Disability and Rehabilitation-Assistive Technology最新文献

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.

Purpose: Environmental control systems (ECS) are designed to assist people with disabilities live more independently by facilitating access to electronics devices around the home. These devices are prescribed and managed by healthcare services within the UK. Despite this there is limited evidence regarding their effectiveness. This review aims to provide an update on the state of evidence for ECS. Materials and methods: A systematic review was conducted using key words linked to ECSs and with a target population of individuals with neurological conditions. The search was conducted in the databases Embase and MEDLINE and covered articles published between 2011 and 2024. The abstracts were screened for inclusion and data extracted. The quality of the research was assessed by completing qualitative CASP checklists. Results: After screening seven articles were selected for inclusion in the review. There were no comparative studies; all were descriptive. Six articles reported increased independence. Impact on well-being and usability was reported across six and five studies respectively, with mixed results. Assessment using CASP checklists indicated the studies were of good quality within the limitations of non-experimental designs. Conclusions: There remains limited research in the ECS field. The evidence for the effectiveness, impact on wellbeing and usability of these devices remains weak. Future studies should consider before and after designs and control conditions to improve the evidence base.

Purpose: A disparity exists in the access and use of assistive technology (AT), with women exhibiting lower rates of access compared to men, despite a higher reported prevalence of disability. To address these gendered inequities in AT, a comprehensive understanding of the influence of sex and gender on AT utilisation, access pathways, and associated perceptions is crucial.

Methods: This scoping review aimed to synthesise existing evidence concerning how sex and gender affect access, use, and attitudes towards AT. A systematic search across seven databases yielded 120 relevant publications.

Results: The identified gendered barriers and facilitators influencing AT engagement are discussed through the lens of the World Health Organization's 5 "P" framework of AT, encompassing policy, provision, product, personnel, and people. Notably, the reviewed studies predominantly operationalised gender within a binary male/female framework. Across seventy-three distinct analyses examining AT use and related factors, a significant association with gender and/or sex was observed. While findings indicated a higher rate of assistive product usage among women, this group also reported a greater degree of unmet need.

Conclusions: Gender-specific facilitators of AT use identified in the literature include tailored clinical counselling approaches, aesthetically considerate product design aligning with diverse gender expressions, gender-adapted training methodologies, and the adoption of patient-centric care models.Future research should consider the nuanced influence of sex and gender on user outcomes, and where data allow, these investigations should include other factors that interact with sex and gender to shape AT access, including age, ethnicity, socioeconomic status, educational attainment, and citizenship status.

Purpose: In the disability support sector, empathy is a critical skill needed by frontline workers. Virtual Reality technology may enhance empathy. Some disability service providers have adopted Virtual Reality to advance their training practices. Currently, it is unknown how accepting the Australian disability support workforce is of Virtual Reality technology. This study evaluates the internal and external factors that are significant in influencing disability support sector employees' acceptance of Virtual Reality technology. Method: A quantitative study using the Technology Acceptance Model (TAM) was completed by 120 cross-sectional respondents from the Australian disability workforce. Data were collected via an online questionnaire with a Likert scale, and analysed using descriptive statistics, reliability, correlation, and path analysis. Results: The external factors of curiosity, and past use had a significant relationship with the acceptance of virtual reality technology. Conclusion: Understanding factors relating to VR acceptance may facilitate greater adoption of VR training programs aimed to enhance empathetic behaviour in the disability support sector. The current study offers important insight relating to key determinants that facilitate the acceptance of VR technology for the disability services workforce. The five recommendations address the crucial findings - (1) evaluate the level of curiosity, (2) evaluate the level of past use, (3) offer hands-on VR workshops, (4) cultivate a sustainable collaborative design environment around training and technology adoption, and (5) cultivate a sustainable collaborative culture that is informative and fosters innovation.

Aims: Wearable devices such as activity monitors can be used to gain insight into children's physical behavior. However, children who are unable to walk are often excluded from validation studies, and therefore, robust information about their physical behavior is lacking. Therefore, we studied the criterion validity of a wearable prototype activity monitor (AM-p) in children who use a manual wheelchair with and without the ability to walk.

Methods: We analyzed the data for both single-sensor (sensor placement on upper arm or ankle) and dual-sensor use. Therefore, we conducted a study with cross-sectional design, assessing 37 children (12 girls) aged 6-19 years (mean 12 years, SD 4.3). Children wore an AM-p on the ankle and upper arm and were filmed while performing an activity protocol in a natural setting. Videos were labeled per 5-second epoch with individual activity labels. Raw data were synchronized with labels. An algorithm was trained, and labels were subdivided into pre-defined activity categories. Overall accuracy and F1 score (harmonic mean of precision and recall) were calculated per activity.

Findings: We demonstrate that the single ankle-worn AM-p can determine "stationary" behavior with excellent accuracy (>90%) and "locomotion" behavior with moderate to good accuracy (77-80%). "Locomotion" behavior includes active wheelchair use of children, which can assist pediatric physical therapists (PPTs) to assess physical behavior correctly in children who use a manual wheelchair. Exploratory analyses indicate that "locomotion" behavior (dual-sensor use), can be divided into "leg activity" and "active wheelchair use" for children who use a manual wheelchair and have the ability to walk.

Conclusions: The single ankle-worn AM-p can determine "stationary" behavior with excellent accuracy and "locomotion" behavior with moderate to good accuracy in children who use a manual wheelchair in daily living. Our findings can assist PPTs to assess physical behavior correctly and tailor individual treatment plans.

Purpose: This study explores the barriers, including psychological and emotional challenges, faced by college students with disabilities while engaging in video gaming. It also investigates the benefits of gaming, utilising Self-Determination Theory (SDT) to understand motivations and experiences. Furthermore, it provides insights into future development and accessibility measures to promote inclusive gaming environments.

Materials and methods: Guided by SDT, we designed the semi-structured interview guide and conducted a hybrid deductive-inductive reflexive thematic analysis that interpreted themes in terms of autonomy, competence, and relatedness.

Results: Three primary themes emerged: (a) Benefits, including social connection, stress relief, and skill development; (b) Barriers, such as physical, cognitive, and financial challenges, and limited accessibility in game design; and (c) Accessibility, emphasising customisable controls, adaptive features, and inclusive designs. Participants highlighted the positive role of gaming in fostering psychosocial well-being and managing symptoms of their disabilities.

Conclusion: This study provides insights into the intersection of gaming and disability, advocating for inclusive game design to enhance autonomy, competence, and relatedness. Findings demonstrate the potential of accessible gaming to promote empowerment, social inclusion, and mental health. Aligned with the goals of rehabilitation and assistive technology, this research offers actionable recommendations for reducing barriers and fostering innovation in game development to support individuals with disabilities.

The transition from inpatient rehabilitation to community living poses significant challenges for individuals with newly acquired disabilities. Peer navigators, individuals with lived experience, are trained to support this transition; however, accessing in-person services can be difficult. To facilitate remote peer support and ensure accessibility, we co-designed a mobile health (mHealth) app with four peer navigators with disabilities. Over the course of three co-design sessions, we developed personas and iteratively refined low- and high-fidelity prototypes. We then conducted a heuristic evaluation with 22 human-computer interaction students to identify usability flaws. Based on this evaluation and feedback from a follow-up focus group with three students, we implemented iterative improvements to enhance usability and interactivity. This paper discusses the design implications and lessons learned for designing mHealth tools in collaboration with people with disabilities.