Disability and Rehabilitation-Assistive Technology最新文献

Purpose: The implementation of Technology-Assisted Rehabilitation (TAR) introduces both challenges and opportunities to enhance patient-therapist interactions. However, the therapist's perspective on TAR often remains understudied. This study aims to address this gap by investigating therapist perceptions of Robot-Assisted Gait Training (RAGT) by developing a specific questionnaire.

Methods: The study is a real-life observational and multicentric pilot study. First, a multidisciplinary board was created to develop the questionnaire. Second, an observational pilot study was conducted, where the questionnaire was administered to therapists involved in RAGT working with a lower-limb robotic device for gait disorders.

Results: Thirty-two questionnaires were collected. Results indicate favourable perceptions among therapists in terms of device's usefulness, ease of use and safety. However, despite the overall positive response trend, therapist engagement showed more variability.

Conclusions: The findings underscore the need of reconceptualizing therapist contribution in TAR, for optimal integration into clinical practice and to improve patient-therapist-device interaction.

Purpose: Mainstream smartphone applications are increasingly replacing the use of traditional visual aids to facilitate independent travel for people with blindness or low vision. However, little is known about which navigation apps are being used, the factors underpinning these decisions and why apps are not used in certain contexts. The goal of this study was to explore the navigation-based apps used by individuals who are blind or who have low vision, the factors influencing these decisions, and perceptions about gaps to address future needs in navigation.

Materials and methods: An international online survey was conducted with 139 participants who self-identified as blind or low vision.

Results: Findings indicate that the decision to use an app based on artificial intelligence (AI) versus live video assistance is related to whether the task is dynamic or static in nature. Although most participants rely on apps only during unfamiliar routes (60.9%), apps are shown to supplement rather than replace traditional tools such as the white cane and dog guide. Participants underscore the need for future apps to better assist with indoor navigation and to provide more precise information about points of interest (POI).

Conclusion: These results provide vital insights for technology developers about the perceived utility of smartphone apps for people with low vision or blindness during navigation. Our results highlight the importance of built-in accessibility features for users with visual impairments. As additional technology-based solutions are developed, it is essential that blind and low vision users, including rehabilitation professionals, are meaningfully included within design.

Purpose: Assistive rehabilitation technologies have been used as a way to address the challenges associated with aging. Therefore, the present study was conducted to investigate the factors related to the intention to use rehabilitative assistive technology in older adults.

Materials and methods: The cross-sectional study conducted in 2024 focused on older adults aged 60 and above who visited comprehensive health service centers in the city of Hamedan. The samples were selected using a multistage random sampling method. The data collection tools included a two-part researcher-designed questionnaire, covering demographic information and the Unified Theory of Acceptance and Use of Technology of the developed questionnaire. The data were analyzed using Pearson correlation tests, linear regression, and structural equation modeling.

Results: A total of 340 older adults participated (mean age = 70.44 ± 7.47 years). PLS-SEM results indicated that perceived need (β = 0.426, p < 0.001), performance expectancy (β = 0.178, p < 0.001), technology anxiety (β = 0.161, p < 0.001), social influence (β = 0.158, p < 0.001), and effort expectancy (β = 0.136, p < 0.001) significantly predicted intention to use assistive technologies. Overall, the extended UTAUT model accounted for 51% of the variance in behavioral intention. Multiple regression also revealed significant associations of age and history of chronic disease with intention to use (p < 0.05).

Conclusions: The findings underscore the importance of perceived need and technology anxiety as key additions to the UTAUT model in predicting intention to use. However, the unexplained variance suggests that additional influences-including personal characteristics, environmental supports and barriers, and technology-related features-should also be considered in future studies to provide a more comprehensive understanding of adoption among older adults.

Purpose: This study aimed to evaluate the relationship between device and service satisfaction among mothers of children with cerebral palsy who use wheelchairs, as well as to examine the connections between satisfaction, wheelchair characteristics, confidence, and proficiency in wheelchair use.

