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Ouellet B, Berthiaume J, Fortin C, Rusu MT, Rushton PW, Dib T, Routhier F, Best KL. User perceptions about resources based on the Wheelchair Skills Training Program for training indoor and community wheelchair skills in pediatrics: a descriptive qualitative study. Disabil Rehabil Assist Technol 2024; 19:2531-2544. [PMID: 38214481 DOI: 10.1080/17483107.2024.2303464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 11/27/2023] [Accepted: 01/04/2024] [Indexed: 01/13/2024]
Abstract
PURPOSE The Wheelchair Skills Training Program (WSTP) is underutilized in pediatrics for training manual wheelchair skills because the voluminous manual lacks pediatric specificity and no materials adapted for pediatric manual wheelchair users (PMWUs) are available. A set of resources (storybook, posters, training workbook) based on the WSTP has previously been developed for training basic indoor wheelchair skills with five to 15-year-old PMWUs. Occupational therapists (OTs) and PMWUs expressed a need for additional resources addressing higher-level skills. Two new sets of resources teaching indoor and community wheelchair skills were developed. OBJECTIVE Describe OTs' and PMWUs' satisfaction and perceptions regarding usability, relevance and feasibility in pediatrics with the new resources. METHODS A descriptive qualitative study was conducted. A focus group and interviews were respectively conducted with a convenience sample of OTs and a criterion sample of PMWUs to document perceptions regarding satisfaction, usability, relevance and feasibility. A deductive approach to data analyses was used following the Framework Method. RESULTS Six OTs expressed satisfaction regarding both sets of resources feeling more confident using the WSTP (relevance) and perceiving potential time efficiencies when planning training interventions (feasibility). They provided suggestions to improve the usability of the second set. Six PMWUs participated in the interviews, two of which provided feedback on both sets. They were satisfied with the resources recommending them to novice and temporary PMWUs aged from three to 11 years. CONCLUSION Participants' suggested the resources may contribute to reducing the gap between the evidence supporting the WSTP and its utilization in pediatrics.
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Affiliation(s)
- Béatrice Ouellet
- Rehabilitation Department, Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec City, Quebec, Canada
| | - Jade Berthiaume
- Rehabilitation Department, Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec City, Quebec, Canada
| | - Charlie Fortin
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, Quebec, Canada
| | - Maria Teodora Rusu
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, Quebec, Canada
| | - Paula W Rushton
- School of Occupational Therapy, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
- CHU Sainte-Justine Research Center, Montréal, Quebec, Canada
| | - Tatiana Dib
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, Quebec, Canada
- CHU Sainte-Justine Research Center, Montréal, Quebec, Canada
| | - François Routhier
- Rehabilitation Department, Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec City, Quebec, Canada
| | - Krista L Best
- Rehabilitation Department, Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec City, Quebec, Canada
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Kenyon LK, Straw L, Wassermann M, Yasick EL, Kiger AL. School-Based Therapists' Perspectives of Wheelchair Use in US Schools: A Survey Study. Pediatr Phys Ther 2024; 36:71-78. [PMID: 38033270 DOI: 10.1097/pep.0000000000001062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
PURPOSE To gather information concerning the current state of students' wheelchair (WC) use in US schools from the perspective of school-based therapists. METHODS This descriptive study used a Web-based survey to gather information regarding factors that facilitated or hindered student WC use at school, the frequency at which various tasks related to WC provision were performed, and factors that would facilitate students' independence with WC use. RESULTS A dependent manual WC was the most common type of WC mobility used at school. Various student and nonstudent factors were reported as a facilitator or a barrier to students' WC use at school. CONCLUSIONS Although most respondents reported working with a student who used a WC, few reported active engagement in tasks related to WC service provision. Future research exploring potential attitudinal issues influencing students' WC use at school and ways to optimally support students' independent WC use is indicated.
