Assistive Equipment Research Articles

Environmental Barriers to Participation of Preschool Children with and without Physical Disabilities.

Environment plays a vital role in affecting participation of young children in home, school, and community. Knowledge of environmental barriers helps to develop solutions or strategies that enable participation. The study compared the environmental barriers perceived by parents of preschool children with physical disabilities (PD, n = 142) and with typical development (TD, n = 192) in Taiwan. Parents identified environmental barriers by structured interview using the Chinese version of the Child and Adolescent Scale of Environment (CASE-C). The CASE-C is an 18-item measure of the impact of problems with physical, social, and attitudinal environmental features. Differences between the PD and TD groups in the summary scores for the CASE-C and the percentages of parents who perceived a problem for each item were examined by the analysis of covariance (ANCOVA) and Chi-square test. Parents of children with PD more often identified barriers related to family resources and community programs or services, social attitudes, assistance and supports outside of home, physical design of home and community, transportation, and assistive devices or equipment. Greater impacts of barriers were also reported by parents of preschool children with PD. Our findings provide evidence of environmental barriers that inform practice and policies to modify the barriers and provide an accessible and inclusive environment for families with young children.

Towards Usable E-Health. A Systematic Review of Usability Questionnaires.

The use of e-health can lead to several positive outcomes. However, the potential for e-health to improve healthcare is partially dependent on its ease of use. In order to determine the usability for any technology, rigorously developed and appropriate measures must be chosen. To identify psychometrically tested questionnaires that measure usability of e-health tools, and to appraise their generalizability, attributes coverage, and quality. We conducted a systematic review of studies that measured usability of e-health tools using four databases (Scopus, PubMed, CINAHL, and HAPI). Non-primary research, studies that did not report measures, studies with children or people with cognitive limitations, and studies about assistive devices or medical equipment were systematically excluded. Two authors independently extracted information including: questionnaire name, number of questions, scoring method, item generation, and psychometrics using a data extraction tool with pre-established categories and a quality appraisal scoring table. Using a broad search strategy, 5,558 potentially relevant papers were identified. After removing duplicates and applying exclusion criteria, 35 articles remained that used 15 unique questionnaires. From the 15 questionnaires, only 5 were general enough to be used across studies. Usability attributes covered by the questionnaires were: learnability (15), efficiency (12), and satisfaction (11). Memorability (1) was the least covered attribute. Quality appraisal showed that face/content (14) and construct (7) validity were the most frequent types of validity assessed. All questionnaires reported reliability measurement. Some questionnaires scored low in the quality appraisal for the following reasons: limited validity testing (7), small sample size (3), no reporting of user centeredness (9) or feasibility estimates of time, effort, and expense (7). Existing questionnaires provide a foundation for research on e-health usability. However, future research is needed to broaden the coverage of the usability attributes and psychometric properties of the available questionnaires.

The effects of a Farm Work Safety Project

Background/Objectives: The objective of this paper was to present the results of a study aimed at improving assistive equipment applying ergonomics and occupational therapy, as well as an exercise program at farms in Korea. Methods/Statistical analysis: The Korean Rural Development Administration's Pilot Assistive Equipment Project for Agricultural Work is expected to reduce the injury and illness potential for farm workers. Thus, this study is intended to ergonomically evaluate assistive equipment and provide exercises to prevent musculoskeletal disorders to improve the physical functioning of farm workers. Findings: The farmers’ ratings of perceived fatigue were improved by 94.6% and their risk of the occurrence of musculoskeletal diseases was decreased by 53%. The 21 participants in the musculoskeletal disease prevention exercise program showed statistically significant improvements in their physical competence such as lower-extremity muscular endurance, balance ability, and flexibility (p<0.05). Improvements/Applications: This study confirmed the effects of “The Pilot Assistive Equipment Project for Agricultural Work” conducted in South Korea’s rural areas and an exercise program. Future studies are required to examine their effects on the participants’ quality of life.

