Assistive Technology最新文献

Access to powered mobility can support play and development for toddlers with disabilities. Using powered mobility in a standing posture has been theorized to support development of muscle coordination, balance, head and trunk stability, and transition to ambulation. The purpose of this study was to quantify and characterize joystick control, bodyweight support, and muscle activity while using the Permobil Explorer Mini in seated and supported standing postures. Nine children with mobility disabilities participated in four visits where they completed two, 15-20 minute play sessions, one in each posture, with a break between. We found that all toddlers engaged with the joystick in both postures, with individual differences in favored directions and control patterns. Participants had similar loading through their feet in both postures, but had slightly higher muscle activity in standing, especially while driving. These results demonstrate that young children with disabilities quickly engage with joystick-based powered mobility in seated and standing postures, with important individual differences that can inform future design of devices and interventions to support play and development.

This study conducted a secondary analysis to objectively measure the effects of modified ride-on cars (MROCs) training in different postures on physical activity (PA) levels in children with motor delays. Data from 39 participants were analyzed in a randomized controlled trial. The participants included those using MROC in standing postures (n = 11, mean age = 22.87 months), MROC in sitting postures (n = 16, mean age = 19.53 months), and a control group that received conventional therapy (n = 12, mean age = 23.30 months). PA intensity was measured using an ActiGraph GT3X on the participants' wrists and right hip at weeks 1, 6, and 12 of the 12-week intervention period. This trial was registered at ClinicalTrials.gov (NCT02527356). The demographic data were similar across the groups. No significant differences were found in the interaction, group, or time effects for any of the positions (p > 0.05). The PA levels were consistent in at least light PA intensity range. MROC training may yield PA levels comparable to those of conventional therapy. Variations in activity and motor impairment severity could affect outcomes. Future studies should investigate factors such as task characteristics, motor delay severity, PA cutoff points, and training dosage that may influence PA intensity.

The operations of a specialty wheelchair (WC) seating center can influence the evaluation to delivery timeframe in days for a complex rehab technology (CRT) WC. Operations at one facility improved due to departmental process improvement (PI) project with evaluation of the delivery workflow and implementation of changes. A retrospective chart audit gathered baseline data on the evaluation to delivery timeframe in days of a CRT WC for 50 individuals prior to PI changes. Standard departmental workflow collected 745 individuals' post-PI changes. The interventions took place from March 25, 2017, to April 5, 2018, and included defining and educating stakeholders on their roles and expectations, revisions of the electronic medical record, weekly and quarterly meetings with supplier leadership, paperwork completion goals, and follow-up paperwork centralization. Mean pre- and post-intervention evaluation to delivery timeframes in days was significantly different (162.2 versus 127.4 days, p < 0.0001). Overall, a reduction in the mean evaluation to delivery timeframe in days of CRT WC by 21.5% or 34.8 days occurred. Systematic change takes time as well as the commitment of all key players. PI changes resulted in evaluation to delivery timeframe reduction for patients to receive their CRT WCs.

The increasing population of wheelchair users in the United States highlights the importance of access to reliable and affordable wheelchair maintenance and repair. Having a well-maintained mobility device is essential to living a safe, healthy, and social life as a wheelchair user. Unfortunately, access to these services is limited. This study aims to address this need by developing and evaluating a workshop program designed to teach basic wheelchair maintenance skills to bike shop employees, allied health professionals, and wheelchair users themselves. The workshops covered key wheelchair maintenance tasks. Pre and post workshop surveys assessed participants' confidence in basic maintenance and repair skills and overall satisfaction with the workshop. Workshop participants reported increased confidence in all maintenance skills following the workshops and bike shop employees expressed increased confidence in their ability to work with and provide resources for wheelchair users. This study highlights that community-based workshops may help to enhance confidence in wheelchair maintenance skills, potentially aiding in bridging the gap in affordable and accessible repair services. The Wheeled Repair Alliance has the potential to empower wheelchair users and improve their quality of life. Further research should consider increasing the precision of measurements and assessing long-term outcomes related to wheelchair maintenance and repair.

Wheelchair part failures and repairs have significantly increased over the last decade, leading to severe consequences for wheelchair users. Servicing these devices by wheelchair repair technicians has reduced part failures. However, no tools or technologies have been developed to support servicing in practice. To inform servicing events, risk factors affecting wheelchair quality and reliability need to be identified. This pilot study tracks wheelchair usage for a week in the community for eight ultralight manual wheelchair users and assesses the relationship between usage variables and user-reported part failures over 20 months. The participants' preferences for using smart technology for wheelchair servicing were evaluated. At least 73 wheelchair part failures and two adverse consequences were reported. Data analysis indicated associations between part failure frequency, usage variable of road shocks, wheelchair maintenance frequency, and the user's demographic characteristics of training status and transportation. Six participants favored using smart technology for wheelchair servicing. This study's findings encourage the development of usage monitoring technology and failure prediction models to support technician-led servicing and prevent wheelchair failures and user consequences.

