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A Touchscreen-Based Quantitative Assessment of Pediatric Hand Function: How Fast Can You Text?
David Shin, BA1; Deborah Bohn, MD2; Julie Agel, MA3; Ann E. Van Heest, MD3
1University of Minnesota Medical School, Minneapolis, MN; 2Park Nicollet Health Services/Tria Orthopaedic Center, Minneapolis, MN; 3University of Minnesota, Minneapolis, MN

Introduction and Clinical Significance: In recent years, touchscreen technology has becoming increasingly relevant to the day-to-day function of modern society. Therefore, the purpose of this project was to develop a novel hand function test using touchscreens to serve as a more accurate present-day evaluation of an individual's ability to interact with his or her environment. Here, we present the outcome of Phase I, the intention of which was to determine whether or not this test could discriminate between normal and impaired subjects.
Methods: The test was developed on the Apple iOS platform using an Apple iPhone 4. Four different tasks were designed that were believed to be representative of touchscreen use. These included: touching dots on a 3x4 grid, dragging shapes, using the camera, and texting using the onscreen keyboard. The test was designed to take approximately 60-120 seconds, with each patient first performing a "pre-test," in order to familiarize the patient with the tasks. Demographic information included: age, gender, years of experience with touchscreens, handedness, and diagnosis. Each section was timed independently, and an overall time was taken. Patients under 9 years of age were not asked to complete the texting portion, and those with less than 6 months of touchscreen experience were excluded.
Results: 74 patients were tested with a variety of upper extremity conditions, 32 of which were considered to exhibit impaired hand function, while 34 were considered to have normal hand function. Ages of subjects ranged from 3-25y, and there was a decreasing trend in completion time with an increase in age. When impaired patients were compared with age-matched normals, there was an average increase in completion time of 17.08s (p = 0.07) across all groups. Subjects in both categories were able to complete the dots and shapes tasks with relatively similar completion time, while the camera and texting tasks were responsible for the majority of time differentials.
Conclusions and Clinical Implications: The touchscreen hand function test does discriminate between subjects with normal versus impaired hand function. Preliminary analysis of the data reveals that this test may discriminate best for certain neuromuscular or congenital conditions. This test provides a new method for hand surgeons to test for normal or impaired function for use of a touchscreen device.


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