Showing papers in "Disability and Rehabilitation: Assistive Technology in 2020"
TL;DR: Research relating to the use of Augmented Reality technology for rehabilitation after stroke is explored in order to better understand the current, and potential future application of this technology to enhance stroke rehabilitation.
Abstract: To explore research relating to the use of Augmented Reality (AR) technology for rehabilitation after stroke in order to better understand the current, and potential future application of this tech...
45 citations
TL;DR: A survey on the research and development of cable-driven rehabilitation devices (CDRDs) finds that with up-to-date human-robot interaction techniques, CDRDs are more interesting and motivating to trainees than conventional manual rehabilitation therapies.
Abstract: Purpose: To conduct a survey on the research and development of cable-driven rehabilitation devices (CDRDs). Method: This review searches in the databases of PubMed, IEEE Xplore Digital Library, Science Direct, and Google Scholar using various combinations of the following keywords: cable, wire, rehabilitation, assistance, therapy, training, robot, elastic, and pneumatic. Searches in the above databases for references cited by the above-searched references are also conducted to include a larger context of CDRDs. Results: CDRDs are classified into four categories, namely, serial exoskeleton-based, parallel exoskeleton-based, serial end-effector-based, and parallel end-effector-based CDRDs. Each category of CDRDs are further grouped based on the part of the human body to be rehabilitated. All four categories of CDRDs are examined and compared and their advantages and shortcomings are discussed based on popular rehabilitation requirements on weight, adaptability, versatility, misalignment, and safety. Open issues of CDRDs are also discussed.Conclusions: Each category of CDRDs has its own advantages and shortcomings. The selection of a CDRD highly depends on the specific application. Regarding the convenience of setting up a CDRD for rehabilitation, parallel CDRDs usually have better adaptability than serial ones. However, uncertainties come with parallel CDRDs, which makes the control of parallel CDRDs more challenging. Moreover, the strategy of inherent safety has a great potential to further improve the safety of CDRDs.Implications for rehabilitationCDRDs (and general RRDs) can deliver high-intensity training while therapists usually cannot. With up-to-date human-robot interaction techniques (e.g., virtual reality), CDRDs are more interesting and motivating to trainees than conventional manual rehabilitation therapies. CDRDs also provide financial benefits in the long-run. Currently existing RRDs available for clinical practice are mainly designed for the rehabilitation of shoulders, elbows, and knees. Parallel exoskeleton-based CDRDs can also be used for the rehabilitation of many other parts of trainees. Thus, CDRDs extend the coverage of RRDs in rehabilitation. Owing to their simple structures and light weights, CDRDs can be portable and used for rehabilitation at home. In this way, CDRDs can improve the duration and intensity of rehabilitation for those with limited access to rehabilitation institutes. As well known, the higher intensity of training leads to a higher rate of recovery.
40 citations
TL;DR: Early evidence from other healthcare disciplines suggests that VR is an engaging means of delivering immersive and interactive training to build functional skills that can be generalized to the real world.
Abstract: Background: Technology devices and applications including virtual reality (VR) are increasingly used in healthcare research and practice as tools to promote health and wellbeing. However, there is limited research examining the potential for VR to enable improved communication for people with communication disability.Aims: To review: (a) current research using VR in speech-language pathology; and (b) the ethical and safety considerations of VR research, to inform an agenda for future research applying VR in the field of speech-language pathology.Main contribution: This review reveals that there is an emergent body of literature applying VR to improve or develop physical, psychological and communication interventions. Use of non-immersive virtual environments to provide speech-language pathology assessment or intervention for people with communication disability has demonstrated positive outcomes, with emerging evidence of the transfer of functional communication skills from virtual to real-world environments. However, the use of VR technology and immersive virtual environments in communication disability practice and research introduces safety and ethical issues that must be carefully considered.Conclusions: Research employing VR is in its infancy in the field of speech-language pathology. Early evidence from other healthcare disciplines suggests that VR is an engaging means of delivering immersive and interactive training to build functional skills that can be generalized to the real world. While the introduction of new technology requires careful consideration of research ethics and patient safety, future VR communication research could proceed safely with adequate engagement of interdisciplinary teams and technology specialists.Implications for rehabilitationImmersive virtual reality may be used in rehabilitation to simulate natural environments to practice and develop communication skills.The sense of immersion that can be achieved using virtual reality may promote the generalization of skills learnt during clinical rehabilitation to real-world situations.Ethical and safety considerations, including cybersecurity and cybersickness, must be carefully monitored during all virtual reality research.
37 citations
TL;DR: Up to the present moment, the main challenges in the field of robot rehabilitation are the lack of unique rehabilitation protocols capable to fulfil the needs of all types of patients and the additional resources to measure the effectiveness of proposals that have not yet been commercialized.
