title: Hand versus mouth for call-bell activation by DMD and Becker patients.
abstract: Severe hand dysfunction is common in patients with Duchenne muscular dystrophy (DMD) and may preclude the use of conventional call-bells. We prospectively evaluated a call-bell with two hand-controlled interfaces (push-button and key-pinch) and two mouth-controlled interfaces (sip-or-puff) in 32 consecutive DMD and Becker patients. Patients called intentionally 348 times, using the sip-or-puff device 237 times and the hand-controlled interfaces 147 times. Use of the hand-controlled interfaces correlated with key-pinch strength (R=0.366; P=0.04). Six patients reported being unable to call with the hand interfaces and five patients reported temporary call failure due to inaccessibility of the sip-or-puff interface. Ease-of-use scores on a visual analogue scale were best for puff, followed by sip then key-pinch interrupter and push-button (8.7+/-2.1, 7.5+/-2.7, 6.2+/-3.9, and 0.5+/-2.0 respectively; ANOVA: P<0.00001). In conclusion sip-or-puff devices should be considered more often to provide neuromuscular patients with greater independence.
authors.affiliation: Intensive Care Unit and Department of Physiology-Functional Testing, Garches Institute, and Centre for Technological Innovation, Raymond Poincaré Teaching Hospital, AP-HP, 92380 Garches, France.
authors.forename: Nadine
authors.initials: N
authors.lastname: Pellegrini
authors.forename: Amélie
authors.initials: A
authors.lastname: Pelletier
authors.forename: David
authors.initials: D
authors.lastname: Orlikowski
authors.forename: Christian
authors.initials: C
authors.lastname: Lolierou
authors.forename: Maria
authors.initials: M
authors.lastname: Ruquet
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Raphaël
authors.forename: Frédéric
authors.initials: F
authors.lastname: Lofaso
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D005260:Female; D005500:Follow-Up Studies; D006225:Hand / Q000503:physiopathology*; D006801:Humans; D008297:Male; D020388:Muscular Dystrophy, Duchenne / Q000473:pathology* / Q000503:physiopathology*; D010147:Pain Measurement; D011446:Prospective Studies; D011597:Psychomotor Performance / Q000502:physiology*