Amihai Rigbi’s research while affiliated with Beit Berl College and other places

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Publications (49)


Lessons learned from a pediatric powered mobility lending program
  • Article

October 2023

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18 Reads

Disability and rehabilitation. Assistive technology

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Patrice L. Weiss

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Amihai Rigbi

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Purpose: To evaluate children's characteristics and impact of a powered wheelchair lending program including comparisons of diagnostic sub-groups, and validation of a predictive model of powered mobility proficiency. Methods and materials: This retrospective study included 172 children who participated in the ALYN powered mobility lending program from 3/2009-7/2022. Demographics and functional levels were measured via questionnaires; driving proficiency was evaluated when the wheelchair was returned, and parents and children were interviewed following their participation in the program. Results: Two diagnostic groups were identified: cerebral palsy (CP) (n = 136, median = 9.75 yrs) and other neuromuscular diseases (NMD) (n = 30, median = 5.83 yrs). They differed significantly in the age they commenced PM training, the male/female ratio, walking ability and access mode. Fifty-seven percent of the participants with CP achieved powered mobility proficiency, a rate that was significantly lower than the 73% proficiency found for the NMD group. Four significant predictors were identified: communication, manual wheelchair operation, access mode and go-stop upon request. They predicted proficiency in approximately 80% of cases. Overall feedback from the parents and children indicated that their personal and family's quality of life improved as a result of their child's ability to use a powered wheelchair. Conclusions: A lending program provides children with opportunities to improve mobility skills in an appropriate powered wheelchair. Children who can communicate verbally, propel a manual wheelchair, use a joystick and go-stop upon request are significantly more likely to become proficient drivers; however, many who were unable to complete these tasks also improved and even became proficient drivers.


Pediatric powered mobility training: powered wheelchair versus simulator-based practice

June 2022

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28 Reads

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3 Citations

Assistive technology: the official journal of RESNA

Method: Participants included 30 children and adolescents (23 males, 13 females) with cerebral palsy and other neuromuscular diseases, aged 6-18. Data were collected and compared at baseline and after 12 weeks of home-based practice via a powered wheelchair or a simulator. Powered mobility ability was determined by the Powered Mobility Program (PMP), the Israel Ministry of Health's Powered Mobility Proficiency Test (PM-PT) and the Assessment of Learning Powered Mobility (ALP). Results: All participants practiced for the required amount of time and both groups reported a similar user experience. Both groups achieved significant improvement following the practice period as assessed by the PMP and PM-PT assessments, with no significant differences between them. A significant improvement was found in the ALP assessment outcomes for the powered wheelchair group only. Conclusions: This is the first study, to our knowledge, that compares two different wheelchair training methods. Simulator-based practice is an effective training option for powered mobility for children with physical disabilities aged 6-18 years old, demonstrating that it is possible to provide driving skill practice opportunities safe, controlled environments.


Pediatric Powered Mobility Training: Powered Wheelchair Versus Simulator-Based Practice
  • Preprint
  • File available

November 2021

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115 Reads

Background: Many children with physical disabilities lack independent mobility. Powered wheelchair mobility can be a viable option, but users must be proficient drivers to ensure safety. To become a proficient driver, children need opportunities to practice. As is often the case, powered wheelchairs are scarce and direct therapy hours dedicated to powered mobility are often limited. Alternative options are needed to enable safe, unsupervised practice. Simulator-based learning has been shown to be an effective training method for powered mobility and other skill-based tasks for adults. The goal of this study was to compare two training methods of powered mobility, powered wheelchair practice (control group) versus simulator-based (experimental group) practice to determine whether simulation is a feasible and effective method for children and adolescents. The hypothesis was that children practicing on either modality at home supervised by a caregiver would similarly improve their powered mobility skills. Method: Participants included 36 children and adolescents (23 males, 13 females) with cerebral palsy and neuromuscular diseases, aged 6-18 years (mean age: 10 y, 7 mo, SD: 3y, 7 mo). Data were collected and compared at baseline and after 12 weeks of home based practice of powered mobility via a powered wheelchair or a simulator. Thirty participants completed the study and were included in the analysis Powered mobility ability was determined by the Powered Mobility Program (PMP), the Israeli Ministry of Health’s Powered Mobility Proficiency Test (PM-PT) and the Assessment of Learning Powered Mobility use (ALP). Participants (21/30) were interviewed after study completion by an independent researcher concerning the child’s and parent’s experiences regarding practice time and user experience (e.g., satisfaction with training program, views of its importance). Results: Both the powered wheelchair and simulator-based practice groups achieved significant improvement following the practice period as assessed by the PMP and PM-PT assessments, with no significant difference between them. A significant improvement was found in the ALP assessment outcomes for the powered wheelchair group only. All participants practiced for the required amount of time and both groups reported a similar user experience. Conclusions: The results demonstrate that simulator-based practice is an effective training option for powered mobility for children aged 6-18 years old with physical disabilities. Simulator-based practice can provide a safe environment to practice driving skills that could endanger the child (e.g., out of doors). This is the first study, to our knowledge, that compares two different wheelchair training methods. Trial Registration: The study protocol for this clinical trial was registered at ClinicalTrials.gov under the ID NCT04531488 and the title “ Simulator Based Powered Mobility Training of Children With Special Needs ”(Protocol ID: 004-17, URL: https://rb.gy/dfeslr).

