Ostensjø Sigrid, Carlberg Eva Brogren, Vøllestad Nina K
Faculty of Health Sciences, Oslo University College, Norway.
Disabil Rehabil. 2005 Jul 22;27(14):849-61. doi: 10.1080/09638280400018619.
The study describes use of assistive devices and other environmental modifications, and their impact on everyday activities and care in young children with cerebral palsy (CP).
Ninety-five children (55 boys, 40 girls; mean age 58 months, SD 18 months) and their parents were studied using a cross-sectional design. The Pediatric Evaluation of Disability Inventory (PEDI) was applied to assess daily activities using the three measurement scales: functional skills, caregiver assistance, and modifications of the environment. Use of modifications was described related to the five severity levels of the Gross Motor Function Classifications System (GMFCS). Impact was rated on the Caregiver Assistance scale of the PEDI and on a five-point Likert scale.
Out of the 1075 provided environmental modifications, 980 were in regular use to support mobility, self-care and social function among 84 children. The number increased with GMFCS levels; children at levels IV and V used 80% of the modifications, with large variations between the children at same level. Adaptations of housing and transportation facilitated effective use of assistive devices. Half of the parents rated the modifications to have moderate to very large effect on the child's mobility, 25% on self-care skills, and 20% on social function. Furthermore, 65% reported that the modifications lightened the caregiving for mobility, 75% for self-care and 25% for social function. Functional independence and care demands often benefited from different types of modifications.
The variations in use and benefits of environmental modifications indicate need of comprehensive assistive technology assessments, including child factors, family factors, technology factors and service system factors.
本研究描述了辅助设备的使用及其他环境改造措施，以及它们对脑瘫（CP）幼儿日常活动和护理的影响。
采用横断面设计对95名儿童（55名男孩，40名女孩；平均年龄58个月，标准差18个月）及其父母进行研究。应用儿童残疾评估量表（PEDI），通过功能技能、照顾者协助和环境改造三个测量量表来评估日常活动。描述了与粗大运动功能分类系统（GMFCS）五个严重程度级别相关的改造措施的使用情况。在PEDI的照顾者协助量表和五点李克特量表上对影响进行评分。
在提供的1075项环境改造措施中，980项被84名儿童经常用于支持移动性、自我护理和社交功能。数量随着GMFCS级别增加；IV级和V级的儿童使用了80%的改造措施，同一级别的儿童之间存在很大差异。住房和交通的改造促进了辅助设备的有效使用。一半的家长认为这些改造措施对孩子的移动性有中度到非常大的影响，25%对自我护理技能有影响，20%对社交功能有影响。此外，65%的家长报告说这些改造措施减轻了移动性护理负担，75%减轻了自我护理负担，25%减轻了社交功能护理负担。功能独立性和护理需求通常受益于不同类型的改造措施。
环境改造措施在使用和益处方面的差异表明需要进行全面的辅助技术评估，包括儿童因素、家庭因素、技术因素和服务系统因素。
