Running head: ASSISTIVE TECHNOLOGY

Assistive Technology Paper

Natasha Arastehmanesh
Touro University Nevada

ASSISTIVE TECHNOLOGY

Client Population and Diagnosis

Showerin Made Easy is an assistive device made for clients who experience difficulty
showering. The clientele this device is most beneficial for include clients with Parkinsons
disease, clients who have suffered from a stroke, and clients with an elbow fracture. Parkinsons
disease is an adult onset degenerative neurological disorder. These individuals display tremors,
rigidity, and bradykinesia. Symptoms include poor endurance, balance, and difficulty in
sequencing and executive function (Schultz-Krohn, Foti, & Glogoski, 2013). Individuals who
have suffered from a stroke are at an increased risk for developing cognitive deficits further
impeding functional performance (Stephens et al., 2005). Cognitive deficits, specifically
attention, is highly correlated with functional disability even more than patients with memory
deficits (Stephens et al., 2005). With this being said, these population would benefit from a
device that would allow them to shower independently and safely without having to preplan,
sequence, and execute in the same fashion prior to their condition.
A stroke, also known as a cerebrovascular accident (CVA), results in the death of brain
cells from the lack of oxygen and blood flow to the brain through a blockage or rupture of a
blood vessel (Wolf & Birkenmeier, 2011). This can leave an individual with muscle weakness or
paralysis on one side of the body known as hemiparesis or hemiplegia. Patients who have
suffered a stroke commonly use assistive devices in feeding, grooming, bathing, toileting,
dressing, and cooking and cleaning (Wolf & Birkenmeier, 2011). In terms of bathing, these
individuals display a difficult time reaching areas on the uninvolved side, reaching their lower
body, getting in and out of the tub or shower, and exhibit impaired sitting and standing balance.
Stroke survivors are more likely to fall risk than any other population (Wolf & Birkenmeier,
2011). Since these patients are at an increased risk for falls, and given the nature of a wet

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environment in the shower, an assistive device anchored for this population to practice safe and
efficient showering will prevent further complications.
An elbow fracture can leave an individual with limited range of motion, strength, and
flexibility. Typically, this leaves an individual utilizing the noninvolved arm to accomplish
activities of daily living. An elbow fracture may leave a patient in a sling or splint until the
fracture heals. The patient will be advised to not lift anything with the involved arm until the
physician has cleared the patient to do so. Passive range of motion and active range of motion for
elbow flexion and extension are advised as tolerated. While these individuals are non-weight
bearing on their involved arm, typically, they are taught compensatory strategies. Through my
personal experience observing a patient with an elbow fracture, showering was possible only
through my assistance. I had to physically take the shampoo and squeeze the product into his
hand. With Showerin Made Easy, the patient would skip the step of having to put product into
their hand before applying it to their hair because the product will be immersed in the device.
Purpose of Innovative Device
Patients currently have a gamut of devices to aide in showering such as a tub transfer
bench, grab bars, and a handheld shower head due to impaired balance and low endurance (Wolf
& Birkenmeier, 2011). The addition of Showerin Made Easy will allow more ease in showering
while expending less energy and reducing steps taken, further ensuring safety and independence.
The purpose of this device is to allow individuals who display limited range of motion,
weakness, and endurance to shower carefully and more efficiently. There are many components
and steps that go into the activity of showering. This device combines multiple steps into one
allowing showering to be completed in half the amount of steps. The act of showering can be a
hazardous activity due to its wet and compact environment. This device does not require the use
of both hands to complete the activity of showering.

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Functional performance would be enhanced through the use of this product by allowing
patients able to only move one side of their body, to be more functional, independent, and safe in
showering. By a push of a button on this device, products such as shampoo or conditioner will
excrete out of the top where the bristles are located and subsequently shampooing and
conditioning can be completed. Incorporating Showerin Made Easy will allow individuals to
lather and massage their hair without the assistance of a family member or caregiver. In addition
to reducing the steps that go into the activity of showering, the device is also compact allowing
the individual to carry it with him or her to any home or facility to complete washing hair. Since
this device contains a compartment where shampoo or conditioner can be poured, it reduces the
amount of bottles and products in the shower, further allowing for a safer and clutter free
environment.
Professional Analysis of Device
This device increases functional performance by allowing an individual to conserve
energy while completing bathing and showering. This device allows individuals who are unable
to reach overhead and utilize both upper extremities to functionally engage in showering.
Through trial and error I was able to make this device utilizing a long handled scrub brush,
gorilla glue, and the bristles of a hairbrush (Table 1). I first took off the sponge component of the
long handles scrub brush so that I could utilize the handle component where any liquid product
could be poured in. I further took a brush and cut out the palate with the bristles attached from
the handle of the brush. I shaved down the bristles to fit the head of the device where the liquid
comes from. I further punctured holes so that the liquid would be able to seep out when the
button on the long handle is pushed. Then by using gorilla glue, I poured glue on the back of
bristles making sure to not cover the areas where the holes were punctured so that product could
come out. After leaving the glue overnight, I attached the brush with the bristles to the long

