Comparison of Hand Range of Motion During the Use of Normal and Adaptive (Built-Up) Silverware

HYPOTHESIS: The purpose of this study was to examine the range of motion (ROM) needed in the metacarpophalangeal (MCP), proximal interphalangeal (PIP), and distal interphalangeal (DIP) joints of the fingers and the MCP and interphalangeal (IP) joint of the thumb using a normal spoon and several adaptive spoons (1-in. and 1.5-in. diameters). The hypothesis was that the larger diameter spoons would require less ROM in all fingers and in all joints compared with a normal spoon.

RATIONALE: Adaptive utensils with built-up handles are commonly used in practice with the theory that they require less ROM than normal utensils. There is limited data behind the actual physiological effects of the larger diameter grips and how they affect the ROM in the joints. Determining these differences can help in choosing optimal adaptive silverware that may decrease pain associated with simple tasks of daily life.

DESIGN: This was a quantitative, experimental design.

PARTICIPANTS: Thirty-four healthy women between the ages of 18 and 30 yr (mean = 20.38 yr, standard deviation = 1.67) participated in this study. Exclusion criteria included having a previous hand injury, a neurological condition that would impair hand movement, arthritis, or any other condition that would prevent the participant from having normal hand function and ROM. Participants were all right handed to reduce the amount of variables that could potentially affect or influence results. All participants read and signed an informed consent form in accordance with institutional review board approval.

METHOD: Measurements were all performed in triplicate by the same tester using a F35 single-axis electrogoniometer (Biometrics Ltd., Ladysmith, VA). The participants’ arms and hands were positioned on a foam armrest to standardize the position for data collection and so that they could comfortably maintain their right arm during the extent of the process. Participants were measured holding a normal spoon, a 1-in. diameter spoon and a 1.5-in. diameter spoon. Each joint was measured in triplicate with each spoon size for each joint of the fingers (MCP, PIP, DIP), and the MCP and IP joints of the thumb.

ANALYSIS: Descriptive statistics were calculated for each finger, by joint and spoon size. Multivariate statistical analysis (3 × 3 × 4 repeated-measures analysis of variance (spoon size × joint × finger) found main effects of ROM between joints (p < .01) and spoon size (p < .01), but not between fingers (p = .264). As the spoon size increased, the ROM needed decreased in all joints and fingers (p < 0.01).

CONCLUSION: The amount of ROM needed to utilize the spoon decreased as the spoon diameter increased (p < .01), for all fingers and for the thumb. The hypothesis that the larger diameter spoons would require less ROM in all fingers and in all joints compared with a normal spoon was confirmed.

DISCUSSION: This study examined the ROM needed in the hand for adults to use a normal spoon and several adaptive spoons, which are commonly thought to require less ROM. The higher angles recorded when participants were gripping the normal spoon required greater ROM when grasping the regular spoon, which may make it more difficult for someone with a limited ROM due to a hand impairment. Using the data and statistical analyses, it was confirmed that less ROM was required to grip the spoons with built-up handles. A statistical comparison between the ROMs needed in each finger for each of the three spoons proved that there was a significant difference between the angles created at each joint in correlation with the spoon size.

IMPACT STATEMENT: This study quantitatively confirms what most therapists have clinically accepted: that larger diameter spoons require less ROM in all fingers and in all joints compared with a normal spoon.