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Neuromuscular disorders
Published in Claudio F. Donner, Nicolino Ambrosino, Roger S. Goldstein, Pulmonary Rehabilitation, 2020
Miguel R. Gonçalves, John R. Bach
NVS via a 15 mm angled mouthpiece is a practical method of daytime NVS. Some patients keep the 15 mm angled mouthpiece between their teeth (12). Most have the mouthpiece held adjacent to the mouth. A flexible metal support arm attached to a wheelchair can be used, or the mouthpiece can be fixed onto motorized wheelchair controls − most often, sip-and-puff, chin or tongue controls (Figure 37.4). The patient grabs the mouthpiece with his lips and teeth. Some neck movement and lip function are needed to grab the mouthpiece and use it without leaking air. The soft palate must move in the posteriocranial direction to seal off the nasopharynx. In addition, the patient must open the glottis and vocal cords, dilate the hypopharynx, and maintain airway patency. These normal reflex movements may require a few minutes to relearn for patients who have been receiving ventilation via a tracheostomy tube (12).
Seating and Mobility for The Severely Disabled
Published in Raymond V. Smith, John H. Leslie, Rehabilitation Engineering, 2018
The quest for increased independence, which includes mobility, by severely handicapped adults has created a demand for improved control options, i.e., options for controlling the wheelchair that go beyond traditional joystick control. Chin and head controls, optical head pointers, touch switches, single-switch scanning control, sip and puff, and voice activation are among the new options that can now be used by people that have little or no use of their upper limbs.
Design insider
Published in Emmanuel Tsekleves, Rachel Cooper, Design for Health, 2017
One of the most interesting objects of restorative equipment is the electric wheelchair. The function of the chair is to move the patient from place to place, but for those who are not able to propel and direct this process manually, adaptive devices can be attached to the chair. One is a ‘sip and puff’ device that allows patients who cannot move their hands to drive the chair by breathing through a tube. People who have the use of their hands can manoeuvre a joystick placed on or near one of the chair arms. In addition, the chair can be raised to a sitting position or lowered to a reclining position. For those patients who cannot operate a joystick, sensors can be placed in the wheelchair’s headrest. By moving the head against the headrest the patient can control the functions of the chair.
User Perspectives on the Service Delivery of Complex Power Wheelchairs
Published in Occupational Therapy In Health Care, 2021
Amanda E. Balser, Dana M. Howell, Shirley P. O’Brien
Individuals with cervical spinal cord injuries or other neuromotor impairments have complex needs and the appropriate power wheelchair, seating system, and incorporated assistive technologies enable access to desired occupations. Power chair systems have drive wheels located in either the front, middle, or rear of the power base and each effects chair performance and maneuverability differently in various environments. The seating system includes seating functions and various choices for cushions and back supports. The appropriately chosen cushion and back support provides a just-right combination of structural support and pressure relieving properties. Self-actuated power seating functions facilitate or assist with activities of daily living (ADLs) by providing changes in the user’s posture and position to optimize function. Examples of power seating functions include tilt-in-space, power reclining backrest, elevating leg supports, and seat elevation. Advanced assistive technologies include alternative drive control methods when a user is unable to access a traditional joystick. Examples include adaptive switches, specialty joysticks, sip-and-puff interface, and head array. Technologies also include features for accessing environmental controls through the power chair, and smartphone and computer access through the joystick. Due to the complex and highly individualized needs of each power wheelchair user, a multitude of options available, and the complicated documentation and reimbursement requirements, a good service delivery process is essential for a client to meet their goals.
Need and availability of assistive devices to compensate for impaired hand function of individuals with tetraplegia
Published in The Journal of Spinal Cord Medicine, 2020
Stephanie Wäckerlin, Armin Gemperli, Diana Sigrist-Nix, Ursina Arnet
Table 3 presents the total number of participants having an assistive device or reporting an unmet need for the devices. The availability of devices ranged from 14.8% (adapted cutlery) to 1.4% (sip- and puff-control, mouthstick, page turner). Only four devices (adapted cutlery, environmental control system, writing orthosis, type support) were available to more than 10% of the participants. The self-declared unmet need was rather low for most devices and was highest for adapted kitchenware (8.9%), followed by touchscreen (4.3%), adapted cutlery and environmental control system (4% each).
User-centered design and development of a trunk control device for persons with spinal cord injury: A pilot study
Published in The Journal of Spinal Cord Medicine, 2022
John M. Looft, Robert Sjoholm, Andrew H. Hansen, Stuart Fairhurst, Greg Voss, Clifford A. Dellamano, Jason Egginton, Christine Olney, Gary Goldish
Both participants had generally positive views on the first-generation trunk control prototype (Table 6). Participant 1 (who had the lower QUEST 2.0 Device Subscale Scores) wrote notes on his survey, and each item rated below a score of 5 was related to either not being tested in his own chair or related to future refinements he hoped to see. Both participants were adamant of a sip and puff control mechanism in future iterations. Despite these concerns, both participants stated it was comfortable and they would be willing to test future designs.