Disability and Rehabilitation-Assistive Technology最新文献

Purpose: This study is a randomized controlled trial (RCT) that examines the feasibility, acceptability, and initial efficacy of a home-based, remotely supported and supervised exercise training program that was developed using a three-step community engaged research process for persons with multiple sclerosis (MS) who are wheelchair users.

Materials and methods: The study design is a parallel group RCT (NCT05888727). We aim to enroll 24 wheelchair users with MS who will be randomly assigned using REDCap randomization module into exercise training or attention/contact wellness control conditions. The conditions will be delivered remotely over 16 weeks and supported using online, one-onone behavioral coaching. The feasibility outcomes of interest include recruitment and retention rates, and safety outcomes collected throughout the study period. The acceptability outcomes include participant satisfaction and perceptions measured using formative surveys and interviews following the 16-week period. Efficacy outcomes include metabolic health, MS symptoms, and exercise behavior measured before and after the 16-week period. The data analysis will follow intent-to-treat principles using 2 group by 2 time mixed factor ANOVA with estimation of Cohen's d values as effect sizes.

Conclusions: The results will guide future research targeting health outcomes using exercise training among wheelchair users with MS who have largely been absent from health promotion research.

The application of robotic devices is being used as Assistive Technology (AT) for improving rehabilitation interventions. The purposes of this research were to (1) test a novel low-cost robotic AT to support interventions for people with Cerebral Palsy (CP); (2) determine its usability; and (3) analyze its impact. It was a pilot study with prospective, longitudinal and analytical cohorts was done. Intervention was developed in one association (NGO) of people with CP. Participants were 6 women and 3 men with CP, with a mean age of 51.67. Intervention with LOLA2 (a robotic platform, not wearable, equipped with artificial intelligence) was implemented for training some activities of daily life (ADL) of participants. Functional Independence Measure (FIM), Psychosocial Impact of Assistive Technology Scale (PIADS), and Assistive Technology Device Predisposition Assessment (ATPA) were used for outcome measures. Level of participants' independence was high (FIM = 98). Psychosocial impact of the robotic platform in terms of competence (M = 0.25), adaptability (M = 0.33), and self-esteem (M = 0.25), was positive, but low. The mean in ATDPA (M = 3) reflects a moderate match. No significant variations concerning the changes in functional independence were detected. The robotic platform is applicable and complementary AT for rehabilitation. This study leads to implementing some improvements in its design, proposed activities, human-robot interaction, and system for registering information.

Cognitive decline is becoming more prevalent as population ages. Technology offers solutions to help people with cognitive decline age in place. A compassionate approach to care can promote engagement in technology use by older adults with cognitive decline and equitable access. This scoping review summarized research literature on approaches to design and selection of technology that could support a compassionate approach to technology use for daily functioning among adults with cognitive decline and their care partners. We used the framework of Arksey and O'Malley. Key words capturing constructs of compassion, technology, and cognitive decline were searched in CINAHL, Medline, and PsycINFO. Peer-reviewed articles about the design for or use of technology by persons with cognitive decline or their care partners were included. Two reviewers screened and extracted data. Data informing compassionate technology use were analysed thematically. Fifty-five included articles represented a variety of technologies and purposes with ethics being the predominant perspective (n = 15). Analysis identified four categories: 1) Person- and care partner-centered approach, 2) Tailoring design to abilities, 3) Tailoring selection and application, and 4) Training and support. Using study findings, we developed a framework for compassionate use of technology for people living with cognitive decline and their care partners.

Purpose: The proposed scoping review aims to explore and map wheelchair outcome measurement instruments for children in the literature.

Method: The proposed scoping review will be conducted in accordance with the Joanna Briggs Institute (JBI) methodology. The review question and eligibility criteria were developed using the PCC (population, concept, context) mnemonic as follows: (P) children manual or motorised wheelchair users (aged ≤ 18 years), (C) wheelchair outcome measurement instruments, (C) primary sources of literature. The search will be conducted in nine relevant electronic databases. including grey literature from Academic Google. Study screening, selection, and data extraction will be performed independently by two authors. A third reviewer will resolve discrepancies between the authors. General characteristics, population, feasibility, interpretability data will be extracted in accordance with the COSMIN methodology (Consensus-based Standards for the selection of health Measurement Instruments). This will encompass data pertaining to the measurement properties of the domains of reliability, validity and responsiveness. A descriptive analysis will be carried out, and the results will be classified into categories and presented in tables accompanied by a descriptive summary.

Results: The results can inform future research directions, clinical practice and the development of wheelchair outcome measurement instruments. Furthermore, it will help professionals in rehabilitation and wheelchair services to find the wheelchair outcome measurement instruments according to the target population and cultural context.

Objective: Access to assistive products (APs) is essential to maximising function, participation, and inclusion of persons with disabilities. Challenges to AP access in low- and middle-income countries include stigma, costs, supply, and rehabilitation capacity gaps. This study aimed to examine AT access in the context of a low-resource setting in rural South India. Objectives were to examine rehabilitation professionals' perceptions of AP needs, barriers and facilitators of AP provision, and AT knowledge.

Methods: A descriptive study design with a 2-part online survey methodology was utilized. This study was conducted in April-September 2020 at a non-governmental organization (NGO) serving children and adults with disabilities in 3 districts of rural South India. Purposive sampling of NGO's multidisciplinary rehabilitation professionals (N=62) was used. The survey was developed based on WHO's Assistive Products List (APL). Barriers and facilitators were classified according to the principles of AT access. Analyses revealed acceptability, affordability, and availability as the top three barrier themes across disciplines, including poor acceptance by clients/families due to stigma, high AP costs, and a long waitlist for government-provided devices. Acceptability, affordability, and accessibility were the top three facilitator themes, including community awareness, availability of AP funding, client/family education, and AT service provision training.