Abstract: Aim: The aim of this review paper is to summarize recent developments and research in robotics, relevant to the field of ankle rehabilitation, to overview new findings and determine the actual state of the art.Method: The literature search was performed using scientific and medical databases (Scopus, PubMed and Web of Science) and other websites related to robots used in the area of ankle rehabilitation, analysing studies from 1950s to present. Information about the mechanical and kinematic specifications, actuation and stage of development was extracted from the selected literature.Results: Several types of rehabilitation robots have been considered, and they were classified depending on their architecture and design features. We we found that, regardless of the differences in architectures, only a few of them have been commercialized. The majority of rehabilitation robots designs allows plantarflexion-dorsiflexion movements. Unless some exceptions, most of the wearable robots do not allow the adduction-abduction movement. Neither the physical appearance of the robot nor the user's perception towards it has not regularly been taken into account in the design stage. This limits the possibility of successful commercialization.Conclusions: Up to the present moment, the main challenges in the field of robot rehabilitation are the lack of unique rehabilitation protocols capable to fulfil the needs of all types of patients and the additional resources to measure the effectiveness of proposals that have not yet been commercialized. Nonetheless, we have mentioned above three areas were the challenges in design are more pressing. The first one is the robot architecture, which still presents some incommodities nowadays to emulate the ankle joint movement in a natural way. Thus, the displacements experienced by the axes in the joint must be adaptable to each patient and a wide range of pathologies. Moreover, many proposals are not been conceived to the purpose of commercialization, and even less to become an object of personal use.Implications for rehabilitationThis review states that the use of robotic devices for ankle rehabilitation is a consolidated paradigm in the ankle's rehabilitation.Platform-based robots allow to do complex and specialized spatial movements and these architectures endow the device with high stiffness, a balanced force distribution and better adaptability to the mechanical properties of human ankle joints. Unless some exceptions, most of the wearable robots do not allow the adduction-abduction movement.For a full integration of these technologies in the ankle's rehabilitation field, more clinical evaluations are needed.Regardless of the potential of robotic devices in rehabilitation, only a few of them have been commercialized.
37 citations
TL;DR: A lightweight unpowered ankle exoskeleton that relies on the spring-like properties of a Pneumatic Artificial Muscle, which is inflated and sealed, to provide significant contribution to the ankle torque, timed to release precisely at the push-off phase of the gait cycle.
Abstract: Aim: Assistive technologies traditionally rely on either powered actuation or passive structures to provide increased strength, support or the ability to perform specific functions. At one end of t...
34 citations
TL;DR: A review of studies that included the use of games for stroke rehabilitation to understand the design principles and characteristics of the games used for these purposes shows that the usage of gaming technologies is a very effective interactive mechanism for stroke based rehabilitation.
Abstract: Aims and Objectives: Stroke is the main cause of long-term disability and happens mostly in the older population. Stroke affected patients experience either of the cognitive, visual or motor losses...
34 citations
TL;DR: Virtual reality therapy has the potential to improve various motor, cognitive and physical deficits following stroke, highlighting its usefulness in rehabilitation settings and is a promising new form of technology that has been shown to increase patient satisfaction towards stroke rehabilitation.
Abstract: Introduction: Virtual reality (VR) are user-computer interface platforms that implement real-time simulation of an activity or environment, allowing user interaction via multiple sensory modalities...
31 citations
TL;DR: The tablet-based program can be highly beneficial for people with moderate intellectual disability, sensory and/or motor impairments, and lack of expressive or expressive and receptive verbal skills to select and access leisure activities and video calls independently.
Abstract: Purpose: This study evaluated a tablet-based program to help eight participants with moderate intellectual disability, sensory and/or motor impairments, and lack of expressive or expressive and receptive verbal skills to select and access leisure activities and video calls independently.Methods: The program relied on the use of a tablet (i.e., Samsung Galaxy Tab S2 LTE) with 8-inch screen, Android 6.0 Operating System, front camera, proximity sensor and multimedia player. The tablet was fitted with a SIM card and two specific applications, that is, WhatsApp Messenger for making video calls and MacroDroid for automating the tablet's functioning in accordance with the program conditions. The tablet presented pictures concerning leisure activities and preferred partners for video calls. The participant could select any activity or partner by touching (or nearing his or her hand to) the tablet's proximity sensor.Results: During the baseline (i.e., without the program), the participants failed to access leisure activities or video calls. During the post-intervention phase (i.e., with the program), they selected and accessed those activities and calls independently and spent between about 75% and 90% of the session time engaging with them.Conclusion: The tablet-based program can be highly beneficial for people like the participants of this study.Implications for rehabilitationA technology-aided program may enable persons with intellectual and other disabilities to independently access leisure activities and communication with distant partners.The program may involve the use of video calls to allow communication to participants with limited or no verbal skills.The program may be realized using a tablet (a) including Android 6.0 Operating System, proximity sensor, and multimedia player, and (b) fitted with a SIM card and applications such as WhatsApp Messenger and MacroDroid.The program may be easily adapted to the participants' characteristics in terms of activities available and partners to reach.
30 citations
TL;DR: The feasibility of integrating the Ekso Gait Training device into inpatient rehabilitation in a neurologic population and overcoming barriers to implementation required administrative support and clinician persistence over several months appears feasible.
