Disability and Rehabilitation-Assistive Technology最新文献

Methods: A published a priori review protocol guided searches of four electronic databases and 11 CPG portals. CPGs published between January 2012 and September 2023 in English for adults with progressive or complex conditions were included. Recommendations were catalogued according to: author, year and country of publication; grading of recommendations made; number of recommendations made overall and number pertaining to AT; target condition and/or population; age group/s recommendations related to (if specified); type of AT (categorised into "cognition", "communication", "vision", "hearing", "self-care", "mobility", "combination" or "other"); target professions to apply recommendations; evidence grading; and reference to supporting evidence. AT-related recommendations were summarised narratively. Analysis of the 18 CPGs that met inclusion criteria demonstrated that only 163 (7%) of the total 2,197 recommendations identified pertained to AT. Vocabulary used to describe AT, and detail offered regarding AT interventions was varied impacting the value of some AT-related CPGs.

Impact: This is the first review internationally to identify and document CPG recommendations for adults with progressive or complex conditions, specific to AT interventions. Guidance on types of assistive products - and personnel required for provision - was limited. Further evidence is required to guide practice.

Purpose: Availability of assistive technologies (ATs) to children with disabilities is a critical human right enshrined in United Nations (UN) treaties and frameworks such as the United Nations Conventions on the Rights of Persons with Disabilities (UNCRPD), the United Nations Conventions on Rights of the Child (UNCRC), and United Nations 2030 Agenda for Sustainable Development. ATs optimize functionality, independence, and enhance educational experiences of children with disabilities. The study explored availability of ATs to children with disabilities in Bulawayo Central District (BCD) in Zimbabwe.

Materials and methods: The study was a predominantly qualitative inquiry but triangulated qualitative research with quantitative data sources and perspectives. Structured and semi- structured questionnaires and interviews were used to elicit data from a sample of 10 teachers, 5 Heads of schools, and 10 parents of children with disabilities. Data from questionnaires were analysed using frequencies and descriptive summaries while data from interviews were presented in narrative summaries and analysed using thematic content analysis.

Results: The study demonstrated that ATs are a human rights enabler which is fundamental for development, equalization, and inclusion of children with disabilities in education. Major barriers to availability of ATs include lack of awareness and knowledge of ATs among educators and other professionals, as well as parents of children with disabilities. In addition, inadequate clear and distinct disability-oriented policies and legislation were a challenge to the availability of ATs in Zimbabwe. The Zimbabwe government seems to have put in place administrative educational policies which guide inclusive education, but the implementation and availability of ATs remains elusive.

Purpose: This article explores the existing research evidence on the potential effectiveness of lipreading as a communication strategy to enhance speech recognition in individuals with hearing impairment.

Methods: A scoping review was conducted, involving a search of six electronic databases (MEDLINE, Embase, Web of Science, Engineering Village, CINAHL, and PsycINFO) for research papers published between January 2013 and June 2023. This study included original research papers with full texts available in English, covering all study designs: qualitative, quantitative, and mixed methods. These studies had to examine lipreading as an approach to enhance speech recognition and involve metrics of word recognition accuracy or speech recognition performance.

Results: This review identified a total of 18 articles that met the inclusion criteria. The research evidence is limited to descriptive analysis of lipreading to enhance speech recognition. Most of the studies focused on audiological, computational and hearing-related aspects. The features supporting the effectiveness of lipreading were found to be related to (a) Speaker: The accurate lip movements and the role of facial expressions; (b) Person lipreading: Skills and personal characteristics; (c) Technology to capture and/or support lipreading, and (d) Environmental and contextual factors.

Conclusion: Findings of this review indicate that lipreading can be an effective approach to enhancing speech recognition of people with hearing disabilities, giving attention to a combination of the factors related to individuals with hearing impairment, speaker, environment, and technology. Further research is required to investigate interaction among these factors to inform development of efficient lipreading systems.

Purpose: The aim of this study was to explore the feasibility of using electrodermal activity (EDA) to detect changes in physiological arousal linked to perceptions of accommodations, focusing on universal design (UD) features. In environments like hotels, designers must consider wellness, social integration, and cultural appropriateness to effectively implement UD. Challenges exist with implementing and evaluating UD to accommodate diverse user needs due to conflicting definitions and application issues. To meet the need for post-design evaluation discerning accommodations by features and user groups, EDA measures offer a way to capture individual reactions to external stimuli.

