IndieTrainer: Enabling Children with Cerebral Palsy to Receive Gamified Power Mobility Training in their Own Manual Wheelchairs

在美国，每年约有10,000名儿童出生时患有脑性瘫痪(CP)，其中30%将死亡 行走能力有限或没有行走能力。对于严重残疾的儿童，独立行动能力通常是 没有电动轮椅的帮助是不可能的。不幸的是，操作一台 电动轮椅可能很难掌握，目前的训练方法既费时又费力 密集的。因此，许多儿童被排除在电动轮椅训练之外，因此 妨碍实现自主行动。为了满足这一需求，我们开发了KWIC教练机 这使得治疗师可以使用儿童自己的手动轮椅提供电动轮椅训练 并包括基于视频游戏的培训模式。尽管它最初取得了成功，但临床医生注意到了两个关键 局限性：1)它只包含单一的访问方法，2)它缺乏某些可用性功能(例如快速 设置时间、可操作性、训练参数选择等)这将是成功所必需的 融入临床实践。治疗师还指出，视频游戏模式需要 扩大到适应学习能力移动性的早期阶段的儿童。因此，我们建议在 这一直接到第二阶段的SBIR完成了改进的、商业上可行的动力的开发 轮椅训练器，这是在我们之前与KWIC训练器成功的基础上发展起来的。为了实现这一目标，我们 已经与发现中心合作，后者开发了一种创新的电力移动设备， 名为IndieGoTM，它将手动轮椅临时转换为电动轮椅，几乎 没有安装时间。我们将扩展和优化IndieGoTM系统，以纳入改进版本的 为KWIC培训员开发了基于视频游戏的培训系统，从而创建了一个有效的新 轮椅训练系统，我们称之为IndieTrainer。我们对这项第二期工程的具体目标是： 目标1)修改IndieGo电子设备以启用与视频游戏程序的通信，并允许 要使用的其他接近方法(例如，特别设计的操纵杆手柄、开关或磁头阵列)； 目的2)开发一种改进的基于视频游戏的渐进式轮椅训练计划 安全和培训环境；目标3)完成IndieTrainer的开放标签、单臂临床试验 脑性瘫痪患者(n=25)。我们的假设是IndieTrainer系统将促进更多的无障碍 和有效的力量活动训练，让更多的儿童提高他们的功能活动能力和 提高他们的独立性。在这个项目结束时，我们将完成初步开发和 一种新型电动轮椅训练系统的效能测试。如果成功，IndieTrainer将成为 首个临床系统，提供安全、游戏化和高可访问性的电动轮椅技能培训 儿童自己的手动轮椅，终于让更严重残疾的孩子接受有效 行动训练，提高他们的独立性。

In the United States, around 10,000 children are born each year with cerebral palsy (CP), and 30% will go on to have limited or no walking ability. For children with severe disabilities, independent mobility is often impossible without the aid of a powered wheelchair. Unfortunately, the skills needed to operate a powered wheelchair can be difficult to master and the current approach to training is both time and labor intensive. Consequently, many children are excluded from powered wheelchair training and are thus prevented from achieving independent mobility. To address this need, we developed the KWIC Trainer that allowed therapists to provide powered wheelchair training using a child’s own manual wheelchair and included a videogame-based training mode. Despite its initial success, clinicians noted two key limitations: 1) it only included a single access method, and 2) it lacked certain usability features (e.g. quick setup time, maneuverability, training parameter selection, etc.) that would be required for successful integration into clinical practice. Therapists also noted that the videogaming mode needed to be expanded to accommodate children at the earlier stages of learning power mobility. Thus, we propose in this Direct-to-Phase II SBIR to complete development of an improved, commercially viable powered wheelchair trainer that builds on our previous success with the KWIC Trainer. To accomplish this goal, we have partnered with the Center for Discovery, who has developed an innovative power mobility device, called indieGoTM, that temporarily converts a manual wheelchair into a powered wheelchair with almost no setup time. We will expand and refine the indieGoTM system to incorporate an improved version of the videogame-based training system developed for the KWIC Trainer, thus creating an effective new wheelchair training system that we call the IndieTrainer. Our specific aims for this Phase II project are to: Aim 1) Modify the indieGo electronics to enable communication with the videogame program and allow additional access methods to be used (e.g. specially designed joystick handles, switches, or head arrays); Aim 2) Develop an improved videogame-based progressive wheelchair training program with adjustable safety and training settings; Aim 3) Complete an open-label, single-arm clinical trial of the IndieTrainer in individuals with CP (n = 25). Our hypothesis is that the IndieTrainer system will facilitate more accessible and effective power mobility training, allowing more children to improve their functional mobility and increase their independence. At the end of this project, we will have completed initial development and efficacy testing of a novel powered wheelchair training system. If successful, the IndieTrainer will be the first clinical system to provide safe, gamified, and highly accessible powered wheelchair skills training in a child’s own manual wheelchair, finally allowing children with more severe disabilities to receive effective mobility training and increase their independence.