Disability and Rehabilitation-Assistive Technology最新文献

Purpose: This study aimed to investigate the effects of a half-sloped (HS) seat surface as a new approach to seating on individuals with cerebral palsy.

Materials and methods: Eight adults with cerebral palsy, with a mean age of 35.88 ± 6.08 years, were enrolled in this study to compare their seating postures and upper limb function between both a standard seat and an HS seat. Measurements included pelvic tilt angle, hip joint angle, thoracic flexion angle, craniovertebral angle and upper limb function test as Simple Test for Evaluating Hand Function (STEF) scores.

Result: The HS seat resulted in an increase in the flexion angle of the thoracic spine by 17.37°, an increase in displacement by 4.07% and a reduction in forward head posture by 14.00°. Additionally, the STEF scores on both hands improved by 14.00 points. The results of this study suggest that the HS seat might improve sitting posture and upper extremity function in individuals with cerebral palsy.

Conclusion: The HS seat might contribute to improving the quality of life in these individuals by promoting pelvic stability and maintaining the physiological curvature of the spine. Further large-scale studies and long-term follow-up are needed to validate the clinical efficacy of the HS seat.

Purpose: Our primary objective was to assess wheelchair service providers' opinions on manual wheelchair-skills courses ("bootcamps"). Our secondary objective was to test the hypothesis that these courses enhance the learners' self-reported capacity and confidence.

Materials and methods: This was an observational study that took place in rehabilitation and conference centers on 407 wheelchair service providers each of whom took part in one of 26 practical workshops on manual wheelchair skills at least 1 day in duration. Post-course, all participants completed a Course Evaluation Form with ordinal (1-5), categorical, and free-response questions. A subset of 103 participants also completed a modified Wheelchair Skills Test Questionnaire (WST-Q) of "capacity" and "confidence".

Results: The percentages of participants who answered 5 ("extremely so") to the questions "useful?", "relevant?", "well-tolerated?", "understandable?", and "enjoyable?" were 94.1, 90.4, 92.6, 95.6, and 97.3%. The median for the Overall Satisfaction Score (OSS) (1-5) of the 26 bootcamps was 4.96. Most participants (87.1%) considered the course "just right" in duration, and (100%) stated that they would recommend the Course to others. There were numerous qualitative comments about the course content, as well as what participants found most and least useful. Over half of the WST-Q respondents reported improvements in capacity and confidence in 26 (90.0%) and 25 (86.2%) of individual skills.

Conclusions: Although there is room for improvement, wheelchair service providers were generally positive about in-person courses, and the courses enhance wheelchair-skills capacity and confidence.

Purpose: This study examined screen time patterns and contextual factors in Italian children and adolescents with neurodevelopmental disorders (NDs), and explored whether parental screen use and stress predicted child screen exposure.

Materials and methods: An online survey was distributed to families of children with NDs (e.g., intellectual disability, genetic syndromes, autism and learning disabilities). The survey collected socio-demographic information, measures of screen time for both children and parents, and parental stress.

Results: Data from 352 families covering 407 children revealed that many children exceeded recommended screen time limits. More older children than younger children were in the higher use categories, while relatively similar patterns emerged across sex, diagnostic groups and levels of functional disability. Television was the most frequently used device, while about half used smartphones. Watching videos and cartoons, often alone, was the most common screen activity, with rehabilitative use reported by few. Difficulties in disengaging from screens were more common among older participants and those with attention deficit and hyperactivity disorder (ADHD). Most parents reported less than one hour of non-work-related screen use per day. However, greater parental loss of control over screen use was linked to higher parental screen time, which, in turn, predicted increased screen use in children. Parental stress was also directly associated with higher child screen time.

Conclusions: The findings highlight the importance of tailored, developmentally appropriate screen time guidelines for children with NDs. Clinicians and rehabilitation therapists can support caregivers in making informed choices about digital media use, promoting positive digital engagement while minimising potential risks.

Objective: This study presents a low-cost assistive navigation system combining a Smart Blind Stick and Smart Glasses to improve mobility safety and independence for blind and visually impaired (BVI) users through multi-level obstacle sensing, emergency alerts, and smart home integration.