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Affiliation(s)
- Lisa K Kenyon
- The Department of Physical Therapy and Athletic Training, Grand Valley State University (Drs Kenyon, Straw, Wassermann, and Yasick), Grand Rapids, Michigan; Permobil, Inc (Ms Kiger), Lebanon, Tennessee
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Pituch E, Rushton PW, Culley K, Houde M, Lahoud A, Lettre J, Routhier F. Exploration of pediatric manual wheelchair confidence among children, parents, and occupational therapists: a qualitative study. Disabil Rehabil Assist Technol 2023; 18:1229-1236. [PMID: 34806519 DOI: 10.1080/17483107.2021.2001059] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 10/26/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE Manual wheelchair (MWC) confidence is a predictor of adult life-space mobility and social participation. To date, scientific literature specific to pediatric MWC confidence is scarce which prevents in-depth understanding. The objective of this study was to explore the perceptions of pediatric MWC users (PMWU), parents, and occupational therapists regarding pediatric MWC confidence. METHODS Five focus groups were conducted with PMWUs (n = 12) and occupational therapists (n = 9), and semi-structured interviews were conducted with parents of PMWUs (n = 2). Inductive thematic analysis was performed following verbatim transcription of audio recorded material. RESULTS Three overarching themes were identified across PMWUs, parents, and occupational therapists: (1) "MWC confidence is not a clinical priority" depicted the construct's varying level of clinical priority and perceived abstractness; (2) "MWC confidence is both a child and parent consideration" revealed nuances between the PMWU's MWC confidence and the parents' perception of the PMWU's MWC confidence; and (3) "Opportunities to develop MWC confidence are context-specific" contrasted afforded and unafforded opportunities to experience independent MWC mobility. CONCLUSIONS Pediatric MWC confidence is an important aspect of wheelchair use that is shaped by a multitude of factors in PMWU's lives. This new area of pediatric study provides support for the need to measure this important construct.IMPLICATIONS FOR REHABILITATIONThis study is the first to explore children's, parents', and occupational therapists' perceptions of pediatric MWC confidence.Pediatric MWC confidence impacts MWC use in a multifaceted fashion.Future studies should consider the development and validation of a self-report measure to assess pediatric MWC confidence.
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Affiliation(s)
- Evelina Pituch
- Faculty of Medicine, School of Rehabilitation, Université de Montréal, Montréal, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montréal, Canada
| | - Paula W Rushton
- Faculty of Medicine, School of Rehabilitation, Université de Montréal, Montréal, Canada
- Centre Hospitalier Universitaire Sainte-Justine Research Centre, Montréal, Canada
| | - Kim Culley
- Faculty of Medicine, School of Rehabilitation, Université de Montréal, Montréal, Canada
- Centre Hospitalier Universitaire Sainte-Justine Research Centre, Montréal, Canada
| | - Martine Houde
- Faculty of Medicine, School of Rehabilitation, Université de Montréal, Montréal, Canada
- Centre Hospitalier Universitaire Sainte-Justine Research Centre, Montréal, Canada
| | - Alexandra Lahoud
- Faculty of Medicine, School of Rehabilitation, Université de Montréal, Montréal, Canada
- Centre Hospitalier Universitaire Sainte-Justine Research Centre, Montréal, Canada
| | - Josiane Lettre
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City, Canada
| | - François Routhier
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City, Canada
- Department of Rehabilitation, Université Laval, Quebec City, Canada
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Best KL, Rushton PW, Sheriko J, Arbour-Nicitopoulos KP, Dib T, Kirby RL, Lamontagne ME, Moore SA, Ouellet B, Routhier F. Effectiveness of wheelchair skills training for improving manual wheelchair mobility in children and adolescents: protocol for a multicenter randomized waitlist-controlled trial. BMC Pediatr 2023; 23:485. [PMID: 37752480 PMCID: PMC10521483 DOI: 10.1186/s12887-023-04303-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 09/09/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Self-directed mobility during childhood can influence development, social participation, and independent living later in life. For children who experience challenges with walking, manual wheelchairs (MWCs) provide a means for self-directed mobility. An effective MWC skills training program exists for adults, but controlled trials have not yet been documented in children and adolescents. This paper outlines the protocol for a multi-centre randomized wait-list controlled trial. The primary objective is to test the hypothesis that children and adolescents