Journal of Rehabilitation and Assistive Technologies Engineering最新文献

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.

Introduction: Activity-based therapy is effective at improving trunk control in children with spinal cord injury. A prototype sensorized rocking chair was developed and confirmed as an activity that activates trunk muscles. This study uses data collected from the chair to predict muscle use during rocking. Methods: The prototype rocking chair included sensors to detect forces, accelerations, as well child and chair movement. Children with spinal cord injury and typically developing children (2-12 years), recruited under an approved IRB protocol, were observed rocking while sensor and electromyography data were collected from arm, leg, and trunk muscles. Features from sensor data were used to predict muscle activation using multiple linear regression, regression learning, and neural network modeling. Correlation analysis examined individual sensor contributions to predictions. Results: Neural network models outperformed regression models. Multiple linear regression predictions significantly correlated (p < 0.05) with targets for four of eleven children with SCI, while decision tree regression predictions correlated for five children. Neural network predictions correlated for all children. Conclusions: Embedded sensors capture useful information about muscle activation, and machine learning techniques can be used to inform therapists. Further work is warranted to refine prediction models and to investigate how well results can be generalized.

In this review and meta-analysis, we aimed to investigate the effect of spine orthotics in osteoporotic patients. The relationship between osteoporosis, osteoporotic vertebral fractures (OVFs), and age-related hyperkyphosis has made this effect unclear. We believe that taking participants' conditions into consideration may help to alleviate this controversy. The electronic database includes Web of Science, PubMed, Cochrane Library, Medline, and ClinicalTrials.gov. For English language literature was searched up to March 2023, and 34 articles were included in the review and 15 article had sufficient quality for meta-analysis based on the methodology quality index. There was no significant effect found from using either rigid or soft orthoses alone during the acute phase of one level (OVFs). Both semi-rigid and weighted orthoses have shown a positive significant effect on thoracic kyphosis angle and back extensor muscle strength in osteoporotic or older hyperkyphotic patients. The results of this review indicate that using a soft or rigid orthosis alone does not have a superior effect in the acute phase of one-level (OVFs) compared to not using an orthosis. However, using a semi-rigid or weighted orthosis in osteoporotic or hyperkyphotic older adults with or without (OVFs) can benefit thoracic kyphosis angle, back muscle strength, and balance.

Introduction: The C-Brace microprocessor-controlled stance and swing control orthosis has been shown to improve function, mobility, and quality of life. A systematic registry to gather long-term, real-world safety and effectiveness data in patients fit with a C-Brace has not been performed.

Methods: International multicenter registry. Patients undergoing routine C-Brace fittings were assessed at baseline and 1 year after fitting. Primary outcomes were fast walking speed (FWS) measured by 25-foot or 10-meter walk test, Timed Up and Go (TUG) and the Activity-specific Balance Confidence (ABC) Scale. Secondary and exploratory outcomes included the Patient-specific Functional Scale (PSFS), falls, pain, PROMIS Pain Interference (PI), and quality of life.

Results: 48 subjects with 1-year baseline and follow up data were analyzed. With the C-Brace, FWS improved by + 0.26 ± 0.33 m/s (p < .0001), TUG by -8.1 ± 14.6 sec (p < .0001), and ABC by + 24.9 ± 25.8% (p < .0001). Mean falls reduced from 33 ± 77 to 3.0 ± 5.6 (p = .0005). PSFS increased by 3.60 ± 2.34 points (p < .0001). Outcomes for pain, PI and quality of life showed significant improvements with the C-Brace.

Conclusion: The C-Brace is an effective option to improve safety, mobility, and quality of life for patients needing a KAFO for ambulation.

Background: Children with developmental coordination disorder (DCD) have difficulty learning and performing movements, often requiring increased feedback. Technology may be useful for delivering augmented feedback. Co-design methodology for developing therapeutic interventions has become popular in healthcare, including for technology in rehabilitation. However, there are limited guidelines on how to use co-design methodology in healthcare. Methods: We applied three key principles, (1) Understanding, (2) Exploring, and (3) Materialising, to inform a co-design process. End-user participants included paediatric clinicians, young learners, their caregivers, and the research team, who shared their expertise and lived experience to inform the creation of a novel system. Results: A team of end-users designed and developed an augmented reality intervention prototype for practicing motor skills aimed at children with DCD using a generative co-design process. From understanding the unmet needs, we explored and then materialised a series of games using bespoke technology solutions. Conclusion: The use of a co-design process was beneficial in engaging end-users as the experts of their experience in the creation of a novel augmented reality intervention prototype aimed for children with DCD. The co-design process was successful in facilitating a prototype that meets consumer needs, and ensured all end-user voices were heard.

Introduction: Lower limb orthoses (LLOs) and assistive devices (ADs) can be used together or separately to improve mobility when performing daily activities. The goal of this study was to examine utilization of LLOs and ADs in a national sample of adult LLO users.

Methods: A survey was designed to ask participants whether they typically use their LLOs and/or ADs to perform 20 daily activities. LLO users from orthotic clinics across the United States were invited to complete the survey. Descriptive statistics were used to examine utilization trends.

Results: Survey responses from 1036 LLO users were analyzed. Community-based activities were performed with LLOs by at least 80% of participants. Activities that involved walking short distances in the home were more often performed without LLOs or ADs. Among participants with the four most prevalent health conditions, LLO use in the community was greatest among participants with Charcot-Marie-Tooth disease.

Conclusions: LLOs were frequently used for a wide range of community-based activities. Simultaneous use of ADs and LLOs may be most beneficial for LLO users when performing activities outside of the home. Clinicians can discuss LLO and AD use with patients to optimize their functional outcomes at home and in the community.