Dr Iain A Sanderson

Research; Cognition and Proprioception

International LawThe United Nations Convention on the Rights of Persons with Disabilities became an International Legal Instrument in 2010.

Article 11 (Situations of Risk) imposes obligations on all States Parties, National/Local Authorities Having Jurisdiction (AHJ's), Building Designers & Fire Engineers to the effect that people with disabilities have a right, recognized in international law, to equal opportunity and to non-discrimination in matters of building fire safety, protection and evacuation.

European Disability Strategy 2010-2020 - guide

The overall aim is to empower people with disabilities so that they can enjoy their rights and participate fully in society

“People With Disability” is the only minority group anyone can join at anytime(Dr Vernon Houk US Center For Disease Control and Prevention)

Now What?

Scottish Government

• The focus on access into premises to enable disabled people to fully use a building, needs to be matched with arrangements for their safe egress in the event of fire.

Research

What is out there ?

Physical Disabilities

• A.P.M. Adams and E.R. Galea• Fire Safety Engineering Group (FSEG)

of the University of Greenwich in collaboration with the Universitair Ziekenhuis (UZ) Gent (University Hospital of Gent) (2008)

HBIF 2012

• EVACUATION CHARACTERISTICS OF BLIND AND VISUALLY IMPAIRED PEOPLE: WALKING SPEEDS ON HORIZONTAL PLANES AND DESCENDING STAIRS

– Janne G. Sørensen & Anne S. Dederichs

• EVACUATION OF PEOPLE WITH DISABILITIES ON STAIRS – Erica Kuligowski, Bryan Hoskins, Richard Peacock, Emily Wiess

• AN ANALYSIS OF THE PERFORMACE OF TRAINED STAFF USING MOVEMENT ASSIST DEVICES TO EVACUATE THE NON-AMBULANT

– Aoife Hunt, Edwin R. Galea and Peter J. Lawrence

HBIF 2012

• ERGONOMIC EVALUATION OF MANUALLY CARRIED AND TRACK-TYPE STAIR DESCENT DEVICES USED FOR THE EVACUATION OF HIGH RISE BUILDINGS

– Steven A. Lavender , Glenn E. Hedman, Paul A. Reichelt, Jay P. Mehta

• EVACUATING VULNERABLE AND DEPENDENT PEOPLE FROM A FIRE IN A BUILDING • David Charters and David Crowder

• KNOWLEDGE OF REFUGE AREAS IN THE EVACUATION OF MULTI-STOREY BUILDINGS: THE END USERS’ PERSPECTIVES

– Nigel C McConnell & Karen E Boyce

Physical Disabilities

• Lifts• Karen Boyce (FireSERT)• DCLG (ADB)• NZ• ABCB (ABC)• SFPE Fire Engineering Handbook• Computer Modeling

Physical Disabilities

• History of Inclusive Design in the UK – P. John Clarkson, Roger Coleman—(Applied Ergonomics 46 (2015))

• No mention of Evacuation Issues

Cognitive Disabilities• Dyslexia

– Dyslexia is the most common form of language-based learning disability.

• Attention Deficit Hyperactivity Disorder (ADHD) – ADHD is a medical condition affecting a

person's ability to focus, sit still, and pay attention. They may have difficulty in focusing on tasks or subjects, or act impulsively; they may also get into trouble.

Cognitive Disabilities

• Brain Injury – There are a number of causes of brain

injury, including Stroke, illness, Traumatic Brain Injury (TBI), brain tumors, and Meningitis, among others.

– Each brain injury is unique - there is no reliable way to predict how an individual's brain will be affected by a particular injury.

Cognitive Disabilities

– The extent of the injury to the person's brain determines the outcome of the person's ability to process information.

Cognitive Disabilities

• Genetic Disability • Disabilities such as Down syndrome,

Autism, and Dementia, affect people individually. Some persons with these disabilities are able to function at higher levels than others.

Cognitive Disabilities

– Persons with Down's syndrome, for example, may function at a high enough level to live independently, while others with the syndrome need consistent assistance with activities of daily living.

