Disability and Rehabilitation-Assistive Technology最新文献

Manual wheelchair skills training programs are novel developments, particularly in the United States. As perceived by the caregivers of participants, this study aimed to examine the long-term impact of the Skills on Wheels program on participants' occupational engagement and quality of life at home, at school, and in the community. Secondly, this study investigated the caregivers' perspectives of the program design of Skills on Wheels. This was a qualitative inquiry based upon thematic analyses of semi-structured interviews after participation in a pediatric wheelchair skills training program. The study participants were 9 caregivers whose children participated in this program over the 2021 and 2022 implementation years. Caregivers were given a 10-question semi-structured interview. The five overarching topics included program impact: (i) occupational engagement, (ii) program impact: quality of life factors, (iii) program resources/design, (iv) novelty/importance of program/wheelchair skills training, and (v) desired continued wheelchair skills practice in the future. Results provided tangible feedback to integrate into program design and supported the Skills on Wheels program's positive value as it relates to impact on quality of life and occupational engagement for participants.

Purpose: Dementia prevalence is increasing worldwide. With the emergence of digital rehabilitation, serious digital games are a potential tool to maintain and monitor function in people living with dementia. It is unclear however whether games can measure changes in cognition. We conducted a scoping review to identify the types of outcomes measured in studies of serious digital games for people with dementia and cognitive impairment.

Methods: We included primary research of any design including adults with cognitive impairment arising from dementia or another health condition; reported data about use of serious digital games; and included any cognitive outcome. We searched Medline (via EBSCO), PsycInfo, CINAHL, Web of Science, from inception to 4th March 2024 and extracted study characteristics.

Results: We reviewed 5899 titles, including 25 full text studies. We found heterogeneity in domains and measures used: global cognition (n = 15), specific cognitive processes (n = 13), motor function (n = 5), mood (n = 6), activities of daily living (n = 5), physiological processes (n = 4) and quality of life (n = 2). Use of outcome measurement tools was inconsistent; the most frequently used measures were the Montreal Cognitive Assessment (n = 8), the Mini-Mental State Examination (n = 7), and the Trail Making Test (n = 7). Nine studies used in-game measures, most of which were related to game performance.

Conclusion: We found very few studies with assessment of cognition within the game. Studies of serious games for people with dementia and cognitive impairment should develop digital outcome tools based on recommendations in Core Outcome Sets, to increase consistency between studies.

Purpose: To evaluate the validity of a consumer-grade wearable for estimating energy expenditure, sedentary behaviour, and physical activity in manual wheelchair users with spinal cord injury (SCI).

Materials and methods: Fifteen manual wheelchair users with SCI (C5-L1, four female) completed activities of daily living and wheelchair propulsion (2-8 km·h^-1). Wrist-worn accelerometry data were collected using consumer-grade (z-Track) and research-grade (ActiGraph GT9X) devices. Energy expenditure was measured via indirect calorimetry. Linear regression was used to evaluate the prediction of criterion metabolic equivalent of task (MET) by each accelerometer's vector magnitude (VM). Area under the receiver operating characteristic curve (ROC-AUC) evaluated the accuracy of VM for discriminating between physical activity intensities and for identifying accelerometer cut-points.

Results: Standardised β-coefficients for the association between z-Track and ActiGraph VM for criterion MET were 0.791 (p < 0.001) and 0.774 (p < 0.001), respectively. The z-Track had excellent accuracy for classifying time in sedentary behaviour (ROC-AUC = 0.95) and moderate-to-vigorous physical activity (ROC-AUC = 0.93); similar values to the ActiGraph (ROC-AUC = 0.96 and 0.88, respectively). Cut-points for the z-Track were ≤37 g·min^-1 for sedentary behaviour and ≥222 g·min^-1 for moderate-to-vigorous physical activity.

Conclusions: This study supports the validity of a consumer-grade wearable to measure sedentary time and physical activity in manual wheelchair users with SCI.

Aim: Physical exercise is essential for the physical and mental health of visually impaired people, but they often face challenges such as inaccurate movements, lack of rhythm and difficulty in mastering postures during exercise. This project introduces an assistive device based on a multi-channel interaction design strategy to improve the accuracy of yoga practice for the visually impaired and to enable their independent exercise.

