Assistive Technology最新文献

This feasibility study aimed to examine the change in trunk control as assessed by the Segmental Assessment of Trunk Control (SATCo), and activities of daily living, mobility, and social/cognitive skills as assessed by the Pediatric Evaluation of Disability Inventory Computer Adaptive Test (PEDI-CAT) in young children with disabilities following MROC use. Eight participants received MROCs through a local GoBabyGo program and were instructed to use the MROC at least 1 hour per week for 8 weeks. Two participants did not complete the study. The remaining 6 participants (3 years, 0 months to 4 years, 5 months) were evaluated using the SATCo and PEDI-CAT 4 weeks before receiving their MROC, upon receiving the MROC, and after 4 and 8 weeks of MROC use. This study found improvement in SATCo level for 3 participants and no change or slight decrease in PEDI-CAT scores for all participants. No adverse events occurred. While improvement was found for the SATCo only in 3 out of the 6 participants, anecdotal reports of functional improvement and enjoyment from participant families indicate that further research is needed to holistically explore trunk control and the functional impact of MROC use in a naturalistic setting.

Mobility level is considered the primary factor for determining the effectiveness of a prosthesis. This study aimed to establish whether mobility and quality of life (QoL) are improved with a microprocessor-controlled knee (MPK) compared with a non-microprocess-controlled knee (non-MPK). Participants who have undergone transfemoral amputation (TFA), aged between 20 and 60 years, and using prosthesis for at least 1 year were included in the study. Participants were divided into two groups according to the use of MPK (n = 35) and non-MPK (n = 28) prosthesis. The PLUS-M criteria was used to score mobility, while the Trinity Amputation and Prosthetic Experience Scales-TAPES was used for classifying QoL. Mobility was higher for MPK prosthesis compared with non-MPK (p < 0.05). Regarding QoL, while there was no difference between the groups for psychosocial adaptation sub-score (p > 0.05), but the group using MPK prosthesis were higher in terms of activity restriction and total TAPES score (p < 0.05). Our data shows that the type of knee joint used by participants with TFA has an effect on their QoL and mobility. Participants using MPK had better mobility, higher sub-scores related to activity restriction, and sub-scores of the QoL compared with non-MPK.

Heel pressure injuries are common among patients with lower limb fractures or those on complete bed rest (CBR). Despite the availability of multiple devices, no gold standard has been established for effectively preventing these injuries. This study aimed to describe the design and development of a heel support orthosis and to assess its preliminary safety and effectiveness. After reviewing the literature and consulting experts, an initial orthosis design was created and tested for efficacy and patient safety. A prototype was made, and after approval, tested on two patients with lower limb fractures for up to three days. Following improvements, a second model was tested on five additional patients over the same period. The orthosis was evaluated for heel and shank pressure injuries, pain, burning, itching, and comfort. The orthosis supported the heel without direct surface contact, allowing for reduced pressure and improved perfusion. The device's hypoallergenic cotton fabric was soft, non-abrasive, and non-elastic. None of the patients developed pressure injuries, pain, or discomfort, and all were satisfied. Based on the pilot study findings, the heel support orthosis demonstrates potential as a valuable tool for preventing heel pressure injuries in a clinical setting.

The ankle-foot complex plays a vital role in stability and mobility, with its dysfunction leading to gait abnormalities. Rigid ankle-foot orthoses (R-AFOs) are commonly used to address anteroposterior instability, but their effectiveness on static mediolateral alignment, particularly in cases of hyperpronation, remains unclear. This study examines the impact of incorporating medial and lateral supports into R-AFOs on enhancing mediolateral alignment. To assess whether adding medial and lateral supports to R-AFOs improve static mediolateral alignment in individuals with hyperpronation by analyzing changes in the resting calcaneal stance position angle (RCSPA). Nine individuals (mean age 20.56 ± 3.22 years) with flexible hyperpronation were recruited. Adjustable medial and lateral supports (3 mm, 6 mm, 9 mm, and 12 mm) were tested within a R-AFO. RCSPA changes were measured to quantify mediolateral alignment changes and pain levels were recorded. Statistical analysis was conducted using Friedman and Wilcoxon signed-rank tests. Lateral support significantly reduced pronation (Z = -2.561, p = 0.01), with a 6 mm depth providing optimal correction (4.83° reduction). Medial support had minimal impact, and higher depths (9 mm, 12 mm) caused discomfort. Lateral support within R-AFOs effectively enhances mediolateral alignment in individuals with hyperpronation, offering a simple and cost-effective intervention. Further research is needed for clinical validation.

