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Questions and Answers
What distinguishes learning from performance in motor skills?
What distinguishes learning from performance in motor skills?
Which type of feedback involves sensory information that comes from within the body?
Which type of feedback involves sensory information that comes from within the body?
What is the primary role of augmented feedback during motor learning?
What is the primary role of augmented feedback during motor learning?
What is essential for achieving relatively permanent changes in movement strategies?
What is essential for achieving relatively permanent changes in movement strategies?
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Which function of the upper limb does NOT include interaction with the environment?
Which function of the upper limb does NOT include interaction with the environment?
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What is the primary role of the interosseous membrane between the ulna and radius during supination?
What is the primary role of the interosseous membrane between the ulna and radius during supination?
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Which muscle is primarily responsible for pronation of the forearm?
Which muscle is primarily responsible for pronation of the forearm?
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Which statement about the humerus's role in forearm movement is correct?
Which statement about the humerus's role in forearm movement is correct?
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What type of joint is the humeroradial joint?
What type of joint is the humeroradial joint?
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Which nerve innervates the pronator teres and pronator quadratus?
Which nerve innervates the pronator teres and pronator quadratus?
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What is the primary purpose of pendular exercises as a treatment?
What is the primary purpose of pendular exercises as a treatment?
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Which of the following conditions is considered a red flag in shoulder assessments?
Which of the following conditions is considered a red flag in shoulder assessments?
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Which action follows the progression of exercise grading in rehabilitation?
Which action follows the progression of exercise grading in rehabilitation?
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Study Notes
Forearm & Upper Limb Applications
- Course: OCCTH 583
- Instructor: Jennifer Krysa, MSc, OT Reg (AB), OTR
- University of Alberta
Forearm Supination & Pronation
- Bones: Ulna and Radius
-
Joints (all synovial):
- Humeroradial joint: Trochlea of humerus sits in trochlear notch of ulna (hinge)
- Proximal radioulnar joint: Head of radius sits in radial notch of ulna (pivot)
- Distal radioulnar joint: Head of ulna sits in ulnar notch of radius (pivot)
- An interosseous membrane runs the length of the two bones.
-
Action on Radius:
- Shape of ulna and its articulation with humerus means it cannot rotate.
- Humerus is uninvolved.
- Pronation: Interosseous membrane is relaxed.
- Supination: Interosseous membrane is tight.
- Limits amount of supination.
Forearm - Muscles of Supination
-
Biceps brachii:
- Origin: Coracoid of scapula (short head) & supraglenoid tubercle of scapula (long head)
- Insertion: Radial tuberosity and fascia
-
Supinator:
- Origin: Lateral epicondyle of humerus & coronoid process of ulna
- Insertion: Distal radius, lateral and middle surface
- Nerve: Radial nerve
Forearm - Muscles of Pronation
-
Pronator teres:
- Origin: Medial epicondyle of humerus & coronoid process of ulna
- Insertion: Radius, proximal shaft
-
Pronator quadratus:
- Origin: Distal ulna
- Insertion: Distal radius
- Nerve: Median nerve
- Pronator quadratus is a deep muscle
Shoulder Treatment Considerations
- Shoulder difficult joint to treat
- What is the underlying problem?
- Acute vs chronic condition?
- Pain
- Body mechanics
- Compensatory movements
Red Flags to Rule Out
- Diseases of digestive system can refer to shoulder
- Fracture proximal humerus
- Injury to blood vessels upper arm or avascular necrosis
- Neoplasm
- Osteoporosis with pathological fracture
- Cardiovascular
Exercise Grading Considerations
- PROM → AAROM → AROM → resistance
- Gravity itself is resistance
- Use positioning to change difficulty
- Correction vs compensation
Treatment - Pendular Exercises
- Good in early stages
- Gravity provides distraction
- Goal: Joint mobility
- Decrease pain & stiffness
- Movement of synovial fluid
- Blood flow in limb
- Safe limited range
- Patient in control
- Easy at home exercise
Treatment - AAROM
- Active Assisted Range of Motion
- One body part assists another to complete the movement
- Until able to move against gravity
Treatment - AROM
- Can perform against gravity or in G.E.
- Closed-chain or open-chain
- Positioning (external stability)
- Adding resistance: bands vs DBs
Learning vs Performance
- Need motor learning if want to effect a permanent change
- Easier to change performance → temporary change in capability to respond
- Harder to get learning but then → relatively permanent changes
- Learning over time can translate to new environments
Modifying Learning
- New movement strategy: goal-directed
- Repeated practice + feedback
- Results in relatively permanent change in movement
Feedback
- Any kind of sensory information resulting from the movement
- Inherent feedback:
- Sight
- Hearing
- Tactile
- Kinesthetic
- Augmented feedback:
- Always extrinsic
- Information in addition to performing task
- E.g. Directions/corrections, tactile cues, mirror
Extrinsic vs Intrinsic Feedback
- Extrinsic feedback → rapid learning; PT reliance; poor generalization to other environments
- Intrinsic feedback → slower to learn; better transfer of skill/motor pattern
- Learner deduces performance independently based on therapist instructions (e.g., keeping joints aligned a certain way while performing and exercise)
Functions of the Upper Limb
- Reach
- Lift
- Pull
- Push
- Carry
- Also: placement of hands to interact with environment; counterbalance, walking speed, protective reactions
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Description
Test your knowledge on the anatomy and mechanics of the forearm, focusing on the ulna and radius, as well as their associated joints and muscles. This quiz covers the concepts of forearm supination and pronation, including bone interactions and muscle origins and insertions.
