Disability and Rehabilitation-Assistive Technology最新文献

Purpose: The demand and popularity of online higher education programmes has increased dramatically, with a sectoral shift to funding, resourcing and increasing options for remote study. Thus, it is important to understand disabled students' experiences in an online learning environment and how they navigate their assistive technology (AT) use. The pivot to online learning during the COVID-19 pandemic provided an opportunity to explore the opportunities and challenges of AT use and identify best practices for disabled students who are studying remotely. The aim of this paper is to present key learnings from AT use in an online, higher education environment during this period.

Methods: Semi-structured interviews were conducted with disabled students (n = 13) in higher education in Ireland during the COVID-19 pandemic, when all students were engaged in online learning. Reflexive thematic analysis was employed to identify themes of interest.

Results: Three themes with related subthemes were identified: (1) the critical role of inclusive support systems, (2) fostering more inclusive and collaborative spaces and (3) the need for systemic attitudinal change.

Conclusion: This paper highlights key learnings from AT use in an online, higher education environment which should be considered and implemented to address inequity. A flexible approach to the delivery of supports and services, which is co-designed with disabled students, should be employed to maximise participation and inclusion, ensuring that students can access the same quality assistance regardless of mode of study. This should form an integral part of widening participation initiatives in higher education institutions and national disability strategies.

Purpose: Emerging technologies, ranging from robotics and artificial intelligence to assistive innovations, hold transformative potential for improving the quality of life among people with disabilities. Yet, despite decades of research, systematic evidence on their adoption intentions, attitudes, and accessibility barriers remains fragmented.

Materials and methods: This study conducts a systematic literature review of 46 studies published over the past two decades, synthesising key determinants influencing technology adoption.

Results: The findings reveal that perceived usefulness is the strongest predictor of adoption intentions, while significant barriers persist. These include usability challenges arising from limited accessibility caused by physical and cognitive constraints, high financial costs, inadequate training and support, and persistent digital inequalities. Psychosocial concerns, such as fear of safety risks, social stigma, and reduced human interaction, further shape negative attitudes towards adoption.

Conclusion: The study highlights the need for inclusive and user-centered design approaches that prioritise accessibility, affordability, and trust. By integrating evidence across disciplines, this review provides a comprehensive framework to guide future research, policy development, and innovation strategies aimed at fostering equitable technology adoption among people with disabilities.

Purpose: To estimate the proportion and timing of assistive technology (AT) device delivery during paediatric inpatient rehabilitation and identify factors associated with delivery rates.

Materials and methods: We conducted a retrospective cohort study at a neurorehabilitation centre in Argentina, including patients <22 years with hospital stays >20 days, discharged between January and December 2024, and with at least one mobility- or participation-related AT prescription. The primary outcome was time from prescription to documented delivery during hospitalisation. Delivery probabilities were estimated with Kaplan-Meier curves and compared using the log-rank test. Factors associated with delivery were analysed with multivariate Cox regression, with clustered standard errors by patient.

Results: Thirty-three patients were included (mean age 10.6 years; 39.4% female). Sixty devices were prescribed; 41 (68.3%) were delivered during the inpatient stay. Median delivery time after prescription was 27 days (IQR 10-64). Cumulative delivery probabilities at 30, 60, and 90 days were 45%, 64.3%, and 72.8%, respectively. In the multivariate model, postural or self-propelled wheelchairs had a lower delivery rate than other devices (adjusted HR 0.32, 95% CI 0.12-0.86; p = 0.02). Devices processed through provincial public health insurance were delivered more slowly compared with social security, private coverage, or out-of-pocket payment (adjusted HR 0.41, 95% CI 0.22-0.76; p < 0.01). No significant associations were observed for prescription timing or clinical priority classification.

Conclusion: Nearly one-third of prescribed AT devices for mobility and participation were not delivered before discharge, and delivery times were often prolonged, particularly for wheelchairs and devices processed through provincial public insurance.