介護者のはさまれ災害に対する入浴介助機器の保護方策の開発—入浴用ストレッチャ式電動リフトへの適用と評価—

介護者のはさまれ災害に対する入浴介助機器の保護方策の開発—入浴用ストレッチャ式電動リフトへの適用と評価—

A Neuro-Fuzzy Fatigue-Tracking and Classification System for Wheelchair Users

With the elderly and disabled population increasing worldwide, the functionalities of smart wheelchairs as mobility assistive equipment are becoming more enriched and extended. Although there is a well-established body of literature on fatigue detection methods and systems, fatigue detection for wheelchair users has still not been widely explored. This paper proposes a neuro-fuzzy fatigue tracking and classification system and applies this method to classify fatigue degree for manual wheelchair users. In the proposed system, physiological and kinetic data are collected, including surface electromyography, electrocardiography, and acceleration signals. The necessary features are then extracted from the signals and integrated with a self-rating method to train the neuro-fuzzy classifier. Four degrees of fatigue status can be distinguished to provide further fatigue and alertness prediction in the event of musculoskeletal disorders caused by underlying fatigue.

Three-dimensional bio-printing equipment technologies for tissue engineering and regenerative medicine.

Three-Dimensional (3D) printing technologies have been widely used in the medical sector for the production of medical assistance equipment and surgical guides, particularly 3D bio-printing that combines 3D printing technology with biocompatible materials and cells in field of tissue engineering and regenerative medicine. These additive manufacturing technologies can make patient-made production from medical image data. Thus, the application of 3D bio-printers with biocompatible materials has been increasing. Currently, 3D bio-printing technology is in the early stages of research and development but it has great potential in the fields of tissue and organ regeneration. The present paper discusses the history and types of 3D printers, the classification of 3D bio-printers, and the technology used to manufacture artificial tissues and organs.

STRATEGI PENGEMBANGAN USAHATANI KEDELAI DI KABUPATEN GROBOGAN DENGAN PENDEKATAN ANALYSIS HIERARCHY PROCESS (AHP)

&lt;p&gt;Soybean is one of the agricultural commodity Grobogan. Soybean commodity is widely cultivated by farmers because the topography is consistent with the characteristics of the soil in Grobogan. In 2010 soybean production Grobogan is most widely in Central Java. However, Indonesia is still dependent on imported soybeans, especially in times of shortages of soybeans. This is partly also due to soybean production in soybean-producing region is very volatile while soybean demand in the market tends to increase. So, we need a strategy development of soybean farming in Grobogan. The goals to be achieved from the preparation of this study was to analyze the condition of soybean farming in Grobogan and obtain soybean farming development strategy in Grobogan based approach Analysis of Hierarchy Process. Alternative measures a priority to develop soybean are: Provision of continuous production factors and affordable, production factor subsidies, assistance to farmers, extension and education on effective post-harvest handling, Counseling institutional strengthening of farmer groups, and technical assistance (equipment, factors of production, training) to farmers. sedagkan least priority are: Incentives for active farmer organizations, cooperatives Revitalization and extension services and farmer partnerships with major employers&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Keywords: &lt;/strong&gt;Soybean, Analysis of Hierarchy Process&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;

Themenerschließung für die sektorenübergreifende Qualitätssicherung der Versorgung bei Schlaganfall und TIA

The development of cross-sectoral quality assurance programs usually requires extensive topic identification. Illustrated by the complex processes of care for stroke and transient ischemic attacks (TIAs), a method for comprehensive topic identification is presented. The first step involves a thorough literature search in terms of systematic reviews, health technology assessments, guidelines, studies into healthcare delivery and the use of specific instruments. Routine data as well as epidemiologic studies are used to analyze the reality of service provision. In addition, experts are consulted to gain expertise concerning deficits of care, approaches to quality assurance and experience with existing quality assurance programs. Furthermore individual patient experiences are collected to add the patients’ perceptions of care. Because of the limitation on the regulatory scope of Book V of the German Social Code, which, in this case, was necessary, another source of information was the legal framework and its impact on rescue chain, acute treatment and rehabilitation. Existent quality management systems, accreditations and quality assurance programs in prevention, acute treatment and rehabilitation have been searched in order to avoid any overlap with existing measures. After identifying a total of 71 quality targets according to deficits of care, recommendations for care and expert opinions in primary and secondary prevention, rescue chain, acute treatment, rehabilitation and supply of assistive equipment and therapies, respectively, the usability of instruments was tested. These instruments included case documentation, patient surveys and routine data. 14 quality targets proved to be reproducible by these instruments and were included in the recommendations for a cross-sectoral quality assurance program for stroke and TIA.

