A Web-Based Caring Training for Caregivers of Children with Cerebral Palsy:

Objectives: Caregivers of children with cerebral palsy have to spend a long time to take care of their child. Also taking care of these children is a source of stress for their caregivers. Dealing with stressful situations has a negative impact on the quality of life of caregivers. The aim of the study was to develop a user-friendly web-based intervention for training parents of children with CP and evaluate the process of development using modified CeHRes road map.Materials and Method: The study was conducted in four main steps including determine the needs of users, content development, design, operational development and evaluation.Results: The website for caregiver training provided nine general topics and had the possibility that the caregivers could determine their educational priorities. Also, the users can share their experiences with other users and can ask questions from an expert. 10 caregivers completed a usability questionnaire after four weeks use. The average score of 70.5 out of 100 was shown among caregivers. The average score of all statements were above three on a Likert scale between 1 and 5.Conclusion: The website has the possibilities including registering caregivers of children with CP, the possibility to confirm registration with an SMS and the possibility to determine the caregiver educational priorities. It has the usability for training caregivers of children with CP.Keywords: Web-based intervention, cerebral palsy, caregive

Using knowledge brokers to facilitate the uptake of pediatric measurement tools into clinical practice: a before-after intervention study

<p>Abstract</p> <p>Background</p> <p>The use of measurement tools is an essential part of good evidence-based practice; however, physiotherapists (PTs) are not always confident when selecting, administering, and interpreting these tools. The purpose of this study was to evaluate the impact of a multifaceted knowledge translation intervention, using PTs as knowledge brokers (KBs) to facilitate the use in clinical practice of four evidence-based measurement tools designed to evaluate and understand motor function in children with cerebral palsy (CP). The KB model evaluated in this study was designed to overcome many of the barriers to research transfer identified in the literature.</p> <p>Methods</p> <p>A mixed methods before-after study design was used to evaluate the impact of a six-month KB intervention by 25 KBs on 122 practicing PTs' self-reported knowledge and use of the measurement tools in 28 children's rehabilitation organizations in two regions of Canada. The model was that of PT KBs situated in clinical sites supported by a network of KBs and the research team through a broker to the KBs. Modest financial remuneration to the organizations for the KB time (two hours/week for six months), ongoing resource materials, and personal and intranet support was provided to the KBs. Survey data were collected by questionnaire prior to, immediately following the intervention (six months), and at 12 and 18 months. A mixed effects multinomial logistic regression was used to examine the impact of the intervention over time and by region. The impact of organizational factors was also explored.</p> <p>Results</p> <p>PTs' self-reported knowledge of all four measurement tools increased significantly over the six-month intervention, and reported use of three of the four measurement tools also increased. Changes were sustained 12 months later. Organizational culture for research and supervisor expectations were significantly associated with uptake of only one of the four measurement tools.</p> <p>Conclusions</p> <p>KBs positively influenced PTs' self-reported knowledge and self-reported use of the targeted measurement tools. Further research is warranted to investigate whether this is a feasible, cost-effective model that could be used more broadly in a rehabilitation setting to facilitate the uptake of other measurement tools or evidence-based intervention approaches.</p

Designing play equipment to develop the social competence of children with cerebral palsy

A thesis submitted in partial fulfilment of the requirements of the University of Wolverhampton for the degree of Doctor of Philosophy.This study investigated the design of play equipment for encouraging peer-to-peer social interactions amongst children with cerebral palsy aged from 4 to 6 years, as a means of developing their social competence. The focus was on developing a new conceptual model and criteria for designing this specialist play equipment and, thus, creating a level playing field for children with different manifestations of cerebral palsy. According to the statistics of the National Health Service, it is estimated that approximately 1 in 400 children is born with cerebral palsy in the UK (NHS, 2017). It is recognised that these children often have reduced social engagement, yet socialisation plays a fundamental role in development. In spite of this, there are few toys specifically developed for children with cerebral palsy and even fewer which support peer socialisation. Therefore, there is a need to develop relational play equipment for them. The research presented here is interdisciplinary and informed by a social perspective on disability. It combined theoretical investigation with design practice within an action-research approach. User-centred design was used for the design development and intervention. Observations of children with cerebral palsy and interviews with their parents and conductors were employed for collecting data about the children’s social interactions before and during the design intervention in order to determine the effectiveness of the proposed concept. Data collection was carried out at the National Institute of Conductive Education in Birmingham, England. A conceptual design model of play equipment for enhancing the social competence in children with cerebral palsy was developed. The model focused on designing semiotic content that could trigger cognitive, emotional, social and physical processes to encourage children to participate in relational play and facilitate peer-to-peer social interactions. Based on this model, design criteria were developed, integrating two interrelated sets of indicators. The first set pertained to the design position and comprised child-friendly design criteria. The second pertained to the social purpose, comprising indicators of social competence, such as social skills and self-confidence. Based on these criteria, a number of design ideas were developed, using ideation, intuitive hand sketching and brainstorming. A final idea of the thematic play environment, “Undersea Friends”, which corresponded best to the conceptual model of play equipment and met most of the design criteria and recommendations from parents and conductors, was chosen for the design intervention. “Undersea Friends” consists of the toys intended for practising particular social skills, where each toy in the play space is a creature-friend and a facilitator of children’s interactions. These toys are Octopush Olly for practising turn taking, Hexapush Hetty for practising cooperation and Larry Long Legs for sharing. Two prototype toys for this environment were developed and evaluated with children with cerebral palsy for the purposes of this study. This completed study highlights the difficulties which children with cerebral palsy may experience with peer interactions while playing. It provides a new understanding of the development of social competence through engaging children in relational play, facilitated by specialist play equipment, as well as the prototype toys of the play environment, “Undersea Friends”. This research contributes to understanding of how designers can approach the creation of such play equipment by providing design criteria, design recommendations and suggestions for further investigation

