PCD Maltron Ltd , trading as Maltron , is a manufacturer of ergonomic special-needs keyboards. It was founded by South African-born inventor Lillian Malt and manufacturer Stephen Hobday. Maltron specialises in making keyboards for the prevention and etiological (root cause) treatment of repetitive strain injury .
93-517: Maltron manufactures several models of keyboard, in varying levels of adaptation. Malt's original invention and the company's flagship design, the Fully Ergonomic 3D Keyboard, is the most highly adapted; it incorporates a curved surface in which the keys' angles and depths are staggered to compensate for the different lengths and placement of the fingers. Customers can choose an integral trackball at extra cost. Other types include single-hand keyboards,
186-464: A low birth weight . In those who are born with a weight between 1 kg (2.2 lbs) and 1.5 kg (3.3 lbs) CP occurs in 6%. Among those born before 28 weeks of gestation it occurs in 8%. Genetic factors are believed to play an important role in prematurity and cerebral palsy generally. In those who are born between 34 and 37 weeks the risk is 0.4% (three times normal). In babies who are born at term risk factors include problems with
279-465: A pain compliance method to force a person to take a certain action, such as allowing a police officer to take him into custody. These are general terms that can be used to describe most movements the body makes. Most terms have a clear opposite, and so are treated in pairs. Flexion and extension are movements that affect the angle between two parts of the body. These terms come from the Latin words with
372-399: A star jump or doing a split , the legs are abducted at the hip. Adduction is a motion that pulls a structure or part towards the midline of the body, or towards the midline of a limb, carried out by one or more adductor muscles. In the case of fingers and toes, it is bringing the digits together, towards the centerline of the hand or foot. Dropping the arms to the sides, and bringing
465-502: A difficult delivery, and head trauma during the first few years of life. New studies suggest that inherited genetic causes play a role in 25% of cases, where formerly it was believed that 2% of cases were genetically determined. Sub-types are classified, based on the specific problems present. For example, those with stiff muscles have spastic cerebral palsy , poor coordination in locomotion have ataxic cerebral palsy , and writhing movements have dyskinetic cerebral palsy . Diagnosis
558-410: A flat version of the fully ergonomic keyboard, a keyboard designed to be used by a single digit or headstick or mouthstick, and a robust expanded keyboard for people with cerebral palsy . Maltron keyboards are electrically compatible with IBM PC keyboards and Apple Keyboards , using USB connectors . Earlier models used mini-DIN or PS/2 connectors but these are now discontinued. Lillian Malt ran
651-576: A higher risk of respiratory failure . For bones to attain their normal shape and size, they require the stresses from normal musculature. People with cerebral palsy are at risk of low bone mineral density . The shafts of the bones are often thin (gracile), and become thinner during growth. When compared to these thin shafts ( diaphyses ), the centres ( metaphyses ) often appear quite enlarged (ballooning). Due to more than normal joint compression caused by muscular imbalances, articular cartilage may atrophy, leading to narrowed joint spaces. Depending on
744-406: A more severe Gross Motor Function Classification System assessment in particular are considered risk factors for multimorbidity . Other medical issues can be mistaken for being symptoms of cerebral palsy, and so may not be treated correctly. Related conditions can include apraxia , sensory impairments, urinary incontinence , fecal incontinence , or behavioural disorders. Seizure management
837-405: A one-handed keyboard that he had designed for the handicapped. Malt made several suggestions for improvement, telling Hobday of her failure to engage the interest of any manufacturers in actually building her ideal keyboard. Hobday told her "You tell me what you want and I'll tell you whether I can build it or not." The first Maltron keyboard was the result of their collaboration. The full name of
930-463: A part of the body such as a joint is overstretched or "bent backwards" because of exaggerated extension motion, then it can be described as hyperextended . Hyperextension increases the stress on the ligaments of a joint, and is not always because of a voluntary movement. It may be a result of accidents, falls, or other causes of trauma. It may also be used in surgery, such as in temporarily dislocating joints for surgical procedures. Or it may be used as
1023-401: A secretarial training business from 1955. Based upon her experience of typing errors (having been closely concerned in the printing industry with retraining Linotype operators to use computer keyboards ), she had the idea for a typewriter keyboard with the keys arranged to fit different finger lengths but found no manufacturer willing to work with her. In 1974, Stephen Hobday came to her with
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#17328699980531116-415: A small jawbone, or a small head sometimes occur along with CP. Symptoms may appear or change as a child gets older. Babies born with cerebral palsy do not immediately present with symptoms. Classically, CP becomes evident when the baby reaches the developmental stage at 6 to 9 months and is starting to mobilise, where preferential use of limbs, asymmetry, or gross motor developmental delay is seen. Drooling