The Sports-Related Injuries and Illnesses in Paralympic Sport Study (SRIIPSS): a study protocol for a prospective longitudinal study.

BackgroundParalympic sport provides sporting opportunities for athletes with a disability, with the Paralympic Games as the main event. Participation in sport is, however, associated with a significant risk for sustaining injuries and illnesses. Our knowledge of sports-related injuries and illnesses in Paralympic sport is very limited and there are no large-scale epidemiological cohort studies. The purpose here is to present a protocol for a prospective longitudinal study: The Sports-Related Injuries and Illnesses in Paralympic Sport Study (SRIIPSS).Methods/designAn argument-based method for investigation of design problems was used to structure the study protocol. The primary requirement of the protocol is to allow prospective studies over time and include exposure to both training and competition. To reflect the complexity of Paralympic sport with athletes’ pre-existing impairments, use of assistive equipment, pain and other and medical issues, it is required that the data collection system is specifically adapted to Paralympic sport. To allow the collection of data, at the same time as there is limited access to coaches and medical personnel, it is advantageous that data can be collected online directly from the athletes. Based on this a self-report athlete monitoring system will be developed, where the athletes can enter data weekly via their mobile phones or lap-tops. Data will be collected from around 100 Swedish Paralympic athletes for approximately 1 year, which will allow us to i) prospectively estimate the annual incidence of sports-related injuries and illnesses and ii) explore risk factors and mechanisms for sustaining sports-related injuries and illnesses based on athlete exposure and training loads.DiscussionFor effective implementation of injury and illness prevention measures, comprehensive epidemiological knowledge is required. This study will be the first prospective longitudinal self-report study of sports-related injuries and illnesses in Paralympic sport over a longer period of time. The results will eventually contribute to the development of evidence-based preventive measures specifically adapted to Paralympic sport in order to provide safe and healthy sport participation. Thereby, the project will be of relevance for Paralympic athletes at all levels and to the Paralympic Movement.Trial registrationThe study is registered at ClinicalTrials.gov (Identifier: NCT02788500; Registration date: 22 May 2016).

Virtually home: Exploring the potential of virtual reality to support patient discharge after stroke

Introduction The level of assessment and intervention received by patients prior to discharge varies widely across stroke services in the United Kingdom. This study aimed to explore the potential value of virtual reality in preparing patients for discharge following stroke. Method Semi-structured interviews were carried out with 13 occupational therapists, eight patients with a stroke and four community stroke survivors. Views were sought of the perceived acceptability, potential utility and limitations of a ‘virtual home’ environment for use in pre-discharge education and assessment. Data were analysed thematically. Findings Interviewees found the virtual home to be an acceptable and visual means of facilitating discussions about discharge. It was perceived as valuable in assessing patient insight into safety risks and exploring the implications of installing assistive equipment at home. Limitations were identified relating to specific software issues and the use of virtual reality with patients with cognitive or perceptual impairments. Conclusion The results demonstrate the potential utility of the virtual home within stroke rehabilitation. Patients and therapists engaged with the virtual home and, moreover, made practical suggestions for future development. Feasibility and pilot testing in a clinical setting is required to compare the use of the virtual home with traditional approaches of pre-discharge assessment.

Influence of Assistive Technology for the maintenance of the Functionality of Elderly People: an integrative review

Introduction: assistive technology consists of resources and services that contribute to provide or extend functional skills and promote independence and social inclusion of disabled or elderly. Objective: identifying the knowledge produced in the scientific literature about contributions of assistive technology for the maintenance of the old functionality. Method: it was conducted an integrative literature review in the following databases: PubMed, Cochrane and LILACS, in May 2015, using the controlled descriptors: Aged, Aging, Self-help devices, Assistive Devices, Assistive Equipment and Assistive Technology. There were selected 13 items based on inclusion criteria. Results: there were identified the following classifications in assistive technology: augmentative and alternative communication, environment control systems, mobility aids, postural adequacy, architectural projects for accessibility and sports and leisure. Conclusion: the use of assistive technology allows the elderly to develop the functional activities of daily living safely, increase their independence and autonomy, prevent comorbidities and thereby contribute to improving the quality of life and social inclusion of the elderly.

