Disability and Rehabilitation-Assistive Technology最新文献

Background: When selecting a manual wheelchair frame, the choice between rigid and folding frames carries significant implications. Traditional folding frames are expected to have more rolling resistance and power dissipation caused by frame deformation, while they are more convenient for transportation, such as in a car. A new hybrid frame, designed to be more rigid, aims to minimize power dissipation while still retaining foldability.

Aim: This study aimed to assess rolling resistance, power output, propulsion technique and physiological demands of handrim wheelchair propulsion across three different frames: a rigid frame, a hybrid frame and a conventional folding frame.

Materials and methods: Forty-eight able-bodied participants performed coast-down tests using inertial measurement units to determine rolling resistance. Subsequently, four-minute submaximal exercise block under steady-state conditions at 1.11 m/s were performed on a wheelchair ergometer (n = 24) or treadmill (n = 24) to determine power output, propulsion technique and physiological demands.

Results: Repeated measures ANOVA revealed that the hybrid frame exhibited the lowest rolling resistance (7.0 ± 1.5N, p ≤ 0.001) and required less power output (8.3 ± 1.0W, p ≤ 0.001) at a given speed, compared to both the folding (9.3 ± 2.2N, 10.8 ± 1.4W) and rigid frame (8.0 ± 1.9N, 9.4 ± 1.6W). Subsequently, this resulted in significantly lower applied forces and push frequency for the hybrid frame. The folding frame had the highest energy expenditure (hybrid: 223 ± 44 W, rigid: 234 ± 51 W, folding: 240 ± 46 W, p ≤ 0.001).

Conclusion: The hybrid frame demonstrated to be a biomechanically and physiologically beneficial solution compared to the folding frame, exhibiting lower rolling resistance, reduced power output, and consequently minimizing force application and push frequency, all while retaining its folding mechanism.

Multi-Modality Aphasia Treatment (M-MAT) is an effective group intervention for post-stroke aphasia. M-MAT employs interactive card games and the modalities of gesture, drawing, reading, and writing to improve spoken language. However, there are challenges to implementation of group interventions such as M-MAT, particularly for those who cannot travel or live in rural areas. To maximise access to this effective treatment, we aimed to adapt M-MAT to telehealth format (M-MAT Tele). The Human-Centred Design Framework was utilized to guide the adaptation approach. We identified the intended context of use (outpatient/community rehabilitation) and the stakeholders (clinicians, people with aphasia, health service funders). People with aphasia and practising speech pathologists were invited to co-design M-MAT Tele in a series of iterative workshops, to ensure the end product was user-friendly and clinically feasible. The use of co-design allowed us to understand the hardware, software and other constraints and preferences of end users. In particular, clinicians (n = 3) required software compatible with a range of telehealth platforms and people with aphasia (n = 3) valued solutions with minimal technical demands and costs for participants. Co-design within the Human-Centred Design Framework led to a telehealth solution compatible with all major telehealth platforms, with minimal hardware or software requirements. Pilot testing is underway to confirm acceptability of M-MAT Tele to clinicians and people with aphasia, aiming to provide an effective, accessible tool for aphasia therapy in telehealth settings.

Purpose: Living with risk is a salient part of everyday living and although risk affects everyone, older adults are often regarded as a high-risk group, particularly older adults who are aging with a disability, such as vision loss. A prominent focus within low vision rehabilitation is the provision, and training, of older adults in the use of low vision assistive devices as a strategy to manage risks in both the home and community environment. This study aimed to unpack the influence of assistive technologies on experiences of risk among eleven older adults (aged 65+) with age-related vision loss.

Materials and methods: This critical ethnographic study used home tours, the go-along method, and a semi-structured in-depth interview.

Results: The study identified five prevailing themes including: 1) Moving away from the individualization of risk; 2) The cost of assistive technologies as a risk contributor; 3) Practicing 'responsible living'; Technology as an adaptive strategy to risk taking; 4) Resisting the label of 'at risk'; The influence of technology on self-identity; and 5) Technology as a substitution versus supplement for social connectedness.

Conclusions: The study findings highlight the importance of moving beyond a technico-scientific perspective of risk, in which risk is framed as an objective phenomenon located in older adults' bodies, and instead framing risk within a broader sociocultural perspective which moves our attention to those contextual or environmental factors that shape experiences of risk for older adults with vision loss.

Purpose: Locomotor experiences in upright postures are essential for developing toddlers' mobility and social functions. This pilot randomised controlled trial aimed to examine the effectiveness of using a modified ride-on car (ROC) with postural combinations of standing and sitting on mobility and social function in toddlers with motor delays.

Materials and methods: Nineteen participants aged 1-3 years with mild, moderate or severe motor delays were randomly assigned to four ROC groups. The ROC groups had different combinations of standing and sitting, namely standing for 70 min (ROC-Stand₇₀, five participants), standing for 45 min (ROC-Stand₄₅, four participants), standing for 25 min (ROC-Stand₂₅, five participants) and sitting for 70 min (ROC-Sit₇₀, five participants). All participants participated in 2-h sessions twice a week for 12 weeks. The Pediatric Evaluation of Disability Inventory, Goal Attainment Scaling and Bayley-III tests were administered before and after the intervention, and after 12 weeks of follow-up. A mixed-model analysis of variance was used to compare inter- and intra-group differences. This trial was registered at ClinicalTrials.gov (NCT03707405).

