Power Mobility Use Research Articles

The IndieTrainer system: a small-scale trial exploring a new approach to support powered mobility skill acquisition in children

The IndieTrainer system, consisting of a mobility device and video-based gamified training modules, was developed to assist children in attaining power wheelchair (PWC) skills. The purposes of this small-scale trial were to explore the use of the IndieTrainer system to provide PWC skills training and document parental satisfaction with the IndieTrainer system. We hypothesized that PWC skills training provided using the IndieTrainer system would result in improvements in both children’s understanding of how to use a PWC and their PWC skill execution, and that parental satisfaction would be high. An open-label, single-arm trial was conduct as follows: (a) Baseline testing (T0); (b) A 3-week intervention consisting of two, 60-min-PWC skills training sessions per week; (c) Post-intervention testing (T1); and (d) A single session retention trial held 4 weeks after completion of the intervention (T2). Outcome measures included the Assessment of Learning Powered mobility use (ALP), Wheelchair Skills Checklist (WSC), Canadian Occupational Performance Measure (COPM), and Client Satisfaction Questionnaire-8 (CSQ-8). 25 child/parent dyads participated. Between T0 and T1, statistically significant differences (p-value <.0001) with large effect sizes in mean ALP and WSC scores (ALP: d = 3.14; WSC: d = 3.25) and COPM performance and satisfaction scores (Performance: d = 4.66; Satisfaction: d = 3.24) were achieved. Mean T1 total CSQ-8 score was 31.52/32. At T2, all children maintained or improved their T1 ALP and WSC scores. This study provides initial support for the usability and feasibility of the IndieTrainer system. Futhermore, larger scaled studies using more rigorous research designs are indicated.

The IndieTrainer system: a clinical trial protocol exploring use of a powered wheelchair training intervention for children with cerebral palsy

Objective The IndieTrainer system, comprised of both a mobility device and gamified training modules, was developed to aid powered wheelchair (PWC) skills acquisition in children with cerebral palsy (CP). The aims of this small-scale study are to: explore use of the IndieTrainer system to improve PWC skills in children who have CP and document parental/caregiver perceptions of, and satisfaction with, the IndieTrainer system. Method This small-scale study is an open-label single-arm clinical trial involving a three-week PWC training intervention consisting of two 60-minute training sessions per week. A single session retention trial will be held four weeks after the completion of the intervention period. All research activities will take place in-person in a laboratory-based setting located within a university. Twenty-five child-parent/caregiver dyads will participate in the study. Each child participant will be 3 to 21 years of age and have a diagnosis of CP or other similar condition. The Assessment of Learning Powered mobility use will be the primary outcome measure. Secondary outcome measures will include the Wheelchair Skills Checklist, the Canadian Occupational Performance Measure, the Customer Satisfaction Questionnaire-8, and a qualitative interview. Data analyses will involve one-way repeated measures ANOVAs followed by paired samples t-tests with Bonferroni adjustments. Impact The IndieTrainer system allows children to explore and use power mobility in their own manual wheelchair and was designed to meet the needs of power mobility learners across the continuum of learning. It is the first PWC training system to optimize learning for early learners who do not yet understand cause and effect concepts.

Powered Mobility Device Use and Developmental Change of Young Children with Cerebral Palsy

Mobility is a fundamental human right and is supported by the United Nations and the ON Time Mobility framework. The purpose of this study was to understand the effect of a powered mobility intervention on developmental changes of children with cerebral palsy (CP). This study was a randomized, crossover clinical trial involving 24 children (12-36 months) diagnosed with CP or with high probability of future CP diagnosis based on birth history and current developmental status. Children received the Explorer Mini and a modified ride-on car in randomized order, each for 8 weeks. The Bayley Scales of Infant and Toddler Development-4th Edition was administered at baseline, mid-study, and end-of-study. Raw change scores were used for analysis. Total minutes of use per device was categorized as low or high use for analysis based on caregiver-reported driving diaries. Explorer Mini: The high use group exhibited significantly greater positive change scores compared to the low use group on receptive communication, expressive communication, and gross motor subscales (p < 0.05). Modified ride-on car: No significant differences between low and high use groups. Regardless of device, low use was associated with no significant developmental change and high use was associated with positive developmental changes. Mobility access is critical to maximize the development of children with CP and may be augmented by using powered mobility devices. Results may have implications for the development of evidence-based guidelines on dosage for powered mobility use.