The Trends of Development of the Assistive Equipment for Rehabilitation

The Trends of Development of the Assistive Equipment for Rehabilitation

TRANSPORT VELOCITY OF VULNERABLE PEOPLE FOR TSUNAMI EVACUATION

In case of Tsunami, vulnerable people must shelter from it by themselves under difficult conditions. Other people's help is essential for them to evacuate as fast as possible. Considering transportation methods is one of the most important issues against a disaster. The purpose of this study is to compare transportation velocity and to obtain fundamental data, evacuation supporter carry vulnerable people by using transportation instruments. We carried out running experiments with three kinds of instruments, (A) a rollator, (B) a transport chair, and (C) a wheelchair. A rollator was installed assistant equipment (Patent No. 5802342) in this experiment because it did not have transportation function fundamentally. The experiments proceeded in three different inclination lanes; steep slope inclination average was 12.99%, gentle slope 6.77%, and flat 0%. Each lane's distance was as follows; steep slope was 100m, gentle 200m and flat 1, 000m respectively. The subjects of this experiment were 31 female students, the age group between 18 and 26. We did pre-questionnaire on individual attribute and ex facto questionnaire on physical burden to the role of evacuation supporters. Every vulnerable people's weight was adjusted to 62.04kg with dumbbells. Every subject watched the video of the Tsunami to image the situation and do practical experiment before the trials. Each trial was video-recorded to measure transportation velocity and observe their movement. Average velocity of (C) a wheelchair was 0.91m/s, (B) a transport chair 0.85m/s, and (A) a rollator 0.77m/s in steep slope, (C) 1.28m/s, (B) 1.14m/s and (A) 0.91m/s in gentle slope, (C) 1.87m/s, (B) 1.58m/s and (A) 1.18m/s. In the order of transportation velocity was a wheelchair, a transport chair and a rollator in every inclination. According to questionnaire, the subject with experience taking part in sports before made a better record than whom without such experiences. Physical burden in gentle slope and flat with a wheelchair was least but then a rollator was added loads. There were few differences in three instruments in steep slope. Especially a rollator had big physical burden within three of them and difficulty to handle. However, as a result of this experiment, rollator's average velocity was faster than that elderly people walk with a rollator under own power. Therefore, evidently having help from evacuation supporters more efficient than pushing it by themselves for elderly usually uses a rollator. Finally, the study presented here clearly demonstrated that making use of transportation instruments such as a wheelchair, a transport chair and a rollator with evacuation supporter's help enable vulnerable people to run away from Tsunami swiftly. We propose that vulnerable people should deploy transportation instruments against a disaster.

A reagent-ready-on-chip microfluidic immunoassay system for rapid detection of influenza A H1N1 and H3N2 viruses

Development of effective disease screening method is the best approach for the control of infectious diseases. However, conventional screening methods require to operate in well-equipped laboratory. That makes the screening operation expensive and time-consuming. In this work, a reagent-ready-on-chip microfluidic immunoassay system was developed and rapid detection of influenza A H1N1 and H3N2 viruses was demonstrated to show its simplicity and rapidity. The microfluidic system integrated 4 single-stroke ther-mopneumatic actuators and a reaction chamber. All related reagents were pre-installed in the system and manipulated automatically for indirect immunoassay. Detection of influenza A H1N1 and H3N2 viruses based on its internal structure protein, i.e., nucleoprotein (NP), was demonstrated using the system. Result was represented by colorimetric signal in the reaction chamber. The use of thermopneumatic actuation could achieve fluid manipulation without external assistive equipment and colorimetric result could be observed directly without the need of external dedicated detector. Influenza virus screening could be completed around 1 hour with less sample volume (20 μL) and reagent volume (50 μL). The system achieved one-step operation of immunoassay. It is highly integrated and has potential to be developed to portable devices to realize rapid diagnostics in remote environment and clinics without well-equipped facility.

