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Fujita H. Early Introduction of Power Mobility Devices for Children with Fukuyama Congenital Muscular Dystrophy and Its Psychological Impact on Caregivers: A Case Report. Pediatr Rep 2023; 15:403-413. [PMID: 37489411 PMCID: PMC10366897 DOI: 10.3390/pediatric15030037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 06/13/2023] [Accepted: 06/19/2023] [Indexed: 07/26/2023] Open
Abstract
Recently, motorized mobility devices (or power mobility devices (PMDs)) have been introduced for infants and toddlers who lack the means for self-mobility. Previous reports have primarily focused on PMDs for individuals with cerebral palsy. Few have explored PMDs for individuals with neuromuscular diseases who have intellectual disabilities. This report presents a case study of the early introduction of a PMD for an infant with Fukuyama congenital muscular dystrophy and presents the results of an interview with the father regarding psychological aspects and the child's manipulative abilities. The PMD was introduced at the age of 1 year and 10 months, and the changes during the 19 months after the introduction were evaluated six times, using the Assessment of Learning Powered mobility use tool (ALP). A semi-structured interview with the father was conducted 19 months after the introduction. The ALP evaluation and the interview were conducted by one physical therapist and two physical therapy students, and the results were shared with the hospital's physical therapist and nurses at the nursing facility. This report provides a basis for expanding the scope of PMD use and for considering the family's involvement, especially for the child.
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Affiliation(s)
- Hitomi Fujita
- Department of Rehabilitation, Faculty of Health Sciences, Nihon Fukushi University, 26-2 Higashihaemi-cho, Handa 475-0012, Aichi, Japan
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2
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Arps K, Darr N, Katz J. Effect of adapted motorized ride-on toy use on developmental skills, quality of life, and driving competency in nonambulatory children age 9-60 months. Assist Technol 2023; 35:83-93. [PMID: 34376119 DOI: 10.1080/10400435.2021.1956643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Adapted motorized ride-on toys (AMTs) provide a feasible option for independent mobility in children with physical limitations. This study explores implications of AMT use on developmental domains and participation in daily activities. It also pilots the Power Mobility Skills Checklist (PMSC) for assessment of AMT operation competency. Nine nonambulatory children, ages 10-35 months, completed a 16-week AMT intervention. The Battelle Developmental Inventory-2 (BDI-2) and Assessment for Life Habits for Children (Life-H) were completed pre- and poststudy to evaluate developmental skills and participation in daily activities. The PMSC was completed at 2-week intervals to assess AMT driving ability. PMSC scores improved significantly for all participants across the intervention. BDI-2 developmental quotients demonstrated clinically significant gains in motor, cognitive, adaptive, communication, and personal-social domains, which varied between participants. Life-H changes were not significant. Improvements in PMSC change scores were associated with more total AMT sessions and increased BDI-2 gains. The PMSC may be effective for obtaining quantitative data on AMT operation and sensitive for assessing change in driving competency.
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Affiliation(s)
- Kara Arps
- School of Physical Therapy, Belmont University, Nashville, Tennessee, USA
| | - Nancy Darr
- School of Physical Therapy, Belmont University, Nashville, Tennessee, USA
| | - Jamie Katz
- School of Physical Therapy, Belmont University, Nashville, Tennessee, USA
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Bray N, Kolehmainen N, McAnuff J, Tanner L, Tuersley L, Beyer F, Grayston A, Wilson D, Edwards RT, Noyes J, Craig D. Powered mobility interventions for very young children with mobility limitations to aid participation and positive development: the EMPoWER evidence synthesis. Health Technol Assess 2021; 24:1-194. [PMID: 33078704 DOI: 10.3310/hta24500] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND One-fifth of all disabled children have mobility limitations. Early provision of powered mobility for very young children (aged < 5 years) is hypothesised to trigger positive developmental changes. However, the optimum age at which to introduce powered mobility is unknown. OBJECTIVE The aim of this project was to synthesise existing evidence regarding the effectiveness and cost-effectiveness of powered mobility for very young children, compared with the more common practice of powered mobility provision from the age of 5 years. REVIEW METHODS The study was planned as a mixed-methods evidence synthesis and economic modelling study. First, evidence relating to the effectiveness, cost-effectiveness, acceptability, feasibility and anticipated outcomes of paediatric powered mobility interventions was reviewed. A convergent mixed-methods evidence synthesis was undertaken using framework synthesis, and a separate qualitative evidence synthesis was undertaken using thematic synthesis. The two syntheses were subsequently compared and contrasted to develop a logic model for evaluating the outcomes of powered mobility interventions for children. Because there were insufficient published data, it was not possible to develop a robust economic model. Instead, a budget impact analysis was conducted to estimate the cost of increased powered mobility provision for very young children, using cost data from publicly available sources. DATA SOURCES A range of bibliographic databases [Cumulative Index to Nursing and Allied Health Literature (CINHAL), MEDLINE, EMBASE™ (Elsevier, Amsterdam, the Netherlands), Physiotherapy Evidence Database (PEDro), Occupational Therapy Systematic Evaluation of Evidence (OTseeker), Applied Social Sciences Index and Abstracts (ASSIA), PsycINFO, Science Citation Index (SCI; Clarivate Analytics, Philadelphia, PA, USA), Social