Methods: A dual-node architecture was developed using ESP32-based modules integrated into a stick and glasses. The stick provides lower-body obstacle detection and includes an emergency panic switch, while the glasses provide upper-body obstacle detection. Both nodes generate audio alerts via a DFPlayer Mini and speaker and additionally transmit Bluetooth messages to a smartphone terminal application, enabling TalkBack-based voice output as a redundant feedback channel. The system also supports SMTP-based emergency email alerts and indoor smart home control using relay switching. A preliminary pilot evaluation was conducted in both indoor and outdoor environments to assess functional reliability and collect initial usability feedback.

Results: The prototype demonstrated reliable obstacle detection and audio feedback across different distances and environments. Emergency panic alerts and smart home control functions were successfully triggered during repeated trials, confirming stable operation of the integrated communication and control features. Participant feedback indicated improved perceived safety, confidence, and usefulness compared to traditional single-device approaches.

Conclusion: The proposed Smart Blind Stick and Glasses system offers an affordable, redundant, and modular assistive technology solution with multi-level sensing, dual-mode audio feedback, emergency notification capability, and smart home integration. The findings support feasibility for real-world use and motivate future work involving expanded user studies and advanced sensing/AI-based upgrades.

Objective: This study analyzed the usability of an assistive cutlery prototype designed to facilitate eating for people with PD (PwPD), focusing on satisfaction, effectiveness, and efficiency.Methods: Thirteen participants used the assistive cutlery at home for 7 to 10 days. Satisfaction was assessed through structured phone interviews that explored perceptions of usefulness, comfort, and safety. Effectiveness was evaluated in a laboratory setting using video recordings of a simulated eating task, assessing how well the cutlery enabled independent eating without spilling or dropping food. Efficiency was measured through kinematic analysis of movement smoothness, using data collected from an inertial measurement unit attached to the wrist.

Impact: Participants reported improvements in task performance and satisfaction. Regarding movement effectiveness, there was a 14.4% increase in the minute transport of solid food using the fork (p ≤ 0.05) and increases of 33.1% and 36% in the total and minute transport of liquid food using the spoon (p ≤ 0.05). Efficiency improvements included reduced task time and enhanced vertical velocity with the spoon (p ≤ 0.05) as well as increased mediolateral velocity with the fork (p ≤ 0.05). These findings suggest that the assistive cutlery prototype demonstrates good usability, enhances user satisfaction, and improves movement effectiveness and efficiency for PwPD.

Objective: This study explored clinicians' perspectives on the usefulness, effectiveness, technology's role, and improvement areas of the Individualised Reduction of Falls Online (iROLL-O) program, a group-based online fall prevention intervention for people with multiple sclerosis (PwMS) or spinal cord injury (PwSCI) who use wheelchairs and scooters (WC/S) full-time. Methods: Occupational and physical therapists with at least four years of clinical experience working with PwMS or PwSCI who used WC/S (N = 5), were recruited for the study. Clinicians reviewed the iROLL-O program and completed Zoom-based semi-structured interviews to provide feedback on the program. Three research team members conducted thematic analysis through iterative coding, with major codes derived from research questions and others generated inductively. Results: Four themes emerged to capture the clinician's views on the iROLL program: (1) Practical and Comprehensive Nature of the iROLL Program, (2) Mechanisms of Change for the iROLL Program, (3) Role of Online Delivery Method and (4) Opportunities for Improvement. Conclusion: This study demonstrates iROLL-O's potential effectiveness for fall prevention among PwMS and PwSCI who use WC/S full-time. Findings emphasise the importance of tailored, accessible programming for enhanced engagement. Clinicians valued iROLL's comprehensive, flexible approach. Future research should aim to refine online delivery and expand the evaluation of program efficacy.

Purpose: Physical activity has major health implications for older adults, but those with mobility disabilities are often excluded from physical activity research. The aims of this study were to 1) describe and compare physical activity and health-related characteristics of older adults in assisted living who primarily ambulate with those who primarily use a wheelchair or scooter and 2) examine correlations between physical activity and health-related characteristics in the same groups.

Materials and methods: This study used a descriptive, cross-sectional comparative analysis design. Thirty-five participants were recruited; they wore an accelerometer to measure physical activity and sleep and completed physical function assessments and health-related surveys. We used t-tests to compare mobility-status groups and Spearman's correlations to examine relationships between physical activity and health variables. We report correlations >0.30 as potentially meaningful relationships.

