Disability and Rehabilitation-Assistive Technology最新文献

Population ageing, multi-morbidity and associated disability is shifting global demand for health and care services. Innovative solutions are required to meet the evolving needs of people with advanced disease, support independent functioning and quality of life. This scoping review aimed to map and examine evidence on the role of assistive technology in adults with advanced disease and those receiving palliative care. A systematic search of Medline, Embase, PsychINFO and Cinahl, was conducted from inception to 31^st July 2024 for studies investigating use of assistive technologies in people with advanced disease or receiving palliative care. Titles and abstracts were independently screened before full texts retrieved for eligibility review, data extraction, synthesis and descriptive analysis. 23/811 screened papers met eligibility criteria. Participants included ALS/MND (n13/23); palliative care (n4/23); cancer (n2/23); dementia (n2/23); Parkinson's (n1/23) and frailty (n1/23). Studies evaluated assistive technologies supporting ten functional domains; most frequently to support communication and information management (n13/23), least frequently orthoses and prosthesis, and domestic activities and participation in domestic life (n1/23). Outcomes of assistive technology use related to functioning, quality of life, dignity in end-of-life care and health service use. Implications for individual users, device design and delivery are discussed. This review highlights potential benefits of assistive technologies and gaps in research on their use for adults with advanced disease or receiving palliative care. Empirical evidence is limited and focuses on communication enhancing high-tech devices. Future research should explore assistive technology's impact over time on health outcomes, alongside strategies to integrate provision in care.

The present study provides a systematic thematic and bibliometric analysis of articles published in the journal "Disability and Rehabilitation: Assistive Technology" from 2006 to 2025. The PRISMA framework and Bibliometrix software were utilised to analyse 1,884 articles indexed in Web of Science, with the objective of elucidating research trends, conceptual structures, and collaboration networks in the domain of assistive technology (AT). The findings indicate a significant rise in scholarly interest, particularly post-2020, with themes focusing on physical rehabilitation, cognitive-emotional support, user-centred design, accessibility, and inclusion. The present study adopts an interdisciplinary theoretical framework integrating the International Classification of Functioning (ICF), the social model of disability, and technology acceptance theories. The results demonstrate a transition from device-oriented research to user experience and social impact, reflecting the evolving nature of assistive technology (AT) as both a clinical tool and a driver of social participation. The United States and Canada are at the vanguard of global AT research, characterised by a high level of international collaboration. The objective of this comprehensive analysis is to inform future research, policy-making, and inclusive innovation strategies by mapping current knowledge and identifying conceptual and geographic gaps in the AT literature.

Discussion and conclusions: This exploratory study provides preliminary insights into how age-related stigma impacts the adoption of technology-based interventions in rehabilitation practices. Our goal is to raise awareness about how our assumptions regarding aging can influence the quality of care provided to older adults.

Objective: This study will assess the feasibility, acceptance, and preliminary efficacy of a novel and engaging task-oriented UE training program, Strength and Power in upper Extremities through Exploratory Driving (SPEED), including joystick-operated ride-on toys, as a therapy adjunct, to advance UE function among children with hemiplegia.

Methods: We will conduct a randomized controlled trial to compare SPEED training to a dose-matched program, Creative Rehabilitation for Arm Function Training (CRAFT), based on standard-of-care. 30 children with hemiplegia between 3 and 9 years will be recruited. Training will last 6 weeks, 4 times/week, 2 sessions by researchers (30-45 min/session) and 2 sessions by caregivers (15-20 min/session). The SPEED group will engage in playful games including ride-on toys and the CRAFT group will complete seated, fine motor activities. The primary outcome measure is treatment adherence. Secondary measures include participant retention, perceived satisfaction, implementation fidelity scores, child engagement, wrist-worn accelerometry, kinematics, scores on the Shriner's Hospital Upper Extremity Evaluation, Quality of Upper Extremity Skills Test, and the ABILHAND-Kids questionnaire, grip strength assessment, and measures of navigational control.

Impact: We propose a community-based, innovative, task-oriented training including modifiedride-on toys to promote self-initiated use of the affected UE in young children with hemiplegia. Study findings have implications for the adoption of the SPEED program by families as an adjunct to conventional therapy to increase children's functional use of their affected arm through playful exploration.

Despite the rising prevalence of hearing loss worldwide, underutilization of hearing aids persists. Direct-to-consumer (DTC) hearing services have emerged as a potential solution to address barriers in conventional audiology services. This scoping review investigates the challenges and opportunities associated with direct-to-consumer service delivery in audiology. This review followed the Arksey and O'Malley and PRISMA-ScR guidelines. A systematic search of four databases and gray literature identified 12,034 records. Studies published in English between January 2015 and October 2024 were included if they explored challenges or opportunities in DTC hearing care service delivery from the perspectives of users aged 18 years or older with hearing loss or healthcare providers. After the screening and full-text review, 24 studies were included. The identified barriers included lack of professional guidance, safety concerns, limited user awareness and trust issues. Opportunities included improved accessibility, cost-effectiveness, integration of DTC into audiological practice, interprofessional collaboration, patient education and research comparing DTC and traditional service models. While DTC models can enhance access to hearing healthcare, overcoming challenges such as user education, trust, and professional involvement is crucial. Task shifting to other healthcare providers has emerged as a crucial strategy for enhancing service efficiency. The findings emphasise the need for a collaborative, multi-disciplinary approach to optimize DTC service delivery and inform future policy and practice.