Sciences Citation Index™ (SSCI; Clarivate Analytics), Conference Proceedings Citation Index - Science (CPCI-S; Clarivate Analytics), Conference Proceedings Citation Index - Social Science & Humanities (CPCI-SSH; Clarivate Analytics), Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects (DARE), NHS Economic Evaluation Database (NHS EED), Health Technology Assessment (HTA) Database and OpenGrey] was systematically searched and the included studies were quality appraised. Searches were carried out in June 2018 and updated in October 2019. The date ranges searched covered from 1946 to September 2019. RESULTS In total, 89 studies were included in the review. Only two randomised controlled trials were identified. The overall quality of the evidence was low. No conclusive evidence was found about the effectiveness or cost-effectiveness of powered mobility in children aged either < 5 or ≥ 5 years. However, strong support was found that powered mobility interventions have a positive impact on children's movement and mobility, and moderate support was found for the impact on children's participation, play and social interactions and on the safety outcome of accidents and pain. 'Fit' between the child, the equipment and the environment was found to be important, as were the outcomes related to a child's independence, freedom and self-expression. The evidence supported two distinct conceptualisations of the primary powered mobility outcome, movement and mobility: the former is 'movement for movement's sake' and the latter destination-focused mobility. Powered mobility should be focused on 'movement for movement's sake' in the first instance. From the budget impact analysis, it was estimated that, annually, the NHS spends £1.89M on the provision of powered mobility for very young children, which is < 2% of total wheelchair service expenditure. LIMITATIONS The original research question could not be answered because there was a lack of appropriately powered published research. CONCLUSIONS Early powered mobility is likely to have multiple benefits for very young children, despite the lack of robust evidence to demonstrate this. Age is not the key factor; instead, the focus should be on providing developmentally appropriate interventions and focusing on 'movement for movement's sake'. FUTURE WORK Future research should focus on developing, implementing, evaluating and comparing different approaches to early powered mobility. STUDY REGISTRATION This study is registered as PROSPERO CRD42018096449. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology programme and will be published in full in Health Technology Assessment; Vol. 24, No. 50. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Nathan Bray
- School of Health Sciences, Bangor University, Bangor, UK.,Centre for Health Economics and Medicines Evaluation, Bangor University, Bangor, UK
| | - Niina Kolehmainen
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.,Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Jennifer McAnuff
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Louise Tanner
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Lorna Tuersley
- Centre for Health Economics and Medicines Evaluation, Bangor University, Bangor, UK
| | - Fiona Beyer
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Aimee Grayston
- Children's Services, Leeds Community Healthcare NHS Trust, Leeds, UK
| | - Dor Wilson
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Rhiannon Tudor Edwards
- School of Health Sciences, Bangor University, Bangor, UK.,Centre for Health Economics and Medicines Evaluation, Bangor University, Bangor, UK
| | - Jane Noyes
- School of Health Sciences, Bangor University, Bangor, UK
| | - Dawn Craig
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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Brooks R, Lambert C, Coulthard L, Pennington L, Kolehmainen N. Social participation to support good mental health in neurodisability. Child Care Health Dev 2021; 47:675-684. [PMID: 33942905 DOI: 10.1111/cch.12876] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 02/10/2021] [Accepted: 04/24/2021] [Indexed: 01/26/2023]
Abstract
BACKGROUND Young people with neurodisability experience lower levels of mental wellbeing and are at increased risk of mental illness compared with their non-disabled peers. Social participation is recognized as a protective factor against mental illness and a potential pathway to support better mental wellbeing in neurodisability. METHOD This co-design study involved young people, parents and clinicians. First, possible interventions were identified through a rapid systematic evidence review. Any study designs were considered, which included people with a neurodisability aged 0-18 years, which evaluated a therapy intervention with social participation and mental health outcomes. Titles and abstracts were screened by two reviewers, from the included studies data were extracted and then presented using written summaries. Second, the summaries were discussed and prioritized in stakeholder groups with young people, parents and clinicians. Groups were audio recorded and framework analysis was used to identify and specify intervention elements and their delivery. RESULTS The evidence review identified 13,870 records, from which 43 were included. These records were published 1994-2017 and reported studies with 4-249 participants aged 16 months-18 years with a range of neurodisabilities. Five intervention approaches (social skills training, arts, sports, technology and play) were identified from the review. Two themes emerged from the stakeholder groups: intervention in the real world, feeling judged and feeling safe. The groups prioritized an intervention in real-world social leisure contexts (i.e. existing clubs and groups) using nine key intervention elements (e.g. feedback and positive verbal reinforcement) delivered by club leaders trained by healthcare professionals using five intervention procedures (e.g. a manual and video training). CONCLUSION This study has identified core elements of social participation interventions that may improve mental health outcomes in young people with neurodisability, which should now be tested.
