1. The efficacy of appropriate paper-based technology for Kenyan children with cerebral palsy
- Author
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Pauline Samia, Suzan R. Taylor, Fiona Williams, Rachel Lindoewood, Catherine Barton, and John Buckley
- Subjects
030506 rehabilitation ,Kenya ,medicine.medical_specialty ,Technology ,Adaptive seating ,Biomedical Engineering ,Physical Therapy, Sports Therapy and Rehabilitation ,Pilot Projects ,Cerebral palsy ,03 medical and health sciences ,Speech and Hearing ,0302 clinical medicine ,Dimaprit ,medicine ,Humans ,Orthopedics and Sports Medicine ,Functional ability ,Child ,Motor skill ,business.industry ,Cerebral Palsy ,Rehabilitation ,Gross Motor Function Classification System ,medicine.disease ,Scale (social sciences) ,Physical therapy ,0305 other medical science ,business ,Inclusion (education) ,030217 neurology & neurosurgery - Abstract
PURPOSE Appropriate paper-based technology (APT) is used to provide postural support for children with cerebral palsy (CP) in low-resourced settings. This pilot study aimed to evaluate the impact of APT on the children's and families' lives. MATERIALS AND METHODS A convenience sample of children with CP and their families participated. Inclusion was based on the Gross Motor Function Classification System levels IV and V. APT seating or standing frames were provided for six months. A mixed methods impact of APT devices on the children and families included the Family Impact Assistive Technology Scale for Adaptive Seating (FIATS-AS); the Child Engagement in Daily Life (CEDL) questionnaire; and a qualitative assessment from diary/log and semi-structured interviews. RESULTS Ten children (median 3 years, range 9 months to 7 years). Baseline to follow-up median (IQR) FIATS-AS were: 22.7 (9.3) and 30.3 (10.2), respectively (p=.002). Similarly mean (SD) CEDL scores for "frequency" changed from 30.5 (13.2) to 42.08 (5.96) (p=.021) and children's enjoyment scores from 2.23 (0.93) to 2.91 (0.79) (p=.019). CEDL questionnaire for self-care was not discriminatory; seven families scored zero at both baseline and 6 months. Qualitative interviews revealed three key findings; that APT improved functional ability, involvement/interaction in daily-life situations, and a reduced family burden of care. CONCLUSIONS APT devices used in Kenyan children with non-ambulant CP had a meaningful positive effect on both the children's and their families' lives.Implications for rehabilitationAssistive devices are often unobtainable for children with cerebral palsy (CP) in low-income countries.APT is a low cost and sustainable solution to make seating and standing devices for disabled children in Kenya.The regular use of a postural support device enhanced the children's motor skills, ability to function and participate in everyday activities, reduced the burden of care for the families and promoted the children's social interaction.The postural support devices were highly valued and utilised by the children and families in this study.
- Published
- 2020