Journal of Rehabilitation and Assistive Technologies Engineering最新文献

Public opinion may influence the adoption of technologies for older adults, yet studies on different contexts of technology for older adults is limited. In an online YouGov survey (N = 500) with text-and-image vignettes, participants gave more positive ratings of social acceptability, trust, and perceived impact on eldercare when the voice assistant ("VA" system) shown in the vignette performed a functional task (medication adherence) versus when it performed a social task (companionship). The VA received more positive sentiment comments when it appeared to use a machine learning (ML)-based dialogue system compared to when it appeared to be using a rule-based dialogue system. These results may assist designers and stakeholders select what type of voice system to develop or use with older adults.

Background: Electrical stimulation of the spinal cord may improve rewiring of the affected pathways. Immediate modulation of stimulation parameters, and its effects of it on kinematics and electromyographic variables is unclear.

Methods: This study piloted the safety and feasibility of the Reynolds Innovative Spinal Electrical Stimulation (RISES) technology with a focus on its novel closed-loop setting. This personalized, task-specific non-invasive stimulation system enables real-time stimulation parameter modulation and supports multi-data acquisition and storage. Four SCI participants underwent a clinical trial coupled with activity-based training. Primary safety outcome measures included adverse events (AEs) and skin integrity; secondary measures were vital signs, pain, and fatigue assessed at the pre, mid, and post-stimulation sessions. The trial included open-loop and closed-loop blocks of transcutaneous spinal cord stimulation (tSCS).

Results: Results showed no serious adverse events, with skin integrity unaffected. Vital signs and pain showed no significant differences across session timepoints. Fatigue levels differed significantly with post-session > mid-session > pre-session. Comparisons between open-loop and closed-loop blocks showed no significant differences in setup time, vital signs, pain, or fatigue. Average stimulation duration per task was significantly longer for open-loop (467.6 sec) than Closed-loop (410.8 sec).

Conclusions: RISES, demonstrated safety and feasibility. Further work will focus on clinical efficacy.

Introduction: Practice of ankle-foot orthoses (AFO) provision for ambulatory children with cerebral palsy is underreported and the literature is not consistent on choice of AFO-design. This study describes clinical practice of AFO provision for children with cerebral palsy and evaluates how clinical practice aligns with existing recommendations.

Methods: An online, cross-sectional survey was conducted, inviting all Norwegian orthotists working with children with cerebral palsy. Orthotic practice was investigated using a self-reported survey design.

Results: From all eligible orthotists, 54% responded, revealing that AFO provision involves patients, physicians, and physiotherapists at different stages. Patient preference directly influenced the ultimate AFO-design. Shank vertical angle was evaluated by 79%. For children with crouch gait and those with short gastrocnemius, a majority preferred a combination of rigid and articulated/flexible AFO-designs. Instrumented gait analysis was conducted by 51% at AFO delivery stage.

Conclusions: The findings show that AFO provision in Norway is collaborative, involving clinical team members and consideration of patient preferences. A discrepancy between clinical practice and existing recommendations for children with crouch gait and those with short gastrocnemius is observed.

The inability to use one's hands or arms greatly restricts the ability to perform daily activities. After a developmental or acquired injury, the intensity and frequency of rehabilitation exercises are essential. To alleviate the burden on the healthcare system, robotic systems have been developed to support clinicians' interventions. However, these systems are often bulky and expensive, limiting their use to specific clinical settings and making them impractical for home use. This paper presents the development of an affordable and easy to install 2-DOF five-bar linkage robot designed to be used at home. This work aims to reduce the cost of the robot through actuation optimization, mechanical optimization and 3D printing. The architecture and links length are chosen to optimize the robot's performance in the required workspace. Using sensor feedback, impedance control algorithms and multiple types of exercise such as virtual walls guidance are implemented. Finally, a user interface was programmed to facilitate the robot's use.

Introduction: The successful integration of socially assistive robots in geriatric care settings hinges on the attitudes and opinions of healthcare professionals. This study explored their needs, expectations, and perceptions regarding robot use, including facilitating factors and barriers to implementation.

Methods: Twenty professionals participated in semi-structured interviews that covered topics such as robot applications, perceived value, acceptance criteria, prerequisites for deployment, ethical considerations, and design attributes. These interviews were analyzed using a deductive qualitative approach guided by the European Network for Health Technology Assessment model (version 3.0).