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Reliability and validity of pediatric powered mobility outcome measures

September 2020

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31 Reads

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16 Citations

Disability and rehabilitation. Assistive technology

Purpose: To determine the intra-rater and inter-rater reliability of the Powered Mobility Program (PMP) and the Israel Ministry of Health Powered Mobility Proficiency Test (PM-PT); to test inter-rater reliability of the Assessment of Learning Powered Mobility (ALP) tool; to determine the convergent validity of these measures for children with physical disabilities. Materials and methods: Participants included 30 children (mean 10 years, 6 months [SD 3 years, 7 months]; range: 6-18 years) with cerebral palsy and other neuromuscular disorders. Participants were non-proficient powered wheelchair drivers. Two blinded raters assessed the driving ability by viewing videos of the participants twice as they drove a pre-designed route at ALYN Hospital, Israel. They were assessed via the PMP, ALP and PM-PT outcome measures. Intra-class correlation coefficients (ICC2,1) were used to test intra-rater and inter-rater reliability and Spearman correlation coefficients were used to assess convergent validity. Results: The PMP intra-rater reliability revealed ICCs2,1 of coefficients were 0.97/0.98 for both raters. For the PM-PT the ICC2,1 was 0.89/0.96 for both raters. The PMP inter-rater reliability ICC2,1 was 0.94/0.87 for the two tests, for the PM-PT the ICC2,1 was 0.91/0.87 for the two tests and for the ALP the ICC2,1 was 0.83. The convergent validity between the PMP and the PM-PT was rs=0.96, between the PMP and ALP was rs=0.89 and between the PM-PT and ALP was rs=0.87. Conclusions: The PMP and PM-PT intra and interrater reliability were good to excellent, the ALP inter-rater reliability was good and the convergent validity between all three measures was good to excellent. Implications for rehabilitation There is evidence of validity and reliability for three tests of powered wheelchair proficiency (PMP, PM-PT and ALP). Children using powered mobility, aged 6-18 years, now have outcome measures with empirical evidence that was previously lacking. When time for assessment is limited, the shorter PM-PT can be used instead of the more comprehensive PMP.


Figure 1. (a-b): The association between factor types, students' ethnic sector and prior teaching experience. (a)The association among students who reported to have prior teaching experience. (b) The association among students who reported not to have prior teaching experience.
Linking demographic variables to motivation: investigating the motivation to choose teaching among Arab and Jewish students in Israel

July 2020

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84 Reads

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2 Citations

European Journal of Teacher Education

The purpose of this paper is to explore the kinds of motivation driving Arab and Jewish students in Israel to choose teaching as a career. This study addressed several issues that have been largely overlooked in previous research such as the focus on Content Value motives (the motivation to teach specific subjects) as well as linking demographic variables to motivational factors, particularly cultural diversity and prior pedagogical experience. The present study yielded three central findings: the importance of Content Value motives; similar motivational patterns have been found between the two sectors despite demographic differences between them; prior teaching experience has been found to have an effect on the kinds of motivations for choosing teaching as career. The paper concludes by exploring the implications of the present study on teacher preparation programs and on future research on the motivation to choose teaching as a career especially in culturally diverse educational contexts.