Results: All groups showed significantly improved mobility, social function and goal achievement at the post-test (p < .001). However, no significant changes were observed in Bayley scores.

Conclusions: Combining physical and social environmental modifications with active exploration is crucial for early power mobility training in toddlers with motor delays. To enhance the robustness and generalisability of our findings, future studies should include larger sample sizes, consider variations in motor delays, and measure energy expenditure during the intervention.Implications for rehabilitationProviding active exploratory experience using ride-on cars (ROCs) with various postural combinations can improve a child's mobility.The ROC training with various postural combinations can improve social function, and the degree of improvement may depend on the severity of motor delays.Setting goals with caregivers and incorporating their roles in the training process can empower them to interact with children more frequently and actively.

Individuals with disabilities face psychological, environmental, and resource-related barriers to participating in exercise and sports. The lack of participation in exercise observed in the disability community poses great concern to this population's health. This review discusses commercially available adaptive equipment and technology for exercise and sports that help people with disabilities circumvent barriers to exercise. The methods section highlights various categories of adaptive tools and their cost, accessibility, ease of learning, and progress level to help people with disabilities determine points of entry to fitness that align with their needs. Additionally, fitness-related businesses, fitness device developers, and researchers can leverage the discussed findings to understand gaps in this field to further advance adaptive equipment and technology and help facilitate widespread use. The paper serves as a comprehensive resource to researchers, entrepreneurs, and consumers to guide developing, accessing, and marketing adaptive exercise technology.

Purpose: This study examines the effective implementation of health and welfare technology (HWT) in sparsely populated Nordic regions within healthcare and social care settings.

Materials and methods: Through re-analysing 12 semi-structured interviews conducted in 2020 across three successfully implementing Nordic regions, the research utilised inductive thematic analysis with a reflexive approach to uncover key experiences.

Results: It identifies five critical success factors: Positive attitudes towards and understanding of digital transformation, Consensus on changing care delivery through HWT, Leadership and organisational readiness for change, Effective feedback mechanisms, and Trust and engagement in the learning process. Highlighting the significance of positive mindsets, leadership, collaboration, and adaptability, the findings underscore the theoretical underpinnings of Weiner's organisational readiness for change and Bronfenbrenner's ecological system theory for planning and understanding HWT implementation. Addressing challenges of adapting to HWT necessitates a comprehensive approach, including tailored training, robust support systems, strategic user engagement, feedback integration, and fostering open communication, ultimately ensuring technology serves the user's needs effectively.

Conclusion: In conclusion, successful HWT adoption in these areas hinges on fostering a culture of learning, strong leadership, and collaborative efforts. It suggests further research with a larger cohort to validate these insights, offering vital considerations for organisations navigating digital transformation in healthcare and social services.

Current wheelchairs used in low-resource settings lack the adjustability required for children with cerebral palsy and are not well-suited for rough terrain environments. This study aimed to examine the durability and functional interface of two wheelchairs specifically designed for use in low-resource settings. This descriptive study assessed 14 wheelchairs used by children with cerebral palsy living in Kenya, Africa (Momentum Wheels for Humanity's Liberty II wheelchair n = 6, Beeline's Honey Bee wheelchair n = 8). Four physical and occupational therapists evaluated durability using the Wheelchair Components Questionnaire (WCQ) and functionality using the Wheelchair Interface Questionnaire (WIQ). Medians were used to compare differences in the chair types using the Wilcoxon-Mann-Whitney test in Statistical Analysis Software (SAS) 9.4 with an alpha = 0.05. Median scores on the WCQ were 8.3/10 for the Liberty II and 7.8/10 for Beeline's Honey Bee wheelchair; however, the durability of the wheel locks was lower in the Beeline wheelchair (5.1/10 compared to the Liberty II 8.1/10 (p = 0.002). Median scores on the WIQ were lower and significantly different in the area of preventing distal lower extremity pain (Liberty II =3.7/10 and Beeline = 7.6/10, p = 0.045). Low scores occurred in both chairs in the areas of transfers and transporting the chairs in the community. The Beeline wheelchairs demonstrated higher average ratings for all areas of the WIQ, indicating the wheelchairs fit the children better and were more functional for use in the home and community environment.

Purpose: Alzheimer's disease (AD) is a common and devastating neurological ailment that affects millions of the elderly worldwide. Therapeutic toys and games have emerged as potential non-pharmacological interventions for AD. However, despite a growing number of documents on the subject, research on the future direction of therapeutic toys and games for AD remains scarce. To address this gap, this study aims to (1) map the future trends of therapeutic toys and games for AD and (2) identify the categories and design characteristics.

Materials and methods: Using a thematic review framework, a systematic literature search was conducted in two electronic databases (Scopus and WoS) using established criteria. Thematic analysis was done using ATLAS.ti 23 to identify prominent themes, patterns and trends.

Results: A total of 180 documents were found. Twenty-five articles met the inclusion criteria. A thematic review of these 25 articles identified 13 initial codes, which were been clustered into four themes: detection and evaluation; intervention; toy/game category; and design characteristics. The word "Cognitive" appears most frequently in documents according to word cloud.

Conclusions: Therapeutic toys and games are used to detect and as an intervention for AD. Most of the current studies focused on specific cognitive functions. More research is needed about play therapy for neuropsychiatric symptoms. This thematic review also proposed a conceptual framework for designing toys and games tailored to the needs of the elderly with AD, offering valuable insights to future researchers focusing on this domain.