Monday, May 2, 2011

multiple sclerosis ms fine motor skill

The human hand: one of the most precious and most commonly taken for granted body part we have. We use our hands to work, to play, to communicate, to feel,  and even to help express our emotions. Unlike other limbs on our body our hands operate on a much more intricate level both mechanically and neurologically. The complex system of tendons and muscles that make our hands work give us what is known as "fine motor skills".

"Fine motor skills are the coordination of small muscle movements which occur e.g., in the fingers, usually in coordination with the eyes. In application to motor skills of hands (and fingers) the term dexterity is commonly used." -Wikipedia

What does this mean? Well more simply put, fine motor control is what allows us to type, hold a pencil, button our pants, or even simply pick up and hold an object. You know how they say "you don't know what you've got til you loose it"? Well that couldn't be more true when it comes to fine motor skills. It's amazing how many little things become complicated tasks when you loose your fine motor skills in even just one hand! Typing becomes near impossible, holding a pencil proves to be more then frustrating, buttoning your pants brings you closer to an emotional breakdown then anything else you have ever experienced, and simply holding a glass of water brings about more stress then holding a ticking time bomb.

There are many different situations and medical causes for a loss of fine motor skill but of course I will be talking about Multiple Sclerosis (MS) and specifically the effects of fine motor control loss in the hands. As explained before, Multiple Sclerosis can cause many physical complications as a result of demyelination and possibly even nerve damage. This prevents electrical signals sent from our brain from getting to the body parts they need to get to such as our hands. This can result in a loss of strength, sensation, and coordination or more simply put: fine motor skills.

I myself have a lot of fine motor issues in my left hand that get better and worse over time. At one point I could barely make a fist and then for a while I was back to playing the piano! Not only did I have my coordination back but I had my strength back! At this point however I am sort of in the middle of those two extremes. If I concentrate really hard I can make my hand do what I want it to do allowing me to carry out certain tasks such as typing or even playing some simple tunes on the piano. However, if I get to comfortable and stop focusing on my fine motor skills my hand grows limp and all coordination goes out the window. I start hitting the wrong keys and will occasional loose grip of something as light as a glass of water.

This is very frustrating to me personally because I have always been a very "hands on" kind of guy. I have always used my hands for artistic purposes weather it be for drawing, playing music, building, or sculpting and now those things that once came so easily to me are sometimes not always possible. It's an odd feeling to look down at your hands while your trying to play piano and not be able to make them play a tune that you once were able to play with your eyes shut! Its almost like looking at someone else's hands trying to will them with your mind to play a song. It just doesn't feel right...

Even more frustrating has been my doctors reactions to my claims. As I just mentioned, if I concentrate really hard and make a conscious effort to use my hands I can, at least right now that is. So as a result of my ability to sometimes carry out intricate tasks my doctors don't understand or believe that I am having a hard time with daily tasks such as brushing my teeth, doing my hair, or making breakfast. I can touch my finger to my nose so clearly I am fine right? Wrong. When we are in the middle of our stressful, hectic, lives, we don't always remember to focus 80% of our attention on making sure our house keys are firmly gripped between our fingers. It's a really frustrating thing when you are droppings something every two seconds.

Now here is where I can go in two directions. Depending on the individual and their current situation they may or may not be in a position to carry out certain tasks no matter how hard they focus their attention on it. So for someone like me I think it's important to keep moving! Practice exercises that help stimulate fine motor skills. This is where an occupational therapist (not to be confused with a physical therapist) would come in handy. An occupation therapis's job is to help you learn how to continue your daily activities or "occupations" with your disability. They might have you carry out certain exercises such as screwing nuts onto bolts or manipulating clay between your fingers to help build muscle strength.

For anyone who is not quite even able to do as much as someone above my advise get's a little weak... When I could barely move my hand my doctor told me trying to exercise it was pointless because the issue was a result of demyelantion... It was a nerve thing. I refused to sit around and do nothing though... I was playing with a barrel of monkeys and continuously manipulating my fingers how ever I could. I don't know if it helped in the long run or not but I don't think it necessarily hurt. I believe the human body is a little more amazing then most people think and in certain situations you can make it heal in extraordinary ways. You might not get everything back but surely exercising with your disability will help you learn how to carry out old tasks in new ways. So again my advise is to keep moving

8 comments:

  1. Matt, I'm excited that you mentioned OT! Have you ever seen an occupational therapist for your MS? I'm not sure which services are covered by insurance and which aren't - I guess it varies by situation - but it would be worth inquiring with your doctor to see if you could get a referral. If you're near USC (best occupational therapy school in the nation!), then there are probably tons of awesome OTs in your area!
    I know that you had mentioned OTA school...I think you'd be great because you definitely think like an occupational therapist already! :-D

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  2. I havn't brought it up to my doctor for any reasons but personally I don't think I would need one. My disability isn't bad enough where I can't figure out how to deal with certain things on my own haha so FOR NOW I think I'm ok. Hopefully it stays that way.

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  3. I think doctors tend to be ignorant here of what can be done with Physical Therapy. If you don't get a good response from your doctor, find other resources like PT. Also, books about the brain can be very interesting here. I recommend "The brain that changes itself" highly.

    Alan

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  4. Thanks, I agree. I just don't know what to do anymore.

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  5. I can totally relate: a recent bad relapse has so screwed up my hands. I'm constantly dropping stuff - it drives me crazy. And it's no wonder people with Ms are exhausted - concentrating on holding anything is tiring! I too play instruments and continue despite it all. I'm giving therapy putty a go to strengthen my fingers - try it! Advice from my PT. I believe in the brain's elasticity and ability to rewire itself so really do keep trying no matter what. i reckon we can all ace the finger-nose test mostly because it's been asked of us too many times! Our brains have that one figured out. :P

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  6. Yeah I think my brain only knows how to do the finger to nose thing because I have done it a jillion times and it knows how the crease on my skin at my elboe should feel. If I realy wanted I bet I could play music again but I just... It's not on my priority list haha,

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  7. Weird how i can still play my violin tunes but putting up shirts, holding things etc is increasingly hard.it's as though the fingers remember tunes and behave!

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    Replies
    1. That IS weird, I had to stop playing piano/guitar because I couldn't hit the notes right anymore. But I guess it is all about what nerve is effecting which tiny muscle. How are you with timing?

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