Date of Award

2009

Degree Type

Thesis

Degree Name

Bachelor of Science Honours

Faculty

Faculty of Computing, Health and Science

First Advisor

Dr Sonya Girdler

Second Advisor

Lois Moir

Abstract

Purpose. To systematically review the effectiveness of powered mobility training interventions in improving driving skills and psychosocial outcomes in children with cerebral palsy. Method. Electronic searches of CINAHL, Medline and Meditext were conducted. Using two assessment tools, two independent reviewers assessed the quality of selected studies and level of evidence. Studies were included if a powered mobility training intervention was described, at least one participant had cerebral palsy and if the majority of participants were aged between 18 months and 18 years old. A narrative analysis was conducted. Results. Seven articles were eligible for inclusion. Intervention protocols included computer simulator training, mobility training on a powered riding toy, and a powered wheelchair. The quality of the studies ranged from strong to limited, with six out of seven studies rated as level IV evidence and one study rated as level III evidence as defined by the National Health and Medical Research Council level of evidence table. Conclusions. Although research is limited observational investigations suggest that powered mobility training programs are potentially beneficial in the development of driving skills for children with cerebral palsy and may have a positive impact on psychosocial outcomes. Methodological weaknesses of the studies were small sample sizes, absence of control groups and largely descriptive data analysis. There is a need for future, more rigorous research which addresses these weaknesses and contributes to an understanding of the utility of powered mobility both as a method of access and as a therapeutic intervention tool. Purpose: To describe the impact of a mobility training program using the Smart Wheelchair on the driving skills and psychosocial outcomes of children with cerebral palsy. Method: A multiple case study design using mixed methods was used. Four children with cerebral palsy were recruited for the study. The intervention was a Smart Wheelchair mobility training program. Data was collected using a quantitative driving skills assessment, field notes and qualitative parent interviews. Results: Three out of four children gained independence in at least three driving skills or more, whilst one child was competent with verbal prompts. Three out of four mothers reported positive changes in their child's confidence, motivation and affect. Conclusions: The Smart Wheelchair has the ability to uncover learning potential and facilitate the recognition of abilities in children with cerebral palsy previously excluded from access to independent mobility. Given the significant limitation that restrictions in mobility pose to participation for children with cerebral palsy, occupational therapists must begin to understand the effectiveness of interventions such as the Smart Wheelchair. The descriptive findings of this study allow for future, more rigorous research, to be conducted on the effectiveness of the Smart Wheelchair as a mobility training tool.

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