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Affiliation(s)
- Rob Brooks
- School of Clinical and Applied Sciences, Leeds Beckett University, Leeds, UK
| | - Charlotte Lambert
- School of Clinical and Applied Sciences, Leeds Beckett University, Leeds, UK
| | - Laura Coulthard
- School of Clinical and Applied Sciences, Leeds Beckett University, Leeds, UK
| | - Lindsay Pennington
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Niina Kolehmainen
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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Longo E, De Campos AC, Spinola Barreto A, de Lima Nascimento Coutinho DL, Leite Galvão Coelho M, Corsi C, Souza Monteiro K, Logan SW. Go Zika Go: A Feasibility Protocol of a Modified Ride-on Car Intervention for Children with Congenital Zika Syndrome in Brazil. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186875. [PMID: 32967070 PMCID: PMC7558945 DOI: 10.3390/ijerph17186875] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 09/09/2020] [Accepted: 09/10/2020] [Indexed: 12/14/2022]
Abstract
Children with congenital Zika syndrome (CZS) present severe motor disability and can benefit from early powered mobility. The Go Zika Go project uses modified ride-on toy cars, which may advance the body functions, activities, and participation of children. This paper describes the study protocol aiming to assess the feasibility of a modified ride-on car intervention for children with CZS in Brazil. A mixed-methods design with a multiple 1-week baseline, 3-month intervention, and 1-month follow-up will be implemented. Modified ride-on car training sessions will be conducted three times a week at the participants’ home or in the clinic. The primary outcome will be a narrative description of study feasibility (photovoice method, focus groups, parent feasibility questionnaire and assessment of learning powered mobility). Secondary outcomes will be switch activation, driving sessions journal, social-cognitive interactions, mobility (pediatric evaluation of disability inventory computer adaptive test), goal attainment scaling (GAS), and participation (young children’s participation and environment measure). Go Zika Go is expected to be viable and to improve function, activity, and participation of children with CZS, providing a low-cost, evidence-based rehabilitation option that will be relevant to early child development in a global perspective.
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Affiliation(s)
- Egmar Longo
- Postgraduate Program in Rehabilitation Sciences and Postgraduate Program in Collective Health, Federal University of Rio Grande do Norte—Faculty of Health Sciences of Trairi (UFRN-FACISA), Santa Cruz 59200-000, Brazil;
- Correspondence: ; Tel.: +55-8432912411
| | - Ana Carolina De Campos
- Department of Physical Therapy, Federal University of São Carlos, São Carlos 13565-905, Brazil; (A.C.D.C.); (C.C.)
| | - Amanda Spinola Barreto
- Postgraduate Program in Rehabilitation Sciences, Federal University of Rio Grande do Norte—Faculty of Health Sciences of Trairi (UFRN-FACISA), Santa Cruz 59200-000, Brazil; (A.S.B.); (D.L.d.L.N.C.)
| | - Dinara Laiana de Lima Nascimento Coutinho
- Postgraduate Program in Rehabilitation Sciences, Federal University of Rio Grande do Norte—Faculty of Health Sciences of Trairi (UFRN-FACISA), Santa Cruz 59200-000, Brazil; (A.S.B.); (D.L.d.L.N.C.)
| | - Monique Leite Galvão Coelho
- Postgraduate Program in Collective Health, Federal University of Rio Grande do Norte—Faculty of Health Sciences of Trairi (UFRN-FACISA), Santa Cruz 59200-000, Brazil;
| | - Carolina Corsi
- Department of Physical Therapy, Federal University of São Carlos, São Carlos 13565-905, Brazil; (A.C.D.C.); (C.C.)
| | - Karolinne Souza Monteiro
- Postgraduate Program in Rehabilitation Sciences and Postgraduate Program in Collective Health, Federal University of Rio Grande do Norte—Faculty of Health Sciences of Trairi (UFRN-FACISA), Santa Cruz 59200-000, Brazil;
- Postgraduate Program in Rehabilitation Sciences, Federal University of Rio Grande do Norte—Faculty of Health Sciences of Trairi (UFRN-FACISA), Santa Cruz 59200-000, Brazil; (A.S.B.); (D.L.d.L.N.C.)
| | - Samuel Wood Logan
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR 97331, USA;
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Huang HH, Huang HW, Chen YM, Hsieh YH, Shih MK, Chen CL. Modified ride-on cars and mastery motivation in young children with disabilities: Effects of environmental modifications. RESEARCH IN DEVELOPMENTAL DISABILITIES 2018; 83:37-46. [PMID: 30098454 DOI: 10.1016/j.ridd.2018.08.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 02/24/2018] [Accepted: 08/02/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Independent mobility is important for children's psychological development. Modified ride-on cars are innovative, alternative options to enhance independent mobility, socialization, and motivation in young children with disabilities. AIM We compared the effects of combining ride-on car use and a social interaction training program on mastery motivation and home affordances with a home education program in young children with disabilities. METHODS AND PROCEDURES Twenty-nine children with disabilities aged 1-3 years were recruited. The treatment group (n = 15) received two 2-h sessions/week for 9 weeks of ride-on car training in a hospital environment in Taiwan. The control group (n = 14) underwent similar home education programs. No treatment except regular therapy was administered during the 9-week follow-up period. Assessments included the Revised Dimensions of Mastery Questionnaire-Chinese version and the Affordance in the Home Environment for Motor Development-Toddler version-Chinese version. OUTCOMES AND RESULTS The treatment group (compared to controls) had significantly greater improvements in object persistence during the intervention. Both groups showed significant improvements in mastery pleasure and home affordances during the intervention. CONCLUSIONS AND IMPLICATIONS This novel study showed the potential use of modified ride-on cars to enhance mastery motivation in a hospital environment.