who receive MWC skills training will have higher MWC skills capacity compared to children and adolescents in the control group who receive usual care. The secondary objectives are to explore the influence of MWC skills training in children and adolescents (MWC use self-efficacy and satisfaction with participation in meaningful activities), and parents (perceived MWC skills); and to measure retention three months later. METHODS A multi-centre, parallel-group, single-blind randomized wait-list controlled trial will be conducted. A sample of 60 children and adolescents who use MWCs will be recruited in rehabilitation centres, specialized schools, and the communities of three Canadian cities. Participants will be randomized (1:1) to the experimental (Wheelchair Skills Training Program [WSTP]) or wait-list control group (usual care). Performance-based and self-report measures will be completed at baseline (T1), three months (post-intervention, T2), and three months post-intervention (T3). The primary outcome will be MWC skills capacity post-intervention. Secondary outcomes will be MWC use self-efficacy and satisfaction with participation of the child/adolescent, and parent-perceived MWC skills. The WSTP will consist of 12 sessions, 45-60 min each, delivered 1-2 times per week by trained personnel with health professions education. Training will be customized according to the child's baseline skills and participation goals that require the use of the MWC. The wait-list control group will receive usual care for 3 months and then receive the WSTP after completing T2 evaluations. Data will be analysed using ANCOVA (controlling for baseline scores). DISCUSSION MWC skills training may be one way to improve self-directed mobility and related outcomes for children and adolescents. The results of this multi-centre randomized wait-list controlled trial will allow for the effectiveness of the intervention to be evaluated in a variety of clinical contexts and geographical regions. TRIAL REGISTRATION ClinicalTrials.gov: NCT05564247, Version October 3, 2022.
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Affiliation(s)
- K L Best
- School of Rehabilitation Sciences, Faculty of Medicine, Université Laval, Quebec City, QC, G1V 0A6, Canada.
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré Universitaire de Santé Et de Services Sociaux de La Capitale-Nationale, 525 Wilfrid-Hamel Boulevard, Quebec City, QC, G1M 2S8, Canada.
| | - P W Rushton
- School of Rehabilitation, Université de Montréal, Montréal, QC, Canada
- CHU Sainte-Justine Research Center, Marie Enfant Rehabilitation, Montréal, QC, H1T 1C9, Canada
| | - J Sheriko
- School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, NS, B3H 4R2, Canada
- Department of Pediatrics, Faculty of Medicine, Dalhousie University, Halifax, NS, B3H 4R2, Canada
| | - K P Arbour-Nicitopoulos
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, M5S 2W6, Canada
| | - T Dib
- School of Rehabilitation, Université de Montréal, Montréal, QC, Canada
- CHU Sainte-Justine Research Center, Marie Enfant Rehabilitation, Montréal, QC, H1T 1C9, Canada
| | - R L Kirby
- Division of Physical Medicine and Rehabilitation, Dalhousie University, Halifax, NS, B3H 4K4, Canada
| | - M E Lamontagne
- School of Rehabilitation Sciences, Faculty of Medicine, Université Laval, Quebec City, QC, G1V 0A6, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré Universitaire de Santé Et de Services Sociaux de La Capitale-Nationale, 525 Wilfrid-Hamel Boulevard, Quebec City, QC, G1M 2S8, Canada
| | - S A Moore
- School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, NS, B3H 4R2, Canada
- Department of Pediatrics, Faculty of Medicine, Dalhousie University, Halifax, NS, B3H 4R2, Canada
| | - B Ouellet
- School of Rehabilitation Sciences, Faculty of Medicine, Université Laval, Quebec City, QC, G1V 0A6, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré Universitaire de Santé Et de Services Sociaux de La Capitale-Nationale, 525 Wilfrid-Hamel Boulevard, Quebec City, QC, G1M 2S8, Canada
| | - F Routhier
- School of Rehabilitation Sciences, Faculty of Medicine, Université Laval, Quebec City, QC, G1V 0A6, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré Universitaire de Santé Et de Services Sociaux de La Capitale-Nationale, 525 Wilfrid-Hamel Boulevard, Quebec City, QC, G1M 2S8, Canada
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Stewart-Height A, Koditschek DE, Johnson MJ. Reimagining robotic walkers for real-world outdoor play environments with insights from legged robots: a scoping review. Disabil Rehabil Assist Technol 2021:1-21. [PMID: 34087079 DOI: 10.1080/17483107.2021.1926563] [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: 10/21/2022]
Abstract
