How to Use Translation for Improving Fine Motor Skills after a Hand Injury:

I’m always looking for new therapy ideas. I want to keep my patients interested and engaged in therapy. I also want to keep things functional and task oriented. So much of what we do with our hands is about fine motor coordination and dexterity, and that is so hard to duplicate in a clinic setting.  Using translation gives me a task to work on fine motor skills and dexterity that is gradable and functional.

So, How does it work?! What fine motor exercises for hands are there?

The Basics of fine motor skills therapy – I lay a pile of small objects on the table and an open container for the client to put them into. What object I use depends on the client’s level. We’ll get to that later. Then, they use a 2-point pincer grasp to pick up one and shift it finger-to-palm.  They do this a 3-4 more times. Each time shifting it fully to the palm. Then the objects are taken, one at a time, from palm to pincer grasp and dropped into the container.  

“Using translation gives me a task to work on fine motor skills and dexterity that is gradable and functional.”

Special Rules –  To keep the client from cheating and to meet the purpose of the task we have a few special rules.

1. No using momentum to ‘throw’ the object from palm to finger. They need to use finger and thumb motion to advance the object.
2. No using gravity to let the object fall from palm to fingers. AKA: no cheating
3. Take it all of the way to the tips of index and thumb. It’s harder but it matters.

Make it fit –  This task is highly scalable to meet the client’s needs and the ‘just right challenge’. Here is the sequence I use as the client improves:

1. Slow foam squares cut into ¾” squares
2. Squares mixed with marbles (pick up 2 of each) and sorting them for sensation work.
3. Mancala pieces or just plain marbles
4. Coins – Pick them up off a towel if flat on a table is too much

Bonus!! –  Aside from the obvious benefits there are a few other added extras that pop up. Sometimes I even use these as the primary reason for picking this task.

Supination/pronation – The forearm is pretty darn active during this whole process

Tactile work – Stereognosis and discrimination skills can be refined with this task

Thumb work – When done right, the thumb is getting a solid workout (e.g. Joint stiffness work)

Whatever you want…

This task can be converted into whatever you want it to be. Use dice to play a game. Use grapes or other food for a self feeding goal. Use small beads and work on ‘storing’ the extras in the ulnar side of the palm while stringing the bead.  The options are ENDLESS! This is one of my favorite tasks and I can’t wait for you to try it and tell us what you think.