach distance | ROM shoulder (anteflexion, abduction, adduction); ROM elbow (flexion-extension) | ROM index finger and thumb |
| Reach + grasp + positioning, displace & lift | ||||
| Reach to the object (cylinder or cube) and grasp it (cylinder or 3-point grasp). The object can be placed in different positions; the patient should reach in different directions (high (90–160 degrees shoulder flexion), low (< 90 degrees shoulder flexion), horizontal 0–90 degrees horizontal shoulder adduction), horizontal 90–130 degrees shoulder abduction). Lift the object and transport it in different directions (< 90 degrees shoulder flexion, horizontal 0–90 degrees horizontal shoulder adduction, horizontal 90–130 degrees shoulder adduction) while keeping it upright. Tilt the object on the tablet, indicating place, moment and speed. | reach distance; reach direction; dosage of grip strength; transport direction; transport distance; velocity |
timing of hand opening and closing; object tilt (in degrees); smoothness; trunk and shoulder compensatory movements; grip strength; reach distance; object tilt (in degrees); transport distance; accuracy of object tilt | ROM shoulder (anteflexion, abduction, adduction); ROM elbow (flexion-extension) | ROM wrist (pronation-supination); ROM index finger and thumb |
| Reach + grasp + push, pull & shove | ||||
| Reach to the object (cylinder or cube) and grasp it (cylinder or 3-point grasp). The object can be placed in different positions; the patient should reach in different directions (high (90–160 degrees shoulder flexion), low (< 90 degrees shoulder flexion), horizontal 0–90 degrees horizontal shoulder abduction), horizontal 90–130 degrees shoulder adduction). Move the object over the back of the head. | reach distance; reach direction; dosage grip strength; velocity |
timing of hand opening and closing; trunk and shoulder compensatory movements; smoothness; grip strength | ROM shoulder (anteflexion, abduction, adduction); ROM elbow (flexion-extension) | ROM wrist (pronation-supination); ROM index finger and thumb; velocity of the hand |
| Reach to the object (cylinder or cube) and grasp it (cylinder or 3-point grasp). The object can be placed in different positions; the patient should reach in different directions (high (90–160 degrees shoulder flexion), low (< 90 degrees shoulder flexion), horizontal 0–90 degrees horizontal shoulder abduction), horizontal 90–130 degrees shoulder adduction). Move the object over the back. | reach distance; reach direction; dosage grip strength; velocity | timing of hand opening and closing; trunk and shoulder compensatory movements, smoothness; grip strength | ROM shoulder (anteflexion, abduction, adduction); ROM elbow (flexion-extension) | ROM wrist (pronation-supination); ROM index finger and thumb; velocity of the hand |
Reach: intentional movement of the arm towards an object; grasp: to make a motion of seizing, snatching or clutching; hold & release: Keeping an object in a fixed position in the hand without external support and freeing the object from grip; Displace, lift & positioning: moving an object without the object being in contact with a surface in the environment and maintaining a fixed position of the shoulder, arm and hand in space; push/pull/shove: to apply force against an object with the intention to move or stabilise; manipulate: to skilfully control the position of an object using the fingers [36]. ROM: Range of Motion.