Journal of Rehabilitation and Assistive Technologies Engineering最新文献

Introduction: Task-specific neurorehabilitation is crucial to optimize hand recovery shortly after a stroke, but intensive neurorehabilitation remains limited in resource-constrained healthcare systems. This has led to a growing interest in the use of robotic gloves as an adjunct intervention to intensify hand-specific neurorehabilitation. This study aims to develop and assess the usability of an operating interface supporting such a technology coupled with a virtual environment through a user-centered design approach.

Methods: Fourteen participants with hand hemiparesis following a stroke were invited to don the robotic glove before browsing through the operating interface and its functionalities, and perform two mobility exercises in a virtual environment. Feedback was collected for improving technology usability. Participants completed the System Usability Scale and ABILHAND questionnaires and their recommendations were gathered and prioritized in a Pugh Matrix.

Results: The System Usability Scale (SUS) score for the operating interface was excellent (M = 87.0 SD = 11.6). A total of 74 recommendations to improve the user interface, calibration process, and exercise usability were identified.

Conclusion: The application of a full cycle of user-centred design approach confirms the high level of usability of the system which is perceived by end users as acceptable and useful for intensifying neurorehabilitation.

Purpose: Trunk stability, an important prerequisite for many activities of daily living, can be impaired in children with movement disorders. Current treatment options can be costly and fail to fully engage young participants. We developed an affordable, smart screen-based intervention and tested if it engages young children in physical therapy goal driven exercises.

Methods: Here we describe the ADAPT system, Aiding Distanced and Accessible Physical Therapy, which is a large touch-interactive device with customizable games. One such game, "Bubble Popper," encourages high repetitions of weight shifts, reaching, and balance training as the participant pops bubbles in sitting, kneeling, or standing positions.

Results: Sixteen participants aged 2-18 years were tested during physical therapy sessions. The number of screen touches and length of game play indicate high participant engagement. In trials lasting less than 3 min, on average, older participants (12-18 years) made 159 screen touches per trial while the younger participants (2-7 years) made 97. In a 30-min session, on average, older participants actively played the game for 12.49 min while younger participants played for 11.22 min.

Conclusion: The ADAPT system is a feasible means to engage young participants in reaching and balance training during physical therapy.

The use of robots in a telerehabilitation paradigm could facilitate the delivery of rehabilitation on demand while reducing transportation time and cost. As a result, it helps to motivate patients to exercise frequently in a more comfortable home environment. However, for such a paradigm to work, it is essential that the robustness of the system is not compromised due to network latency, jitter, and delay of the internet. This paper proposes a solution to data loss compensation to maintain the quality of the interaction between the user and the system. Data collected from a well-defined collaborative task using a virtual reality (VR) environment was used to train a robotic system to adapt to the users' behaviour. The proposed approach uses nonlinear autoregressive models with exogenous input (NARX) and long-short term memory (LSTM) neural networks to smooth out the interaction between the user and the predicted movements generated from the system. LSTM neural networks are shown to learn to act like an actual human. The results from this paper have shown that, with an appropriate training method, the artificial predictor can perform very well by allowing the predictor to complete the task within 25 s versus 23 s when executed by the human.

Background: Preferences of informal caregivers of people with neurocognitive disorders for technological solutions are important in user- centered design approaches. It is crucial to take into consideration the needs and preferences of users when developing new technology to facilitate their uptake.

Objectives: The objective of this study was to determine caregiver preferences for potential technological solutions to help address their needs and compare technology preferences of caregivers who provide care to those with and without neurocognitive disorders (NCD).

Methods: This was a quantitative descriptive study. We surveyed informal caregivers of older adults with disability in Canada. Participants were asked to answer questions about their preferences for 10 potential technological solutions that could be developed to make caregiving easier.

Results: Data from 125 respondents (72 caregivers of people with NCD and 53 caregivers of people with non-NCD-related disabilities) were analyzed. Generally, caregivers preferred web-based solutions as these were among the first five choices for both groups combined. However, there were some differences in the order of preference of potential solutions in both groups.

Conclusion: Informal caregivers of people with NCD preferred web-based solutions to help address their needs.

Introduction: This study investigated the needs of stroke survivors and therapists, and how they may contrast, for the design of robots for at-home post stroke rehabilitation therapy, in the Ontario, Canada, context.

Methods: Individual interviews were conducted with stroke survivors (n = 10) and therapists (n = 6). The transcripts were coded using thematic analysis inspired by the WHO International Classification of Functioning, Disability, and Health.

Results: Design recommendations, potential features, and barriers were identified from the interviews. Stroke survivors and therapists agreed on many of the needs for at-home robotic rehabilitation; however, stroke survivors had more insights into their home environment, barriers, and needs relating to technology, while therapists had more insights into therapy methodology and patient safety and interaction. Both groups felt a one-size-fits-all approach to rehabilitation robot design is inappropriate. Designs could address a broader range of impairments by incorporating household items and breaking activities down into their component motions. Designs should incorporate hand and wrist supports and activities. Designs should monitor trunk and shoulder motion and consider incorporating group activities.

Conclusion: While therapists can provide insight in the early stages of design of rehabilitation technology, stroke survivors' perspectives are crucial to designing for the home environment.

