Karaoke for quads: a new application of an old recreation with potential therapeutic benefits for people with disabilities.

PURPOSE: Karaoke is a recreational activity whereby individuals sing into a microphone along with the melodies and lyrics provided both visually and auditorily by a machine. METHODS: The potential therapeutic benefits of karaoke are explored in terms of increased respiratory strength, endurance, control, and capacity, as well as emotional and physical release for people with disabilities. RESULTS: Although many individuals with disabilities could benefit from this activity, it is likely to be particularly beneficial to people with compromised respiratory systems, such as persons with high-level quadriplegia (tetraplegia). CONCLUSION: This article examines theoretical considerations and proposes a research agenda. Empirical research would be valuable to confirm the potential benefits of karaoke for people with disabilities.

Changing chairs: anticipating problems in prescribing wheelchairs.

PURPOSE: This article presents a framework for prescribing, ordering, and adapting a new wheelchair, focusing on individual, environmental and wheelchair factors that must be taken into consideration to ensure optimal function. METHOD: A review and analysis was conducted of all factors relevant to the transition to a new wheelchair. Without appropriate planning and implementation, this transition can result in unnecessary expenses, duplication of effort, and possibly even injury to the user and abandonment of the wheelchair. RESULTS: Recommendations are provided to manufacturers, therapists, technicians, users, insurers and physicians, who must work together throughout this process. To the extent feasible, the authors suggest that major changes from the previous wheelchair should be avoided, particularly for people with substantial functional limitations. Therapists and technicians must measure the user accurately, and anticipate those factors that can impede a smooth transition. Insurers and other payors must recognize that changing wheelchairs will often require substantial professional assistance, including several fittings to adjust the new chair to the needs of the user. CONCLUSION: Additional research and case reporting on outcomes of adjusting to a new wheelchair appear warranted.

A do-it-yourself membrane-activated auditory feedback device for weight bearing and gait training: a case report.

An augmented auditory feedback device comprised of a thin membrane switch mini-buzzer, and battery is described as a modification of a previously described feedback device. The membrane switch can be customized for the patient and is designed to fit inside a patient's shoe without altering the heel height. Its appeal lies in its simplicity of construction, low cost, and ease of implementation during a patient's training for weight bearing and gait. An ever-present source of information, it provides performance-relevant cues to both patient and clinician about the occurrence, duration, and location of a force component of motor performance. The report includes suggested applications of the device, instructions to construct it, and a case report in which the device was used to improve weight bearing and gait in a cognitively healthy person with spina bifida.

The validity and reliability of the GAITRite system's measurements: A preliminary evaluation.

OBJECTIVE: To compare the concurrent validity and reliability of the GAITRite computerized gait analysis system with validated paper-and-pencil and video-based methods. DESIGN: Within-groups, repeated-measures design. SETTING: Research laboratory in a physical therapy education program. PARTICIPANT: One healthy woman, age 27 years. INTERVENTIONS: A subject walked across the walkway of the GAITRite system at various walking rates and degrees of step symmetry for 2 of the 3 analyses. Paper placed over the walkway enabled concurrent paper-and-pencil analysis. The subject was concurrently videotaped from the side. For the other analysis, a stride simulator with known step and stride lengths was applied to the walkway to simulate 2 steps and 1 stride. MAIN OUTCOME MEASURES: Cadence, walking speed, right and left step and stride lengths, and right and left step times. RESULTS: Excellent paper-and-pencil and GAITRite correlations (intraclass correlation coefficient [ICC] > 95) for spatial measures and excellent video-based and GAITRite correlations (ICC > 93) for temporal measures were found. GAITRite measures of step lengths and times were reliable in both walkway center and left-of-center measurements. CONCLUSIONS: Based on this data, GAITRite is a valid and reliable tool for measuring selected spatial and temporal parameters of gait.

The effects of circumferential wrist pressure on reproduction accuracy of wrist placement in healthy young and elderly adults.

BACKGROUND: The purpose of this study was to determine the effect of circumferential wrist pressure on reproduction accuracy of wrist placement in healthy young and elderly adults. A convenience sample of 20 young adults having a mean age of 22.9 years and 20 elderly adults with a mean age of 68.2 years participated in the study. METHOD: Blindfolded subjects were asked to actively self-select a neutral wrist position (reference) and then, when signaled, to actively reproduce the previously selected position. Wrist joint reproduction accuracy was assessed under four pressure conditions: no contact, wrist contact, 10 mm Hg, and 20 mm Hg. A single axis dynamic wrist electrogoniometer measured three dependent variables: absolute, constant, and variable errors. Data were analyzed by means of multivariate analysis of variance (MANOVA) for repeated measures. RESULTS: No significant differences in reproduction accuracy under the four pressure conditions for young or elderly adults were found. CONCLUSIONS: Healthy young and elderly adults may utilize existing intrinsic feedback and central control mechanisms to achieve accuracy during a reproduction task. Some subjects in both age groups who entered into the study with high error scores benefited from circumferential pressure by possibly relying on peripheral mechanisms. Further studies are needed to determine the effect of circumferential pressure on subjects with poor reproduction performance.

An augmented auditory feedback device.

An augmented auditory feedback device is described. The device can be easily and economically constructed and implemented during a patient's physical rehabilitation. The rationale is to provide an external source of information to the user in order to correct errors during weight-bearing activities. Possible applications of the augmented auditory feedback device include increasing symmetry and weight distribution during sitting, standing, and gait. Instructions regarding its construction are provided, and a case study using the device is presented. Improved midline alignment and weight distribution in sitting for a 2-hour duration was achieved by a stroke patient using the augmented auditory feedback device in conjunction with physical therapy.