What is Fine Motor Disability?
Fine motor disability is a difficulty or impairment in doing tasks which need a certain amount of manual skill. This is not a disease by itself, but it’s usually a sign of another underlying medical condition. Being able to make even simple delicate movements with our hands or feet involves a number of different parts of our brain and nervous system. These parts work together to make sure we can perform tasks accurately and smoothly.
Sometimes, if you injure your muscles or bones, this might also affect your ability to make fine movements. Although we often use our hands for these tasks, being able to control your feet precisely is also important. This is particularly true for athletes who need to make small, specific movements when they’re playing sports. For example, some people who were born without hands but still need to perform tasks requiring fine motor skills (like painting), will use their toes instead.
However, when doctors check for fine motor disability, they usually focus more on how able someone is to use their hands. This is because our hands play an important role in our everyday life. Look at young children, for instance. By observing how well a child can use their hands, doctors can tell whether they are developing as expected. For example, a two-month old baby should be able to hold a rattle and by the time they are a year old, they should be able to hold objects between two fingers of the same hand.
Our ability to use our hands in this way is actually one of the features that sets humans apart from other animals. It allows us to carry out complex tasks with precision and control. And throughout history, being able to use and make tools has been crucial for our survival.
Being able to diagnose fine motor disability quickly is especially important for children. This is because if a child has this disability, it’s a signal that they might have an underlying neurological disorder. Plus, fine motor skills are an indicator of a child’s social and cognitive development. Finally, three key parts of fine motor control are how well we can adjust our grip strength, how quickly we can move, and how well coordinated our movements are.
What Causes Fine Motor Disability?
Fine motor skills, or the ability to make small, precise movements, require a complex interaction between different parts of your nervous system. There are many reasons why these skills can be impaired, so let’s discuss a bit more about what controls your fine motor skills and what can potentially go wrong.
Fine motor control centers in our brain, like the Pre-motor and motor cortex, start our movements. Damage to these areas can lead to paralysis of certain muscle groups, which can stop us from performing detailed or larger movements.
The cerebellum, another area in our brain, is responsible for coordinating our movements, especially complex, pre-planned ones. If this area gets damaged, our coordination can be affected, and we might face trouble executing fine movements.
The basal ganglia are crucial for coordinating movement and controlling voluntary movement. Diseases like Parkinson’s and Huntington’s specifically affect this area, causing shaking and stiffness, making smooth and detailed movements difficult.
Descending corticospinal tracts are pathways that carry instructions for movement from our brain to our spinal cord. If these pathways are damaged, you might face difficulty in performing both larger and smaller tasks. For example, pressure from a cervical disc prolapse can impact your hand movements.
Peripheral nerves carry instructions from the spinal cord to our muscles. The severity of movement problems can depend on which specific nerve is affected. For example, carpal tunnel syndrome can disrupt fine motor control in the affected hand due to pressure on the median nerve.
Visual feedback plays a crucial role in developing fine motor skills. However, some people can develop these skills without visual feedback. For instance, many professional musicians who are born blind have exceptional fine motor abilities.
The hand has one of the highest concentrations of sensory nerves and receptors in the body. Any interruption to these nerves can lead to a loss in fine motor control. For example, diabetic peripheral neuropathy, a condition where diabetes damages nerves, can disrupt fine motor functions.
The hand also includes over 30 muscles, 20 major joints, and hundreds of ligaments. Precise joint movement is critical for fine motor control, and any disease that results in joint damage can affect these skills. For example, rheumatoid arthritis, an autoimmune disease, can cause fine motor disability.
Your emotional wellbeing can also influence fine motor control. For example, ‘choking’, or performing below your usual level due to performance anxiety, can reduce your fine motor control.
Lastly, certain neuropsychiatric conditions like Autism spectrum disorder and attention-deficit disorder have been linked to delays in developing fine motor control. This is thought to be due to delays in cognitive development.
Risk Factors and Frequency for Fine Motor Disability
Fine motor disability, which affects the small movements of the body like those in the hands, can result from a variety of different causes. This diversity makes it challenging to precisely determine how many people are affected by it. Besides, not many population-based studies have solely focused on fine motor disability. However, let’s have a look at some stats related to conditions that often come with fine motor disabilities.
In the case of kids in the U.S., about 17.8% have some kind of developmental disability. Here’s how that breaks down:
- About 9.5% have attention deficit hyperactivity disorder (ADHD).
- Approximately 2.5% are on the autism spectrum.
- About 1.2% have an intellectual disability.
- Other causes account for around 4.1%.
As for adults:
- About 2.8% of the U.S. population has had a stroke. Half of those people end up with hemiparesis, which is weakness on one side of the body.
- Rheumatoid arthritis affects about 2% of people in North America. Around 30% of those people need help with personal care.
- About 1.1% of the U.S. population has endured a traumatic brain injury, and 43% of these patients have a lasting disability.
- About 3.6% of U.S. folks have a disability that affects self-care.
Signs and Symptoms of Fine Motor Disability
Fine motor disability is a term used to describe issues that affect a person’s small body movements, like the hands and fingers. It differs from gross motor disability, which affects the large muscles in the body, like the arms and legs. These two types of motor disabilities are tested in different ways by doctors.
When testing gross motor ability, the doctor often asks the patient to perform basic movements. For example, the patient might be asked to keep their arm out and resist the doctor trying to push it down. This allows the doctor to check if the larger muscles like the deltoid muscle (in the shoulder) are working properly.
