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Extra resources for Neurorehabilitation of the Upper Limb Across the Lifespan: Managing Hypertonicity for Optimal Function
The proximal transverse arch is located at the level of the distal carpal bones. It is rigid and provides mechanical advantage to the tendons of the finger flexor muscles by acting as a fulcrum for their movement . 4). A power grip involves the whole hand, while a precision grip involves different positions and combinations of the thumb and fingers, and possibly other parts of the hand such as the thumb web-space or the ulnar side of the hand for stabilising objects . The typical hand position for a power grip is between 10∘ and 30∘ of wrist extension, finger MCP flexion to approximately 90∘ , and finger PIP joint flexion between 45∘ and 60∘ .
8. 9. 8). Spinal reflexes become hyperactive due to disruption of the regulating influences of the descending pathways involved in motor control, that is, the closely-associated corticospinal (pyramidal) and brainstem (parapyramidal) pathways. These pathways control stretch, flexor and extensor reflexes by modulating (adjusting) signals to the motor neurons in the spinal cord on the basis of sensory feedback from the periphery [11,77]. It is most likely that a reduced threshold is the reason that the motor neuron is hyperactive.
14). The longitudinal arch of the hand is mobile and follows the long lines of the metacarpal and phalangeal bones. It allows flexion of the MCP, proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints. 4 Common hand grasps [49–52]. Grasp Description Cylindrical Whole palmar surface grasps around a cylindrical object, with the thumb ﬂexed and opposed on the opposite side of the object from the ﬁngers (holding a jar or drink bottle) Hook Fingers extended at MCP joints, ﬂexed at IP1 joints.