Materials and Methods: In this study, 22 adults (14 young, 8 older) completed an independent hotel walkthrough while expressing their perceptions. EDA was measured using a wristband, and participants' perceived stress and usability were assessed through questionnaires. Phasic EDA was extracted to represent discrete event-evoked changes in arousal.

Results: Findings demonstrated the potential of EDA to identify physiological response variations based on age and location within the hotel. Older adults displayed significantly higher levels of arousal and more favorable usability ratings (4.61 out of 5) compared to young adults, with peak arousal in the corridor and public restroom. Younger adults showed the highest arousal in the bathroom, often with negative associations. The groups differed in their reactions to the bathroom and reception areas.

Conclusions: Divergences between physiological responses and subjective outcomes highlighted the complexity of translating arousal measures into meaningful insights. EDA, combined with commentary, enhanced our understanding of user reactions to design elements to fill gaps left by subjective methods.

Purpose: An assistive technology ecosystem requires co-ordinated collaboration between policy, products, provision processes, and personnel. A needs assessment was conducted of the assistive technology sector in Queensland to examine these components from the perspective of all key stakeholders. Materials and Methods: This paper reports the findings of the expressed needs of the assistive technology sector as experienced by the AT advisors and suppliers. A sequential mixed methods design supported completion of a quantitative online survey (n = 29) followed by qualitative exploration with assistive technology advisors (n = 9) and suppliers (n = 6).

There was an identified need to address the processes that led to delays or unfavourable outcomes for AT. Despite reporting confidence in the quality of services delivered, the advisors were worried about reduced access to expert consultation and a need to better build capacity and capability in the sector. Access to AT for hire or trial was problematic with conflicting tensions identified by the advisors and suppliers. However, both worried about the impact on the agency of the AT recipient in the process.

Conclusions: There are opportunities to enhance the personnel, provision, and policy aspects of the assistive technology ecosystem in Queensland. Pressure points are: workforce capacity and capability to meet the growing need; finding ways to support the trial of assistive technology required to ensure appropriate recommendations for assistive technology that is fit for purpose; and improving information from the bodies that manage funding to reduce the waste in the provision process.

This study explores the integration of telerehabilitation, virtual reality, and serious games technologies in addressing physical disabilities. Specifically, it focuses on game-based telerehabilitation for patients with stroke, Parkinson's disease, and multiple sclerosis undergoing home-based rehabilitation. Utilising the PICO approach, a search in Scopus and PubMed until February 21st, 2024, identified 31 relevant English articles out of 258 initially considered. The study employed three independent reviewers to select, extract data, and analyse studies based on the research question. The final included studies were analysed to extract and categorise the most critical items, including rehabilitation tools, opportunities, and challenges. Of the 258 studies, 31 met the eligibility criteria, with the majority conducted in the United States and the United Kingdom. Key opportunities identified include the effectiveness of telerehabilitation and the use of new, engaging, user-friendly, and affordable technologies. However, challenges such as motivation, usability, exercise adherence, and technical barriers were significant. The Wii gaming console emerged as the most commonly used telerehabilitation device. This systematic review offers a comprehensive analysis of telerehabilitation features, opportunities, and challenges. It highlights the importance of tailored remote rehabilitation programs, potentially leading to more effective patient services. The study suggests that sustained use of these systems is crucial for positive clinical outcomes and emphasises the impact of affordability and engagement on long-term patient adherence to treatment plans in remote rehabilitation systems.

Purpose: Work-related musculoskeletal disorders (WMSDs) during bed-to-wheelchair and wheelchair-to-commode transfers are a significant concern, yet prior assessments often focused on specific subtasks, overlooking potential cumulative risks.

Methods: This study employed Xsens Inertial Measurement Units (IMUs) and force plates integrated with an automated Rapid Entire Body Assessment (REBA) system to provide a continuous and comprehensive evaluation of WMSDs risks associated with the use of a walking belt and a floor lift.

Results: The continuous assessment revealed peak REBA scores ranging from 8.81 to 9.19, categorizing tasks such as applying the sling, repositioning the patient from supine to sitting, and adjusting the wheelchair footrest as high-risk. During bed-to-wheelchair transfers, the floor lift significantly reduced the mean peak REBA score by 1.73 points (95% CI [1.23, 2.24], p < 0.001) and the mean vertical force by 14.68 N (95% CI [10.15, 19.22], p < 0.001) compared to the walking belt.

Conclusion: These findings highlight the value of a continuous risk assessment approach in identifying high-risk tasks and informing targeted ergonomic interventions. The results underscore the need for optimizing patient handling practices and developing advanced assistive devices to enhance caregiver safety and efficiency.

