Running head: ASSISTIVE TECHNOLOGY LITERATURE REVIEW

Assistive Technology Literature Review: Hairdryer Holder/Hair Tools Anthea Mourselas Touro University Nevada

ASSISTIVE TECHNOLOGY LITERATURE REVIEW Assistive Technology Literature Review: Adapted Hairdryer/Hair Tools Diagnosis: Freidreich Ataxia Friedreich ataxia (FDRA) is a neurodegenerative disease caused by a defect in the Frataxin (FXN) gene, which is located on chromosome 9 (Kumari & Usdin, 2012). Changes in the FXN gene can cause overproduction of part of the DNA named trinucleotide (GAA) (U.S National Library of Medicine, 2012). The majority of individuals with FDRA have 600-900 copies of GAA (Kumari & Usdin, 2012). Eight to 33 copies of GAA are considered the normal range (Kumari & Usdin, 2012). This change leads to a decrease in FXN protein production, which plays a role in creating energy needed for cells to function (U.S National Library of Medicine, 2012). This lowered production of cell energy over time leads to cell death and eventual loss of vital body functions. Thus, FDRA is a progressive disease that worsens over time. Friedreich ataxia (FDRA) is caused by a defect in the Frataxin (FXN) gene, which is located on chromosome 9 (Kumari & Usdin, 2012). FDRA is a chromosomal disorder that is inherited through recessive genes (U.S. National Library of Medicine, 2012). This means that

both mother and father must have the gene and then pass that gene on to their child. Researchers estimate that FDRA is about one or two within 40,000 people of European descent (Durr, 2002). The life expectancy of an individual with disease is usually affected. Most commonly, people with FDRA usually die in adulthood from complication associated with heart disease (National Institutes of Health (NIH) (2013). However, people with less severe symptoms can live up to their seventies (NIH, 2013). Neurological pathologies of FDRA include degeneration of the posterior columns of the spinal cord which causes loss to both myelinated axons in peripheral neurons and loss of fibers of peripheral sensory nerves (Kumari & Usdin, 2012). These

ASSISTIVE TECHNOLOGY LITERATURE REVIEW underlying neural abnormalities cause the uncoordinated muscle movement and muscle weakness seen in those who have FDRA. Lowered production of cell energy over time leads to cell death and eventually loss of vital body functions (U.S. Library of Medicine, 2012). The National Institutes of Health (2013), states that the signs and symptoms of FDRA

often begin at puberty and affect individuals in a distal to proximal direction, beginning in lower and upper extremities and then slowly progressing inward to affect the trunk area. The first noticeable signs are impairments in walking and increased muscle fatigue (NIH, 2013). Some individuals will also experience nystagmus (involuntary eye movements), scoliosis, hypertrophic cardiomyopathy (enlarged heart), and dysarthria (slurred speech) (NIH, 2013). Occupational Profile Marijane is a 26-year-old single female with a diagnosis of FDRA. Her whole life she loved fashion, styling hair, and doing make-up. She is very social and has close relationships to many friends and family members.. Debility from FDRA Her onset of the disease was earlier than the average individual in this population. At just four-years-old she developed hypertrophic cardiomyopathy, and was diagnosed with FDRA at only seven years old. She had severe scoliosis in her early adolescence, which was corrected by the surgical procedure placing a luque rod into her spine at age 15. She had been using a wheelchair since she was about nine due to low muscle tone and muscle weakness in her lower extremities, but was still able to walk for short periods of time before becoming fatigued. Postsurgery, she had become completely reliant on her wheelchair for mobility. Over the years, her muscle weakness and fatigue has been progressively increasing. The hypertrophic cardiomyopathy has decreased her endurance level and caused difficulty in performing

