Hand versus mouth for call-bell activation by DMD and Becker patients

Neuromuscul Disord. 2007 Jul;17(7):532-6. doi: 10.1016/j.nmd.2007.03.016. Epub 2007 May 29.


Severe hand dysfunction is common in patients with Duchenne muscular dystrophy (DMD) and may preclude the use of conventional call-bells. We prospectively evaluated a call-bell with two hand-controlled interfaces (push-button and key-pinch) and two mouth-controlled interfaces (sip-or-puff) in 32 consecutive DMD and Becker patients. Patients called intentionally 348 times, using the sip-or-puff device 237 times and the hand-controlled interfaces 147 times. Use of the hand-controlled interfaces correlated with key-pinch strength (R=0.366; P=0.04). Six patients reported being unable to call with the hand interfaces and five patients reported temporary call failure due to inaccessibility of the sip-or-puff interface. Ease-of-use scores on a visual analogue scale were best for puff, followed by sip then key-pinch interrupter and push-button (8.7+/-2.1, 7.5+/-2.7, 6.2+/-3.9, and 0.5+/-2.0 respectively; ANOVA: P<0.00001). In conclusion sip-or-puff devices should be considered more often to provide neuromuscular patients with greater independence.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Analysis of Variance
  • Chi-Square Distribution
  • Female
  • Follow-Up Studies
  • Hand / physiopathology*
  • Humans
  • Male
  • Muscular Dystrophy, Duchenne / pathology*
  • Muscular Dystrophy, Duchenne / physiopathology*
  • Pain Measurement
  • Prospective Studies
  • Psychomotor Performance / physiology*