1209-629: A thumb cluster area where thumbs can hit keys other than the space bar. Cerebral palsy Cerebral palsy ( CP ) is a group of movement disorders that appear in early childhood. Signs and symptoms vary among people and over time, but include poor coordination, stiff muscles , weak muscles , and tremors . There may be problems with sensation , vision , hearing , and speech . Often, babies with cerebral palsy do not roll over, sit, crawl or walk as early as other children. Other symptoms may include seizures and problems with thinking or reasoning . While symptoms may get more noticeable over
1302-583: A very reliable indicator of malnutrition in children with cerebral palsy. Due to challenges in feeding, evidence has shown that children with cerebral palsy are at a greater risk of malnutrition. Speech and language disorders are common in people with cerebral palsy. The incidence of dysarthria is estimated to range from 31% to 88%, and around a quarter of people with CP are non-verbal. Speech problems are associated with poor respiratory control, laryngeal and velopharyngeal dysfunction, and oral articulation disorders that are due to restricted movement in
1395-406: Is a developmental disability . Once a person is diagnosed with cerebral palsy, further diagnostic tests are optional. Neuroimaging with CT or MRI is warranted when the cause of a person's cerebral palsy has not been established. An MRI is preferred over CT, due to diagnostic yield and safety. When abnormal, evidence from neuroimaging may suggest the timing of the initial damage. The CT or MRI
1488-412: Is a motion that pulls a structure or part away from the midline of the body, carried out by one or more abductor muscles. In the case of fingers and toes, it is spreading the digits apart, away from the centerline of the hand or foot. For example, raising the arms up, such as when tightrope -walking, is an example of abduction at the shoulder . When the legs are splayed at the hip, such as when doing
1581-416: Is a small risk associated with sedating children to facilitate a clear MRI. The age when CP is diagnosed is important, but medical professionals disagree over the best age to make the diagnosis. The earlier CP is diagnosed correctly, the better the opportunities are to provide the child with physical and educational help, but there might be a greater chance of confusing CP with another problem, especially if
1674-418: Is against the chest, the neck is flexed, and the trunk is flexed when a person leans forward. Flexion of the shoulder or hip is movement of the arm or leg forward. Extension is the opposite of flexion, a straightening movement that increases the angle between body parts. For example, when standing up, the knees are extended. When a joint can move forward and backward, such as the neck and trunk, extension
1767-405: Is also capable of revealing treatable conditions, such as hydrocephalus , porencephaly , arteriovenous malformation , subdural hematomas and hygromas , and a vermian tumour (which a few studies suggest are present 5–22% of the time). Furthermore, abnormalities detected by neuroimaging may indicate a high likelihood of associated conditions, such as epilepsy and intellectual disability. There
1860-656: Is also classified according to the topographic distribution of muscle spasticity. This method classifies children as diplegic , (bilateral involvement with leg involvement greater than arm involvement), hemiplegic (unilateral involvement), or quadriplegic (bilateral involvement with arm involvement equal to or greater than leg involvement). Spastic cerebral palsy is the type of cerebral palsy characterized by spasticity or high muscle tone often resulting in stiff, jerky movements. Itself an umbrella term encompassing spastic hemiplegia , spastic diplegia , spastic quadriplegia and – where solely one limb or one specific area of
1953-482: Is also common where eating difficulties exist, caused by undetected aspiration of food or liquids. Fine finger dexterity, like that needed for picking up a utensil, is more frequently impaired than gross manual dexterity, like that needed for spooning food onto a plate. Grip strength impairments are less common. Children with severe cerebral palsy, particularly with oropharyngeal issues, are at risk of undernutrition . Triceps skin fold tests have been found to be
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#17328699980532046-1019: Is based on the child's development. Blood tests and medical imaging may be used to rule out other possible causes. Some causes of CP are preventable through immunization of the mother, and efforts to prevent head injuries in children such as improved safety. There is no known cure for CP, but supportive treatments, medication and surgery may help individuals. This may include physical therapy , occupational therapy and speech therapy . Mouse NGF has been shown to improve outcomes and has been available in China since 2003. Medications such as diazepam , baclofen and botulinum toxin may help relax stiff muscles. Surgery may include lengthening muscles and cutting overly active nerves . Often, external braces and Lycra splints and other assistive technology are helpful with mobility. Some affected children can achieve near normal adult lives with appropriate treatment. While alternative medicines are frequently used, there
