2015 Grand Prize Winner – Sidney Krandall
Progressive Resistance Exercise (PRE) Design Concept
Two years ago I began volunteer work at the Ann Arbor VA Hospital where I worked closely with patients in occupational therapy (OT), many of whom were struggling with the dexterity of their hands. I became particularly interested in a set of patients who, due to issues such as radial nerve injury, lacked the strength to open their hand at all. Patients struggling with issues involving hand dexterity are likely to require daily assistance, and often face diminished quality of life. While therapist’s work with many of these patients to re-educate the muscles involved in abduction of the phalanges, many patients instead are given a bulky fin-like splint to force the hand open so it may be used. These splints however are reminiscent of a wicked issue in the United States healthcare ideology: the emphasis on quick solutions as opposed to quality solutions. After working with the OT patients I began designing a series of concepts to address hand dexterity so patients can recover daily autonomy, and quality of life. The PRE Design concept submitted for this competition is one of those designs.
The PRE concept was developed so that patients who need to strengthen muscles involved in hand abduction would be able to do so outside of the clinical setting. Often, in-house patients voiced interest in practicing therapies on their own time to reduce the number of clinical visits and speed up recovery. For patients who are not in-house for treatment, this could mean less money spent on travel and less time away from work. The PRE concept is designed to be made of thermoplastic, foam, and weighted Velcro. The body of the design has two parts that create a splint to keep the wrist comfortable and secure while patients practice their exercise. The exercise its self, involves repetition of opening and closing the hand, or individual fingers. It is important that the wrist be kept in a neutral position to ensure it is not assisting the abduction of the phalanges. Debilitation of wrist movement is promised by the ball like form seen in the palm and is part of the anterior portion of the splint. On the phalanges themselves, this PRE design concept demonstrates weighted sleeves that might be slipped onto each finger and secured with Velcro. These sleeves can be graduated to prevent the patient from reaching a plateau. Additionally, if only specific phalanges need treatment, this design allows for customization as the five sleeves are designed to be five separate entities. The concept drawing itself was produced using pen and ink on paper, and was then scanned into and labeled in Adobe Photoshop.