Abstract: Objective: Learning to walk is a major goal of inpatient rehabilitation and robotic exoskeletons may provide a new gait training approach. Our purpose was to determine the feasibility of integrating the Ekso Gait Training device into inpatient rehabilitation in a neurologic population.Design: Longitudinal cohort design and convenience sample including physical therapists trained to use the Ekso Bionics Ekso GT™ robotic exoskeleton or inpatients with stroke or SCI. Therapists completed a focus group and survey at baseline and 6 months after initial Ekso training. Patients completed a survey indicating their satisfaction with using the Ekso.Results: Twenty-five patients used the Ekso an average of 4.5 sessions during their 38.5-day rehabilitation stay. Survey and focus group feedback revealed that therapists encountered measurement difficulties with the Ekso and limited treatment time influencing effectiveness of usage. After 6 months, therapists reported an improvement in feasibility. Patients tolerated Ekso sessions well, without any complications or adverse incidents, and reported improved mobility post session.Conclusion: Integrating Ekso gait training into clinical practice was not seamless but appears feasible. Barriers were addressed within the rehabilitation team and received administrative support in a process lasting several months. Patients enjoyed walking in Ekso and felt secure within the device.Implications for rehabilitationIntegrating Ekso gait training into clinical practice during inpatient rehabilitation is feasible.Overcoming barriers to implementation required administrative support and clinician persistence over several months.Patients tolerated Ekso sessions well, without any complications or adverse incidents.
27 citations
TL;DR: Positive participant responses including decrease in pain, anxiety, and depression are yielded, and knowledge gaps and evolving models of creative arts therapies telehealth for military-connected populations are elucidated.
Abstract: Purpose: Telehealth provides psychotherapeutic interventions and psychoeducation for remote populations with limited access to in-person behavioural health and/or rehabilitation treatment. The Unit...
27 citations
TL;DR: Smart home and communication technology can improve outcomes for people living with disabilities and complex needs, but a number of factors impact the successful implementation of technology, including personalization, flexibility and ongoing support to the person with a disability and their close others.
Abstract: The links between disability, activity limitation and participation restriction are well established. Recent and continued advancement of technology, particularly smart home and communication techn...
TL;DR: Using humanoid robots as social assistive robots may benefit therapeutic processes on children with motor disabilities, and requires researchers to conduct more studies to validate the potential of the use of social robots in therapeutic interventions that promote development in children with cerebral palsy.
Abstract: Background: Children with cerebral palsy have difficulty to sit, stand, walk, run and jump independently. Therapy is an important factor in improving these aspects, and if applied in early intervention treatments, when the child is growing, it could have many benefits. These therapies require intensive and extended sessions, which in turn demand dedication and effort. New strategies that provide interesting and motivating interventions are often incorporated to improve the participation and performance of the children in the therapies. Therapies using social assistive robots can be alternative and complementary methods to promote the participation and motivation of children with cerebral palsy.Methods: The objective of this work is to validate the effectiveness of a 16-session physical therapy program to improve the participation and fulfillment of therapeutic objectives on an 8 year-old boy with dyskinetic cerebral palsy for motor learning to walk using a social assistive robot. The therapy program was carried out through a methodological proposal that uses SMART objectives (Specific, Measurable, Achievable, Realistic and Timed), Goal-Directed Therapy (GDT) and its evaluation through Goal Attainment Scaling (GAS). Results: A NAO robot was used as a social assistive robot to support a physical therapy for a child with cerebral palsy. In this work, it was observed that the motivation generated by the interaction with the social assistive robot facilitated the persistence in the walking and the fulfillment of the objectives. Conclusion: Using humanoid robots as social assistive robots may benefit therapeutic processes on children with motor disabilities. The methodology developed provides a formal way to achieve objectives in therapeutic processes for children with cerebral palsy.Implications for rehabilitationIt requires researchers to conduct more studies to validate the potential of the use of social robots in therapeutic interventions that promote development in children with motor disabilities, such as cerebral palsy.Promoting the use of new technologies in therapeutic processes such as humanoid robots allows us to create new strategies to know the impact of this technology in the area of rehabilitation.The use of formal methodologies focused on the patient, along with multidisciplinary teams, could increase the possibilities of using social robots to improve cognitive and motor outcomes in children with cerebral palsy.The formulation of SMART objectives and their quantification through the GAS scale can be used as recommendations to improve the formulation of goals in therapeutic interventions for children with cerebral palsy.
TL;DR: Success of SARs as a home-health technology for ADRD is reliant on the timing of their integration, commercial viability, funding provisions, and their bonding with the care recipient, according to a broader outlook.