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handled brush. Lastly, I twisted off the opposite end of the brush to pour the shampoo and
conditioner in the long handled brush (Figure 1).
Table 1
Price Analysis
Items
Conair Brush 1
Conair Brush 2
Scrub Brush x2
Gorilla Glue
Shampoo
Conditioner
Total:

Vendor
Target
Target
Target
Target
Target
Target

Cost
$5.89
$4.29
$12.98
$5.89
$0.99
$0.99
$31.03

Similar Devices/Vendors
During my research of similar products, I found two devices that
displayed a similar functionality to Showerin Made Easy (Table 2). The first
product listed below, Rozinsanitary stainless steel three head liquid soap
dispenser wall mount shampoo box, is typically seen in acute rehab settings.
Not only is this device more expensive, it requires installation which may be
difficult for an individual with a disability to set up. The second item, the etch
hair brush, does have a massaging component and a long handle but does
not combine steps the way Showerin Made Easy does. Specifically, it does
not contain a compartment to store product such as shampoo and
conditioner.

Table 2
Similar Devices
Name

Price

Product

ASSISTIVE TECHNOLOGY
$63.00
Rozinsanitary
Stainless Steel
Three Head
Liquid Soap
Dispenser Wall
Mount
Shampoo Box

Etac hair brush

$18.00

Figure 1: Model of Device

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Literature Review
According to researchers Lamb, Ferrucci, Volapto, Fried, & Guaralink (2003), residual
balance, dizziness, and spinning are stroke symptoms associated with a high risk of falling. The
researchers concluded that interventions designed at reducing falls in stroke patients should be
aimed at reducing the frequency of incoordination during complex tasks. Falls are common post
stroke up to 30 months and at times even longer (Lamb et al., 2003). Given the high nature of
falls post stroke, and the wet environment of a shower, the number of falls can increase
exponentially. The participants in the study reported showering and bathing as a problem post
stroke 63% of the time. Preventing falls should be a goal that practitioners prioritize given the
frequency of falls is 40% within the first year, and secondary conditions such as hip fractures that
occur post stroke are due to falls (Lamb et al., 2003). The researchers also felt improving
postural stability and perceptual skills that are a part of complex activities should be addressed in
therapy. In addition, encouragement of safer behaviors will also promote a better outcome for
stroke patients post discharge. With this being said, this article supports the need of an assistive
device that will reduce the complexity of showering and furthermore encourage independence
and reduce falls.
Parkinsons disease affects up to 4 million individuals worldwide (Bushnell & Martin,
1999). These patients may experience cognitive disorders such as poor memory, slowness in
motor tasks, problems in visio-spatial functioning, and psychological responses. In a survey
researchers Bushnell and Martin (1999) conducted, showering was the second activity of daily
living after dressing, patients with Parkinsons disease struggled with. The fact that they
experience cognitive delays is another reason why Showerin Made Easy would be beneficial to
these patients. By reducing the amount of steps and allowing individuals to complete showering

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without many products around them, this device would be of beneficial value to these
individuals.

References
Bushnell, D. M., & Martin, M. L. (1999). Quality of life and Parkinson's disease: translation and
validation of the US Parkinson's Disease Questionnaire (PDQ-39). Quality of Life
Research, 8(4), 345-350. doi: 10.1023/A:1008979705027
Lamb, S. E., Ferrucci, L., Volapto, S., Fried, L. P., & Guralnik, J. M. (2003). Risk factors for
falling in home-dwelling older women with stroke the womens health and aging
study. Stroke, 34(2), 494-501. doi: 10.1161/01.STR.0000053444.00582.B7

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Schultz-Krohn, W., Foti, D., Glogoski, C. (2013). Degenerative diseases of the central nervous
system. In H. McHugh Pendleton & W. Schultz-Krohn (Eds.), Pedrettis Occupational
Therapy: Practice Skills for Physical Dysfunction (7th ed. pp. 916-953). St. Louis, MO:
Mosby Elsevier.
Stephens, S., Kenny, R. A., Rowan, E., Kalaria, R. N., Bradbury, M., Pearce, R., ... & Ballard, C.
G. (2005). Association between mild vascular cognitive impairment and impaired
activities of daily living in older stroke survivors without dementia. Journal of the
American Geriatrics Society, 53(1), 103-107. doi: 10.1111/j.1532-5415.2005.53019.
Wolf, T. J., Birkenmeier, R. (2011). Intervention to increase performance and participation
following stroke. In C. H. Christiansen & K. M. Matuska (Eds.), Ways of living:
Intervention strategies to enable participation (4th ed., pp.281-298). Bethesda, MD:
American Occupational Therapy Association.