Results: Sixty-one percent of participants primarily ambulated, while 39% used wheelchairs or scooters. Ambulatory assisted living residents had worse sleep quality, while the seated mobility group had worse lower body and self-reported physical function. Ambulatory participants' physical activity was negatively correlated with sleep onset latency (r= -0.30) and wake after sleep onset (r= -0.38) and positively correlated with mental health (r = 0.42). Seated mobility participants' physical activity was positively correlated with total Short Physical Performance Battery score (r = 0.48) and balance (r = 0.46).

Conclusion: These findings underscore the interplay between mobility status, physical activity, sleep, and function, suggesting tailored interventions are needed to enhance the health of older adults in assisted living with different levels of mobility.

Purpose: Cognitive impairments, such as difficulties with memory, planning, organisation and information processing, are common after brain injury. Assistive Technology for Cognition (ATC) can provide support to improve independence in everyday tasks and reduce reliance on caregiver support. Recommendation and support needs to be tailored to individual factors and therefore understanding individual experiences and preferences is essential. The aim of this study was to understand the lived experience of people using ATC after brain injury.

Materials and methods: Semi-structured interviews were conducted with seven people (six people with brain injury and one caregiver) who were involved with both a Community Acquired Brain Injury Service and an Assistive Technology Service. Interviews were recorded and transcribed and analysed using principles of Framework Analysis.

Findings: We identified five themes: 1) Motivations and decisions to use ATC, 2) The anticipated and unanticipated impact of ATC, 3) ATC becoming part of everyday life, 4) Support and education from professionals (although I don't know who from) and 5) Family and friends as back-up and trouble-shooters.

Conclusion: We use the themes to illustrate factors which can help professionals to match technology to individuals and their situations and therefore potentially optimise acceptability and use for this population. Findings emphasise the importance of support from family and friends and a lack of clarity about longer-term support.

Purpose: There is a growing interest in home-based exercise for persons living with Chronic Obstructive Pulmonary Disease (COPD), but little is known about how they experience engaging in such interventions over time. This qualitative study explores how persons with COPD perceive and make sense of engaging in a long-term, home-based, virtual cycling intervention following hospitalisation due to exacerbation of COPD.

Materials and methods: Eleven participants with moderate to severe COPD, who had taken part in the intervention, were interviewed using a semi-structured interview guide. The interviews were analysed through a phenomenological-hermeneutic approach, involving multiple researchers in the interpretive process to ensure rigour.

Results: The analysis revealed three themes: (1) Making sense of exercise-Beliefs, habits, and personal preferences, (2) Doing what you can-Physical resources, timing, and disruption, (3) Alone but not lonely-Social presence and importance. We found that the participants' engagement was shaped by a multitude of factors. While many participants found home-based, virtual cycling enjoyable, accessible, and meaningful, others faced challenges such as lack of structure, technical difficulties, and fluctuating health. Engagement was not fixed, but shaped dynamically by individual, social, and practical circumstances.

Conclusion: These findings show that long-term, home-based, virtual cycling can be a motivating and relevant form of exercise for persons with COPD, especially the more affected. However, to sustain engagement, ongoing support and attention to individual barriers are essential.

Objective: To describe the improvements of new power wheelchair (PWC) users' performance in virtual environments during home-based training.

Materials and methods: This post hoc analysis used archival data from 24 new PWC users who participated in a two-week training program with the McGill immersive wheelchair (miWe) simulator (computer + joystick). The simulator offered six virtual environments (e.g., adapted transport, market) with three difficulty levels. Participants were instructed to practice each activity at least once, for 20 min every two days. Collisions, completion time and joystick movement fluidity were analysed across three training phases, at the beginning (T1: days 1-3), middle (T2: days 4-6) and end (T3: days 7-10) of training.

Results: Participants trained on average 9.7 times (4.9 h ± 3.1), completing 170 (±120) activities. The difficulty level chosen increased at the beginning and then remained stable. A significant effect of training phase was observed, with fewer collisions, faster completion times and smoother movements (all p < 0.001), most improvement occurring between T1 and T2. Activity-specific analyses revealed heterogeneous patterns: bathroom, market and elevator activities improved mainly from T1 to T2 and then stabilised, whereas street crossing performance remained stable, suggesting an early ceiling effect.

Conclusions: The miWe simulator seemed well accepted and could support engagement of new PWC users in improving driving skills from home. Given activity-dependent plateaus and users' tendency not to select the highest difficulty, future research should explore optimal difficulty adjustments, integrate more complex scenarios and compare outcomes with experienced users to refine training strategies and maximise the learning potential of the simulator.