Hello all, sorry for crossposting.
So I saw a client diagnosed with bulbar style ALS today. He is fully ambulatory. He is having severe problems with neck range of motion and requires a neck brace most of the time while walking. Shoulder flexion is very limited, but he has very good distal motion. Neck brace is key, since he cannot look down at what he is manipulating, nor does he have enough upper extremity function to hold whatever devices up to eye level.
He recognizes that disease is progressive but he is looking for something for the next 10-12 months while ambulation and distal upper extremity function remains good. He is able to touch type pretty effectively on a Apple Bluetooth keyboard which we connected to an iPad.
What I am thinking about is a platform that he can wear at his belt loop, probably with a suspension going to the outside portion of the platform as well. I know that CJT used to sell something like this. They do not sell it anymore. We have a rehab engineer who I am sure can fabricate something.
What I am then thinking about is a android tablet since he can connect a Bluetooth keyboard and Bluetooth mouse at the same time to give him the most options for taking advantage of the relatively strong direct selection and distal upper extremity function. At some point down the road we can look at a USB input for alternative mouse if that becomes necessary.
Then I am thinking about a phone or mini tablet mounted from the tray via a rod or something like that more or less at eye level for him.
Probably will connect a external rechargeable speaker via cable since I do not think Bluetooth will run mouse/keyboard and speaker all at the same time. Happy to hear additional opinion on that one.
So I am looking for any other bright ideas on the whole situation. But I am also wondering if there is anything still commercially available in terms of a platform that is wearable? I know there are plenty of iPad cases that you can wear like a briefcase or shoulder bag and then pick up; but he really wants to be able to touch type, and I would like him to use a mouse and I do not think he has enough power in the shoulders and elbows to be able to hold it up effectively while manipulating input devices.
Thanks all, Ed.
Ed Hitchcock OT/L
Technology Center
Rehabilitation Institute of Chicago
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