Materials and methods: A descriptive cross-sectional study was conducted involving 30 mothers of children and adolescents with severe cerebral palsy that are not able to propel the wheelchair by themselves. Participants' satisfaction and the skills for moving with a wheelchair were assessed with the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST 2.0), the Wheelchair Skills Test Questionnaire. Statistical analysis, including correlation tests and Analysis of Variance (ANOVA-OneWay), was performed and supplemented by qualitative analysis for a more comprehensive understanding.

Results: The results showed that factors such as wheelchair dimensions, ease of adjustment, weight, comfort, and the quality of delivery and technical assistance services raised concerns and dissatisfaction among participants. Safety and comfort were identified as key factors for satisfaction, reported by 73.3% of participants, while 36.7% mentioned ease of use. A significant correlation between ability and confidence was established (p < 0.001), with a high magnitude (R = 0.94).

Conclusion: The findings highlight the importance of including primary caregivers in wheelchair assessments to understand the determinants of satisfaction better and proposes Assistive Technology interventions that prioritize caregivers' perspectives. This may improve prescription practices, thereby increasing user satisfaction and usability. Additionally, it highlights the potential of modular and collapsible support systems tailored to meet diverse physical needs.

Approximately 60-70% of people with stroke experience a mild incident. However, mild stroke can significantly impact daily life for these individuals and their significant others. Reviews suggest that the use of information and communication technology (ICT) can add value to the existing stroke rehabilitation. The purpose of the current study was to co-design and evaluate an ICT-based solution with and for people with mild stroke and their significant others to support them through the stroke trajectory. Inspired by experience-based co-design, the study focused on developing an ICT-based solution in a co-design workshop, testing the prototype in co-design teams, and pilot testing and evaluating the intervention through interviews with individuals with mild stroke and their significant others. Through the co-design process, a prototype was developed and tested. The developed ICT-based solution offers targeted information and tips for managing mild stroke consequences, such as concentration issues and fatigue. The evaluation led to the identified four categories: Diverse ways of using the ICT-based solution, Significant others' use of information tailored for people with mild strokes and vice versa, Essential elements related to the usability of the ICT-based solution, and Suggestions for further development and implementation. The evaluation showed that the app provided useful information to both participants with stroke and their significant others, which may have supported their stroke trajectory and coping abilities. Introducing the app during the hospital stay was beneficial. Over time, participants valued the app's information as they adapted to living with mild stroke.

The impact of Multiple Sclerosis (MS) on mobility and other functions varies considerably and the trajectory of the disease is unpredictable. People often need timely funding for home modifications, with some needing specialist disability housing and support. This rapid review examined existing literature on the housing needs of people with MS. A representative reference group guided our process. Concentrating on the home environment, we systematically searched peer-reviewed literature through three databases and grey literature using a focused web-based process. The inclusion of 19 peer-reviewed articles and 13 grey literature documents revealed the need for accessible housing, affordable in-home assistive technology, and proximity to the community. A lack of timely funding was a primary barrier to independence in the home, resulting in calls for financial aid that is responsive to the progressive nature of MS. People with MS need comprehensive support, including timely access to information, affordable and accessible housing, and funding for necessary home modifications. These resources are crucial to promote independence at home, reduce hospitalisations, and prevent early admission to residential aged care. Further research is needed to capture the unique barriers people with MS face in their local context as a precursor to developing participant-led recommendations.

