Functional Capacity and Self-Esteem of People With Cerebral Palsy.

OBJECTIVE: We assessed whether functional capacity predicts self-esteem in people with cerebral palsy (CP). METHOD: We conducted a cross-sectional observational study of 108 people with CP, ages 16-65 yr, who were residents of Spain. Self-esteem was captured using the Rosenberg Self-Esteem Scale (RSES), and functional capacity using the Barthel Index (BI). Sociodemographic characteristics were recorded. The relationship between the RSES score and the BI score was analyzed using linear regression. RESULTS: RSES scores increased significantly as BI scores increased (regression coefficient = 0.047, 95% confidence interval [0.017, 0.078], p = .003). People with a higher level of education, active employment, and independent living arrangements tended to have better functional capacity and higher self-esteem. CONCLUSION: Greater functional capacity predicted higher self-esteem; this effect is probably partly mediated by education, employment, and living arrangements.

The use of robots for augmentative manipulation during play activities among children with motor impairment: a scoping review.

PURPOSE: To describe the extent, type, and quality of studies involving robots for augmentative manipulation during play by children with severe motor impairments (CwSMI), and to explore how they influenced children's cognitive skills and engagement. METHODS: Web of Science, Scopus, PubMed & EBSCO were systematically searched for articles published until March 2021, that reported cognitive skills and/or engagement outcomes from interventions involving the use of robots in play activities, where participants included CwSMI, and full-text was available. Data extracted comprised characteristics of participants, study design, purpose of the study, outcomes assessed, collection methods, and intervention carried out (robot-environment interaction and robot used). RESULTS: Eight mobile robots and five robotic arms were reported in the 17 included and reviewed articles. Most of them informed a positive impact on CwSMI's cognitive skills and/or engagement. However, the studies scored poorly on a five-criteria quality assessment, and only one single-case design proved strong evidence of treatment. None of the analysed interventions was an evidence-based practice. CONCLUSION: The use of manipulative robots during play activities may have a positive impact on the CwSMI's cognitive skills and engagement in activities. However, further studies with higher internal and external validity are needed to support stronger evidence.Implications for rehabilitationThe use of robots for augmentative manipulation during play activities may have a positive influence on the cognitive functions and the engagement in activities of children with severe motor impairments.Through manipulative robots, this population could be able to show the abilities that are hidden due to their motor impairments, and subsequently, receive educational and physical training more aligned with their real capacities and potential.

A Mobile App Directory of Occupational Therapists Who Provide Home Modifications: Development and Preliminary Usability Evaluation.

BACKGROUND: Home modifications provided by occupational therapists (OTs) are effective in improving daily activity performance and reducing fall risk among community-dwelling older adults. However, the prevalence of home modification is low. One reason is the lack of a centralized database of OTs who provide home modifications. OBJECTIVE: This study aimed to develop and test the usability of a mobile app directory of OTs who provide home modifications in the United States. METHODS: In phase 1, a prototype was developed by identifying OTs who provide home modifications through keyword Web searches. Referral information was confirmed by phone or email. In phase 2, community-dwelling older adults aged older than 65 years and OTs currently working in the United States were purposefully recruited to participate in a single usability test of the mobile app, Home Modifications for Aging and Disability Directory of Referrals (Home Maddirs). Participants completed the System Usability Scale (SUS) and semistructured interview questions. Interview data were coded, and themes were derived using a grounded theory approach. RESULTS: In phase 1, referral information for 101 OTs across 49 states was confirmed. In phase 2, 6 OTs (mean clinical experience 4.3 years, SD 1.6 years) and 6 older adults (mean age 72.8 years, SD 5.0 years) participated. The mean SUS score for OTs was 91.7 (SD 8.0; out of 100), indicating good usability. The mean SUS score for older adults was 71.7 (SD 27.1), indicating considerable variability in usability. In addition, the SUS scores indicated that the app is acceptable to OTs and may be acceptable to some older adults. For OTs, self-reported barriers to acceptability and usability included the need for more information on the scope of referral services. For older adults, barriers included high cognitive load, lack of operational skills, and the need to accommodate sensory changes. For both groups, facilitators of acceptability and usability included perceived usefulness, social support, and multiple options to access information. CONCLUSIONS: Home Maddirs demonstrates good preliminary acceptability and usability to OTs. Older adults' perceptions regarding acceptability and usability varied considerably, partly based on prior experience using mobile apps. Results will be used to make improvements to this promising new tool for increasing older adults' access to home modifications.

Examination of Community Participation of Adults With Disabilities: Comparing Age and Disability Onset.

Objective: Explore community participation between adults with disabilities ⩽50 and >50 years and between early-(⩽40) and late-(>40) onset disability. Method: A survey examining participation was conducted with a national convenience sample of 692 community-dwelling adults with disabilities. Results: Participants ⩽50 reported presence of more (p < .05) environmental supports for work/volunteer/education and use of transportation. Participants >50 had higher (p < .01) visits to pharmacies; higher (p < .05) evaluative quality of participation (EQOP) at gas stations, exercise facilities, beauty salons/barbers, and use of transportation (p < .01); and more difficulty participating without assistance at grocery stores (p < .05) and gas stations (p < .01). The early-onset group reported higher (p < .05) EQOP at work/volunteer/education and homes of family/friends. The late-onset group reported higher (p < .01) EQOP at exercise facilities; more (p < .05) environmental supports at pharmacies, restaurants, grocery stores (p < .01), doctors' offices (p ⩽ .01), and beauty salons/barbers (p < .01); greater (p < .01) influence of pain/fatigue; and more difficulty without assistance at grocery stores (p < .05) and gas stations (p < .01). Discussion: Understanding these differences can improve interventions to support community participation of individuals aging with disabilities.

How available to European children and young people with cerebral palsy are features of their environment that they need?

BACKGROUND: The UN Convention on the Rights of Persons with Disabilities requires accessibility to the physical and social environments. However, individuals with cerebral palsy (CP) have many difficulties in accessing the environment they need for functional independence and social inclusion. AIMS: To examine the availability of environmental features which children with CP need for optimal participation, and whether availability changed for them between ages 8-12 and 13-17 years. METHODS: The sample is the 594 children with CP, born 31/07/1991-01/04/1997, who took part in the SPARCLE study at age 8-12 (SPARCLE 1) and again at 13-17 years (SPARCLE 2). Participants were randomly sampled from population registers of children with CP in eight European regions; one further region recruited from multiple sources. Data about environment were captured with the European Child Environment Questionnaire (60 items). Differences in availability of environmental features between childhood and adolescence were assessed using McNemar's test; differences between regions were assessed by ranking regions. Differences in availability between regions were assessed by ranking regions. RESULTS: For seven environmental features significantly (p<0.01) fewer individuals needed the feature in SPARCLE 2 than in SPARCLE 1, whilst for two features more individuals needed the feature. Nine features in SPARCLE 1 and six features in SPARCLE 2 were available to less than half the participants who needed them. Eight features showed significantly (p<0.01) higher availability in SPARCLE 2 than in SPARCLE 1 (enlarged rooms, adapted toilet, modified kitchen and hoists at home, adapted toilets and lifts at school, an adequate vehicle, grants for home modifications) while none showed significantly lower availability. The relative rankings of the better and less good regions persisted from the age 8-12year age group to the 13-17year age group. CONCLUSIONS: Needed environmental features are unavailable to many children at ages 8-12 and 13-17 years. This lack of availability is more pronounced in some regions than others, which probably results from their policy, legislative and statutory frameworks.