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Biomedical subjects

Heidi Schwellnus

Publications and source records attributed to Heidi Schwellnus.

3 recordsLinked to original sources

A novel instrument for quantifying grip activity during handwriting.

OBJECTIVE: To describe and exemplify a noninvasive instrumentation system that uniquely records grip forces exerted on the barrel of the writing utensil along with typical temporal and kinematic parameters. DESIGN: Exploratory case series. SETTING: A tertiary care, pediatric rehabilitation hospital. PARTICIPANTS: Convenience sample of 6 primary school children with spastic hemiplegic cerebral palsy (CP) with documented fine motor difficulties and 6 children with no known handwriting difficulties. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Grip and normal forces during handwriting. RESULTS: The instrumentation revealed nontrivial correlations between normal and grip forces (0.55 +/- 0.16), a temporal delay between normal and grip forces (97.7 +/- 16 ms), and a consistent grip-to-normal force ratio (4.3 +/- 1.5), across all participants. Grip force distributions agreed intuitively with qualitative observations of individual grasps of the writing utensil. Further, 5 new parameters derived from grip force measures statistically differentiated between able-bodied children and those with hemiplegic CP. CONCLUSIONS: The proposed instrumentation provides new insight into grip and normal force coordination and has the potential to uncover discriminatory grip force characteristics between writers with and without handwriting difficulties. Further study with larger populations is required to define functional ranges for the new grip measures.

Biomechanical Phenomena↗

Caregiving process and caregiver burden: conceptual models to guide research and practice.

BACKGROUND: Parental care for a child with a developmental disability is an enormous responsibility, one that can far exceed that of typical parental care. While most parents adapt well to the situation of caring for a child with a disability, some do not. To understand parents' adaptations to their children's disabilities, the complex nature of stress processes must be accounted for and the constructs and factors that play a role in the caregiving must be considered. DISCUSSION: Evidence suggests that there is considerable variation in how caregivers adapt to their caregiving demands. Many studies have sought to qualify the association between caregiving and health outcomes of the caregivers. Contextual factors such as SES, child factors such as child behaviour problems and severity of disability, intra-psychic factors such as mastery and self-esteem, coping strategies and social supports have all been associated with psychological and/or physical outcome or parents or primary caregivers. In reviewing these issues, the literature appears to be limited by the use of traditional analytic approaches which examine the relationship between a factor and an outcome. It is clear, however, that changes to single factors, as represented in these studies, occur very rarely even in the experimental context. The literature has also been limited by lack of reliance on specific theoretical frameworks. SUMMARY: This conceptual paper documents the state of current knowledge and explores the current theoretical frameworks that have been used to describe the caregiving process from two diverse fields, pediatrics and geriatrics. Integration of these models into one comprehensive model suitable for this population of children with disabilities and their caregivers is proposed. This model may guide future research in this area.

Adaptation, Psychological↗

The development of the tool for optimizing written productivity (TOW-P).

Many school-aged children experience difficulties in written productivity, which result in a large number of referrals for school-based Occupational Therapists (OTs). Health care practitioners are being called upon to establish consistent practice, yet there are presently no guidelines to facilitate consistency in this clinical area. The Tool for Optimizing Written Productivity (TOW-P) was developed to assist OTs in decision-making regarding intervention selections for this population. A pilot study and a province-wide survey yielded specific frequencies of intervention for different written productivity issues that can be used to guide a therapist's selection of interventions.

Child↗