Running head: ASSISTIVE TECHNOLOGY ROLL AND WRAP YOGA MAT 1

Assistive Technology Device: The Roll and Wrap Yoga Mat

Hayley J. Meredith
Touro University Nevada












ASSISTIVE TECHNOLOGY ROLL AND WRAP YOGA MAT 2

The Roll and Wrap Yoga Mat
This adaptive device was designed to benefit people with rheumatoid arthritis (RA) who
participate in yoga. The Roll and Wrap Yoga Mat assists in rolling the yoga mat up, replaces
repetitive hand movements, and encourages engagement in yoga as both an occupation and
exercise program. Yoga has many health related benefits for people with RA which will be
explained later in detail later. There is evidence-based research to support the purpose of the
Roll and Wrap Yoga Mat, and how it can enhance function performance of this population.
There is no other product available for purchase like this adaptive device. A consultation with
Caren Strait, a gentle yoga instructor in Henderson, Nevada, was conducted for project and she
showed support the potential for this device with her yoga students. The Roll and Wrap Yoga
Mat is a practical solution to ensure continued engagement in yoga for clients with RA without
fear of generating pain when operating their yoga mat.
Introduction to Rheumatoid Arthritis
RA is a chronic condition which is often unpredictable and may lead to long term
disability. RA is the most common type of autoimmune arthritis and affects at least 1.3 million
adults in the United States (Rheumatoid Arthritis, 2014). About 75% of those affected are
women and the disease most often begins in the fourth and sixth decades of life (Rheumatoid
Arthritis, 2014). However, RA can begin at any age. Being an autoimmune disease, RA causes
cells of the bodys immune system to dysfunction and attack healthy tissue in the joints
(rheumatology.org). In RA, the focus of inflammation is in the tissue that lines the joint, known
as the synovium (Rheumatoid Arthritis, 2014). The immune cells release inflammation-causing
chemical which damage the joint cartilage which cushions the joint between the bones
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(Rheumatoid Arthritis, 2014). The ultimate result is a disabling and painful condition which can
lead to the loss of functioning and mobility if left untreated.
Treatment for Rheumatoid Arthritis
Pharmacological and non-pharmacological are current treatment options for those
suffering from RA. There is no cure for RA, but treatments are accomplished to improve
symptoms and slow the progression of the disease. Goals of treatment are to minimize
experienced symptoms such as pain and swelling, to prevent bone deformity, and to maintain
daily functioning. Medicinal treatment can be achieved by analgesics and disease-modifying
antirheumatic drugs (Lifestyle and Home Remedies, 2013). However, management of RA also
includes lifestyle changes, complementary alternative medicine, dietary supplements, and
surgery (Lifestyle and Home Remedies, 2013). Regular exercise, a healthy diet, and good stress
management are golden rules that can benefit everyone. However for clients with RA, these
lifestyle changes can help manage a chronic disease.
Lifestyle Remedies
There are several self-care measures that client can use along with RA medication to
manage their symptoms at home. Regular exercise and relaxation are recommended by the
Arthritis Foundation (2014). They suggest that an exercise regime may be just what a client
needs to ease their pain and improve their energy level. Studies show that regular RA exercise
may help to reduce joint pain and stiffness, increase joint mobility and muscle strength, and
improve psychological well-being (Rheumatoid Arthritis, 2014). Yoga is a practice of exercises,
breathing techniques, and meditation that began in ancient India 5,000 years ago, and is proven
to help people with arthritis improve many of their physical and psychological symptoms
(Rheumatoid Arthritis, 2014). Gentle yoga for clients with arthritis includes slow and gentle
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poses, which help to spread lubrication like synovial fluid and the nutrients around the joints in
the body (C. Strait, personal communication, 2014).
Innovation of the Device & Clientele
The Roll and Wrap Yoga Mat is an assistive device designed to accommodate the needs
of clients with RA, specifically adults. This idea for this device was conceived during a yoga
class at Trufusion Yoga studio in Las Vegas after a woman was struggling to roll up her yoga
mat after a class. Caren Strait, a gentle yoga instructor in Henderson, Nevada was contacted for
consultation on this project. In an interview, she stated, I do have students with arthritis and
other issues in the hands. It can make it tough to roll a [yoga] mat; especially on the bad days
(C. Strait, personal communication, 2014). There are many adults who are involved with yoga as
a means of exercise and relaxation to maintain their RA symptoms who could benefit from an
assistive yoga mat. Caren Strait also defends how RA can affect the clients participation in their
program, Some people would have to skip class, or have a private lesson where the teacher sets
up the mat and props (C. Strait, personal communication, 2014). When asked if she believed
this assistive device would benefit her clients with RA she stated, I think this has promise, not
just for arthritis, but for amputees, persons recovering from stroke or traumatic brain injury,
persons with multiple sclerosis, and many more! ... they could sit in the chair or use it for more
stability while picking up the mat and using the self-rolling feature (C. Strait, personal
communication, 2014).
Purpose of Assistive Device
This adapted device was developed to assist adults with RA who participate in yoga, so
that they no longer struggle rolling up their mat or flare up their hand and wrist pain by trying to