Introduction: The wheelchair service delivery process (SDP) is a large complex system and therefore has many potential points of failure; determining priorities for improvement is challenging. The complexities introduce several barriers to accessing and maintaining wheelchairs for individuals with mobility impairments. Given the breadth and depth of the barriers, it is important to know in which areas to focus future policy reform efforts.

Purpose:The purpose is to explore the perceptions of stakeholders regarding the performance of the wheelchair SDP in the United States and guide future policy reforms.

Methods: A cross-sectional, observational, online questionnaire was deployed. Questions were positive statements regarding the wheelchair SDP and participants rated their agreement with the statements on a standard six-point Likert scale. A snowball sampling strategy was used and consisted of emailing 42 organisations representing 5 stakeholder groups: (1) consumers/caregivers; (2) clinicians; (3) manufacturers; (4) payers; and (5) suppliers.

Results: 1,052 responses were collected: 41% clinicians, 30% suppliers, 24% consumers/caregivers, 3% manufacturers, 2% payers. Stakeholders view the wheelchair SDP as not performing well. Less than 18% of all responses indicate a positive perception. Funding and procurement was viewed in the least positive light, with 5% positive responses. Follow-up, maintenance, and repair was the second least positive component with 9% positive responses. Fitting, training, and delivery was viewed most positively with over 42% positive responses.

Conclusion: The wheelchair SDP is not viewed as performing well by its stakeholders. Funding, procurement, maintenance, and repairs are viewed particularly negatively, representing opportunities for focused system reform efforts.

Purpose: There is insufficient information on whether the use of assistive devices is associated with a lower burden on caregivers of individuals with disabilities. This study was conducted (1) to examine how care recipient-level factors, caregiver-level factors, and the use of assistive devices were associated with caregiver burden, and (2) to investigate the assistive device needs of caregivers.

Materials and methods: This cross-sectional descriptive study used surveys. The participants were caregivers of people with disabilities living in Korea (n = 499). The independent variables were care recipient-level factors, caregiver-level factors, and utilization of assistive devices. The outcome variable, caregiver burden, was measured using the Korean Caregiver Burden Scale. For the data analysis, multivariate logistic regression models were built on the caregiver burden using variables that showed statistical significance in the univariate analysis.

Results: Model 1 included care recipient-level factors. Model 2 included caregiver-level factors in addition to care-recipient factors to examine caregiver factors associated with burden. Model 3 included the utilization of care devices, in addition to the variables used in Model 2, to investigate whether the use of care devices was associated with a lower burden. Caregivers who were married, were informal caregivers, or experienced greater psychological stress had an increased probability of experiencing caregiver burden. Moreover, not using assistive devices increases the odds of experiencing caregiver burden. The most desirable properties of devices are transfer, mobility, and bathing.

Conclusion: As the use of assistive devices is associated with caregiver burden, such care devices should be developed and provided to caregivers based on their individual needs.

Purpose:Pressure injuries (PrI) are a prevalent and serious health issue for wheelchair users. This study aims to identify the personal factors associated with PrI occurrence and their significance by synthesizing existing literature.

Materials and methods:We conducted an umbrella review, systematically searching four databases for reviews published from 2007 to May 2024. The search terms were selected by an independent, experienced librarian. To evaluate the risk of bias and methodological quality of the included studies, we applied the ROBIS tool and the GROOVE procedure. Identified risk factors were categorized into relevant groups.

Results:After an assessment of 5,797 potential articles, 21 studies met the inclusion criteria. Among these, 43% were systematic reviews, 24% meta-analyses, 19% literature reviews, 9% scoping reviews, and 5% narrative reviews. The findings revealed 33 individual personal factors, categorized into the general health, clinical condition, initial pathology, environment/lifestyle, person-related, and combined risk factor groups. Key individual risk factors frequently encountered among wheelchair users included advanced age, obesity, spinal cord injury (SCI), higher levels of SCI, diabetes, infections, incontinence, immobility, respiratory and perfusion impairments, sensory perception issues, and low physical activity.

Conclusions:This study is the first to synthesize literature on internal risk factors associated with PrI among wheelchair users. It confirmed well-established factors such as SCI, diabetes, and aging. The findings provide healthcare professionals and decision-makers with critical information for the prevention and management of PrI in this population, offering new insights into adopting a holistic approach to assessing and addressing individual risks factors.