Journal of Rehabilitation and Assistive Technologies Engineering最新文献

Introduction: In this study, we developed a unilateral, hybrid exoskeleton designed to augment post-stroke mobility through integration of noninvasive neural stimulation and a motorized knee orthosis. We evaluated proof of concept for this hybrid exoskeleton in a stroke survivor by assessing whether: (1) the motor and transmission possess sufficient backdrivability to facilitate effective muscle-generated movements, (2) the motor can independently drive movement, and (3) the combined application of stimulation and motor generate kinematic improvements superior to either modality used in isolation. Methods: The device was evaluated on an ambulatory stroke survivor under four overground walking conditions: (1) without the device, (2) stimulation only while wearing the exoskeleton, (3) motor assistance only, and (4) hybrid stimulated and motorized assistance. A motion capture system was used to obtain lower limb joint angles to assess the differences in each walking condition. Results: Changes towards neurotypical hip, knee and ankle angles were found between the gait with no device compared to the assistive conditions. Hip-knee cyclograms suggest hybrid assistance most resembled neurotypical gait. Conclusions: Individually, neural stimulation and motor assistance resulted in improved gait kinematics and hybrid assistance provided greater improvement than each form of individual assistance.

Background: Individuals with spinal cord injuries (SCI) face substantial mobility challenges that affect their independence and quality of life. Traditional medial linkage reciprocal gait orthoses (MLRGO) often lack efficiency in enhancing mobility and stability. This study introduces the Advanced MLRGO, designed to overcome these limitations and improve walking function for SCI patients. Material and methods: The Advanced MLRGO was developed using orthopedic engineering and biomechanics principles, with detailed simulations performed in COMSOL Multi-physics to evaluate force distribution and resistance. A clinical trial involving five individuals with SCI was conducted to compare the performance of the Advanced MLRGO against the Prime-Walk orthosis and the standard MLRGO. Results: Results showed that the MLRGO system significantly improved walking speed (p = 0.03) and distance traveled (p = 0.04) compared to the Prime-Walk. The Advanced MLRGO also exhibited notable enhancements over the standard MLRGO, showing increased walking speed (p = 0.033) and distance (p = 0.026), as well as reduced donning time (p = 0.048). Conclusion: These findings indicate that the Advanced MLRGO significantly enhances mobility and independence for individuals with thoracic SCI. Future research should focus on improving doffing efficiency and assessing individual user experiences to maximize these benefits.

Background: AI-enabled social robots present the potential to resolve the loneliness and social isolation of older adults in long-term care (LTC). There is limited research on how older adults perceive and make sense of these robots and how human-robot companionship is formed. This study investigated older adults' experiences using LOVOT, a social robot.

Methods: Using an ethnographic study design, we introduced LOVOT robots to a Canadian LTC home for four weekly interaction sessions. Thirty-six residents, seven family members and two healthcare staff participated. Data collection involved observational field notes and conversational interviews. The analysis was guided by ikigai, a Japanese well-being concept.

Findings: Reflexive thematic analysis identified four key themes. 1) Joy: The robot offers joy and excitement through interactions. 2) Acceptance: For older adults with mobility or cognitive impairments, LOVOT gives consistent positive responses, offering a sense of unconditional acceptance. 3) Creativity: The robot's non-verbal communication allows older adults to grow creative imagination, encouraging personal expression and expanding interaction possibilities. 4) "Not for me": Not all participants like the LOVOT robot.

Conclusion: AI-enabled social robots show potential in supporting the psychosocial needs of older adults, which have broader implications for LTC practices and future research directions. Future research should further explore the creative utility of social robots among LTC residents.

Introduction: The Ponseti technique is highly effective for correcting congenital clubfoot; however, recurrence must be prevented using orthoses. The double abduction brace (D- A) is recommended by Ponseti and is widely used. However, more user-friendly orthoses have been developed because treatment abandonment with the traditional orthosis is frequent. We report the results obtained using a newly designed unilateral orthosis.

Methods: A unilateral orthosis (UNIC-Brace) was developed and tested in a prospective non-randomized study conducted between 2017 and 2020. The Pirani score was used to monitor the progression of the deformity during plaster correction. The D-A brace (Denis Browne model) served as the control group. The primary outcomes were recurrence rate, treatment adherence, and caregiver satisfaction.

Results: The study included 58 patients (87 feet) in the test group and 51 patients (75 feet) in the control group, with a minimum follow-up period of 3 years. No significant differences in epidemiological data or follow-up duration were observed between the two groups. The failure feet rates in D-A brace and UNIC-Brace groups were 41.3% and 17.2%, respectively (p < .001). Non-adherence patients to treatment were 23.5% in the D-A brace and 13.8% in the UNIC-Brace group (p < .001). Overall, 13.7% of families were not satisfied with the D-A orthosis, whereas 5.2% were not satisfied with the UNIC- Brace (p < .001).

Conclusions: The UNIC-Brace yielded better outcomes than the traditional orthosis at a minimum follow-up period of 3 years.

[This corrects the article DOI: 10.1177/20556683241277179.].

