Wrist support for pianist
28th October 2018
Linda is an accomplished singer and pianist and teaches both, so she was deeply affected when treatment for breast cancer left her unable to support her left arm or move it sufficiently to play, even though her fingers were unaffected. She wasn’t able to work any more or enjoy her piano, so felt very frustrated. Linda needed a device of some sort to support her left wrist while playing the piano.
Occupational therapist Heidi Grant contacted Remap Bournemouth and a local volunteer Alan Blundell came to meet Heidi and Linda.
Wrist support in action
Together they came up with the idea of fitting a rail to the front edge of the piano, then adding a wheeled wrist support like a truck that would run silently up and down the rail. The rail would need to run from the centre of the piano – middle C – to just beyond the end of the left hand keys, so that the wrist support could be parked out of the way when not needed.
Alan set to work, fitting the supporting rail from underneath so as to have the minimum impact on the appearance of the piano. The truck which runs along the support rail was shaped so that the Linda’s wrist is comfortably supported with expanded foam and chamois leather. On trying out the aid Linda was immediately able to play without any trouble. She was delighted and was able to resume giving music lessons and playing for her own pleasure.
Heidi commented “As a Community Occupational Therapist I’m looking out for opportunities for people to enjoy meaningful activity so when Linda mentioned that she was a piano/singing teacher and was struggling to play the piano anymore, I jumped at the chance to help her. Remap was able to take an idea and make it a reality – just brilliant!”
See the piano aid in action here
One-handed kayaking
3rd December 2015
An 11 year old boy with only one hand was keen to start kayaking, and the problem was to make a safe (and easy release) attachment for the kayak paddle. He had a simple prosthesis provided by the NHS, consisting of a forearm sleeve terminating in a 19 x 1mm threaded stub.
A standard brass garden hose connector, with the O-ring seal removed, provides a rotatable but positive connection that is readily freed by a simple pull on the sleeve. The male part was connected to the prosthesis by a threaded brass adapter (see photo). A nylon bobbin was turned to be a sliding fit on the kayak paddle shaft, its position being constrained by two large O-rings that could be adjusted along the shaft. The bobbin was connected to the female part of the hose connector by a stainless steel yoke. This arrangement provides all the necessary degrees of freedom for use of the paddle. In the event of a capsize, the user can release the paddle by pulling on the brass sleeve with his free hand.
Bournemouth & District panel ref. 89/54
Control of tremor
3rd December 2015
The client had trouble controlling the joystick of his wheelchair because of a severe tremor in his forearm.
He was supplied with a wristband containing a flat rare earth magnet, and a small steel plate was attached to the arm of is wheelchair. The effect was to hold his wrist against the arm with sufficient force to suppress the tremor, although he was able easily to remove his hand when required.
Bournemouth & District panel ref. 67/69
Chair mover
2nd December 2015
Parkinson’s sufferers often have difficulty pulling their chair up to the dining table, and carers struggle to help.
A light framework of 20mm angle iron is welded to be a reasonable fit around the chair legs, with the wheels from 75mm castors attached at each corner. For the rear corners, the swivel base of braked castors is cut off and discarded, as in the photo, and the remaining yoke, carrying the castor and brake assembly, is welded to the frame. There is no need to fix the chair into the frame. The chair just stands in the frame, which is placed behind the table. The framework increases the height of the chair seat by no more than 20mm. The client sits down and the carer can then wheel the chair to the table and lock the rear brakes.
This allows clients to join in family meals in the normal way, with no alteration to the furniture.
Bournemouth & District panel ref. 23/124
Weak-grip braking for 3-wheel rollators
30th November 2015
Many clients lack sufficient grip in at least one hand to operate the brakes on their rollator.
If they have an adequate grip with the other hand, the brake cables can be paired through a ‘monkey face’ balancing plate to allow both brake pads to be operated from a single brake lever – see photo A.
Situations also arise where the client has insufficient grip in either hand. In the case of 3-wheel rollators, this can be solved by cutting one handle and inserting a bicycle gear change twist-grip, with the outer twist-grip component locked to the rollator hand grip and the inner scroll fixed to the portion of the handle that locks into the rollator frame. The cable leading to the balancing plate is attached to the inner scroll. Rotation of the handle by <10° is then sufficient to apply the brakes – see photo B.
It has been found that clients can use their rollators successfully and safely with this adaptation, and are not disconcerted by the relatively small rotary movement of the handle.
Bournemouth & District panel ref. 90/125
Child-proof lock for fridge-freezers
28th November 2015
Some autistic children have a compulsion to raid the fridge, which gives rise to a need for a child-proof lock that is easily controlled by the parents.
