Effectiveness of Adaptive Silverware on Range of Motion of the Hand

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 x 3 x 4 repeated measures ANOVA (Spoon handle size by Joint by Finger) found main effects on ROM of Joint (F (2,33) = 318.68, Partial η2= .95, p < .001), Spoon handle size (F (2,33) = 598.73, Partial η2 = .97, p < .001), and Finger (F (3,32) = 163.83, Partial η2 = .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

Fall prevention intervention technologies: A conceptual framework and survey of the state of the art

In recent years, an ever increasing range of technology-based applications have been developed with the goal of assisting in the delivery of more effective and efficient fall prevention interventions. Whilst there have been a number of studies that have surveyed technologies for a particular sub-domain of fall prevention, there is no existing research which surveys the full spectrum of falls prevention interventions and characterises the range of technologies that have augmented this landscape. This study presents a conceptual framework and survey of the state of the art of technology-based fall prevention systems which is derived from a systematic template analysis of studies presented in contemporary research literature. The framework proposes four broad categories of fall prevention intervention system: Pre-fall prevention; Post-fall prevention; Fall injury prevention; Cross-fall prevention. Other categories include, Application type, Technology deployment platform, Information sources, Deployment environment, User interface type, and Collaborative function. After presenting the conceptual framework, a detailed survey of the state of the art is presented as a function of the proposed framework. A number of research challenges emerge as a result of surveying the research literature, which include a need for: new systems that focus on overcoming extrinsic falls risk factors; systems that support the environmental risk assessment process; systems that enable patients and practitioners to develop more collaborative relationships and engage in shared decision making during falls risk assessment and prevention activities. In response to these challenges, recommendations and future research directions are proposed to overcome each respective challenge.The Royal Society, grant Ref: RG13082

The use of assistive devices and change in use during the ageing process among very old Swedish people

Purpose: To investigate the characteristics and change in use among very old Swedish users and non-users of assistive devices (ADs) for mobility and personal care, over a six-year period, and to investigate factors predicting AD use over a six-year period. Method: Descriptive statistics and logistic regression were used to analyse quantitative data from a subsample from the Swedish part of the ENABLE-AGE Survey Study, n = 154. Variables according to socio-demographics, environment and health were utilized. Results: The number of users increased over time, particularly those using both types of ADs (mobility and personal care). There were differences in health between users and non-users, while no such differences were seen regarding socio-demographics or environmental factors. Health factors most prominent predicted AD use after six years, but also variables within socio- demographics and the environment had an impact on the use; income for ADs for personal care and aspects in the outdoor environment for ADs for mobility. Conclusions: As ADs increases over time, it is important, to pay attention to health as well as other factors, among users and non-users of ADs, to provide important information in planning for and supporting healthy and active ageing