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Hand and arm use

The assessment of potentially existing impairments in hand and arm use is initially undertaken through performance tasks. Should this screening suggest any impairment, a further assessment of hand and arm use can be conducted using an FCE specific test (a test from “Functional capacity evaluation” ©)

Performance tasks

Screening

Required material: None

Procedure: The doctor requests the patient to carry out the following performance tasks with their afflicted hand:

1. Pushing and pulling of objects (e.g. opening and closing a door, moving a chair)
2. Reaching for something (e.g. reaching for a book across a table)
3. Twisting movements in hands or arms (e.g. using a tool, for instance a screwdriver or kitchen Utensils)
4. Throwing and catching an object (e.g. a tennis ball over a distance of 3m)

The doctor evaluates and documents their observation using the following assessment criteria: The activity procedure is (1) possible without any restrictions, (2) only possible with compensation, (3) not possible at all.

 Documentation example:

19_hand_and_arm

Tests following the Functional Capacity Evaluation (FCE)

Supplementary testing

Prerequisite: Licensing and staff training according to the requirements of the Isernhagen Work System

Required material: FCE test materials (including moveable objects with defined weights)

Procedure: Hand arm use can be assessed with the following FCE tests:

1) Static pushing
2) Static pulling
The object with the maximum possible weight is chosen. The activity is maintained for 3 seconds, and each test is repeated 3 times.

3) Dynamic pushing
4) Dynamic pulling
The object with the maximum possible weight is chosen. The object is pushed (or pulled over a distance of 9 metres.

The therapist assesses the activity procedure according to the following criteria: The movement is (1) vigorous, coordinated and can be carried out to the full extent, (2) possible with the help of compensatory mechanisms, (3) not possible. For each activity the weight used as well as the respective assessment is noted (kg to one decimal point).

Documentation example:

20_hand_and_arm_efl

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