Making the Law More ABLE: Reforming Medicaid for Disability

Passed on the eve of Medicaid’s fiftieth anniversary, the Achieving a Better Live Experience (ABLE) Act was a hard-fought victory for individuals with significant disabilities and their families. The law, which creates a new form of tax-preferred savings account, represents an invaluable work-around for highly restrictive Medicaid eligibility requirements. Medicaid eligibility is crucially important for individuals with intellectual, developmental, and other significant disabilities because it provides nearly exclusive access to government-coordinated habilitative care, such as in-home assistance, job supports, and adaptive equipment. These services are necessary to maintain a base-level quality of life, facilitate independent living, and preserve the dignity of individuals with disabilities. Despite their importance, they are difficult to purchase and coordinate in the private market, and due to income and asset-holding restrictions on eligibility, only the very poor can access them through Medicaid, even after passage of the Affordable Care Act. This Article argues that despite their facial neutrality, income and asset-holding restrictions, commonly referred to as means testing, result in undue hardship when they are applied to the provision of government-coordinated habilitative care for individuals with significant disabilities. Congress’s attempts to mitigate this hardship, including the recently passed ABLE Act, are important steps forward, but they also can impose economic, dignitary, and emotional harms on individuals with disabilities. Based on the distinctive needs of individuals with significant disabilities, this Article takes the counter-intuitive position that these individuals should be afforded access to government-coordinated habilitative care without regard to income or wealth. Under current market conditions, non-means tested access to habilitative care is a normatively superior solution because it preserves the autonomy and dignity of individuals with disabilities and may be simultaneously cost-neutral and utility increasing. Granting unrestricted access to government-coordinated habilitative care to individuals with significant disabilities would eliminate perverse employment and financial planning incentives created by Congress’s past attempts to broaden access. Finally, it would create parity among parents who plan for the future of children with disabilities and those whose children are typically-abled, as well as parity for retirement savings among workers with significant disabilities and those without. As a result, Congress should revisit and revise means tested access to disability-related services through Medicaid.

Telerehabilitation for people with low vision.

Low vision affects over 300 million people worldwide and can compromise both activities of daily living and quality of life. Rehabilitative training and vision assistive equipment (VAE) may help, but some visually impaired people have limited resources to attend in-person visits at rehabilitation clinics. These people may be able to overcome barriers to care through remote, Internet-based consultation (i.e., telerehabilitation). To compare the effects of telerehabilitation with face-to-face (e.g., in-office or inpatient) vision rehabilitation services for improving vision-related quality of life and reading speed in people with visual function loss due to any ocular condition. Secondary objectives are to evaluate compliance with scheduled rehabilitation sessions, abandonment rates for visual assistive equipment devices, and patient satisfaction ratings. We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (2015 Issue 5), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1980 to June 2015), EMBASE (January 1980 to June 2015), PubMed (1980 to June 2015), ClinicalTrials.gov (www.clinicaltrials.gov) and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any language restriction or study design filter in the electronic searches; however, we restricted the searches from 1980 onwards because the Internet was not introduced to the public until 1982. We last searched the electronic databases on 15 June 2015. We planned to include randomized controlled trials (RCTs) or controlled clinical trials (CCTs) in which participants were diagnosed with low vision and were undergoing low vision rehabilitation using an Internet, web-based technology compared with an approach based on in-person consultations. Two authors independently screened titles and abstracts, and then full-text articles against the eligibility criteria. We planned to have two authors independently abstract data from included studies. We resolved discrepancies by discussion. We did not find any study that met the inclusion criteria for this review and, hence, we did not conduct a quantitative analysis. As a part of the background, we discussed review articles on telemedicine for facilitating communication with elderly individuals or for providing remote ophthalmological care. We did not find any evidence on whether the use of telerehabilitation is feasible or a potentially viable means to remotely deliver rehabilitation services to individuals with low vision. Given the disease burden and the growing interest in telemedicine, there is a need for future pilot studies and subsequent clinical trials to explore the potential for telerehabilitation as a platform for providing services to people with low vision.

