Improvement of instrument manipulation of ataxic arm and hand of a cerebellar hemorrhage patient

Abstract

The patient with ataxia of the upper right limb caused by cerebellar hemorrhage was provided occupational therapy to attain independent chopstick-use. The patient initially grasped the chopsticks using excessive force with the paralyzed right hand. Moreover, to stop the right hand from shaking, the patient strengthened its grip on the chopsticks and had difficulty perceiving the sensory information from the operation target. To promote purposeful finger action, the patient was instructed to perform continuous flexions and extensions of the fingers while objects were grasped and handled with the entire hand. Thereafter, the patient manipulated the chopstick in three ways:cutting, mixing, and picking up material. That was subsequently instructed to perform movements to straighten the tips of the chopsticks, resulting in the improvement of chopstick-use.