Disability and Rehabilitation-Assistive Technology最新文献

Purpose: This research aims to identify information that is important to provide on supply of custom-contoured seating. The way this information would be best communicated is also of interest. A two-round e-Delphi study was utilised to explore consensus. A panel of stakeholders from Ireland including experts in positioning clients in custom-contoured seating and caregivers were recruited. The first round consisted of open-ended questions and was analysed using thematic analysis. The second round employed a rating technique and 7-point Likert scale. Consensus was set a priori at 70% agreement. The way information should be communicated and by whom was rated in order of preference.

Materials and methods: Fifteen participants were recruited, nine clinicians and four caregivers. Fifty-two statements under six themes (transfers = 10, positioning = 22, pressure care = 4, general use = 4, post-supply follow-up = 8, functional activity = 4) were generated in round 1 by 13/15 participants. Round 2 was completed by 10/15. 49/52 statements reached consensus and were deemed important. The ways information should be communicated and by whom was identified. Caregivers want individualised information whereas clinicians preferred a more generic approach.

Results and conclusions: There was a high degree of consensus on what information is required to support caregivers. The topics demonstrate the extensive information that should be provided. The preferred delivery method for primary caregivers was hands-on training with the opportunity to practice and take videos. Stakeholders differed in how they would prefer information delivered. Further research should evaluate the method of delivering training and its effectiveness.

Purpose: We determined over-the-counter magnifier usage rates by patients who newly presented for vision rehabilitation services, and sought to elucidate whether patients' ratings of over-the-counter magnifiers were associated with vision rehabilitation management strategies.

Methods: Retrospective records reviews of 274 new vision rehabilitation patients seen between 2021-2023 were completed by three optometric providers at an ophthalmic academic center, college of optometry, and private practice.

Results: Over half (58%) of patients tried an over-the-counter magnifier. Older age was significantly associated with trying over-the-counter magnifiers (OR:1.04; p < 0.001). Patients who tried an over-the-counter magnifier had significantly greater odds of the provider recommending and/or dispensing a prescribed hand-held optical illuminated magnifier (P< =0.04) or recommending a CCTV electronic magnifier (p = 0.049). The majority indicated over-the-counter magnifiers were somewhat (46%) or not helpful (38%). There was a significantly greater odds of rating the over-the-counter magnifier as not helpful when the provider subsequently recommended a CCTV (OR:4.8; p = 0.01) or higher spectacle-based near add power (OR: 2.0; p = 0.02).

Conclusions: Since most new patients were unsatisfied with over-the-counter magnifiers, it is encouraging that previous over-the-counter magnifier use often led to upgrades with hand-held optical illuminated magnifiers prescribed by vision rehabilitation providers, or patients were transitioned to CCTV electronic magnifiers or spectacle-based high add powers for near reading. These findings support that older adults who have previously experienced that over-the-counter magnifiers were either helpful or unhelpful are ideal candidates to receive vision rehabilitation by optometric providers who can transition them to a prescribed magnification device to better support their visual functioning needs for near reading.

Purpose: Falls cost the NHS over £2 billion a year, with incidence increasing rapidly with age. Design of indoor walking frames remains limited, often needing to be lifted and not supporting sit-to-stand and turning manoeuvres, which can lead to falling. This study explored aspects of safety and satisfaction and potential for clinical use of a novel prototype walking frame.

Methods: Within a proof-of-concept design study, between April and November 2023 nine healthcare professionals (HCPs) [3 male 13.4 mean years clinical experience] assessed 10 in-patients and 8 community-based patients [9 male, mean ± SD age 81 ± 9.98]. Patient participants performed mobility activities with the prototype frame and a standard frame. Professionals then completed a questionnaire on safety and satisfaction when using the devices with free text options. Data were analysed using frequency and descriptive statistics and paired comparisons for ranked data, with open comments analysed using thematic analysis.

Results: HCPs reported the prototype as safe in 100% assessments (18/18), with 17/18 stating they would have prescribed it immediately if available ("Not as safe with a standard frame as she was with the prototype".). HCP satisfaction was greater for the prototype regarding dimensions (p = 0.006; "Good ability to personalize to individual".), safety and security (p = 0.003), ease of use (p = 0.005; "Automatically started to use it".), and effectiveness (p = 0.003; "Turns well, minimise lifting, glides but still grips").

Conclusions: This study demonstrates significantly better satisfaction of HCPs with the new design regarding ease of use and safety, in inpatient and community settings, and a strong desire to prescribe it.