2139-604: Is between 21% and 64%. Higher levels of impairment on the GMFCS are associated with scoliosis and hip dislocation. Scoliosis can be corrected with surgery, but CP makes surgical complications more likely, even with improved techniques. Hip migration can be managed by soft tissue procedures such as adductor musculature release. Advanced degrees of hip migration or dislocation can be managed by more extensive procedures such as femoral and pelvic corrective osteotomies . Both soft tissue and bony procedures aim at prevention of hip dislocation in
2232-597: Is characterized by abnormal muscle tone , reflexes, or motor development and coordination. The neurological lesion is primary and permanent while orthopedic manifestations are secondary to high muscle tone and progressive. In cerebral palsy with high muscle tone, unequal growth between muscle-tendon units and bone eventually leads to bone and joint deformities. At first, deformities are dynamic. Over time, deformities tend to become static, and joint contractures develop. Deformities in general and static deformities in specific ( joint contractures ) cause increasing gait difficulties in
2325-604: Is common among children with cerebral palsy, which can have a variety of impacts including social rejection, impaired speaking, damage to clothing and books, and mouth infections. It can additionally cause choking. An average of 55.5% of people with cerebral palsy experience lower urinary tract symptoms , more commonly excessive storage issues than voiding issues. Those with voiding issues and pelvic floor overactivity can deteriorate as adults and experience upper urinary tract dysfunction . Children with CP may also have sensory processing issues. Adults with cerebral palsy have
2418-480: Is common and may result from the inherent deficits associated with the condition, along with the numerous procedures children typically face. When children with cerebral palsy are in pain, they experience worse muscle spasms. Pain is associated with tight or shortened muscles, abnormal posture, stiff joints, unsuitable orthosis , etc. Hip migration or dislocation is a recognizable source of pain in CP children and especially in
2511-510: Is common in children with CP. Children with CP may have too little or too much sensitivity around and in the mouth. Poor balance when sitting, lack of control of the head, mouth, and trunk, not being able to bend the hips enough to allow the arms to stretch forward to reach and grasp food or utensils, and lack of hand-eye coordination can make self-feeding difficult. Feeding difficulties are related to higher GMFCS levels. Dental problems can also contribute to difficulties with eating. Pneumonia
2604-463: Is described using specific anatomical terms . Motion includes movement of organs , joints , limbs , and specific sections of the body. The terminology used describes this motion according to its direction relative to the anatomical position of the body parts involved. Anatomists and others use a unified set of terms to describe most of the movements, although other, more specialized terms are necessary for describing unique movements such as those of
2697-503: Is due to abnormal development or damage occurring to the developing brain. This damage can occur during pregnancy, delivery, the first month of life, or less commonly in early childhood. Structural problems in the brain are seen in 80% of cases, most commonly within the white matter . More than three-quarters of cases are believed to result from issues that occur during pregnancy. Most children who are born with cerebral palsy have more than one risk factor associated with CP. Cerebral palsy
2790-427: Is intention (action) tremor , which is especially apparent when carrying out precise movements, such as tying shoe laces or writing with a pencil. This symptom gets progressively worse as the movement persists, making the hand shake. As the hand gets closer to accomplishing the intended task, the trembling intensifies, which makes it even more difficult to complete. Dyskinetic cerebral palsy (sometimes abbreviated DCP)
2883-561: Is more difficult in people with CP as seizures often last longer. Epilepsy and asthma are common co-occurring diseases in adults with CP. The associated disorders that co-occur with cerebral palsy may be more disabling than the motor function problems. Managing respiratory illnesses in children with severe CP is considered complex due to the need to manage oropharyngeal dysphagia of both food/drink and saliva, gastroesophageal reflux , motor disorders, upper airway obstruction during sleep, malnutrition, among other factors. Cerebral palsy
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2976-407: Is movement in the posterior direction. Extension of the hip or shoulder moves the arm or leg backward. Even for other upper extremity joints – elbow and wrist, backward movement results in extension. The knee, ankle, and wrist are exceptions, where the distal end has to move in the anterior direction for it to be called extension. For the toes , flexion is curling them downward whereas extension
3069-422: Is no evidence to support their use. Potential treatments are being examined, including stem cell therapy . However, more research is required to determine if it is effective and safe. Cerebral palsy is the most common movement disorder in children, occurring in about 2.1 per 1,000 live births. It has been documented throughout history, with the first known descriptions occurring in the work of Hippocrates in
