Improvement in Activities of Daily Living Using the Freehand: A System Designed for People with Tetraplegia

2003 ◽  
Vol 66 (3) ◽  
pp. 113-117 ◽  
Author(s):  
Julie Esnouf ◽  
Paul Taylor ◽  
John Hobby
Keyword(s):  
Activities Of Daily Living ◽  
Functional Ability ◽  
Daily Living ◽  
Tendon Transfer ◽  
Hand Function ◽  
International Classification ◽  
Home Work ◽  
Set Up ◽  
Implanted Device ◽  
At Home

The Freehand system is an implanted device for people with C5/6 tetraplegia, international classification 0, 1 and 2. The implant is designed to improve hand function, particularly in those who lack voluntary muscles suitable for tendon transfer. This study investigated how the Freehand system was being used at home, work and leisure. Twelve participants, who were assessed, implanted and trained with the Freehand system, were reviewed against their preoperative goals. Prior to surgery, eight activities of daily living goals that the participant would like to perform with the Freehand system were selected by him or her. Each task was assessed in three sections: the set-up of the task, the performance and the take-down. The amount of assistance for each section was recorded. This was repeated after training had been completed and daily use established. Each participant was also asked to state a preference on how the tasks would be completed, whether with the system or by the method prior to surgery. The results of this study show an improvement in the participants' functional ability in their selected goals when using the Freehand system. The preference for using the Freehand system to complete tasks applied to 84% of the total 96 tasks chosen by the 12 participants in this study.

A pediatric robotic thumb exoskeleton for at-home rehabilitation

2014 ◽  
Vol 7 (3) ◽  
pp. 233-252 ◽  
Author(s):  
Patrick Aubin ◽  
Kelsey Petersen ◽  
Hani Sallum ◽  
Conor Walsh ◽  
Annette Correia ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Degrees Of Freedom ◽  
Hand Function ◽  
Maximum Efficiency ◽  
Fine Motor ◽  
Content Type ◽  
Flexion Extension ◽  
Linear Force ◽  
At Home

Purpose – Pediatric disorders, such as cerebral palsy and stroke, can result in thumb-in-palm deformity greatly limiting hand function. This not only limits children's ability to perform activities of daily living but also limits important motor skill development. Specifically, the isolated orthosis for thumb actuation (IOTA) is 2 degrees of freedom (DOF) thumb exoskeleton that can actuate the carpometacarpal (CMC) and metacarpophalangeal (MCP) joints through ranges of motion required for activities of daily living. The paper aims to discuss these issues. Design/methodology/approach – IOTA consists of a lightweight hand-mounted mechanism that can be secured and aligned to individual wearers. The mechanism is actuated via flexible cables that connect to a portable control box. Embedded encoders and bend sensors monitor the 2 DOF of the thumb and flexion/extension of the wrist. A linear force characterization was performed to test the mechanical efficiency of the cable-drive transmission and the output torque at the exoskeletal CMC and MCP joints was measured. Findings – Using this platform, a number of control modes can be implemented that will enable the device to be controlled by a patient to assist with opposition grasp and fine motor control. Linear force and torque studies showed a maximum efficiency of 44 percent, resulting in a torque of 2.39±1.06 in.-lbf and 0.69±0.31 in.-lbf at the CMC and MCP joints, respectively. Practical implications – The authors envision this at-home device augmenting the current in-clinic and at-home therapy, enabling telerehabilitation protocols. Originality/value – This paper presents the design and characterization of a novel device specifically designed for pediatric grasp telerehabilitation to facilitate improved functionality and somatosensory learning.

scholarly journals Brachioradialis to flexor digitorum profundus tendon transfer to restore finger flexion

2018 ◽  
Vol 51 (02) ◽  
pp. 123-130 ◽  
Author(s):  
R. Srikanth ◽  
Koteswara Rao Rayidi ◽  
Subha Kakumanu
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Tendon Transfer ◽  
Hand Function ◽  
Flexor Digitorum Profundus ◽  
Tendon Transfers ◽  
Wrist Extensor ◽  
Nerve Transfers ◽  
Finger Flexion ◽  
Flexor Digitorum