Assessment and Intervention for Tool-Use in Learning Powered Mobility Intervention: A Focus on Tyro Learners

Young infants, children, and persons of any age who have cognitive limitations can be thought of as tyro learners, who are beginners in learning. For tyro learners, the self-produced mobility afforded by a powered mobility device offers opportunities, to explore tool-use learning and interact with the surrounding environment, thereby potentially enhancing development and learning, providing a foundation for future goal-directed, tool-use activities. The Assessment of Learning Powered mobility use tool, version 2.0 (ALP), developed with tyro learners, is a process-based implementation package, focused on assessing and progressing an individual’s understanding of how to use a powered mobility device. Although the ALP tool can be used with any powered mobility learner, research suggests that this process-based approach may be, especially, beneficial for tyro learners, who are in the early phases of learning how to operate a powered mobility device. This article aims to (1) explain tool-use learning in powered mobility intervention; (2) distinguish between the characteristics of process-based and task-based implementation packages; (3) provide an in-depth description of using the ALP tool in providing powered mobility intervention; and (4) highlight the benefits of using the ALP tool, with a focus on tyro learners.

Children's Progression of Control of a Powered Mobility Device Using a Joystick

Abstract Date Presented 04/23/21 Currently, there is limited information available to therapists to help them in advising parents about possibilities for very early powered mobility use in infants and very young children. Presenters will discuss the results of a pilot study that examined the progression of joystick driving skills in typically developing children from ages 12 to 24 months. Possible implications of the findings from this study for evidence-based practice will be considered. Primary Author and Speaker: Jennifer Iglthaler Contributing Authors: Erika Dalida, Caitlin Maclang, Eunice Cho, Hekanne Simbolon, and Marielle Santiago

Stakeholder perspectives of pediatric powered wheelchair standing devices: a qualitative study.

To explore and describe the experiences and perspectives of various stakeholders regarding the use of powered wheelchair standing devices (PWSDs). The purposive sample included: children aged 6 to 18 years who used a PWSD (n=8; diagnoses: cerebral palsy, spinal muscular atrophy, spina bifida, spinal cord injury), parents of children 18 years of age or younger who used a PWSD (n=12), rehabilitation professionals working with children who used a PWSD (n=12), and professionals working at companies manufacturing PWSDs (n=3). Data were gathered via face-to-face interviews conducted either in person or via Zoom® and analyzed using the constant comparative method. Three main themes emerged in the data: (1) 'Stand-on-demand' revealed how participants perceived PWSDs as allowing children to stand whenever and wherever they wanted, thereby increasing participation; (2) 'It's more than weight-bearing' uncovered participants' perceptions of psychological and physical benefits from PWSD use; and (3) 'Ecosystems influencing PWSD acquisition and use' revealed child- and non-child-related factors perceived as influencing children's procurement and use of a PWSD. Use of a PWSD was perceived as providing a unique opportunity for children to stand whenever and wherever they desired. Findings suggest the possible transdiagnostic application of PWSDs. What this paper adds The ability to stand when desired was unique to powered wheelchair standing device (PWSD) use. Participants perceived numerous psychological and physical benefits from PWSD use. Child- and non-child-related factors influenced procurement and use of a PWSD.

