PIP and Driving

PIP and Driving

Just to add some information about driving, and the correlation with (supposedly!) every other PIP activity. Please have a look at the following which is a comment from an Occupational Therapist friend, when I asked her about this issue.

"It is very difficult to find research for this particular issue regarding grip but in one of my books and from my experience as an Occupational Therapist there are several types of grip used in different ways to grasp different items e.g handles, tools etc. The book is muscles, nerves & movement in human occupation 3rd edition by Barbara Tyldesley & June Grieve, Blackwell publishing p 117-120.

It proposes that the power grip is where all of the fingers are bent around an item and the thumb is used to press against with other fingers or the object e.g pan handle. It goes into a lot of explanation how the other joints and muscles work in order for the grip to be successful in function.

It states a cylinder grip (another type of power grip) is used for handles that are at right angles to the forearm e.g jug handle or handbrake of a car.

A ball grip (power grip) has a loose, wide grip e.g circular knobs, balls and tops of jam jars.
A hook grip (power grip) is used for carrying a suitcase or shopping bag - by side of body with straight elbow and wrist. Precision grips are where an object is held between the tips of the thumb and 1,2 or 3 fingers e.g a pencil or small tool.

Plate grip e.g holding the edge of a plate.

Pinch grip e.g holding a screwdriver or sewing needle

A key grip e.g for holding a key

And pincer grip e.g for picking up beads or pins

All have slightly different ways of gripping the items.

Other issues should also be considered as well as grip e.g. standing or sitting to do a task, strength in wrist, elbow and shoulder and pain as well as powered assisted steering wheels!"

My own personal research suggests that the whole arm is required to coordinate to eg chop and peel a carrot or potato, using a downward motion to chop and of course rotation to peel.

The steering wheel of a car has the same grip at all times and little force is required. (I wouldn't recommend trying this whilst driving - but you can balance the steering wheel on the palms, or even lightly on the fingers. If you have power steering, it's surprising how little grip you do need.)

However chopping and peeling a carrot using only one hand, and not holding it is incredibly difficult for anyone, let alone someone who has problems with hands/arms!

The steering wheel, is always held in the same plane, ie eg at quarter to three position. The wheel (according to learn to drive websites,) advocate that the wheel basically swings through the hands, using a push-pull method. If you think about this, unless you are struggling to control the car, even when turning there is little deviation from the starting quarter to three. You certainly don't need to lift your hand up and down as with a chopping knife, or rotate at the wrist and manipulate anything, or make fine adjustments with the fingers. The wheel stays in one place, and isn't potentially dangerous and sharp like a knife.

Whilst I don't know this part for certain, I am sure that even with somewhat shaky hands, you can maintain a reasonable/sufficient grip of the wheel, which is wider to grip anyway, unless you have a very chunky knife. I would not consider if safe to try and use a knife with shaky hands, or indeed carry or use any cooking utensil, unless under strict supervision.

Yes, of course you need coordination to drive, it's just not the same, it is of course (DWP take note!) a totally different task!

I hope this helps. LL26