Running head: ASSISTIVE DEVICE

Swimstay Kickboard Assistive Device

Edith Feld
Touro University Nevada

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Introduction

The use of the upper extremities are extremely important in everyday life activities. The
ability to manipulate the shoulder, wrist, hands, and fingers to perform different functions is
crucial to ones life. Though it is possible to live a healthy and independent lifestyle without the
use of one or both upper extremities pain, discomfort, and deformities brought on by disease and
disability, such as rheumatoid arthritis, can negatively impact an individual in many ways.
Rheumatoid arthritis is an autoimmune connective tissue disease that is characterized by a
decrease in functional ability, pain, and joint destruction (Durmus, Uzuner, Durmax, Bilgici, &
Kuru, 2013), and can effect adults and children. One area of the body that is primarily effected
by this painful condition are the hands. The hands are an intricate tool used in many individuals
daily lives, but if pain and discomfort come with utilizing them it may hinder ones ability to
engage and participate in the occupations they need and want to do.
Population
Literature Review
Loss of the ability to grip is a major deficit observed in those with rheumatoid arthritis.
Normally, individuals use their hands to grip, manipulate, feel, and hold objects and tools, which
would be compromised over time for someone with this diagnosis. A study conducted on those
with rheumatoid arthritis looked into the relationship clients have with disease activity, quality of
life, and handgrip strength (Durmus et al., 2013). According to researchers, the most frequently
involved joints in RA are hand and wrist joints. Structural damage in these joints during disease
course can lead to deteriorations in hand functions (Durmus et al., p. 471). Not everyone will
experience the same effects that come along with rheumatoid arthritis, but as previously
mentioned the hands are almost always impacted. Based on these statements, according to the

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study, it is estimated that the hands and wrists are affected in 80% to 90% of the patients with
rheumatoid arthritis (Durmus et al., 2013, p. 467). The goal of the study was to measure the
clinical relevance of the Michigan Hand Questionnaire with patients with rheumatoid arthritis as
well as evaluate the relationship between the questionnaire and the disease activity of rheumatoid
arthritis, quality of life, and hand grip strength separately. The study utilized multiple tools such
as the Disease Activity Score, Visual Analog Scale, Disabilities of Arm, Shoulder, and Hand,
MHQ, Short-Form 36, Health Assessment Questionnaire, and Arthritis Impact Measurement
Scales-hand and finger function scale-2 along with a dynamometer to evaluate pain, current
disabilities, and hand muscle strength. At the conclusion of the study researchers stated that an
individuals functional incapacity occurs due to a decline in hand motor coordination,
performance, and quality of life because of increased pain and disability, which was found based
on the results from the assessment instruments (Durmus et al., 2013).
Though an individual with rheumatoid arthritis may be experiencing these symptoms it is
not an indicator to not participate in physical daily life activities, such as exercise. According to
a study on the benefits of exercise on physical and mental health for a population of those with
rheumatoid arthritis there are various options about what types of exercise is appropriate for
those with rheumatoid arthritis such as walking, swimming, aerobic exercise classes, and cycling
(Zippenfening & Sirbu, 2014). Researchers were aware that lack of physical activity and
depression are common among individuals with rheumatoid arthritis. This study was then
designed to determine the benefits of moderate intensity exercises on physical activity and
mental health in those with rheumatoid arthritis. The correlation between physical activity and
mental health, including depression was also studied. Continued participation in these activities
has been shown to improve muscle function, joint stability, endurance, and physical functioning.

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It has also been found that moderate intensity exercise programs are safe and beneficial to
individuals with rheumatoid arthritis (Zippenfening & Sirbu, 2014). Engagement in physical
activity also contributes to improvement in mental health and quality of life. These factors allow
individuals to remain involved in regular exercise activities, which are useful in controlling the
symptoms of joint stiffness, fatigue, and depression. As a result functional disability occurs due
to deterioration of motion, coordination, and motor performance (Zippenfening & Sirbu, 2014).
Results also indicated that higher levels of physical activity were related to improvement in an
individuals mental health. Furthermore, physical and mental health outcomes increased
significantly after six months of engagement in moderate aerobic training (Zippenfening &
Sirbu, 2014).
An occupation that has been studied and known to positively affect those with
rheumatoid arthritis is the activity of swimming. Swimming, or hydrotherapy, is an occupation
that individuals of various ages can engage in at their own pace. It has the ability to be graded
up or down to suit the needs of the individual whether it be used as a recreation activity or for
therapy. According to Eversden, Maggs, Nightingale, and Jobanputra (2007) hydrotherapy
performed in warm water decreases the load on painful joints, promotes muscle relaxation, and
allows exercise activities to be done against water resistance. The National Arthritis Foundation
also stated that heated pools temperature for those with rheumatoid arthritis should range
between 82 and 88 degrees Farenheit to help soothe joints (Pagn & Kelley, n.d.). The study
aimed to see whether hydrotherapy or land exercises affected an individual with rheumatoid
arthritis more positively in health, physical function, and quality of life. At the end of their study
researchers discovered that the individuals who participated in exercises in a heated pool were
more likely to feel much better or very much better than patients doing similar exercises on

