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Individuals with movement disorders often face challenges in writing independently due to factors such as spasticity, lack of precise motor control, muscle weakness, and tremors. This paper aims to develop a handwriting assistive device (HAD) for individuals with movement disorders, to stabilize the motion of user's hand, through initial needs assessment, iterative design, and a preliminary evaluation. The research is scoped to include only initial testing with a small user group, six potential users with movement disorders, providing foundational insights for future refinement. The findings from the initial needs assessment revealed that current assistive technologies do not fully meet handwriting challenges for individuals with motor impairments. The HAD prototype, developed with adjustable damping mechanism and customizable handles to suit different levels of motor control, enabled steadier handwriting in preliminary testing with six participants. Children drew shapes more accurately, and some traced letters they couldn't otherwise. The adult participant showed greater fluidity and legibility, completing tasks 4.81 times faster with the HAD. The qualitative feedback indicated the device's potential to enhance handwriting independence and usability across age groups. Future prospects for this study include developing an electronic version of the HAD, allowing real-time adjustable damping to better support users' voluntary movements while further stabilizing involuntary motions. [ABSTRACT FROM AUTHOR]

Purpose: To conduct a systematic review on the impacts of using mechanical assistive devices on function, performance in activities and participation of persons with upper extremity impairments, and to synthesize the strengths and limitations of these devices. Method: Three independent reviewers conducted systematic searches of articles published between 2003 and 2023 in Compendex, Inspec, Embase, PubMed/Medline, IEEE Xplore, and Web of Science, as well as manual searches on the RESNA website for conference papers over the same period. The methodological quality of articles was appraised using the QualSyst tool. Results: From the 34 retained studies, 28 mechanical devices were identified and classified into two categories: (1) mobile arm supports (MASs) designed to perform multiple activities, and (2) devices used to assist with a specific activity of daily living (ADL). Overall, MASs helped users to perform manual activities in elevation and/or against gravity. Specific ADL devices allowed users to perform unique activities requiring fine motor skills such as opening a medicine container. Some of these devices have advantages like portability, adaptability, low cost, and ease of use. Limitations most often reported included interference or mobility restraints. Conclusion: This review synthesizes the impacts of mechanical devices on the three domains of the International Classification of Functioning, Disability and Health (ICF) for individuals with upper extremity impairments. Impacts regarding function and performance in activities were more often measured than participation. Future studies should include outcomes related to participation, as taking this aspect into account might favor successful continued use of assistive devices. IMPLICATIONS FOR REHABILITATION: Mechanical mobile arm supports can compensate for upper extremity muscle weakness and help users to perform diverse activities against gravity, including self-care, productivity and leisure activities. Mechanical assistive devices designed for specific activities of daily living (ADLs) can increase users' ability to perform activities requiring manual dexterity and fine motor skills, such as eating, handwriting, performing personal care or playing a musical instrument. Portability, adaptability, low cost, and ease of use are most often reported as strengths of specific ADL devices, while interference and mobility restrictions are aspects that still need to be reduced with respect to mechanical mobile arm supports. [ABSTRACT FROM AUTHOR]

Most activities of daily living (ADLs) require the use of both upper extremities. However, few assessments exist to assess bimanual performance, especially among adults living with cerebral palsy (CP). The aim of this preliminary study is to assess the interrater reliability and convergent validity of the Assisting Hand Assessment (AHA) scoring grid applied to unstandardized ADLs. For this validation study, nineteen adults living with spastic unilateral CP were videotaped performing seven bimanual ADLs. Three raters assessed the videos independently using the 20-item grid of the AHA. Gwet's AC2 was used to assess interrater reliability. Kendall's Tau-b correlation was used between the observation-based scoring grid and Jebsen-Taylor Hand Function Test (JTHFT) scores to assess convergent validity. Interrater reliability was good (0.84, SD = 0.02). The correlation with the JTHFT was high (τb = −0.74; p < 0.001). The results show the potential of using an observation-based scoring grid with unstandardized ADLs to assess bimanual performance in adults living with CP, but further research on psychometric properties is needed. This method allows for an assessment that is occupation-oriented, ecological, and meaningful. An observation-based scoring grid (Assisting Hand Assessment) can be applied in unstandardized activities of daily living to assess bimanual performance in adults with cerebral palsy. This method allows an occupation-oriented, ecological, and client-meaningful assessment. Although this approach is a pilot measure, it can be used by clinicians and researchers until further psychometric analyses are undertaken. [ABSTRACT FROM AUTHOR]