Purpose: Navigating urban environments poses significant challenges for individuals who are blind or have low vision, especially in areas affected by construction. Construction zones introduce hazards such as uneven surfaces, barriers, hazardous materials, excessive noise, and altered routes that obstruct familiar paths and compromise safety. Although navigation tools assist in trip planning, they often overlook these temporary obstacles. Existing hazard detection systems also struggle with the visual variability of construction sites.

Methods: We developed a computer vision-based assistive system integrating three modules: an open-vocabulary object detector to identify diverse construction-related elements, a YOLO-based model specialised in detecting scaffolding and poles, and an optical character recognition module to interpret construction signage.

Results: In static testing at seven construction sites using images from multiple stationary viewpoints, the system achieved 88.56% overall accuracy. It consistently identified relevant objects within 2-10 m and at approach angles up to 75°. At 2-4 m, detection was perfect (100%) across all angles. Even at 10 m, six of seven sites remained detectable within a 15° approach. In dynamic testing along a 0.5-mile urban route containing eight construction sites, the system analysed every frame of a first-person walking video. It achieved 87.26% accuracy in distinguishing construction from non-construction areas, rising to 92.0% with a 50-frame majority vote filter.

Conclusion: The system can reliably detect construction sites in real time and at sufficient distances to provide advance warnings, enabling individuals with visual impairments to make safer mobility decisions, such as proceeding with caution or rerouting.

Objective: This study presents a low-cost assistive navigation system combining a Smart Blind Stick and Smart Glasses to improve mobility safety and independence for blind and visually impaired (BVI) users through multi-level obstacle sensing, emergency alerts, and smart home integration.

Methods: A dual-node architecture was developed using ESP32-based modules integrated into a stick and glasses. The stick provides lower-body obstacle detection and includes an emergency panic switch, while the glasses provide upper-body obstacle detection. Both nodes generate audio alerts via a DFPlayer Mini and speaker and additionally transmit Bluetooth messages to a smartphone terminal application, enabling TalkBack-based voice output as a redundant feedback channel. The system also supports SMTP-based emergency email alerts and indoor smart home control using relay switching. A preliminary pilot evaluation was conducted in both indoor and outdoor environments to assess functional reliability and collect initial usability feedback.

Results: The prototype demonstrated reliable obstacle detection and audio feedback across different distances and environments. Emergency panic alerts and smart home control functions were successfully triggered during repeated trials, confirming stable operation of the integrated communication and control features. Participant feedback indicated improved perceived safety, confidence, and usefulness compared to traditional single-device approaches.

Conclusion: The proposed Smart Blind Stick and Glasses system offers an affordable, redundant, and modular assistive technology solution with multi-level sensing, dual-mode audio feedback, emergency notification capability, and smart home integration. The findings support feasibility for real-world use and motivate future work involving expanded user studies and advanced sensing/AI-based upgrades.

Objective: This study analyzed the usability of an assistive cutlery prototype designed to facilitate eating for people with PD (PwPD), focusing on satisfaction, effectiveness, and efficiency.Methods: Thirteen participants used the assistive cutlery at home for 7 to 10 days. Satisfaction was assessed through structured phone interviews that explored perceptions of usefulness, comfort, and safety. Effectiveness was evaluated in a laboratory setting using video recordings of a simulated eating task, assessing how well the cutlery enabled independent eating without spilling or dropping food. Efficiency was measured through kinematic analysis of movement smoothness, using data collected from an inertial measurement unit attached to the wrist.

Impact: Participants reported improvements in task performance and satisfaction. Regarding movement effectiveness, there was a 14.4% increase in the minute transport of solid food using the fork (p ≤ 0.05) and increases of 33.1% and 36% in the total and minute transport of liquid food using the spoon (p ≤ 0.05). Efficiency improvements included reduced task time and enhanced vertical velocity with the spoon (p ≤ 0.05) as well as increased mediolateral velocity with the fork (p ≤ 0.05). These findings suggest that the assistive cutlery prototype demonstrates good usability, enhances user satisfaction, and improves movement effectiveness and efficiency for PwPD.

