OBJECTIVE. We described the frequency and distribution of keyboard users’ potentially risky postural behaviors. METHOD. Forty-three participants’ keyboard postural behaviors were rated with the Keyboard–Personal Computer Style instrument (Baker & Redfern, 2005). The frequency and distribution of keyboard postural behaviors and the associations and differences between the right and left sides were assessed. RESULTS. Generally, each static posture had one criterion that occurred frequently, whereas dynamic postures were distributed throughout the criteria. The right and left sides were significantly associated for shoulder flexion, elbow flexion, hand displacement, wrist extension, forearm rotation, isolated fifth digit, metacarpophalangeal hyperextension, and wrist support use and significantly different for hand displacement, isolated thumb, number of digits, and metacarpophalangeal hyperextension. CONCLUSION. Potentially problematic postural behaviors are common among keyboard users. Our results suggest that occupational therapists must systematically assess postures on both the right and the left sides to develop the most effective intervention strategies.

Occupational therapists working with infants in neonatal intensive care units (NICUs) make positioning recommendations to optimize self-regulation, with little published data supporting this practice. In this retrospective descriptive study, 15 hospitalized preterm infants (M_{gestational age} = 32 weeks) were videotaped during noncaregiving periods in order to record the frequency of specific behaviors in relation to six infant positions (prone nested, prone un-nested, side-lying nested, side-lying un-nested, supine nested, and supine un-nested). Behaviors coded were those that suggest infant stress or motor efforts at self-regulation, as defined for the original study. Mixed effects regressions and post-hoc Tukey Honestly Significant Difference tests were used to analyze the data, after the calculation of a ratio of the number of behaviors in each position. Higher ratio values reflect a greater occurrence of behaviors. The number of motor self-regulatory and stress behaviors were related to infant position, with the highest ratios of behaviors observed in side-lying un-nested and the lowest in prone nested. Behavior ratios did not differ between prone un-nested and prone nested, nor between supine un-nested and supine nested. More self-regulatory and stress behaviors were related to longer periods of fussing and crying. Longer periods of light sleep were related to fewer stress behaviors. Infants performed the fewest stress behaviors in prone nested, prone un-nested, or side-lying nested. These positions may benefit infants in the NICU by reducing the need for motor-based self-regulatory behaviors and potentially conserving energy for growth.

Objective. The purpose of this study was to investigate the effect of haptic attributes of objects on infants’ grasping patterns and evaluate whether this effect is influenced by the infant’s age (i.e., phase of motor development). Method. Grasping patterns of 180 infants who were typically developing were measured by the Posture and Fine Motor Assessment of Infants (PFMAI); the PFMAI-I was administered to infants 2 months to 6 months of age (n =60), and the PFMAI-II was administered to infants 6 months to 12 months of age (n = 120). Grasping patterns were compared for ages by month and for three objects, each with differing haptic features. The interaction between age and object was analyzed. Results. Grasping patterns were significantly different when scores by age in months were compared. In addition, grasping patterns differed depending on the object and its haptic features and were influenced by the interaction between object held and age. Certain haptic features were associated with primitive grasp at younger ages and precision grasp at older ages. More mature skiffs were observed when the objects’ haptic features appeared to match an infant’s perceptual-motor skill. Conclusion. The haptic features of objects influence an infant’s grasping patterns, and this influence changes with the infant’s age. These results suggest that therapists attempt to match the haptic features of objects to the infant’s perceptual-motor skiff in intervention in order to enhance grasping patterns.

Objectives. Asymmetrical posture during static stance has been identified as a common problem in persons with hemiplegia. This study examined the effect of an activity-based therapy regimen on symmetric weight bearing and midline position of center of gravity (COG) in three adult subjects with hemiplegia. Method. An ABAB single-subject design was used. The intervention program, including sanding in front of a standing table and play a bean bag game, was introduced for 30 min each day during each intervention phase. Quantitative measurements of the weight distribution and the midline position of COG were taken with the Balance Master System (version 2.20). Results. Visual inspection and statistical analysis of the data revealed a significant improvement in symmetric weight distribution and midline position of COG. The study suggests that this program may be a promising alternative to a variety of postural rehabilitation programs for persons with hemiplegia. Conclusion. Insecurity caused by poor stabilization and abnormal reactions to body weight bearing in an antigravity position might contribute to asymmetric postures. Results of this study suggest that an activity-oriented program can be effective in helping the persons with hemiplegia achieve symmetric stances.