Conception of Assistive Equipment for Rehabilitation of Patients with Spinal Cord Injury

Mobility is the urgent requisite of post spinal cord injury (SCI) patient. Since the alternative and compensatory approach is considered as the major function of mobility assistive device for post-SCI patients, the device should possess capability to acclimate to the ‘abnormal’ gait generate by the patients who usually undergo alternative and compensatory rehabilitation in their neural circuit. The functional ability of individual should be taking into account. Yet according to the requirement of neuro-protective treatment in post-SCI rehabilitation processing, locomotor-like activity is still an essential factor to patient. This study presents a novel concept and prototype of assistive technology base on foot control strategy to take an equilibrium between mobility and gait realization. To demonstrate that foot-induced over-ground locomotor assistive method is capable of achieving locomotor-like activity (dragging step), simulation analysis and prototype preliminary experiment have been conducted. Simulation analysis show that foot-induced assistance can allow more volitional activity compare to the hip-knee-induced assistive device. Yet the input and disturbance act on such kind of device may be increased. Surface electromyography (sEMG) from muscles of lower limb (right rectus femoris, right biceps femoris and right gluteus maximus) have been recorded during the preliminary experiment, and the mean of integrated EMG (iEMG) was used as evaluation of muscle activity. The result of the testing show that the mean of iEMG in the right gluteus maximus was reduced in the swing phase when the subject moving ahead with the prototype, but no significant change in the right rectus femoris. It may imply that foot-induced over-ground locomotor assistive device can reduce the muscle activity when patient complete locomotor-like movement and retain some amount of residual recruitment of lower limb, instead of substituting arbitrarily.

Improvement of Motivation and Learning Level in Neuroanatomy Among Hamadan Medical Students Using Human Brain Sections

Background: Using new methods in teaching anatomy could have a significant impact on students’ learning. Objectives: Neuroanatomy is one of the most complicated courses in anatomy. Absence of educational assistance equipment is one the most important problems in this field. Using human brain sections could solve some of the problems and enhance students’ learning. Materials and Methods: The brains of cadavers in dissection room of medicine faculty of Hamadan University of Medical Sciences were used in the present study. After fixation, the brains cut in three coronal, transverse and sagittal sections. Then, the sections were presented to one group of students in practical classes. Another group continued as control with routine educational method. The students filled out a questionnaire and declared their ideas about the new methods in Neuroanatomy education. Finally, two groups were compared for marks gained in the final exam. Results: Using present method had remarkable effect on learning progress and prevention of exhaustion of students in the classroom. Moreover, it increased marvelously their ability in three-dimensional imagination in anatomy. Quantitative analysis of the final examination showed significant increase in the marks of experimental group (P < 0.05). Conclusions: According to the subjective and objective results, the new method used in anatomy education had a good effect on learning of anatomy and interested students in anatomy. Besides, it decreased students’ stress at exam time. It can be a complementary method for conventional methods. It is very useful for those who need retraining courses.

33. Let's Get Motivated!: Identifying What Facilitates Youth's Motivation for Learning About Health Self-Management

In this study we focused on youth's perceptions of healthcare providers as potential motivational supports in learning how to self-manage their health and healthcare needs. As youth transition to adulthood, they need to know how to communicate with healthcare providers, who to call when sick, and when it is necessary to call a healthcare provider. In this study we tested the universality of basic psychological needs in facilitating motivation for learning about health management among youth with varying degrees of mobility limitations (ML). That is, we wanted to determine whether autonomy, relatedness, and or competence, would be more or less important for one group of youth, than for others. Data come from the MyPath project, a longitudinal study that investigates the transition from pediatric to adult centered healthcare for youth with and without ML. The community-based sample from the Midwest includes 352 young people with severe (n=67), moderate (n=84), and little to no (n=201) mobility limitations (ML) between the ages of 16 and 24. Participants completed an online survey at baseline and at 18 months following enrollment. Predictor variables were measured at baseline and include healthcare autonomy (4-items, α= .81), health competence (6-items, α= .85), and relatedness (4-items, α= .82). The dependent variable, motivation for learning about self-management (5-items, α= .87), was measured at 18 months. Covariates included age, sex, geographic location, maternal education level, and assistive equipment use. We employed a multigroup path analysis comparing three groups of youth: no ML, moderate ML and severe ML. Results from the multigroup path analysis revealed that the model was invariant between the three groups. The path coefficients from autonomy to motivation and relatedness to motivation were only significant for youth with severe ML. Results indicate the invariance constraints on autonomy to motivation were significant X2(2) = 17.750, p = .001, as were relatedness to motivation, X2(2) = 8.265, p=.016. Although path coefficients were different for competence, the path was not significantly different. Results from our study show that for youth with severe ML, autonomy matters, as does relatedness. For youth with severe ML, their sense of control in their interactions in the healthcare environment and sense of freedom of health-related choice facilitates their motivation to learn about health self-management. Additionally, relatedness had a surprisingly negative effect on motivation for youth with severe ML—it impeded youth's motivation for learning about health self-management. The more belonging or affiliated youth felt to healthcare providers, the less motivated they were in learning how to manage their healthcare. Motivation for learning about health self-management is critical as youth are expected to manage their health and healthcare needs in adulthood; and knowing what facilitates or impedes this motivation can help providers in developing effective interventions. As we develop programs that teach youth about the healthcare transition and engage them in transition related conversations we need also to be examining their motivation to learn such information.

