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ARTÍCULOS
Occupational
Therapy
Functional Levels of the Hemiplegic Upper Extremity
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Classification of Function -
7 Levels
Level 1 - No voluntary motion,
no functional use
Level 2 - Beginning active
motion, no functional use
Level 3 - Passive Stabilizer
Minimal voluntary motion,
able to do the following activities.
1. Move arm away from side
while putting shirt into pants on affected side.
2. Move arm away from side
while adjusting side or back of shirt with good arm.
3. Stabilize shirt at bottom
for buttoning in front.
4. Stabilize wet cloth at
lap level while good am applies soap.
5. Weight down paper while
good arm is writing.
Level 4 - Active Stabilizer
Moderate mass flexion pattern,
including some shoulder motion against gravity, and moderate gross grasp
are capable of performing the following activities.
1. Hold up trousers while
transferring from and to toilet.
2. Hold toothbrush while
good arm applies tooth paste.
3. Hold handle and help
open a long chest or dresser drawer.
4. Stabilize mixing bowl
at table level while good arm mixes or stirs.
5. Stabilize a bottle with
a cap while good arm opens with a cap opener.
Level 5 - Gross Motor Assist
Strong mass flexion pattern,
some elbow extension, moderate gross grasp and some lateral pinch should
be able to perform the following activities. Some release is helpful but
not necessary.
1. Assist good arm in pulling
on or taking off socks and nylons.
2. Reach and wash those
parts (in front) which cannot be reached by good arm.
3. Hold dish while washing
or wiping with good arm
4. Hold and assist in pulling
a broom for sweeping.
5. Assist good arm in wringing
a rag or sponge.
Level 6 - Fine Motor Assist
Ability to combine components
of strong mass flexion and extension patterns, including fair plus shoulder
control, strong grasp, release and strong pinch are able to perform the
following activities.
1. Assist in tying bows.
2. Assist in fastening a
side zipper.
3. Hold utensil and stabilize
potato while cutting it with a knife.
4. Hold lid on hot pot while
good arm pours out hot liquids.
5. Hold pencil and beginning
to write legibly
Level 7 - Dominant with fine
motor
Fair plus to good isolated
control in shoulder, elbow and wrist, strong grasp and release, lateral
and palmar prehension, and ability to use fingers individually are able
to perform the following activities.
1. Laces shoes.
2. Thread needle.
3. Managing a safety pin
to secure material.
4. Screw nut onto bolt
5. Pick up coins
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Classification of Function -
4 Levels
Level 1 - Placement of Arm
No prehension
Move then fix in space,
hold paper, leaning into it
Level 2 - Use in Relationship
to an Object
Shoulder abduction clamp
to hold object under arm
Forearm hook to carry
Finger hook to carry
Fixed hand to push and pull,
as weight to stabilize
Level 3 - Use of Prehension
Supportive - handrail
Transportive - moving objects
Use of Tool - use of object
to accomplish a task
Level 4 - Skilled Independent
Finger Motion
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