3162-579: Is not contagious and cannot be contracted in adulthood. CP is almost always developed in utero, or prior to birth. While in certain cases there is no identifiable cause, typical causes include problems in intrauterine development (e.g. exposure to radiation, infection, fetal growth restriction ), hypoxia of the brain (thrombotic events, placental insufficiency , umbilical cord prolapse ), birth trauma during labor and delivery, and complications around birth or during childhood. In Africa birth asphyxia , high bilirubin levels , and infections in newborns of
3255-407: Is often found in the child before they are 1 year old, or also before they are four or five. In addition to these, functional gastrointestinal abnormalities contributing to bowel obstruction, vomiting, and constipation may also arise. Adults with cerebral palsy may have ischemic heart disease , cerebrovascular disease , cancer , and trauma more often. Obesity in people with cerebral palsy or
3348-420: Is primarily associated with damage to the basal ganglia and the substantia nigra in the form of lesions that occur during brain development due to bilirubin encephalopathy and hypoxic-ischemic brain injury. DCP is characterized by both hypertonia and hypotonia , due to the affected individual's inability to control muscle tone. Clinical diagnosis of DCP typically occurs within 18 months of birth and
3441-415: Is primarily based upon motor function and neuroimaging techniques. Dyskinetic cerebral palsy is an extrapyramidal form of cerebral palsy. Dyskinetic cerebral palsy can be divided into two different groups; choreoathetosis and dystonia . Choreo-athetotic CP is characterized by involuntary movements, whereas dystonic CP is characterized by slow, strong contractions, which may occur locally or encompass
3534-416: Is rotation towards the axis of the body, carried out by internal rotators . External rotation ( lateral rotation or extorsion ) is rotation away from the center of the body, carried out by external rotators . Internal and external rotators make up the rotator cuff , a group of muscles that help to stabilize the shoulder joint . Dorsiflexion and plantar flexion refer to extension or flexion of
3627-439: Is sometimes genetic and can cause ataxic cerebral palsy . After birth, other causes include toxins, severe jaundice , lead poisoning , physical brain injury, stroke , abusive head trauma , incidents involving hypoxia to the brain (such as near drowning ), and encephalitis or meningitis . Infections in the mother, even those not easily detected, can triple the risk of the child developing cerebral palsy. Infection of
3720-483: Is the original curved, retro-styled keyboard. The other three are geared towards people with more pervasive disabilities. Although the general form has remained the same, the original keyboard has gone through several revisions. Maltron keyboards became well known in the 1980s and 1990s for their distinctive layouts. Hackaday described the Maltron keyboard as "a mass of injection-moulded plastic with two deep dishes for all
3813-501: Is uncurling them or raising them. Abduction is the motion of a structure away from the midline while adduction is motion towards the center of the body. The center of the body is defined as the midsagittal or longitudinal plane. These terms come from Latin words with similar meanings, ab- being the Latin prefix indicating ' away ' , ad- indicating ' toward ' , and ducere meaning ' to draw or pull ' . Abduction
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3906-453: Is under-recognized in children with cerebral palsy, even though three out of four children with cerebral palsy experience pain. Adults with CP also experience more pain than the general population. Associated disorders include intellectual disabilities , seizures, muscle contractures , abnormal gait, osteoporosis , communication disorders, malnutrition, sleep disorders, and mental health disorders, such as depression and anxiety. Epilepsy
3999-405: Is where the toes are brought closer to the shin . This decreases the angle between the dorsum of the foot and the leg . For example, when walking on the heels the ankle is described as being in dorsiflexion. Similarly, dorsiflexion helps in assuming a deep squat position. Plantar flexion or plantarflexion is the movement which decreases the angle between the sole of the foot and the back of
4092-569: The Communication Function Classification System , and the Eating and Drinking Ability Classification System have been proposed to describe those functions. There are three main CP classifications by motor impairment: spastic, ataxic, and dyskinetic. Additionally, there is a mixed type that shows a combination of features of the other types. These classifications reflect the areas of the brain that are damaged. Cerebral palsy
4185-498: The dorsal side of forearm. Pronation and supination refer generally to the prone (facing down) or supine (facing up) positions. In the extremities, they are the rotation of the forearm or foot so that in the standard anatomical position the palm or sole is facing anteriorly when in supination and posteriorly when in pronation. As an example, when a person is typing on a computer keyboard, their hands are pronated; when washing their face, they are supinated. Pronation at
