Recovering Fine Motor Skills After Stroke

I have many patients that learn to open and close their hand after stroke but then lack the fine motor skills needed to do many functional activities. Opening and closing the hand is different than individual finger control and in-hand manipulation of objects. Here are some exercises to help improve individual finger movements and manipulation of objects within the hand:

Opposition exercises—try touching the thumb to each finger.

Individual finger raises—Place the hand on a table and try to raise each finger individually. To increase difficulty try lifting each finger back and forth over a pencil.

Shifting exercises—Place a pen in the affected hand (regular pen grasp). Try to move the pen with your fingers until your fingers are on the end of the pen. Then move the pen back the other way so that the fingers are now on the other end of the pen.

Rotation exercises—place a pen in the hand and try to rotate it forward 5 times and then backwards 5 times.

Translation exercises—Set several small objects in front of you. Pick up one object at a time and move it from your fingertips to your palm cupping the object. Then attempt to pick up the next object but don’t let the object in your hand fall out. Keep going until your hand is full then try moving the objects one at a time from your palm to your fingertips and place them back on the table. The smaller the object, the harder this activity will be.

Place pegs in a pegboard.

Perform theraputty exercises.