Occupational and Biomechanical Analyses of Texting

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Table of Contents

Brief Description of Occupation
Meaning of the Occupation
Roles and Habits
Environment
Occupational Performance
References

Brief Description of Occupation

The occupation is writing and sending a text message with the help of a smartphone. This occupation is performed by Dianne Andrews, who is 42 years old and was diagnosed with seropositive rheumatoid arthritis (RA) ten years ago. RA is a progressive condition that can be rather painful; it affects people’s everyday activities and is especially common among women (Bailey, 2016; Singh, 2000). Dianne is unable to work due to her condition because RA has impacted her hands and fingers, and under that influence, her grasp and pinch are no longer as strong as required to perform certain tasks. In addition, Dianne is a grandmother for a one-year-old girl Sophie for whom she cares two times a week because Sophie’s mother had to return to work. Typing and sending a text message via smartphone is a challenge for Dianne since her hands are visibly deformed, not as strong as needed for tasks that require fine motor skills, and are difficult to coordinate.

Meaning of the Occupation

Sending text messages is a valuable occupation for Dianne, especially now that she has become a caretaker for her granddaughter. Text messaging is an important part of caregiving since this tool allows a parent and the individuals watching their children communicate with higher productivity providing both sides with instant information (Five Ways to Communicate with Your Nanny, 2016). Even though text messaging is recognized as a rather young medium of communication, 91% of people from 30 to 49 use it on the regular basis in their daily life (Family Touch, 2015; Carbonell & Stephanidis, 2003). Overall, being able to communicate successfully by means of text messaging and using her smartphone is crucial for Dianne as a member of modern society.

Roles and Habits

In her everyday life, Dianne plays a role of a caregiver, a mother, and a grandmother. Being able to send text messages to her daughter about her day with Sophie and read the texts from her daughter reminding her about chores she is to accomplish is necessary for Dianne. Moreover, as an individual in a relationship, Dianne is to communicate with her partner, and text messaging can be rather helpful in this area. A smartphone may be viewed as an assistive device for Dianne’s rehabilitation (Ling, 2011). As soon as she develops a stronger grasp, pinch, and improves her fine motor skills, she will be able to return to work and have her daughter care for Sophie.

Environment

Dianne’s environment for text messaging is her home. She could perform this activity while standing up or sitting down. The only objects involved in the procedure are the smartphone and, sometimes, pieces of furniture around the house such as a couch or a table.

Occupational Performance

Typing a text message, Dianne would have to use the muscles of her hands and fingers without having to apply much force as the smartphone screen is very sensitive. The individuals who are unaffected by RA use abductor pollicis brevis and flexor pollicis brevis typing with their thumbs (Muscles of the Hand and Wrist, 2015; Muscles of the hand, 2015). Apart from flexion and extension of the thumb, texting requires its adduction and abduction (Jonsson, Johnson, Hagberg, & Forsman, 2010). In fact, these days, texting is recognized as one of the causes of arthritis, and that is why Dianne, who already has this condition, may face difficulties performing this activity normally (Rush University Medical Center, n.d.). Texting requires communication, processing, sensory, and motor skills. Dianne has a problem with the latter. Her strategy to address the issue involves a wristband for a stronger grip and better range of motion in her hands.

Biomechanical Analysis

Occupational Performance: Biomechanical Analysis of Writing a Text Message
Occupation – caretaker
Role performance: digital communication
Task: writing and sending a text message using smartphone
Name of the activity: sending a text message by smartphone
List of steps:
1. Taking the smartphone out of a bag or a pocket
2. Picking the smartphone up
3. Pressing ON button to activate the device
4. Sliding a finger across the screen
5. Tapping on a text message icon
6. Tapping COMPOSE icon
7. Typing in the text of the message
8. Selecting a contact to whom the message is addressed
9. Pressing SEND button

Alternative sequence of steps for recent models of iPhone that have Siri:

Pressing and holding HOME button
Saying the text of the massage aloud
Tapping SEND button

What capacities and abilities are prerequisite to successful task comprehension:

Eyesight good enough to see the symbols on the smartphone screen
Ability to memorise the sequence of the steps required for the completion of the task
Ability to press and tap small buttons with one finger
Ability to hold a smartphone (optional since the phone can be put on a surface)

Describe the external (contextual) constraints:

Positions of the objects and their size
1. The buttons and icons on the smartphone screen are too small and located too close to one another
2. The individual cannot see the icons properly or distinguish between them
3. The individual cannot use screen keyboard properly and keeps pressing wrong buttons, so the messages are unclear
Task constraints: what utensils and tools are required for the activity:
1. A smartphone (the size may vary depending on the brand and model)
2. Possibly, glasses for better visibility of the screen
Environmental constraints: where is the task usually carried out?
1. The activity is recommended to be practiced in the areas where the individual can sit down and place the smartphone in front of themselves on a flat and firm surface
Environmental constraints: does the activity, or how it is done, hold particular meaning for certain cultures or social roles:
1. The person needs to inform others about accomplishing certain daily activities
2. The person finds digital devices complicated and frustrating when it comes to texting
Internal constraints description

