1 Tamara Vos-Draper, OT, ATPPower Mounts: Create Powerful Solutions for Your Clients Dianne Goodwin, MEBME Nicholas Lee, BSME BlueSky Designs, Inc. Minneapolis, MN, USA Tamara Vos-Draper, OT, ATP Moriah Kane, OT Mayo Clinic Rochester, MN, USA RESNA Workshop July 14, 2016 Charting the C's

2 Presenters BlueSky Designs Mayo Clinic Dianne Goodwin, MEBME, UVAFounder, BlueSky Designs Rehab Engineer (Gillette, Tamarack, BlueSky Designs) Products: Mount’n Mover, Pow!r Mount, Freedom Tent, Garden Rocker AbleNet: Specs switch, All-Turn-It spinner, TV/VCR remote Nick Lee, BSME, University of Minnesota Mechanical Design Engineer Products developed: Mount’n Mover and Pow!r Mount Mayo Clinic Tamara Vos-Draper, OTR, ATP Clinical Lead in Assistive Technology Center for AT Research Moriah Kane, OTR Occupational Therapist, Physical Medicine and Rehab AT Specialist Power Mount Workshop RESNA 2016

3 Workshop Agenda Intro to Power Mounts Case study and medical necessityNeed for access and repositioning Features, functions and configurations Case study and medical necessity Power mount control and access Hands-on activities Discussion Power Mount Workshop RESNA 2016

4 Learning Objectives 1. Describe 4 Power Mount configurations 2. Identify 3 end uses for a power mount which are medically justified 3. Hands-on control of powered mounts by three access methods Power Mount Workshop RESNA 2016

5 Need: Independent access and positioningPeople with significant disabilities (no UE) reliant on others Independent access electronic devices, speech, water, controls, etc Move/position things independently move it where they need it, when they want it easily, safely and efficiently Across environments—bed, w/c, table Power Mount Workshop RESNA 2016

6 Review: Existing mounting and positioning technologyStatic mounts Folding or swingaway Movable with custom locks Wheelchair-mounted Robotic Arms Focus on reaching and grasping Load capacity <3.5 pounds Power Mount Workshop RESNA 2016

7 Wheelchair-mounted Robotic ArmJACO Holds 1 kg (2.2 pounds ) Reach 70 cm (27.5 in) Speed: 20 cm/s (8 in/s) Weight: 5 Kg (6 pounds) $38-50,000 Power Mount Workshop RESNA 2016

8 Power Mount: powerful positioning -supports and moves up to 15 poundsJoint is a building block Single joint—DIY Hybrid mounts—add a Power joint to a mount Multi-joint power systems Single Arm, Dual Arm With Tilt or Lift Accessible controls End Cap keypad, switches, App Power Mount Workshop RESNA 2016

9 End cap and App Single joints/Hybrids Multi-joint systemsBuilt-in keypad (no app req’d) Plug in your switch Switch 1: Toggles direction Switch 2: Goes to Target position Two switches: Directional Multi-joint systems App control Touch or switches Timed scan or Step scan Power Mount Workshop RESNA 2016

10 Hybrid Systems = Mount’n Mover + Power moduleHybrid Mount’n Mover with Power Add a Power module: Tilt, Shoulder, Lift Move your mount at the flick of a switch Supported by NIH SBIR grant Power Mount Workshop RESNA 2016

11 Powered multi-joint systems Joints, Tilt and HeightDual or Single Arm Control with an App App supported by Wireless RERC’s App Factory Direct touch or switch access Power Mount Workshop RESNA 2016

12 App Control: Main functionsGroups Target Move/Adjust Of Targets Positions individually Power Mount Workshop RESNA 2016

13 Power supply options Dedicated battery Wheelchair batteryBuilt-in Tethered Wheelchair battery Wall power supply Power Mount Workshop RESNA 2016

14 Who might use it? People with: ALS, MD, SCI, SMA, CPLittle to no use of upper extremities Very limited strength and range of motion What might they use it to position? Speech devices Tablets and laptops Trays, food and drinks Hydration and suctioning Cameras, armrests… Power Mount Workshop RESNA 2016

15 Power Mount Workshop RESNA 2016Rosie: Many uses and positions With a Power mount, she could move it A testimonial from Rosie. Power Mount Workshop RESNA 2016 PRC

18 Medical JustificationsVisual access for driving Tilted positioning for access Change positioning from more than one access method or activity (direct/eye gaze; eat/speak; speak and drive) Able to transfer Reposition to use the toilet Hygiene: move to use a sink Positioning changes, so device must change Must adapt as a person changes Power Mount Workshop RESNA 2016

