Furumasu Jan, Guerette Paula, Tefft Donita
Rancho Los Amigos National Rehabilitation Center, Downey, CA 90242, USA.
Dev Med Child Neurol. 2004 Jul;46(7):468-74. doi: 10.1017/s0012162204000775.
In a previous study we developed a cognitive assessment battery called the Pediatric Powered Wheelchair Screening Test (PPWST) to help clinicians determine a young child's readiness to drive a powered wheelchair. The current multicenter study sought to determine: (1) whether the PPWST is appropriate for use in a population of children with cerebral palsy (CP) who use joysticks to drive their wheelchair; (2) whether two additional factors (symbolic representation and coping) would increase the predictive power of the PPWST for this group and for children with orthopedic or neuromuscular disabilities only; and (3) whether the test was appropriate for children with severe motor impairments who use switches to control their wheelchair. Fifty children (27 males, 23 females) between the ages of 21 months and 6 years 11 months participated. Twenty-six children (mean age 4 years 4 months, SD 15 months) had triplegic or tetraplegic CP and 24 children (mean age 27 months, SD 5 months) had orthopedic or neuromuscular disabilities. Sixty-nine per cent of children had some limited form of mobility (such as rolling or scooting) but none was a functional ambulator. Each child was assessed with the PPWST and with measures of symbolic representation and coping. After six wheelchair training sessions, driving ability was scored. The PPWST was found to be predictive of functional driving ability for children with CP who used a joystick to control their wheelchair. Assessment of symbolic representation skills increased the predictive power for this group but not for children with orthopedic or neuromuscular disabilities; coping scores did not increase the predictive power for either group. The PPWST accounted for only 20% of the variance in overall driving skills for switch users, and thus is not yet considered an adequate screening device for this group. The PPWST is designed to help clinicians determine whether a child currently has the specific cognitive skills found to be related to powered wheelchair driving but is not intended to be used exclusively to determine whether or not a child is ultimately a candidate for powered mobility.
在之前的一项研究中，我们开发了一种名为儿童电动轮椅筛查测试（PPWST）的认知评估组合，以帮助临床医生确定幼儿是否准备好驾驶电动轮椅。当前的多中心研究旨在确定：（1）PPWST是否适用于使用操纵杆驾驶轮椅的脑瘫（CP）儿童群体；（2）另外两个因素（符号表征和应对能力）是否会提高PPWST对该群体以及仅患有骨科或神经肌肉残疾儿童的预测能力；（3）该测试是否适用于使用开关控制轮椅的重度运动障碍儿童。50名年龄在21个月至6岁11个月之间的儿童（27名男性，23名女性）参与了研究。26名儿童（平均年龄4岁4个月，标准差15个月）患有三肢瘫或四肢瘫型CP，24名儿童（平均年龄27个月，标准差5个月）患有骨科或神经肌肉残疾。69%的儿童有某种有限形式的移动能力（如翻滚或滑行），但没有一个是功能性步行者。每个儿童都接受了PPWST评估以及符号表征和应对能力的测量。经过六次轮椅训练课程后，对驾驶能力进行评分。结果发现，PPWST可以预测使用操纵杆控制轮椅的CP儿童的功能性驾驶能力。符号表征技能的评估提高了该群体的预测能力，但对患有骨科或神经肌肉残疾的儿童没有提高；应对能力得分对两组的预测能力均未提高。对于使用开关的用户，PPWST仅占总体驾驶技能方差的20%，因此尚未被认为是该群体的充分筛查工具。PPWST旨在帮助临床医生确定儿童目前是否具备与电动轮椅驾驶相关的特定认知技能，但并非专门用于确定儿童最终是否是电动移动的候选人。