Enhancing Function, Fun and Participation with Assistive Devices, Adaptive Positioning, and Augmented Mobility for Young Children with Infantile-Onset Spinal Muscular Atrophy: A Scoping Review and Illustrative Case Report

Recent advances in medical interventions have changed the prognosis for children with infantile-onset spinal muscular atrophy (SMA-1); however, little has been published regarding rehabilitation management. A rapid scoping review was conducted in November 2020 using Medline and CINAHL databases. Evidence supporting use of assistive devices and equipment to enhance participation, mobility, function, and posture in lying, sitting, and standing positions was sought. From 239 articles, only five studies (describing use of augmentative communication, manual and power mobility, supported standing and orthotic devices) met inclusion criteria. Results are presented alongside a case report of a 5-year-old boy (treated with Nusinersen since 7 months-of-age) who uses a variety of devices to enhance his activity and participation in family life. While reclined and tilted sitting positions as well as power mobility were previously considered for children with SMA-1, this child has progressed to supported upright standing, self-propelling a lightweight manual wheelchair indoors, communicating using multiple methods and taking steps in a dynamic mobility device. Power mobility was introduced in a switch-adapted cart at 11 months and he was independently exploring indoors and outside in his power wheelchair before 20 months. Research evidence is limited, but alongside the case report highlights the importance of a comprehensive and proactive approach to enhancing function, fun and participation with family and friends through adaptive equipment for children with significant and life-limiting disabilities.

Exploring young children’s activity and participation change following 6 months’ power mobility experience

Introduction This pre-post study explored the effect of children’s 6 months’ experience in one of four early power mobility devices. Method Satisfaction with parent-selected goal achievement was measured using the wheelchair outcome measure for young people and compared with the assessment of learning powered mobility use, as well as device expectation fulfilment ratings. Results Forty-six children with mobility limitations, aged 13–68 months (mean 40.40; SD 15.60) participated. The most common condition was cerebral palsy ( n = 33; 71.74%). The Wilcoxon signed rank test measured the positive change in goal achievement ( z = 4.90; P&lt;0.001; r = 0.51). Fair to good statistically significant Spearman’s correlations were observed between power mobility skill and goal achievement, as well as parent and therapist device expectation scores ( rs = 0.48, 0.46 and 0.66, respectively; P&lt;0.001). Parent and therapist ratings did not differ significantly. No statistically significant associations were found between goal achievement and child (age, diagnosis, abilities) or environmental factors (device, access method, loan length). Conclusion Children at all phases of power mobility skill, using various devices and access methods, can demonstrate activity and participation change following power mobility experience. This study adds validity evidence supporting the use of the wheelchair outcome measure for young people with young children by parent-proxy rating.

Exploring change in young children’s power mobility skill following several months’ experience

Purpose To measure and compare progression in children’s power mobility skill among process and task-based measures following a loan of one of four early power mobility devices. Additionally, to explore different power mobility learner groups and skill development trajectories. Methods In this pre-post study, children were purposefully sampled and power mobility skill was measured from video taken pre-post several months’ experience (mean 192.40; SD 42.79 days) using the Assessment of Learning Powered mobility use (ALP) and two task-based measures. Associations among power mobility skill measures were examined. Child and environmental factors influencing ALP phase at loan-end were explored. Results Forty-six children aged 13 − 68 months (mean 40.40; SD 15.60) participated, with cerebral palsy being the most common condition (n = 33; 71.74%). ALP change scores ranged from −2 to +4 ALP phases (median 1.0). Wilcoxon signed rank test was significant for pre-post differences with a large effect size (z = 5.50, p < 0.001; r = 0.57). End-of-loan Spearman correlations between ALP and two task-based paediatric measures were excellent (rs = 0.92). Kruskal-Wallis test revealed significant effect of device, access method, diagnostic group and communication abilities on loan-end ALP phase. Conclusion Positive change was demonstrated with most children (n = 39; 84.78%) changing at least one ALP phase during the study. Positive change was seen with children at all phases of tool-use, using all devices and access methods. Process and task-based measures were highly correlated, but differed in application for different learner groups. Different trajectories of skill development may be associated with different child profiles and access abilities. IMPLICATIONS FOR REHABILITATION Children at all phases of tool-use can demonstrate positive change in power mobility skill using different devices and switch as well as joystick access methods The Assessment of Learning Powered mobility use (ALP) is useful for assessing tool-use and learning process skills for young children across the power mobility skill continuum. Task-based measures may also be helpful for guiding training and recording progress; The Power Mobility Training Tool (PMTT) is most useful for children exploring cause-effect and direction (ALP Phases 1–5), while the Power Mobility Program (PMP) is most useful for functional learners and those progressing from exploring direction to functional use (ALP Phases 5–8). Access method may influence power mobility learning trajectory and training