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Affiliation(s)
- Hsiang-Han Huang
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, Chang Gung University, Taoyuan, Taiwan; Joint Appointment with Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, Taiwan.
| | - Hsuan-Wen Huang
- Department of Rehabilitation, Saint Mary's Hospital Luodong, Yilan, Taiwan
| | - Yi-Mei Chen
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Yu-Hsin Hsieh
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, Chang Gung University, Taoyuan, Taiwan
| | - Ming-Ke Shih
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, Chang Gung University, Taoyuan, Taiwan
| | - Chia-Ling Chen
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, Taiwan; Graduate Institute of Early Intervention, College of Medicine, Chang Gung University, Taoyuan, Taiwan
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Huang HH, Chen YM, Huang HW, Shih MK, Hsieh YH, Chen CL. Modified Ride-On Cars and Young Children with Disabilities: Effects of Combining Mobility and Social Training. Front Pediatr 2018; 5:299. [PMID: 29387682 PMCID: PMC5776004 DOI: 10.3389/fped.2017.00299] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 12/26/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Research has shown that the use of power mobility devices is safe and beneficial for motor and cognitive development in children with motor disabilities; nevertheless, strong evidence of the benefits for social skill development is limited. This study aimed to examine the effects of combining ride-on car training with an adult-directed, social interaction program in a hospital-based environment on mobility and social functions in young children with motor disabilities. METHODS This study used a prospective, nonequivalent pretest-posttest control group design. Twenty-nine young children with motor disabilities, aged between 1 and 3 years, were recruited from local hospitals in Taiwan. The treatment group (n = 15) underwent 2-h ride-on car training sessions twice per week for a total of 9 weeks in the hospital environment. The control group (n = 14) underwent a 9-week home education program (mean: 200 min/week) focusing on mobility and social skills training. The Chinese version of the Pediatric Evaluation of Disability Inventory, Parenting Stress Index, and Goal Attainment Scaling were administered to all participants before and after the intervention, and at the end of the 9-week follow-up phase. RESULTS Mobility and social functions significantly improved in both groups after the 9-week intervention, but this improvement was not maintained at the follow-up phase. The treatment group showed significantly better improvement in social function, parenting stress levels, and goal achievement than the control group at posttest. CONCLUSION This two-group design study showed the benefits of combining a ride-on car use with a family-centered, structured, social interaction program for positive impacts on mobility, social function, and parenting stress levels. The combination of a modified ride-on car and a social training program has the potential to enhance socialization in young children with motor disabilities. CLINICAL TRIAL REGISTRATION www.ClinicalTrials.gov, identifier NCT02527499.
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Affiliation(s)
- Hsiang-Han Huang
- Department of Occupational Therapy, Graduate Institute of Behavioral Sciences, Chang Gung University, Taoyuan, Taiwan
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Yi-Mei Chen
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Taoyuan, Taoyuan, Taiwan
| | - Hsuan-Wen Huang
- Department of Rehabilitation, Saint Mary’s Hospital Luodong, Yilan, Taiwan
| | - Ming-Ke Shih
- Department of Occupational Therapy, Graduate Institute of Behavioral Sciences, Chang Gung University, Taoyuan, Taiwan
| | - Yu-Hsin Hsieh
- Department of Occupational Therapy, Graduate Institute of Behavioral Sciences, Chang Gung University, Taoyuan, Taiwan
| | - Chia-Ling Chen
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, Taiwan
- College of Medicine, Graduate Institute of Early Intervention, Chang Gung University, Taoyuan, Taiwan
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Huang HH. Perspectives on Early Power Mobility Training, Motivation, and Social Participation in Young Children with Motor Disabilities. Front Psychol 2018; 8:2330. [PMID: 29375444 PMCID: PMC5767308 DOI: 10.3389/fpsyg.2017.02330] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 12/21/2017] [Indexed: 12/13/2022] Open
Abstract
The efficacy of traditional training programs (e.g., neurodevelopmental therapy) in promoting independent mobility and early child development across all three International Classification of Functioning, Disability, and Health levels lacks rigorous research support. Therefore, early power mobility training needs to be considered as a feasible intervention for very young children who are unlikely to achieve independent mobility. This perspective article has three aims: (1) to provide empirical evidence of differences in early independent mobility, motivation, daily life activities, and social participation between young children with typical development and motor disabilities; (2) to discuss the contemporary concepts of and approaches to early power mobility training for young children with motor disabilities and the current need for changes to such training; and (3) to provide recommendations for early power mobility training in pediatric rehabilitation. Independent mobility is critical for social participation; therefore, power mobility can be accessible and implemented as early as possible, specifically for infants who are at risk for mobility or developmental delay. To maximize the positive effects of independent mobility on children's social participation, early power mobility training must consider their levels of functioning, the amount of exploration and contextual factors, including individual and environmental factors.
