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TABLE 3: Activities which aggravate the
Boutonnière and Swan Neck Deformities
of the thumb and fingers.
The weakest point on a
finger with a zigzag deformity is on its tip. Any
force applied on the tip and directed towards the
long axis of the finger (axial loading) can
aggravate the collapse or "buckling" of successive
finger joints. Resistive pinching tasks place an
axial load on the tip of your thumb, index, and
middle fingers which accentuate the zigzag deformity
pattern. Lateral pinching, that is, pinching with
the thumb pad and side of the index finger, takes
the load off the finger tips and is less deforming. |
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Activities |
Joint Protection
Techniques |
Assistive Device
Recommendation |
Self- Care Tasks:
1. Squeezing tooth paste tube. |
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Technique 1:
Avoid squeezing or pinching the
toothpaste tube with the fingers.
Place the tube on the counter and
press with the palm instead.
Technique
2: Buy toothpaste tubes
with flip caps instead of twist on
caps to avoid pinching with fingers.
Plastic tubes are easier to squeeze
compared to tin tubes.
Technique
3: Use assistive
toothpaste dispensers. Some brands
of toothpaste have a push
button dispensing mechanism which is
very convenient to use. |
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Technique
1: Use lateral pinch
(pinching with thumb pad and side of
index finger) instead of fingertip
pinch when buttoning. It may be
difficult at first but practice
makes perfect!
Technique
2: Use button hooks that
allow you to grip a handle instead
of pinching the buttons with your
fingers.
Technique 3:
Use velcro
tabs on your garments when possible. |
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1. Button
hooks.
2. Velcro tabs.
3. Cuff and collar button extender. |
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Technique
1: Use clothing with
bigger zipper handles that allow for
lateral pinch instead of tip to tip
pinch.
Technique 2:
To avoid pinching with the
fingertips, bend the index and
middle fingers and pinch the zipper
handle in between them.
Technique3:
Attach
loop tabs on handles of zipper. This
will allow you to pull the zipper by
slinging your thumb on the loop
instead of pinching the zipper with
your fingers.
Technique 4:
Use
clothing with Velcro closures
instead of zippers. |
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1. Zipper
rings/loops.
2. Zipper hook handle.
3. Velcro tabs. |
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Kitchen Tasks:
Turning a stove switch. |
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Technique 1:
Use lateral pinch (pinching with
thumb pad and side of index finger)
instead of fingertip pinch when
turning the stove switch. While
keeping your wrist straight, turn
the switch by rotating the entire
forearm. Do not turn the switch by
using isolated wrist or finger
movements.
Technique
2: To avoid pinching with
the fingertips, bend the index and
middle fingers and pinch the stove
switch in between them. While
keeping your wrist straight, rotate
the entire forearm to turn the
switch on.
Technique
3: Use an assistive
grip device such as the Uniturner,
which allows you to turn the stove
switch by gripping a handle instead
of pinching with your fingers.
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Household Tasks:
1. Turning a key. |
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Technique
1: Use lateral pinch
(pinching with thumb pad and side of
index finger) instead of fingertip
pinch when holding the key.
Technique 2:
While keeping your wrist straight,
turn the key by rotating your
forearm instead of using isolated
wrist or finger movements.
Technique
3: Use a lever key
holder which allows you to turn the
key by pushing the lever against
your palm instead of pinching the
key with your fingers. |
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2. Turning a lamp switch. |
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Technique
1: For lamps with
rotating switches: Avoid turning the
switch using the tips of the thumb
and index fingers. Use a lateral
pinching pattern by holding the
switch with the pad of the thumb and
the side of the index finger. While
keeping your wrist straight, rotate
the switch by moving your entire
forearm and elbow.
For lamps with push pin type
switches: Do not push the pin switch
using the tips of your thumb or
index finger. This happens when you
position your hand directly in front
of the switch. Doing so will
hyper-extend a weak joint. Instead
try positioning your hand at the
side of the switch and while keeping
the thumb or index finger joint
straight, push the pin switch with
the fleshy pad of the thumb or index
finger.
Technique 2:
Increase the size of a rotating lamp
switch by attaching an adaptive
lever.
Technique 3:
Use a palm switch on most commonly
used lamps which allow pressing with
the palm, thereby protecting finger
joints.
Technique 4:
Use lamps
with Touch Tronic switches. These
lamps can be turned on by simply
touching anywhere on its body. |
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1. Lamp
switch extension lever.
2. Touch Tronic lamp converter.
3. Palm-push switch.
4. IKEA slide switch? |
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3. Opening caps of small bottles
or containers.
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Technique
1: Do not twist the cap
by pinching with the tips of the
thumb, index and/or middle fingers.
Use a lateral pinching pattern by
holding the cap with the pad of the
thumb and the side of the index
finger. Avoid isolated finger or
wrist movements when turning the
cap. While keeping your wrist
straight, turn the cap by using
elbow and shoulder movements.
Technique 2:
For smaller caps, bend the index and
middle fingers and pinch the cap in
between them. Turn the cap by using
rotating forearm movements.
Technique
3: Avoid over-tightening
bottle caps to make it easier to
re-open them.
Technique 4:
Use containers with flip caps as
much as possible.
Technique 5: Use
medicine dispensers for frequently
used medications. |
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4.
Opening envelopes and other
packages. |
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Technique
1: Do not use the tips of
your thumb, index, and middle
fingers to pinch and tear open
envelopes or packages. Use lateral
pinching patterns by holding these
items with the pad of the thumb and
the side of the index finger. Avoid
twisting movements of the wrist and
fingers. While keeping your wrist
straight, use gross movements of the
elbows and shoulders to pull
packages open.
Technique
2: Avoid manual tearing
if possible to protect finger
joints. Cut them open using utility
knives or spring loaded scissors.
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1. Spring
loaded scissors.
2. Utility knife. |
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Technique
1: Do not hold the pen by
using the tip if the thumb and index
finger. Use lateral pinching
patterns by placing the pen between
the fleshy pad of the thumb and the
side of the index finger.
Technique 2:
Avoid heavy pinch pressure when
writing. Learn how to write
"lightly".
Technique 3:
Use ergonomic pens. They are usually
wider and makes use of a roller gel
ink that glides easily on paper for
light and smooth writing.
Technique 4:
Increase the diameter of a regular
pen by using cylindrical foam
inserts.
Technique 5:
Avoid isolated wrist and finger
movements when writing. Learn how
write using gross movements of the
forearm and elbow while minimizing
movements on your wrist and fingers. |
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1.
Ergonomic pens.
2. Cylindrical foam inserts.
3. Pen grip assists. |
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