Journal of Rehabilitation and Assistive Technologies Engineering最新文献

Introduction: Minimizing repetitive strain (RS) is a key recommendation from clinical practice guidelines for preservation of upper limb. Propulsion force, which is required to overcome wheel rolling resistance (RR), is a major source of RS. A drum-based RR test method has been developed but has not been directly validated against propulsion forces. A previous validation study compared Drum versus treadmill RR, with excellent consistency (intraclass correlation coefficient (ICC) = 0.94) and accuracy. Methods: Drum RR system estimates (N = 192) were compared to SmartWheel RR measurements and resultant force (Fres) for multiple wheelchair setups and surfaces. We hypothesized that Drum RR will consistently predict SmartWheel RR and Fres based on ICC and accuracy based on Bland Altman limits of agreement (LOA) and coefficient of determination (R²). Results: RR ICC = 0.966, 95%CI [0.955-0.975], mean difference between methods (4.2 N), and LOA [+/-5.5 N], which varied by surface. Drum RR explained 88% (R²) of SmartWheel RR variability. Drum RR prediction of Fres ICC = 0.83, 95%CI [0.77-0.87], explaining 60% of variability. Conclusions: Drum RR consistently predicts SmartWheel RR with excellent reliability and reasonable accuracy, and predicts Fres with good reliability and reasonable accuracy, reinforcing the validity of Drum RR for predicting system-level RR, and use guiding wheel selection to reduce RS.

Background: Suction cup handholds are sometimes recommended by Occupational Therapists for bathing transfers when permanent grab bars are not feasible. The efficacy of suction cup handholds on typical bathroom surfaces is unknown.

Purpose: This study evaluated the efficacy and failure characteristics of two brands of suction cup handholds on six typical bathtub wall surfaces, under environmental and loading conditions associated with bathing.

Method: Eighteen suction cup handholds underwent controlled longevity testing under wet and dry conditions in separate sessions. Handhold efficacy was evaluated through (a) visual inspection, (b) manual manipulation, and (c) controlled loading, with days to failure and other failure details as outcome measures.

Findings: No handhold-wall sample combinations were effective over the 28 day test period, with at least one handhold on each wall sample failing on day one. Handhold failure was most frequently due to sliding along the wall surface, and occurred most frequently during manual manipulation testing.

Conclusion: Handhold efficacy was poor in a controlled experimental environment. These results can inform clinicians of the risks suction cup handholds pose and assist in clinical recommendations against their use.

Introduction: Wrist hand orthoses are widely used in rehabilitation to improve hand function and alleviate pain. However, their use may restrict wrist motion, causing functional disabilities in activities of daily living (ADLs). This study aimed to evaluate the effects of wrist hand orthoses on upper limb activity during daily life, focusing on differences between padded fiberglass and thermoplastic wrist hand orthoses.

Methods: 35 healthy, right-handed adults wore two types of wrist hand orthoses (padded fiberglass and thermoplastic) for 24 h during daily activities. Upper limb activity was measured using accelerometers, while ADL difficulties were evaluated using the Hand20 questionnaire. Activity levels were compared across no-orthosis, fiberglass, and thermoplastic orthosis conditions.

Results: Both wrist hand orthoses significantly reduced upper limb activity (magnitude ratio and use ratio) compared to the no-orthosis condition (p < 0.05). The Hand20 scores indicated greater ADL difficulties under both orthotic conditions, with no significant difference between the two types of orthoses (p > 0.05).

Conclusions: Wrist hand orthoses restrict wrist and forearm motions, reduce upper limb activity, and increase perceived ADL difficulties. No significant differences were observed between fiberglass and thermoplastic orthoses, suggesting comparable effects on daily life. Design modifications can improve user comfort and functionality.

Introduction: This study aimed to explore the relationship between training volume during 4 weeks of robot-assisted arm training (RAAT) and changes in arm-and hand function, grip strength, gross motor skills, spasticity, and daily activities.

Methods: Twenty participants, >18 years of age, in subacute phase following stroke, with impaired arm function admitted to Sunnaas Rehabilitation Hospital, completed 4 weeks robot-assisted arm training (45 min, 3-5 times a week). Before and after this intervention, the participants' arm and hand function, grip strength, gross motor dexterity, spasticity and activities of daily living were assessed.

Results: The key findings of this study indicated no association between training volume and improvements in arm and hand function, grip strength, gross motor dexterity, spasticity, or activities of daily living. Also, no significant associations between changes in arm and hand function and age, gender, or affected side. However, subgroup analysis showed significant improvements in arm-hand function for participants with shorter time post-stroke (p = 0.01) and better initial arm and hand function (p < 0.0001).

Conclusion: These findings highlight the importance of early initiation and individualized treatment based on initial function when using robot-assisted arm training in stroke survivors.

Introduction: We report findings from two feasibility studies with persons with SCI that aimed to leverage social support to increase PA: a two-week study with nine participants and a four-week study with six participants.