CLINICAL UTILITY OF A NOVEL SENSORIMOTOR APPROACH FOR A PATIENT PRESENTING WITH IDIOPATHIC NEUROLOGICAL SYMPTOMS: A CASE STUDY

Event Abstract Back to Event CLINICAL UTILITY OF A NOVEL SENSORIMOTOR APPROACH FOR A PATIENT PRESENTING WITH IDIOPATHIC NEUROLOGICAL SYMPTOMS: A CASE STUDY Edythe Heus1* and Alexander Kalinkos2 1 Neuro Think Tank, United States 2 Neuro Think Tank, United States Movement and other neurodegenerative disorders can encompass a wide variety of disease entities, many of which are difficult to diagnose. Here we present a 50 year old female, with idiopathic, progressive neurological symptoms including ataxia, idiopathic dyskinesia, dysphonia, dysarthria and dysphagia. MRI showed a nonspecific, small, right paraventricular hyperintensity. PET scan showed mild decreased activity in cerebellum and temporal lobes. Patient was unresponsive to conventional drug therapy (clonazepam), neuropsychiatry and lifestyle changes. Patient was only able to work limited hours, with assistive equipment from home, and any excessive stimuli would trigger physical collapse. Patient participated in an inexpensive, novel sensorimotor approach comprising of specific patterns of movement on equipment that enhances sensory feedback and is unstable by design. The instability and sensorimotor stimulation was speculated to increase cerebellar functioning, neuroplasticity and cognitive function. 3, 20 minute sessions over 5 weeks were increased to an hour, 2 times weekly as her condition improved, for 14 months with noticeable improvement upon commencement. At week 56, patient’s neurologist noted a 90% improvement. Progress was steady during treatment, with gradual recovery of activities of daily living (ADLs). After 16 months of treatment, patient returned to work, without the use of assistive equipment, and ADLs were within normal limits. Excessive stimulation combined with weariness can trigger dyskinesia but is less severe and easily managed. Given the degree of improvement with this patient, we believe that a larger study is warranted to determine if this outcome is repeatable in other cases of idiopathic, progressive neurological dysfunction. Keywords: Ataxia, idiopathic dyskinesia, Dysphonia, Dysarthria, dysphagia, sensorimotor, Neurodegenerative disorders Conference: International Symposium on Clinical Neuroscience: TBI and Neurodegeneration, Orlando, Florida, United States, 10 Dec - 14 Dec, 2015. Presentation Type: Poster Presentation Topic: Case Study Reports Citation: Heus E and Kalinkos A (2015). CLINICAL UTILITY OF A NOVEL SENSORIMOTOR APPROACH FOR A PATIENT PRESENTING WITH IDIOPATHIC NEUROLOGICAL SYMPTOMS: A CASE STUDY. Front. Neurol. Conference Abstract: International Symposium on Clinical Neuroscience: TBI and Neurodegeneration. doi: 10.3389/conf.fneur.2015.58.00032 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 31 Oct 2015; Published Online: 02 Nov 2015. * Correspondence: Dr. Edythe Heus, Neuro Think Tank, Kenmore, United States, dredythe@revinmo.com Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers Edythe Heus Alexander Kalinkos Google Edythe Heus Alexander Kalinkos Google Scholar Edythe Heus Alexander Kalinkos PubMed Edythe Heus Alexander Kalinkos Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. Please enable Javascript in your browser settings in order to see all the content on this page.