Application of a novel integrated pointing device apparatus for children with cerebral palsy.

BACKGROUND To improve the computer operation of children suffering from cerebral palsy (CP) with severe disabilities, more flexible pointing devices are required. This study investigates the effectiveness of a newly developed Integrated Pointing Device Apparatus (IPDA) that can integrate numerous commercial pointing devices. METHODS We enrolled 27 children with quadriplegic CP and 15 healthy children. All children were required to perform three specific mouse operation tasks. Children with CP were classified into two groups based on hand operation: one hand (group A) and both hands (group B). The efficiency of children with CP in each mouse operation task was expressed as a percentage of that for normal children (% NL). RESULTS Group A operated a standard mouse with their dominant hand; group B had to use both hands to operate a mouse via IPDA. Group A demonstrated better efficiency of continuous-clicking tasks than group B (p < 0.05). Group B had a similar level of efficiency in the target-acquisition task (30% NL) and drag-and-drop task (20% NL) as that of group A, although group B could not operate a standard mouse with one hand. All children in group A were spastic quadriplegia, while 30% of children in group B were spastic-athetoid (p < 0.05). All children in group B were at level 3 of the gross motor functional classification system (GMFCS) but only 57% of children in group A were at level 3 (p < 0.05). CONCLUSION The IPDA can help some children with CP, who cannot utilize a commercial mouse alone, to achieve acceptable operational efficiency. The operation methods for children with CP were determined by their underlying motor control.

[1]  G. Fraser Shein,et al.  An overview of human-computer interaction techniques for people with physical disabilities , 1992 .

[2]  Johannes Springer,et al.  Position controlled input device for handicapped: Experimental studies with a footmouse , 1996 .

[3]  M S Hawley,et al.  Implementation of a PC-based integrated control system for children. , 1994, Medical engineering & physics.

[4]  N Walker,et al.  Spatial and Temporal Characteristics of Rapid Cursor-Positioning Movements with Electromechanical Mice in Human-Computer Interaction , 1993, Human factors.

[5]  M. Betke,et al.  The Camera Mouse: visual tracking of body features to provide computer access for people with severe disabilities , 2002, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[6]  R. Palisano,et al.  Development and reliability of a system to classify gross motor function in children with cerebral palsy , 1997, Developmental medicine and child neurology.

[7]  Kyung S. Park,et al.  Eye-controlled human/computer interface using the line-of-sight and the international blink , 1996 .

[8]  Jin-Shin Lai,et al.  A head movement image (HMI)-controlled computer mouse for people with disabilitiesAnalysis of a time-out protocol and its applications in a single server environment , 2003, Disability and rehabilitation.

[9]  Shari Trewin,et al.  Keyboard and mouse errors due to motor disabilities , 1999, Int. J. Hum. Comput. Stud..

[10]  M L Lin,et al.  Gain effects on performance using a head-controlled computer input device. , 1992, Ergonomics.

[11]  Mats Hagberg,et al.  Computer mouse and track-ball operation:: Similarities and differences in posture, muscular load and perceived exertion , 1999 .

[12]  Brain.  Aids to the Examination of the Peripheral Nervous System , 1987 .

[13]  M L Lin,et al.  A Method for Evaluating Head-Controlled Computer Input Devices Using Fitts' Law , 1990, Human factors.

[14]  Thomas G. Whisenand,et al.  Analysis of Cursor Movements with a Mouse , 1997, HCI.

[15]  Michael Wagner,et al.  User verification through pointing characteristics: an exploration examination , 1996, Int. J. Hum. Comput. Stud..

[16]  R D Jackson,et al.  Analysis of intentional head gestures to assist computer access by physically disabled people. , 1990, Journal of biomedical engineering.

[17]  R. Burgess-Limerick,et al.  The prevalence of neck and upper extremity musculoskeletal symptoms in computer mouse users , 2000 .

[18]  Richard W. Bohannon,et al.  Interrater reliability of a modified Ashworth scale of muscle spasticity. , 1987, Physical therapy.

[19]  Sherry Perdue Casali,et al.  Computer-based system access by persons with disabilities: Differences in the effects of interface design on novice and experienced performance , 1995 .