Upper Limb Strength as a Factor in Effective Operation of Body-Powered Terminal Devices


A DOE/NIDRR funded study is in progress to improve grip in young children's body-powered terminal devices. We planned to measure the strength children have available for operation of a terminal device and compare findings to the mechanical operating requirements of children's terminal devices in a "power in-power out" equation. Data from this study will be useful for subsequent terminal device design studies and for guiding clinical decision making about children's terminal devices. This presentation will describe the study on children's upper limb strength. The study of mechanical (power out) factors of body powered terminal devices is being conducted at Stanford University and will not be discussed in detail at this time. A pilot study was conducted to measure strength of arm and shoulder girdle motions of 14 children, between 3-6 years of age, who have unilateral congenital below-elbow limb deficiencies. Using a myometer, and recently reported normative data, we learned that the children's strength is below the norm on both the sound and limb deficient sides. A second phase of the study is in progress with 20 children, of the same age and diagnosis as those in the pilot study, to find out (1) whether these children also have less than normal arm and shoulder strength (to increase the sample), (2) whether these children's strenuous play activities differ from those of non-limb deficient children, and (3) whether strength can be increased, in comparison to the norms, through an intervention that increases specific strenuous play activities focusing on arm and shoulder motion, and appropriate to the child's age and interests. Specific findings from the pilot study and the methodology of the second phase of the study on children's strength will be presented.

Shriner's Hospital for Crippled Children, 3160 Geneva St., Los Angeles, CA 90020-1199