Disability and Rehabilitation-Assistive Technology最新文献

Purpose: Assistive rehabilitation technologies have been used as a way to address the challenges associated with aging. Therefore, the present study was conducted to investigate the factors related to the intention to use rehabilitative assistive technology in older adults.

Materials and methods: The cross-sectional study conducted in 2024 focused on older adults aged 60 and above who visited comprehensive health service centers in the city of Hamedan. The samples were selected using a multistage random sampling method. The data collection tools included a two-part researcher-designed questionnaire, covering demographic information and the Unified Theory of Acceptance and Use of Technology of the developed questionnaire. The data were analyzed using Pearson correlation tests, linear regression, and structural equation modeling.

Results: A total of 340 older adults participated (mean age = 70.44 ± 7.47 years). PLS-SEM results indicated that perceived need (β = 0.426, p < 0.001), performance expectancy (β = 0.178, p < 0.001), technology anxiety (β = 0.161, p < 0.001), social influence (β = 0.158, p < 0.001), and effort expectancy (β = 0.136, p < 0.001) significantly predicted intention to use assistive technologies. Overall, the extended UTAUT model accounted for 51% of the variance in behavioral intention. Multiple regression also revealed significant associations of age and history of chronic disease with intention to use (p < 0.05).

Conclusions: The findings underscore the importance of perceived need and technology anxiety as key additions to the UTAUT model in predicting intention to use. However, the unexplained variance suggests that additional influences-including personal characteristics, environmental supports and barriers, and technology-related features-should also be considered in future studies to provide a more comprehensive understanding of adoption among older adults.

Purpose: The objective of this study is to develop and assess a wearable assistive device, enabled by the Internet of Things (IoT), that improves obstacle perception, mobility, and interaction with the environment for those with visual impairments. The technology amalgamates real-time object detection, facial recognition, and obstacle sensing into a unified framework to facilitate autonomous and secure navigation.

Materials and methods: An experimental design-and-build methodology was employed to create the prototype utilising an ESP32-CAM module, Arduino microcontroller, ultrasonic sensor, and text-to-speech feedback interface. Deep learning and machine learning algorithms-Support Vector Machine (SVM) for facial detection, ResNet-50 Convolutional Neural Network (CNN) for facial identification, and YOLOv4 for object detection-were employed to facilitate precise, low-latency performance. An evaluation of the system was performed under various environmental conditions utilising conventional criteria such as accuracy, precision, recall, and F1-score.

Results: The implemented system attained a recognition accuracy surpassing 90% with negligible computational latency, making it appropriate for real-time applications. The hybrid SVM-YOLOv4 model exhibited a harmonious mix of precision and efficiency, facilitating dependable multi-object recognition under various environmental and lighting situations. The quantitative results confirm the strength and flexibility of the proposed wearable device for supportive purposes.

Conclusions: The IoT-enabled wearable assistive technology demonstrates considerable promise to enhance mobility, environmental awareness, and independence in those with visual impairments. The device combines hardware sensors with advanced computer vision models, linking theoretical innovation to practical rehabilitative applications. Future endeavours will encompass extensive user validation to improve usability, accessibility, and user comfort. Consequences for rehabilitation: Wearable devices driven by IoT can enhance mobility and situational awareness for those with visual impairments. The incorporation of machine learning-derived feedback facilitates safer, autonomous navigation in fluctuating situations. The modular system architecture facilitates adaption for a wider range of assistive and rehabilitation applications. The research enhances the design of cost-effective, intelligent assistive technologies that align with rehabilitative objectives and the creation of inclusive technology.

This paper explores the integration of artificial intelligence into assistive technologies (AI-ATs) for individuals with visual and hearing impairments. While these technologies enhance independence and quality of life, they raise complex ethical challenges demanding systematic examination. We conducted a systematic review synthesising findings from 81 peer-reviewed publications (2010-2024), searching nine databases with rigorous inclusion criteria. An analytical framework examined 11 ethical dimensions across various implementation contexts. The analysis reveals equity and accessibility as primary ethical concerns, followed by autonomy and privacy protection. Workplace applications dominate the literature, while educational contexts remain underrepresented. Implementation strategies prioritise user-centred design but show limited attention to technical accountability. Findings indicate critical misalignment between ethical principles and practical implementation. This review contributes a comprehensive framework for evaluating AI-AT ethics and highlights the need for integrated development approaches emphasising interdisciplinary collaboration among technologists, ethicists and end-users.

Purpose: Logistical and financial barriers to accessing medical equipment through registered suppliers may push people to use online peer-to-peer marketplaces. We sought to characterise the availability of standard wheelchairs sold on these platforms.