Inter-rater reliability of the assessment of learning powered mobility use, version 2.0, when applied with children and adults engaged in Driving to Learn in a powered wheelchair.

The Assessment of Learning Powered mobility use (ALP) tool including the ALP instrument and facilitating strategies, was developed for Driving to Learn. This therapeutic intervention aims to provide children and adults who have profound cognitive disabilities with opportunities to learn tool use through powered mobility practise. To allow for longer intervention periods, a partnership was developed between professionals supervising Driving to Learn and persons accompanying children or adults to their practice sessions. Accompanying persons (relatives or assistants) gradually took on shared responsibility for applying the intervention and conducting assessments with the ALP-instrument. The aim of this study was to test the inter-rater reliability of the ALP-instrument version 2.0 as applied in this novel partnership in assessment and intervention. A psychometric analysis compared pair-wise assessments with the ALP-instrument version 2.0, made independently by professional supervisors and accompanying persons following each Driving to Learn session. Weighted kappa statistic was used to compare the matched pair ordinal data. Eight professional supervisors and 22 accompanying persons independently completed assessments with the ALP-instrument after 55 sessions with six children and five adults, who each participated in five Driving to Learn sessions. When the scores from the 55 pairs of assessments were compared, a weighted kappa value of 0.85 was obtained, indicating very good inter-rater reliability between the two rater groups. The resulting inter-rater reliability suggests that it is reliable to implement the ALP-instrument as part of partnership in intervention between supervisors and accompanying persons. Provision of longer periods of Driving to Learn is possible when those who accompany the child or adult are able to gradually assume responsibility for practice and assessment under the supervision of a professional. This partnership approach enables children and adults with multiple and complex disabilities to practise and learn in accordance with their conditions and needs.

Changes in Electroencephalography Activity in Response to Power Mobility Training: A Pilot Project.

Purpose: The purposes of this pilot project were to examine the impact of power mobility training on (1) electroencephalography (EEG) activity in children with severe cerebral palsy (CP) and (2) power mobility skill acquisition. Method: A single-subject A-B-A-B research design with a 5-week duration for each phase (20 wk total) was replicated across three participants with severe CP (Gross Motor Function Classification System Level V). Data related to the target behaviour, as represented by EEG activity, were collected each week. Power mobility skills were assessed using the Canadian Occupational Performance Measure (COPM), the Wheelchair Skills Checklist (WSC), and the Assessment of Learning Powered mobility use (ALP). Weekly power mobility training was provided during the intervention phases. EEG data were analyzed by means of three measurement metrics (power spectral density, mutual information, and transfer entropy). Results: All three participants demonstrated changes in activation in frontoparietal EEG recordings and clinically significant improvements in power mobility skill acquisition as measured by the COPM as well as by the ALP and WSC. Conclusions: Power mobility training appeared to affect both neuroplastic and skill acquisition. Combining the use of EEG with direct therapist-observation measurement tools may provide a more complete understanding of the impact of power mobility training on children with severe CP.