do so. Pain and reduced grip are major symptoms in RA (Nordenskild and Grimby, 1996), and
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clients would experience difficulty rolling up the yoga mat because of painful inflammation in
joints, and muscle weakness.
Activity demands are specific features that influence the type and amount of effort
required to perform an activity (Occupational Therapy Practice Framework, 2014). The activity
demands required to roll up a yoga mat in the tradition way include particular body functions.
These required body functions are neuromusculoskeletal and movement-related functions of
joints and bones, such as joint stability and mobility. Muscle functions like strength and
endurance are also required. To roll a classic yoga mat, the client must then perform repetitive
fine motor movements of the fingers, hands, and wrists to wind up one end of the mat, and then
continue rolling it tightly to the other end. It is difficult to roll a yoga mat without telescoping to
one side and requires bilateral fine motor movements and adjustments to roll it properly. A
typical yoga mat is 68 inches and such a distance may become strenuous for a person with RA.
Enhanced Functional Performance
The Roll and Wrap Yoga Mat requires the use of both upper extremities to coordinate the
device. One hand manipulates the mat, while the other stabilizes the frame. Once in a c-shaped
grasp at the base of the mat, the client is required to perform a single wrist flexion movement to
roll up their mat. Caren Strait enforced the importance of limiting repetitive movements while
doing gentle yoga, We don't do a lot of repetitions or high stress movements, which can cause
more inflammation (C. Strait, personal communication, 2014). There is added foam padding
around the frame of the device which promotes comfort in the opposite hand while opposite hand
holds the strap. The device, including the yoga mat, weighs a total of three pounds which is a
feasible load for a client with RA to carry on their own. After timing the performance of the
device, the spring-loaded mechanism generates the mat to easily roll up in less than 2 seconds. A
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strap is attached to the frame so that the client eliminates the added task of adjusting a strap
around the yoga mat before and after each session. Caren Strait spoke positively of the strap and
padding in her interview, The padding will also make it more comfortable when carrying with
the strap so the wood doesn't bump sensitive or inflamed areas (C. Strait, personal
communication, 2014).
Construction of the Device
The construction of the Roll & Wrap Yoga Mat began at Home Depot where the roller
window shade was cut to fit the width of the yoga mat, two feet wide. At home the wooden
frame was first assembled.
Wooden Frame
A wooden one inch squared dowel was sawed into three portions. Two short four and a
half inch sections, and one long twenty-six and a half piece. The ends of the two small
rectangular pieces were attached perpendicularly with two screws each to each end of the longer
portion. The hinges for the roller curtain shade were screwed in to the inside of the short legs of
the wooden frame.
Yoga Mat
The curtain of the roller window shade was removed from the spring loaded roller
mechanism. The yoga mat was then attached at one end to the cylindrical spring mechanism
permanently with a staple gun. The yoga mat was then rolled by hand and placed into the hinges
of the wooden frame. The device was tested and determined to be operational.
Comfort and Aesthetics
The long handle of the wooden frame was covered permanently with foam and fabric to
add padding and comfort. Two eyelet screws were attached to the top of the short legs of the
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frame so that a strap could be fixed. A small foam and fabric pad was sewn around the strap, and
could be moved freely to adjust for comfort.
Similar Devices & Vendors
There are two known adapted yoga mats advertised on the internet, the Iku Mat and the
Nadi Yoga Mat. Both were developed in 2012, but are each patent pending and not available for
purchase. Although each of these mats provides an increased level of assistance than the classic
yoga mat, neither was created with a specific diagnosis or disabled population in mind.
Photographs are available in Appendix A.
Iku Mat
This mat was created with snap-bracelet- like technology. Creators used bi-stable spring
material reengineered on a larger scale to incorporate it onto a yoga mat. To roll out the Iku Mat
one end is dropped to the ground and it snaps flat. To roll it up it is flipped over and one end is
lifted, or snapped (IKU MAT, 2012), up using a lateral pinch of the hand. The mat then rolls
up onto itself without telescoping. The Iku Mat is advertised online, however it is not available to
purchase.
Nadi Yoga Mat
This yoga mat is less assistive than the Iku Mat because it required more manual
manipulation to operate. The Nadi mat uses magnets embedded in the cord of the foam in the
yoga mat to reduce the frustration of using a yoga mat (Magnetized Exercise Mats, 2012). Tiny
neodymium magnets are placed along the long edges of the mat at specific points. The additional
weight of the magnets helps the mat to stay flat after unrolling, and when done practicing yoga
the unobtrusive magnets aid in the rolling up of the mat and keeping the mat together during
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transportation without a bag or strap (Magnetized Exercise Mats, 2012). This mat does require
the client to manually roll up the mat but with more ease and in any hand position they choose.
Comparable Cost Analysis
Neither the Iku Mat nor Nadi Yoga Mat is available for purchase, so the cost analysis will