Materials and methods: From March 21-26, 2025, we searched for "manual wheelchairs" across five commonly used online peer-to-peer marketplace platforms (Facebook Marketplace, Craigslist, eBay, OfferUp and Mercari) in an urban zip code (55455). We extracted the first 20 results per platform with at least 1 photo. We extracted information, including asking price, reported retail price, reported condition, etc. We aggregated data across platforms and used descriptive analysis to characterise listings.

Results: We identified and included 67 wheelchair listings. The median (IQR) asking price was $150 ($102-$270). Sellers reported that 33 (49%) wheelchairs were in "new or like new" condition, 30 (45%) were in "used or good" condition, and 4 (6%) noted deficiencies such as missing wheels. Twelve listings featured 1-2 photos (18%), 24 (36%) featured 3-5 photos, and 31 (46%) listings featured >5 photos. Fifty-three (79%) listings offered shipping; median (IQR) shipping price $19 ($0-$41). Fifty-six (84%) were from individuals, while 11 (16%) were listed by businesses.

Conclusion: The abundant listings for manual wheelchairs on online peer-to-peer marketplaces represent a workaround to current barriers in access through traditional, regulated sources. While these options improve access to critical medical equipment in the short term, they mask underlying systemic issues and put vulnerable individuals at risk. Future directions could explore policies to improve access and regulation of online wheelchair sales.

With global populations aging at an unprecedented pace, health and social care systems face mounting challenges in supporting older adults to live safely and independently. A wide range of assistive and digital technologies has emerged to enhance well-being, autonomy, and safety in later life. This systematic review explores the current landscape of such technologies, critically assessing their reported benefits, usability and implementation barriers. A structured search was conducted across six major databases for peer-reviewed studies published between January 2015 and May 2025. The review followed PRISMA 2020 guidelines, and methodological quality was assessed using the Mixed Methods Appraisal Tool (MMAT) (2018), augmented with technology-specific criteria. Of the 1838 records screened, 69 studies met the inclusion criteria. These studies evaluated interventions such as smart home systems, wearable health monitors, socially assistive robots and artificial intelligence (AI)-driven behaviour recognition tools. Reported outcomes included improved fall prevention, more rapid emergency response, increased engagement in daily activities and enhanced emotional well-being. Despite these promising results, many studies reported persistent challenges related to usability, affordability, data privacy and the mismatch between design and user needs. Only 17.4% of the studies included achieved high methodological quality. The findings highlight a need for more robust, user-centred research and the development of implementation models that account for the diversity of older adults' needs. This review provides actionable insights for researchers, clinicians and developers aiming to design effective, equitable, and scalable technological interventions in rehabilitation and aging.

Purpose: Amyotrophic Lateral Sclerosis (ALS) is a progressive disease leading to loss of muscle strength and control, and as such limiting patients' independence. Assistive devices can help individuals with ALS; however, their use by ALS patients is limited. To increase use rates, we expect that devices need to be tailored to ALS patients. The aim of this study was to identify wishes, requirements and values of ALS patients regarding assistive devices for the upper extremity through focus groups involving ALS patients, their relatives and medical professionals.

Methods and materials: Four focus groups were conducted, recorded and transcribed. Two focus groups with ALS patients and their relatives contained a "Day in a Life" and "Empathy map" method, while during two focus groups with medical professionals, "Day in the Life" method and "Provoking statements" were used. Activities mentioned were counted and categorized into "Daily activities" and "Elective activities".

Results: Qualitative analysis of transcripts yielded three themes: (1) ALS patients' considerations on use and wishes for assistive devices, (2) external factors influencing the use of assistive devices and (3) change in ALS patients' needs over time. In addition to maintaining independence in activities of daily living, the results highlight that retaining the ability to perform elective activities such as hobbies, is important. Moreover, there is a clear need for assistive devices designed for ALS patients with limited upper extremity strength, but who are not confined to a wheelchair.

Conclusion: These findings can guide the development of assistive devices tailored to the needs of ALS patients.