On the other hand, the evaluation of fine motor skills involves tasks that require delicate coordination. The medical specialist might ask the patient to unbutton a shirt, pick up a coin, or draw a spiral. These tasks help the doctor to assess the precision and control in the patient’s small movements.
Some commonly used assessments for fine motor skills are writing tests and the Nine-hole peg test. The writing test involves checking the person’s handwriting, focusing on how readable and quick their writing is. Meanwhile, the Nine-hole peg test examines a person’s manual dexterity by asking them to move small pegs into small holes. This is a standard test used for patients with conditions like multiple sclerosis, which can affect the nervous system and motor skills.
Testing for Fine Motor Disability
In situations where someone is having trouble with fine movements (fine motor disability), the cause can vary greatly which means the tests that doctors order can also vary. The decision to order certain tests is usually made based on the individual’s health history and the findings from the physical examination. In some cases, doctors can make a diagnosis purely on what they see during the clinical exam, and no additional tests are needed. But for other cases, more investigation is necessary. Here are some of the most common tests they might ask for, although there are many others that could be used:
* Blood tests: A complete blood count (this measures different parts of your blood), a comprehensive metabolic panel (a group of blood tests that give information about your body’s metabolism), liver function test (to check how well your liver is working), C-reactive protein (a substance that increases in your blood with inflammation), B12 level, folate level, bone profile (a series of tests to assess the health of your bones), rheumatoid factor (a protein found in your blood if you have certain autoimmune diseases like rheumatoid arthritis), anti-neutrophil cytoplasmic autoantibody (substances produced by your immune system that can mistakenly target your own cells and tissues), fasting glucose, and hemoglobin A1c (both of these tests check your sugar levels)
Imaging: Computed tomography (CT scan) of the brain or spine (uses X-rays to make detailed pictures of the structures inside your body), X-ray of the neck vertebrae, magnetic resonance imaging (MRI) of the brain or spine (uses powerful magnets and radio waves to make detailed pictures of the inside of the body)
Nerve conduction studies: These tests measure how fast your nerves conduct electrical signals. They can help detect nerve injury or damage.
Cerebrospinal fluid sampling: A procedure where a small amount of the fluid that surrounds your brain and spinal cord is removed and tested. This can help diagnose infections, diseases, or other problems affecting the brain and spinal cord.
Genetic testing: These tests can look for changes in your genes that might cause health problems.
Treatment Options for Fine Motor Disability
The way we would go about treating a person’s difficulty with precise movements, often called a fine motor disability, depends largely on what’s causing the issue. There are various approaches we could take to help manage this issue, and I’ll mention just a few:
If the problem is due to something called ‘cervical myelopathy’, a medical term for compression on the spinal cord in the neck area, surgical procedures can be carried out to alleviate the pressure.
For stroke survivors, a new type of treatment that uses noninvasive magnetic pulses to stimulate the brain has shown promising results. This kind of ‘non-invasive brain stimulation’ treatment can potentially improve the person’s ability to handle objects and control their fingers and hands – skills that are often referred to as ‘manual dexterity’.
Another procedure, called ‘deep brain stimulation’, which involves sending electrical signals to certain areas of the brain, can be helpful for patients with movement disorders like Parkinson’s Disease.
Interestingly, practices like music training have been found to enhance manual dexterity in stroke survivors, probably due to the fine hand movements required to play most instruments.
Medication may also play a role in managing fine motor disabilities. For example, Parkinson’s disease patients might be prescribed a combination drug known as carbidopa/levodopa, which can help manage the movement difficulties associated with this condition.
Lastly, therapies involving physical activity or occupational tasks, such as physiotherapy and occupational therapy, can also be beneficial in improving fine motor skills. These therapies are especially helpful for stroke survivors and people with other brain-related conditions affecting their motor abilities.
What else can Fine Motor Disability be?
Fine motor disability isn’t a condition by itself, but rather a symptom that could indicate various underlying issues. As discussed earlier, there are several ways to establish whether such a symptom exists or not. The range of possible root causes, as, pointed out previously, is broad.
What to expect with Fine Motor Disability
The outlook for fine motor disability largely depends on its root cause, which means there’s no one-size-fits-all prognosis. Fine motor disability can affect anyone, regardless of their age, and can have a variety of causes.
Possible Complications When Diagnosed with Fine Motor Disability
The complications a person might face depend heavily on the age at which the symptoms began, how severe those symptoms are, and what underlying condition is causing them. A common complication is that fine motor skills may be significantly affected, which can have a big impact on their day-to-day life and may even affect their mood and thinking abilities.
The circumstances that can lead to complications include:
- The age the symptoms first started
- The severity of the symptoms
- The underlying condition causing the symptoms
- Impairment of fine motor skills
- Impact on daily activities
- Effects on mood and cognitive abilities
Preventing Fine Motor Disability
Research has shown a close link between problems with fine motor skills (how well kids can make small movements with their hands, fingers, and wrists) and developmental disorders in children. It’s also been found that kids who have good fine motor skills tend to also be better at thinking and controlling their emotions. It seems that having problems with thinking skills or emotional control can affect fine motor skills and vice versa.
Given these findings, health care professionals encourage parents to engage their young children in activities that help improve fine motor skills. We see similar impacts in elderly people. For them, difficulties with fine motor skills can significantly affect their quality of life, because these skills are needed for day-to-day tasks.
Therefore, for both children and seniors, it’s important to make the most of surgeries, medications, physical therapy, and occupational therapy. They can all help improve fine motor skills, and thus overall health.