Introduction: Clinical practice guidelines for preservation of upper extremity recommend minimizing wheelchair propulsion forces. Our ability to make quantitative recommendations about the effects of wheelchair configuration changes is limited by system-level tests to measure rolling resistance (RR). We developed a method that directly measures caster and propulsion wheel RR at a component-level. The study purpose is to assess accuracy and consistency of component-level estimates of system-level RR.

Methods: The RR of N = 144 simulated unique wheelchair-user systems were estimated using our novel component-level method and compared to system-level RR measured by treadmill drag tests, representing combinations of caster types/diameters, rear wheel types/diameters, loads, and front-rear load distributions. Accuracy was assessed by Bland-Altman limits of agreement (LOA) and consistency by intraclass correlation (ICC).

Results: Overall ICC was 0.94, 95% CI [0.91-0.95]. Component-level estimates were systematically lower than system-level (-1.1 N), with LOA +/-1.3 N. RR force differences between methods were constant over the range of test conditions.

Conclusion: Component-level estimates of wheelchair-user system RR are accurate and consistent when compared to a system-level test method, evidenced by small absolute LOA and high ICC. Combined with a prior study on precision, this study helps to establish validity for this RR test method.

Introduction: Many barriers to physical activity (PA) exist for individuals with spinal cord injury (SCI). Social engagement may improve motivation to perform PA, which in turn may increase PA levels. This pilot study investigates how social engagement facilitated by mobile technology may reduce lack of motivation as a barrier to PA in individuals with SCI and demonstrates design implications for future technologies.

Methods: A user-needs survey was conducted with participants in the community. We recruited 26 participants (16 individuals with SCI and 10 family members or peers). A participatory design process using semi-structured interviews was used to identify themes relating to PA barriers.

Results: One theme related to PA barriers was lack of PA-focused forums to connect with peers. Participants with SCI considered connecting with other individuals with SCI more motivating than connecting with their family members. Another key finding was that participants with SCI did not perceive that personal fitness trackers were targeted towards wheelchair-based activities.

Conclusions: Engagement and communication with peers who have similar functional mobility levels and life experiences can potentially improve motivation for PA; however, PA-motivational platforms are not tailored towards wheelchair-users. Our preliminary findings show that some individuals with SCI are not satisfied with current mobile-technologies for wheelchair-based PA.

Introduction: Total hip replacement (THR) is performed in an increasing number of individuals around the world and while improvements in pain reduction and long-term enhancement of muscle strength are well documented, the improvement in daily activity does not follow the same trend. This study aimed to determine the feasibility of a 5-week intervention where a personalised outdoor walking distance is monitored using a commercial activity monitor (Fitbit Charge 4).

Method: Data was collected on gait and activities of daily living using patient reported outcome measures. Following the completion of the intervention period, participants took part in a semi-structured interview to voice their opinion on the use of the activity monitor, their experiences, and any challenges in order to assess the feasibility of the intervention. All quantitative data were presented descriptively, using appropriate summary statistics. Interviews were analysed using thematic analysis.

Results: Five participants who had undergone total hip replacement surgery within the postoperative period of 3 to 6 months were recruited from the local community.

Conclusion: The findings suggest that the intervention was feasible and that it encouraged all participants to increase their daily activity. Therefore, it can be concluded that a follow-up effectiveness trial is warranted.

Introduction: No previous study has explored the effectiveness of current prescription standards for evaluating power mobility device (PMD) maneuverability. To verify the current prescription standards for PMDs using a virtual reality (VR)-based PMD simulator and to present the possibility of using a VR-based PMD simulator as an alternative to current evaluation standards.

Methods: A total of 52 patients with brain diseases were enrolled. All participants were over 18 years old and had gait disturbance or limited outdoor walking ability. Participants performed a driving ability test using a VR PMD simulator.

Results: The driving ability test using the VR PMD simulator indicated that cognitive impairment, measured by the K-MMSE (p = 0.017), and unilateral neglect, measured by line bisection (p = 0.031), led to reduced driving ability and safety. In addition, patients with cognitive impairment or neglect presented driving stability problems, which were observed in the driving trajectory. There was also no correlation between driving scores and MBI subitems.

Conclusion: In patients with brain lesions, a driving ability test using a VR PMD simulator can be a safe, objective method for comprehensively evaluating a driver's capacity, offering an alternative to the current prescription standards for PMDs.

Introduction: Force measurement wheels are essential instruments for analysing manual wheelchair propulsion. Existing solutions are heavy and bulky, influence propulsion biomechanics, and are limited to confined laboratory environments. In this paper, a novel design for a compact and lightweight measurement wheel is presented and statically validated.

Methods: Four connectors between the push-rim and wheel-rim doubled as force sensors to allow the calculation of tangential and radial forces as well as the point of force application. For validation, increasing weights were hung on the push-rim at known positions. Resulting values were compared against pre-determined force components.

Results: The implemented prototype weighed 2.1 kg and was able to transmit signals to a mobile recording device at 140 Hz. Errors in forces at locations of propulsive pushes were in the range up to ±3.1 N but higher at the frontal extreme. Tangential force components were most accurate.

Conclusion: The principle of instrumenting the joints between push-rim and wheel-rim shows promise for assessing wheelchair propulsion in daily life.