technology lecture exam

importance of assistive tech

empowers independence and participation

facilitates occupational engagement

enhances QOL for individuals with disabilities

categories of AT

low tech- inexpensive, simple to use

medium tech- may have batteries involved, loud speakers on phone, timer

high tech- software, more difficult to use, VR

setting of therapeutic technology

primarily clinical environments

occupation-enabling technology (OET)

supports daily life occupations

purpose of therapeutic technology

to remediate deficits or improve skills

setting of OET

home, school, and community environments

sources of funding for AT

grants, insurance, nonprofits, vocational rehab programs

assistive technology act (1998)

ensures individuals with disabilities have access to AT

provides state funding for AT services and programs

supports device loan libraries, demonstrations, and training

individuals with disabilities education act

guarantees children with disabilities a free and appropriate public education

AT must be provided if necessary for Childs education

IEPs much include AT needs

Americans with disabilities act

prohibits discrimination against individuals with disabilities

section 504 of the rehabilitation act

prevents discrimination in federally funded programs

requires accommodations, including AT, for individuals with disabilities

TBI deficits

muscles weakness, ataxia, postural deficits, limitation in joints, sensation, memory, imitation/termination, attention/concentration

primary prevention

focuses on health individuals to decrease vulnerability or susceptibility to diseases

secondary prevetnion

focuses on persons at risk or in early stage of disease with goal of arresting the disease progression

tertiary prevention

focuses on persons with disease or disability and attempts to prevent further complications

AT for primary prevention

Apple Watch, heart rate monitor

AT for secondary prevention

medication management, AT to get them back to where they were

AT for tertiary prevention

walker, wheelchair, prosthetics,

transtheroaretical model

pre contemplation, contemplation, preparation, action, maintenance, termination

precontemplation

im perfect and don’t need to change

contemplation

maybe ill make a change within 6 months

preparation

ok! im ready to do it within 30 days

action

im doing it

maintenance

im still doing it > 6 months

termination

I did it and im good now

precede-proceed model

assessment phase and implementation evaluation phase

assessment phase

looks at everything in the individuals. what they need and why they need it.

evaluation phase

implementation, process evaluation, impact evaluation, outcome evaluation.

environment-health-occupation-wellness model (EHOW)

environment, health, occupation, wellness. focuses on wellness as an outcome rather than performance

COAST goal writing

client, occupation, assist level, specific condition, timeline

•A client with a left middle cerebral artery (MCA) stroke presents with right hemiparesis, aphasia, and difficulty performing activities of daily living (ADLs). Which assistive technology device would be most appropriate to support their independence in feeding?

•A. Weighted utensils
B. Universal cuff
C. Adaptive rocker knife
D. One-handed cutting board

B. compensates for trouble with grip

•A client with a right-sided CVA demonstrates left-sided neglect and difficulty using a wheelchair effectively due to reduced awareness of their left side. Which assistive technology strategy would best improve their safety and mobility?

•

A. Install a left armrest tray to support the affected arm.
B. Place bright, contrasting tape on the left side of the wheelchair.
C. Provide a joystick-controlled power wheelchair.
D. Train the client to rely solely on their right arm for propulsion

B. highlighting neglected side brings more awareness to that side

•A client with a recent CVA experiences difficulty typing on a standard keyboard due to impaired fine motor control in their dominant hand. They need to return to work as an administrative assistant. Which assistive technology solution would be the most effective?

•A. Splinting the affected hand during typing.
B. Providing a voice-to-text software program.
C. Recommending a one-handed keyboard.
D. Training on the use of a standard keyboard with larger keys.

B. they NEED to return to work, they do not have time to train on the standard keyboard with larger keys.

inclusion

the action or state of including or of being included within a group or structure

barriers to inclusion

socioeconomic challenges, lack of awareness, cultural stigmas, inadequate infrastructure

sociocultural challenges

poverty and limited resources, unemployment or underemployment, digital divide

lack of awareness

ignorance of needs, stereotyping, limited advocacy

cultural stigmas

discrimination, social isolation, reinforced inequalities

inadequate infrastructure

physical barriers, service gaps, geographic isolation

components to mobility

activity component, human component, context component

activity component

ICF classifications

• personal mobility

• mobility as an activity

• locations

• transportation

human component

how individuals are using mobility devices and how it is increasing and why

increase in individuals using mobility systems

disorders resulting in mobility impairments

mobility issues across the lifespan

mobility and obesity

context component

physical, social, cultural, institutional context

where they use the AT, attitudes of using AT, values and beliefs of AT, and funding

standard w/c

seat width 18”

seat height 18”

stea dept 16”

folds, locks, pedals remove, removable arm rest

c1-c4 AT

power w/c

head control

mouth stick

sip and puff

chin control

C5 SCI w/c

power w/c or manual

power chair with hand controls

manual chair for short distances

C6 SCI w/c

manual

w/c pegs, gloves, power assist

may still use power chair over some surfaces

C7-T1 w/c

independent with manual

lightweight

w/c pegs, gloves

level surface slide board transfers

T2-T12 w/c

independent with w/c propulsion

curbs, uneven surfaces, terrain

use of lightweight w/c

L1-L5 w/c

may still use w/c for community/long distance

can ambulate with leg braces and walking devices

S1-S5 w/c

increased ability to walk with fewer or no bracing or assistive devices

C1-C3 AT equipment

sip and puff/ voice controlled devices

C3-C4 AT equipment

head control

C5 AT equipment

joystick control and U-cuff

C6 AT equipment

built up handles

C7-T1 AT equipment

manual w/c and hand controls

T2-T12 AT equipment

standing frames

L1-S5

lower limb orthoses/ crutches

therapeutic arm supports

devices to support, protect, or enhance arm function for individuals with weak upper extremities