PURPOSE For children with mobility impairments, without cognitive delays, who want to participate in outdoor activities, existing assistive technology (AT) to support their needs is limited. In this review, we investigate the control and design of a selection of robotic walkers while exploring a selection of legged robots to develop solutions that address this gap in robotic AT. METHOD We performed a comprehensive literature search from four main databases: PubMed, Google Scholar, Scopus, and IEEE Xplore. The keywords used in the search were the following: "walker", "rollator", "smart walker", "robotic walker", "robotic rollator". Studies were required to discuss the control or design of robotic walkers to be considered. A total of 159 papers were analyzed. RESULTS From the 159 papers, 127 were excluded since they failed to meet our inclusion criteria. The total number of papers analyzed included publications that utilized the same device, therefore we classified the remaining 32 studies into groups based on the type of robotic walker used. This paper reviewed 15 different types of robotic walkers. CONCLUSIONS The ability of many-legged robots to negotiate and transition between a range of unstructured substrates suggests several avenues of future consideration whose pursuit could benefit robotic AT, particularly regarding the present limitations of wheeled paediatric robotic walkers for children's daily outside use.IMPLICATIONS FOR REHABILITATIONChildren with lower limb disabilities can benefit from assistive technology designed for daily usage in outdoor surroundings.An extension of existing robotic assistive technology that allows the user to travel safely on irregular surfaces both indoors and outdoors is needed.Approaches used to solve research problems in the field of robotics (outside of the rehabilitation area) can be used to address problems that robotic assistive technology currently faces.There is a need for more research on the development of robotic assistive technology for children with mobility impairments without cognitive delays.
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Affiliation(s)
- Abriana Stewart-Height
- Department ofElectrical & Systems Engineering, University of Pennsylvania, Philadelphia, PA, USA.,General Robotics, Automation, Sensing, & Perception (GRASP) Lab, University of Pennsylvania, Philadelphia, PA, USA
| | - Daniel E Koditschek
- Department ofElectrical & Systems Engineering, University of Pennsylvania, Philadelphia, PA, USA.,General Robotics, Automation, Sensing, & Perception (GRASP) Lab, University of Pennsylvania, Philadelphia, PA, USA
| | - Michelle J Johnson
- General Robotics, Automation, Sensing, & Perception (GRASP) Lab, University of Pennsylvania, Philadelphia, PA, USA.,Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, USA.,Department of Physical Medicine and Rehabilitation, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Kenyon LK, Hesse EN, Pakkala KJ, Vanderest S. Outcomes of a child-based manual wheelchair skills peer training program: an exploratory case report. Disabil Rehabil Assist Technol 2021; 18:1-5. [PMID: 34048664 DOI: 10.1080/17483107.2021.1931966] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 05/10/2021] [Accepted: 05/15/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE The purpose of this exploratory case series was to describe the outcomes for both a child-learner and a child-peer after a single manual wheelchair (MWC) skills training session involving child-based peer training techniques, followed by related home-based skills practice. MATERIALS AND METHODS Participants were a 9-year-old with L4-L5 spina bifida (pseudonym: Amari) and a 3-year-old with T10 spina bifida (pseudonym: Mary). Pre-intervention examination included administration of the Wheelchair Skills Test Questionnaire (WST-Q), the MWC short scale within the Mobility domain of the Paediatric Evaluation of Disability - Computer Adapted Test (MWC PEDI-CAT), and the Canadian Occupational Performance Measure (COPM). The peer training session, facilitated by a physical therapy team, involved games and activities involving MWC use. When appropriate, Amari was asked to talk aloud and verbally describe the components of the skills she was performing. Each child and her mother were instructed in specific MWC skills to practice at home over a 3-week period. RESULTS Both participants' post-intervention WST-Q capacity, confidence, and performance scores increased. Increases in parent-proxy COPM scores indicated clinically meaningful change in all identified occupational performance problems. Mary's total MWC PEDI-CAT post-intervention score increased by 11 points. Both mothers reported that the participation in the activities helped also to improve their child's self-esteem and self-image. CONCLUSIONS Both the participants in this exploratory case appeared to demonstrate improvements in MWC skills, self-esteem, and self-image following a single child-based MWC skills peer training session and related home-based skills practice. Future research involving such peer training methods is warranted.