Item development, internal consistency, and known-groups validity of the Self-Directed Mobility Scale

Purpose The aims of the current study include to: (1) describe the item development; and (2) begin the process of establishing the internal consistency and known-groups validity of the Self-Directed Mobility Scale. The purpose of the scale is to assess paediatric physical and occupational therapists’ views towards self-directed mobility and their perceived ability and intentions to advocate for children’s access to self-directed mobility. Methods Three individuals with expertise in kinesiology, psychology, paediatric rehabilitation, and disability studies served as the expert panel for item development. Four samples were included to determine internal consistency and known-groups validity: 350 physical therapists, 89 occupational therapists, 279 kinesiology undergraduate students, and 528 health and wellness undergraduate students. Results The internal consistency was above the acceptable level of 0.70 (range = 0.72–0.77) for all samples when two items regarding promoting other motor skills prior to powered mobility use and the temporary use of a mobility device were removed. Known-groups validity was established between all samples. Conclusions The Self-Directed Mobility Scale appears to be a valid tool for assessing views of self-directed mobility and mobility advocacy intentions in paediatric physical and occupational therapists, as well as undergraduate students. Future work should examine the internal consistency based on study sample to ensure the (> 0.70) acceptable Cronbach’s alpha level is met. Implications for rehabilitation The Self-Directed Mobility Scale is a viable measurement tool to assess views of self-directed mobility and mobility advocacy intentions of pediatric physical and occupational therapists. In combination with other measures, the Self-Directed Mobility Scale may be used in future rehabilitation research to evaluate factors associated with provision of mobility technology to children with disabilities.

Exploring the Effects of Power Mobility Training on Parents of Exploratory Power Mobility Learners: A Multiple-Baseline Single-Subject Research Design Study.

Purpose: This study investigated the effects of power mobility training provided to exploratory power mobility learners with cerebral palsy (CP; Gross Motor Function Classification System Level V) on (1) parenting stress, (2) parents' perceptions of their children, and (3) children's attainment of power mobility skills. Method: A non-concurrent, multiple-baseline A-B single-subject research design study was conducted with three participants. The target behaviour was changes in the magnitude of parenting stress as measured by the Parenting Stress Index-Short Form. Parents' perceptions of their children were assessed using the Caregiver Priorities and Child Health Index of Life with Disabilities Questionnaire and a parent interview. Children's attainment of power mobility skills was assessed using the Canadian Occupational Performance Measure (COPM), the Assessment of Learning Powered mobility use, and the Wheelchair Skills Checklist. Power mobility training was provided twice a week for 8 weeks using an alternative power mobility device. Results: Positive and negative changes in both magnitude of parenting stress and parents' perceptions were identified post-intervention. All participants gained power mobility skills, assessed with the COPM. Conclusions: Power mobility training provided to exploratory power mobility learners with CP may influence levels of parenting stress.

Beginning power mobility: An exploration of factors associated with child use of early power mobility devices and parent device preference.

ObjectivesDescribe and compare young children’s use of four early power mobility devices and examine associations between child and environmental factors that may influence power mobility use and parent device preference.DesignCross-sectional observational study.MethodsPower Mobility Days introduced four devices: Wizzybug, Bugzi, Tiger Cub, and a switch-adapted ride-on toy car in a single 60–90 min, play-based session.ResultsA convenience sample of 74 children, aged 9–68 months (mean: 32.45, SD: 14.08) with mobility limitations, and their parents participated. Children had a range of motor, postural and communication profiles, with cerebral palsy being the most common condition (n = 55; 73.33%). Assessment of Learning Powered mobility use phase achieved ranged from 1 to 6; mean: 2.34; median: 2. For children who tried all four devices (n = 51), Friedman test (χ2: 8.27, p = 0.04) suggests Assessment of Learning Powered mobility use phase differs across devices. Of 73 parents who identified a device preference, 43 (59%) chose Wizzybug. Regression analyses suggest that access method and communication function may influence children’s power mobility use, while age, access and postural support requirements may influence parent device choice.DiscussionParent impressions of an early power mobility device may be influenced by many factors, yet be less influenced by child performance.