Evidence-based clinical care and outcomes research are essential for developing objectively based standards of practice in prosthetic and orthotic care. Traditionally, outcome measures have been collected using paper-based methods. However, digital collection of these measures may offer several advantages. The COMET© (Clinical Outcome Measures Electronic Toolkit) mobile app was developed to facilitate the assessment of commonly used patient-reported and performance-based outcome measures in prosthetics and orthotics. The usability of the COMET app was evaluated among 15 individuals with lower limb amputation and nine clinicians using the System Usability Scale (SUS). The mean SUS score among individuals with lower limb amputation was 84 ± 12 (Grade: A; Percentile: 90-95; Adjective: Excellent; Acceptable), and the mean SUS score among the clinicians was 80 ± 14 (Grade: A-; Percentile: 85-89; Adjective: Good; Acceptable). There were no significant differences in SUS score between the two groups, indicating that the app was acceptable to both groups of participants in clinical settings.

HERL-Town is a game-based training tool designed to educate mobility device users (MDUs) and their travel companions about transportation barriers and compensatory strategies, focusing on decision-making, problem-solving, and wheelchair skills to promote safe, independent community mobility. The game currently offers a validated physical board game and an alternative digital game to suit different training settings. This study aimed to compare the gameplay experience of both games. In this cross-sectional crossover study, 43 MDUs and travel companions completed session 1, in which they were randomized to either a board game or a digital game group. Twenty-nine participants completed session 2, in which they played the other type of game from session 1. Participants rated their game experience after each session using the Model for the Evaluation of Educational Games (MEEGA+) questionnaire. In session 1, the MEEGA+ scores for both games met good-level criteria (board game: 57.10, digital game: 59.30). In session 2, the board game reached excellent-level criteria (77.55), while the digital game stayed at good level (58.15). Findings highlight consistent game quality between the board and digital games, when playing for the first time. The board game's higher quality in session 2 suggests further improvement in the digital game's mechanics.

Participation in leisure and recreational activities has been associated with improvements in quality of life and social relationships for individuals with physical disabilities. The purpose of this study was to determine the most frequent facilitators and barriers that individuals with physical disabilities experience, both when starting with adaptive video gaming and when maintaining participation. A self-administered survey was used to collect data from individuals who currently participate in adaptive gaming and included three sections: (1) Demographic Section, (2) Gamer Habits Section, and (3) Facilitators and Barriers to Adaptive Gaming Section. A total of 256 participants met inclusion criteria and completed the study survey. Family, friends, rehabilitation staff members, social media/YouTube, and peer support were found to play a role in facilitating the initiation of adaptive gaming participation. Common facilitators of adaptive gaming were fun/entertainment, stress relief/relaxation, and prior involvement in video gaming. Barriers to adaptive gaming participation were cost of equipment and difficulties with gameplay. Older age and greater severity of hand impairment were associated with experiencing a higher number of barriers (p < 0.01). Improving funding resources, game accessibility, and access to professional assistance for adaptive gaming may help overcome some of the commonly reported barriers in this study.

The use of assistive technology in education has been shown to enhance academic performance, increase educational engagement, and improve both academic self-efficacy and the social and psychological well-being of students with disabilities. Despite these proven benefits, assistive technology is not always utilized systematically or effectively. Many educators report feeling insufficiently competent in using assistive technology in the classroom, with their knowledge often being limited. This study aimed to assess higher education teaching staff's knowledge of the features of both assistive and mainstream technology (including devices, software, and apps), as well as their experience in using them. A total of 131 teaching staff members from Italy, Germany, Spain, and Greece participated in the study by completing a questionnaire that included items related to both types of technology. The results indicated that staff members were far more familiar with mainstream technology than with assistive technology, and their knowledge and experience with the latter were limited. Age and prior training emerged as significant predictors of both knowledge and use of assistive technology. Notably, the study highlighted specific types of assistive technology that were more familiar to higher education teaching staff.

Assistive lower-limb exoskeletons (LLEs) have been recognized as promising tools for enhancing physical capacity in stroke survivors. Involving end-users in the early development stages is essential to ensure these technologies meet user needs. Co-design approaches, which actively engage end-users, support this goal. This study aims to (1) evaluate the impact of fatigue on daily living, (2) identify activities that could benefit from LLE assistance, (3) outline design and usability requirements for home-based LLEs, and (4) define physical parameters LLEs should monitor and assess. Discussions were structured using the PERCEPT co-design methodology and thematically analyzed. Four chronic stroke survivors participated in three focus group sessions, each lasting approximately 2 hours. Fatigue was identified as a significant factor in daily life, underscoring the importance of assistive technologies, such as LLEs, to help mitigate exhaustion. Participants recognized LLEs as valuable tools for enhancing physical performance, with benefits for muscle strength, balance, fatigue management, coordination, and general mobility. Design considerations included system modularity, battery efficiency, ease of donning and doffing, and practical needs for daily use. Our findings offer valuable insights into stroke survivors' design and usability concerns regarding LLEs and provide a foundation for advancing the development and adoption of new assistive technologies.