The Contribution of Reading Abilities to the Writing Quality of Expository Text Structure in Hebrew Speaking Elementary School Children

June 2020

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41 Reads

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4 Citations

Three decades of inquiry have explored the nature of the relationship between writing and reading, yielding at least three theoretical models (interactive, socio-cognitive, and separate processing), numerous perspectives within each model, and a wide range of research methodologies to support or refute these theories. Texts in general and written texts in particular, must have content (i.e., the information depicted in the text) and structure (i.e., the way this information is organized), both constructs are interrelated and essential in the construction of a good expository text. For example, reading research has shown that awareness of text structure contributes to reading fluency, and assists the construction of a coherent mental representation of the text structure improving (Williams JP, Journal of Special Education 39:6–18, 2005) or hampering (Williams, Literacy in the curriculum: integrating text structure and content area instruction. In: McNamara DS (ed) Reading comprehension strategies theories, interventions, and technologies. Lawrence Erlbaum Associates, Hoboken, pp 199–220, 2007) comprehension. Drawing on different aspects of each of these theories, this study explores the relations between reading and writing abilities in elementary school children, in middle class integrative schools in central Israel. Our assumption that a high-quality written text contains the various structural components in accordance with the genre requirements was corroborated. We conclude that the indicators that relate to text-structure-quality of different text genres is dynamic and its development is age-dependent.


Age at Onset of Parkinson's Disease among Ashkenazi Jewish Patients: Contribution of Environmental Factors, LRRK2 p.G2019S and GBA p.N370S Mutations

April 2020

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106 Reads

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30 Citations

Journal of Parkinson's Disease

Gilad Yahalom

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Amihai Rigbi

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[...]

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Lior Greenbaum

Background: Both genetic and environmental factors contribute to Parkinson's disease (PD) risk. Objective: We investigated the potential association of several relevant variables with PD age at onset (AAO), focusing on LRRK2 p.G2019S and GBA p.N370S mutations. Methods: Ashkenazi Jewish (AJ) PD patients, screened for LRRK2 and GBA mutations, underwent an interview regarding exposure to the following environmental and lifestyle factors: cigarette smoking, consumption of coffee, tea and alcohol, history of head injury and rural living. Multivariate linear regression (adjusted for sex) was used to examine the association with AAO, and models included LRRK2 and GBA mutation status (carrier/non-carriers), single environmental variable and their interactions terms, as independent variables. Results: 225 Israeli AJ PD patients were enrolled: 65 LRRK2 p.G2019S mutation carriers, 60 GBA p.N370S carriers and 100 non-carries of both mutations. In the dichotomized exposure/non-exposure analyses, positive LRRK2 p.G2019S status was associated with younger AAO in all models, at nominal or near significant levels (p = 0.033-0.082). Cigarette smoking was associated with older AAO (p = 0.032), and the interaction between GBA p.N370S and history of head injury was associated with younger AAO (p = 0.049), both at nominal significance. There was no indication of a consistent main effect for GBA p.N370S status or significant LRRK2 p.G2019S-environmental factor interaction. In the dose-dependent analysis, increased coffee and tea consumption levels were associated with older AAO (p = 0.001 and p = 0.002, respectively). Conclusions: Our results suggest that both genetic and environmental factors may affect AAO in PD patients, but validation in additional samples is required.


Comparing children’s driving abilities in physical and virtual environments

December 2019

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43 Reads

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9 Citations

Disability and rehabilitation. Assistive technology

Purpose: To compare children’s driving abilities in a physical and virtual environment and to validate the McGill Immersive Wheelchair Simulator (MiWe-C) for the use of children with disabilities. Materials and methods: Participants included 30 children (17 males, 13 females; mean age 14 y 1 mo, [SD 3 y 6 mo]; range: 5–18 y) with cerebral palsy, neuromuscular disease and spinal cord injury. All children were proficient drivers with more than 3 months’ experience, who had their own powered wheelchairs. Participants drove a 15-minute physical route and high-fidelity simulation of that route in a counterbalanced order. Performance of the two routes was compared using the 32 item Powered Mobility Programme (PMP). Differences between the driving modes were analyzed with the non-parametric Wilcoxon signed-rank test. Significance was set at α = 0.05. Results: The scores for the total PMP score as rated during both simulator wheelchair driving and during physical driving were very high (M = 4.90, SD = 0.20; M = 4.96, SD = 0.12, respectively) with no significant difference between them (z= −1.69, p = .09). Five out of the 32 PMP tasks showed significant differences between driving modes (narrow corridors, crowded corridors, doorway, sidewalks), with higher scores for the physical driving mode. Conclusions: Having a validated powered mobility simulator for children provides a viable option for an additional practice mode. The MiWe-C simulator is affordable and a user-friendly simulator that can be used anywhere including at home and in school. Children can be independent when practicing even if they are not yet proficient drivers since continual adult assistance is not needed. • Implications for rehabilitation • Having a validated powered mobility simulator for children provides a viable option for an additional practice mode. • The MiWe-C is now validated to be used with children 5–18 years with physical disabilities. • The MiWe-C is one of the few options for children to practice outside of a research environment.


