Evaluation of a novel client-centred therapeutic device for improving functional hand skills in children with cerebral palsy

Abstract

Aim: This study sought to investigate how Digiclap contributes to the functional hand skills required for the engagement of children with cerebral palsy (CP) in their daily life occupations. Digiclap is an innovative smart device that uses augmented reality (AR) to support habilitation of children with CP. It was produced through Project ‘SMARTCLAP’ within the University of Malta. Research Design and Method: A Mixed Methods Case Study design was employed, involving six children aged 6 to 12 years diagnosed with CP, their caregivers, and three senior paediatric occupational therapists. The children participated in a maximum of eight sessions using Digiclap, with caregivers attending each session alongside them. Following the sessions, caregivers completed a perspective questionnaire and participated in a one-on-one semi-structured interview. Some of the children filled a child’s feedback form. Occupational therapists attended a block of sessions and took part in a focus group. Data collected included the children’s game scores, caregivers’ and occupational therapists’ perspectives, and additional feedback from the children themselves. Results: Digiclap was perceived by the participants as a beneficial, therapeutic, and innovative device. It served as a source of encouragement for children in carrying out upper limb related games and also as a motivator in therapy sessions. The limitations related to using Digiclap centred around the limited sensory feedback it provided to the users, the restricted number of games, and issues with connectivity and the wearable parts such as the finger rings. Digiclap can be used as an adjunct to occupational therapy sessions; however, feedback from stakeholders indicates that its effective use requires the guidance of an occupational therapist. The use of AR in Digiclap was perceived to have mixed benefits by the occupational therapists and the caregivers alike. Conclusion: The findings in this study indicate that a smart device like Digiclap can positively impact the children with CP, with the potential to enhance traditional occupational therapy sessions. Increasing the range of available games as well as more multisensory feedback (visual, audio, and rewards) in the game playing is desirable for better participation of the children when using the device. Digiclap can be further personalised to meet the specific needs of children within an occupational therapy programme. Technical issues with the device limited the collection of participant performance data and hindered the ability to demonstrate changes in function. Future research is crucial to ensure that this promising and potentially revolutionary device continues to evolve and improve the lives of many individuals.