This paper presents the preliminary results of a novel rehabilitation therapy for cervical and trunk control of children with cerebral palsy (CP) based on serious videogames and physical exercise. The therapy is based on the use of the ENLAZA Interface, a head mouse based on inertial technology that will be used to control a set of serious videogames with movements of the head. Ten users with CP participated in the study. Whereas the control group (n = 5) followed traditional therapies, the experimental group (n = 5) complemented these therapies with a series of ten sessions of gaming with ENLAZA to exercise cervical flexion–extensions, rotations and inclinations in a controlled, engaging environment. The ten work sessions yielded improvements in head and trunk control that were higher in the experimental group for Visual Analogue Scale, Goal Attainment Scaling and Trunk Control Measurement Scale (TCMS). Significant differences (27% vs. 2% of percentage improvement) were found between the experimental and control groups for TCMS (p < 0.05). The kinematic assessment shows that there were some improvements in the active and the passive range of motion. However, no significant differences were found pre- and post-intervention. Physical therapy that combines serious games with traditional rehabilitation could allow children with CP to achieve larger function improvements in the trunk and cervical regions. However, given the limited scope of this trial (n = 10) additional studies are needed to corroborate this hypothesis.

This paper presents an experiment to validate a head-mounted inertial interface for human-computer interaction (HCI) developed for people with cerebral palsy (CP). The method is based on Fitts’s law, an empirical model of human motor performance for aimed movements. Head motion is recorded in a series of goal-crossing tasks and a regression model of the movement time (MT) is estimated for each user. Values of R2 above 0.9 are indicators of a strong correlation of those motion patterns with the linear model proposed by Fitts. The analysis of MT confirmed that head movements of users without disability follow Fitts’s law and showed that 3 users with CP (MACS IV and V) had the same behavior. There was a weaker correlation (R2=0.839) for one individual with cervical dystonia and ballistic movements and no correlation for two users with cervical hypotonia and dyskinetic CP. Results show the impact of ballistic movements and poor postural control in computer interaction. They also provide the foundation for new interaction techniques to develop a universal computer interface for motor impaired users.Authors would like to thank the members and staff in ASPACE Cantabria, specially Teresa González and Antonio Ruiz. This work was possible thank to ABC EU Project (FP7-ICT-2011-7-287774), InterAAC Project (RTC-2015-4327-1), CP-Walker Project (DPI2012-39133-C03-01), INTERPLAY Project (RTC-2014-1812-1), and IVANPACE Project, which was funded by Fundación Caja Cantabria. A. Clemotte would also like to thank to Itaipu Binacional for its support.Peer reviewe

This paper analyzes the presence of positive and negative motor signs in people with cerebral palsy (CP). Positive motor signs are those that lead to involuntarily increased frequency or magnitude of muscle activity. Negative motor signs describe insufficient muscle activity or insufficient control of muscle activity. In this paper, a head-mounted alternative computer interface based on inertial technology was used to assess motor signs in seven users with CP. Task performance and control of posture was related to the impairment. There are no significant differences between users with CP and healthy control participants in the frequency domain of the head movement. Results suggest that this kind of motor disorders is not related to positive motor signs. Moreover, a control mode based on posture more than on movements is not optimum; an alternative control mode must be specially designed for users with poor postural control.

This article evaluates the performance of individuals with cerebral palsy (CP) using an inertial human–computer interface (HCI) based on head movements and a novel facilitation algorithm which we named MouseField. In total, 17 participants from three centers specialized in CP participated in a series of tests that evaluated rapidity and accuracy in pointing tasks using a head mouse named ENLAZA, with and without MouseField. Cluster analysis was used to classify the participants into three categories, C₁–C₃ ordered by throughput. MouseField improved rapidity in C₂ and C₃ and accuracy in C₃. Although the accuracy of the least impaired (C₁, MACS IV–V) decreased, MouseField improved task performance of users with severe motor disorders (MACS V), with decrements of 33.3 and 65.5% in the task execution time. The results show that severely impaired individuals who cannot use traditional input devices could benefit from using MouseField and ENLAZA for a facilitated navigation that minimizes targeting errors.