Introduction: Traditionally, augmentative and alternative communication (AAC) user interface development has been a time-intensive process requiring expertise in software development, often excluding people who use AAC. This paper demonstrates the involvement of an end user in the design and testing of prototype AAC user interfaces (UIs) developed using a platform called the Open Source Design and Programmer Interface (OS-DPI).

Methods: Micro-analysis of in-person conversation involving an adult with intellectual and developmental disabilities who uses AAC revealed several problems related to accessing his aided AAC device. The OS-DPI was used to co-design, develop, and test UIs aimed at addressing these observed problems.

Results: Researcher efforts to independently design and develop novel UIs that addressed the problems identified in research were ineffective. Inclusive design practices led to a shared determination of required functionality and co-design of UIs with reported improvements for access and communication.

Conclusions: This paper demonstrates the potential of the OS-DPI for the co-design and development of AAC UIs to address unique needs.

The mobility of people with severe visual impairment is limited affecting their comfort and productivity. There are about 45 million people who are blind with global financial burden and annual global cost of productivity estimated to be USD411 billion according to World Health Organization report of 2024. The contributions of the people who are visually impaired to the gross domestic product (GDP) can be enhanced deploying technology. A novel sensory substitution device that enables people who are visually impaired or blind to fairly hear objects in place of seeing objects is proposed. The wearable echolocation device was developed using three ultrasonic sensors, one placed in the right, left, and middle of the goggle with each connected to a buzzer. Audible compass is implemented in the circuitry to guide the user on the direction while walking. In this configuration, the user is guided and alerted of any obstacle within the field of coverage and so can navigate to any desired destination unaided without relying on internet. The developed prototype is easy to use and does not require complex training. The echolocation device was tested by ten enrolled people that are visually impaired or blind who validated its effectiveness and efficiency. The device is comparatively low cost, noninvasive, energy efficient and mass producible.

The need for Artificial Intelligence (AI) in gerontology education is underscored by the potential benefits it offers in addressing loneliness and supporting social connection among older adults in long-term care (LTC) homes. While the workforce in LTC is often overburdened, AI-enabled service robots present possible solutions to enhance residents' quality of life. However, the incorporation of AI and service robots in current gerontology curricula is lacking, and the views of students on this subject remain largely unexamined. This study aims to fill this gap by capturing the perspectives of university students regarding the deployment of an AI robot, Aether, in LTC environments. In this qualitative study, we conducted focus groups with 22 university students. Our thematic analysis identified three themes: (1) Aether's anticipated usage in geriatric care: companionship support and complementing the work of staff; (2) Challenges in using Aether: technical and emotional challenges; and (3) Solutions and future possibilities: expanding functionalities and integrating personalization features. Students expressed a positive outlook on the role of AI-enabled robots while also highlighting the necessity of addressing ethical and practical considerations. To effectively integrate AI technology in gerontology education, it is essential to understand and incorporate student perspectives, attitudes, and opinions.

Regular use of standardized observational tools to assess nonverbal pain behaviors results in improved pain care for older adults with severe dementia. While frequent monitoring of pain behaviors in long-term care (LTC) is constrained by resource limitations, computer vision technology has the potential to mitigate these challenges. A computerized algorithm designed to assess pain behavior in older adults with and without dementia was recently developed and validated using video recordings. This study was the first live, real-time evaluation of the algorithm incorporated in an automated system with community-dwelling older adults in a laboratory. Three safely-administered thermal pain tasks were completed while the system automatically processed facial activity. Receiver Operating Characteristic curves were used to determine the sensitivity and specificity of the system in identifying facial pain expressions using gold standard manual coding. The relationship between scoring methods was analyzed and gender differences were explored. Results supported the potential viability of the system for use with older adults. System performance improved when more intense facial pain expressiveness was considered. While average pain scores remained homogenous between genders, system performance was better for women. Findings will be used to further refine the system prior to future field testing in LTC.

Background: Spinal cord injury and stroke are neurological disorders that lead to aerobic deconditioning and increased likelihood of cardiovascular disease. Sessions of at least 20 minutes of moderate-to-vigorous intensity exercise is recommended but decreased mobility limits engagement in such exercise. The aim of the study was to assess whether individuals can achieve exercise recommendations with the assistance of an end-effector robot assisted gait trainer (E-RAGT). Methods: We conducted an observational study during which participants were required to complete one exercise session on an E-RAGT. Heart rate, dyspnea, lower limb fatigue and enjoyment were monitored. Based on current guidelines, participants were considered to have reached exercise recommendations if they reached prespecified intensity thresholds for at least 20 minutes. Results: Five people with spinal cord injury and ten people with stroke agreed to participate. Every participant was able to reach moderate-to-vigorous exercise intensity and 3 out of 5 participants with spinal cord injury and 4 out of 10 participants with stroke were able to maintain this intensity for at least 20 minutes. Overall, participants rated their session as very enjoyable with a median score of 4 out of 5 on a Likert Scale (IQR 3 to 4). Discussion: Individuals with spinal cord injury or stroke who use an E-RAGT can reach moderate-to-vigorous exercise intensity, but not all are able to maintain this intensity of exercise according to disease-specific recommendations. Future research should explore the effectiveness of a training program using an E-RAGT.