Kebutuhan Alat Bantu Asistif bagi Penyandang Cerebral Palsy

Kompleksnya masalah-masalah yang dihadapi bagi penyandang cerebral palcy, maka diperlukan layanan kompensatoris. Layanan kompensatoris yang dimaksud adalah pemenuhan alat bantu asistif bagi cerebral palcy. Penelitian ini bertujuan untuk mengetahui gambaran kebutuhan alat bantu asisitif bagi penyandang cerebral palsy. Penelitian ini dilaksanakan dengan menggunakan pendekatan deskriptif kualitatif. Data penelitian didaptkan melalui proses wawancara, dokumentasi, observasi dan FGD. Informan dalam penelitian ini merupakan Guru dan orang tua dengan anak cerebral palcy. Hasil kajian menunjukkan bahwa adanya perhatian, kasih sayang yang didapatkan olaeh anak cerebral palcy dapat menumbuhkan kepercayaan diri. Orang tua dan lingkungan terdekat menjadi sangat central dalam upaya tersebut. Peran orang tua dan lingkungan terdekat juga sangat diperlukan dalam upya rehabilitasi motorik yang baik. Anak dengan cerebral palcy memilki keterbatasan terutama pada aktifitas keseharian seperti makan, minum, memegang benda, gosok gigi dan lain-lain. Artinya keterbatasan tersebut terdapat pada aktifitas penggunakan tangan. Pemenuhan alat bantu asistif guna pemenuhan rehabilitasi motorik menjadi sangat diperlukan

Presence and rehabilitation: toward second-generation virtual reality applications in neuropsychology

Virtual Reality (VR) offers a blend of attractive attributes for rehabilitation. The most exploited is its ability to create a 3D simulation of reality that can be explored by patients under the supervision of a therapist. In fact, VR can be defined as an advanced communication interface based on interactive 3D visualization, able to collect and integrate different inputs and data sets in a single real-like experience. However, "treatment is not just fixing what is broken; it is nurturing what is best" (Seligman & Csikszentmihalyi). For rehabilitators, this statement supports the growing interest in the influence of positive psychological state on objective health care outcomes. This paper introduces a bio-cultural theory of presence linking the state of optimal experience defined as "flow" to a virtual reality experience. This suggests the possibility of using VR for a new breed of rehabilitative applications focused on a strategy defined as transformation of flow. In this view, VR can be used to trigger a broad empowerment process within the flow experience induced by a high sense of presence. The link between its experiential and simulative capabilities may transform VR into the ultimate rehabilitative device. Nevertheless, further research is required to explore more in depth the link between cognitive processes, motor activities, presence and flow

Development of a toolbox for the kinematic evaluation of hands-up video games

Children with cerebral palsy (CP) often have limited upper extremity (UE) control, Virtual reality (VR) is a current technology being evaluated as a form of UE therapy for children with CP, The systems currently available have been developed with games that cannot be graded to match the skill level of children with severely impaired UE control. A novel video game platform, Hands-Up , has been developed at New Jersey Institute of Technology. The platform features software that allows for the customization of games and encourages users to make purposeful UE movements. To quantify changes and improvement in movement due to increased game play, a MATLAB-based toolbox of functions was developed. The functions include measures of peak velocity, percentage time to peak velocity, number of movement units, and straightness ratio. Data collected during reaching tasks were analyzed to validate the toolbox. The toolbox of functions provides different ways to interpret user intent