Article Review: Koontz, et al. (2006). Investigation of the Performance of an Ergonomic Handrim as a Pain-Relieving Intervention for Manual Wheelchair Users. Assistive Technology, 18 (2), 123-143. Pittsburgh, PA.

Jennifer Rowland, Ph.D.

Pain is a common secondary condition for many people with disabilities and can be a major barrier to independence and a satisfying quality of life. Assistive technology that is designed to decrease the risk of pain in daily activities can therefore be an important adaptation for people with disabilities. Carpal tunnel syndrome (CTS) among manual wheelchair users has been reported in the research literature to range from 40% to 74%, and wheelchair propulsion has been shown to contribute to development and exacerbation (worsening) of CTS. In the Journal of Assistive Technology, Koontz et al. (2006) investigated an ergonomic handrim as a means of reducing pain for manual wheelchair users.

Three related studies were conducted to determine the effect of an ergonomic wheelchair handrim on hand and wrist pain reduction and improved ability to function for manual wheelchair users. The handrim tested was the 'Natural-Fit' and included the following design features:

• Contoured slot for the thumb that improves grip for propulsion
• High friction coating on propulsion surface that enhances propulsion efficiency
• Expanded smooth surface for braking without pinching
• Ergonomic grip reduces pressure on the carpal tunnel and reduces forces necessary to stabilize the hand on the rim
• Larger overall surface area eliminates need for a pinch grip, removes need to grip tire, and avoids awkward postures

Results from the three studies indicated that pain decreased and functional outcomes increased across three populations of manual wheelchair users who were testing the device. Therefore, the implications of using assistive technology to alleviate pain can potentially provide a means of adaptations to prevent a common and extremely limiting secondary condition.

To readers: if you use assistive technology that has been helpful in reducing secondary conditions for you, let me know and I may feature it in an upcoming column.

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