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Affiliation(s)
- Lisa K Kenyon
- Department of Physical Therapy, Grand Valley State University, Grand Rapids, MI, USA
| | - Elizabeth N Hesse
- Department of Physical Therapy, Grand Valley State University, Grand Rapids, MI, USA
| | - Katelynn J Pakkala
- Department of Physical Therapy, Grand Valley State University, Grand Rapids, MI, USA
| | - Sebastian Vanderest
- Department of Physical Therapy, Grand Valley State University, Grand Rapids, MI, USA
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Huegel M, Otieno S, Kenyon LK. Validity of the WST and the WST-Q in children with spina bifida: a pilot project. Disabil Rehabil Assist Technol 2019; 14:744-750. [DOI: 10.1080/17483107.2018.1550114] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Micah Huegel
- Mary Free Bed Rehabilitation Hospital, Grand Rapids, MI, USA
| | - Sango Otieno
- Department of Statistics, Grand Valley State University, Allendale, MI, USA
| | - Lisa K. Kenyon
- Department of Physical Therapy, Grand Valley State University, Grand Rapids, MI, USA
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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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Casey J, McKeown L, McDonald R, Martin S. Wheelchairs for children under 12 with physical impairments. Hippokratia 2017. [DOI: 10.1002/14651858.cd010154.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Jackie Casey
- University of Ulster; Health & Rehabilitation Sciences Research Centre, Institute of Nursing and Health Research, School of Health Sciences, Faculty of Life and Health Sciences; Shore Road Newtownabbey Co. Antrim, Northern Ireland UK BT37 0QB
| | - Laura McKeown
- University of Ulster; Faculty of Life and Health Sciences; Shore Road Newtownabbey Co. Antrim, Northern Ireland UK BT37 0QB
| | - Rachael McDonald
- Swinburne University of Technology; Department of Health and Medical Sciences; John Street, Hawthorne Melbourne Australia 3122
| | - Suzanne Martin
- University of Ulster; Faculty of Life and Health Sciences; Shore Road Newtownabbey Co. Antrim, Northern Ireland UK BT37 0QB
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McCourt E, Casey J. Electrically powered indoor/outdoor chair performance for children aged 7 to 9 years. Br J Occup Ther 2016. [DOI: 10.1177/0308022616636405] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction Northern Ireland wheelchair guidelines state that wheelchair users who wish to drive their National Health Service provided powered wheelchairs outdoors must complete an electrically powered indoor/outdoor chair test. Within the same guidelines, children in Northern Ireland under the age of 10 years are not permitted to complete this assessment. Research was completed to evaluate how children under 10 years would perform in electrically powered indoor/outdoor chair training and testing under adult supervision. Method A case-study design was utilised with three children aged 7–9 years to evaluate if: (a) these children can complete electrically powered indoor/outdoor chair training/testing safely with adult supervision; (b) the length of time using an electric powered indoor chair correlates with performance on electrically powered indoor chair training/testing; (c) the current Northern Ireland guidelines on age restriction should be re-evaluated so that each child is assessed on an individual basis rather than age. Findings Paediatric powered wheelchair users aged seven to nine years can become competent electrically powered indoor/outdoor chair users with adequate training and adult supervision. Length of time (years) driving an electrically powered indoor chair may not correlate with improved electrically powered indoor/outdoor chair performance. Conclusion Regional Northern Ireland criteria relating to electrically powered indoor/outdoor chair provision for children should be revised in order to consider an individual needs assessment, rather than imposing an age restriction.
