Case Studies of Technology-aided Interventions to Promote Hand Reaching and Standing or Basic Ambulation in Persons with Multiple Disabilities

Abstract

Motor impairments such as lack of standing and/or independent ambulation are common among persons with multiple disabilities. These two studies assessed technology-aided programs for persons with those impairments. Specifically, Study I assessed a program to teach two non-ambulatory adults to hand reach a stimulation-linked object by standing up. Study II assessed a program to teach a child and a man to ambulate while holding a rail or following a corridor wall. Standing increased from below 15% to about or over 80% of the session duration in Study I. The participants of Study II managed to complete brief ambulation trials independent of guidance. These performance achievements were discussed in relation to the technology-aided programs employed in the studies and the programs' applicability in daily contexts.

Programs Using Stimulation-Regulating Technologies to Promote Physical Activity in People With Intellectual and Multiple Disabilities: Scoping Review

“…The 42 studies (Tables 1 and 2, Multimedia Appendix 1 [10,12,27,28,32,35,37,[59][60][61][62][63][64][65][66][67][68][69][70][71][72][73][74][75][76][77][78], and Multimedia Appendix 2 [26,33,34,36,47,[79][80][81][82][83][84][85][86][87][88]) were conducted in Italy (n=15, 36%), Taiwan (n=14, 33%), the United States (n=5, 12%), Chile (n=1, 2%), Egypt (n=1, 2%), France (n=1, 2%), Hong Kong (n=1, 2%), Israel (n=1, 2%), New Zealand (n=1, 2%), Portugal (n=1, 2%), and the Netherlands (n=1, 2%). A total of 465 participants were included in the studies.…”

“…The second group includes studies that focused on promoting physical activity through the use of video games (exergames) and related auditory and visual stimulation (eg, Wii-or other system-supported video games involving activities such as dancing or playing sports [33,79,80]). Single-subject (ABAB) design Technology was as in Shih et al [35] (14-17) Shih et al [64], Taiwan Positive Right and left leg-foot lifting Single-subject (multiple probe) design Optic sensors linked to a computer system (22-42) Lancioni et al [12], Italy Positive Walker-aided ambulation Single-subject (ABAB) design Technology was as in Lancioni et al [59] (10.5-34) Lancioni et al [65], Italy Positive Body movements Single-subject (ABAB) design A gyration air mouse linked to a mini computer and television Technology was as in Lancioni et al [71] (10-29) Lancioni et al [72], Italy Positive Walker-aided ambulation and indices of happiness Single-subject (extended ABAB) design An optic sensor linked to a control system (5 and 6) Stasolla et al [37], Italy Positive Leg or hand pedaling, stepping movements, and heart rates Single-subject (ABAB) design Optic sensors linked to a computer (18-50) Lancioni et al [27], Italy Positive Head, arm-hand and leg-foot responses Single-subject (ABAB or multiple probe) design Technology was as in Lancioni et al [71] (16-40) Lancioni et al [28], Italy Positive Walker-aided step responses and indices of happiness Single-subject (extended ABAB) design Technology was as in Stasolla et al [37] (13-17) Stasolla et al [73] Tables 1 and 2 provide preliminary information about the studies conducted within the 2 groups. Multimedia Appendices 1 and 2 include brief summaries for all these studies.…”

“…Of the 42 studies, 27 (64%; including 112 participants; Table 1 and Multimedia Appendix 1) were conducted to promote physical activity via technology-regulated delivery of preferred stimulation contingent on specific participants' responses [10,12,27,28,32,35,37,[59][60][61][62][63][64][65][66][67][68][69][70][71][72][73][74][75][76][77][78]. The reasoning at the basis of these studies was that (1) the possibility of helping people with intellectual and multiple disabilities engage in physical activity may largely depend on the context's ability to motivate them to do so and (2) an effective way of motivating them could involve the use of preferred stimulation contingent on responses considered functional for their physical activity [10,27,35].…”

“…The preferred stimulation available for the single responses targeted during the studies could include auditory, visual, and vibrotactile events. The single events could last between approximately 2 and 12 seconds [10,27,71,72,74], with the possibility of producing a continuous stimulation input if responding occurred with consistency [12,37,65,68].…”