Abstract: Purpose: Innovative assistive technology can address aging-in-place and caregiving needs of individuals with Alzheimer's disease and related dementia (ADRD). The purpose of this study was to beta-test a novel socially assistive robot (SAR) with a cohort of ADRD caregivers and gather their perspectives on its potential integration in the home context.Methods: The SAR involved a programmable research robot linked with commercially available Internet of things sensors to receive and respond to care recipient's behaviour. Eight caregivers observed the SAR perform two care protocols concerning the care recipient's daily routine and home safety, and then participated in a focus group and phone interview. The researchers used grounded theory and the Unified Theory of Acceptance and Use of Technology as a framework to gather and analyse the data.Results: The caregivers' asserted the potential of the SAR to relieve care burden and envisioned it as a next-generation technology for caregivers. Adoption of the SAR, as an identified theme, was subject to the SAR's navigability, care recipient engagement, adaptability, humanoid features, and interface design. In contrast, barriers leading to potential rejection were technological complexity, system failure, exasperation of burden, and failure to address digital divide.Conclusion: From a broader outlook, success of SARs as a home-health technology for ADRD is reliant on the timing of their integration, commercial viability, funding provisions, and their bonding with the care recipient. Long-term research in the home settings is required to verify the usability and impact of SARs in mediating aging-in-place of individuals with ADRD.IMPLICATIONS FOR REHABILITATIONSocially assistive robots (SARs), an emerging domain of assistive technology, are projected to have a crucial role in supporting aging-in-place of individuals with Alzheimer's disease and related dementia (ADRD).Caregivers of individuals with ADRD who observed and interacted with a novel SAR asserted their acceptance of the technology as well as its scope and feasibility for the upcoming generation of caregivers.Navigability, care recipient engagement, adaptability, humanoid features, and interface design were stated to be critical factors for SAR's acceptance by caregiver and care recipient dyads.In contrast, technological complexity, system failure, exasperation of burden, and failure to address digital divide are detrimental to SAR's adoption.Several design and implementation requirements must be considered towards the full-scale development and deployment of the SARs in the home context.
TL;DR: The common barriers to acquiring and using assistive technology for users with chronic conditions are identified through a systematic meta-synthesis by applying a transdiagnostic approach to identify if barriers are common across chronic conditions.
Abstract: Assistive technology can provide a key tool to enabling independence, greater inclusion and participation in society for individuals with chronic conditions. This potential is currently not always ...
TL;DR: Considering that most of the studies related to the satisfaction and adjustment of the prosthesis are cross-sectional studies, longitudinal studies should be conducted, since monitoring individuals over the years and verifying how these variables change over time may contribute to obtaining more data on the factors that influence prosthetic fitting and satisfaction.
Abstract: Background: Adjustment to amputation is a complex process because it encompasses physical and psychosocial aspects as well as satisfaction with the artificial limb.Purpose: To review the scientific...
TL;DR: The aesthetics of assistive devices was observed as an important factor that influences the adoption or abandonment of the device, and designers should consider aesthetics in addition to functionality in order to avoid the perceived stigma, thereby reducing the chances of device abandonment.
Abstract: Purpose: The aim of this study was to identify factors that influence the perceived stigma of two assistive devices for visual impairment, namely the white cane and smart glasses.Method: Face-to-face semi-structured interviews with eight European students were conducted to probe their experiences and knowledge related to disability, assistive technology, visual impairment, as well as handheld and wearable devices.Results: Close relationships with disabled people seems to have a positive influence on participants perceptions about stigma, disability, and assistive technology. Academic background seems to not have any influence. The aesthetics of assistive devices was observed as an important factor that influences the adoption or abandonment of the device.Conclusion: Device without negative symbolism but with modern aesthetics (smart glasses) were positively accepted by the participants than the device with traditional aesthetics and symbolisms of visual impairment (white cane). Designers should, therefore, consider aesthetics in addition to functionality in order to avoid the perceived stigma, thereby reducing the chances of device abandonment.IMPLICATIONS FOR REHABILITATIONUnderstanding the factors that influence the perceived stigma associated with assistive technology can help designers and developers to reduce assistive technology abandonment and perceived stigma.Designers need to consider both functionality and aesthetics. While functionality is crucial for the users' adaptation, aesthetics is important for the users' positive perceptions.
TL;DR: Considering the usability issues and solutions identified in this study will go a long way towards aiding subsequent researchers and developers in the implementation of more usable and valid telecare monitoring systems.
Abstract: BACKGROUND: The idea of product usability has been discussed in several research areas including product research and development. Usability, in telecare monitoring systems, determines how much the ...
TL;DR: The adaptability of additive manufacturing and soft robotics to the highlighted concerns of participants shows that further research into these techniques is a feasible method to improve patient satisfaction and acceptance in prosthetic hands.