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Affiliation(s)
- Eileen McCourt
- Clinical Lead Occupational Therapist (Wheelchairs), Belfast Health and Social Care Trust, Belfast, UK
| | - Jackie Casey
- Lecturer in Occupational Therapy, School of Health Sciences, Ulster University, Newtownabbey, UK
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Abstract
BACKGROUND Children with cerebral palsy (CP) often walk with a slower speed and a higher energy cost. Their walking performance and choice of mobility method may vary in different environments. Independent mobility is important for activity and participation. QUESTIONS/PURPOSES We described walking performance at different distances and environments in relation to gross motor function, CP subtype, and age. PATIENTS AND METHODS We performed a cross-sectional study including all 562 children 3 to 18 years with CP living in southern Sweden during 2008. Data were extracted from a Swedish CP register and healthcare program. The Functional Mobility Scale (FMS) was used for rating mobility at home (5 m), at school (50 m), and in the community (500 m). The FMS scores were analyzed in relation to Gross Motor Function Classification System (GMFCS) level, CP subtype, and age. RESULTS In this population, 57% to 63% walked 5 to 500 m without walking aids and 4% to 8% used walking aids. We found a correlation between FMS and GMFCS. The walking performance varied between the subtypes from 96% to 98% in those with spastic unilateral CP to 16% to 24% in children with dyskinetic CP. An increased proportion of children walked independently on all surfaces in each successive age group. CONCLUSIONS The overall walking performance increased up to 7 years of age, but the proportion of children walking independently on uneven surfaces was incrementally higher in each age group up to 18 years. The ability to walk on uneven surfaces is important for achieving independent walking in the community.
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Sawatzky B, Rushton PW, Denison I, McDonald R. Wheelchair skills training programme for children: A pilot study. Aust Occup Ther J 2011; 59:2-9. [DOI: 10.1111/j.1440-1630.2011.00964.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Rodby-Bousquet E, Hägglund G. Use of manual and powered wheelchair in children with cerebral palsy: a cross-sectional study. BMC Pediatr 2010; 10:59. [PMID: 20712899 PMCID: PMC2933698 DOI: 10.1186/1471-2431-10-59] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2010] [Accepted: 08/16/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mobility is important for the cognitive and psychosocial development of children. Almost one third of children with cerebral palsy (CP) are non-ambulant. Wheelchairs can provide independent mobility, allowing them to explore their environment. Independent mobility is vital for activity and participation and reduces the dependence on caregivers. The purpose of this study was to describe the use of manual and powered wheelchair indoors and outdoors in relation to the degree of independent wheelchair mobility or need for assistance in a total population of children with CP. METHODS A cross-sectional study was performed including all children aged 3-18 years with CP living in southern Sweden during 2008. Data was extracted from a register and health care programme for children with CP (CPUP). There were a total of 562 children (326 boys, 236 girls) in the register. Information on the child's use of manual and powered wheelchair indoors and outdoors and the performance in self-propelling or need for assistance were analysed related to age, CP subtype and gross motor function. RESULTS Wheelchairs for mobility indoors were used by 165 (29%) of the 562 children; 61 used wheelchair for independent mobility (32 using manual only, 12 powered only, 17 both) and 104 were pushed by an adult. For outdoor mobility wheelchairs were used by 228 children (41%); 66 used a wheelchair for independent mobility (18 using manual only, 36 powered only, 12 both) and 162 were pushed. The use of wheelchair increased with age and was most frequent in the spastic bilateral and dyskinetic subtypes. Most powered wheelchairs were operated by children at GMFCS level IV. CONCLUSION In this total population of children with CP, aged 3-18 years, 29% used a wheelchair indoors and 41% outdoors. A majority using manual wheelchairs needed adult assistance (86%) while powered wheelchairs provided independent mobility in most cases (86%). To achieve a high level of independent mobility, both manual and powered wheelchairs should be considered at an early age for children with impaired walking ability.
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Fernandes T. Independent mobility for children with disabilities. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2006. [DOI: 10.12968/ijtr.2006.13.7.21410] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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