Objective: This study explored clinicians' perspectives on the usefulness, effectiveness, technology's role, and improvement areas of the Individualised Reduction of Falls Online (iROLL-O) program, a group-based online fall prevention intervention for people with multiple sclerosis (PwMS) or spinal cord injury (PwSCI) who use wheelchairs and scooters (WC/S) full-time. Methods: Occupational and physical therapists with at least four years of clinical experience working with PwMS or PwSCI who used WC/S (N = 5), were recruited for the study. Clinicians reviewed the iROLL-O program and completed Zoom-based semi-structured interviews to provide feedback on the program. Three research team members conducted thematic analysis through iterative coding, with major codes derived from research questions and others generated inductively. Results: Four themes emerged to capture the clinician's views on the iROLL program: (1) Practical and Comprehensive Nature of the iROLL Program, (2) Mechanisms of Change for the iROLL Program, (3) Role of Online Delivery Method and (4) Opportunities for Improvement. Conclusion: This study demonstrates iROLL-O's potential effectiveness for fall prevention among PwMS and PwSCI who use WC/S full-time. Findings emphasise the importance of tailored, accessible programming for enhanced engagement. Clinicians valued iROLL's comprehensive, flexible approach. Future research should aim to refine online delivery and expand the evaluation of program efficacy.

Purpose: Physical activity has major health implications for older adults, but those with mobility disabilities are often excluded from physical activity research. The aims of this study were to 1) describe and compare physical activity and health-related characteristics of older adults in assisted living who primarily ambulate with those who primarily use a wheelchair or scooter and 2) examine correlations between physical activity and health-related characteristics in the same groups.

Materials and methods: This study used a descriptive, cross-sectional comparative analysis design. Thirty-five participants were recruited; they wore an accelerometer to measure physical activity and sleep and completed physical function assessments and health-related surveys. We used t-tests to compare mobility-status groups and Spearman's correlations to examine relationships between physical activity and health variables. We report correlations >0.30 as potentially meaningful relationships.

Results: Sixty-one percent of participants primarily ambulated, while 39% used wheelchairs or scooters. Ambulatory assisted living residents had worse sleep quality, while the seated mobility group had worse lower body and self-reported physical function. Ambulatory participants' physical activity was negatively correlated with sleep onset latency (r= -0.30) and wake after sleep onset (r= -0.38) and positively correlated with mental health (r = 0.42). Seated mobility participants' physical activity was positively correlated with total Short Physical Performance Battery score (r = 0.48) and balance (r = 0.46).

Conclusion: These findings underscore the interplay between mobility status, physical activity, sleep, and function, suggesting tailored interventions are needed to enhance the health of older adults in assisted living with different levels of mobility.

Purpose: Cognitive impairments, such as difficulties with memory, planning, organisation and information processing, are common after brain injury. Assistive Technology for Cognition (ATC) can provide support to improve independence in everyday tasks and reduce reliance on caregiver support. Recommendation and support needs to be tailored to individual factors and therefore understanding individual experiences and preferences is essential. The aim of this study was to understand the lived experience of people using ATC after brain injury.

Materials and methods: Semi-structured interviews were conducted with seven people (six people with brain injury and one caregiver) who were involved with both a Community Acquired Brain Injury Service and an Assistive Technology Service. Interviews were recorded and transcribed and analysed using principles of Framework Analysis.

Findings: We identified five themes: 1) Motivations and decisions to use ATC, 2) The anticipated and unanticipated impact of ATC, 3) ATC becoming part of everyday life, 4) Support and education from professionals (although I don't know who from) and 5) Family and friends as back-up and trouble-shooters.

Conclusion: We use the themes to illustrate factors which can help professionals to match technology to individuals and their situations and therefore potentially optimise acceptability and use for this population. Findings emphasise the importance of support from family and friends and a lack of clarity about longer-term support.