– The greater the severity of the cognitive disability the person experiences, the more difficult it is for the individual to comprehend

Cognitive DisabilitiesAccess to Buildings

• L. Castell (Department of Construction Management, Curtin University of Technology, Perth, Western Australia)

– “However, the lack of evidence based research means designers may not understand what they need to do to provide appropriate access. Interestingly though, previous case studies have shown that, when asked, people with ID have described a whole range of issues that affect their use of a building.”

Cognitive DisabilitiesEscape From Buildings

• Limited research has been conducted on evacuation procedures for intellectually-impaired occupants.

• Most research on this subject presents specific case studies, where a person with an intellectual disability has been trained to evacuate a building under various stimulus conditions using reinforcement(Guylène Proulx 2002)

Cognitive Disabilities

• GCU• NZ (University of Canterbury)• Daniel J. Goble, Assistant Professor

and Director of the SMaRTlab at San Diego State University

• Vince Bowles (Scottish Autism)• Alzheimer's Scotland

Proprioception

Impact on Evacuation

What is it?

Coined in 1906 by neurophysiologist Charles Scott Sherrington

Proprioception• Perception of stimuli relating to position,

posture, equilibrium, or internal condition. Receptors (nerve endings) in skeletal muscles and on tendons provide constant information on limb position and muscle action for coordination of limb movements.

• Awareness of equilibrium changes usually involves perception of gravity.

Proprioception

• The proprioceptive sense is the part of the nervous system that integrates the input from the five senses, vision, hearing, taste, smell, and touch, to create meaning of the environment and your place in it.  

Proprioception

• The proprioceptive sense is quite dependent on visual-spatial and tactile input to sense up/down/under/over- any position in space.  

• This information is processed in the brain’s vestibular centre, - the area that fails to develop normally in children with ASD.  

• It is also the area in the brain that is particularly vulnerable to many neurodegenerative diseases.

Proprioception

• Position sense– The ability to sense the static position of a

joint, or limb segment

• Motion sense– The ability to sense joint movement, known

as kinesthesia

Field Sobriety Test

Romberg Test

A test used in an examination of neurological function, and also as a test for drunken driving.

Romberg TestThe examination is based on the premise that a person requires at least two of the three following senses to maintain balance while standing: proprioception (the ability to know one's body in space); vestibular function (the ability to know one's head position in space); and vision (which can be used to monitor [and adjust for] changes in body position).

When is Proprioception an Issue?

• Ataxia with Vitamin E Deficiency• Degenerative disease • Familial isolated deficiency of vitamin E• Ischemia Meningitis • Malignant astrocytoma• Multiple Sclerosis • Olivopontocerebellar atrophy• Sensory ataxia• Shingles

When is Proprioception an Issue?• Spinal Cord Injury • Spinal cord tumour • Tuberculosis • Louis Gehrig’s Disease/ Amyotrophic Lateral

Sclerosis (ALS) • Parkinson’s • Autism Spectrum Disorder (ASD)• Elderly

Ataxia

• Ataxia is defined as a difficulty of gait. It is a very common neurologic complaint, particularly in an elderly population and is often multi-factorial.

• Ataxia is a generic term for inability to coordinate movement. It is often applied to imbalance of gait.

Parkinson’s Disease

World Parkinson’s Day 11th April 2015

1.2 million people living with Parkinson’s Disease in Europe

Parkinson's Disease (PD)

• Evidence indicates that PD patients also experience an array of sensory problems that negatively impact motor function.

• This is especially true for proprioceptive deficits, which profoundly degrade motor performance.

Parkinson’s Disease (PD)

• Kinaesthesia is commonly defined as the conscious awareness of body or limb position and motion in space. It is based on sensory information derived from receptors in the muscles, tendons, and joint capsules.

Parkinson’s Disease (PD)

• These receptors provide information about muscle length, contractile speed, muscle tension, and joint position.

• Collectively, this is also referred to as proprioception or muscle sense.

• Levodopa medication may further decrease proprioceptive sensitivity

Elderly• Proprioception• Mounting evidence suggests that

declines in proprioceptive function may represent a fundamental aspect of the aging process

Elderly

• Proprioception is a large component of normal development.

• It is also a large component of reverse development (aka Alzheimer’s).

Autism Spectrum Disorder (ASD)

• Proprioception• Hypersensitivity• Hyposensitivity• Routine• Communication• Learning

What Now?

• Research• Education• Compassion