4278-406: The forearm is a rotational movement where the hand and upper arm are turned so the thumbs point towards the body. When the forearm and hand are supinated, the thumbs point away from the body. Pronation of the foot is turning of the sole outwards, so that weight is borne on the medial part of the foot. Supination of the forearm occurs when the forearm or palm are rotated outwards. Supination of
4371-525: The 5th century BCE. Extensive study began in the 19th century by William John Little , after whom spastic diplegia was called "Little's disease". William Osler first named it "cerebral palsy" from the German zerebrale Kinderlähmung (cerebral child-paralysis). Cerebral palsy is defined as "a group of permanent disorders of the development of movement and posture, causing activity limitation, that are attributed to non-progressive disturbances that occurred in
4464-405: The Latin terms with similar meanings. Elevation is movement in a superior direction. For example, shrugging is an example of elevation of the scapula. Depression is movement in an inferior direction, the opposite of elevation. Rotation of body parts may be internal or external, that is, towards or away from the center of the body. Internal rotation ( medial rotation or intorsion )
4557-521: The Model-B, the key bowl required the hands, although separated from each other, still to be rotated outward as though operating a flat keyboard. Another change moved the twelve function keys to a new top row inside the bowl rather than as a straight line along the back, which the single-handed versions retain. The standard numeric row (1 through 0) has also been shifted one column to the left aligning "1" with "F1", "2" with "F2" and so on. The blank area between
4650-450: The ability to walk. The effects of cerebral palsy fall on a continuum of motor dysfunction, which may range from slight clumsiness at the mild end of the spectrum to impairments so severe that they render coordinated movement virtually impossible at the other end of the spectrum. Babies born with severe cerebral palsy often have irregular posture; their bodies may be either very floppy or very stiff. Birth defects, such as spinal curvature,
4743-632: The adolescent population. Nevertheless, the adequate scoring and scaling of pain in CP children remains challenging. Pain in CP has a number of different causes, and different pains respond to different treatments. There is also a high likelihood of chronic sleep disorders secondary to both physical and environmental factors. Children with cerebral palsy have significantly higher rates of sleep disturbance than typically developing children. Babies with cerebral palsy who have stiffness issues might cry more and be harder to put to sleep than non-disabled babies, or "floppy" babies might be lethargic. Chronic pain
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#17328699980534836-454: The body is affected – spastic monoplegia. Spastic cerebral palsy affects the motor cortex of the brain, a specific portion of the cerebral cortex responsible for the planning and completion of voluntary movement. Spastic CP is the most common type of overall cerebral palsy, representing about 80% of cases. Botulinum toxin is effective in decreasing spasticity . It can help increase range of motion which could help mitigate CPs effects on
4929-399: The body's palmar surface, which in anatomical position is considered the anterior side of the arm. The direction of terms are opposite to those in the foot because of embryological rotation of the limbs in opposite directions. Palmarflexion is flexion of the wrist towards the palm and ventral side of forearm . Dorsiflexion is hyperextension of the wrist joint, towards
5022-509: The central nervous system are main cause. Many cases of CP in Africa could be prevented with better resources available. Between 40% and 50% of all children who develop cerebral palsy were born prematurely. Most of these cases (75–90%) are believed to be due to issues that occur around the time of birth, often just after birth. Multiple-birth infants are also more likely than single-birth infants to have CP. They are also more likely to be born with
5115-431: The child is 18 months of age or younger. Infants may have temporary problems with muscle tone or control that can be confused with CP, which is permanent. A metabolism disorder or tumors in the nervous system may appear to be CP; metabolic disorders, in particular, can produce brain problems that look like CP on an MRI. Disorders that deteriorate the white matter in the brain and problems that cause spasms and weakness in
5208-551: The child is 36 months of age before making a diagnosis because, by that age, motor capacity is easier to assess. CP is classified by the types of motor impairment of the limbs or organs, and by restrictions to the activities an affected person may perform. The Gross Motor Function Classification System -Expanded and Revised and the Manual Ability Classification System are used to describe mobility and manual dexterity in people with cerebral palsy, and recently
5301-450: The child's mobility, speech and language, hearing, vision, gait, feeding and digestion are also useful to determine the extent of the disorder. Early diagnosis and intervention are seen as being a key part of managing cerebral palsy. Machine learning algorithms facilitate automatic early diagnosis, with methods such as deep neural network and geometric feature fusion producing high accuracy in predicting cerebral palsy from short videos. It
