Running head: ASSISTIVE TECHNOLOGY PAPER

Assistive Technology Paper

Evelyn Babaroudi
Touro University Nevada
Introduction
Since the inception of assistive technology (AT), occupational therapy (OT) has expanded
its scope of practice to incorporate technological devices into clinical practice. The
implementation of AT devices has increased the efficacy of interventions and created
opportunities for individuals with various and complex disabilities to engage in meaningful
occupations. In the process of conceiving and developing an AT device, an important role of the
OT is to assess the impact of impairment on the clients ability to engage in a desired occupation.
The AT device addressed in this paper, Get a Grip, provides individuals diagnosed with a hand
impairment a simple and economical approach to painting.
Rheumatoid Arthritis
Hand function is a dominating component of everyday life. For individuals diagnosed
with a hand impairment, the capacity to perform various activities can be limited due to

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increased pain and functional loss. Impaired hand function is a common consequence associated
with Rheumatoid Arthritis (RA) and often impacts an individuals ability to participate in daily
tasks. According to Adams, Burridge, Mullee, Hammond, and Cooper (2002) Rheumatoid
Arthritis (RA) is a chronic systemic autoimmune disorder of unknown aetiology characterized by
symmetrical joint synovitis and pain (p. 406). Since occupational therapists (OTs) are
concerned with daily activity and participation, hand function is an important consideration for
practitioners working with clients diagnosed with a hand impairment. Individuals with RA
typically experience limitations in the extent to which they can engage in occupations and
activities. RA is prevalent amongst 1% to 2% of the United States population, primarily affecting
women, with symptoms characterized by aches, pain, stiffness, and swelling affecting small and
large joints on both side of the body (Engel, 2013). When working with clients diagnosed with
RA, the OTs assessment of hand function is important in determining the individuals ability to
engage in important life roles and activities. The implementation of AT can positively influence
the lives of clients diagnosed with RA and enable performance in meaningful activities.
Client and Diagnosis
Emma Lynn is a 67-year-old female recently diagnosed with Rheumatoid Arthritis (RA).
Professional painting is Emmas primary occupation. She reports that art has grown to be a
central aspect of her life, and a leisure activity in which she participates in daily. Emmas work
spans across a wide range of media, including: pastels, watercolors, water-soluble oils, and
acrylics. Emmas medical history includes Carpal Tunnel Syndrome (CTS) in the left upperextremity (UE). She was diagnosed with CTS over 10 years ago, however continued painting
despite symptoms of increased pain and weakness in the affected hand.

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Currently, Emma experiences bilateral joint pain, swelling and stiffness in the hands
secondary to RA. She also has reduced range of motion (ROM) in the left UE secondary to CTS.
Emma is independent in all activities of daily living (ADL) and instrumental activities of daily
living (IADL), however expresses concern regarding her pain, decreased grip strength, and
inability to manipulate a paintbrush efficiently. Emma would like to minimize her symptoms
while continuing to participate in the activity of painting.
Purpose of Device
Participation in leisure activities is important to maintaining a healthy and well-balanced
life. Get a Grip is an AT device that enables individuals diagnosed with a hand impairment the
ability to engage in the activity of painting. The device is designed for individuals with
decreased hand function who are unable to hold a paintbrush, either properly or for an extended
period of time, secondary to physical symptoms, including: pain, swelling, stiffness, decreased
range of motion (ROM) of the wrist, and flexion of the thumb and fingers.
The device is beneficial for individuals with reduced grip strength or weakness of the
hand or wrist, as it helps stabilize the wrist in an extended position while painting. In addition to
this, it reduces pressure and grip force, thereby decreasing pain or functional impairment. The
device provides a spherical object in which the individual can insert a paintbrush through and
paint with better stability. The device also addresses different components or tasks associated
with painting, such as opening paint bottles. A visual of the product is presented in Figure 1. The
clip of a keychain is removed and inserted into the tennis ball to help open or access paint
bottles. This is particularly beneficial for individuals with severe pain, stiffness, swelling, or
weakness of the hands.
Figure 1: Model of Device