Aim: Well-designed assistive devices improve the quality of life of individuals with severe and permanent impairments and reduce the burden on their caregivers. This study investigated whether interactive smart agents (ISAs) are effective in supporting individuals who are affected by neurological conditions causing severe mobility issues, and the factors aiding ISAs' adoption.

Materials and methods: The North Thames Regional Environmental Control Equipment Services (NTRECES) supported this study by recruiting service users (people with severe mobility impairments due to neurological ailments) in the study. Health Research Authority approval was obtained (255096). NTRECES prescribes medical-grade environmental control (EC) devices, unlike smart speakers (ISAs). Research on ISA adoption by NTRECES users could support prescribing ISAs as assistive EC devices in the future. Through secondary research and exploratory primary data, this user-centred study developed an initial technology adoption model, subsequently revised in light of the insights from a multi-point qualitative primary research.

Conclusion: This research uncovered that novelty, ease of voice interaction and its entertainment value play a key role in the adoption decision. Willingness to overlook reliability, privacy and security attributes was identified, providing that the service users had back-up devices for security and privacy critical tasks. The originality of this work consists in the development of a technology adoption model tailored to consider the characteristics of service users with severe physical disabilities and the attributes of ISAs technology. The research contributes to the discussion on contextual factors and technology design features that may improve the inclusivity of ISAs and their use as medical devices.

Background: Participation in leisure activities is important for childhood development; however, youth with disabilities (YWD) experience participation limitations due to various barriers, including a lack of information about available adaptive and inclusive leisure activities. The Jooay mobile app, addresses this barrier by providing YWD, parents, and clinicians with information about adaptive and leisure activities in their neighborhoods across Canada. Game-like features, known as gamification, can enhance user engagement with mobile technologies and support health behavior change.

Objective: This study sought to explore the needs and perspectives of YWD, parents, clinicians, and community organizations about how gamification can increase their engagement with a mobile app that targets health behavior changes.

Materials and methods: We used a qualitative interpretive description methodology and conducted semi-structured interviews (N = 21) with YWD, parents, clinicians, and community organization representatives. Interviews were recorded and transcribed verbatim. Deductive and inductive approaches alongside constant comparative analysis were used.

Results: Qualitative analysis revealed four interconnected gamification strategies: (1) supporting participation goals; (2) bringing fun; (3) connecting with others; and (4) consideration for different users' experiences. We learned that mobile apps may have increased success in facilitating health behavior changes if they are tailored to individual preferences and may benefit from including personalized goal setting, a feedback system, such as a progress tracker, fun-related elements (especially for YWD), social networking for peer support, tailored user experiences for different user types, and expanded safety features to ensure privacy.

Conclusions: These findings inform the inclusive and participatory design of digital health tools like Jooay, highlighting their potential to support behavior change, and promote meaningful participation in leisure activities.

We examined the concurrent change in developmental language phase (DLP) and linguistic status of children with Autism Spectrum Disorder (ASD)/autism, identified as Nonverbal/Minimally-Verbal (NV/MV), utilizing Augmentative/Alternative Communication (AAC) systems. We compared the linguistic output of NV/MV autistic children concurrently, with and without use of AAC systems. Additionally, we compared the linguistic level, characteristics, and early developmental milestones for AAC users and non-users. A sample of 23 autistic children (3-12 years-of-age) identified as NV/MV based on the DLP results by the Developmental/Verbal Language Phase parent-report questionnaire, participated in this cross-sectional study in Cyprus. Two groups formed based on AAC systems use (AAC users, AAC non-users). Parents completed the questionnaire through convenience sampling, determining the children's overall DLP concurrently, with and without use of AAC systems. Only 52.0% of participants used aided AAC systems to support their communication. No significant differences were noted in demographic/other variables between the groups. When AAC systems use was included in measuring linguistic expression for AAC users, 75.0% of them displayed improved linguistic level (DLP), half of whom elevated to a verbal-linguistic status. AAC users in the DLP-2 First-Words phase/level were more likely to switch to DLP-3 Word-Combinations and thus to verbal status, than those in the DLP-1 Preverbal phase/level. AAC system use can be associated with improved communication level and status, especially for autistic children already verbalizing at the word-level. Most AAC users were at an advantage in their language skills through AAC systems use, compared to non-users.

Purpose: Assistive Technologies for Cognition (ATCs), such as the Cognitive Orthosis for coOKing (COOK), offer support to individuals with traumatic brain injury by enhancing safety and independence. While the usability of COOK's client interface has been tested, the expert interface-used by occupational therapists to customize the interface to clients' needs-requires further study. We therefore aimed to: (1) Prioritize the modifications to be made to COOK's configuration interface; and (2) Describe the effectiveness and efficiency of the interface within a laboratory context.

Materials and methods: A Human-Centered Design (HCD) approach was used. Fourteen occupational therapists and master's students in occupational therapy participated. A convergent mixed-methods design was used. Data was collected through laboratory testing of the interface. Qualitative data was analyzed using deductive thematic analysis [1], and quantitative data with descriptive statistics.

Results: Our study highlighted the importance of balancing effectiveness and efficiency during technology design. Participants emphasized that the configuration process should ensure both a quality that allows customization to meet client needs and an ease of use to minimize the time required for the configuration of COOK. Overall, a good usability of COOK's configuration interface was demonstrated both qualitatively and quantitatively.

Conclusion: Future studies will be needed to implement the technology in clinical practice and gather further insights on this interface for the design of further iterative improvements to meet the needs of occupational therapists and their clients.