Yamamoto Akio, Kihara Kenji, Yagi Mariko, Matsumoto Yoko, Tsuneishi Shuichi, Otaka Hideo, Yonezawa Masaya, Takada Satoshi
Department of Community Health Science, Graduate School of Health Science, Kobe University, Kobe, Japan.
Nikoniko-house Medical Welfare Center, Kobe, Japan.
Disabil Rehabil Assist Technol. 2020 Jan;15(1):54-59. doi: 10.1080/17483107.2018.1520309. Epub 2019 Feb 7.
Children with cerebral palsy may face difficulties using handheld pointing devices, due to involuntary muscle movements. This study aimed at describing the idea of the new wearable sensor switch and assessing its feasibility as an access solution in a case of mixed-type cerebral palsy. The study participant was a 17-year-old male with mixed-type cerebral palsy characterized by chorea-athetotic movements and bilateral spasticity with gross motor function classification system level V. He exhibited sudden and irregular involuntary upper limb movements when sitting. Because spastic finger movements limited his ability to use a handheld mouse, he used a trackball near his neck as a pointing device (previous input method). The wearable switch system using a stretchable strain sensor was introduced; the sensor was attached to a groove worn on the dorsal regions of the right hand crossing the proximal interphalangeal and metacarpophalangeal joints of the middle finger (new input method). The switch turned on when the subject flexed his middle finger. The user successfully turned the switch on and typed almost the same numbers of characters per trial compared with the previous input method. The speed of his head movements during typing reduced ( < .01), and his sitting posture was nearly upright during computer operation ( < .01). No involuntary movement, requiring physical assistance, was observed when using the wearable switch. The new switch system can be a new option for people with difficulty using standard handheld input devices due to paralysis and involuntary muscle movements.Implications for rehabilitationCerebral palsy is a major cause of motor dysfunction and spasticity and dyskinesia in the fingers and upper limbs may prevent children with cerebral palsy from using handheld input devices.Wearable devices may be useful for children with cerebral palsy who have limited access to handheld pointing devices.We developed a new wearable switch to control devices using a flexible stretchable sensor.The wearable switch contributed to the improvement of sitting posture and reduction of neck burden during the typing task at the speed equivalent to that using the previous method in a child with mixed type of cerebral palsy exhibiting choreoathetotic movements and bilateral spasticity.
由于非自主肌肉运动，脑瘫患儿在使用手持指向设备时可能会面临困难。本研究旨在描述新型可穿戴传感器开关的概念，并评估其作为混合型脑瘫患者接入解决方案的可行性。研究参与者是一名17岁男性，患有混合型脑瘫，其特征为舞蹈徐动症和双侧痉挛，粗大运动功能分类系统为V级。他坐着时表现出突然且不规则的上肢非自主运动。由于手指痉挛运动限制了他使用手持鼠标的能力，他使用颈部附近的轨迹球作为指向设备（先前的输入方法）。引入了使用可拉伸应变传感器的可穿戴开关系统；传感器附着在右手背侧穿过中指近端指间关节和掌指关节的凹槽上（新的输入方法）。当受试者弯曲中指时，开关打开。与先前的输入方法相比，用户每次试验成功打开开关并输入的字符数几乎相同。他打字时头部运动的速度降低了（<0.01），并且在计算机操作期间他的坐姿几乎是直立的（<0.01）。使用可穿戴开关时未观察到需要身体协助的非自主运动。对于因瘫痪和非自主肌肉运动而难以使用标准手持输入设备的人来说，新的开关系统可能是一个新的选择。
康复意义
脑瘫是导致运动功能障碍的主要原因，手指和上肢的痉挛和运动障碍可能会阻止脑瘫患儿使用手持输入设备。
可穿戴设备可能对难以使用手持指向设备的脑瘫患儿有用。
我们开发了一种使用柔性可拉伸传感器来控制设备的新型可穿戴开关。
对于一名患有舞蹈徐动症和双侧痉挛的混合型脑瘫患儿，该可穿戴开关在打字任务中有助于改善坐姿并减轻颈部负担，且速度与使用先前方法相当。