Methods: The system uses a 1:1 model combined with an output interaction model. The effectiveness was verified through controlled experiments with unassisted exercise as the control group and yoga-assisted exercise as the experimental group. Improvements in yoga accuracy and product usability were verified using the Assisted Accuracy Scale and the SUS Scale, respectively.

Results: The results showed that the multi-channel interaction design significantly improved the accuracy and usability of yoga exercises and enhanced the ability of visually impaired people to exercise independently.

Conclusion: Through this project, we hope to replicate this design strategy to help more visually impaired individuals independently perform effective physical exercise at home, in a gym, or in an outdoor space, thereby improving their quality of life and overall health.

Introduction: Most people with a spinal cord injury are concerned by pressure injuries (PrI). Since dynamic activities may involve distributions of forces over time that are different from static and given the significant impact of PrIs on healthcare costs, it is, important to study these sitting forces. We aim to investigate sitting forces (overall normal, shear forces and Peak Pressure Index (PPI)) assessed in both able-bodied and wheelchair users (WCU) under static and dynamic conditions. Our hypothesis is that wheelchair sitting forces encountered by able-bodied participants are significantly different from those of WCUs.

Material and methods: An experimental seat and a pressure mapping system were used to investigate forces in two different populations, 102 able-bodied and 15 WCUs, in static conditions and during synchronised hand-cycling. The analysis includes statistical comparisons of the sitting conditions (static/dynamic) and of the populations (able-bodied/WCUs).

Results and discussion: Significant differences in normal forces and PPI were observed between able-bodied and WCUs; conversely, differences in shear forces were non-significant. This suggests that contrary to shear forces, no conclusion on normal forces drawn from trials with healthy participants can directly be applied to WCUs. Secondly, the present results indicate significant reduced averaged: normal force, PPI, and shear forces for able-bodied performing a dynamic activity compared to static sitting. WCUs experienced non-significant lower averaged normal force and PPI but significant lower averaged shear forces.

Conclusion: While the present results seem to indicate lower forces for able-bodied performing a dynamic activity compared to static sitting, due to reduced averaged forces, this conclusion is less clear-cut for WCUs.

Many Canadian manual wheelchair users face many challenges in winter months such as slippage on ice- or snow-covered ramps, snow windrows, and casters becoming stuck in deep or hard packed snow. These barriers impact wheelchair users' ability to participate in the community. This study aimed to evaluate the validity and feasibility of a winter wheelchair obstacle course known as the Standardized Navigation Of Winter Mobility & Accessibility Network (SNOWMAN). The results demonstrated that the SNOWMAN course authentically represented real-world winter conditions, as confirmed by participant responses and qualitative feedback from four manual wheelchair users. The course was comprehensive, covering a range of winter obstacles typically encountered by wheelchair users. Construct validity was established by differentiating performance between manual wheelchairs and a motorized platform with snow tracks, showcasing varying completion times and device satisfaction levels. Feasibility was also assessed, with the administration protocol being mostly adhered to, safety measures implemented, and usability scores meeting acceptable thresholds. The SNOWMAN course showed promise for evaluating wheelchair adaptations and devices for winter conditions, as well as training users in winter mobility skills. Future research directions include comparing different wheeled mobility devices, exploring adaptations for usability in winter, and developing new technology tailored for challenging terrains and winter conditions. The SNOWMAN course could serve as a valuable tool for both research and clinical applications in enhancing winter mobility for wheelchair users.

Purpose: In an increasingly technology-driven world, this study explores the accessibility of assistive technology for individuals with intellectual disabilities through assistive technology loan libraries. Assistive technology refers to devices or systems that enhance the ability of individuals with and without disabilities to function and undertake activities of daily living.

Materials and methods: The study, grounded in the Social Determinants of Health framework, employed multiple methods including both qualitative (interviews) and quantitative (questionnaire) methods, involving 19 participants comprising assistive technology professionals and users.

Results: Key findings from the study underscore the pivotal role of assistive technology loan libraries, which lend various assistive devices to individuals, enabling them to try these technologies before making a long-term commitment. However, challenges, such as a restricted variety of devices and extended waiting periods for access were highlighted. The research points to a need for improved training for both staff at the loan libraries and the users of the technology. It also suggests that policy enhancements are required to better align with rapid technological advancements and address the uneven regional distribution of these technologies.

Conclusions: Participants in the study highlighted the importance of expanding the range of assistive devices available in these libraries and improving the efficiency of the service they provide. The study advocates for targeted efforts to enhance the effectiveness and accessibility of assistive technology loan libraries, highlighting their critical role in empowering individuals with intellectual disabilities.

