Enabling self-directed computer use for individuals with cerebral palsy: a systematic review of available assistive devices and technologies

Aim  The purpose of this study was to systematically review published evidence on the development, use, and effectiveness of devices and technologies that enable or enhance self-directed computer access by individuals with cerebral palsy (CP). Methods  Nine electronic databases were searched using keywords ‘computer’, ‘software’, ‘spastic’, ‘athetoid’, and ‘cerebral palsy’; the reference lists of articles thus identified were also searched. Thirty articles were selected for review, with 23 reports of development and usability testing of devices and seven evaluations of algorithms to increase computer recognition of input and cursor movements. Results  Twenty-four studies had fewer than 10 participants with CP, with a wide age range of 5 to 77 years. Computer task performance was usually tested, but only three groups sought participant feedback on ease and comfort of use. International standards exist to evaluate effectiveness of non-keyboard devices, but only one group undertook this testing. None of the study designs were higher than American Academy for Cerebral Palsy and Developmental Medicine level IV. Interpretation  Access solutions for individuals with CP are in the early stages of development. Future work should include assessment of end-user comfort, effort, and performance as well as design features. Engaging users and therapists when designing and evaluating technologies to enhance computer access may increase acceptance and improve performance

Investigation of Unintentional Movement in People with Cerebral Palsy to Improve Computer Target Aquisition

People with Cerebral Palsy (CP) have difficulty using computer pointing devices due to unintentional movement in their upper extremities. Fifty percent of people with CP have impaired arm-hand function which limits their ability to interface with pointing devices and effectively control cursor movement on the computer screen. This thesis involves two studies which utilize an Isometric Joystick in order to access the computer and complete target acquisition tasks. The first study titled "Quantification of Cursor Movement of People with Athetoid and Spastic Cerebral Palsy to Improve Target Acquisition," aims to guide real-time digital filter development for people with athetoid and spastic CP for target acquisition tasks. By investigating the cursor movement measures throughout the target acquisition trajectory we gained a better insight as to when and how to compensate for unintentional movement in people with CP. Results showed that both people with athetoid CP and spastic CP have more difficulty hovering over the target than they did moving to the target, indicating that filter development should focus on the hovering portion of the target acquisition task in order to improve target acquisition time. The second study titled "Customized Control for People with Athetosis and Dystonia to Improve Computer Access," aims to develop a method to prescribe appropriate switch/scanning control for people with athetosis and dystonia as well as to determine if customized switch/scanning control is more effective in completing icon selection tasks than the proportional isometric control. Results of this study suggest that switch/scanning control could be useful in moving on the most direct path to the target as shown by a significantly smaller percent distance error for customized control as compared to proportional isometric control (F(1,6) = 361.2, p < 0.01)

The importance of social experience in the schoolroom to the cerebral palsied child

Thesis (Ed.M.)--Boston Universit

The work place experiences of individuals with cerebral palsy who have communication difficulties and their colleagues.

Masters Degree. University of KwaZulu-Natal, Durban, 2015.Employment is a form of independence and self-acceptance which, for many individuals with disabilities, is crucial to improving quality of life. Communication underpins quality of life and, for individuals with cerebral palsy, communication may act as a barrier to successful employment. This study aimed to explore the employment experiences of individuals with cerebral palsy who have communication difficulties and their colleagues. A phenomenological qualitative approach was used within the context of the International Classification Framework and a critical paradigm. Individual semi-structured interviews were conducted with six individuals with cerebral palsy who had full-time employment and a colleague of each. Data was analysed using thematic analysis. Results revealed that individuals with cerebral palsy had reduced speech intelligibility that varied with the nature and severity of the cerebral palsy and led to communication breakdowns with colleagues. Communicating in a group and over the phone produced feelings of nervousness and one-on-one conversations were preferred. Gaps were noted in implementing legislation regarding inclusion and equal opportunities for individuals with disabilities in education and employment. Individuals with cerebral palsy faced numerous barriers to employment which included accessibility, communication, transportation, limitations in education, and a lack of opportunities. Employment opportunities included financial independence, social aspects, contributing to society, educating others about disability, improved self-perception and the impact of employing a person with cerebral palsy. A Speech-Language Therapist can assist with some of these barriers and is recommended across stages of life for different purposes. There are implications for improving service delivery and employment opportunities for individuals with cerebral palsy

An investigation of the main components of physical and occupational therapy and therapeutic treatments for children with cerebral palsy

Physical and occupational therapy are both up-and-coming allied health fields within the medical profession and play an integral role in bettering the quality of lives for all types of conditions and populations. Without these therapeutic disciplines, hope for improvement and for a fulfilling lifestyle for those with disabilities would be lost. However, given the importance of both physical and occupational therapy in the recovery process for many people, it is also vital that parents, families, patients, along with current and aspiring therapists, like myself, understand the background and roles of each therapeutic practice in order to make more educated decisions on treatment. Further, because the condition of cerebral palsy is one of the most commonly treated pediatric issues by both physical and occupational therapists, being more knowledgeable about the definition, treatment options, and prognosis of the condition is quite necessary to give the best of care. As an aspiring pediatric physical therapist, I felt compelled to complete a thesis analyzing the specific components of both physical and occupational therapy, the definition and types of cerebral palsy, some general therapeutic treatment options, and the prognosis for the condition in order to better educate myself and other future therapists, along with the general population and families of disabled children.Thesis (B.?)Honors Colleg

The effect of aquatic performance on balance of cerebral palsied children

The education of the cerebral palsied child has often been compared to making a telephone call on a disrupted switchboard. Only through a long process involving trial and error and repetition, can the call eventually be completed over another circuit. So it is with the cerebral palsied individual. The neurological pathways facilitating movement have been disrupted by a lesion, origin oftentimes unknown in certain areas of the brain, resulting in imbalance and incoordination

Cerebral Palsy: an Analysis of Hip Pathology and Possible Treatments

Cerebral Palsy (CP) occurs in about one to five of every 1000 births in Western countries (DeLuca 1996), and is also the most common cause of severe physical disability in childhood (Koman et al. 2004). Cerebral Palsy is an umbrella term used to describe a number of conditions that are caused by brain damage during fetal development or shortly after birth, and that are characterized by poor muscle control, spasticity (muscle tightness), and paralysis, among many other neurological deficiencies (Berkow 1997). The magnitude of these manifestations depends on the extent and location of the brain damage and can range in severity from subtle motor impairment to total body involvement (Koman et al. 2004). Cerebral Palsy is a static, rather than progressive disorder, where the condition will not worsen over time (DeLuca1996). Brain damage usually occurs in the cerebral cortex, which can results in many Central Nervous System (CNS) impairments such as: CNS hemorrhage (ruptured blood vessel in the central nervous system), mechanical spinal cord or brainstem damage, deep CNS hypoxia (deprivation of oxygen), cerebral cortex hypoxia and transient or irreversible ischemia (blood deficiency to the brain, which results in nervous/brain cell death). Cerebral Palsy is usually diagnosed based on delayed development of motor function (Eicher and Batshaw 1995)