Disability and Rehabilitation-Assistive Technology最新文献

People with disabilities, specifically, those that are having a problem associated with sight or hearing, which falls under the categories of blind and deaf, require technological assistance to move freely. The technological area that is concerned with "Obstacle Detection and Feedback System" can be utilised to address the specific issues of dealing with the abovementioned problems. The growing demand for improved obstacle detection methods has pushed major developments in assistive technologies for people with visual impairments. The information needed and interrelationships among important criteria impacting the efficacy of obstacle detection systems are investigated in this work using the Decision-Making Trial and Evaluation Laboratory (DEMATEL) approach. Nine critical criteria, including Safety (SF), Accuracy of Detection (AD), Response Time (RT), Ease of Use (EU), Portability (PT), Battery Life (BL), Environmental Adaptability (EA), Cost (CT) and Durability (DD), are used. Data was collected from 21 expert participants through structured questionnaires, and the influence of each criterion was analysed using a total relation matrix. The most influential criteria identified were SF with a total influence score of 42.07, AD (41.08), RT (41.01) and Ease of EU (40.83). Factors such as BL (37.51) and CT (38.54) were found to be dependent on improvements in primary criteria. This study provides a structured decision-making framework to enhance obstacle detection systems by prioritising safety, real-time response and usability. The findings offer practical insights for developing AI-driven assistive technologies, ensuring improved accessibility, efficiency and integration into smart city environments.

Purpose: For people with mobility impairments, timely access to an appropriate wheelchair can be essential to their health, safety, and function. This is especially important for individuals who use medically necessary, specialized, and customized mobility devices such as wheelchairs and adaptive seating systems, also known as complex rehabilitation technologies (CRT). Not everyone receives appropriate CRT, or in a timely manner. This study sought to understand stakeholder perspectives about CRT policies and processes, and their implications.

Materials and methods: As part of an ethnographic study, thirty-seven semi-structured interviews with twelve clients/caregivers, thirteen clinicians, and twelve CRT suppliers, ranging from 19 to 66 years old, were completed at an outpatient clinic in Colorado and beyond. Abductive analytical techniques and constant comparative analysis were used to identify primary themes and sub-themes.

Results: Three primary themes, and thirteen sub-themes were identified. Primary themes included Troublesome Policies, Onerous Processes, and Unintended Consequences. Participants had concerns about policies linking a beneficiary's eligibility to their diagnosis, limiting coverage to devices "suitable for use in the home," or requiring prior authorization for repairs. Insufficient funding for seat elevation, backup devices, and repair services were other concerns. Redundant paperwork, inconsistent policy interpretations, and payor practices were burdensome. Potential implications included a tendency to avoid denials, limited access, poor outcomes, and higher overall costs. Participants described Colorado Medicaid policies that may guide policy reforms.

Conclusion: Policymakers should consider CRT policy changes to improve access for users and reduce costs for individuals, insurance companies, and the healthcare system.

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.