Abstract: Purpose: Upper limb prostheses are part of a rapidly changing market place. Despite development in device design, surveys report low levels of uptake and dissatisfaction with current prosthetic design. In this study, we present the results of a survey conducted with people with upper limb difference in Australia on their use of current prostheses and preferences in a prosthetic in order to inform future prosthetic hand design.Methods: An online survey was conducted on upper limb amputees, with 27 respondents that completed the survey. The survey was a mixture of open-ended questions, ranking design features and quantitative questions on problems experienced and desired attributes of future prosthesis designs.Results: Common key issues and concerns were isolated in the survey related to the weight, manipulation and dexterity, aesthetics, sensory feedback and financial cost; each of which could be addressed by additive manufacturing and soft robotics techniques.Conclusions: The adaptability of additive manufacturing and soft robotics to the highlighted concerns of participants shows that further research into these techniques is a feasible method to improve patient satisfaction and acceptance in prosthetic hands.Implications for rehabilitationEven with recent developments and advances in prosthetic design, the needs and desires of prosthetic users are not being met with current products.The desires and needs of those with upper limb difference are diverse.Using additive manufacturing to produce prosthetics allows for mass customization of prosthetics to meet these diverse needs while reducing costs.A soft robotic approach to prosthetics can help meet the desires of reducing weight and costs, while maintaining functionality.
TL;DR: A standardized 3D printing assistive technology intervention and a research methodology are developed, using pillboxes as an example, to develop a replicable process that supports professionals in printing their own assistive technologies.
Abstract: Three-dimensional (3D) printing now allows rehabilitation professionals to design and manufacture assistive technologies in a few hours. However, there is limited guidance for researchers and clinicians for implementing 3D printing assistive technology interventions and measuring their outcomes. The goal of this study was to develop a standardized 3D printing assistive technology intervention and a research methodology, using pillboxes as an example. Fourteen pillbox users engaged in a study comparing their use of an off-the-shelf pillbox to a customized 3D printed pillbox. Study outcomes were evaluated on feasibility (recruitment capability, study procedures and outcome measures, acceptability of the study procedures, the research team's ability to manage and implement the study, and the participant's preliminary response to intervention). Participant outcomes were measured on satisfaction with the device and medication adherence. Fourteen participants completed the study and received customized 3D printed pillboxes. The study design performed well on all aspects of feasibility except the research team's ability to manage and implement the study, as they experienced several technical issues. Notably, the participants reported improved device satisfaction and medication adherence with the 3D printed device with large effect sizes. The 3D printed assistive technology intervention is a replicable process that supports professionals in printing their own assistive technologies. Recommendations are made to further enhance feasibility of 3D printing assistive technology studies. Future research is warranted.IMPLICATIONS FOR REHABILITATION3D printing is an increasingly feasible approach allowing for the design and manufacture of customized assistive technologyEvaluation for assistive technology that will be 3D printed should include information about the person's activities, routines, skills, abilities, and preferences. Evaluation of outcomes should include satisfaction with the device and a functional measure.3D printed assistive technology interventions should include the collaboration between the assistive technology professional and client. It should also include device training.Future 3D printing research studies should report pragmatic data including printing device, time to print, and number of errors.
TL;DR: This article provides an overview of prosthetic design considerations and options to help create a more informed rehabilitation team, leading to improved outcomes in prescription and management of upper limb prosthetics.
Abstract: Purpose: This review was conducted to provide an overview of current literature as it relates to upper limb difference, available componentry, and prosthetic options and design. Emerging technologies combined with an increased awareness of the limb difference community have contributed to recent advancements in upper extremity prosthetics.Methods: A search of five major clinical databases utilizing keywords relating to upper limb prostheses, componenty and limb difference levels resulted in over 1200 articles. These articles were subjected to inclusion and exclusion criteria in order to identify current peer reviewed research relevant to this topic.Results: Fifty-five applicable articles and sources of standards were reviewed based on the inclusion and exclusion criteria, presenting five general options for prosthetic intervention. This information was assimilated and categorized in this article, which provides an overview of the aforementioned options.Conclusion: While a noteworthy amount of research focuses on technological advancements, the five options for prosthetic intervention are inherently represented in the current literature. For individuals with upper limb difference, as well as their care team, successful rehabilitation hinges on awareness of new components, the functional efficacy of these components, and the evolved techniques used in prosthetic design and fabrication. It is noted that the rapid evolution of upper limb prosthetics consistently outpaces research and publication of information.Implications for rehabilitationTo provide an overview of prosthetic design considerations and options to help create a more informed rehabilitation team, leading to improved outcomes in prescription and management of upper limb prosthetics.To bring awareness of current research in the field of upper limb prosthetics in order to provoke further exploration of the efficacy of prosthetic options and design considerations.
TL;DR: Most of the reviewed systems suffer from a rather fixed scheme for the semi-autonomous control and an inability to handle arbitrary objects, which makes the systems unlikely to perform well outside a controlled environment, such as a lab.