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Affiliation(s)
- Hsiang-Han Huang
- Department of Occupational Therapy, Graduate Institute of Behavioral Sciences, Chang Gung University, Taoyuan, Taiwan
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, Taiwan
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Abstract
PURPOSE To summarize and critically appraise the existing evidence related to power mobility training methods used in research studies conducted with children 21 years or younger. METHODS A systematic review was conducted using 16 electronic databases to identify primary source quantitative studies published in peer-reviewed journals. Data extraction, determination of level of evidence, evaluation of methodological rigor, and assessment of the risk of bias were completed. The Evidence Alert Traffic Light Grading System (EATLS) was used. RESULTS Twenty-seven studies were included in the review. Levels of evidence were II to V; scientific rigor scores were 2 to 7. CONCLUSIONS An overall Yellow EATLS level of evidence was found indicating that therapists should use caution when providing power mobility training interventions and measure outcomes related to established goals in areas such as development, functional skills, or use of a power mobility device.
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Ross SM, Catena M, Twardzik E, Hospodar C, Cook E, Ayyagari A, Inskeep K, Sloane B, MacDonald M, Logan SW. Feasibility of a Modified Ride-on Car Intervention on Play Behaviors during an Inclusive Playgroup. Phys Occup Ther Pediatr 2018; 38:493-509. [PMID: 29236563 DOI: 10.1080/01942638.2017.1400491] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AIMS Children with mobility related disabilities often experience limited participation and access to social interactions. An emerging pediatric powered mobility device are modified ride-on cars that provide self-directed mobility experiences to children with disabilities. This study aimed to determine: (1) the feasibility of a modified ride-on car intervention during an inclusive playgroup, (2) the effect of a modified ride-on car intervention on the play behaviors of children with and without mobility related disabilities. METHOD A single-subject research design was implemented. Thirteen children participated in a weekly inclusive playgroup. The five children with mobility related disabilities were provided modified ride-on cars during the intervention. Children's play behaviors were classified with Howes' Peer Play Scale. Intervention effects were examined using nonoverlap of all pairs (NAP). RESULTS The intervention was feasible based on participants' good attendance, retention rates, and successful use of modified ride-on cars. Overall children did not experience significant changes in play behaviors, with a few exceptions for decreased solitary, and increased parallel play, and/or direct peer interaction, among children with mobility related disabilities. Future research could examine modified ride-on car use by children with mobility related disabilities focusing on changes in unique play interactions between children with and without disabilities.
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Affiliation(s)
| | - Michele Catena
- a Kinesiology, Oregon State University , Corvallis , Oregon
| | - Erica Twardzik
- b Kinesiology, University of Michigan , Ann Arbor , Michigan
| | | | - Erika Cook
- a Kinesiology, Oregon State University , Corvallis , Oregon
| | | | - Kelsey Inskeep
- a Kinesiology, Oregon State University , Corvallis , Oregon
| | - Bethany Sloane
- c Child Development & Rehabilitation Center , Oregon Health & Science University , Portland , Oregon
| | | | - Samuel W Logan
- a Kinesiology, Oregon State University , Corvallis , Oregon
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Ride-On Car Training for Behavioral Changes in Mobility and Socialization Among Young Children With Disabilities. Pediatr Phys Ther 2017; 29:207-213. [PMID: 28654486 DOI: 10.1097/pep.0000000000000426] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To characterize behavioral changes in mobility and socialization in children with disabilities aged 1 to 3 years while they are receiving ride-on car training in the hospital environment. METHODS Ten young children with motor disabilities received ride-on car training for 9 weeks (2 hours per session, 2 sessions per week). The driving and socialization behaviors were videotaped for 20 minutes per session (1 session per week) within the same period. RESULTS Independent mobility, visual attention to the switch, and positive facial expressions during the training period were significantly improved. CONCLUSIONS Ride-on car training has positive effects on behavioral changes in mobility and socialization among young children with motor disabilities. This provides clinicians a novel option for implementing early mobility training in a hospital-based environment.
