title: Application of a novel integrated pointing device apparatus for children with cerebral palsy.
abstract: BACKGROUND
  To improve the computer operation of children suffering from cerebral palsy (CP) with severe disabilities, more flexible pointing devices are required. This study investigates the effectiveness of a newly developed Integrated Pointing Device Apparatus (IPDA) that can integrate numerous commercial pointing devices.
  
  
  METHODS
  We enrolled 27 children with quadriplegic CP and 15 healthy children. All children were required to perform three specific mouse operation tasks. Children with CP were classified into two groups based on hand operation: one hand (group A) and both hands (group B). The efficiency of children with CP in each mouse operation task was expressed as a percentage of that for normal children (% NL).
  
  
  RESULTS
  Group A operated a standard mouse with their dominant hand; group B had to use both hands to operate a mouse via IPDA. Group A demonstrated better efficiency of continuous-clicking tasks than group B (p < 0.05). Group B had a similar level of efficiency in the target-acquisition task (30% NL) and drag-and-drop task (20% NL) as that of group A, although group B could not operate a standard mouse with one hand. All children in group A were spastic quadriplegia, while 30% of children in group B were spastic-athetoid (p < 0.05). All children in group B were at level 3 of the gross motor functional classification system (GMFCS) but only 57% of children in group A were at level 3 (p < 0.05).
  
  
  CONCLUSIONS
  The IPDA can help some children with CP, who cannot utilize a commercial mouse alone, to achieve acceptable operational efficiency. The operation methods for children with CP were determined by their underlying motor control.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Chang Gung Memorial and Children Hospital, Taipei, ROC.
authors.forename: Chia-Ling
authors.initials: CL
authors.lastname: Chen
authors.forename: Ching-Yi
authors.initials: CY
authors.lastname: Wu
authors.forename: Hsieh-Ching
authors.initials: HC
authors.lastname: Chen
authors.forename: Wei-Hsien
authors.initials: WH
authors.lastname: Hong
authors.forename: Wen-Yu
authors.initials: WY
authors.lastname: Liu
authors.forename: Alice May-Kuen
authors.initials: AM
authors.lastname: Wong
authors.forename: Chia-Ying
authors.initials: CY
authors.lastname: Chung
authors.forename: Hung Chih
authors.initials: HC
authors.lastname: Hsu
mesh_terms: D002547:Cerebral Palsy / Q000523:psychology*; D002648:Child; D002675:Child, Preschool; D003201:Computers; D005260:Female; D006801:Humans; D008297:Male; D009048:Motor Skills