Fridge-freezers usually have provision to mount the doors on either side, so there will be a pair of unused tapped holes between the doors on the open side. These can be used to mount a base plate carrying a sliding hook that, when in the closed position, traps the corners of both doors. The sliding component is fitted with a short cap-head screw, the lower section of which is filed to a rectangular shape. This runs in a slot in the base plate and, in the ‘locked’ position, coincides with a hole of the same diameter as the screw.
With both doors closed, the hook is slid until it traps the doors, and the cap-head screw is given a quarter turn by means of an Allen key inserted through the gap between the doors. This prevents the screw, and the slider, from moving until the screw is rotated back to its free position.
This lock has proved child-proof with different children over a number of years, and has been found easy to use by the parents.
Trolley walker with gutters and brakes
28th November 2015
Fitting gutters to a tea trolley is a common requirement. On the older-style Bardon trolley, this is easily done by attaching the upper sections of standard gutter crutches. However, these trolleys are unbraked, and clients with balance problems may have trouble controlling them. The newer Days trolley walker is supplied with brakes, but the position of the handles precludes attaching standard gutters.
The two requirements – gutters plus brakes – can be met because both the Days trolley and standard gutter crutches use 7/8” diameter tubing. The brake handles are removed from the trolley and replaced by the upper sections of the gutter crutches (after drilling an appropriate range of adjustment holes). The original Days handles, with the brake levers reversed, can then be fitted in place of the original hand grips from the gutter crutches.
With this combination, clients can remain mobile while supporting their weight but with the reassurance that the trolley cannot run away from them.
Bournemouth & District panel ref. A34/086
Anchoring pedal exercisers
27th November 2015
There is often a need to fix pedal exercisers in relation to the client’s chair, to stop them travelling when in use. The problem can be solved by standing both pedal assembly and chair on a board. The example shown was made for use in a hospital, and so is adjustable to suit different clients’ leg length. For individual clients, it is usually sufficient to engage only the front legs of the chair.
Bournemouth & District panel ref. 23/043
Bed or chair control switches
23rd November 2015
Clients with restricted finger movement or arthritis often have trouble operating the small ‘blister’ switches on bed controls. The solution is to clamp on a framework carrying extended rockers with plastic buttons (B&Q drawer stops) that bear on the blisters. The rockers are made of polycarbonate, and are usually transparent to enable any icons on the control unit to be seen. They can also be colour-coded.
The same idea has been extended to the controls for a riser-recliner chair.
Clients find these much easier to operate as little or no manual dexterity is required.
Bournemouth & District panel ref. A45/039
Weighted cuffs to reduce shake
27th April 2014
The client, who has Parkinson’s disease, likes to dine out and work at his bench. He finds his forearms tend to shake when using cutlery utensils and small tools.
Linen cuffs were made and pocketed to take 10mm diameter steel rods to make a total weight of 680g to act as ‘vibration’ dampers. The rods may be removed to enable laundering of the cuffs.
The client is able to enjoy meals out and work at his bench with more confidence.
Unlocking walk-in bath
27th April 2014
Pauline has severe gout, leaving her unable to grip and pull the door clamps on her walk-in bath to release them.
Two stainless steel levers, one for each clamp, were fitted to the door and capped with golf balls.
A light push on each lever now releases the door clamps, enabling Pauline to get out of her bath without assistance.
Twist grip control for electric scooter
27th April 2014
Vivian is dependent on his electric scooter for mobility, but arthritis in his hands meant that he was unable to maintain continuous pressure on the thumb-operated control lever.
A gear-change twist grip from a bicycle was modified to remove the 10-position notches and the internal diameter increased to give greater travel on the control wire. This was then fitted in place of the normal hand grip, and the wire led over a semi-circular block attached to the throttle rocker bar. The wire terminated in a spring, allowing the rocker to be thumb-operated in the usual way when reverse was required.
Vivian found the twist grip much easier and more controllable than the rocker lever, and is now able to embark on long trips on his scooter without fatigue in his hands.
Tricycle modification
27th April 2014
Restricted growth meant that Leo could not reach the pedals on his tricycle.
The saddle support was lowered by 40mm and moved forward, and a new backrest fitted. The steering column and forks were both shortened by 20mm, and a narrower crank was fabricated.
Leo can now keep up with his sister on her bicycle!
Tabletop scissors
26th April 2014
The client has upper limb weakness and found it very difficult to cut up triple-gauze bandage. Commercially-available tabletop scissors were suitable only for cutting paper.
The plastic handles were removed from a pair of standard 20 cm stainless steel scissors. One blade was fixed into a cradle and the other (moving) blade fitted with a handle and palm pad. A torsion spring from a mousetrap opened the scissors. The assembly was cased in 2mm PVC, with a button on the tip of the fixed blade as a guard.
The client can now cut her bandage unaided.
Shower curtain rail to accommodate hoist transfer
24th April 2014
Beth has a 7-year-old son who is disabled and requires lifting into the shower. He is now too heavy for Beth to manage, so a hoist has been installed. This meant removing the existing shower rail and curtain, giving no privacy to anyone standing in the shower.
