The Therapeutic Effects of Independent Eating for the Severely Physically Disabled

Independence in eating is one of the goals in the therapeutic intervention of people with severe disabilities of the upper extremities, who lack the voluntary movements and are completely dependent upon others to feed them. We performed a three-dimensional motion analysis using the Vicon system on a normal subject and found that the use of chopsticks and forearm supination/pronation are critical components. These were incorporated in a meal manipulator to help promote ease and accuracy of control of the device. The manipulator included a base that made positioning of the manipulator flexible; a swing arm that moves to the same point each time; a terminal device that holds the half-spoon-shaped chopsticks and produces supination/pronation movements; a table that moves the food into position for reaching; and, a control box that the user can manipulate by mouth or chin. Consequently, the user is not fed but uses his/her remaining functions to eat independently. The manipulator was evaluated on two high level quadriplegic subjects, who provided valuable feedback. The authors concluded that independent eating using a meal manipulator could be very beneficial psychologically. Collaboration between engineers and therapists may lead to more independence for the disabled.