welcome to module 6 everybody so far if we go back and we review everything that we've done we've really gone through and talked about manual muscle testing and what's required to do a manual muscle test we've done range of motion and what's required to do range of motion and specifically when it comes to manual muscle testing we've gone through and identified how to do it against gravity and also how to do it with gravity minimized we've also talked about the three Foundation principles that are required for easy transfers not only do we need those three principles for easy transfers we also need them for so many different occupations that we move in we also began to talk about the four subcomponents of gate now the four subcomponents of gate which are limb swing propulsion stance control and postural stability are the simplest ways to look at walking and really make it easy for you and me as occupation therapist to incorporate walking into our occupations because how many of our occupations require walking there are so many so those are kind of the main core pieces that we've gone over we've also talked about specifically range of motion of the lower extremity and range of motion of the shoulder joint now today's lecture we're going to be going over the pronation superation wrist and different digits on the hand those particular joints are really ones that a lot of Occupational therapists including myself love to make sure are working appropriately the reason for that is because so many different occupations that we we enjoy they tend to be ones that require fine motor movement now in the world of OT and physical therapy OT has kind of tried to stake its claim on the fine motor type tasks and I think that's because majority of occupations really require some version of fine motor let's think about certain occupations like brushing your teeth yep having to unscrew the cap let's think about showering having to pump and then rub your hands together and get it all in your hair and wash all parts of your body so many tasks require this the problem is that it's not just an upper extremity thing it also requires our trunk and requires our lower extremity so just make sure that as we talk about different occupations that require upper extremity use that we're not neglecting what the lower body is doing because it is just as important as the upper body when it comes to moving especially if the individual is capable of moving their lower body so let's talk about pronation so pronation is going to be the movement when the forearm rotates at the elbow just a little bit past the elbow actually and it rotates so that the palm of your hand is actually facing towards the ground supination is the opposite direction now this is an interesting thing for me is that if you look at my superation and I hold and prevent remember how there's comp uh compensatory strategies in order to get the actual movement that we're looking for one of the ones in superation is external rotation so when I want to get my hand flat up towards the ceiling at this point because I have limited range in superation I have to rotate externally at the arm so as we go through this I want you to be thinking about different compensatory strategies that you would see when it comes to the movement of the arm now the wrist the wrist we're going to really go into oner deviation towards the Ona or radial Dev ation towards the radius okay that's that left and right and then we have extension and we have flexion and then when we start going into we'll go through the uh the joints of the finger really we have just flexion and extension except for when it comes to the thumb now the thumb we have some really interesting movements and this is probably the one that's the hardest to really get so don't worry we're going to be spending a good amount of time trying to figure this out and making sure that we answer all your questions in class however one of the best ways that I've ever had it explained to me is that when I go into where I make made like a duck bill and that movement if I go this way that movement is going to be abduction and adduction so think about like a duck Duck's mouth duck bills that's going to be the abduction and adduction now if we turn to the side and we go like this movement away is going to be extension and then movement towards towards the pinky is going to be flexion at the carpel metacarpal joint that's the important piece everything else on the fingers becomes really quite easy because it's it's flexion and extension it just matters where you're going to measure for that extension or flexion that's it for the range of motion for the pronation supination owner deviation radial deviation and extension flexion of the wrist and then we go to the carpal metacarpal joint of the thumb with abduction and adduction and then extension and flexion of the thumb and then really the rest of the joints tend to be flexion and extension so be ready to go through both range of motion manual muscle testing for these particular movements on class next week I'm excited to keep working with you guys you guys are doing fantastic job this is a lot to go through and especially with it being the summer it's going to feel like it's so much work and you don't have enough time but keep trusting the process keep working hard and making the necessary s sacrifice to do what's necessary to understand you do that you guys are going to be just fine until next time always remember that you can send me an email ask me questions and I'm more than happy to talk to you about things