Abstract: Purpose: The advances in artificial intelligence have started to reach a level where autonomous systems are becoming increasingly popular as a way to aid people in their everyday life. Such intelligent systems may especially be beneficially for people struggling to complete common everyday tasks, such as individuals with movement-related disabilities. The focus of this paper is hence to review recent work in using computer vision for semi-autonomous control of assistive robotic manipulators (ARMs). Methods: Four databases were searched using a block search, yielding 257 papers which were reduced to 14 papers after applying various filtering criteria. Each paper was reviewed with focus on the hardware used, the autonomous behaviour achieved using computer vision and the scheme for semi-autonomous control of the system. Each of the reviewed systems were also sought characterized by grading their level of autonomy on a pre-defined scale.Conclusions: A re-occurring issue in the reviewed systems was the inability to handle arbitrary objects. This makes the systems unlikely to perform well outside a controlled environment, such as a lab. This issue could be addressed by having the systems recognize good grasping points or primitive shapes instead of specific pre-defined objects. Most of the reviewed systems did also use a rather simple strategy for the semi-autonomous control, where they switch either between full manual control or full automatic control. An alternative could be a control scheme relying on adaptive blending which could provide a more seamless experience for the user.Implications for rehabilitationAssistive robotic manipulators (ARMs) have the potential to empower individuals with disabilities by enabling them to complete common everyday tasks. This potential can be further enhanced by making the ARM semi-autonomous in order to actively aid the user.The scheme used for the semi-autonomous control of the ARM is crucial as it may be a hindrance if done incorrectly. Especially the ability to customize the semi-autonomous behaviour of the ARM is found to be important.Further research is needed to make the final move from the lab to the homes of the users. Most of the reviewed systems suffer from a rather fixed scheme for the semi-autonomous control and an inability to handle arbitrary objects.
TL;DR: A systematic review was performed evaluating the effectiveness of Information and Communication Technology-based Assistive Technology to compensate for impaired cognition in everyday life activities and concluded smartphones, personal digital assistants (PDAs), etc. can improve prospective memory, especially for people with ABI.
Abstract: Purpose: A systematic review was performed evaluating the effectiveness of Information and Communication Technology-based Assistive Technology (ICT-based-AT) to compensate for impaired cognition in...
TL;DR: In this article, a systematic literature review was conducted to examine the use of instruments, approaches, scales, or assessment tools to evaluate the technology acceptance and usability of ICTs for people living with dementia and their care partners.
Abstract: PURPOSE This review aims to examine the instruments, approaches, scales, or assessment tools used to evaluate technology acceptance, technology adoption, and usability of information and communication technologies (ICTs) for people living with dementia and their care partners. METHODS A systematic literature review was conducted. Studies that explored the use of instruments, approaches, scales, or assessment tools to evaluate the technology acceptance and usability of ICTs for people living with dementia and their care partners were identified through five databases: Medline, EMBASE, CINAHL, Web of Science, and Scopus. RESULTS We included 74 out of 2182 papers. The most common scales used included the System Usability Scale (SUS) (11%), the ISONORM 9241/10 Questionnaire (4%), and the Post-Study System Usability Questionnaire (PSSUQ) (4%). Most (59%) of the included approaches, however, were bespoke (i.e., created by the authors for a particular study) and were not named. The approaches or tools used to assess technology acceptance, technology adoption, and usability of ICTs that applied to people living with dementia had an average of 15 items and used an average of 5.23 scale points. CONCLUSION There is no clear, standardised approach for assessing the technology acceptance, technology adoption, and usability of ICTs for people living with dementia and their care partners. The findings of this review may be used by academics to design and implement improved and more consistent assessment tools to assess technology acceptance, technology adoption, and usability of ICTs for people living with dementia and their care partners.IMPLICATIONS FOR REHABILITATIONThe number of ICTs for people with dementia and their care partners that can be used for rehabilitation is increasingThe most commonly recognized assessment tools used in this study were the SUS, ISONORM 9241/10, and PSSUQ questionnaires.For the custom assessment tools, the average number of items included in this study was 15 with five-point bidirectional labelling.There is no clear, standardized approach for assessing the technology acceptance, technology adoption, or usability of ICTs for people with dementia and their care partners.
TL;DR: The introduction of care robots in elder care services seems to be more challenging than that of welfare technology in general, given the context and prevailing attitudes and preconceptions about robotics.
Abstract: Introduction: Care robots are machines, operating partly or completely autonomously, that are intended to assist older people and their caregivers. Care robots are seen as one part of the solution to the aging population, allowing fewer professional caregivers to provide the necessary assistance and care. Despite the potential benefits, the dissemination of care robots, and welfare technology in general, is limited in Swedish elder care.Purpose: To explore the challenges of introducing welfare technology, particularly care robots, in elder care.Materials and methods: Twenty-one individual interviews with key actors at the societal level, analysed by thematic analysis.Results: The challenges, from the societal actors' perspectives, were related to; the beliefs in technology, attitudes, ethics, collaboration, and the need for knowledge and skills regarding care robots (individual and group challenges). Challenges of a national character were: national governance, infrastructure, laws and regulations, economics, and procurement (systemic and societal challenges). In addition, the necessary preconditions for successful introduction were revealed as: the utility of the technology, implementation, evaluation and safety, security, and integrity (preconditional challenges).Conclusions: The introduction of care robots in elder care services seems to be more challenging than that of welfare technology in general, given the context and prevailing attitudes and preconceptions about robotics. Significant challenges need to be managed, at all levels of the society, before care robots can become an integral part of daily care and assist older people and their caregivers in activities and rehabilitation.IMPLICATION FOR REHABILITATIONThe challenges described by the societal actors', are partly similar to those of the end users', in terms of attitudes, ethics, knowledge and skills, and collaboration. This consensus should provide a solid foundation for the conceptualization and introduction of care robots in elderly care.The challenges follow the pattern of an ecosystem involving all sections of society, which are intertwined and require consideration before the expected benefits can be realised.A user-centred approach is necessary to support the design, implementation, and usefulness of care robots and their suitability for meeting the real needs of older persons and professional caregivers.
