THE POWER OF ACCESS ACROSS THE LIFESPAN

Transcription

1 THE POWER OF ACCESS ACROSS THE LIFESPAN Amy Morgan, PT, ATP National Clinical Education Manager Hymie Pogir Product Marketing Manager 1

2 Learning Objectives: List three aspects of choosing a drive control to match the consumer s functional needs Identify two options for computer access through the wheelchair Compare and contrast environmental needs for children, adults, and the elderly.

3 Access Needs Across the Lifespan Children - communication, computer (learning/play), lower heights (desks), playgrounds, floor time, etc. Teenagers - communication, computer (advanced skills/social), environmental controls (esp. media), driving, SOCIAL!! Adults - communication, computer (life skills/social), environmental controls (independence), driving, etc. Elderly Adults - communication, computer (reminders/social), emergency access, environmental controls, etc. 3

4 Consumer s Goals Evaluation Factors Where and what is their control? Proper positioning to increase stability Should not have to work to access the drive control Progression of medical condition Cognitive ability Is movement cognitive? Visual/perceptual abilities

5 Why Program? Set different parameters for different environments Optimize driving skills and control of environment Modify settings as needs change Progressive conditions Learning Compensate for range of motion, motor control deficits Identify type of specialty input device being used

6 Relationship: Ability & Technology Ability & Technology have an inverse relationship Decreasing Ability requires Increasing Technology 6

7 Proportional vs. Switched (Digital) Infinite control of speed (0 to max) and of direction Continuous & fluid response as the joystick is moved further from or closer to neutral Either On or Off Up to 8 discrete directions (Forward, Reverse, Left, Right & in between at every 45 0 ) Can be programmed for single or multiple speeds

8 Checklist Input Device and Control Site It never hurts to have a checklist to jog your memory. So we prepared one! Details Issues and Considerations, e.g. ROM Force Location of device To name some of the covered subjects 8

9 Checklist Input Device and Control Site This is a check -list of issues to be aware of when selecting an appropriate control site and control input device Issue Considerations ROM How much movement is required to effectively operate the input Force & Strength How much force is required to operate the input and how much strength correspondingly is needed from the driver Endurance & Does the driver have adequate endurance for the chosen input device over the time of operation? Can they reasonably meet travel goals (i.e. home to Fatigue store) or may fatigue be an issue & cause too many rest stops? Does the input device require fine control or will gross movements suffice Control Movements Interactive Skill Location Stability & Consistency Seating Proportional devices require constant and well controlled interaction with the dri ver. Non proportional devices require a less intense interactivity between driver and device Can the device/s be located at the preferred control site? i.e. Can a Fiber Optic switch be positioned for repetitive, everyday use? Interface A custom Goal Post, a Tennis Ball, a customized chin cup? What is needed? Is the control site (Chin, Head, Knee, Finger etc.) the most consistently stable relative to other options? What special seating and positioning interventions may be required to operate the chosen input device? 9

10 Hierarchy of Drive Controls Standard Joystick Specialty Input Device (SID) Proportional Multiple Switches Single Switch

11 Hierarchy of Programming Performance Adjustments (i.e. Speeds, Accel, Decel, J.S. Throw, etc.) Seat Function Control (Tilt, Recline, PELRs etc.) Alternative Controls (driver & Control inputs) Computer, ECU, & Aug. Comm

12 Joystick Configurations Compact Joystick Advanced Color Joystick Heavy Duty Joystick LED Joystick Compact Joystick

13 Joystick Handle Options

14 Proportional SID s Video Game Controller Mini Joystick/Haims Harness RIM Head Control Stealth Tray Tablet Control VIC

15 Non-Proportional SID s Sip n Puff/Head Array Wafer Board Head Array Microswitch Penta-Switch Fiber Optics

16 Other Switch Options Buddy Button/Jelly Bean Active Touch Mini Cup Proximity Fiber Optic Microlite

17 Where Do I Go From Here? Real Life Case Examples Across the Lifespan

18 Meet Kendal Congenital Muscular Dystrophy

19 Joystick Options Joystick Throw Joystick Orientation Acceleration/Deceleration Speeds Different profile for caregiver or pulling up to table Special Names to distinguish