Although research has demonstrated that tailored intervention for infants and toddlers leads to best outcomes, children who may benefit from interventions incorporating assistive technology (AT) are routinely not enrolled in these services until preschool or later. The purpose of this study is to describe five years of service delivery associated with an interdisciplinary AT program for infants and toddlers with complex neurodevelopmental disabilities. Data describing service delivery was extracted from the medical records of 85 patients who received evaluation or intervention sessions from 2018 to 2023. Data were analyzed using descriptive statistics to examine trends in implementation. Although trends suggest that implementation strategies were successful in providing participants with AT equipment (92% of sample), participation in the program as designed was only completed for 31% and outreach to early interventionists was only completed for 28% of the sample. Analysis of data within constructs and subconstructs of the consolidated framework for implementation research (CFIR1211), revealed that barriers to implementation included: COVID-19 (outer setting), lack of scheduling and administrative staff support (inner setting), cost (innovation) and limited structure to revision (implementation process). Facilitators included: community partnerships with Go Baby Go Oregon (outer setting), insurance reimbursement of virtual care (outer setting), and internal funding for patient equipment (inner setting). Changes in implementation strategies seem warranted to expand the adoption of AT equipment. Proposed strategies include formal strategy review process (structured revisions), altering internal funding source ordering procedures, and adding dynamic outreach options for increased participation by early interventionists.

Purpose: This study aims to estimate hearing aid (HA) uptake and possible hearing-related and demographic factors influencing it in tertiary care hospitals. Method: A retrospective cross-sectional study assessed the uptake and usage patterns of HAs among 6277 individuals (aged ≥10 and ≤91) with hearing loss, focusing on demographic and hearing-related factors. Key details such as type, severity, laterality and symmetry of hearing loss were recorded, along with a survey on usage patterns for those who acquired HAs.

Results: About 8.15% (512) underwent hearing aid trial (HAT), 2.89% (182) of individuals obtained HAs from a total of 6277, while 35.54% (182) of those who participated in a HAT (512) acquired them. A multinomial logistic regression analysis examined how demographic and hearing-related factors influenced participation in HAT, procurement status and usage regularity. Results showed that older adults and those with greater hearing loss in the better ear and better speech recognition in the worse ear were more likely to undergo trials. However, older age with higher speech scores was associated with lower procurement odds. Age and audiometric factors did not significantly predict daily HA usage duration.

Conclusions: Hearing aid adoption was higher among trial participants than those who only received recommendations. Age and audiological factors influenced trial participation and usage, older adults with better speech scores were less likely to get HAs.

Around 8 million children with functional disabilities in India need postural support wheelchair designs. This study tests the durability and usability of a new tilt-in-space, postural support wheelchair design for children. The International Organization for Standardization (ISO) wheelchair durability testing was followed by a mixed-method observational field with a purposively selected, diverse sample of children aged 3-17 with varying diagnoses needing a tilt-in-space wheelchair in the rural and urban community settings in South India. Children were fitted with appropriate size wheelchairs. Demographic information was collected at baseline. Customized rapid surveys and interviews evaluated usability, use satisfaction, and willingness to buy and use the wheelchair device at the 2- and 12-month follow-up visits. The wheelchair passed ISO durability testing without part failures. Twelve participants (n = 7 boys, n = 5 girls), aged 10.25 ± 2.67 years, reported high to moderate satisfaction of use. During follow-up, caregivers reported improvements in the child's physical function, social interaction, and time spent in the chair. No part failures were reported. Themes were found regarding the inappropriateness of previous wheelchair designs and the benefits for children's growth, function, and participation, as well as burden reduction for caregivers. The participants reported that they would buy the wheelchair for a price range of Rs. 15500-28751 ($186-346). The study results demonstrate the benefits of high-quality and usability of the postural support wheelchair design for children with functional disabilities. Such a design is necessary to promote growth, social skills, and reduced parental burden. Future studies should compare the design with wheelchairs currently prescribed in India.

Aim: To assess the effectiveness of adaptations in electric-ride-on toy cars for improving mobility in children with Spinal Muscular Atrophy (SMA) with two copies of SMN2, emphasizing their use in natural environments.

Method: A case series study, including children (aged 10 months to 5 years) with severe motor disabilities, was conducted. Each child received a customized adaptation of an electric toy car, modified to meet their specific postural and motor needs. The "Assessment of Learning Powered Mobility" 2.0 (ALP 2.0) tool was employed to track learning progress during weekly training sessions conducted in the children's natural environments with family involvement.

Results: Nine children successfully completed the study protocol. By week 8, all participants had reached at least level 6 on the ALP 2.0 tool, demonstrating significant improvement in driving ability. Adaptations were refined for two children during the study due to improvements in handling skills.

Interpretation: Personalized adaptations and training in familiar environments enhance independent mobility and participation in children with SMA with two copies of SMN2. The findings suggest that neither initial motor skills nor the type of adaptation required limits progress. This study underscores the importance of early powered mobility interventions and highlights the need for further research to optimize training and adaptation strategies for young children with motor impairments.