5394-453: The company, PCD Maltron Ltd, stems from Hobday's original electronics firm, Printed Circuit Design Limited, based in Farnborough, Hampshire . The seeds of PCD Maltron were sown when another Hampshire business had inquired about the possibility of custom manufacture of a computer keyboard. This led to discussions with Farnborough Technical College about the design of the keyboard and in turn to
5487-460: The context of sporting activities. Hip dislocation and ankle equinus or plantar flexion deformity are the two most common deformities among children with cerebral palsy. Additionally, flexion deformity of the hip and knee can occur. Torsional deformities of long bones such as the femur and tibia are also encountered, among others. Children may develop scoliosis before the age of 10 – estimated prevalence of scoliosis in children with CP
5580-475: The degree of spasticity, a person with the spastic form of CP may exhibit a variety of angular joint deformities. Because vertebral bodies need vertical gravitational loading forces to develop properly, spasticity and an abnormal gait can hinder proper or full bone and skeletal development. People with CP tend to be shorter in height than the average person because their bones are not allowed to grow to their full potential. Sometimes bones grow to different lengths, so
5673-669: The developing fetal or infant brain." While movement problems are the central feature of CP, difficulties with thinking, learning, feeling, communication and behavior often co-occur, with 28% having epilepsy , 58% having difficulties with communication, at least 42% having problems with their vision, and 23–56% having learning disabilities . Muscle contractions in people with cerebral palsy-related high muscle tone are commonly thought to arise from overactivation. Although most people with CP have problems with increased muscle tone, some have low muscle tone instead. High muscle tone can either be due to spasticity or dystonia . Cerebral palsy
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#17328699980535766-439: The devices among the "world's weirdest keyboards", particularly the right-handed single-hand model that sold for US$ 413 at the time. In the Maltron layout, the home row of keys are "ANISF" for the left hand and "DTHOR" for the right. This can be used to type many more complete words than that found on a QWERTY keyboard. The Maltron layout was derived from frequency of use (FoU) statistics, plus additional considerations, such as
5859-416: The earlier PC-XT compatible Model B featured opposing keys near each other such as PgUp and PgDn aligned vertically on the left little finger, and arrow keys arranged UP/DN and LF/RT on either thumb, later models were to introduce a complete design philosophy where such keys were split into left-right locations matching the former re-arrangement of such characters as "(" and ")" which had been moved to sit above
5952-575: The early phases or aim at hip containment and restoration of anatomy in the late phases of disease. Equinus deformity is managed by conservative methods especially when dynamic. If fixed/static deformity ensues surgery may become mandatory. Growth spurts during puberty can make walking more difficult for people with CP and high muscle tone. Due to sensory and motor impairments, those with CP may have difficulty preparing food, holding utensils, or chewing and swallowing. An infant with CP may not be able to suck, swallow or chew. Gastro-oesophageal reflux
6045-458: The fetal membranes known as chorioamnionitis increases the risk. Intrauterine and neonatal insults (many of which are infectious) increase the risk. Rh blood type incompatibility can cause the mother's immune system to attack the baby's red blood cells. It has been hypothesised that some cases of cerebral palsy are caused by the death in very early pregnancy of an identical twin. The diagnosis of cerebral palsy has historically rested on
6138-461: The first years of life, underlying problems do not worsen over time. Cerebral palsy is caused by abnormal development or damage to the parts of the brain that control movement, balance, and posture. Most often, the problems occur during pregnancy, but may occur during childbirth or shortly afterwards. Often, the cause is unknown. Risk factors include preterm birth , being a twin , certain infections or exposure to methylmercury during pregnancy,
6231-418: The foot at the ankle. These terms refer to flexion in direction of the "back" of the foot, which is the upper surface of the foot when standing, and flexion in direction of the sole of the foot. These terms are used to resolve confusion, as technically extension of the joint is dorsiflexion, which could be considered counter-intuitive as the motion reduces the angle between the foot and the leg. Dorsiflexion
6324-423: The foot is turning of the sole of the foot inwards, shifting weight to the lateral edge. Inversion and eversion are movements that tilt the sole of the foot away from (eversion) or towards (inversion) the midline of the body. Eversion is the movement of the sole of the foot away from the median plane . Inversion is the movement of the sole towards the median plane . For example, inversion describes
6417-456: The form of tip-toeing gait , due to tightness of the Achilles tendon, and scissoring gait , due to tightness of the hip adductors. These gait patterns are among the most common gait abnormalities in children with cerebral palsy. However, orthopaedic manifestations of cerebral palsy are diverse. Additionally, crouch gait (also described as knee flexion gait) is prevalent among children who possess