Background: Advancements in wearable technology have created new opportunities to monitor stroke survivors' behaviors in daily activities. Research insights are needed to guide its adoption in clinical practice, address current gaps, and shape the future of stroke rehabilitation. This project aims to: (1) Understand stroke rehabilitation researchers' perspectives on the opportunities, challenges, and clinical relevance of wearable technology for stroke rehabilitation, and (2) Identify necessary next steps to integrate wearable technology in research and clinical practice.

Methods: Using a phenomenological qualitative design, two 90-minute focus groups were conducted with 12 rehabilitation researchers. The focus groups consisted of semi-structured, open-ended questions on functional movement behavior, motor performance and benefits and pitfalls of wearable technology. The transcribed focus groups were analyzed using inductive thematic analysis.

Results: Three main themes were derived from the analysis: (1) Assessing activity performance is critical to inform interventions, (2) The demonstrated benefit is not commensurate with the added hassle, (3) Collaboration is needed between the industry, academia and end-users. Necessary future steps were recognized including the identification of intuitive and actionable metrics, and the integration of sensor-derived data with electronic health records and into clinical workflow to support self-management strategies.

Conclusion: Wearable technology shows great potential to complement and support stroke rehabilitation. Many key barriers to clinical adoption remain which underscore the necessity to foster collaborations between industry, academia, and the participants we serve.

Methods: A published a priori review protocol guided searches of four electronic databases and 11 CPG portals. CPGs published between January 2012 and September 2023 in English for adults with progressive or complex conditions were included. Recommendations were catalogued according to: author, year and country of publication; grading of recommendations made; number of recommendations made overall and number pertaining to AT; target condition and/or population; age group/s recommendations related to (if specified); type of AT (categorised into "cognition", "communication", "vision", "hearing", "self-care", "mobility", "combination" or "other"); target professions to apply recommendations; evidence grading; and reference to supporting evidence. AT-related recommendations were summarised narratively. Analysis of the 18 CPGs that met inclusion criteria demonstrated that only 163 (7%) of the total 2,197 recommendations identified pertained to AT. Vocabulary used to describe AT, and detail offered regarding AT interventions was varied impacting the value of some AT-related CPGs.

Impact: This is the first review internationally to identify and document CPG recommendations for adults with progressive or complex conditions, specific to AT interventions. Guidance on types of assistive products - and personnel required for provision - was limited. Further evidence is required to guide practice.

Purpose: Availability of assistive technologies (ATs) to children with disabilities is a critical human right enshrined in United Nations (UN) treaties and frameworks such as the United Nations Conventions on the Rights of Persons with Disabilities (UNCRPD), the United Nations Conventions on Rights of the Child (UNCRC), and United Nations 2030 Agenda for Sustainable Development. ATs optimize functionality, independence, and enhance educational experiences of children with disabilities. The study explored availability of ATs to children with disabilities in Bulawayo Central District (BCD) in Zimbabwe.

Materials and methods: The study was a predominantly qualitative inquiry but triangulated qualitative research with quantitative data sources and perspectives. Structured and semi- structured questionnaires and interviews were used to elicit data from a sample of 10 teachers, 5 Heads of schools, and 10 parents of children with disabilities. Data from questionnaires were analysed using frequencies and descriptive summaries while data from interviews were presented in narrative summaries and analysed using thematic content analysis.

Results: The study demonstrated that ATs are a human rights enabler which is fundamental for development, equalization, and inclusion of children with disabilities in education. Major barriers to availability of ATs include lack of awareness and knowledge of ATs among educators and other professionals, as well as parents of children with disabilities. In addition, inadequate clear and distinct disability-oriented policies and legislation were a challenge to the availability of ATs in Zimbabwe. The Zimbabwe government seems to have put in place administrative educational policies which guide inclusive education, but the implementation and availability of ATs remains elusive.

Purpose: This article explores the existing research evidence on the potential effectiveness of lipreading as a communication strategy to enhance speech recognition in individuals with hearing impairment.

Methods: A scoping review was conducted, involving a search of six electronic databases (MEDLINE, Embase, Web of Science, Engineering Village, CINAHL, and PsycINFO) for research papers published between January 2013 and June 2023. This study included original research papers with full texts available in English, covering all study designs: qualitative, quantitative, and mixed methods. These studies had to examine lipreading as an approach to enhance speech recognition and involve metrics of word recognition accuracy or speech recognition performance.

