The use and impact of assistive devices and other environmental modifications on everyday activities and care in young children with cerebral palsy
The use and impact of assistive devices and other environmental modifications on everyday activities and care in young children with cerebral palsy
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DOI：
10.1080/09638280400018619
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发表时间：
2005-07-22
影响因子：
2.2
通讯作者：
Vollestad, NK
中科院分区：
文献类型：
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作者：
Ostensjo, S;Carlberg, EB;Vollestad, NK
目的.该研究描述了使用辅助设备和其他环境改造，以及它们对脑瘫（CP）幼儿日常活动和护理的影响。95名儿童（55名男孩，40名女孩;平均年龄58个月，SD 18个月）和他们的父母进行了研究，采用横断面设计。应用儿科残疾评估量表（PEDI）评估日常活动，使用三个测量量表：功能技能，护理人员的帮助，和修改的环境。描述了与粗大运动功能分类系统（GMFCS）的五个严重度水平相关的修改的使用。根据PEDI的护理人员协助量表和五点Likert量表对影响进行评级。在提供的1 075个环境改造项目中，有980个项目经常使用，以支持84名儿童的行动、自我照顾和社会功能。这一数字随着GMFCS水平的增加而增加; IV级和V级儿童使用了80%的修改，同一水平儿童之间的差异很大。住房和交通的调整促进了辅助器具的有效使用。一半的父母认为这些修改对孩子的活动能力有中度到非常大的影响，25%对自理能力有影响，20%对社会功能有影响。此外，65%的人报告说，这些修改减轻了行动能力，75%的人减轻了自我照顾能力，25%的人减轻了社会功能。功能独立性和护理需求往往受益于不同类型的修改。环境改造的使用和效益的差异表明，需要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。
Purpose. 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).Method. 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.Results. 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.Conclusion. 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.