Neural implants are being developed to treat various conditions, including sensory impairments such as blindness and deafness. In these technologies there is a growing role for artificial intelligence (AI) to enable interpretation of complex data input. Current users of cochlear implants (CIs) face challenges in noisy environments, prompting the development of AI-driven software for personalized and context-aware noise suppression and speech enhancement. For blindness, an AI-driven cortical visual neural implant (cVNI) for artificial visual perception is under development. Here, AI-driven software may be used to process camera imaging for interfacing with the brain. If successful, these devices can offer important advantages for their users yet may also have ethical implications. Perspectives of (potential) users of these technologies is an important source for ethical analysis, yet so far these have not been explored in-depth. We performed a focus-group and interview study including potential users of a) the AI-driven cVNI (n = 5) and of b) the AI-driven CI (n = 3), and c) current or (former) users or a retinal implant (n = 3). Focus groups and interviews were transcribed and analyzed thematically. Perspectives were clustered under 1) expectations and experiences, including improvements from the status quo, enhancement of autonomy and design requirements, and 2) perceived risks and anticipated disadvantages, including uncertainty on effectiveness, operational risks, surgical risks, and media attention. AI-driven neural implants for vision and hearing were positively received by potential users due to their potential to improve autonomy. Yet, possible conditions for uptake were identified, including device aesthetics and sufficient levels of user-control.

Purpose: Endometriosis is a common condition affecting around 10% of women of childbearing age worldwide. Currently, adapted physical activities (APA) are increasingly used in the context of chronic diseases, often in conjunction with digital devices to help overcome some of the barriers to regular practice. However, it is essential to examine the technological acceptability to optimise the future use of these devices. The main aim of this study is to analyse the intention of women with endometriosis to use digital tools offering physical activities and to identify the factors most likely to predict this intention.

Materials and methods: Participants completed an online survey, which included socio-demographic and medical questions, as well as subscales derived from the HITAM model on intention to use digital tools. The data were analysed using univariate and multivariate logistic regressions.

Results and conclusion: A total of 313 women (Mean age = 34.4; SD = 8.69) met the inclusion and exclusion criteria. The statistical analyses showed that the intention to use a digital APA program was fairly high, with a preference for technologies that offer a high degree of freedom in practice. Analyses of the theoretical model showed in particular the importance of a favourable social discourse. The final model (perceived threat, norms, perceived ease of use, perceived usefulness, and age) explained 57.74% of the variance in intention. Findings should be interpreted with caution due to the self-selected online sample and the high dropout rate (899 incomplete responses).

Modern automatic text adaptation often fails to meet the specific needs of targeted readers. The TextAD project aimed to address this gap by creating tailored texts for students with intellectual disability (ID), focusing on their unique challenges. This exploratory study presents findings from three rounds of testing automatic adaptations at lexical, syntactic, and discourse levels in expository texts. Reading comprehension, self-reported ratings of comprehension, interest, and perceived difficulty, along with metacognitive insights were assessed with 27 students with ID, refining adaptations based on each iteration's results. While comprehension gains for the adapted versions were not significant overall, promising outcomes appeared with lexical and syntactic adaptations in the later rounds of testing, although group heterogeneity influenced results. Despite reporting high comprehension, students noted persistent difficulty understanding many expository concepts. Alongside evaluating the effects of text adaptations on comprehension and perceived understanding, this paper offers insights into assessment approaches for developing automatic adaptations tailored to this audience.

The implementation of Fuzzy control systems on microcontrollers provides a low-cost, efficient, and innovative approach for assistive technologies, such as wheelchairs controlled by head and neck motion. However, their practical implementation is sensitive to several design parameters that are often overlooked. This study presents a statistical evaluation of a Fuzzy control system implemented on Arduino Mega and Due microcontrollers, focusing on the effects of the Iteration Step (IS) during defuzzification, microcontroller architecture, and overlap between membership functions, using the Center of Gravity (COG) method. System performance was evaluated using Root Mean Squared Error (RMSE) and processing time. The influence of an overlap between membership functions on the RMSE was also investigated. It was found that a smaller IS, such as 0.01, increased the precision of the system but led to long processing times (over 700 ms). Intermediate IS values (0.1 and 1) offered the most favourable trade-off between speed and accuracy, with RMSEs as low as 0.13% of the motor's total output and processing times under 260 ms. The Arduino Due significantly outperformed the Mega in processing time at low IS values, with little variation in accuracy. At higher ISs, the difference in processing time was negligible for practical use, making the Mega a viable cost-effective option. These findings provide empirical guidance for optimising Fuzzy control parameters in low-cost control systems, especially in applications where both real-time responsiveness and accuracy are critical.