TL;DR: A comparison of expectations and experiences of service dog ownership highlights both the positive and negative aspects of the service dog–owner relationship and identifies potential aspects of having a service dog that may be unanticipated or overestimated by those on the waitlist.
Abstract: Purpose: To qualitatively describe and compare the expectations and experiences of living with a mobility or medical service dog among those with a physical disability or chronic condition.Materials and methods: A total of 64 participants living with a service dog and 27 on the waitlist to receive a service dog participated in a cross-sectional open-ended survey. Qualitative content analysis was used to identify themes and sub-themes.Results: A total of 101 codes were summarized into themes of Physical Benefits, Psychosocial Benefits, and Drawbacks to having a service dog. Psychosocial benefits included the human-animal relationship as well as emotional, quality of life, and social benefits. Drawbacks included service dog care, public access and education, lifestyle adjustments, and dog behaviour. While participants on the waitlist were more likely to anticipate physical benefits of having a service dog, those with a service dog largely described psychosocial benefits. Findings also suggest that some drawbacks, such as public discrimination, may be unanticipated by the waitlist.Conclusions: A comparison of expectations and experiences of service dog ownership highlights both the positive and negative aspects of the service dog-owner relationship and identifies potential aspects of having a service dog that may be unanticipated or overestimated by those on the waitlist.Implications for RehabilitationWhen asked about helpful and important aspects of having a service dog, 98% of service dog owners described the psychosocial benefits of their dog's assistance and companionship.The human-animal relationship was the most discussed psychosocial benefit from both current owners as well as those on the waitlist, demonstrating the unique strength of the service dog-owner bond in this population.Those on the waitlist to receive a service dog did not anticipate as many drawbacks as current owners described. In particular, difficulties with public access and education as well as dog behaviour were commonly experienced, but not expected, drawbacks to service dog ownership.Findings identify aspects of having a service dog that may be unanticipated or overestimated by those on the waitlist, providing rehabilitation professionals with a basis for preparing those who may be considering incorporating a service dog into their lives.
TL;DR: Hearing aids were unaffordable for three-fourths of Americans with functional hearing loss, and their purchase would result in impoverishment for hundreds of thousands of individuals.
Abstract: Substantial out-of-pocket costs for hearing aids constitute a barrier to hearing health care accessibility for older adults among whom prevalence of hearing loss is high. This study is the first to...
TL;DR: This systematic review confirms previous findings that assistive technology users should be involved in the AT-SDP in order to achieve positive outcomes and gives some indication that new technologies could be used to improve the AT, reduce costs and that training in using the assistive devices seems to be useful.
Abstract: Purpose: The objective of this systematic review was to investigate effects of different assistive technology service delivery processes (AT-SDPs) for people with functional limitations, including ...
TL;DR: An in-depth global portrait of the wheelchair service provision education offered in academic rehabilitation programs, the process of its integration and the associated facilitators and barriers is developed to assist the global community of educators in preparing future rehabilitation professionals to better serve wheelchair users.
Abstract: Purpose: An estimated 75 million people with disabilities need wheelchairs globally, of whom 5-15% have one. Access to an appropriate wheelchair requires rehabilitation professionals trained to provide wheelchair service. One aim of the International Society of Wheelchair Professionals (ISWP) is to promote and facilitate the integration of wheelchair service provision education into academic rehabilitation programs worldwide. To inform the development of integration strategies, the purpose of this study was to develop an in-depth global portrait of the wheelchair service provision education offered in academic rehabilitation programs, the process of its integration and the associated facilitators and barriers.Method: Semi-structured qualitative interviews were conducted with a purposive sample of 14 representatives from academic rehabilitation programs (i.e., occupational therapy, physical therapy, and prosthetics and orthotics) in 11 countries, including low, middle and upper resourced settings.Findings: Thematic data analyses identified three overarching themes. The first theme, "impact of context", portrays factors related to local population needs, governance and supply chain of equipment and service delivery. The second theme, "current and planned wheelchair education", describes the content, pedagogic approach, student evaluation and feedback process. The third theme, "integration process", details five states of this process.Conclusions: This study describes in-depth the wheelchair service provision education across academic rehabilitation programs and resource settings, illustrating the context-dependent nature of its integration. This understanding may assist the global community of educators in preparing future rehabilitation professionals to better serve wheelchair users. This work has informed the development of ISWP's Seating and Mobility Academic Resource Toolkit (http://smart.wheelchairnetwork.org/).Implications for RehabilitationThe Dynamics of Context-Dependent Integration of Wheelchair Service Provision Education in Curricula model, depicting the findings of this study, may help to inform key stakeholders (i.e., academic institutions, health care providers and policy makers) about potential barriers and facilitators to the implementation of adequate wheelchair service provision education in the curricula of academic rehabilitation program.Study findings may lead to creative strategies, such as the expansion of ISWP's Seating and Mobility Academic Resource Toolkit (SMART; http://smart.wheelchairnetwork.org/), that may enable academic rehabilitation programs to be a part of the solution to strengthening rehabilitation systems worldwide, through appropriately trained rehabilitation professionals in wheelchair service provision.