Continued
Evaluation of Diagnostic Yield in Fetal Whole-Exome Sequencing: A Report on 45 Consecutive Families

June 2019

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159 Reads

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37 Citations

Prenatal ultrasound (US) abnormalities often pose a clinical dilemma and necessitate facilitated investigations in the search of diagnosis. The strategy of pursuing fetal whole-exome sequencing (WES) for pregnancies complicated by abnormal US findings is gaining attention, but the reported diagnostic yield is variable. In this study, we describe a tertiary center’s experience with fetal WES from both terminated and ongoing pregnancies, and examine the clinical factors affecting the diagnostic rate. A total of 45 consecutive families of Jewish descent were included in the analysis, for which clinical fetal WES was performed under either single (fetus only), trio (fetus and parents) or quatro (two fetuses and parents) design. Except one, all families were non-consanguineous. In 41 of the 45 families, WES was sought following abnormal fetal US findings, and 18 of them had positive relevant family history (two or more fetuses with US abnormalities, or single fetus with US abnormalities and an affected parent). The overall diagnostic yield was 28.9% (13/45 families), and 31.7% among families with fetal US abnormalities (13/41). It was significantly higher in families with prenatal US abnormalities and relevant family history (10/18, 55.6%), compared to families with prenatal US abnormal findings and lack of such history (3/23, 13%) (p = 0.004). WES yield was relatively high (42.9–60%) among families with involvement of brain, renal or musculoskeletal US findings. Taken together, our results in a real-world setting of genetic counseling demonstrates that fetal WES is especially indicated in families with positive family history, as well as in fetuses with specific types of congenital malformation.


Predictive model of proficiency in powered mobility of children and young adults with motor impairments

May 2019

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75 Reads

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8 Citations

Aim To identify variables that can predict proficiency in powered mobility use for children in young adults. Method Participants included 80 children and young adults (42 males, 38 females; mean age 10y 2mo, [SD 5y 1mo]; range: 2–22y) with cerebral palsy, neuromuscular disease, and spinal cord injury who participated in the ALYN Hospital Powered Mobility Lending Program from 2009 to 2016. Data were collected and compared before and after participation in the program and powered mobility levels were determined by the Israeli Ministry of Health (MOH) Powered Mobility Proficiency Test. Multivariate logistic regression analysis followed by a bootstrapping procedure that was based on 1000 samples were used to determine if the variables were predictive of success on the Israeli MOH Powered Mobility Proficiency Test. Results Significant variables for predicting success were identified: manual wheelchair propulsion, go‐stop voluntarily upon request, and using a joystick. The model was able to correctly identify 80% of the children. Interpretation Children and young adults with the ability to go‐stop upon request, propel a manual wheelchair short distances, and use a joystick to activate the powered wheelchair had a higher chance of becoming proficient. In countries where wheelchair proficiency is a requirement for powered wheelchair procurement, these findings may support policy changes, as they did in Israel. What this paper adds Using powered wheelchairs offers children earlier and more natural practice to determine driving proficiency. Manual wheelchair propulsion, go‐stop voluntarily upon request, and using a joystick were predictors of powered mobility proficiency. More than 80% of children use a joystick with their hand to activate a powered wheelchair.


Citations (37)


... Twenty studies fulfilled the inclusion criteria and were therefore included in this systematic review. Three single-case studies, [35][36][37] eight case series, [38][39][40][41][42][43][44][45] four studies with two-group pre-test/ post-test design, [46][47][48][49] three studies with one-group pre-test/ post-test design, [50][51][52] and two randomized controlled trials (RCTs) were identified. 53,54 Appendix S3 reports all the remaining excluded articles with the reasons for exclusion. ...

Reference:

Effectiveness of wheeled mobility skill interventions in children and young people with cerebral palsy: A systematic review
Pediatric powered mobility training: powered wheelchair versus simulator-based practice
  • Citing Article
  • June 2022

Assistive technology: the official journal of RESNA

... Studies of the inter-rater reliability of the original eight-phase instrument [18] and the ALP instrument, version 2.0 [15], both showed a very good degree of agreement with a linear weighted kappa value of 0.85 [23,24]. Professionals and researchers, in various powered mobility contexts internationally, have applied the ALP tool, version 2.0 [25][26][27][28][29][30], recommended it in guidelines [31], and also tested the ALP instruments' inter-rater reliability [32]. Even though the structure and organization of the universal ALP instrument are identical with version 2.0, some concepts related to powered-mobility use were omitted or replaced by corresponding universal behavior indicators, which requires new tests of the instrument's inter-rater reliability. ...

