Biomechanical assessment of grasping postures in individuals with rheumatoid arthritis when holding adaptive silverware.

INTRODUCTION

Utensils with built-up handles are often recommended to minimize the required finger joint angles for functional grasping to reduce pain and help individuals with Rheumatoid Arthritis (RA) overcome participation barriers. However, there is a paucity of data describing the impact of built-up handles on range of motion (ROM) requirements of the hand. Therefore, the purpose of this study was to evaluate how built-up handles of varying thickness affect hand ROM in individuals with RA.

METHODS

Thirty-five individuals with RA were instructed to grasp a standard handle spoon, a 1.00 inch, and a 1.50 inch built-up handle spoon and perform a simulated eating task. Electrogoniometers were used to measure the finger joint angles of the metacarpophalangeal (MCP), proximal interphalangeal (PIP), and distal interphalangeal (DIP) joints for digits 2-5.

RESULTS

In general, there were significant decreases in finger joint flexion as handle diameters increased. Twenty-nine of the thirty-five individuals selected the 1.50 inch handle to take home with the remainder choosing the 1.00 inch.

DISCUSSION: This study is the first to provide quantitative data to support the notion that the grasping postures required when using built-up handled spoons utilizes reduced finger joint angles for individuals with RA when compared to a standard handle spoon which could help providers when assessing patient needs and when designing hand orthoses. We recommend practitioners provide built-up handled utensils where possible, or educate people with RA on where to buy or how to make adaptive utensils, to assist the independence of individuals with RA.

CONCLUSION

This paper supports the appropriate prescription and use of adaptive silverware by healthcare providers in the promotion of independence for individuals with RA.