static arm supports

for positioning, pain relief, ROM maintenance

to prevent subluxation, use in bed or wheelchair

• pillows, lap trays, over bed tables

dynamic arm supports

to enable movement, strengthen muscles, engage in occupations

reduce friction and assist motion

• JAECO sling, MAS, robots

categories of dynamic arm supports

non actuated: provide no external power

passively actuated: assist the UE with rubber bands, springs, or weights

actively actuated: uses electrical power such as robotic arms

benefits for robotic assisted therapy

high-intensity, repetitive motion with feedback

combines with neuromuscular electrical stimulation

primary population for RAT

stroke survivors

symptoms of ALS

muscle weakness and atrophy

difficulty speaking or swallowing

loss of voluntary motor control

progressive paralysis

respiratory difficulties

stage 1 ALS

mild weakness and clumsiness

stage 2 ALS

moderate weakness, slight decreased independence (stairs, fine motor, raining arms)

stage 3 ALS

increased weakness (ankles, wrists, hand) easily fatigues with long dis amb., increased respiratory effort

stage 4 ALS

hanging arm syndrome, w/c dependent, severe LE weakness

Stage 5 ALS

severe LE weakness, mod-severe UE weakness, w/c dependent, increasingly dependent in ADLs, at risk for skin breakdown

stage 6 ALS

dependent with all positioning

dependent with ADLs

extreme fatigue

stage 1 ALS OT services

focus: minimal support for independent ADL

possibly no need for AT

ROM, strengthening, energy conservation

Stage 2 ALS OT services

focus: maintaining independence and Saftey

dressing aids (button hook, zipper pull)

mobility support (canes, walkers, ankle-foot orthoses

adaptive bathroom equip. (grab bars, shower chair, raised ts seat)

stage 3 ALS OT services

focus: enhance mobility, communication, caregiver support

mobility aids (lightweight manual w/c, power scooters)

transfer aids (transfer board, transfer bench)

computer access (voice to text software, adaptive keyboards

environmental controls (voice activated smart home devices

stage 4 ALS OT services

focus: maximizing mobility, communication, caregiver support

powered mobility (customized electric w/c with joystick, head, chin control)

communication (evaluate needs for speech-generating devices)

advanced seating (pressure relieving cushions/customized positioning supports

stage 5 ALS OT services

focus: communication, environmental access, comfort, and safety

communication (eye gaze communication, advanced SGD)

environmental control units (eye or minimal movement activated devices for home control

mobility aids (mechanical lift if needed)

ventilation support (non invasive )

adaptive bedding (pressure relief mattress, adjustable beds)

stage 6 ALS OT services

focus: comfort, dignity, minimal communication, caregiver support

comfort care equipment (fully adjustable hospital beds, pressure relief systems

minimal movement communication (eye-blink or gaze based yes/no response system

full environmental automation (fully integrated eye controlled environmental system)

respiratory equipment (invasive vents)

huntingtons symptoms

involuntary jerking movement

muscle rigidity and dystonia

impaired gait and balance

cognitive decline

emotional and behavioral changes

stage 1 Huntingtons

preclinical stage (no obvious symptoms)

stage 2 Huntington

early stage

mild- difficulty walking and with daily activities

cognitive decline

behavioral changes

stage 3 Huntington

middle stage

motor- difficulty walking and with daily activities

significant cog decline

psychiatric symptoms (anxiety, depression, psychosis)

stage 4 Huntingtons

late stage

severe motor impairment (bed bound)

profound cog decline (loss of communication)

adv. psychiatric symptoms

sage 5 Huntington

end stage

complete loss of motor and cog abilities

requires total care and support

reduced life expectancy

Alzeimers’s Symptoms

memory loss affecting daily activities

difficulty performing family tasks

disorientation to time/place

impaired judgment and decision making

changes in personality and mood

stage 1 Alzehimer’s

preclinical

stage 2 Alzehimer’s

MCI

stage 3 Alzheimers

mild dementia

stage 4 Alzheimers

moderate dementia

stage 5 Alzheimers

severe decline and moderate to severe physical decline

Alzheimers disease and AT

memory and cognition

Saftey and security

environmental control

social engagement and stimulation

daily living aids

MS symptoms

fatigue, numbness/weakness in one or more limbs, partial or complete loss of vision, double vision/blurring vision, tingling or pain in parts of the body, shock sensations that occur with certain neck movements, tremor, lack of coordination, slurred speech, dizziness, problems with bowel and bladder function

stage 1 Parkinsons

unilateral tremor, micrographic, poor endurance for previous occupations, fatigue

stage 2 parkinson’s

bilateral motor disturbances, mild rigidity reported, difficulties with simultaneous tasks, difficulties with executive function

stage 3 parkinson’s

balance problems with delayed reactions, difficulties with skilled sequential taks

stage 4 parkinson’s

fine motor control severely impaired, oral motor deficits

stage 5 parkinson’s

client severely compromised in regard to motor skills, dependent with ADLs