Reliability and validity of pediatric powered mobility outcome measures
  • Citing Article
  • September 2020

Disability and rehabilitation. Assistive technology

... Student teachers have a mixture of motives for entering teacher education and becoming a teacher (e.g. Bergmark et al. 2018;Frei, Berweger, and Buschor 2017;Meens and Baks 2019;Sarid et al. 2022). Most studies examining student teachers' motives include three main constructs: altruistic, intrinsic and extrinsic motives (for reviews, see Fray and Gore 2018;Heintz 2015). ...

Linking demographic variables to motivation: investigating the motivation to choose teaching among Arab and Jewish students in Israel

European Journal of Teacher Education

... High and low reading skills were related to composition quality (Abbott & Berninger, 1993) and word-reading ability affects the compositional quality (Olinghouse, 2008). Moreover, the relations found between the reading skills and the structure of the texts vary across ages, genres, and text components (Stavans et al., 2020). ...

The Contribution of Reading Abilities to the Writing Quality of Expository Text Structure in Hebrew Speaking Elementary School Children
  • Citing Chapter
  • June 2020

... Affecting millions globally, the prevalence of PD increases with age 3 . Despite extensive research, the exact etiology of PD remains unclear, involving a complex interplay of genetic, environmental, and lifestyle factors 4,5 . ...

Age at Onset of Parkinson's Disease among Ashkenazi Jewish Patients: Contribution of Environmental Factors, LRRK2 p.G2019S and GBA p.N370S Mutations
  • Citing Article
  • April 2020

Journal of Parkinson's Disease

... The body of research highlighted the benefits of using realistic virtual environments and found that they meet the participants' expectations of real-life powered wheelchair driving [26]. Moreover, participants may easily transfer the skills learnt in VR to real life, given that the tasks in the two contexts are similar [28]. In a study conducted by Torkia et al. [26], participants (clinicians and children who are wheelchair users) were asked for feedback about their VR training experience (driving through a replica of a rehabilitation centre); they suggested increasing the interaction with the VR environment and adding sounds to improve the sense of presence and training efficacy [26]. ...

Comparing children’s driving abilities in physical and virtual environments
  • Citing Article
  • December 2019

Disability and rehabilitation. Assistive technology

... The pooled ES diagnostic yield of RASopathies for NIHF was 9% -Kouatly et al., 2023) in addition to our updated search as a part of our meta-analysis calculations Correa et al., 2021;Daum et al., 2019;Dempsey et al., 2021;Deng et al., 2020;Greenbaum et al., 2019;Jelin et al., 2020;Kuci nska-Chahwan et al., 2022;Qi et al., 2020;Shamseldin et al., 2015Shamseldin et al., , 2018Sun et al., 2020;Tolusso et al., 2021;J. Zhou, Yang, et al., 2021). ...

Evaluation of Diagnostic Yield in Fetal Whole-Exome Sequencing: A Report on 45 Consecutive Families

... However, the evidence was mainly based on case studies where the selection process of study participants impacted the risk of potential bias. 36,40,41 Thus, although a joystick steering system has been linked to a higher chance in reaching driving proficiency, 78,79 it is crucial that the chosen steering system fits the potential capabilities and needs of the wheelchair user. For example, for a child with severe CP and very limited manual abilities, alternative head and foot steering systems may well be the only option for independent mobility. ...

Predictive model of proficiency in powered mobility of children and young adults with motor impairments

... Furthermore, since 54-65% of children with ADHD demonstrate co-occurring SMD [19,[62][63][64], their difficulties are amplified in sensory-intensified environments, such as schools [24,50,65]. Of note, like children with ADHD, children with SMD are reported to have mothers with SMD symptoms [66,67]. This suggests the parental sensory profile and the home environment are important contributors to the behavioral expressions of both mothers and children. ...

An exploratory study of parent–child association in sensory modulation disorder involving ADHD-related symptoms
  • Citing Article
  • April 2019

Pediatric Research

... T1W images aid in detecting infarctions and assessing brain atrophy, while T2W images are valuable for identifying typical focal lesions associated with ischemia, such as lacunes, infarcts, white matter hyperintensities, and enlarged perivascular spaces. [9][10][11][12][13] Some studies have utilized MRI information for diagnosing ischemic diseases, such as predicting ischemic stroke using conventional MRI, 14 improving predictions of delayed cerebral ischemia in patients with subarachnoid hemorrhage through MRI, 15 and detecting cerebral venous thrombosis with conventional MRI. 16 However, there is still a lack of research on CCH. ...

White matter lesions, cerebral inflammation and cognitive function in a mouse model of cerebral hypoperfusion
  • Citing Article
  • May 2019

Brain Research