Feasibility Study of a Therapeutic Mobility Summer Camp for Children with Severe Cerebral Palsy: Power Fun

Aim: Powered mobility has positive effects on development of children with limited independent locomotion, but many are deprived of this opportunity due to their limitations. This study aimed to evaluate the feasibility of Power Fun, a therapeutic summer camp, for students with severe cerebral palsy (CP).Methods: Five students with CP, ages 11–15, received personally adapted powered wheelchairs and participated daily in the camp. The camp ran five days a week during three weeks and included two mobility sessions daily. Assessments were conducted three weeks prior to the camp (T1), at baseline (T2), post-intervention (T3) and six weeks follow-up (T4). Measures used were Power Mobility Program (PMP), Assessment of Learning Power mobility use (ALP), Wheelchair Outcome Measure for Young People (WhOM-YP), Goal Attainment Scaling (GAS) and Dimensions of Mastery Questionnaire (DMQ).Results: All participants finished the camp. Outcome measures showed no change between T1-T2 but improved significantly (p<.05) after the intervention (T2-T3), and gains were maintained at T4 (Wilcoxon signed-rank test). Goals improved to slightly above the expected outcome (GAS average 0.11).Conclusions: Power Fun shows good feasibility and significant improvement in mobility skills and goals of children with severe CP. Further studies are warranted.

American and Canadian therapists’ perspectives of age and cognitive skills for paediatric power mobility: a qualitative study

Purpose: To explore the views of paediatric occupational therapists and physical therapists in Canada and the USA related to (1) the rationale for the age at which power mobility is considered for children and (2) the cognitive skills considered when trialling power mobility.Materials and methods: This study was part of a larger web-based survey study and analyzed responses to two open-ended survey questions: one related to age and one related to cognitive skills. Data were analyzed using the constant comparative method.Results: Analysis revealed four unique themes in the question related to age: (1) ‘Power Mobility Should be Introduced at a Specific Age or Stage’; (2) ‘Child Requirements’; (3) ‘Developmental Impact of All Forms of Independent Mobility’; and (4) ‘Benefits of Power Mobility’. In the question concerning cognitive skills, two unique themes were identified: ‘Cognitive Skill Requirements?’ and ‘Non-Cognitive Requirements’. Two additional themes were identified in both questions: (‘Non-child Requirements’ and ‘Power Mobility Trials, Use, and Options Are Dependent on Age and Goal’).Conclusions: Data indicate wide variability in respondents’ views related to the provision of power mobility. Additional research is needed to explore both therapists’ reasoning regarding power mobility use for children and how to best facilitate knowledge translation in this area.Implications for RehabilitationWide variability exists related to the provision of power mobility for children.Children’s age or stage in life influences therapists’ consideration of power mobility.Many respondents considered cognitive skills when trialling power mobility but some did not.

Predictive model of proficiency in powered mobility of children and young adults with motor impairments.

To identify variables that can predict proficiency in powered mobility use for children in young adults. Participants included 80 children and young adults (42 males, 38 females; mean age 10y 2mo, [SD 5y 1mo]; range: 2-22y) with cerebral palsy, neuromuscular disease, and spinal cord injury who participated in the ALYN Hospital Powered Mobility Lending Program from 2009 to 2016. Data were collected and compared before and after participation in the program and powered mobility levels were determined by the Israeli Ministry of Health (MOH) Powered Mobility Proficiency Test. Multivariate logistic regression analysis followed by a bootstrapping procedure that was based on 1000 samples were used to determine if the variables were predictive of success on the Israeli MOH Powered Mobility Proficiency Test. Significant variables for predicting success were identified: manual wheelchair propulsion, go-stop voluntarily upon request, and using a joystick. The model was able to correctly identify 80% of the children. Children and young adults with the ability to go-stop upon request, propel a manual wheelchair short distances, and use a joystick to activate the powered wheelchair had a higher chance of becoming proficient. In countries where wheelchair proficiency is a requirement for powered wheelchair procurement, these findings may support policy changes, as they did in Israel. Using powered wheelchairs offers children earlier and more natural practice to determine driving proficiency. Manual wheelchair propulsion, go-stop voluntarily upon request, and using a joystick were predictors of powered mobility proficiency. More than 80% of children use a joystick with their hand to activate a powered wheelchair.

