1. Tamara Vos-Draper, OT, ATP
Power 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, UVA
Founder, 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 necessity
Need 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 positioning
People 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 technology
Static 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 Arm
JACO
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 pounds
Joint 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 systems
Built-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 module
Hybrid 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 Height
Dual 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 functions
Groups Target Move/Adjust Of Targets Positions individually
Power Mount Workshop
RESNA 2016

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

14. Who might use it? People with: ALS, MD, SCI, SMA, CP
Little 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 2016
Rosie: Many uses and positions
With a Power mount, she could move it
A testimonial from Rosie.
Power Mount Workshop RESNA 2016
PRC

16. Independence: Move it to Transfer
Gae moves her device to the side to transfer to her stair lift and the restroom.
Ryan is no longer dependent on family for removing device to transfer.
He moves it to the side and can go to bed and get up on his own schedule.
He and his mom say it’s “life-changing”
Power Mount Workshop RESNA 2016

17. Impacts on health and function
Sarah
Does her work without getting fatigued
School activities: “easier for everyone!”
Changes in device positioning
Wheelchair propulsion
Capabilities change
Power Mount Workshop
RESNA 2016

18. Medical Justifications
Visual 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 mount
Study 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

20. Eye Gaze and Head Tracker access
Positioning is critical
Consistent placement of device is essential
Change to allow access to speak and to drive
As a person’s position changes, the device must
Power Mount Workshop
RESNA 2016

21. Eye Gaze Positioning is critical and it changes
Need consistent placement of device relative to the person
Recalibration is often necessary
As position changes thru the day – so must the mount
Adjust height, tilt and rotation
Place to side to see
Easy for caregivers – multiple locked positions
Positioning changes from chair to bed, or floor stand
Power Mount Workshop
RESNA 2016

22. Adjust for different situations How do you move it out of the way?
The Stand +90 provides a safe alternative for accessing eye gaze devices from a reclined position.
Power Mount Workshop
RESNA 2016
PRC

23. Case Study: Scott Overview
Tetraparesis 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 Shoulder
Case 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 shoulder
Power 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 Workshop
RESNA 2016

28. Case Study Outcomes Quantitative Qualitative
Decrease 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 access
Choose 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 options
Timed Scan (1 switch)
Step/Select (2 switches)
Access in Demo mode (below)
Power Mount Workshop
RESNA 2016

32. App Settings for Different Users
Audio 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/Locked
Shows
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 Impairments
Power Mount Workshop
RESNA 2016

35. Editing and saving targets/devices
Move 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 system
Go 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 2016
QUESTIONS???
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 development
App 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 2016
Contact information
BlueSky Designs
Dianne Goodwin
Nick Lee
Moriah Kane, OTR
Tamara Vos-Draper, OTR
Power Mount Workshop RESNA 2016