19 Psychosocial benefits of a movable mountStudy by Ithica College OT department Dr. Lynn Gitlow and Adam Kinney, grad student PIADS: “How are you affected by the MM?” Increased: Happiness, Usefulness, Productivity, Competence, Quality of Life, Ability to participate, Ability to adapt to activities of daily living, Ability to take advantage of opportunities Reduced: Frustration, Embarrassment, Confusion Power Mount Workshop RESNA 2016

23 Case Study: Scott OverviewTetraparesis secondary to advanced Spinal Muscular Atrophy (SMA) Lives in an apartment alone receives 19.5 hours of PCA care/day Enjoys independently playing games, watching movies and socializing with friends on the computer Need for power mount: Create opportunity to independently suction himself during the 4.5 hours he is at home alone working on his computer Power Mount Workshop RESNA 2016

24 Case Study: Scott Why? Where? How?Decrease risk for aspiration pneumonia, choking Where? Sitting in power wheelchair at computer desk How? Right UE: thumb and index finger flexion, extension, trace supination Left UE: slight pronation Voice no active head/neck range of motion Power Mount Workshop RESNA 2016

25 *Hybrid Mount with Power ShoulderCase Study: Scott *PowerLink 2 *Hybrid Mount with Power Shoulder Final Setup: *Kensington Expert Trackball Mouse *MicroLite Switches (2) Power Mount Workshop RESNA 2016

26 Independent suctioning via a Hybrid mount with Power shoulderPower shoulder joint Brings suction tube(yaunker) in position with thumb and MicroLite switch Actuates suction with index finger and MicroLite switch Attaches tube to plate with PVC angle and clips Power Mount Workshop RESNA 2016

27 Case Study: Scott Scott’s new independence Power Mount WorkshopRESNA 2016

28 Case Study Outcomes Quantitative QualitativeDecrease in frequency of respiratory illness Qualitative Patient-Specific Functional Scale Score improved from 0 to 10 in regards to independence with self suctioning Decreased anxiety “I would limit what I would do because I had a feeling of drowning” Increased engagement with friends “I actually talk to people a lot and now can talk the whole time…my voice doesn’t get a gurgly” Power Mount Workshop RESNA 2016

29 How does it work? Hybrid single joint systems App videos (available)Connect switch into End Cap Toggle mode: Switch Jack 1 (L) Target mode: Switch Jack 2 (R) Directional: 2 switches App videos (available) Basic Operations (Levels/Targets/Adjust) Settings Saving Power Mount Workshop RESNA 2016

30 App Control: Main functions/screens Direct touch or Switch accessChoose a Group (ie, Device, Use) Go To a Target Spot (varies per Device) Adjust Joints (one at a time) Power Mount Workshop RESNA 2016

31 Switch access Switches plug into End Cap Switch use optionsTimed Scan (1 switch) Step/Select (2 switches) Access in Demo mode (below) Power Mount Workshop RESNA 2016

32 App Settings for Different UsersAudio feedback: On/off Scan Rate: Slow/Medium/Fast Easy Save Button: Enabled/Disabled Visual Theme: regular/high contrast Manage Access and Display options Open/Touch/Locked Open: Switch users can access Touch: Only touch users can access Locked: Doesn’t show as an option at all Power Mount Workshop RESNA 2016

33 App Settings: Open/Touch/LockedShows Switch access Touch Only No switch access Locked Does not show Adjust: Locked Adjust doesn’t show Adjust Power Mount Workshop RESNA 2016

34 Two visual themes: high contrast for people with Visual ImpairmentsPower Mount Workshop RESNA 2016

35 Editing and saving targets/devicesMove the system where you’d like; then hit Save icon Choose to save position to an existing Target or Add a new one Define/name the new Target New Target shows up Power Mount Workshop RESNA 2016

36 Hands-on Activities Multi-Joint system Hybrid systemGo To Target positions Adjust an individual joint Save a new Target Hybrid system Toggle directions Create a Target position Go To Target position Power Mount Workshop RESNA 2016

37 Power Mount Workshop RESNA 2016QUESTIONS??? Questions from the hands-on experience? How did it go? How might you use the power mount? Any suggestions to improve the App or access? Other questions? Power Mount Workshop RESNA 2016

38 Seeking input in Power Mount developmentApp Feedback Power mount testers Auto-repositioning of Power Mount ALS Society Technology Challenge grant Development support NIH Small Business Innovation Research App Factory, Georgia Tech Wireless RERC ALS Society AT Challenge Grant Power Mount Workshop RESNA 2016

39 Power Mount Workshop RESNA 2016Contact information BlueSky Designs Dianne Goodwin Nick Lee Moriah Kane, OTR Tamara Vos-Draper, OTR Power Mount Workshop RESNA 2016