ASSISTIVE TECHNOLOGY LITERATURE REVIEW prolonged activities. Marijane has full range of motion in her arms, but her strength and

coordination are progressively declining. In addition, she experiences cramping and contractures in her hands due to overuse, and has difficulty grasping and maneuvering items that require fine motor skills or grip strength. Road to Assistive Technology Device Marijanes mother has been her primary caregiver her whole life, along with the help of her older sister. However, three months ago Marijane moved to her own apartment to live her dream of being independent. Her mother still checked in daily, and they have hired a part-time caregiver to help Marijane with functional mobility with transferring. A couple weeks ago, Marijane was blow drying her hair in the bathroom and dropped the hairdryer behind her wheelchair. Marijanes caregiver was in another room, when she finally heard her screams she ran to assistance and removed the hairdryer. Unfortunately, Marijane still suffered a seconddegree burn to her lower back. Her mother wants her to return home, but she insists on wanting to live in her own apartment. The Hairstyle Helper An assistive technology device that would allow for her to independently style her hair but prevent her from possibly injuring herself again would be a hairdryer holder. This equipment does exist however, it is very difficult to find in store, and the ones online are designed for a counter top. Because Marijane is in a wheelchair she would prefer to have one that is on the ground and could reach above her head while she is in her wheelchair. She also wanted one that was easily moveable for her while in her chair. Adding wheels, a wider base, and a longer arm to the stand would create an excellent piece of equipment for her needs. The longer arm is adjustable as well. This allows for her to be able to dry her hair in her wheelchair or possibly other places such as on her bed or in other chairs. The bendable nossle on the top of the

ASSISTIVE TECHNOLOGY LITERATURE REVIEW equipment was somewhat week to hold the weight of the hair dryer. Adding extra wire to the

nozzle made it strong enough to hold the weight of the hairdryer. Overall, the adaptive hairdryer stand made it safer and easier for Marijane to dry her independently. In order to make the hairstyling process even more feasible for Marijane was to add shower caddy that she already had, but Velcro on both her wheelchair arm rest and around the basket. Having this allows her to have her hairstyling extras (hair products, brushes, etc.) easily accessible. Another add on to the hairstyle helper was a brush that has towel pieces already embedded in it to increase drying time. The brush also has an adapted foam handle that will help her to increase her grip strength. Velcro was also attached to the handle and allows her to place it around her fingers, so she has a more secure hold on the brush and is less likely able to drop it. Overall, the adaptive hairdryer, stand hairbrush, and caddy allow Marijane dry and style her hair independently and safely. Cost Analysis Table Hair Dryer Stand (only used base and clasp) Long arm 3-6 ft. 4 rubber wheel casters (swivel) Round pine base Screws Shower caddy Hairbrush Mounting tape Foam Home Depot Home Depot Home Depot $9.87 $11.88 $12.32 (pre-owned) (pre-owned) (pre-owned) (in kind donation) (in kind donation) www.target.com $14.09

ASSISTIVE TECHNOLOGY LITERATURE REVIEW Velcro (in kind donation)

Total Cost: $48.16 Comparable Products Pro-Styling Stand Hair Dryer Holder Company Bendable But only 20 inches tall Metal holder and base Counter top only Bendable Adjustable height Claims to be either stand up and/or counter Everything Medical In store $46.95

Drying and Styling Stand Jobar International

Bed Bath and Beyond online only

$19.99

ASSISTIVE TECHNOLOGY LITERATURE REVIEW

References Albertyn, C. (2009). Friedreich's ataxia: A review. Irish Medical Times, 43(40), p. 44. Retrieved from http://search.proquest.com/docview/227289527?accountid=28843 Kumari, D., & Usdin, K. (2012). Is Friedreich ataxia an epigenetic disorder? Clinical Epigenetics, 4(2), 1-10. doi: 10.1186/1868-7083-4-2 National Institutes of Health (NIH). (2013). Friedreich ataxia. In Genetic and Rare Diseases Information Center (GARD). Retrieved from http://rarediseases.info.nih.gov /gard/6468/friedreich-ataxia/more-about-this-disease U.S National Library of Medicine. (2013). Friedreich ataxia. In Genetics Home Reference: Your guide to understanding genetic conditions. Retrieved from http://ghr.nlm.nih.gov/ condition/friedreich-ataxia