Disability and Rehabilitation-Assistive Technology最新文献

To determine whether a detachable bidirectional (push-pull) propulsion module for manual wheelchairs can be rapidly learned, perceived as safe, and accepted by long-term users with spinal cord injury (SCI). Twenty adult SCI wheelchair users (mean age 59.4 ± 11.2 yr; wheelchair experience 20.1 ± 12.3 yr) propelled their chairs, equipped with the module, along a 20 m indoor corridor, completing five push and five pull trials after ∼10 min of familiarization and seat-belt fitting. Usability was assessed using a 45-item, 7-domain Likert scale (1 = strongly disagree, 5 = strongly agree) with excellent internal consistency (Cronbach's α = 0.927). Across domains, learnability, safety, user satisfaction, effectiveness, and efficiency were rated highly, with mean scores above 4.3 on a 5-point scale. Universality received comparatively lower ratings, reflecting cost considerations and adaptability to different contexts. The highest-rated single item was ease of understanding propulsion-mode switching, while willingness to use the device considering cost was lowest. No falls or entrapment events occurred during the trials. Overall, the push-pull module was intuitive, safe, and efficient after minimal training, with potential to diversify upper limb loading patterns and reduce shoulder strain in manual wheelchair users. Some participants noted challenges related to device width, weight (∼8 kg), and cost, indicating the need for further design optimization and structured training resources prior to widespread implementation.

Purpose: This study examines the experiences and lessons learned from six Sub-Saharan African countries in developing National Priority Assistive Products Lists (APLs) between 2020 and 2024, aiming to provide insights for improving assistive technology (AT) access in low- and middle-income countries (LMICs).

Materials and methods: The study employed qualitative descriptive methodology with a multi-faceted approach, including a comprehensive desktop review of documentation and publications, followed by semi-structured interviews and information review with key stakeholders (n = 9) from all six countries. Data analysis involved synthesising information to identify common themes, challenges, and best practices in APL development.

Results: Key findings include the importance of multi-stakeholder engagement, challenges in data availability, varied prioritisation frameworks, and the need for local context adaptation. Countries faced common barriers, such as limited funding and regulatory challenges, however also identified facilitators like government leadership and integration with existing health systems.

Conclusions: The study highlights the complex nature of developing National APLs and emphasises the importance of inclusive stakeholder engagement, data-driven prioritisation, and integration within broader health system strengthening efforts. These insights can guide other countries in developing and implementing effective APLs, ultimately improving AT access and advancing disability rights.

Purpose: To clarify the issues in providing assistive products for cognitive function (APCs) to older adults with dementia or cognitive impairment based on healthcare professionals' perceptions in Japan.

Methods: Fifteen healthcare professionals providing assistive products to older adults with dementia participated in semi-structured online interviews (mean age 44.6 ± 6.5 years, 11 women, 4 men). Data were analyzed using qualitative thematic analysis.

Results: The following four categories were identified as issues in the introduction, assessment, and use of assistive products for cognitive impairment: (1) lack of acceptance of assistive products by older adults with dementia and their ability to operate these products; (2) lack of cognitive assistive products available to older adults; (3) gaps in awareness of APC between professionals and caregivers; and (4) insufficient follow-up systems. Opinions were also extracted to create an environment in which it was easier for older adults with dementia to use electronic devices and information and communication technology (ICT).

Conclusions: To effectively utilize the assistive products needed by older adults with dementia or cognitive impairment, caregivers' understanding of assistive products and the continued involvement of professionals are essential so that the functions of assistive products match the characteristics of the users. To facilitate these efforts, it is necessary to establish a framework for providing assistive products for dementia-related cognitive function.

Purpose: To understand how mainstream technology may support rehabilitation needs after acquired brain injury (ABI), this research aimed to investigate reasons, importance, and psychosocial impact of technology use after ABI and explore perceived benefits, challenges, and facilitators. Method: 66 individuals with ABI (59% male) attending outpatient brain injury rehabilitation and 60 controls without neurological injury (47% male) completed a survey regarding technology use. Following their rehabilitation, semi-structured interviews were conducted with a purposive sample (n = 20) of individuals with ABI and were analysed using content analysis. Results: Total reasons for frequent technology use did not significantly differ between pre- and post-injury, although participants with ABI rated technology as significantly more important and used technology more frequently for medical and rehabilitation appointments post-injury. Total reasons for frequent technology use, perceived importance and psychosocial impacts did not significantly differ between the ABI and control samples. However, a significantly lower proportion of participants with ABI used technology frequently for productivity, personal affairs, general health and wellness and navigation (44-74%) than controls (68-100%, p <. 01). The qualitative analysis identified an overarching theme of making technology work for me after ABI, depicting individuals' experiences of how it works and when it works optimally to meet their everyday needs. Conclusion: Technology use may change after ABI, as individuals strive to achieve optimal balance between personal investment in technology and benefits for supporting everyday functioning. Key implications relate to the need for rehabilitation clinicians to tailor support for technology use to individuals' lifestyle and preferences.

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: 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.

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.