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Usability Assessment
For individuals with greater pain or functional loss, the Get a Grip glove can be strapped
on the hand for better stability and support. In order to utilize the device, the individual simply
inserts the paintbrush through the hole of the tennis ball, straps on the glove, positions their hand
around the ball (velcro attaches ball to glove), and begins painting. For better accuracy in
brushstrokes, simply slide or position the tennis ball closer to the brush. For lighter movement or
faster brushstrokes, simply slide or position the ball toward the end of the brush, as Figure 2
shows.
Figure 2. Get a Grip

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Figure 2. Positioning the ball toward the brush helps stabilize the paintbrush for fine details.
Construction and Cost Analysis of Device
Get a Grip provides a simple and inexpensive approach to painting for individuals with
limited hand function. The tools and materials required to construct the device can be purchased
in craft supply stores, department stores or hardware stores. Items such as a tennis ball and key
chain may be available at no cost, reducing the cost of Get a Grip by more than one half.
Table 1
Cost Analysis
Materials
Penn Championship
3-pack Tennis balls
12-pack nickel free key
chain

Quanti
ty

Price per
item

Total price*

Store

3
12

$0.73
$0.25

$0.73
$0.25

Target
Michaels

Total price

$0.98

*Total price denoted above indicates total cost for a quantity of 1.

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Cost Analysis with glove

Materials
Penn Championship
3-pack Tennis balls
12-pack nickel free key
chain
1 Pair of Weight Lifting
Gloves
Black Velcro
Adhesive Tape

Quanti
ty

Price per
item

Total price*

Store

3
12

$0.73
$0.25

$0.73
$0.25

Target
Michaels

$3.50

$3.50

Marshalls

1/10

$1.00
$0.50

$1.00
$0.50

Michaels
Jo-Ann Fabric &
Craft

Total price

$5.98

Current Products
Similar products are currently available online and in art supply stores. One product is
the Black Egg Handles Brushes, referenced in Figure 3, which costs $14.67. The product can be
purchased at an art supply store, such as Blick. Although the device does provide an ergonomic
handle for individuals with decreased grip strength, the product is still relatively expensive.
Another limitation of the device is that in order to hold the handle, the individual still requires a
proper grasp, which may be difficult for those with weaker grip strength. Get a Grip is
potentially easier to utilize as it requires a spherical grasp and only requires cupping of the object
with slight finger flexion.
Figure 3. Black Egg Handles Brush

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Figure 3. Retrieved from: http://www.dickblick.com/items/05195-1012/

Another potential product is the Abilitations AbiliGrip Adapted Foam Grip. A set of 12
foam grips can be purchased on the Amazon website for $17.32. Similar to the previous product,
this foam grip helps increase fine motor skills for holding objects. It helps enhance the
individuals stability and grip while utilizing eating utensils, writing instruments, or paintbrushes.
One quality of the product is its soft texture, as it provides good durability and comfort while
gripping the utensil or tool. Similar to the previous product, a potential drawback or limitation of
the AbiliGrip is that it still requires proper grasp. In addition to this, the product is sold in a pack
of 12 ($17.32), therefore is more expensive than the Get a Grip.
Figure 4. Abiligrip

Figure 4. Retrieved from: http://www.amazon.com/AbiliGrip-Adapted-Foa Grips/dp/B0042S

