Disability and Rehabilitation-Assistive Technology最新文献

Purpose: This pilot study aimed to (a) investigate opportunities for immersive Virtual Reality (VR) technology in communication, physical, and visual rehabilitation by examining the interaction of people without disabilities in a range of structured virtual environments; and (b) validate research protocols that might be used to evaluate the physical, visual, and verbal interaction of users in virtual worlds, and their safety while using the technology.

Methods: Thirteen adults identifying as people without disability were exposed to VR via a head-mounted display. A video-review method was used to qualitatively code and analyse each participant's communication, movement, orientation, and support needs.

Results: All participants oriented to their virtual environments sufficiently to use applications. Their spoken language was effective for interaction, although unconventional social behaviours were also observed. Two participants reported minor adverse reactions consistent with mild cybersickness.

Conclusion: The results provide insight into the types of environments and characters that support the greatest communicative, physical, and visual interaction in immersive VR. The tested protocols are useful to assess safety when using VR, and to observe communicative, physical, and visual interaction with virtual environments and characters. Implications for future research and use of VR with people with communication, physical and visual disability are discussed.

Purpose: This study addresses the learning requirements of learners with learning difficulties by monitoring their learning experience in an Intelligent Tutoring System. Intelligent Tutoring Systems were developed to enrich the teaching-learning process.

Materials and methods: In the present work, the interface is designed and developed utilizing the potential of Artificial Intelligence to meet their individual needs. Designing an online learning platform for a learners with learning difficulties requires consideration of their learning problems and preferences. The interface was developed focusing on all the requirements of the LD learners. The objective of the present study is to monitor the learning experience in the form of induced emotions and cognitive load of the learners to determine the impact of learning.

Results: 83 learners were observed during various stage of learning. The results obtained through the Support Vector machine (SVM) classification technique showed the positive attitude towards intelligent tutoring. The analysis revealed that a total of 0.23% of learners were positively induced. Their learning experience was positive and effective. The cognition load on learners was minimum with single-mode instruction and least disturbed.

Conclusions: The system was improved based on preference feedback on design features. This helps in improving content design and creating device independent and responsive visual design. The fatigue effect analysis on cognitive load implied that multiple modes of instruction increased drowsiness. Single mode of instruction have a positive impact on the learning process and it reduces the cognitive load of the learners.Implications for RehabilitationThe user interface designed and developed for learners with Dyslexia, Dysgraphia and Dyscalculia has learning disabled-friendly features. These can be used to create a device-independent and responsive design.Learning experience is monitored along with the impact on cognitive load of the learners.The research helps in understanding the stimulation and response of learners with learning disability for different learning conditions.Most existing learning systems are limited to non-learning-disabled learners. The ITS developed during research presents a Universal learning design helpful for all learners with and without learning disability.

Purpose: The aim of this study was to investigate the experiences of standing powered wheelchair (SPWC) users with spinal cord injury (SCI).

Materials and methods: This cross-sectional study included 20 participants with SCI. SPWC daily usage time (total, in sitting position and standing position) and the frequency of using the SPWC's standing feature were recorded. Participants' level of satisfaction and comfort associated with the SPWC were assessed on a five-point Likert scale. If there was a dissatisfaction reason with the SPWC, the issues related to it were recorded. Participants were asked about their positive and adverse experiences with the use of SPWC.

Results: Mean age of the participants was 41.65 (± 9.35) years. Eighty percent were tetraplegic. Ninety percent of the participants stood for at least 30 minutes at least one day a week, and 55% stood for at least 30 minutes at least four days a week. The most commonly reported perceived benefits were improvement in activities of daily living, bowel movements, and blood pressure regulation, better perception of body image, and feeling better. The most frequently identified reasons for dissatisfaction with the SPWC were its big dimensions, heavy weight, and difficulty of use in indoor environment and on uneven surfaces.

Conclusions: The findings show positive perceived experiences for SPWC users with SCI in terms of physical, social, and psychological aspects. Prospective controlled studies are needed to explore the benefits of SPWC use regarding secondary complications of SCI.

Purpose: Frame Running is an adapted community-based exercise option for people with moderate-to-severe walking impairments. This mixed-methods study aimed to examine the feasibility of 1) community-based Frame Running by young people with moderate-to-severe walking impairments and 2) conducting future studies on the impact of Frame Running on functional mobility and cardiometabolic disease risk factors.

Materials and Methods: Weekly training sessions and data collection occurred in two sites. Quantitative data were collected at baseline, and after 12 (both sites) and 24 (one site) weeks of training, followed by interviews or focus groups. Consent and retention rates, attendance and outcome measure completion rates were calculated. Qualitative data were analysed abductively using concurrent inductive and deductive thematic content analysis. Data for the assessments at baseline, 12 and 24 weeks were available for 23, 15 and 5 participants respectively.

