Congratulations to Charlotte Caskey for passing her General Exam!
Charlotte’s proposed work titled Effects of Spinal Stimulation on Neuromechanics in Cerebral Palsy was approved by her Ph.D. committee. Woot! Go Charlotte!
M Yamagami, K Mack, JC Mankoff, KM Steele (2022) “’I’m Just Overwhelmed’: Investigating Physical Therapy Accessibility and Technology Interventions for People with Disabilities and/or Chronic Conditions”
Journal Article in ACM Transactions on Accessible Computing
Many individuals with disabilities and/or chronic conditions (da/cc) experience symptoms that may require intermittent or on-going medical care. However, healthcare is an often-overlooked domain for accessibility work, where access needs associated with temporary and long-term disability must be addressed to increase the utility of physical and digital interactions with healthcare workers and spaces.
Aim: Our work focuses on a specific domain of healthcare often used by individuals with da/cc: physical therapy (PT).
Methods: Through a 12-person interview study, we examined how people’s access to PT for their da/cc is hampered by social (e.g., physically visiting a PT clinic) and physiological (e.g., chronic pain) barriers, and how technology could improve PT access.
Results: In-person PT is often inaccessible to our participants due to lack of transportation and insufficient insurance coverage. As such, many of our participants relied on at-home PT to manage their da/cc symptoms and work towards PT goals. Participants felt that PT barriers, such as having particularly bad symptoms or feeling short on time, could be addressed with well-designed technology that flexibly adapts to the person’s dynamically changing needs while supporting their PT goals.
Interpretation: We introduce core design principles (adaptability, movement tracking, community building) and tensions (insurance) to consider when developing technology to support PT access. Rethinking da/cc access to PT from a lens that includes social and physiological barriers presents opportunities to integrate accessibility and adaptability into PT technology.
Congratulations to Nicole Zaino on being named a Gatzert Child Welfare Fellow
Nicole was selected from a extremely competitive application pool to become a 2022 Gatzert Child Welfare Fellow. This fellowship will support Nicole in her research and as she writes her dissertation contributing to the lives of children with disabilities. Way to go Nicole! ConGATZERTulation!
Alyssa Spomer featured on Department of Mechanical Engineering website!
The Ability & Innovation Lab’s own Alyssa Spomer was featured in an article, Supporting mobility in cerebral palsy, via the Department of Mechanical Engineering. This article highlighted her work on how a robotic exoskeleton device paired with real-time feedback can enhance rehabilitation therapy for children with cerebral palsy. Way to go Alyssa!
BC Conner, AM Spomer, SSPA Bishe, KM Steele, ZF Lerner (2022) “Soleus H-reflex modulation in cerebral palsy and its relationship with neural control complexity: a pilot study”
Journal Article in Experimental Brain Research
Individuals with cerebral palsy (CP) display motor control patterns that suggest decreased supraspinal input, but it remains unknown if they are able to modulate lower-limb reflexes in response to more complex tasks, or whether global motor control patterns relate to reflex modulation capacity in this population.
Aim: To further elucidate the multifaceted effects of CP on inhibitory and faciliatory supraspinal pathways and global measures of motor control, providing novel information for improving targeted neuromuscular interventions in this patient population.
Methods: Eight ambulatory individuals with CP (12–18 years old) were recruited to complete a task complexity protocol, where soleus H-reflex excitability was compared between bilateral (baseline) and unilateral (complex) standing. We also investigated the relationship between each participant’s ability to modulate soleus H-reflex excitability and the complexity of their walking neural control pattern determined from muscle synergy analysis. Finally, six of the eight participants completed an exoskeleton walking protocol, where soleus H-reflexes were collected during the stance phase of walking with and without stance-phase plantar flexor resistance.
Results: Participants displayed a significant reduction in soleus H-reflex excitability (− 26 ± 25%, p = 0.04) with unilateral standing, and a strong positive relationship was observed between more refined neural control during walking and an increased ability to modulate reflex excitability (R = 0.79, p = 0.04). There was no difference in neuromuscular outcome measures with and without the ankle exoskeleton (p values all > 0.05), with variable reflex responses to walking with ankle exoskeleton resistance.
Interpretation: These findings provide evidence that ambulatory individuals with CP retain some capacity to modulate lower-limb reflexes in response to increased task complexity, and that less refined neural control during walking appears to be related to deficits in reflex modulation.