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Huang HH, Chen CL. The use of modified ride-on cars to maximize mobility and improve socialization-a group design. RESEARCH IN DEVELOPMENTAL DISABILITIES 2017; 61:172-180. [PMID: 28087203 DOI: 10.1016/j.ridd.2017.01.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 12/13/2016] [Accepted: 01/02/2017] [Indexed: 06/06/2023]
Abstract
AIM To examine the effects of ride-on car (ROC) training versus conventional therapy on mobility and social function in young children with disabilities in a hospital-based environment. METHODS AND PROCEDURES Twenty young children with disabilities, aged 1-3 years, were recruited. The treatment group (n=10) received ROC training of 2h/session, 2 sessions/week for a total of 9 weeks in the hospital environment. The control group (n=10) received conventional therapy alone. Assessments included the Chinese version of the Pediatric Evaluation of Disability Inventory and the Parenting Stress Index. OUTCOMES AND RESULTS After a 9-week intervention, the treatment group showed improvements in mobility and social function, whereas the control group showed improvements in social function alone. Four children in the treatment group had clinically meaningful changes in mobility and 3 in social function, as compared to 2 and 1, respectively, in the control group. CONCLUSIONS AND IMPLICATIONS This is the first group study that demonstrated the potential benefits of ROC training on mobility and social function in young children with disabilities in the hospital environment. Future studies should include a larger sample size to detect any differences between ROC training and conventional therapy.
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Affiliation(s)
- Hsiang-Han Huang
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, Chang Gung University, Taoyuan, Taiwan; Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan; Joint Appointment with Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, Taiwan.
| | - Chia-Ling Chen
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, Taiwan; Graduate Institute of Early Intervention, College of Medicine, Chang Gung University, Taoyuan, Taiwan
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Casey AF, Pickard V, Ullrich C, MacNeil Z. An adapted walking intervention for a child with Pitt Hopkins syndrome<sup/>. Disabil Rehabil Assist Technol 2017; 13:25-30. [PMID: 28125296 DOI: 10.1080/17483107.2016.1278469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE To investigate the effects of a community-based adapted walking intervention on a child with Pitt Hopkins syndrome (PTHS). METHODS A four-year old boy with PTHS participated in a 12-week intervention comprising five one-hour long walking sessions per week at a local daycare. Walking sessions used the Upsee mobility device (Firefly by Leckey Ltd., Ireland). Outcome measures included Goal Attainment Scaling and the Mobility Ability Participation Assessment. RESULTS Parental and caregiver goals for social interaction, physical activity and physical health surpassed expectations by post-testing. Gains were not sustained at three months follow-up. The participant's ability and mobility may have increased following the intervention. CONCLUSIONS Participants with PTHS may benefit from regular physical activity and early intervention. The Upsee mobility device is a feasible and fun way to promote inclusive community-based physical activity and social engagement in a young child with PTHS. Further research into the health benefits of physical activity and the Upsee for children with PTHS may be warranted. Implications for Rehabilitation Physical activity may be beneficial for a child with Pitt Hopkins syndrome, a rare genetic disorder. New design, implementation of mobility intervention for a child with neurodevelopmental disabilities. The Upsee mobility device may offer physical benefits for a child with a neurodevelopmental disability. The Upsee mobility device may offer social benefits for a child with a neurodevelopmental disability.
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Affiliation(s)
- Amanda Faith Casey
- a Department of Human Kinetics , St. Francis Xavier University , Antigonish , NS , Canada
| | - Vanessa Pickard
- a Department of Human Kinetics , St. Francis Xavier University , Antigonish , NS , Canada
| | - Claire Ullrich
- a Department of Human Kinetics , St. Francis Xavier University , Antigonish , NS , Canada
| | - Zachary MacNeil
- a Department of Human Kinetics , St. Francis Xavier University , Antigonish , NS , Canada
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Livingstone R, Field D. The child and family experience of power mobility: a qualitative synthesis. Dev Med Child Neurol 2015; 57:317-27. [PMID: 25403793 DOI: 10.1111/dmcn.12633] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/30/2014] [Indexed: 12/22/2022]
Abstract
AIM The aim of this study was to critically synthesize qualitative evidence regarding the child and family experience of power mobility, and to examine how this evidence fits with current theoretical concepts. METHOD Electronic database/hand searches were undertaken in September 2012 and updated in February 2014. The searches were restricted to qualitative studies published in English before February 2014 that included at least one child under the age of 19 with a disability and described an outcome related to the use of power mobility. Inclusion criteria were set a priori. Two reviewers independently screened titles, abstracts, and full-text articles and extracted data. McMaster qualitative review forms were used for quality appraisal. RESULTS Of 259 titles, 21 met inclusion criteria. From 143 codes, 15 second-order themes were developed using constant comparison and analysis. Three overarching themes emerged: power mobility experience promotes developmental change and independent mobility; power mobility enhances social relationships and engagement in meaningful life experiences; and power mobility access and use is influenced by factors in the physical, social, and attitudinal environment. INTERPRETATION This qualitative research provides rich and rigorous evidence supporting the benefits of power mobility for children and families. Numerous factors, which warrant careful consideration, influence power mobility access and use.