A foam cushion was designed for wheelchair users who propel their wheelchairs with the assistance of one lower extremity. It allows users to extend one hip to reach the ground without having to slide forward on the seat, thus maintaining a more erect posture. The cushion was evaluated to identify contraindications for its use. Eleven subjects (10 stroke patients and 1 patient with an above-the-knee amputation) were tested on the Hemi Wheelchair Cushion and on a second cushion chosen by their primary occupational therapists. Seat interface pressures, both before and after dynamic movement, sitting balance, and wheelchair mobility were measured for each cushion. An analysis of mean pressure values revealed no significant difference between the cushions (p = .80). Average pressures after dynamic movement showed a statistically significant difference from pressures before activity (p < .05). Subjective evaluation revealed that the Hemi Wheelchair Cushion did not adversely affect sitting balance or wheelchair mobility, and no contraindications for its use were identified. The results of this clinical evaluation indicate that the Hemi Wheelchair Cushion is an economical and appropriate option for wheelchair users who propel themselves with the assistance of one leg.

This study investigated the concurrent and construct validity of the Posture and Fine Motor Assessment of Infants (PFMAI) (Case-Smith, 1991). The subjects were 90 infants, 65 of whom were healthy and full-term and 25 of whom were premature and had medical risk factors. Concurrent validity was investigated through administration of the Peabody Developmental Motor Scales (Folio & Fewell, 1983) and the PFMAI (n = 25). Strong positive correlations resulted between the Peabody Gross Motor scale and PFMAI Posture scale and between the Peabody Fine Motor scale and PFMAI Fine Motor scale. Concurrent validity was also measured through correlation scores on the Bayley Scales of Infant Development (Bayley, 1969) with scores on the PFMAI. The correlations between the Bayley Motor scale and the PFMAI Posture scale and between the Bayley Mental scale and the PFMAI Fine Motor scale were high. Construct validity was estimated through an evaluation of how accurately the PFMAI discriminated between the premature subjects and the full-term subjects . A discriminant analysis indicated that the PFMAI accurately classified 78% of the subjects as being either premature or full-term (i.e., 80% of the full-term subjects and 72% of the premature subjects). When the premature subjects were categorized as low-risk or high-risk according to their medical histories, the PFMAI accurately classified 66.7% of the total subject population as full-term, low-risk premature, or high-risk premature. These results indicate that the PFMAI has the adequate reliability and validity necessary for use as a clinical and a research instrument. Uses of this instrument include obtaining baseline data for planning therapy and evaluating the short-term effectiveness of intervention focused on enhancing posture and movement. The PFMAI can assist occupational therapists in analyzing posture and movement when using a neurodevelopmental approach and provides a prototype for objective measurement of the qualitative aspects of movement.

Published protocols for the volumetric assessment of upper-extremity edema differ regarding patients’ posture. The present study was designed to determine the effect of posture on test–retest reliability and mean volume. Thirty women were tested in both seated and standing postures. For the dominant hand, test–retest reliabilities for the seated posture were identical to those for the standing posture. Test–retest reliability was slightly stronger for the nondominant hand in sitting than for the same hand in standing. Both postures afforded clinically acceptable test–retest reliabilities. The mean volumes in sitting were significantly lower than those in standing (p < .0001), thus suggesting that volumetric measures should be considered discontinuous if the patient’s test posture is altered. Mean volumes of the dominant hand averaged 9.3 ml more than those of the nondominant hand. It is suggested that this discrepancy be considered in the establishment of goals for edema control and in the determination of the need for continued edema treatment.