Background: Web-based programmes offer parents of children with communication difficulties promising access to parent-mediated, early interventions. However, empirical evaluations of such programmes are limited. This study focused on parents and used mixed methods to examine the feasibility of ComAlong online.

Methods: ComAlong online is a Swedish, self-managed web-resource teaching parents supportive strategies to promote child communication. Data of different types were collected from a total of 71 parents: ten individual parent interviews, 21 pre-questionnaires and 10 post-questionnaires, and finally 50 anonymous digital evaluation surveys. Descriptive statistics and deductive qualitative content analysis were used.

Results: Findings indicate that parents perceived improved child communication and own competence after using the ComAlong online. The most valued parts included podcasts with experts and videos of parent-child interaction. Parents reported that the resource was easy to use, but they wanted to have gained access to the resource when the child was younger. Suggestions for changes included adding a chat function with experts, a parent net forum, and the possibility of creating personalised playlists of videos and podcasts. Evaluation of the research process revealed difficulties in recruiting parents from local child healthcare services and parents of children not yet with a diagnosis.

Conclusions: This study supports the potential for self-managed, web-based resources to disseminate evidence-based parent training for supporting early communication development. Importantly, parents lack individual guidance from experts and contact with other parents. Also, measures need to be made to disseminate the resources within local child healthcare services.

Background: Wheelchair racing is a traditional modality of Paralympic athletics. In general, racing wheelchairs are customized according to the athletes' anthropometric conditions, based on pre-established dimensions according to the manufacturer's manual. Usually, athletes choose the dimensions for their new sports wheelchairs, and when they are delivered for use, they often have problems due to incorrect body adjustments.

Purpose: To develop a new customization methodology that is made possible through a new multi-adjustable racing wheelchair prescription equipment (RWPE) for athletics. This equipment performs several measurements and adjustments according to the athlete's anthropometric characteristics, evaluating the best-fit athlete to obtain better performance in the personalized wheelchair.

Materials and methods: Customizing racing wheelchairs is based on anthropometric measurements of the individual and specific ergonomic adjustments for better performance and safety. The RWPE is a multi-adjustment device composed of modules that use measuring instruments to guarantee maximum precision and accuracy of the assessments. This project's innovation is associated with the multi-regulation equipment itself and a conventional process of manufacturing a racing wheelchair through an online form. The RWPE has a robust and rigid structure for conducting race-track experimental tests.

Results and conclusions: The experimental tests allowed the equipment to be validated regarding safety, comfort, and prescription methodology. A high-performance athlete validated the equipment and prescription methodology, and as a result, a new version of a parameterized wheelchair was also developed using the prescription methodology. A comparison between prescription tests showed better athlete performance regarding estimated average power, considering dimensions optimized through RWPE.

Background: Due to progressive muscle wasting and weakness in patients with Duchenne Muscular Dystrophy (DMD), physical fatigability increases, upper extremity function reduces, which negatively impacts quality of life. Assistive technology such as dynamic arm supports (DAS) may help reduce this fatigability. This study aims to assess whether the novel Yumen 'EXone' DAS can reduce upper extremity fatigue and fatigability in DMD patients and healthy controls (HC), both with and without the DAS. Additionally, longitudinal changes in DMD patients were evaluated.

Methods: Five DMD patients from the Yumen Bionics pioneer program and five HCs participated. Two submaximal tests simulating drinking and reaching were performed for two minutes, each with and without DAS. DMD participants completed these tests twice, at baseline (T0) and after 6-9 months (T1), while HCs completed them once. Physical fatigability was measured by the number of repetitions and changes in surface electromyography (sEMG) amplitude. Subjective fatigue was assessed using the Borg Scale (6-20) Rate of Perceived Exertion (RPE).

Results: DMD participants generally performed more repetitions with the DAS than without. HCs showed similar or increased repetitions with the DAS. Assessing fatigability with sEMG was difficult due to the compensatory mechanisms used for the tests. Subjective fatigue scores on the Borg Scale were lower with the DAS for both DMD patients and HCs.

Conclusion: The Yumen 'EXone' DAS effectively reduces both fatigue and fatigability in DMD patients and healthy controls. Despite the methodological shortcomings, this research is one of the first studies investigating the impact of DAS on fatigue and fatigability.