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Literature Review
Individuals with RA experience various symptoms that may fluctuate daily and progress
over time. Loss of grip strength is one aspect of hand function that can deteriorate rapidly in
clients diagnosed with arthritis and interfere with daily functioning. In an empirical
demonstration describing the hand strength, self-reported ability and health status of individuals
diagnosed with osteoarthritis (OA) or RA, Chen and Giustino (2007) found that individuals with
arthritis exhibited decreased grip strength and pinch strength, greater functional limitations, and
barriers to participation in everyday activities. The study featured 14 participants diagnosed with
arthritis (12 women, 2 men) ranging from 55 to 82 years of age. The participants were recruited
from a rehabilitation department in a medical facility in the United States.
The Manual Ability Measure (MAM) is an outcome measure designed to capture a
clients self-perception of hand use or performance in everyday living (Chen and Giustino,
2007). The questionnaire consists of 36 items measuring the degree of difficulty in performing
everyday tasks with responses based on a 4-point likert scale. The researchers of this study
administered the MAM to participants. Upon completion of the questionnaire, the researchers
measured the participants grip and pinch strengths (tip pinch, lateral pinch, 3-jaw chuck) using
standard procedures. The results of the study indicated that participants had weaker grip and
pinch strength in comparison to 70-year-old female norms as arthritis is typically more prevalent
in females than males (Chen and Giustino, 2007). This information is important as physical
impairment can potentially affect a variety of tasks, as well as inhibit an individuals capacity or
desire to engage in preferred activities.

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The MAM was also administered to predict the participants level of difficulty with
performing specific tasks. Chen and Giustino (2007) found that activities such as cutting nails
and opening medicine bottles were a difficult task for individuals with arthritis to perform. These
tasks require precision, coordination, and strength. Therefore, symptoms such as pain, swelling,
and decreased muscle strength in individuals with arthritis may potentially interfere with an
individuals ability to perform tasks that require similar characteristics or patterns of movement.
According to Chen and Giustino (2007), Physical impairment due to arthritis such as joint pain,
deformity, loss of strength or range of motion may interfere with a persons occupational
performance at the task level, or at the role level (p. 12). The results of this study perhaps
indicate the need for AT in individuals diagnosed with arthritis or any other condition in which
similar symptoms are present.
Another research study highlights the role of occupational therapy in enabling individuals
diagnosed with RA to resume important life roles. For example, Malcus-Johnson, Carlqvist,
Sturesson and Eberhardt (2005) found that the use of AT is highly prevalent amongst individuals
diagnosed with RA indicating that women typically receive on average 12 devices and that from
the various OT interventions (e.g., orthoses, AT, hand exercise, patient education) AT is used in
41% of cases. The article goes on to identify different adapted devices that are commonly used
amongst females, including: scissors, potato peelers, springy tongs, tap extension, and special
knife. AT devices utilized for grip function and household activities were most prevalently used
for completion of day-to-day activities. According to Malcus et al. (2005), All patients
described benefits from different [AT] devices.One patient stated, assistive devices are
enormously important to achieve quality of life (p. 131). This perhaps suggests that the

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implementation of AT in OT practice plays a significant role in addressing the needs of

individuals with RA that may have decreased hand function.
Conclusion
Get a Grip provides individuals diagnosed with a hand impairment a simple and costeffective approach to painting. The device is designed to be used with individuals with varying
degrees of hand impairment, ranging from CTS, RA, OA, and so forth. Get a Grip essentially
helps increase capacity and reduce pain, thereby enhancing an individuals willingness and
ability to engage in the activity of painting. Hand function may deteriorate rapidly in
individuals with RA, therefore implementation of AT can decrease pain and functional
impairment while still allowing the individual to engage in meaningful activities.

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References
Adams, J., Burridge, J., Mullee, M., Hammond, A., & Cooper, C. (2004). Correlation between
upper-limb functional ability and structural hand impairment in an early rheumatoid
population. Clinical Rehabilitation, 18(4), 405-413.
Chen, C., & Giustino, J. (2007). Grip strength, perceived ability, and health status in individuals
with arthritis: an exploratory study. Occupational Therapy In Health Care, 21(4), 1-18.
Engel, J. M. (2013). Evaluation and pain management. In H. M. Pendleton & W. Schultz-Krohn
(Eds.), Pedrettis occupational therapy: Practice skills for physical dysfunction (7th ed.,
p. 721). St. Louis, MO: Elsevier.
Malcus-Johnson, P., Carlqvist, C., Sturesson, A., & Eberhardt, K. (2005). Occupational therapy
during the first 10 years of rheumatoid arthritis. Scandinavian Journal Of Occupational
Therapy, 12(3), 128-135.