compare the Roll and Wrap Yoga Mat to a classic single yoga mat. A classic yoga mat may be
purchased for starting around $9.00 and can exceed $100.00 for elite models. The Roll and Wrap
Yoga Mat is adapted specifically for clients with RA, includes a carrying strap, added padding,
and cost less than $60.00 to construct. The cost analysis of the Roll and Wrap Yoga Mat is
addressed in Table B of the appendix.
Evidence-Based Research
Women were the primary gender addressed in the literature review because they account
for 75% of the RA population in the United States. Nordenskild and Grimby (1996) assessed
the disability in women with RA in relation to their grip force and pain. The researchers used the
Health Assessment Questionnaire (HAQ) to evaluate the relationship between grip force and
pain, and the consequences to daily activities (Nordenskild and Grimby, 1996). Twenty women
with RA that were assessed used various adaptive devices at home for activities such as eating,
grip, and hygiene (Nordenskild and Grimby, 1996). The results showed that the participants had
the most difficulty with hygiene activities like taking a shower or bath (Nordenskild and
Grimby, 1996). The majority of women also answered unable to do for other activities like
vacuuming, shopping, reaching, and opening jars (Nordenskild and Grimby, 1996). On average,
each woman owned 15 adaptive devices, and 91 percent of those devices were used to complete
daily activities. This proves that women with RA are utilizing adaptive equipment which allows
them to participate in their desired occupations.
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Results showed a large variation in the grip force, although there was significantly lower
grip force for peak and average values than the control group (Nordenskild and Grimby, 1996).
In fact, the average peak grip force value over 10 seconds in the RA participants was only 22%
of the control groups values. While, the average grip forces value over 10 seconds was only
19% of the control values (Nordenskild and Grimby, 1996). These results represent the need for
adaptation to support the 80% of omitted grip force of women with RA. Overall, there were
significant correlations between pain, grip force, and the HAQ disability index. All women in the
study reported pain with a large range of variation, and pain increased significantly after the grip
force test (Nordenskild and Grimby, 1996). This indicates that pain in RA patients within the
small joints of the hand and wrist, partially depends on circumstances. It is a practical solution to
introduce more adaptive devices to this population to ensure continued engagement in
occupations without fear of generating pain. The Roll & Wrap Yoga Mat is a perfect example of
how this could be achieved with female clients who wish to easily utilize their yoga mat before
and after their exercise programs.
Evans, et al. (2013) from University of California at Los Angeles Medical Center
conducted a six-week study of the effects of Iyengar yoga on a group of women with RA. The
aim of this study was to assess the impact of a 6-week bi-weekly yoga program on quality of
young adults with RA compared with a usual-care waitlist control group (Evans, et al., 2013).
The participants were all women suffering with RA with a mean age of 28 (Evans, et al., 2013).
This is a younger population to utilize as evidence; however RA treatment is focused on
prevention and management. This younger population of women is significant because early
diagnosis and prompt treatment is the key to preventing joint destruction and organ damage
(Rheumatoid Arthritis, 2014). Researcher recorded weekly ratings of anxiety, depression, pain,
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and sleep. On average there was 96 percent attendance rate to the yoga classes, and women
assigned to the yoga program showed significantly greater improvement post treatment (Evans,
et al., 2013). The results showed an immediate, positive impact on the participants after they
completed questionnaires to measure pain, disability, mood, and function. There were significant
improvements in standardized measures of quality of life, pain disability, general health, mood,
fatigue, acceptance of chronic pain, and self-efficacy regarding pain (Evans, et al., 2013).
Participants also sat for interviews where many explained that their day-to-day levels of pain had
not changed, but their relationship to the pain had changed (Evans, et al., 2013). Almost half of
the yoga group reported clinically meaningful symptom improvement and continued process at
their two-month check-up. This evidence confirms that yoga should be encouraged as an
intervention because it is an achievable and safe exercise-based treatment for women with RA.
Conclusion
The Roll and Wrap Yoga Mat provides enhanced functional performance for clients with
RA who wish to participate in yoga classes. Occupational therapists should encourage yoga as an
occupation for women with RA because it is an exercised-based program that may reduce joint
pain and stiffness, increase joint mobility and muscle strength, and improve psychological well-
being (Rheumatoid Arthritis, 2014). Caren Strait explained the importance of participation, One
of the most important things people learn in Gentle Yoga is to honor the body, being aware of
sensations present and listening to what the body needs in each moment of the practice. When
people begin to learn to adjust their movements based on what they feel, they are more likely to
take that into daily life (C. Strait, personal communication, 2014).
Construction of the Roll and Wrap Yoga Mat consisted of three phases. There are two
adapted yoga mats advertised the internet. However, The Iku Mat and Nadi Yoga Mat are not
ASSISTIVE TECHNOLOGY ROLL AND WRAP YOGA MAT 11