Joint position of motion	ROM degrees	Primary muscles	Gravity assist/ resist/ no effect	Minimal strength required	Type of contraction
Cylindrical grasp		extensors	No effect	to 2	isometric
Wrist stabilisation		All wrist muscles	No effect	to 1	isometric
Interphalangeal joint flexion	0-10	Flexor pollicis longus	Assists	to 1	concentric
Metacarpophalangeal joint flexion	0-10	Flexor pollicis longus and Flexor pollicis brevis	Assists	to 1	concentric
Trapeziometacarpal joint flexion	0-5	Flexor pollicis brevis	Assists	to 1	Concentric
Interphalangeal joint extension	10-0	Abductor pollicis brevis	Resists	to 1	eccentric
Metacarpophalangeal joint extension	10-0	Abductor pollicis brevis	Resists	to 1	eccentric
Trapeziometacarpal extension	10-0	Abductor pollicis brevis	Resists	to 1	eccentric
Thumb basal joint abduction	0-45	First Dorsal Interosseous	No effect	to 1	eccentric
Thumb basal joint adduction	45-0	First Dorsal Interosseous	No effect	to 1	concentric
In case if a person is using her index finger to tap and type while the phone is on a flat and firm surface
Wrist extension	0-20	All wrist muscles	Resists	to 1	eccentric
Wrist flexion	20-0	All wrist muscles	Assists	to 1	concentric
Metacarpophalangeal joint	10-0	First unipennate	No effect	to 1	isometric

(With available Siri function, the patient does not need to use her fingers for typing. Instead, she is only required to activate her iPhone, and press two buttons – HOME in the beginning, and SEND in the end).

What should be stabilised to enable certain clients to do this activity?
1. Nothing
For which ages is this activity appropriate?
1. 10+ years primarily
2. 8-10 years secondary
What is the estimated metabolic equivalent of this activity?
1. 1 MET
What precautions must be considered when using this activity?
1. If the individual’s eyesight is bad, it would be helpful to download and install an application providing a keyboard with larger buttons. If the range of motion of fingers and fine motor skills are weak, the smartphone could be equipped with a voice recognition and input to minimise the need for typing.
2. An individual with bad eyesight might need to purchase glasses for looking at the objects from up close.
3. An individual with a weaker hand grip should not be using a smartphone while standing up and above surfaces that may break the device if it falls down. Instead, an individual should prefer to take time to sit down and place the device on a flat and firm surface (such as a table) for easier use.
For which short term goals is this activity appropriate?
1. For the development of cylindrical grip to be able to hold smaller objects
2. For the development of fine motor skills of wrist and fingers
3. For stretching of thumb muscles
4. For coordination between two hands (in case if the individual is using two hands for the activity
How can this activity be graded to increase?
1. Grip function
  1. Using devices of different sizes
2. Active range of motion
  1. Using different hands as dominant for typing texts
  2. Using different fingers
  3. Using just one hand for both holding the phone and typing
3. Passive range of motion
  1. Not applicable
4. Coordination
  1. Using keyboards with bigger and smaller letters
  2. Holding the smartphone vertically and horizontally for the development of fine motor skills
5. Endurance
  1. Increase the amount of typing (writing longer text messages or sending more messages a day)
How can this activity be graded to decrease?
1. Strength
  1. Place the smartphone on a table instead of holding it
  2. Use only one finger of one hand and just move the wrist muscles for typing
  3. Install and use voice input application (such as Siri for iPhone) to eliminate the need for typing and reduce the finger movements to the minimum
2. Active range of motion
  1. Use the words offered by the device instead of typing them fully
3. Passive range of motion
  1. Not applicable
4. Coordination
  1. Use keyboard with bigger buttons
  2. Use autocorrect suggestions instead of typing the words fully
5. Endurance
  1. Send fewer text messages a day and write short and factual messages
6. Reduce oedema
  1. Not applicable
7. Reduce pain
  1. Do not hold the phone while typing, use lighter grip and touch
8. How else could this task be completed?
  1. Ask someone else to type and send the messages
  2. Use voice recognition and input to eliminate the need for typing

References

Bailey, A. (2016). Restricted Finger Movement From Rheumatoid Arthritis. Web.

Carbonell, N., & Stephanidis, C. (2003). Universal access. Berlin, Germany: Springer.

Family Touch. (2015). Texting for health. Web.

Five Ways to Communicate with Your Nanny. (2016). Web.

Jonsson, P., Johnson, P., Hagberg, M., & Forsman, M. (2010). Thumb joint movement and muscular activity during mobile phone texting – A methodological study. Journal of Electromyography and Kinesiology, 21(2), 363-370.

Ling, S. (2011). Rehabilitation of Older Adult Patients with Arthritis. Web.

Muscles of the Hand and Wrist. (2015).

Rush University Medical Center. (n.d.). When technology hurts.

Singh, M. (2000). Exercise, nutrition, and the older woman. Boca Raton, FL: CRC Press.

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