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Paleg G, Livingstone R. Outcomes of gait trainer use in home and school settings for children with motor impairments: a systematic review. Clin Rehabil 2015; 29:1077-91. [PMID: 25636993 DOI: 10.1177/0269215514565947] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2014] [Accepted: 12/06/2014] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To summarize and critically appraise evidence regarding use of gait trainers (walkers providing trunk and pelvic support) at home or school with children who are unable to walk independently or with hand-held walkers. DATA SOURCES Searches were performed in seven electronic databases including EBM Reviews, CINAHL, Medline and EMBASE for publications in English from database inception to November 2014. REVIEW METHODS Included studies involved at least one child with a mobility limitation and measured an outcome related to gait trainer use. Articles were appraised using American Academy of Cerebral Palsy and Developmental Medicine criteria for group and single-subject designs and quality ratings completed for studies rated levels I-III. The PRISMA statement was followed with inclusion criteria set a priori. Two reviewers independently screened titles, abstracts and full-text articles. RESULTS Seventeen studies involving 182 children were included. Evidence from one small randomized controlled trial suggests a non-significant trend toward increased walking distance while the other evidence level II study (concurrent multiple baseline design) reports increased number of steps. Two level III studies (non-randomized two-group studies) report statistically significant impact on mobility level with one finding significant impact on bowel function and an association between increased intervention time and bone mineral density. Remaining descriptive level evidence provides support for positive impact on a range of activity outcomes, with some studies reporting impact on affect, motivation and participation with others. CONCLUSIONS Evidence supporting outcomes for children using gait trainers is primarily descriptive and, while mainly positive, is insufficient to draw firm conclusions.
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Affiliation(s)
- Ginny Paleg
- Montgomery County Infants and Toddlers Program, Rockville, Maryland, USA
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Livingstone R, Field D. Systematic review of power mobility outcomes for infants, children and adolescents with mobility limitations. Clin Rehabil 2014; 28:954-64. [PMID: 24764156 DOI: 10.1177/0269215514531262] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To summarize and critically appraise the evidence related to power mobility use in children (18 years or younger) with mobility limitations. DATA SOURCES Searches were performed in 12 electronic databases along with hand searching for articles published in English to September 2012 and updated February 2014. REVIEW METHODS The search was restricted to quantitative studies including at least one child with a mobility limitation and measuring an outcome related to power mobility device use. Articles were appraised using American Academy of Cerebral Palsy and Developmental Medicine (AACPDM) criteria for group and single-subject designs. The PRISMA statement was followed with inclusion criteria set a priori. Two reviewers independently screened titles, abstracts and full-text articles. AACPDM quality ratings were completed for levels I-III studies. RESULTS Of 259 titles, 29 articles met inclusion criteria, describing 28 primary research studies. One study, rated as strong level II evidence, supported positive impact of power mobility on overall development as well as independent mobility. Another study, rated as moderate level III evidence, supported positive impact on self-initiated movement. Remaining studies, rated evidence levels IV and V, provided support for a positive impact on a broad range of outcomes from to International Classification of Functioning (ICF) components of body structure and function, activity and participation. Some studies suggest that environmental factors may be influential in successful power mobility use and skill development. CONCLUSION The body of evidence supporting outcomes for children using power mobility is primarily descriptive rather than experimental in nature, suggesting research in this area is in its infancy.
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Affiliation(s)
| | - Debra Field
- Sunny Hill Health Centre for Children, Canada Graduate Programs in Rehabilitation Sciences, University of British Columbia, Canada
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Chen X, Ragonesi C, Galloway JC, Agrawal SK. Design of a robotic mobility system with a modular haptic feedback approach to promote socialization in children. IEEE TRANSACTIONS ON HAPTICS 2014; 7:131-139. [PMID: 24968377 DOI: 10.1109/toh.2013.38] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Self-initiated mobility is a causal factor in children's development. Previous studies have demonstrated the effectiveness of our training methods in learning directional driving and navigation. The ultimate goal of mobility training is to enable children to be social, that is, to interact with their peers. A powered mobility device was developed that can localize itself, map the environment, plan an obstacle-free path to a goal, and ensure safety of a human driver. Combined with a positioning system, this system is able to apply a force field using a modular haptic feedback approach to train subjects to drive towards an object, a caregiver, a peer, or a group of peers. System feasibility was tested by designing a 'ball chasing' game. Results show that the system is promising in promoting socialization in children.
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Abstract
PURPOSE Children with cerebral palsy have limited opportunities to explore their physical and social environment. The purpose of this study was to determine the feasibility of using a "ride-on toy car" as a readily available, low-cost, fun, and functional option for children with special needs. METHODS Brenden, a 21-month-old child, was provided a modified ride-on toy car for a 15-week study period divided up into a 1-week baseline, 12-week intervention, and 2-week postintervention. We coded mobility and socialization measures from video recordings. RESULTS Brenden was more mobile and had more vocalizations during the 12-week intervention. CONCLUSIONS Modified toy cars have serious potential to be a fun and functional power mobility option for children with special needs. The opportunity now exists to quantify several effects, including peer socialization, cognitive measures, and body structure/function goals involving neural, muscular, and skeletal physiology. Group study is required to formally test these findings.
