Effectiveness of adaptive silverware on range of motion of the hand

Susan S McDonald, David Levine, Jim Richards, Lauren Aguilar, Susan S McDonald, David Levine, Jim Richards, Lauren Aguilar

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.

Keywords: Activities of daily living; Adaptive equipment; Arthritis; Disability; Electrogoniometer; Finger; Hand; Range of motion; Self-care; Thumb.

Conflict of interest statement

David Levine is an Academic Editor for PeerJ.

Figures

Figure 1. Adaptive utensils with modified handles.
Figure 1. Adaptive utensils with modified handles.
These images depict a standard spoon (A), a spoon with a 3.18 cm (1.25 inch) diameter handle (B), and a spoon with a 4.45 cm diameter handle (1.75 inch) (C).
Figure 2. Foam arm rest to support…
Figure 2. Foam arm rest to support the forearm.
Figure 3. Single axis electrogoniometer measuring flexion…
Figure 3. Single axis electrogoniometer measuring flexion of the fifth (pinky) finger metacarpophalangeal (MCP) joint.
Image is demonstrating measuring the MCP joint of the pinky finger. Sensor ‘A’ is placed on the metacarpal shaft and sensor ‘B’ is placed on the proximal phalanx. (Source: Goniometer and Torsiometer Operating Manual. Biometrics Ltd.)

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Source: PubMed

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