Researchers know that fine motor skills decline with age, but despite the many daily tasks that are performed with the hands — dressing, grooming, taking medications — there isn’t much research on hand health in older adults.

Susan Brown, an Arthur F. Thurnau Professor and associate professor of movement science at the School of Kinesiology, hopes to change that. Through her Motor Control Lab, Brown oversees the Hands and Health at Home program, where kinesiology students visit older adults in the Ann Arbor area twice a week to perform exercises to improve hand function.

Hands and Health at Home began as a grant proposal from Ann Arbor Meals on Wheels. U-M Health’s Department of Community Health Services, which houses Meals on Wheels, had funding available for community organizations to address priority areas, including obesity and related illnesses.

Meals on Wheels and Brown’s lab sought to address this issue by improving older adults’ hand function and thus increasing their ability to access and consume healthy foods.

The initiative developed from there into a for-credit experiential study course where students would visit older adults in their homes and teach them exercises focused on improving the dexterity and strength of their hands.

Rachel Logue Cook has run the program for five years. She recently successfully defended her doctoral dissertation.

“When I heard about the program, I thought, ‘Oh, this has teaching, this has aging, this has all the different aspects that I really enjoy in one project,'” she said.

Before sending students into clients’ homes, Logue Cook teaches them how to perform the exercises and monitor their clients’ progress, and how to keep sessions on track while still engaging in meaningful conversations.

Logue Cook collects data at each client’s first and last session, which was used for her dissertation and also the larger work of Brown’s lab. A small pilot study of eight individuals who took the six-week training program was published in the Journal of Gerontology & Geriatrics Education in December.

The study found:

• 75% of clients reported better upper limb mobility after training.
• Significant improvement in pinch strength was observed in most clients.
• Dexterity and grip strength improved in several clients.
• Modest improvements in psychosocial well-being occurred in three clients.
• 88% of trainers saw improvement in their client’s function.

George Valenta volunteered for the program because at age 90, his hand strength had declined. By the end, he saw significant improvement, opening water bottles that once gave him trouble and gripping the rowing machine handles with more force.

“I had absolutely outstanding students,” he said, adding that he appreciated their dedication to developing a tailored program for him. “We were the only group in the project that had perfect attendance. I had so much respect for them.”

Researchers know that there are disparities in hand health, with older Black and Hispanic adults experiencing greater declines than older white adults. They also know that more than 90% of homebound older adults need assistance with at least one activity of daily living, so this type of training is of particular interest to this population, although it’s not just for homebound adults.

“We have enough evidence now to say we could make recommendations,” Brown said. “You know, ‘Here are activities that you could be doing on your own.’ This could go into a nursing home. This doesn’t have to be one-on-one in a home setting.”

Brown and Logue Cook are now working to secure long-term funding solutions to maintain and scale up the Hands and Health at Home program within U-M’s Movement Science curriculum. They are looking at ways to share their training with other organizations — from memory care facilities to rural senior centers — that might benefit.

“We currently have funding to run the program next fall. In the absence of support past that, it will be difficult to continue,” said Brown, who is looking for a part-time coordinator to work with the Meals on Wheels programs and with students.

Long-term goals include taking the program into local chronic care and memory care facilities and expanding to other Meals on Wheels programs. Brown would also like to reach people in the community with age-related hand impairments, such as stroke and Parkinson’s disease.

While it may not result in improved hand function in specific clinical populations, the intergenerational model can help with mood and feelings of isolation, Brown said.

“There’s a lot of different directions this program could go in, so right now it’s just, ‘How do we build it up?’ Because we know it works,” she said.

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