title: Effectiveness of adaptive silverware on range of motion of the hand.
abstract: Background. Hand function is essential to a person's self-efficacy and greatly affects quality of life. Adapted utensils with handles of increased diameters have historically been used to assist individuals with arthritis or other hand disabilities for feeding, and other related activities of daily living. To date, minimal research has examined the biomechanical effects of modified handles, or quantified the differences in ranges of motion (ROM) when using a standard versus a modified handle. The aim of this study was to quantify the ranges of motion (ROM) required for a healthy hand to use different adaptive spoons with electrogoniometry for the purpose of understanding the physiologic advantages that adapted spoons may provide patients with limited ROM. Methods. Hand measurements included the distal interphalangeal joint (DIP), proximal interphalangeal joint (PIP), and metacarpophalangeal joint (MCP) for each finger and the interphalangeal (IP) and MCP joint for the thumb. Participants were 34 females age 18-30 (mean age 20.38 ± 1.67) with no previous hand injuries or abnormalities. Participants grasped spoons with standard handles, and spoons with handle diameters of 3.18 cm (1.25 inch), and 4.45 cm (1.75 inch). ROM measurements were obtained with an electrogoniometer to record the angle at each joint for each of the spoon handle sizes. Results. A 3 × 3 × 4 repeated measures ANOVA (Spoon handle size by Joint by Finger) found main effects on ROM of Joint (F(2, 33) = 318.68, Partial η (2) = .95, p < .001), Spoon handle size (F(2, 33) = 598.73, Partial η (2) = .97, p < .001), and Finger (F(3, 32) = 163.83, Partial η (2) = .94, p < .001). As the spoon handle diameter size increased, the range of motion utilized to grasp the spoon handle decreased in all joints and all fingers (p < 0.01). Discussion. This study confirms the hypothesis that less range of motion is required to grip utensils with larger diameter handles, which in turn may reduce challenges for patients with limited ROM of the hand.
authors.affiliation: Department of Occupational Therapy, University of Tennessee-Chattanooga , Chattanooga, TN , United States.
authors.forename: Susan S
authors.initials: SS
authors.lastname: McDonald
authors.affiliation: Department of Physical Therapy, University of Tennessee-Chattanooga , Chattanooga, TN , United States.
authors.forename: David
authors.initials: D
authors.lastname: Levine
authors.affiliation: Allied Health Research unit, University of Central Lancashire , Preston , United Kingdom.
authors.forename: Jim
authors.initials: J
authors.lastname: Richards
authors.affiliation: Honors College, University of Tennessee-Chattanooga , Chattanooga, TN , United States.
authors.forename: Lauren
authors.initials: L
authors.lastname: Aguilar
keywords: Activities of daily living; Adaptive equipment; Arthritis; Disability; Electrogoniometer; Finger; Hand; Range of motion; Self-care; Thumb