Manual wheelchairs can promote independence among users. However, the user's level of disability, strength, stamina, and the environmental conditions within which the wheelchair is used may limit manual wheelchair functionality. The use of power assist add-ons may mitigate these limitations and help individuals to age in place. This scoping review analyzes scientific and gray literature to examine the use of power assist add-ons among adults across the life course who use manual wheelchairs, as well as their advantages and limitations in promoting independence and active aging. This review was guided by the PRISMA checklist for scoping reviews, and the Arksey and O'Malley review methodology. The literature search involved a keyword and MeSH search of electronic databases, proceedings, Google, Google Scholar and symposia. Articles were selected based on pre-defined inclusion criteria. Of the 945 unique titles returned, 17 articles were included. PADs such as rear-mounted power assist devices, powered main wheels, and front-end attachments were identified. Power-assist add-ons for manual wheelchairs show promise in improving mobility and reducing exertion for users. However, concerns regarding safety, indoor maneuverability, and user preferences highlight the need for specialized training and retrofitting power assist add-ons, especially among older users.

Wheelchair users with poor trunk control and postural abnormalities require additional posture support devices and wheelchair modifications to sit upright. Therefore, this study was conducted to observe the function of wheelchair users in the modified wheelchair and their satisfaction with both the modified wheelchair and intermediate wheelchair service. A descriptive study was conducted, and 14 participants were recruited through consecutive sampling. Post-intervention data were collected from these wheelchair users using the Functioning Every Day with a Wheelchair (FEW) and the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST) questionnaires. The data were analyzed through frequency tables and a two-sample t-test. The scores indicated that wheelchair users functioned well in the modified wheelchairs. The range of FEW was 4.8 to 5.6, respectively, with a mean of 5.15 ± 0.227, out of a maximum possible score of 6. The QUEST device sub-score was 4.514 ± 0.2381 and the service sub-score was 4.550 out of a maximum possible score of 5 (SD = 0.3716) indicating that the users were highly satisfied with both the modified wheelchairs and intermediate service provided. Wheelchair users functioned well in the modified wheelchair and expressed a high level of satisfaction with both the modified wheelchair and intermediate wheelchair service provided.

This study translated and culturally adapted the Wheelchair Use Confidence Scale for Manual Wheelchair Users (WheelCon-M) and the Wheelchair Use Confidence Scale for Power Wheelchair Users (WheelCon-P) into Arabic and examined their reliability and validity. Internal consistency and test-retest reliability were examined, and concurrent validity was evaluated using Pearson correlation coefficients with the Arabic versions of the Functioning Everyday with a Wheelchair (FEW) and the Functional Mobility Assessment (FMA). The Arabic translated versions of the WheelCon-M (WheelCon-M-A) and the WheelCon-P (WheelCon-P-A) were administered to 33 adult wheelchair users. Cronbach's α was 0.94 (p < 0.01) for the WheelCon-M-A and 0.95 (p < 0.01) for the WheelCon-P-A. The WheelCon-M-A and WheelCon-P-A were reliable with respect to test-retest with an ICC of 0.974 (p < 0.01) and 0.965 (p < 0.01), respectively. The Pearson correlation coefficient of the WheelCon-M-A scores was 0.776 with the FEW scores and 0.685 with the FMA scores (p < 0.01). The Pearson correlation coefficient of the WheelCon-P-A scores was 0.782 with the FEW scores and 0.654 with the FMA scores (p < 0.01). This study has provided preliminary evidence of new valid, reliable, and useful tools for healthcare professionals to help measure confidence with wheelchair use among Arab wheelchair users.

The purpose of this RESNA Position Paper is to provide evidence from the literature and share typical clinical applications supporting the application of ultralight manual wheelchairs (ULWCs) to assist practitioners in decision-making and justification of wheelchair recommendations.

myAccessibleHome is a home safety screening and intervention app developed to be used by PwD, aging adults, support persons, and stakeholders vested in facilitating improved community living outcomes in home-dwellers desiring to age-in-place. This study describes the iterative development process and content validation of myAccessibleHome. App development involved participatory action research (PAR) methodology and engaged PwD, caregivers, and contractors (N = 6) as part of the core research and development team. For content validity, an expert panel (N = 7) and target population end-users (N = 15) completed a web-based survey which evaluated relevance and clarity. Item and scale content validity (I-CVI, S-CVI) indices were calculated. The PAR team and content validation process contributed to iterative and ongoing refinement of content, design, and features of myAccessibleHome. For the expert panel, mean I-CVI was 0.96 [0.57-1.00] for relevance and 0.89 [0.29-1.00] for clarity. The S-CVI was 0.93. For target population end-users, mean I-CVI was 0.64 [0.40-0.87] for relevance and 0.82 [0.53-0.93] for clarity. Items were removed and revised based on respondent feedback. Engaging potential end-users in PAR and content validation studies contributed to myAccessibleHome matching wants and needs of targeted end-users.