Many people living with neurological disorders, such as cerebral palsy, stroke, muscular dystrophy or dystonia, experience upper limb impairments (muscle spasticity, loss of selective motor control, muscle weakness or tremors) and are unable to eat independently. This article presents the development of a new device to assist with eating, aimed at stabilizing the movement of people who have movement disorders. The design was guided by insights gathered through focus groups, with occupational therapists and engineers, about the challenges faced by individuals who have movement disorders and difficulty in eating autonomously. The proposed assistive device prototype is designed to be fixed on a table and to support a spoon. The mechanism is designed so that the spoon maintains a position parallel to the ground for the user. Dampers and inertia allow stabilizing the user's motion. A preliminary trial with five individuals living with cerebral palsy is presented to assess the prototype's performance and to guide future iterations of the prototype. Task completion time generally decreased and movement fluidity generally improved when using the assistive device prototype. The prototype showed good potential in stabilizing the spoon for the user and improving movement fluidity. [ABSTRACT FROM AUTHOR]

AbstractPurposeMaterials and methodsResultsConclusion\nIMPLICATIONS FOR REHABILITATIONTo investigate the psychometric properties of the MOSE-Benin, a French-language version of the Measure of Stroke Environment (MOSE) for Sub-Saharan Africa.The original English version of the MOSE has been translated into French following the guidelines for cross-cultural adaptation. The resulting questionnaire (MOSE-Benin) was administered to a convenience sample of participants recruited in Benin, a French-speaking country.Eighty-two stroke survivors (41 females; mean ± SD: 54.94 ± 11.6 years old) participated in the study. Internal consistency of each domain of the MOSE-Benin and the overall questionnaire was high (Cronbach’s α: 0.78 to 0.92). Test-retest reliability was excellent (n = 31; ICC: 0.977 to 0.998). Overall, the standard error of measurement (SEM) and the minimum detectable change (MDC) showed very low values (SEM = 0.85; MDC = 2.35). Convergent validity demonstrated moderate correlations for the three domains in separate comparison respectively with the ACTIVLIM-Stroke questionnaire, the Participation Measurement Scale, and the communication domain of the Stroke Impact Scale (r or ρ: 0.42 to 0.54; p < 0.0001).MOSE-Benin has good evidence regarding psychometric properties (i.e., content validity, convergent validity, internal consistency, and test-retest reliability) that can support its use for the assessment of perceived environmental barriers after stroke in a French-speaking Sub-Saharan African country, such as Benin.Stroke survivors in French-speaking Sub-Saharan Africa may face environmental challenges related to acceptability, physical environment, and communication.Stroke survivors should be assessed in their communities to identify environmental barriers, using valid and robust tools.A French version of the MOSE (MOSE-Benin) is now available and can be used to assess the environmental concerns faced by stroke survivors in Sub-Saharan Africa.Stroke survivors in French-speaking Sub-Saharan Africa may face environmental challenges related to acceptability, physical environment, and communication.Stroke survivors should be assessed in their communities to identify environmental barriers, using valid and robust tools.A French version of the MOSE (MOSE-Benin) is now available and can be used to assess the environmental concerns faced by stroke survivors in Sub-Saharan Africa. [ABSTRACT FROM AUTHOR]

Objective: To conduct a systematic review using validated critical appraisal scales to analyze both the quality and content of the psychometric evidence of spasticity measurement tools in cerebral palsy children and adolescents., Data Sources: The literature search was performed in 3 databases (Pubmed, CINAHL, Embase) up to March 2012., Study Selection: To be retained for detailed review, studies had to report on at least one psychometric property of one or many spasticity assessment tool(s) used to evaluate cerebral palsy children and adolescents., Data Extraction: Two raters independently reviewed admissible articles using a critical appraisal scale and a structured data extraction form., Data Synthesis: A total of 19 studies examining 17 spasticity assessment tools in cerebral palsy children and adolescents were reviewed. None of the reviewed tools demonstrated satisfactory results for all psychometric properties evaluated, and a major lack of evidence concerning responsiveness was emphasized. However, neurophysiological tools demonstrated the most promising results in terms of reliability and discriminating validity., Conclusions: This systematic review revealed insufficient psychometric evidence for a single spasticity assessment tool to be recommended over the others in pediatric and adolescent populations.