Development of a cart for independent mobility assistance for non-ambulatory children

Abstract

Some parents of non-ambulatory children are not eager to allow their children to use powered wheelchairs because of apprehension of further deterioration of their functionality and the risk for accidents. The authors think that not all but some such children could develop their ability to operate powered wheelchairs and might expand their knowledge about the circumstances and interests in them. Thus we made a prototype cart for them eventually to experience motion by themselves. Based on a 6-wheeled chassis, the two middle wheels are driven with a traction roller drive system. We had been testing this prototype with a child with cerebral palsy for one year. Acquisition of skills in pushing switches and enjoyment of motion were confirmed. However, we encountered several problems such as difficulty in rolling on a carpet and in handling due to its weight. The ability to record moving speed and operation of input devices helps rehabilitation experts to conduct quantitative performance evaluation. To solve these problems, we manufactured another prototype. The second prototype was tested with another child with cerebral palsy for one year. The problems were solved. She acquired the operation skills necessary to operate the prototype with four switch operation.

Powered mobility interventions for very young children with mobility limitations to aid participation and positive development: the EMPoWER evidence synthesis

“…l Ability to undertake basic tasks related to looking after oneself, such as eating or drinking l Caregiver assistance l Autonomy, freedom, choice and control l Participation Autonomy, independence, choice and control, and freedom (quantitative studies; 12,13,58,62,75,76,86,89,[91][92][93]98,[106][107][108] He played baseball this year, so he was able to run the bases in his power chair, which he could never have done beforehand. Parent, Wiart et al 102 Enjoying movement for its own sake was also important, particularly for some of the boys who both described and demonstrated their enjoyment of the sensation of movement and speed.…”

“…. limit 6 to ("newborn infant (birth to 1 month)" or "infant (1 to 23 months)" or "preschool child (2 to 5 years)" or "child (6 to 12 years)" or "adolescent (13 to 18 years)" or "young adult (19 to 24 years)" 12 Jone et al, 13 Jones et al, 14 Tefft et al, 15 Huang et al, 17 Bottos et al, 23 Bamer et al, 55 Galloway et al, 57 Pritchard-Wiart et al, 58 Evans et al, 59 Feldner et al, 60 Kenyon et al, 61 Evans and Baines, 62 Furumasu et al, 81 Logan et al, 87 Butler, 89 Cooper et al, 168 Huang and Galloway, 169 Kornafel et al, 104 Logan et al, 90,118 Mockler et al, 111 Odor and Watson, 91 Pope et al, 125 Smania et al, 123 Stokes et al, 92 Uyama and Hanaki, 112 Zazula and Foulds, 119 Durkin, 109 Gudgeon and Kirk, 99 Pituch et al, 100 Sonday and Gretschel, 101 Wiart et al, 102 Currier et al, 105 Feldner, 116 Home and Ham, 106 Huhn et al, 130 Kakimoto et al, 107 Lovett, 113 Omori et al, 114 Schoepflin et al, 128 Weinstein et al, 93 Larin et al,…”

Effectiveness of wheeled mobility skill interventions in children and young people with cerebral palsy: A systematic review

“…Regarding experience with wheelchair driving, 55% of participants were non‐experienced drivers ( n = 112 out of 203); 36,39,42,49–51,54 however, experienced drivers were also included ( n = 47 out of 203, 23%) 36–38,46–48 . Driving experience was not clearly specified in the remaining participants ( n = 44 out of 203, 22%) 35,40,41,43,52,53 . Notably, although most of the studies reported patient characteristics such as age, sex, GMFCS level, and previous wheelchair use experience, included studies typically did not distinguish between these characteristics in their subsequent analyses.…”

“…High variability in intervention duration and intensity was displayed across the studies. The duration of the interventions varied from one session 37,38 to 1 year 35 . The intensity of the interventions varied from once 40,43,44 to five 39,51,52 times per week, with six of the interventions taking place twice a week 36,41,42,46–48 .…”

“…Driving efficiency was investigated in two interventions with critical risk of bias because of possible issues with confounding variables and selection of study participants. 35,37 Evidence from a case study showed some improvements in line tracking tasks already after a single session of training 64,65 with a smart wheelchair, 37 while improvements in time efficiency and input needed to drive were reported over a 1-year period with no structured training. 35 Learning continuum of power mobility use Six studies 40,41,44,49,51,52 reported improvements in the learning continuum of power mobility use.…”