Impact: Our study identified key enabling strategies for AT access, aimed at reducing reported barriers. Enabling AP provision was determined to be multi-factorial, aimed at users/ families, service providers, organizations, communities, and policymakers. Local stakeholder groups are crucial to understanding challenges and opportunities to AP provision within a low-resource context.

Purpose: Visually impaired people (VIP) find it challenging to understand and gain awareness of their surroundings. Most activities require the use of the auditory or tactile senses. As such, assistive systems which are capable of aiding visually impaired people to understand, navigate and form a mental representation of their environment are extensively being studied and developed. The aim of this paper is to provide insight regarding the characteristics, as well as the advantages and drawbacks of different types of sonification strategies in assistive systems, to assess their suitability for certain use-cases.

Materials and methods: To this end, we reviewed a sizeable number of assistive solutions for VIP which provide a form of auditory feedback to the user, encountered in different scientific databases (Scopus, IEEE Xplore, ACM and Google Scholar) through direct searches and cross-referencing.

Results: We classified these solutions based on the aural information they provide to the VIP - alerts, guidance and information about their environment, be it spatial or semantic. Our intention is not to provide an exhaustive review, but to select representative implementations from recent literature that highlight the particularities of each sonification approach.

Conclusions: Thus, anyone who is intent on developing an assistive solution will be able to choose the desired sonification class, being aware of the advantages/disadvantages and at the same time having a fairly wide selection of articles from the representative class.

Purpose: To identify correlations between demographic, health-related, environmental factors and the employment status of power wheelchair (PWC) users.

Method: We retrospectively analysed semi-structured interviews with 128 participants, their assistants or family members, and the participant's provided medical records. Participants were adult PWC users who applied for grants in purchasing a new PWC for gaining or keeping employment between 2019-2021 in Mazovian Province, Poland.

Results: Forty-six PWC users (35.9%) were employed while applying for the financial support programme. Fischer's Exact Test of Independence identified positive correlations between employment and education level (p < 0.001), residing in an urban area (p = 0.02), being employed before starting PWC use (p < 0.001), having vocational rehabilitation (p < 0.001), and living in a relationship (p = 0.002). There were no associations between employment status and sex, age at study entry, age at disability onset, living alone or with others, duration of PWC use, or full or part-time PWC use. Our findings indicate that PWC users are at risk of non-employment and financial hardship. This research may support policies for PWC provision that would support gainful employment. The results show that access to quality education, vocational rehabilitation, and perhaps the physical/emotional support from others in close relationships matter. These aspects should be considered in educational policies, transportation, and physical environmental accessibility for PWC users, supporting their gainful employment.

Wheelchair provision training is essential to overcome barriers related to the lack of knowledge of health professionals on this topic. Appropriate knowledge of the service provision process may lead to higher quality service and products, and thus be more likely to help people with mobility impairments achieve the fundamental human right of personal mobility. This study aimed to describe a training intervention for two groups of future physiotherapists in Colombia, assess cohort differences in performance on a knowledge test, and explore their post-training perceptions. A quantitative retrospective study with a historical, descriptive-comparative design was conducted. 525 sixth-semester participants completed the International Society of Wheelchair Professionals Wheelchair Service Provision - Basic Test online in Spanish after curriculum modifications were implemented. The test assesses knowledge in seven domains: Assessment; Prescription; Products; Fitting; User training; Follow-up, maintenance, and repairs; and Process. The training intervention was successfully implemented with Physiotherapy students from two institutions, resulting in a 57% increase in test approval rates. Participants demonstrated increased knowledge, satisfaction with the course content, and application of learning to their current work. These results suggest implications for what pedagogical approach to employ, when curricular change may be warranted, and specific considerations for the Colombian context. Furthermore, identifying the minimal knowledge basis for undergraduate programs and facilitating its dissemination can support interprofessional education and enhance professionals' capacity to support wheelchair provision services.

Background: Despite the widely recognised benefits of assistive technology (AT) in everyday life, AT abandonment rate due to unmet user needs or expectations is high. World Health Organisation emphasised the importance of evaluating AT outcomes as a top research priority, but comprehensive approaches to assess users' needs and AT impact are still limited.

Aim: The research study OMAT (outcomes of mobility assistive technology in rehabilitation pathways) aimed to evaluate the feasibility of a new AT assessment protocol for mobility AT, spanning from an initial evaluation of users' and relatives' needs to a follow-up after real-world use of assistive products (APs).

Material and methods: An observational single-arm study involving 95 AT users was conducted at Fondazione Don Gnocchi (Milan, Italy). The OMAT protocol encompassed baseline assessment, user training, prescription, authorisation, delivery and follow-up. The evaluations blend standard clinical evaluations with validated AT outcome measures for perceived effectiveness of AT, user satisfaction and changes in quality of life.

Results: The feasibility of OMAT in clinical settings was established, with 67 user participants completing the protocol. Data showed positive impacts on user satisfaction and perceived AT effectiveness by all participants (users and relatives), with an improvement in the perceived degree of severity in problems. Quality of life outcomes, however, showed mixed results across various domains.

Conclusion: OMAT is a feasible protocol for assessing mobility APs in clinical settings, underscoring the importance of involving users in the prescription process and the need for comprehensive AT monitoring mechanisms. This approach could enhance AT service delivery, exceeding the current standards of the Italian-National-Health-Service.Implication for rehabilitationPersonalise assistive technology (AT) based on user needs for higher effectiveness.Include structured follow-up in rehabilitation for better AT outcomes.Enhance patient involvement in AT selection to improve use.Focus on AT's role in enhancing overall quality of life.Use validated tools for AT impact assessment and monitoring.