Single-Button Mobility Platform's Effect on Reaction Time and Keystroke Accuracy in Children with Cerebral Palsy

The experimental timeline includes eight weekly sessions, each lasting 30 minutes. Initially, therapists will receive an explanation on how to use the platform and the accompanying configuration application. They will familiarize themselves with it a couple of weeks before the experiment begins. During the sessions, children in the experimental group will use the platform, while those in the control group will continue receiving their traditional therapy.

Researchers will pre-adjust the children's interactions to match the platform variables, allowing for meaningful comparisons. Therapists will assess changes in the children's mood or emotional state during each session. To do this, they will calculate the differences between the SAM (Self-Assessment Manikin) tests conducted at the beginning and end of each session. A positive difference in valence indicates an improvement in the participant's happiness or positive emotions during the session. Similarly, positive changes in arousal reflect increased calmness or reduced excitation. A seven-item Likert scale will be used for measurement. For instance, if there is a positive change of seven points in valence during a session, the participant moves from a very sad state to a very happy one.

To minimize bias in conducting the experiment and evaluating SAM tests, therapists will be randomly assigned to either the control or intervention groups for each session, while ensuring an equal number of sessions conducted by each therapist. As a result, each therapist will conduct four sessions with the experimental group and four with the control group, with random session assignments.

The dependent variables include reaction time (RT) and the number of incorrect selections (NIS). The mean and standard deviation of these dependent variables allow for the following statistical analyses: Kruskal-Wallis Test: This will be used to compare the dependent variables across groups. SAM Test: It will score the statistically significant differences between the experimental and control groups, with the level of significance set at 5% (p = 0.05). Pearson Regression Analysis: This will identify trends in the dependent variables over time.

The registration procedure is as follows: Variables are collected, transmitted, and stored in a database on a cellphone for later analysis. To achieve this, the investigators used an Open Source Frontend SDK , which enables the deployment of hybrid mobile applications based on web development tools such as HTML, CSS, and JavaScript. The apps run in a browser shell. Several Capacitor plugins were used to manage the database and Bluetooth connectivity, which are essential for data storage and communication. The application interface includes buttons for therapists to enable/disable Bluetooth connections, start/stop recording, and a panic button to halt the platform and abort the experiment. Additionally, users can select their username and group name. Control group therapy involves the use of educational resources that require children to press a button repeatedly. For this group, the investigators chose fairy tale or cartoon videos from YouTube. The specific videos will be tailored to the user's preferences. These videos pause intermittently and require the child to perform an action to resume playback. A microcontroller is used to record time intervals and host an application that detects the child's keystrokes. This data is transmitted via Bluetooth to the same mobile application used for the mobility platform, ensuring synchronization between the experimental and control groups.

Inclusion criteria

• Diagnosed with cerebral palsy
• Classified as GMFCS level IV or higher, indicating an inability to walk or operate a powered wheelchair.
• Under 12 years old.
• Must be affiliated to a center whose facilities guarantee a proper navigation experience

Exclusion criteria

• Inability to act on an actuator (Start button)