What Are the Attitudes and Practices of Pediatric Therapists Concerning Power Mobility Use in Children?

Abstract Date Presented 4/20/2018 This study collected responses from pediatric therapists to determine attitudes and practices related to power mobility use for young children with mobility impairments. A majority of respondents had a positive attitude toward power mobility, but few engaged in providing these experiences. Primary Author and Speaker: Becky Breaux Additional Authors and Speakers: Jessica Tsotsoros Contributing Authors: Lisa K. Kenyon, Roslyn Livingstone, Maria Jones

Power mobility skill progression for children and adolescents: a systematic review of measures and their clinical application.

To identify and critically appraise standardized measures of power mobility skill used with children (18y or younger) with mobility limitations and explore the measures' application for 'exploratory', 'operational', and 'functional' learners. Five electronic databases were searched along with hand-searching for peer-reviewed articles published in English to July 2017 (updated 31st August 2017). Key terms included power(ed) mobility, power(ed) wheelchair, and database-specific terms. Studies included at least one child with a disability, and a detailed description of the measure of power mobility skill. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was followed with inclusion criteria set a priori. Two reviewers independently screened titles, abstracts, and full-text articles. Of 96 titles, 24 articles met inclusion criteria, describing nine measures of power mobility skill. The Wheelchair Skills Checklist, the Powered Mobility Program (PMP), and the Power Mobility Training Tool were augmented by three adaptations of the PMP. Two additional measures were further developed to create a third, the Assessment of Learning Powered mobility use. Validity evidence related primarily to content development while reliability evidence was reported on only two measures. All measures are in the initial stages of development and testing. Research investigating the measures' appropriateness for different types of learners and environments is warranted. There are four distinct measures of paediatric power mobility skill: three task-based, one process-based. Power mobility learners may be divided into three groups: exploratory, operational, and functional. Application of measures of power mobility skill differs for these three groups.

Does power mobility training impact a child’s mastery motivation and spectrum of EEG activity? An exploratory project

Purpose: The purposes of this exploratory project were: (1) to evaluate the impact of power mobility training with a child who has multiple, severe impairments and (2) to determine if the child’s spectrum of electroencephalography (EEG) activity changed during power mobility training.Study design: A single-subject A–B–A–B research design was conducted with a four-week duration for each phase. Two target behaviours were explored: (1) mastery motivation assessed via the dimensions of mastery questionnaire (DMQ) and (2) EEG data collected under various conditions. Power mobility skills were also assessed.Methods: The participant was a three-year, two-month-old girl with spastic quadriplegic cerebral palsy, gross motor function classification system level V. Each target behaviour was measured weekly. During intervention phases, power mobility training was provided.Results: Improvements were noted in subscale scores of the DMQ. Short-term and long-term EEG changes were also noted. Improvements were noted in power mobility skills.Conclusions: The participant in this exploratory project demonstrated improvements in power mobility skill and function. EEG data collection procedures and variability in an individual’s EEG activity make it difficult to determine if the participant’s spectrum of EEG activity actually changed in response to power mobility training. Additional studies are needed to investigate the impact of power mobility training on the spectrum of EEG activity in children who have multiple, severe impairments.Implications for RehabilitationPower mobility training appeared to be beneficial for a child with multiple, severe impairments though the child may never become an independent, community-based power wheelchair user.Electroencephalography may be a valuable addition to the study of power mobility use in children with multiple, severe impairments.Power mobility training appeared to impact mastery motivation (the internal drive to solve complex problems and master new skills) in a child who has multiple, severe impairments.