Method: We recruited a total of 17 participants across two phases (10 participants in Phase 1 and seven participants in Phase 2). In dyads, participants used a smartphone-smartwatch application that we iteratively developed based on participant feedback. The application delivered just-in-time support based on measured PA and encouraged reciprocal self-disclosure to increase closeness within dyads.

Results: Participants found the delivery of messages during detected PA to be motivational. Some liked automatically sharing tracked PA with others and did not have privacy concerns about doing so, and most preferred exchanging real-time messages more than context- or activity-triggered messages. Participants also expressed that feeling connected to their partner increased motivation to engage in PA.

Conclusion: Participants expressed that they liked being able to connect with individuals with shared life experience to exchange encouraging messages. There are, however, challenges that need to be addressed before a large-scale deployment of this technology, including user concerns about automatically detected activity.

The Study was done to examine the use, non-use, the quality of clinical advice, challenges in acquiring AFOs (Ankle Foot Orthosis), and user satisfaction, using a WHO based Rapid Assistive Technology Assessment (rATA) and Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST) questionnaire. The cohort (n = 100) consisted mainly of males (71%) and residents of city (82%). It was found that 98 subjects were under advice from healthcare providers to use an AFO but only 59 subjects were using AFO at present. Common complaints were pain, fitting related and social stigma among users. The majority of the subjects (87%) paid for their AFOs. It was found that the majority of the subjects were "more or less satisfied" with the device however 59% strongly agree that they dislike the appearance of their AFO and 37% were completely dissatisfied with the accessibility of their home and surroundings while using the AFO. It is evident that we should work on improving the design and fit of the orthosis so that the acceptance and satisfaction improves. This study also explores the possibility of usage of rATA for the specific assistive Technology (like AFO in this context) assessment. It was observed that patients often have high expectations regarding a cure with the use of an AFO. Therefore, it is essential for service providers to explain that the AFO is intended to improve function rather than provider a cure. This mismatch of understanding may contribute to dissatisfaction by patients using AFOs, hence user education is essential along with technology provision.

Forward head posture (FHP), defined as the anterior positioning of the cervical spine where the head protrudes forward in relation to the body's vertical line, has become increasingly common, primarily due to sedentary lifestyles and extensive use of technology, impacting approximately 66% of the population. This condition frequently leads to secondary hyperkyphosis and various musculoskeletal problems, highlighting the urgent need for effective intervention strategies. A systematic review was performed across multiple databases, including Web of Science, PubMed, Scopus, and Google Scholar, encompassing studies published until June 2024. The review specifically targeted studies utilizing orthotic devices to address FHP. Two independent reviewers screened titles and abstracts, followed by comprehensive data extraction using a standardized form. The review included 10 studies involving a total of 450 patients with FHP. The findings demonstrated that orthotic devices significantly enhance postural parameters, notably improving spinal alignment and reducing FHP. However, the studies also underscored the necessity for better device design to improve comfort and usability for patients. Orthotic devices exhibit considerable potential in improving postural conditions associated with FHP. Future research should concentrate on optimizing device design and examining long-term effectiveness to enhance clinical application and patient outcomes.

Adaptive kayaking devices currently limit biomechanical fidelity, constraining range of motion and introducing unnatural dynamic profiles that impair user performance. This study proposes a four-bar linkage mechanism that replicates the natural semi-ellipsoidal and multi-phase forward stroke, grounded in biomechanics research and motion capture data. The stroke path was benchmarked against a standard derived from a prior kayak stroke analysis and refined using data characterizing movement across three spatial axes. A representative stroke profile was developed and implemented in a computer-aided design environment, with design optimization performed using engineering simulation tools. Two adaptive linkage models-one for high-performance use and one for recreational users-were validated by comparing their motion paths to the target profile. The high-performance model achieved a deviation of 22.0 mm; the recreational model achieved 79.7 mm. In contrast, a widely used commercial mount showed a deviation of 272.7 mm. This conceptual redesign addresses known biomechanical limitations, offering a scalable assistive solution with translational potential in rehabilitation and adaptive recreation.

Introduction: Prolonged immobilization during long-range aeromedical evacuation (LAE) is vital for stabilizing patients with spinal fractures, spinal cord injuries, and traumatic brain injuries. However, pressure injuries are a significant risk during long periods of immobilization, as continuous high pressure on soft tissues can lead to ulceration. This paper introduces a novel adaptive spine board (ASB) overlay, an air-cell-based support surface, designed to optimize interface pressure redistribution during LAE. Methods: The ASB overlay was developed, tested, and compared with currently available MedEvac Litter and warrior evacuation litter pad (WELP) in terms of immersion and interface pressure. Furthermore, a pressure-maintaining algorithm was tested to ensure that the pressure within the air cells remains constant, regardless of environmental effects due to climate and elevation changes. Results: The American National Standard for Support Surfaces immersion test showed the ASB overlay achieved 10 mm more immersion than the WELP. The interface pressures for all regions of the ASB overlay were lower than those seen in the litter and the WELP, with values remaining below 40 mmHg. Conclusions: These results demonstrated that the ASB overlay can reduce more interface pressure compared to commercial support surfaces while maintaining set air cell pressure under varying pressure and temperature conditions.