6510-430: The gap in the next row). As the middle and ring fingers share the same tendon along the back of the hand, removing excess "under-reach" for the ring finger alleviates potential stress on this tendon thus contributing to the keyboard's overall success in reducing repetitive strain injuries . The keyboards have been made by hand since the 1970s. They have vacuum-formed cases and each switch is hand-wired. The keyboards have
6603-407: The growing bones of children. There may be an improvement in motor functions in the children and ability to walk. however, the main benefit derived from botulinum toxin A comes from its ability to reduce muscle tone and spasticity and thus prevent or delay the development of fixed muscle contractures. Ataxic cerebral palsy is observed in approximately 5–10% of all cases of cerebral palsy, making it
6696-459: The hands, feet, and eyes. In general, motion is classified according to the anatomical plane it occurs in. Flexion and extension are examples of angular motions, in which two axes of a joint are brought closer together or moved further apart. Rotational motion may occur at other joints, for example the shoulder , and are described as internal or external . Other terms, such as elevation and depression , describe movement above or below
6789-447: The horizontal plane. Many anatomical terms derive from Latin terms with the same meaning. Motions are classified after the anatomical planes they occur in, although movement is more often than not a combination of different motions occurring simultaneously in several planes. Motions can be split into categories relating to the nature of the joints involved: Apart from this motions can also be divided into: The study of movement in
6882-411: The human body is known as kinesiology . A categoric list of movements and the muscles involved can be found at list of movements of the human body . The prefix hyper- is sometimes added to describe movement beyond the normal limits, such as in hypermobility , hyperflexion or hyperextension . The range of motion describes the total range of motion that a joint is able to do. For example, if
6975-401: The keys." Tom's Hardware said that the keyboards were "one of the real first ergonomic, split keyboard to use keywells. Designed for people suffering from RSI, its makers sought to address the needs of people who were, or at the risk of, being harmed by extensive typing." Customers requested a halfway house between a conventional QWERTY keyboard and the curved Maltron, so a flat (2D) version
7068-433: The knees together, are examples of adduction. Adduction of the wrist is also known as ulnar deviation which moves the hand towards the ulnar styloid (or, towards the little finger ). Abduction of the wrist is also called radial deviation which moves the hand moving towards the radial styloid (or, towards the thumb ). Elevation and depression are movements above and below the horizontal. The words derive from
7161-451: The least frequent form of cerebral palsy. Ataxic cerebral palsy is caused by damage to cerebellar structures. Because of the damage to the cerebellum , which is essential for coordinating muscle movements and balance, patients with ataxic cerebral palsy experience problems in coordination, specifically in their arms, legs, and trunk. Ataxic cerebral palsy is known to decrease muscle tone. The most common manifestation of ataxic cerebral palsy
7254-404: The leg; for example, the movement when depressing a car pedal or standing on tiptoes. Palmarflexion and dorsiflexion refer to movement of the flexion (palmarflexion) or extension (dorsiflexion) of the hand at the wrist. These terms refer to flexion between the hand and the body's dorsal surface, which in anatomical position is considered the back of the arm; and flexion between the hand and
7347-612: The legs, may be mistaken for CP if they first appear early in life. However, these disorders get worse over time, and CP does not (although it may change in character). In infancy it may not be possible to tell the difference between them. In the UK, not being able to sit independently by the age of 8 months is regarded as a clinical sign for further monitoring. Fragile X syndrome (a cause of autism and intellectual disability) and general intellectual disability must also be ruled out. Cerebral palsy specialist John McLaughlin recommends waiting until
7440-405: The main early symptoms of CP. Symptoms and diagnosis typically occur by the age of two, although depending on factors like malformations and congenital issues, persons with milder forms of cerebral palsy may be over the age of five, if not in adulthood, when finally diagnosed. Cognitive assessments and medical observations are also useful to help confirm a diagnosis. Additionally, evaluations of
7533-648: The meeting with Malt. Stanley notes that Malt was almost erased from history in the 1970s, with only one of two 1979 articles in The Inventor (the journal of the British Institute of Patentees and Inventors) even mentioning her, crediting only Hobday. However, Malt did present a paper describing her work: Malt, Lillian G., 'Keyboard design in the electronic era', Printing Industry Research Association, Symposium Paper No. 6, September 1977. There are five models of Maltron keyboard. Two target general users, of which one