ABSTRACT Introduction: The main deformity following an adult lower brachial plexus injury is the loss of finger flexion. Distal nerve transfers have been used to restore finger and thumb flexion followed by tendon transfers for intrinsic replacement for opening of the fingers. When patients present beyond 6 months, only tendon transfers are applicable. Since the brachioradialis (BR) is always spared in such injuries, it is the ideal muscle to provide finger flexion. Wrist extensor power may not be normal for the use of the radial wrist extensor to serve as donor. BR to FDP transfer provides reasonable flexion range and an acceptable hand function to permit activities of daily living, when associated with ancillary procedures like opponensplasty, PIPJ arthrodesis. Materials and Methods: Eleven patients underwent a BR to FDP tendon transfer between January 2013 and January 2017 of which eight patients came for follow-up. Results: Four of the eight patients got a functionally useful hand to carry out activities of daily living with hook grip, span grasp, key pinch, chuck grip and pulp pinch. These patients also underwent simultaneous or secondary ancillary procedures. Four of the patients need secondary procedures to further improve functionality of the hand inspite of having a flexion range. Conclusion: The BR is an effective donor in providing adequate range and power of finger flexion in lower plexus injuries.

Using the Internet to assess activities of daily living and hand function in people with Parkinson's disease

2008 ◽  
Vol 23 (3) ◽  
pp. 253-261 ◽  
Author(s):  
Tammy Hoffmann ◽  
Trevor Russell ◽  
Leah Thompson ◽  
Amy Vincent ◽  
Mark Nelson
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Hand Function ◽  
The Internet

Assessment of Hand Function: A Review of Some Tests in Common Use

1985 ◽  
Vol 48 (12) ◽  
pp. 360-362 ◽  
Author(s):  
J A Dent ◽  
Margaret Smith ◽  
Jeannette Caspers
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Elective Surgery ◽  
Hand Function ◽  
Trauma Patients ◽  
Realistic Description

In studies of hand function recently carried out in Edinburgh, one of the problems was to find valid comprehensive measures of outcome following trauma or elective surgery. A small supplementary study was therefore undertaken to examine some commonly used tests of strength and dexterity, and to compare the results with the use of the hand in activities of daily living (ADL). The results indicated that ADL function was more closely correlated with strength than with dexterity. However, no test used in isolation gave a realistic description of hand function for either rheumatoid or trauma patients. It is therefore suggested that a battery of tests, including ADL assessment related to individual need, is necessary.

Non-invasive monitoring of the activities of daily living of elderly people at home – a pilot study of the usage of domestic appliances

2008 ◽  
Vol 14 (5) ◽  
pp. 231-235 ◽  
Author(s):  
Georgina Corte Franco ◽  
Floriane Gallay ◽  
Marc Berenguer ◽  
Christine Mourrain ◽  
Pascal Couturier
Keyword(s):  
Pilot Study ◽  
Activities Of Daily Living ◽  
Elderly People ◽  
Daily Living ◽  
Invasive Monitoring ◽  
Non Invasive ◽  
Domestic Appliances ◽  
At Home

Brachioradialis Transfer for Digital Palsy

1990 ◽  
Vol 15 (3) ◽  
pp. 312-316
Author(s):  
J. M. FAILLA ◽  
C. A. PEIMER ◽  
F. S. SHERWIN
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Tendon Transfer ◽  
Flexor Digitorum Profundus ◽  
Flexor Pollicis Longus ◽  
Pinch Grip ◽  
The Common ◽  
Finger Motion ◽  
Flexor Digitorum ◽  
Tendon Excursion

Although brachioradialis tendon transfer is thought to offer limited tendon excursion and finger motion, we have used it to restore active thumb and digital function in eight patients. Three had Volkmann’s contracture, one avulsion of forearm muscles and four had tetraplegia resulting in inability to perform activities of daily living and loss of pinch or grasp and extrinsic extension. The brachioradialis was transferred to the flexor pollicis longus, to the flexor digitorum profundus or to the common digital extensors. Except for one patient who had unremitting pain, all were pleased with their improved motion, pinch, grip, and independence. Function, however, remained abnormal in all but one.

scholarly journals Rheumatoid arthritis: hand function, activities of daily living, grip strength and essential assistive devices.

Curationis ◽  
2003 ◽  
Vol 26 (3) ◽  
Author(s):  
I Shipham
Keyword(s):  
Rheumatoid Arthritis ◽  
Activities Of Daily Living ◽  
Grip Strength ◽  
Daily Living ◽  
Hand Function ◽  
Assistive Devices ◽  
Hand Dexterity

Persons with rheumatoid arthritis use assistive devices to enable them, in spite of impaired hand dexterity and grip strength, to manage Activities of Daily Living (ADL).

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