Browsing by Author "Zewdie, Ephrem"

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    Bilateral actigraphic quantification of upper extremity movement in hemiparetic children with perinatal stroke: a case control study
    (2021-12-16) Hollis, Asha; Cole, Lauran; Zewdie, Ephrem; Metzler, Megan J.; Kirton, Adam
    Abstract Background Hemiparetic cerebral palsy impacts millions of people worldwide. Assessment of bilateral motor function in real life remains a major challenge. We evaluated quantification of upper extremity movement in hemiparetic children using bilateral actigraphy. We hypothesized that movement asymmetry correlates with standard motor outcome measures. Methods Hemiparetic and control participants wore bilateral wrist Actiwatch2 (Philips) for 48 h with movement counts recorded in 15-s intervals. The primary outcome was a novel statistic of movement asymmetry, the Actigraphic Movement Asymmetry Index (AMAI). Relationships between AMAI and standard motor outcomes (Assisting Hand Assessment, Melbourne Assessment, and Box and Block Test [BB]) were explored with Pearson or Spearman correlation. Results 30 stroke (mean 11 years 2 months (3 years 10 months); 13 female, 17 male) and 23 control (mean 11 years 1 month (4 years 5 months); 8 female, 15 male) were enrolled. Stroke participants demonstrated higher asymmetry. Correlations between AMAI and standard tests were moderate and strongest during sleep (BB: r = 0.68, p < 0.01). Conclusions Standard tests may not reflect the extent of movement asymmetry during daily life in hemiparetic children. Bilateral actigraphy may be a valuable complementary tool for measuring arm movement, potentially enabling improved evaluation of therapies with a focus on child participation.
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    Unleashing Potential: Harnessing Brain-Computer Interfaces to Empower Children with Severe Physical Disabilities
    (2023-06) Kelly, Dion Marie; Kirton, Adam; Zewdie, Ephrem; Debert, Chantel; Esser, Michael
    Independence, inclusion, and full participation are fundamental human rights. Yet, children with significant physical disabilities like quadriplegic cerebral palsy (QCP) encounter numerous barriers to these rights. Despite their cognitive abilities, these children may struggle to communicate, interact with their environment, and participate in activities that other children take for granted. Brain-computer interfaces (BCIs) offer a potential solution. However, pediatric-focused research in BCI literature is strikingly scarce, underscoring the need for targeted research to optimize this technology for children with severe disabilities. This thesis delves into BCIs tailored for children, specifically those with severe neurological disabilities. We first explored the ability of typically developing children to control BCIs using five different mental control paradigms, refuting earlier assumptions about children's BCI capabilities, and demonstrating that they can competently control BCIs with accuracy similar to adults while highlighting the differential effects of age. We then examined the impact of gamified calibration on BCI performance, discovering that gamification doesn't benefit all children equally, highlighting the need for personalized approaches. Subsequently, we evaluated a novel Home BCI Program for children with QCP and their families, showcasing its feasibility and benefits such as enhanced convenience and social interaction, while highlighting diverse family needs. Our fourth study applied user-centered design principles to illustrate BCIs as an empowering tool for children to achieve home-based personalized goals. Lastly, we probed the feasibility of BCI-facilitated online gaming and its potential psychosocial impacts. We provided evidence that BCIs can enhance the quality of life for children with disabilities by enabling participation in simple, yet meaningful activities from which they are typically excluded. Our research deepens the understanding of pediatric BCIs and underscores their transformative potential for improving the lives of children with disabilities and their families. Moving forward, refining BCI technologies for children and emphasizing collaboration with pediatric end-users and their families is vital.