TL;DR: There is an important clinical opportunity to help wheelchair users avoid repairs in the first place and reduce adverse consequences after breakdowns occur by improving wheelchair quality, providing preventative chair maintenance, and repairing breakdowns in a timely and efficient manner.
Abstract: Purpose Investigate the type and frequency of wheelchair repairs and resulting adverse consequences in a Veteran population. Design Convenience cross-sectional sample survey. Setting Data were collected at the 2017 National Veterans Wheelchair Games. Participants Veterans who use a wheelchair ≥ 40 h/wk (n = 60). Intervention Not applicable. Main outcome measures Repairs and associated adverse consequences, wheelchair age and usage, type of repairs completed, time elapsed between breakdowns and repairs, and who completed repairs. Results 60 participants reported 124 repairs in the previous 6 months with 88.3% of participants requiring at least one repair. Consequences were reported by 43.5% of those experiencing repairs and were most commonly secondary to repairs in the electrical system, wheelchair frame, power/control system, and wheels and casters. Travelling greater distances during the week and on weekends was associated with increased rates of repairs (p = 0.01 and p = 0.02, respectively) and consequences (p = 0.03 and p = 0.03, respectively). Power wheelchairs were more likely to require repairs than manual wheelchairs (p = 0.007). The median time to repair was 7 [0.8,30] days. Vendors completed 82.1% of the repairs. Those experiencing longer repair times were more likely to experience adverse consequences (p Conclusion A high number of repairs and resulting adverse consequences occur for wheelchair users, particularly power wheelchair users, in a sample of Veterans. Interventions to prevent breakdowns and to address repairs and adverse consequences in a time-efficient manner are needed. Implications for rehabilitation In a sample of Veterans, a high number of repairs and resulting adverse consequences occur for wheelchair users, particularly power wheelchair users. There is an important clinical opportunity to help wheelchair users avoid repairs in the first place and reduce adverse consequences after breakdowns occur by improving wheelchair quality, providing preventative chair maintenance, and repairing breakdowns in a timely and efficient manner. These interventions may prove impactful in reducing the adverse medical, functional, and social consequences of wheelchair breakdowns.
TL;DR: Students in schools for the blind who have binocular best corrected vision acuity of 1/60 or better should be encouraged to use visual based assistive technology instead of tactile based technology.
Abstract: Background: To understand the awareness and utilization of assistive technology in students at schools for the blind in Delhi.Methods: A cross sectional study was conducted among 250 students selected randomly from 10 blind schools in Delhi. Binocular distance presenting and pinhole vision acuity were assessed using Snellen "E" chart and a multiple pinhole occluder. Students were also interviewed using a questionnaire about 42 assistive devices to understand their awareness and use.Results: Male participants were 72.8%. Of the total, 27.6% students had best corrected visual acuity <6/18 to 1/60, and the rest had <1/60 vision. The awareness about tactile and sound-based technology was good among students: Braille books (98%), Braille slate and stylus (99.2%), handheld audio recorders (77.6%) and screen readers (77.2%). Good awareness was reported for abacus (88.8%), walking long canes (94.4%) and smart cane (89.6%), audible balls (96%), Braille chess (82.8%) and talking watch (98%). Among the students with <6/18 to 1/60 vision, the awareness of visual based technology ranged from 0.8% (typoscope) to 43.6% (video magnifiers). Braille technology was used for reading by 96.4% (books) and for writing by 96.8% (Braille slate and stylus) irrespective of visual status. Other devices were poorly used ranging from nil (typoscope) to 55% (screen readers). The use of math and science learning devices was poor (<20%). Walking canes were used by 59% of students whereas 87.2% students used audible ball for games.Conclusion: The results showed that majority of students used tactile based technology irrespective of visual status.Implications for rehabilitationStudents with visual disability need assistive technology for a wide range of activities including academic learning.Students in schools for the blind who have binocular best corrected vision acuity of 1/60 or better should be encouraged to use visual based assistive technology instead of tactile based.Students with binocular best corrected vision acuity less than1/60 should be encouraged to use other available tactile and sound-based assistive technologies as well as Braille books and Braille slate and stylus for their academic activities including maths and sciences.Teachers should be trained in the use of various assistive technologies for reading, writing, maths, sciences, sports, mobility and activities of daily living.