Hand function and fine motor skills are often impaired after having a stroke. Hand exercises are beneficial in improving strength and dexterity regardless of whether the stroke patient is just beginning to get hand movement or already has good hand range of motion. The exercises below can help improve fine motor skills that have deteriorated after a stroke. Please note that some activities may be too easy or too hard depending on the extent of impairment. If the stroke patient has no hand movement, see the paragraph at the end of this page for treatment ideas. For those that do have hand movement, try the following:
Turn cards over
Assemble nuts and bolts.
Put together puzzles.
Play the piano.
Pick up small objects like buttons, coins, etc.
Crumple a sheet of paper into a ball. Try to spread it back out into a flat piece of paper using only the affected hand.
Pick up empty cans and then put them back down.
Roll a pencil between the thumb and fingers.
Place your hand on the table, and try to lift each finger one at a time off of the table.
Pick up toothpicks with tweezers.
Wring out washcloths.
Fill a bowl with rice and place objects in the rice. Try to find the objects with your hand without looking.
Pick up small objects (e.g. marbles or checkers) one at a time transferring each one to the palm of your hand and holding onto it as you pick up the next object. Then without letting objects fall out of the hand, place each object back down one at a time.
Try some of the fine motor apps available for smart phones and tablets. Some apps that work on fine motor skills include Dexteria, Dot to Dot Number Whiz, and Fruit Ninja to name a few.
Perform theraputty exercises. See video below for some examples of putty exercises.
In Hand Manipulation Skills
In hand manipulation skills refer to the ability to manipulate objects within the hand and include the skills of translation, rotation, and shift. Translation involves moving objects from the fingertips to palm and from the palm to fingertips. Rotation is the ability to rotate objects with the fingers, and shift is the ability to move objects with the fingers linearly. Below is a video that demonstrates the various in hand manipulation techniques. One can practice these exercises to help improve fine motor coordination and the ability to manipulate a pen for writing.
The Paralyzed Hand
If one is unable to move the hand or fingers, then exercises should emphasize on stretching the hand and using the other hand to move the fingers of the paralyzed hand. When the hand is without movement, one can also practice placing the open hand on an object such as a table or ball and trying to keep it there without the hand falling off or fingers curling up. One can attempt to elicit finger and wrist movement by tapping the muscles in the forearm. Tapping the back of the forearm will help elicit the fingers and wrist straightening. Tapping the other side of the forearm will elicit finger and wrist flexion (or bending). With the help of a therapist, one can also try equipment designed to help improve hand function such as the Hand Mentor or Bioness. Ask your therapist if these treatments would be appropriate for you.