Exploring the Unmet Need for Technology to Promote Motor Ability in Children Younger Than 5 Years of Age: A Systematic Review

Abstract

Objective To (1) identify types of technology that promote motor ability in children younger than 5 years of age, (2) report on the type of support these devices provide, and (3) evaluate their potential for use in the community (outside of the laboratory or clinic). Data Sources A literature search of PubMed was conducted in February 2019 using specific terms, including child, rehabilitation, movement, and instrumentation. Study Selection The search yielded 451 peer-reviewed articles, which were screened by multiple reviewers. Articles that described the use of devices for the purpose of motor rehabilitation and/or assistance (regardless of device type or body part targeted) in the age range of 0-5 years were eligible for inclusion. Data Extraction In conformity with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, final stage data extraction consisted of full text readings where each article was reviewed twice by 3 independent reviewers. Data Synthesis About half of the devices available (46%) for children younger than 5 years of age are orthotics and corrective casting devices. There are more facilitative (ie, power mobility devices) than inhibitive (ie, casting) technologies being used. Approximately 60% of the devices are designed for use by a single body part. Walking is the most common motor skill addressed. Although most of the devices were used to some degree outside of the laboratory or clinic, most of the devices available are considered investigative and are not available for commercial purchase. Conclusions Many types of pediatric devices to assist movement exist, but the current scope of employed devices is limited. There is a need for developing technology that allows for, if not supports, high-dosage, early, and variable motor practice that can take place in community settings.

ON Time Mobility: Advocating for Mobility Equity

“…Research evidence for this population references multiple types of interventions focused on gross motor skill development, but there is little study of supplemental technologies for the child to be mobile until walking is achieved 40,41. Similarly, durable medical technologies for children younger than 5 years most commonly target walking in contrast to technologies, which support other mobility strategies 42…”

“…40,41 Similarly, durable medical technologies for children younger than 5 years most commonly target walking in contrast to technologies, which support other mobility strategies. 42 These examples illustrate a misdirected focus on a single mode approach to mobility. This is in direct contrast to the variability in typical development where learning to move consists of constantly emerging behaviors that allow children to cocreate and adapt in complex environments.…”

Closed-loop Position Control of a Pediatric Soft Robotic Wearable Device for Upper Extremity Assistance

“…Despite a range of assistive devices proposed for these populations, upper extremity assistive devices for very young pediatric populations (i.e. <2 years of age) are limited [6], [7] and mainly passive [8], [9]. The present work specifically focuses on the development of a soft robotic wearable device for upper extremity assistance in infants.…”

A Bidirectional Fabric-based Pneumatic Actuator for the Infant Shoulder: Design and Comparative Kinematic Analysis

“…The use of assistive devices can help pediatric populations with functional impairments engage in such activities, leading to gains in motor function [3]. The availability of assistive devices specifically for pediatric populations under the age of two years is limited [4], with only a few UE devices being under development [5] and/or being tested with infants [6], [7].…”