Results: Results indicated that professionals generally viewed robots favorably, noting their usefulness in various non-intimate tasks like meal assistance and toileting. Ease of use was identified as a critical factor for robot adoption in geriatric care. Furthermore, the necessity of educating all stakeholders and providing comprehensive training to professionals emerged as essential for successful implementation. The discussions also included financial and ethical issues related to the introduction of these technologies.

Conclusion: These findings will contribute to develop guidelines for designing and deploying socially assistive robots that align with the preferences and requirements of geriatric care professionals.

People with transtibial limb loss frequently experience suboptimal gait outcomes. This is partly attributable to the absence of the biarticular gastrocnemius muscle, which plays a unique role in walking. Although a recent surge of biarticular prostheses aims to restore gastrocnemius function, the broad design space and lack of consensus on optimal hardware and control strategies present scientific and engineering challenges. This study introduces a robotic biarticular prosthesis emulator, comprising a uniarticular ankle-foot prosthesis and knee flexion exoskeleton, each actuated by a custom off-board system. Benchtop experiments were conducted to characterize the emulator's mechatronic performance. Walking experiments with one transtibial amputee demonstrated the system's capability to provide knee and ankle assistance. The -3 dB bandwidths for the knee exoskeleton's torque and motor velocity controllers were measured at approximately 5 Hz and 100 Hz, respectively. A feedforward iterative learning controller reduced the root-mean-squared torque tracking error from 6.04 Nm to 0.99 Nm in hardware-in-the-loop experiments, an 84% improvement. User-preference-based tuning yielded a peak knee torque of approximately 20% of the estimated biological knee moment. This biarticular prosthesis emulator demonstrates significant potential as a versatile research platform that can offer valuable insights for the advancement of lower-limb assistive devices.

The LSU Community Playground Project (LSUCPP) collaborates with communities (especially the true experts at play, the children) to design and build playgrounds that reflect "the soul of the community." One member of the LSUCPP undertook a research project in an effort to design better playgrounds for use by children who are visually impaired or blind. A recommendation from this research was to provide a 3D-printed tactile map of each play area, such that children who were visually impaired or blind could feel the location and type of equipment and ground surfaces prior to entering a playground, which would enable them to play independently. In this paper, we tell the story of how engineering students and faculty collaborated with children with visual impairments or blindness and their teachers and professional staff to co-design and build a 3D printed tactile map at the Louisiana School for the Visually Impaired (LSVI). Specifically, we detail how we co-designed this artifact, the ways in which the artifact developed due to this inclusive approach, briefly present the design, and discuss how engineers engaged in the design of assistive technologies can put inclusive design principles and community-based design processes into action.

Introduction: Increasingly, geriatric institutions are adopting video calling services to promote social interactions between residents and their loved ones. However, a gap persists between the technologies used and the needs and abilities of older users. Interactive Televisions (iTVs) could be part of the solution as they provide a familiar and accessible way to strengthen the relationship between residents and their environment (family, friends, professionals).

Methods: User tests were conducted to evaluate the ability of older adults (OAs) from different place of living to use iTV. A total of 32 user tests were carried out with OAs living at home, in residential facilities (RFs), and in nursing homes (NHs) between November 2022 and June 2023.

Results: The quantitative analysis revealed mixed opinions on the iTV's usability. OAs living at home tended to produce less errors and needed less help to successfully use video calling and messaging functionalities of the iTV than others. However, participants in NHs required more repetitions to benefit from a learning effect, unlike participants in RFs and at home.

Conclusions: This study proposed another approach to user testing, based on cognitive psychology methods. Based on the analysis of the critical stages, ergonomic recommendations were identified.

Introduction: The purpose of this study was to compare the impact of three types of orthoses (knee orthosis, ankle foot orthosis (AFO), and foot orthosis) on knee alignment, pain, function, and quality of life in individuals with medial knee osteoarthritis (MKOA).

Method: Thirty patients took part in this study and were randomly assigned to three groups (n = 10 in each group) based on the type of intervention. Knee function was assessed using the knee injury and osteoarthritis outcome score (KOOS) questionnaire, and knee alignment was evaluated by measuring angles using the images of bony prominence (AMI) method.

Results: After using knee orthosis and AFO, all subscales of KOOS showed significant improvement (p < .05). However, there was no significant difference in the results after using foot orthosis (p > .05).

Conclusion: The findings indicate that knee orthosis or AFO for 6 weeks can improve clinical outcomes for individuals with MKOA. This suggests that clinicians can consider using knee orthosis and AFO among the available treatment options to improve clinical outcomes.