The therapeutic importance of ergonomic hand rims:
HANDICAP editor Steffen Schüngel talks to the physiotherapist Margit Schreiner from the specialist unit for paraplegics at the BG Unfallklinik (trauma clinic) in Tübingen about how important ergonomic hand rims, such as the Carbolife Curve, can be from a therapeutic point of view.
Looking back on many years of practical experience, Margit Schreiner is familiar with user needs and knows how to assess the medical effects of medical aids in general and their prophylactic potential in particular. The BG Unfallklinik in Tübingen was one of the first institutions the Curve was available to. Meanwhile, it has become a fixed part in the prescription of medical aids to new patients at the clinic.
But also patients who are readmitted or those who come to the clinic to have their medical aids inspected are generally provided with the opportunity to 'test-drive' the hand rim and to experience its advantages first hand.
"Especially the 'veterans', who have been using a wheelchair for 40 or 50 years now knowing it inside out, and who know exactly what they want, keep surprising me. They very rarely want a new, different wheelchair regardless of it being more light-weight or even better. However, having tested the new hand rim for just a few metres, most of them immediately say that they just have to have it," Margit Schreiner recounts her personal experiences at the clinic. She is glad about the positive response especially from a medical-therapeutic point of view, "The profile of the Curve particularly helps to put the thumb into a better position thus reducing the load on the thumb saddle joint considerably. The carpal tunnel is under less strain, too.“
In practice, she believes, the reduced load means the effective prophylaxis of both the carpal tunnel syndrome and severe arthrotic changes that often occur due to prolonged strain on the upper extremities. "Avoiding malpositioning and intermittent overload of the hand and the wrist joint does not only have a distal, but also a proximal effect," Margit Schreiner explains. "Positioning your hands properly will lead to a load reduction not only in the elbow but also in the shoulder region." It is exactly these loads leading to muscular tension in the shoulders that cause problems with the rotator cuffs and lead to shoulder arthrosis, Margit Schreiner points out and continues to explain that this is the reason why the Curve is also the appropriate choice in case of already existing degenerative problems; because acute pain due to unequal load distribution could be avoided and the progression of the injury delayed. Therefore, she considers the Curve to be an absolutely advisable aid, particularly for paraplegics for whom obtaining a respective prescription is even more complicated than for tetraplegics. "For tetraplegics, whose muscles stabilising the wrist and thumb saddle joints are weakened, the anti-slip coating of the Curve Grip makes it easier to push the wheelchair. It is the special profile of the Curve, however, that exerts the prophylactic effect," she says explaining her request to the cost bearers to take a closer look at the results that could be attained. To users who are interested in the Curve, Schreiner recommends pointing out these particular aspects in connection with already existing injuries or those to be expected to their prescribing doctor. Due to the fact that the upper extremities are essential for the everyday mobility of wheelchair users, an ergonomic hand rim such as the Curve can be medically advisable and necessary.