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land (Eversden et al., 2007, p. 6). Researchers continued to report that they cannot say
hydrotherapy is a better form of exercise over other activities for rheumatoid arthritis, but it does
positively impact an individuals current joint pain and stiffness (Eversden et al., 2007).
Swimstay Kickboard Assistive Device
Swimming is an occupation that has been a huge part of my life over the years. I have
seen people of all ages and disabilities use swimming as a therapeutic tool to enhance range of
motion, muscle strength, and endurance capabilities. Individuals can utilize their own bodies or
have the option to incorporate equipment, such as flippers, goggles, life-jackets, and kickboards.
One item that may not be able to be used by someone with rheumatoid arthritis is a kickboard,
which is widely used in the swimming community. This equipment piece requires an individual
to grasp and stabilize the front of the board with their hands the entire time they are swimming.
It provides an individual a source of support for the arms, so they can concentrate on proper
technique for kicking and breathing. It would also allow an individual with rheumatoid arthritis
to increase their physical fitness capacity. With that in mind I felt passionate about designing a
kickboard that can be used by those with decreased hand function, especially for those with
rheumatoid arthritis. The extra support would give an individual with rheumatoid arthritis the
opportunity to use this popular piece of equipment so they participate in the activity a lot more
and feel safer when in the water. Adapting a kickboard would allow someone with decreased
grip strength and hand function the opportunity to swim laps, increase their endurance, and
practice their kicking without having to worry about using their hands to stabilize the board. The
adapted kickboard would have elastic band straps for the wrists and forearms that would secure
the arms and hands to the board, but would allow someone to remove their hands immediately if
needed for safety. The straps would not put pressure on wrists if they were to be swollen or

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suffer from any type of deformity. The board will also would have a surface over the top that
would provide more of a cushion and support for the user. Non-slip strips will be placed down
the length of the board to provide a less slippery surface. Swimming in a heated pool with the
support of an adapted kickboard would allow an individual to be more functionally independent
with swimming in a safe and fun way. All of the materials used on the kickboard were meant for
the water, so it is extremely durable in the pool. The total cost of materials for the board with
one elastic strap was 28.98 dollars and the total for the board with two individual straps was
29.06 dollars. See Table 1 below for material cost breakdown.
Table 1
ITEM
Kickboard

VENDOR
All American Swim

ONE STRAP
BOARD
$12.95

TWO STRAPS
BOARD
$12.95

*Item Donated

*Item Donated

Place Mat

99 Store

$0.50

$0.50

Elastic Band Strap

Michaels Craft Store

$3.14

$3.14

Gorilla Glue

Michaels Craft Store

$3.50

$3.50

Pins

Walmart

$0.04

$0.12

Clear Outdoor
Double-Sided Tape

Home Depot

$7.45

$7.45

Non-Slip Strips

Walmart

$1.40

$1.40

Similar Device
In regards to existing models of an adapted kickboard there has not been much produced
for providing support to the wrists or hands. There is one kickboard designed to have a flexible
plastic strap across the top of it for only one hand, but still requires finger and hand strength to

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keep the hands in place. This product can be found online by the company Finis. It is sold
through the company itself or through Amazon and Swim Outlet. It can be sold for a standard
price around 20 dollars, which does not include shipping and handling. The product description
states that an individual would not have to grip this board because of the strap, but it is only
meant for one hand. The other hand is placed on top which would still require some hand
strength to keep it stable. If used by someone with rheumatoid arthritis it would make that
individual put pressure on a possible swollen hand, which could be extremely painful. There are
also boards with cut outs to assist an individual with different placements for gripping, but they
still require someone to utilize their hand and figure strength to keep the board in place. These
type of boards can be found online from the same companies and are sold for a standard price
between 15 and 25 dollars. After researching current products I found multiple patent designs
aiming to alter the shape and contour of kickboards, but none reconstructing a way to enhance
grip or stabilization for those who are unable to perform the action of gripping, which is required
to properly use a kickboard.
Conclusion
Overall, impairments can contribute to a decline in function over time. Individuals with
rheumatoid arthritis will see various areas of their body impacted, but will especially see a
decline in hand function. Though they may experience painful symptoms those with the
diagnosis can engage in everyday activities, such as swimming, with the assistance of adaptive
devices such as the Swimstay Kickboards.

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8
References

Durmus, D., Uzuner, B., Durmaz, Y., Bilgici, A., & Kuru, O. (2013). Michigan Hand Outcomes
Questionnaire in rheumatoid arthritis patients: relationship with disease activity, quality
of life, and handgrip strength. Journal of Back and Musculoskeletal Rehabilitation, 26(4),
467-473
Eversden, L., Maggs, F., Nightingale, P., & Jobanputra, P. (2007). A pragmatic randomised
controlled trial of hydrotherapy and land exercises on overall well being and quality of
life in rheumatoid arthritis. BMC Musculoskeletal Disorders, 8(1), 23.
Pagn, C. N. & Kelley, S. (n.d.). Water walking 101. In Arthritis Foundation. Retrieved May 7,
2015 from http://www.arthritis.org/living-with-arthritis/exercise/workouts/simpleroutines/water-walking.php.
Zippenfening, H. & Sirbu, E. (2014). Benefits of exercise on physical and mental health in
rheumatoid arthritis patients. Timisoara Physical Education & Rehabilitation
Journal, 7(13).