20 Who s Cuter? 20

21 C4 Complete SCI Meet Cale

22 Compact Joystick Lite Larger Throw Less Sensitive Used at: Chin Hand Foot Anywhere! 22

23 Extremity Uses 23

24 Chin Control Options Acceleration/Deceleration Mode Switch vs. Timeout to menu Orientation (invert F/R) Add sleep to menu Haims Harness vs. Swing Away Chin Boom (power seat functions) Latch? Sip n Puff

25 Meet Stevonte Arthrogryposis

26 Meet Samantha Brain Injury due to Meningitis as an Infant Dystonia Difficulty with Joystick Head Array started with Right only Hand/Extremities Stabilized

27 New Head Array - Options! Easily adjustable Plug and play switches Not tied to the head Use anywhere Electric or Mechanical 27

28 Important Programming Parameters Fwd/Rev auto toggle Speeds ACC/DEC (smoothness more like proportional control) ESP/tracking technology Sleep 12V - ON Actuators R/L; L/R; Swap Training mode start with one direction

29 Options for ALS? Modular control to progress with client VS. Programs that allow exchange of drive controls Rapid Progression Provide mobility and control of seating, environment, communication, etc. AS LONG AS POSSIBLE!

30 Single Switch Scanning Important Programming Parameters: Scan Rate Customizing user menu Switch access for driving as well as seat functions, IR, computer access, etc. Type of switch and Location/Mounting

31 Eye Gaze Single Switch required Safety Produced in Norway: 31

32 Switches and Joystick? When would this be beneficial? Important Programming Options: Universal vs. JSM/OMNI assign drive control to profiles Port 1/Port 2 Modes can also be controlled with j/s and switches

33 Options for SMA Type 1 Challenging because very little strength and ROM: Mini j/s Switch-It Micropilot Fiber Optics Single Switch 33

34 Important Programming Parameters Change beam height Start with single direction (R/L) training mode REMOTE STOP SWITCH

35 Why Is Control Important? Improved self-esteem and psycho-social development associated with improved control Decreased learned helplessness/non-use Positive contribution to society.

36 Types of Signal Transmission Wired Options Wireless Options Infrared (IR) Optical (Light); requires line of sight Radio Frequency Radio Waves, no line of sight required, penetrates walls Bluetooth is an example of RF

37 Wired Options USB Mouse Emulator R-Net Input/Output Module (IOM) Communication Device Often combined with wireless devices Door Opener ECU devices X-10 Scanning controller

38 Input/Output Module (IOM) R-Net IOM provides a single input port for switched or proportional devices Also can be used as an output port Communication Devices Environmental Controls The included jack provides for an on/off switch

39 Infrared (IR) Transmission Environmental Controls TV/Cable Remote Controls ipod Dock Speakers X-10 Controller Phone Toys Computer Access ASL Mouse Mover Switch-It Mouse Mover

40 R-Net Omni - IR Consumer uses input device to control environment TV DVD DVR ipod dock Etc. How to tell if remote is IR? Can customize menus for user using IR configurator

41 Radio Frequency (RF) Transmission Environmental Controls Garage Door Openers Ceiling Fans/Lights Some household electronics Computer Access Bluetooth Mouse Modules

42 R-Net Mouse Module Easily paired with up to 4 devices Example: 1.Home computer 2.Laptop computer 3.Work/School computer 4.AAC device (ex. Dynavox ) Range 30 feet No line of sight required Important for seating/positioning

43 Options for Mouse Clicks Buttons on joystick Movement of drive control (dab) External switches Integrated into the mouse control Aftermarket products Dwell software

44 Remote Stop Switches Used to stop wheelchair from a distance Wired Single Switch into monojack port Wireless ASL distance 20 feet Switch-It distance feet R-Net distance 300 feet (open air)

45 Who Completes Programming? Dealer Therapist Manufacturer s Representative Client/Family? Drive programming IR/RF device programming Training is essential!

46 Various Electronics PG Drives R-Net Permobil Sunrise Invacare Mark VI Delphi (iq) Sunrise discontinued 04/09 Curtis - Q-Logic Pride/Quantum

47 What s the Difference? Minor variations all are improved! Varying number of profiles Programming parameters semantics Timers available Display types Speed, Color, Size, Pictures, etc. On-board programming vs. PC programming

48 Consumer Resources Door Openers Home Automation Superstore VGM Home Accessibility

49 Computer Access Resources Dwell Clicker FREE Accessibility Options on Computer FREE Voice Recognition Software

50 Q&A Questions? Please use the Ask A Question section to the left to submit your questions to our speaker.

51 Thank You!

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