Results: Participants were aged 5-25 with most diagnosed with cerebral palsy (GMFCS II-IV). Consent, intervention drop-out and adherence rates were 55%, 17% and 83% respectively with no serious adverse events. Outcome measure completion rates ranged between 60% and 98%. Themes related to facilitators to participating in Frame Running were mostly identified in the personal and social domains with barriers more common in the environmental and policy domains.

Conclusions: The study results support the existing evidence that Frame Running is a safe and acceptable community-based exercise option for those with moderate-to-severe walking impairments. Themes identified in personal, social, environmental and policy domains can guide the implementation of community-based Frame Running participation. Our feasibility data can inform the design of future definitive studies.

Purpose: Wheelchairs and associated seating and positioning systems require maintenance and repair services to sustain essential functions for wheelchair users. This study aims to amplify wheelchair users' opinions and experiences related to their perceived access to crucial wheelchair maintenance and repair services.

Methods: We conducted semi-structured interviews with four full-time wheelchair users using five semi-structured interview questions. The collected data was analyzed using a reflexive thematic analysis approach. Six interconnected themes were inductively, reflexively, and collaboratively constructed through critical discussions and mind-mapping techniques.

Results: These themes are as follows: "improving accessibility and efficiency: service delivery," "access challenges: diversifying repair options and locations," "systemic challenges: the role of policy," "design, durability, and dependability: meeting the user's needs," "empowering accessibility: bridging the knowledge gap," and "The system Itself: a call for change."

Conclusions: Our findings suggest that wheelchair users prioritize not only the revision of existing barriers to access but also the implementation of preventative measures to minimize repair needs. Stakeholders are encouraged to collaborate to critically analyze existing wheelchair service delivery processes and associated policies. Practical implications include adjusting current policies, establishing best practice guidelines, and enacting preventative measures to facilitate improved user access to maintenance and repair services and optimize related outcomes.

Purpose: Knowledge translation (KT) refers to the process of applying the most promising research outcomes into practice to ensure that new discoveries and innovations improve healthcare accessibility, effectiveness, and accountability. The objective of this perspective paper is to discuss and illustrate via examples how the KT process can be implemented in an era of rapid advancement in rehabilitation technologies that have the potential to significantly impact pediatric healthcare.

Methods: Using Graham et al.'s (2006) Knowledge-to-Action cycle, which includes the knowledge creation funnel and the action cycle, we illustrate its application in implementing novel technologies into clinical practice and informing healthcare policy changes. We explore three successful applications of technology research: powered mobility, head support systems, and telerehabilitation. Additionally, we examine less clinically mature technologies such as brain-computer interfaces and robotic assistive devices, which are hindered by cost, robustness, and ease-of-use issues.

Conclusions: The paper concludes by discussing how technology acceptance and usage in clinical settings are influenced by various barriers and facilitators at different stakeholder levels, including clients, families, clinicians, management, researchers, developers, and society. Recommendations include focusing on early and ongoing design partnerships, transitioning from research to real-life implementation, and identifying optimal timing for clinical adoption of new technologies.

Purpose: Information and communication technologies are crucial for social and professional integration, but access to technology can be difficult for people with physical impairments. Text entry can be slow and tiring. We developed a free and open-source module called Predict4All for use with AAC (augmentative/alternative communication) software in French language. It offers spelling error-tolerant word prediction. We aimed to evaluate the feasibility of using the system in people with learning or physical impairments and to perform a preliminary evaluation of its efficacy on spelling correctness and text input speed.

Materials and methods: We conducted a prospective interventional, two-center feasibility study between February 2020 and March 2022. We included people with learning difficulties or neurological diseases impacting verbal or written communication. We evaluated fatigue, cognitive load and satisfaction, spelling correctness and text input speed and technical issues. We used 3 experimental setups: WITHOUT (neither prediction nor correction), PRED (prediction without correction), PREDCORR (prediction with correction).

Results: Twelve participants completed the study. Fatigue (all conditions), cognitive load, satisfaction (PRED and PREDCORR) did not differ between Day 0, Day 30 and Day 120, for either center. No technical issues were reported. The percentage of errors decreased significantly between Day 30 and Day 120 with word prediction software (p = 0.026), with no difference between PRED and PREDCORR (p < 0.447).

Conclusion: Our study has shed light on the potential of the Predict4All engine with successful results, as the system performed effectively without technical or methodological obstacles. Furthermore, the engine has been adopted in clinical practice at both centers by both healthcare professionals and users.

