The Natural-Fit Handrim: The Natural-Fit Handrim www.out-front.com How much farther would you go?


The Natural-Fit: Quick Facts I : The Natural-Fit: Quick Facts I The Natural-Fit is unique because it: Gives a better grip for a better push Eliminates pushing on the tire Eases pain in the hands and wrists Provides greater control when braking The combination of the oval and the thumb piece create the ergonomic grip of the Natural-Fit The Natural-Fit is designed for a person with good hand function (e.g. it is not intended for quads)


The Natural-Fit: Quick Facts II: The Natural-Fit: Quick Facts II Research Evidence of Benefits of the Natural-Fit: Provides better performance & efficiency than standard handrims Treats Carpal Tunnel Syndrome pain in the hands & wrists Evidence is from the Univ. of Pittsburgh and the Univ. of New Mexico and was published in 2006 in the Journal Assistive Technology Currently, the Natural-Fit is: Prescribed at over 30 VA Medical Centers. Prescribed by leading wheelchair clinics everywhere To get the Natural-Fit on new chairs for your clients, check the Natural-Fit option on the Manufacturer’s order form Made of lightweight aluminum; weighs just 12 ounces more than a standard handrim. Offers 80% more surface area for gripping than a standard handrim.


Overview of Detailed Presentation: Overview of Detailed Presentation Background & History of the Natural-Fit Handrim Description of the Natural-Fit and its Features Comparisons with Standard Handrims and Evidence of the Benefits of Using the Natural-Fit Product Information Summary: The Natural-Fit Handrim: Why it matters!


Wheelchair users push on their handrim an average of 2000 to 3000 times per dayProblems with the Standard Round-Tube Handrim: Wheelchair users push on their handrim an average of 2000 to 3000 times per day Problems with the Standard Round-Tube Handrim Poor ergonomic fit to the hand Small surface area for gripping Requires unhealthy “pinch grip” Gap between the rim and the wheel Pinch Grip with Standard Handrim Handrims are used for propulsion and braking Round-tube handrims are poorly designed for both


The Result of Poorly Designed Handrims: The Result of Poorly Designed Handrims 60% of wheelchair users grip their tire Results in dirty hands, cuts and infections Pinch grip strains hands and wrists 30%-70% of users have pain in their hands and wrists associated with Carpal Tunnel Syndrome The high prevalence of pain leads to: Decreases in quality of life Increases in healthcare costs


Redesigning The Handrim: Background of the Natural-Fit: Redesigning The Handrim: Background of the Natural-Fit One of the inventors, Rory Cooper, is a wheelchair user and leading researcher Three Rivers received an NIH grant to further develop the 1st prototype Through a redesign of the 1st prototype, Three Rivers created the Natural-Fit The Natural Fit has one issued patent and one additional patent pending Dr. Rory A. Cooper


Natural-Fit Features & Benefits: Natural-Fit Features & Benefits The ergonomic grip of the Natural-Fit: Eliminates the pinch grip Eases stress on the hands and arms when pushing and braking Reduces pain related to Carpal Tunnel Syndrome The Natural-Fit also has dual surfaces: High friction surface for pushing Large smooth surface for braking Ergonomic Grip with the Natural-Fit Cross Section of the Natural-Fit


Natural-Fit Use Leads to Positive Outcomes: Natural-Fit Use Leads to Positive Outcomes Reduced fatigue, pain, and injury helps to: Improve and/or maintain quality of life Extend ability to remain in a manual wheelchair Avoid medical costs associated with pain and injury Avoid costs of switching to a power wheelchair Cleaner hands, less cuts and infections Eliminates fingers catching between rim and wheel


Direct Evidence of Benefits: Objective Testing: Direct Evidence of Benefits: Objective Testing NIH funded research comparing a Natural-Fit prototype to the Standard Round-Tube Handrim Comparisons between the two rims followed a two-week trial period with the Natural-Fit The Natural-Fit resulted in decreased grip forces on the rim with no differences in propulsive power output Conclusion: When using the Natural-Fit, wheelchair users generated the same power, with lower grip forces Lower grip forces reduces pressure within the carpal tunnel when propelling the wheelchair


Direct Evidence of Benefits: Ask the End-User: Direct Evidence of Benefits: Ask the End-User Two comprehensive questionnaire studies have been conducted: In 2004 by Three Rivers (sample of 46 users) In 2005 by the University of New Mexico (82 users) Responses to both questionnaires were anonymous and use of the Natural-Fit ranged from 2 weeks to over 2 years The results of both questionnaires indicated that the Natural-Fit led to reductions in pain in the hands and wrists 76%-85% reported less pain in the hands 71%-80% reported less pain in the wrists


Direct Evidence of Benefits: Activities of Daily Living: Direct Evidence of Benefits: Activities of Daily Living The 2005 questionnaire also examined daily function. Since using the Natural-Fit: 67% reported that daily tasks were “less work” Each of 8 activities of daily living were perceived, on average, as less difficult Length of time using the Natural-Fit was included as a factor in the 2005 Study Reports of reduced pain were more pronounced as time using the Natural-Fit increased The Power of Converging Evidence: Evidence of reduced grip forces, questionnaire evidence, and consistency with ergonomics literature


Natural-Fit Handrim: Product Information: Natural-Fit Handrim: Product Information The Natural-Fit is designed for a person with paraplegia or with good hand function The oval and the thumb piece components create the ergonomic grip of the Natural-Fit The oval is a large, smooth, hard anodized surface for braking The thumb piece is a propulsion surface that comes with two coating options: The Standard Grip The Super Grip


Natural-Fit Handrim: Coating Options on the Thumb Piece: Natural-Fit Handrim: Coating Options on the Thumb Piece How do you select the Standard Grip or the Super Grip for the Natural Fit thumb piece? The Standard Grip is a light weight powder coat with a slightly higher friction surface than the smooth oval For those who: Are most interested in the ergonomic benefit, have good grip strength, and do not like higher friction surfaces The SuperGrip is a higher friction copolymer that is similar to a vinyl coating – but, although not quite as grippy, it is more durable and lighter weight than vinyl. For those who: Are interested in the ergonomic benefit, but who also want a grippier higher friction propulsion surface


Natural-Fit Handrim: On a New Chair or Replace an Old Rim: Natural-Fit Handrim: On a New Chair or Replace an Old Rim The Natural-Fit replaces the old handrim on your current wheelchair or can be ordered with a new wheelchair. Available on chairs from TiLite, Quickie, Invacare, Top End, Colours, Quantum Rehab, Freedom Designs, Melrose, RGK, Kϋschall, & Lasher Sport. The Natural-Fit is also available on Magic Wheels, and to dealers through The Aftermarket Group (TAG). The Natural-Fit fits on spoke, mag, Spinergy, X-core, Quickie, and other wheels. The Natural-Fit fits on 22”, 24”, 25”, or 26” wheels The retail prices are: $295 for the Standard Grip $340 for the SuperGrip Sample Letters of Medical Necessity (LMN) citing the scientific, evidenced-based benefits of the Natural-Fit are posted on our website at www.3rivers.com


Summary - The Natural-Fit: Why It Matters: Summary - The Natural-Fit: Why It Matters Wheelchair users push on the handrim 2000-3000 times a day A handrim that doesn’t fit (like a shoe that doesn’t fit) has costly, negative consequences. The Natural-Fit is specifically designed to fit the human hand Significant Outcomes: Reduced pain (treatment of symptoms related to CTS) Improved comfort and increased function Extends ability to remain in a manual wheelchair Eliminates grabbing the tire and promotes cleaner hands The Natural-Fit: “How much farther would you go?”