Results: This review identified a total of 18 articles that met the inclusion criteria. The research evidence is limited to descriptive analysis of lipreading to enhance speech recognition. Most of the studies focused on audiological, computational and hearing-related aspects. The features supporting the effectiveness of lipreading were found to be related to (a) Speaker: The accurate lip movements and the role of facial expressions; (b) Person lipreading: Skills and personal characteristics; (c) Technology to capture and/or support lipreading, and (d) Environmental and contextual factors.

Conclusion: Findings of this review indicate that lipreading can be an effective approach to enhancing speech recognition of people with hearing disabilities, giving attention to a combination of the factors related to individuals with hearing impairment, speaker, environment, and technology. Further research is required to investigate interaction among these factors to inform development of efficient lipreading systems.

Purpose: The aim of this study was to explore the feasibility of using electrodermal activity (EDA) to detect changes in physiological arousal linked to perceptions of accommodations, focusing on universal design (UD) features. In environments like hotels, designers must consider wellness, social integration, and cultural appropriateness to effectively implement UD. Challenges exist with implementing and evaluating UD to accommodate diverse user needs due to conflicting definitions and application issues. To meet the need for post-design evaluation discerning accommodations by features and user groups, EDA measures offer a way to capture individual reactions to external stimuli.

Materials and Methods: In this study, 22 adults (14 young, 8 older) completed an independent hotel walkthrough while expressing their perceptions. EDA was measured using a wristband, and participants' perceived stress and usability were assessed through questionnaires. Phasic EDA was extracted to represent discrete event-evoked changes in arousal.

Results: Findings demonstrated the potential of EDA to identify physiological response variations based on age and location within the hotel. Older adults displayed significantly higher levels of arousal and more favorable usability ratings (4.61 out of 5) compared to young adults, with peak arousal in the corridor and public restroom. Younger adults showed the highest arousal in the bathroom, often with negative associations. The groups differed in their reactions to the bathroom and reception areas.

Conclusions: Divergences between physiological responses and subjective outcomes highlighted the complexity of translating arousal measures into meaningful insights. EDA, combined with commentary, enhanced our understanding of user reactions to design elements to fill gaps left by subjective methods.

Purpose: An assistive technology ecosystem requires co-ordinated collaboration between policy, products, provision processes, and personnel. A needs assessment was conducted of the assistive technology sector in Queensland to examine these components from the perspective of all key stakeholders. Materials and Methods: This paper reports the findings of the expressed needs of the assistive technology sector as experienced by the AT advisors and suppliers. A sequential mixed methods design supported completion of a quantitative online survey (n = 29) followed by qualitative exploration with assistive technology advisors (n = 9) and suppliers (n = 6).

There was an identified need to address the processes that led to delays or unfavourable outcomes for AT. Despite reporting confidence in the quality of services delivered, the advisors were worried about reduced access to expert consultation and a need to better build capacity and capability in the sector. Access to AT for hire or trial was problematic with conflicting tensions identified by the advisors and suppliers. However, both worried about the impact on the agency of the AT recipient in the process.

Conclusions: There are opportunities to enhance the personnel, provision, and policy aspects of the assistive technology ecosystem in Queensland. Pressure points are: workforce capacity and capability to meet the growing need; finding ways to support the trial of assistive technology required to ensure appropriate recommendations for assistive technology that is fit for purpose; and improving information from the bodies that manage funding to reduce the waste in the provision process.

This study explores the integration of telerehabilitation, virtual reality, and serious games technologies in addressing physical disabilities. Specifically, it focuses on game-based telerehabilitation for patients with stroke, Parkinson's disease, and multiple sclerosis undergoing home-based rehabilitation. Utilising the PICO approach, a search in Scopus and PubMed until February 21st, 2024, identified 31 relevant English articles out of 258 initially considered. The study employed three independent reviewers to select, extract data, and analyse studies based on the research question. The final included studies were analysed to extract and categorise the most critical items, including rehabilitation tools, opportunities, and challenges. Of the 258 studies, 31 met the eligibility criteria, with the majority conducted in the United States and the United Kingdom. Key opportunities identified include the effectiveness of telerehabilitation and the use of new, engaging, user-friendly, and affordable technologies. However, challenges such as motivation, usability, exercise adherence, and technical barriers were significant. The Wii gaming console emerged as the most commonly used telerehabilitation device. This systematic review offers a comprehensive analysis of telerehabilitation features, opportunities, and challenges. It highlights the importance of tailored remote rehabilitation programs, potentially leading to more effective patient services. The study suggests that sustained use of these systems is crucial for positive clinical outcomes and emphasises the impact of affordability and engagement on long-term patient adherence to treatment plans in remote rehabilitation systems.