Jennifer Angelo

Neck range of motion and use of computer head controls

Head controls provide an alternative means of computer access. This study determined whether neck movement limitations are associated with reduced performance with such head controls. This study also identified features of the cursor movement path that could aid in assessing computer access limitations. Fifteen subjects without disabilities and ten subjects with disabilities received neck range of motion evaluations and performed computer exercises using head controls. Reduced neck range of motion was correlated with reduced accuracy (R2 = 93.5%) and speed (R2 = 79.5%) in icon selection. A model was developed with the use of cursor positioning time and number of velocity peaks to identify when a person was having difficulty with target acquisition (kappa = 0.81). Models such as this may allow head controls to adapt to a users needs, accommodating difficulties resulting from neck range of motion limitations.

A force feedback joystick and control algorithm for wheelchair obstacle avoidance

Many powered wheelchair users have difficulty manoeuvring in confined spaces. Common tasks such as traversing through doorways, turning around in halls or travelling on a straight path are complicated by an inability to accurately and reliably control the wheelchair with a joystick or other common input device, or by a sensory impairment that prevents the user from receiving feedback from the environment. An active joystick with force feedback to indicate obstacles in the environment has been developed. Two force feedback schemes designed to assist a powered wheelchair user have been developed and implemented using the active joystick. The development of the joystick and associated control algorithms are described.

Head-operated computer controls: effect of control method on performance for subjects with and without disability

Head-operated computer controls provide an alternative means of computer access for people with physical disabilities. A persons ability to use such head controls may be reduced if he or she experiences neck movement limitations. Five experimental methods of compensating for neck movement limitations were evaluated in comparison to a standard head control interface. Twenty-two subjects without disabilities and three subjects with multiple sclerosis performed icon acquisition exercises using the standard interface and each of the five experimental compensation methods. Subjects without disabilities had less tendency to overshoot the target icons when using an interface with decreased sensitivity or one in which head movements controlled cursor velocity rather than cursor position (p<0.05). Subjects with multiple sclerosis tended to be more accurate when using an interface with increased sensitivity, and had less tendency to overshoot icons when using head movements to control cursor velocity rather than cursor position. Overall, subjects tended to demonstrate faster performance when using an interface with reduced sensitivity.

Technology competencies for occupational therapy practitioners.

A task force has created a recommended set of technology competencies for occupational therapy practitioners at three levels of practice: entry/basic, intermediate, and advanced. The competencies relate to assistive technology (AT) evaluation, intervention, and resource coordination and reflect minimum knowledge and skills for registered occupational therapists (O.T.R.s) and certified occupational therapy assistants (C.O.T.A.s). The competencies were reviewed by members of the American Occupational Therapy Association (AOTA), the COTA network and RESNA, and were coordinated with RESNAs ongoing AT quality assurance and certification efforts. They represent a base for the component of outcome management related to ensuring the quality and competency of AT service deliverers.

A Survey of Persons Who Use Integrated Control Devices

Integrated devices allow users to operate multiple pieces of assistive technology items from a single input device. Through this single input device, users with severe physical limitations are able to operate several other devices such as a wheelchair, telephone, computer, and communication aid. Twenty-four integrated control users completed a telephone survey to ascertain consumer satisfaction with integrated controls. Eighteen were either satisfied or very satisfied with the evaluation for an integrated control, one was neither satisfied nor dissatisfied, two were very dissatisfied, and three did not respond to the question. Twenty were very satisfied or satisfied and four were either dissatisfied or very dissatisfied with the training they received. Twenty-two respondents indicated they were either very satisfied or satisfied with their integrated control device, one was neither satisfied nor dissatisfied, and one was very dissatisfied. In general, respondents were satisfied with their integrated control devices. Specifically, respondents were satisfied with the increase in independence and the ability to control other equipment such as television sets and computers. Simplicity, touch sensitivity, and visual/auditory feedback appeared to play important roles in satisfaction.

Computer head control software to compensate for neck movement limitations

Computer head controls provide an alternative means of computer access for people with disabilities. However, a persons ability to use head controls may be reduced if his or her disability involves neck movement limitations. Software was developed which incorporates five methods of compensating for a users neck movement limitation. This software will be used to evaluate and compare these methods, in order to determine their effectiveness in helping people operate a computer using head controls.

Using single-subject design in clinical decision making: the effects of tilt-in-space on head control for a child with cerebral palsy.

Single-subject design methodology is a research technique useful in demonstrating the effects of treatment. The technique is described here using the effects of tilt-in-space on the ability to maintain head control. The subject is a 9-year-old child with cerebral palsy. The tilt-in-space angles used are 0 degrees , 15 degrees , and 30 degrees . Data are collected for the three different tilt angles in 10 sessions using an alternating rapid treatment design. Visual analysis of the results indicate that the subject displays greater head control when the wheelchair is placed at 15 degrees or 30 degrees tilt rather than at 0 degrees . This study shows how clinicians can complete single-subject studies to support recommendations for their clients and document the effects of their treatments.

Comparison of Anterior Trunk Supports for Children with Cerebral Palsy

The purpose of this study was to demonstrate outcome measures of one seating component--anterior trunk supports--when used by children with cerebral palsy during a functional activity. The functional activity was pressing a single switch to activate a computer software program. Seventeen children with a mean age of 9 years were included in the study. Subjects had mild to moderate spastic or athetoid cerebral palsy. Seven had a primary diagnosis of athetoid and 10 had a primary diagnosis of spastic cerebral palsy. All subjects needed supplemental seating to maintain an upright posture. The four trunk supports tested were an anterior chest panel, a 1-inch-wide single horizontal chest strap, an anterior shoulder support, and a tray with molded chest support. Data included prehits, response time, and the length of time the subject pressed the switch. A repeated analysis of variance test was used to analyze the data. Data for athetoid and spastic cerebral palsy subject groups were analyzed separately. No statistically significant differences were found between the four trunk supports. Therefore, the choice of trunk supports for this population should be based on client preferences, ease of removal for the caregiver, cost, and aesthetics.