available for purchase, and neither was created to assist a specific diagnosis or disabled
population in mind. The evidence-based research review proved that yoga is a feasible and safe
exercise-based treatment program for women with RA. Women with RA suffer from decreased
grip force and increased pain in their hands and wrists that affect their functional daily activities.
Furthermore, the Roll and Wrap Yoga Mat is a practical solution to ensure continued
engagement in yoga for clients with RA without fear of generating pain when operating their
yoga mat.
















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Appendix A
Table A Similar Devices and Vendors Comparision
Type of
Yoga Mat

Picture of Yoga Mat Price of
Yoga Mat
Where to
Purchase


Rolling Yoga
Mat



$56.76


Constructed by
Hayley
Meredith




Iku Mat





Not for sale



Not available
for purchase



Nadi Yoga
Mat




Not for sale


Not available
for purchase


Classic Lotus
Yoga Mat





$8.97



WalMart


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Appendix B
Table B1 - Cost Analysis for the Rolling Yoga Mat - Essentials
Item Cost
Lotus Yoga Mat Classic 3mm $8.97
White Blackout Roller Shade $21.25
1 x 36 Hardwood Square $3.42
Inside Mount Roller Shade Bracket $0.98
4 Wood Screws $0.40
Staples $0.50

Total = $35.52

Table B2 - Cost Analysis for the Rolling Yoga Mat - Comfort and Aesthetics
Item Cost
2 Eyelet Screws $0.59
Fabric $9.37
Foam Padding $4.32
Cotton Webbing Shoulder Strap $6.99

Total = $21.27





Total Price of the Roll and Wrap Yoga Mat = $56.76

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References
AOTA. (2014). Occupational therapy practice framework: Domain and process (3rd ed.).
American Journal of Occupational Therapy, 68(Suppl. 1), S1-S48. http://dx .doi .org/10
.5014/ajot .2014 .682006
Evans, S., Moieni, M., Lung, K., Tsao, J., Sternlieb, B., Taylor, M., et al. (2013). Impact of
Iyengar Yoga on Quality of Life in Young Women With Rheumatoid Arthritis. The
Clinical Journal of pain, 29(11), 988-997. Retrieved from
http://dx.doi.org/10.1097/AJP.0b013e31827da381
IKU MATS. (2012). IKU MATS. Retrieved from http://ikumats.com/index.htm
Magnetized Exercise Mats. (2012). TrendHunter.com. Retrieved from
http://www.trendhunter.com/trends/nadi-yoga-mats
Nordenskild, U., & Grimby, G. (1997). Assessments of disability in women with rheumatoid
arthritis in relation to grip force and pain. Disability & Rehabilitation,19(1), 13-19.
Retrieved from: http://web.b.ebscohost.com/ehost/detail?sid=f67d8ca5-b49c-4573-b594
efa10ae737df%40sessionmgr111&vid=9&hid=126
Rheumatoid arthritis. (2013). Lifestyle and home remedies. Retrieved from
http://www.mayoclinic.org/diseases-conditions/rheumatoid-arthritis/basics/lifestyle-
home-remedies/con-20014868
Rheumatoid Arthritis. (2014). Rheumatoid Arthritis (RA): Treatment Programs for Rheumatoid
Arthritis Pain. Retrieved from http://www.arthritis.org/conditions-treatments/disease-
center/rheumatoid-arthritis/
Personal Interview by Email
Strait, C. (2014, May 22). Email interview.