Mobile arm supports: criteria for successful use in muscle disease patients

Twenty-nine subjects who had been fitted with mobile arm supports 6 months to 11 years prior to the initiation of this study were evaluated to determine criteria for successful use of such supports. All subjects were diagnosed as having Duchenne muscular dystrophy or spinal muscular atrophy. Three methods were used to collect data: 1) review of medical charts, 2) interview with patient and family member(s), and 3) observation of the patient in his wheelchair for sitting stability, adjustment and control of the mobile arm support, and speed and efficiency in self-feeding with and without the support. The physical criteria previously established for optimal use were met by the successful users in the sample except for presence of elbow flexion contractures. Among those who had curvature of the spine, spinal fusion increased the percentage of successful users of mobile arm supports. Successful use declined with muscle grades of below poor in elbow flexors. The incidence of success was greater when the tasks of self-feeding, driving a motorized wheelchair and performing leisure skills could be accomplished only with the support. Primary reasons for early rejection of the support were related to attitude toward the equipment, influence of the social support system, and patterns of activities performed with the equipment.