7626-459: The most frequent two- and three-letter combinations found in words. As much as possible, such combinations need to be placed as non-blocking sequences. Whilst the letter E is the most common letter in English, the space character is nearly twice as common; the comma and full stop are more frequent than the letters KVJZXQ. Directional or cursor keys have also been subject to changes in design. Whilst
7719-449: The numbers 5 & 6 (as "< >","[ ]", "{ }" and "/ \" had been similarly separated). This meant that any movement to the left or up (Backspace, PgUp, Left etc.) was keyed with the left hand, and any that moved right or down were keyed with the right hand. Further variation in design has been a slight rotation of the key bowl upward in the centre which reduces the amount of pronation in operators' wrists. Referring back specifically to
7812-797: The oral-facial muscles. There are three major types of dysarthria in cerebral palsy: spastic, dyskinetic (athetotic), and ataxic. Early use of augmentative and alternative communication systems may assist the child in developing spoken language skills. Overall language delay is associated with problems of cognition, deafness , and learned helplessness . Children with cerebral palsy are at risk of learned helplessness and becoming passive communicators, initiating little communication. Early intervention with this clientele, and their parents, often targets situations in which children communicate with others so that they learn that they can control people and objects in their environment through this communication, including making choices, decisions, and mistakes. Pain
7905-468: The person may have one leg longer than the other. Children with CP are prone to low trauma fractures , particularly children with higher Gross Motor Function Classification System (GMFCS) levels who cannot walk. This further affects a child's mobility, strength, and experience of pain, and can lead to missed schooling or child abuse suspicions. These children generally have fractures in the legs, whereas non-affected children mostly fracture their arms in
7998-433: The person's history and physical examination and is generally assessed at a young age. A general movements assessment , which involves measuring movements that occur spontaneously among those less than four months of age, appears most accurate. Children who are more severely affected are more likely to be noticed and diagnosed earlier. Abnormal muscle tone, delayed motor development and persistence of primitive reflexes are
8091-399: The placenta, birth defects , low birth weight, breathing meconium into the lungs , a delivery requiring either the use of instruments or an emergency Caesarean section , birth asphyxia, seizures just after birth, respiratory distress syndrome , low blood sugar , and infections in the baby. As of 2013 , it was unclear how much of a role birth asphyxia plays as a cause. It is unclear if
8184-403: The same meaning. Flexion is a bending movement that decreases the angle between a segment and its proximal segment. For example, bending the elbow , or clenching a hand into a fist, are examples of flexion. When a person is sitting down, the knees are flexed. When a joint can move forward and backward, such as the neck and trunk, flexion is movement in the anterior direction. When the chin
8277-446: The size of the placenta plays a role. As of 2015 it is evident that in advanced countries, most cases of cerebral palsy in term or near-term neonates have explanations other than asphyxia. Cerebral palsy is not commonly considered a genetic disease. About 2% of all CP cases are expected to be inherited, with glutamate decarboxylase-1 being one of the possible enzymes involved. Most inherited cases are autosomal recessive . However,
8370-410: The two thumb keys has also been raised to prevent the "dropped-wrist" operation of the number pad, although because of its location and layout, the keyboard must be moved laterally when entering continuous numeric data, to accommodate the dominant hand (left or right). This increases the amount of desk space the keyboard needs. There is only one key below the home row for the ring finger (made obvious by
8463-417: The vast majority of CP cases are connected to brain damage during birth and in infancy. There is a small percentage of CP cases caused by brain damage that stemmed from the prenatal period, which is estimated to be less than 5% of CP cases overall. Moreover, there is no one reason why some CP cases come from prenatal brain damage, and it is not known if those cases have a genetic basis. Cerebellar hypoplasia
8556-399: The whole body. Mixed cerebral palsy has symptoms of dyskinetic, ataxic and spastic CP appearing simultaneously, each to varying degrees, and both with and without symptoms of each. Mixed CP is the most difficult to treat as it is extremely heterogeneous and sometimes unpredictable in its symptoms and development over the lifespan. Pronation Motion , the process of movement,
8649-598: Was introduced which although lacking the curvature of the 3D keyboard, incorporates split key groups, and offset letter rows to accommodate the different lengths of the fingers. For severely disabled users, there are the single-handed, headstick, mouthstick and expanded models. All Maltron keyboards use Cherry MX brand key-switches, which are much more responsive and durable than the membrane or dome key-switches used on most keyboards. Maltron 3D and 2D (flat) keyboards are produced with three different layouts: QWERTY , Dvorak and Maltron. In 2009, PC World magazine named
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