Dear OncoLink "Ask The Experts,"
I am a hand therapist working with a patient who had 2 separate cases of a brain tumor. She is now seeing us for treatment of an abnormal grasp reflex. She is showing the signs of the infant grasp reflex (stroking the palm causes an instant, very strong grasp). She is unable to actively release this grasp at times. She is now starting to show slight finger extension when this reflex is triggered. From your standpoint, is there anything we can do or anything she can do to help with this situation? I'm asking this not only for this patient, but for any other person who may have this reflex and not know what to do to stop it.
, Margie Roos, PT, DPT, NCS, Assistant Professor and Director of Clinical Education at the University of the Sciences in Philadelphia, Physical Therapy Department responds:, responds:
The hyper-reflexia that you are describing occurs when there is an upper motor neuron injury (UMN). When you have an UMN injury, the threshold for an excited response is lower, so that even a minor noxious trigger can initiate the reflex. To decrease the tone, you can try weight bearing through the upper extremity. A recommended position is with the arm extended, slightly abducted, and externally rotated. The wrist should be in extension and weight bearing through a surface. Hold this position until the tone releases. The patient can do this whenever the "reflex" is triggered.