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Modified ride-on car for mobility and socialization: single-case study of an infant with Down syndrome. Pediatr Phys Ther 2014; 26:418-26. [PMID: 25192001 DOI: 10.1097/pep.0000000000000070] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Before the onset of walking, children with Down syndrome experience limited mobility yet are never considered candidates for traditional powered mobility devices. The purpose of this single-case study is to quantify the feasibility and family perceptions of including modified ride-on car use as an option for increasing daily mobility, socialization, and fun for a child with Down syndrome. METHODS A 13-month-old child, Natalie, and her family were video recorded during the 28-week study using her ride-on car in their home and community. RESULTS Natalie demonstrated and her family reported increased movement, mobility, and socialization over the study period. CONCLUSIONS Ride-on car use appears feasible, fun, and functional to increase daily mobility for pediatric populations working toward independent walking.
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Chen X, Ragonesi C, Galloway JC, Agrawal SK. Design of a robotic mobility system to promote socialization in children. IEEE Int Conf Rehabil Robot 2013; 2013:6650477. [PMID: 24187294 DOI: 10.1109/icorr.2013.6650477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Self-initiated mobility is a causal factor in children's development. Previous studies have demonstrated the effectiveness of our training methods in learning directional driving and navigation. The ultimate goal of mobility training is to enable children to be social, that is, to interact with peers. A powered mobility device was developed that can localize itself, map the environment, plan an obstacle-free path to a goal, and ensure safety of a human driver. Combined with a positioning system, this system is able to apply a force field to train subjects to drive towards an object, a caregiver, a peer, or a group of peers. System feasibility was tested by designing a 'ball chasing' game. Results show that the system is promising in promoting socialization in children.
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Abstract
Wheeled power mobility can fulfil an intrinsic desire to be mobile, to explore one's environment and to be active and participate in occupations regardless of age. This opinion piece briefly presents the potential of power mobility for children with physical impairments, the recent evidence base, an exploration of the readiness and training of children in the use of power mobility, and current United Kingdom prescription practice. This mode of intervention should no longer be considered as the final option but, rather, as a tool to prevent passivity and dependence and to enable children to optimise their participation in childhood occupations.
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Affiliation(s)
- Jacqueline Casey
- Lecturer in Occupational Therapy, Institute of Nursing and Health Research, School of Health Sciences, University of Ulster, Newtownabbey, Co. Antrim, Northern Ireland
| | - Ginny Paleg
- Physiotherapist, Montgomery County Infant and Toddlers Program, Rockville, Maryland, USA
| | - Roslyn Livingstone
- Occupational Therapist, Sunny Hill Health Centre for Children, Vancouver, British Columbia, Canada
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Larin HM, Dennis CW, Stansfield S. Development of robotic mobility for infants: rationale and outcomes. Physiotherapy 2012; 98:230-7. [DOI: 10.1016/j.physio.2012.06.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2011] [Accepted: 06/25/2012] [Indexed: 10/28/2022]
Affiliation(s)
- Hélène M Larin
- Department of Physical Therapy, Ithaca College, Ithaca, NY 14850, USA.
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Ragonesi CB, Galloway JC. Short-term, early intensive power mobility training: case report of an infant at risk for cerebral palsy. Pediatr Phys Ther 2012; 24:141-8. [PMID: 22466381 PMCID: PMC3319352 DOI: 10.1097/pep.0b013e31824c764b] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
PURPOSE This case report describes the feasibility of quantifying short-term, intensive power mobility training for an infant soon after a diagnosis of cerebral palsy. KEY POINTS An 11-month-old infant with significant mobility impairments and her parents were filmed during 14 consecutive daily training sessions. The infant moved the power chair with hand-over-hand assistance and performed open exploration of the joystick and toys. Mobility measures, coded from video, were compared across training. Frequency and combination of looking at and interacting with the joystick, percentage of time of moving independently, and average percentage of success in moving when prompted, all increased across the training. CLINICAL IMPLICATIONS Quantifying short-term, intensive power mobility training for infants is feasible and may have yielded positive short-term effects for this infant. The "who," "when," and "how" of early power mobility training, as well as the critical need for paradigm shifts in power mobility training, are discussed.
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Affiliation(s)
- Christina B Ragonesi
- Infant Motor Behavior Laboratory, Department of Physical Therapy and Biomechanics and Movement Sciences Program, University of Delaware, Newark, Delaware, USA.
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Abstract
BACKGROUND AND PURPOSE Children with significantly decreased mobility have limited opportunities to explore their physical and social environment. A variety of assistive technologies are available to increase mobility; however, no single device provides the level of functional mobility that children developing typically enjoy. The purpose of this technical report is to formally introduce a new power mobility option--the modified ride-on toy car. KEY POINTS This report will provide (a) an overview of toy car features, (b) examples of basic electrical and mechanical modifications, and (c) a brief clinical case. CLINICAL IMPLICATIONS With creative use and customized modifications, toy cars can function as a "general learning environment" for use in the clinic, home, and school. As such, we anticipate that these cars will become a multiuse clinical tool to address not only mobility goals but also goals involving body function and structure such as posture and movement impairments.
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Children--start your motors! Pediatr Phys Ther 2012; 24:129. [PMID: 22466377 DOI: 10.1097/pep.0b013e31824e9045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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