Developing fine motor strength by targeting the core
By Jessica Jordan, MS, OTR/L
As an occupational therapist, we look at several things before we jump to look at strength in any individual's hands. Like most things in life, a strong foundation is essential to build upon. Our foundation in the human body so happens to be our core, our trunk (both the anterior and posterior musculature of our body). Proximal (in this case musculature closer to the center of our body) strength aka strong trunk musculature helps to lay down the foundation for distal (musculature further away from the body). So in most cases, it would be very hard to develop strength in the hands if an individual has a weaker core or shoulders. This can also be said with overall mobility, and stability; proximal stability before distal mobility.
So how might an occupational therapist explore this? Through clinical observations and informal testing an occupational therapist might observe an individual slouching or requiring additional support to maintain an upright seated posture in a chair. This might suggest proximal weakness which would further lead evaluation to an individual’s distal strength, specifically intrinsic hand strength. I find this to be the case with many students I see in the school based setting, therefore it is so important to develop core and upper extremity strength in order to improve fine motor skills.
There are several ways you might see an occupational therapist doing this. In the following picture, this student and occupational therapist were working together at a playground structure working on outdoor gymnastic rings in order to challenge the student’s core with hanging and pulling up. In turn, this was also targeting upper extremity strength and in this case specifically working on grip strength which is so important in the school based setting in order to develop functional grasp patterns for long term writing success. The added proprioceptive input the student received in their hands and throughout their arms and shoulders also provided increased feedback and awareness which just added to the multitude of things that were being addressed in this one activity!
Another activity that we find motivating for so many of our clients includes paddle boarding. Paddle boarding is another exercise where proximal stability and strength is essential prior to distal mobility. Hence, a grounded and activated core is necessary in order for an individual to maintain their balance in order use their upper extremity to paddle and even grip the paddles. Don’t even get us started on the sensory benefits of this activity too!
We have included some other pictures of where you might see the same concept outlined. Can you tell what is being worked on in the following pictures below?