Purpose: Assistive device non-use among individuals with disabilities is often attributed to issues in service provision and user satisfaction with assistive devices. However, systematic research on the service quality and satisfaction of assistive devices among disabled populations is lacking. Therefore, this study aims to analyze the service delivery and satisfaction of assistive devices among individuals with disabilities.

Method: The Technology Acceptance Model (TAM) was employed in this study to examine the self-reported needs and usage of assistive devices by people with disabilities in China and to explore the relationship between service provision and satisfaction with assistive devices. Additionally, potential mechanisms underlying this relationship were evaluated. The World Health Organization's Rapid Assistive Technology Assessment (rATA) questionnaire was utilized, and stratified sampling was employed. A total of 872 individuals with disabilities living in China were interviewed. Multiple regression analyses were conducted to examine the independent and interactive relationships between service provision and satisfaction.

Results: Self-reported demand for assistive technology was associated with the type of disability. Pre-fitting evaluation and training services were positively correlated with satisfaction (β=0.514, p<0.05). However, no significant effect of post-fitting maintenance services on product satisfaction was found, and the moderating effect of service convenience was not significant.

Conclusions: Policy formulation can adjust resource allocation based on the composition of its disabled population. Priority should be given to providing mobility aids and other basic equipment for people with multiple disabilities to enhance the effectiveness and pertinence of assistive services. The capacity for post-installation maintenance of assistive technologies and the accessibility of services should be improved to ensure that disabled people can continuously benefit from assistive devices. Extensive educational and publicity activities should be carried out to raise people's awareness of the importance of pre-assembly assessment, training services, and post-assembly maintenance services. The importance of disease prevention, early intervention, and rehabilitation to reduce the disability rate has been emphasized.

Introduction: Persons living with spinal cord injury (SCI) often lacks access to outdoor mobility, which can significantly impact their ability to participate in activities outside the home, to take part in their community, and to have meaningful occupations and relationships with loved ones.

Purpose: To better understand the importance of outdoor mobility for persons with SCI, the aim of this cross-sectional study was to explore transport modes, car adaptations, and their perceived function and safety.

Method: A web-survey, addressing outdoor mobility and driving, was distributed among people with different physical impairments. Of 274 responses, a total of 93 reported living with SCI and were selected for this study.

Results: Public transportation was often underutilized due to inaccessibility and distance. In total, 88 persons (95%) owned a car. Almost everyone used their car weekly (97%) and the annual average driving distance was 17,400 km (SD 22,820 km). Most of the car owners had a station wagon (63%) or van/minibus (27%) and larger vehicles were more common among those needing extensive adaptations (p = 0.014).

Discussion: The results corroborate earlier findings on public transport for persons living with SCI and the importance of their having a suitably modified vehicle. The results also offer insights into outdoor mobility and car driving among persons with SCI in Sweden that can support accessibility planning and promote innovations in transport options. Persons living with SCI and other physical impairments could benefit from a comprehensive, national-level knowledge base that encompasses outdoor mobility and car adaptations and their implications for these populations.

Purpose: Rehabilitation technology (RT) development has grown, however evidence suggests poor uptake by therapists and patients, with many devices abandoned. Successful implementation encompasses both "adoption," where RT is first utilized, and "sustained use," wherein RT remains in use over time. This scoping review and qualitative analysis aimed to explore the extent and nature of the relevant evidence base and investigate factors that influence adoption and sustained use of RT in clinical practice, from the perspectives of patients and therapists.

Methods: A systematic search was conducted to identify qualitative and quantitative articles investigating adoption and/or sustained use of RT. Study characteristics were analyzed quantitatively. Factors influencing adoption and sustained use were analyzed using a two-stage thematic analysis. Stage 1 employed an inductive approach, analyzing data related to RT adoption from review papers. Stage 2 employed an abductive approach, where data related to sustained use from primary research and reviews was mapped to Stage 1 themes and new themes were identified.

Results: The review included 42 articles. The majority of articles explored RT adoption. Thematic analysis revealed five themes. Four influenced adoption of RT: (1) "Knowledge" about RT; (2) "Design" of RT; (3) "Circumstances and Characteristics;" and, (4) the "Person-centered" approach. These were confirmed and refined in the sustained use analysis, and a fifth theme, "Healthcare Ecosystem," was identified.

Conclusion: These findings highlight factors influencing adoption and sustained use of RT, providing insights for development and implementation of technology in rehabilitation clinical practice. Further research is needed to identify strategies that facilitate sustained use of RT.