The shower rail is an aluminium extrusion, bent in the centre and attached to the walls in the corner of the bathroom. The rail was cut in the centre, and braced hinges made to attach each half to the walls. The rail was joined in the middle with a plate and wing nut, allowing the two halves to be swung apart to allow entry of the hoist.
Beth and her son can now enjoy a normal level of privacy in the shower.
Repositioning of joystick wheelchair control
21st April 2014
With the joystick in a normal right-hand position this client had difficulty controlling his powered wheelchair. It was thought he would get much better control if he could use both hands together.
The joystick unit was mounted on a horizontal bar using vertical tubes already fitted to the front ends of the armrests. In order to allow clear access to the seat the whole assembly could be lifted clear of one of these tubes and swung out forwards.
He now has proper control of his wheelchair.
Lift for wheelchair transfer
13th April 2014
Kelvin has no arms or legs. In his own words “For outdoor purposes I use an electric wheelchair. However, when I am in my house I crawl on the floor. Currently I get out of my wheelchair by jumping into an armchair and then jumping off this, sliding on to the floor. The armchair is situated in the kitchen and is taking up too much room. I am looking for a piece of equipment that will enable me to transfer in and out of the wheelchair.”
A platform lift was built, based on a lathe leadscrew in a steel tube frame and with controls placed within Kelvin’s reach both in his wheelchair and on the lift. The lift platform can be lowered to within 4cm of the floor. Kelvin’s kitchen is now free of armchairs and he no longer needs to jump and climb.
High heart rate alarm
12th April 2014
The client, a young 11 year old child with cerebral palsy and epilepsy, can have a silent fit whilst asleep. This is accompanied with a dramatic increase in heart rate and immediate medical attention is required. To alert the parent, a high heart rate alarm has been suggested.
The client will not tolerate wired electrodes and so a sports heart rate transmitter has been modified to detect and transmit the heart rate signals to a small receiver below the child’s mattress. A co-ax cable connects the receiver to a unit at the parent’s bedside which produces an alarm if the heart rate exceeds a predetermined level.
The client’s parents feel much more confident that they will be able to respond to an emergency in the night.
Hand-operated substitute for foot-operated dictaphone controller
11th April 2014
The client works as a transcriber using a dictaphone controlled by a foot-operated device, which was giving her RSI problems. A hand-operated controller which could be positioned close to the space bar of her keyboard and be operated by her thumbs was suggested.
A new controller was built to imitate the functions of the foot-operated one, using push-buttons taken from an old audio tape deck and a connecting cable taken from an old foot-operated controller. The small amount of electronic circuitry required used CMOS logic.
She can now do her job efficiently without discomfort.
Folding crutches
10th April 2014
The client likes to ride pillion on her husband’s motorcycle, but cannot dismount without her crutches. The requirement was for folding crutches that can be carried in a back pack.
An old pair of aluminium elbow crutches was cut and fitted with box hinges from aluminium rod with carbon fibre tongues, arranged to fold in only one direction and to leave a space of 8mm between the legs when folded (to accommodate a sliding sleeve of grp tubing that locks them in position when open).
Family outings are back on the agenda.
Drawing board for mouth artist
8th April 2014
Anson is quadriplegic and draws with a pencil in his mouth. He needed a rigid, portable drawing stand, easily adjustable by his carers, so that he could start a college course.
A light folding table, attached by case clips to outriggers permanently clamped to the wheelchair, supports a photographic tripod lodged in rails. The tripod panning head is fixed to a horizontal arm carrying an A3 board on a vertically-mounted slide. The system has five degrees of freedom, with adjustment knobs colour-coded to guide the carers. Anson can now work away from home and has begun his college course.
Child’s bath seat
13th March 2014
Abbie is a small girl with severe quadriplegic cerebral palsy who loves having a bath but has outgrown her bath seat and is now too heavy for her mother to support in the bath.
A standard Fisher-Price high chair was stripped of the footrest and all straps & padding. The rear legs were shortened to give a greater rake, and golf balls attached to fit the bath contours. A towel provides adequate padding.
Abbie loves her new bath seat and can now have a bath every day. A secondary benefit is that this adaptation provides a low level support for other purposes.
Braking trolley
11th March 2014
A client with Parkinson’s disease uses an indoor trolley with trays to carry cups of tea, etc. The trolley had four fully-castoring wheels but no brakes, so when the client’s legs ‘froze’, the trolley ran away and he fell. The castoring wheels made direct braking impracticable.
An H-shaped sub frame, carrying a bar which could be angled downwards onto the floor, was attached to the wheel supports. Either or both hand levers operate the brake. The trolley can be adjusted without affecting the braking system.
The client has regained confidence in his support and a measure of independence.
