Persons with multiple disabilities exercise adaptive response schemes with the help of technology-based programs: three single-case studies

Literature review on assistive devices available for quadriplegic people: Indian context

PURPOSE

This literature review aims to find the current state of the art in self-help devices (SHD) available for people with quadriplegia.

MATERIALS AND METHODS

We searched original articles, technical and case studies, conference articles, and literature reviews published between 2014 to 2019 with the keywords ("Self-help devices" OR "Assistive Devices" OR "Assistive Product" OR "Assistive Technology") AND "Quadriplegia" in Science Direct, Pubmed, IEEE Xplore digital library and Web of Science.

RESULTS

Total 222 articles were found. After removing duplicates and screening these articles based on their title and abstracts 80 articles remained. After this, we reviewed the full text, and articles unrelated to SHD development or about the patients who require mechanical ventilation or where the upper limb is functional (C2 or above and T2 or below injuries) were discarded. After the exclusion of articles using the above-mentioned criterion 75 articles were used for further review.

CONCLUSION

The abandonment rate of SHD currently available in the literature is very high. The major requirement of the people was independence and improved quality of life. The situation in India is very bad as compared to the developed countries. The people with spinal cord injury in India are uneducated and very poor, with an average income of 3000 ₹ (41$). They require SHDs and training specially designed for them, keeping their needs in mind.Implications for rehabilitationPeople with quadriplegia are totally dependent on caregivers. Assistive devices not only help these people to do day-to-day tasks but also provides them self-confidence.Even though there are a lot of self-help devices currently available, still they are not able to fulfil the requirements of people with quadriplegia, hence there is a very high abandonment rate of such devices.This study provides an evidence that developing devices after understanding the functional and non-functional requirements of these subjects will decrease the abandonment rate and increase the effectiveness of the device.The results of this study can be used for planning and developing assistive devices which are more focussed on fulfilling the requirements of people with quadriplegia.

Three non-ambulatory adults with multiple disabilities exercise foot-leg movements through microswitch-aided programs

This study assessed the use of microswitch-aided programs to help three non-ambulatory adults with multiple disabilities exercise foot-leg responses. Those responses served to activate a largely neglected part of the participants' body, with possibly positive physical implications (e.g., for blood circulation, swelling, and muscle strength). Intervention focused on the left and right foot-leg response, separately. Eventually, sessions with one response were alternated with sessions with the other response. Responses were monitored via microswitches and followed by 8s of preferred stimulation (e.g., music and vibrotactile stimulation), which was automatically delivered. The results showed that all three participants had high levels of foot-leg responses during the intervention phases and a 3-week post-intervention check. The participants also displayed expressions of positive involvement during those study periods (i.e., engaged in behaviors, such as music-related head movements, smiles, or touching the vibratory devices) that could be interpreted as forms of interest/pleasure and happiness. These results are in line with previous findings in this area and can be taken as an important confirmation of the strength and dependability of the approach in motivating non-ambulatory persons with multiple disabilities to engage in foot-leg movements. The practical implications of these findings are discussed.

Technology-aided programs to support exercise of adaptive head responses or leg-foot and hands responses in children with multiple disabilities

OBJECTIVE

Assessing the effectiveness of technology-aided programs to help three children with multiple disabilities exercise adaptive head or leg-foot and hands responses independently.

METHOD

The response selected for the two children included in Study I was head rotation (i.e. movements of at least 25 degrees to the left that could start from a full right position as well as from other positions). The responses selected for the child included in Study II involved forward movement of the left leg-foot and forward movement of his hand(s) to touch objects. Tilt or optic microswitches were used to monitor the responses and a computer system regulated the stimuli contingent on them.

RESULTS

The responses targeted in the two studies showed large frequency increases during the intervention phases of the studies (i.e. when followed by stimulation).

CONCLUSION

Technology-aided programs can be a useful resource to help children with multiple disabilities exercise relevant responses independently.

Current status of the Matson Evaluation of Drug Side Effects (MEDS)

The Matson Evaluation of Drug Side Effects (MEDS) is currently the best established and most researched measure of drug side effects in the intellectual disability (ID) literature. Initial research was conducted on its psychometric properties such as reliability and validity. More recent research studies have used the measure to determine the interactive effects of severity of drug side effects on adaptive and social behaviors as well as symptoms of commonly medicated psychiatric conditions among persons with ID. Most recently the MEDS has been used to study potential risk factors of psychotropic drugs. The present study was written to review the current status of MEDS research in the broader context of psychotropic drug side effect research in general.