week 3 blog (HAND)

Hello everyone, how’s the last placement?

Somehow… I realized my 3^rd week blog is missing? *_* so here goes:

Wanted to blog about the hand and the homunculus. What happened during the 3^rd week of placement was steph did a tut on the hand. She taped my hand into a “hemi-hand with flexor synergy” – flexed wrist and finger flexors. Before she did that, she got me to do a timed finger tapping and finger opposition test as outcome measure. So.. my (L) hand was taped in that position for 20min.

It was amazing what happened during that 20min.. I changed from an alert mode to fatigue mode. I wasn’t sure whether i) it was due to me feeling as if I’ve suddenly lost the function of my hand at that point in time, hence totally lost interest in what was going around me; or ii) the cells representing the hand in homunculus has switched off (Recall: The lips, hands, feet and sex organs have more sensory neurons than other parts of the body, so the homunculus has correspondingly distortedly large hands.), iii) it was close to lunch time :P. I just felt totally “switched off” and had to attempt to keep myself awake thoughout the 20min of tutorial. Even the rest noticed my quick change in upright posture to a passive slump posture while sitting on the wheely stool, n my (L) elbow resting in flexed position on my lap. At that point in time, I really empathize with the stroke patients – having lost the function of the hand… N this really got me thinking about what the clin supervisor shared during 1^st week of placement: they noticed that patients who had UL rehab felt very tired the next day.

After 20min of “pseudo-stroke-hand”, I felt total relief when the tape was removed. A reassessment of the timed finger tapping and finger opposition test showed slower timing; (can’t remember whether it was) (R) or (L) nystagmus, and slower lateral movement of eye to (L) side? on vision testing. My 2 clinical placement classmates then did hand mobs and stretches for my hands, n I felt much more “wakened up”. My (L) hand felt as if it was alive again.

This was an interesting experience, something which I would have never tried myself. This tut has certainly got us thinking about the hand more, and its representation in the homunculus, and how hand mobs, UL rehab are equally important in our treatment plan.