Wheelchair-mounted robotic arms: a survey of occupational therapists’ practices and perspectives

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Purpose Despite the benefits of wheelchair-mounted robotic arms (WMRAs), occupational therapists are not yet widely involved in the recommendation or implementation of these assistive devices. The purpose of this study was to investigate and compare the current practices and perspectives of occupational therapists who had and had not recommended a WMRA on the recommendation, training, and implementation of WMRAs. Methods This was a descriptive cross-sectional study. An online survey was sent to Canadian, European, and American occupational therapists who had or had not worked with WMRAs. Respondents were asked close-ended questions about their experience, role, barriers, motivations, and future needs regarding WMRAs. We compared results between respondents who had and had not recommended WMRAs using descriptive statistics. Results Ninety-three North American and European occupational therapists completed the survey. Of those, 29 (31.2%) had recommended a WMRA, mostly the JACO robotic arm (n = 26, 89.7%) in rehabilitation centres (n = 18, 62.1%). Their perspectives on their role and barriers related to WMRAs were similar to those who had never recommended a WMRA. All respondents recognised the relevance of occupational therapists’ contribution, and most reported interest in WMRAs (n = 76, 81.7%). However, many barriers emerged, mainly related to limited funding (n = 49, 76.6%), lack of training and knowledge (n = 38, 59.4%), and resource constraints (n = 37, 54.4%). Future needs identified matched these barriers. Conclusion This survey provides novel insight into occupational therapists’ perspectives on WMRAs. It highlights that health professionals need to have easier access to funding, formal training, and resources to support their involvement with WMRAs. Implications for rehabilitation Most occupational therapists are interested in working with WMRAs, considering the potential of these devices to support individuals with upper extremity impairments in their daily activities. They also recognise their unique contribution to the assessment, recommendation, and implementation process among multidisciplinary teams. WMRA recommendation is relevant in various clinical settings and with a wide range of client populations. Nevertheless, it appears that occupational therapists working with adults, in rehabilitation centres or specialised clinics, may have more opportunities to get involved in this process and to attend formal training on this technology, as compared to other settings. Many barriers remain, impeding occupational therapists’ role in the recommendation and implementation of WMRAs. Addressing these barriers may increase the number of devices that are successfully adopted and utilised by individuals with upper extremity impairments. In particular, future research and health policies should focus on access to sufficient funding, formal training, and resources for occupational therapists relative to their role in recommending and implementing WMRAs.

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CitationsShowing 4 of 4 papers
  • Open Access Icon
  • Research Article
  • 10.1080/17483107.2025.2477679
Social impact of the JACO wheelchair-mounted robotic arm on users and their caregivers
  • Mar 14, 2025
  • Disability and Rehabilitation: Assistive Technology
  • Orthelo Léonel Gbètoho Atigossou + 6 more

Purpose The efficacious implementation of robotic assistive technologies must be built on a thorough understanding of the experiences and perceptions of all concerned interest groups, particularly those of users and their caregivers. This study provides an in-depth insight into the experiences and perceptions of users of the JACO wheelchair-mounted robotic arm and those of their caregivers. Methods Users of JACO (n = 21; Female: 6; Male: 15) and caregivers (n = 11; Female: 9; Male: 2) participated in individual interviews used to gain qualitative insight into the impact of JACO on their day-to-day lives. Interview transcripts were analyzed using a hybrid deductive-inductive coding process. Thematic analysis was conducted in accordance with the Consortium on Assistive Technology Outcomes Research (CATOR) taxonomy. This article exclusively reports data on the social impact of the JACO wheelchair-mounted robotic arm. In addition, participants completed three questionnaires to gather more objective data for quantitative assessment. These included the Caregiver Assistive Technology Outcome Measure (CATOM), a sociodemographic questionnaire, and a home-based questionnaire to assess the social impact of using JACO. Results Findings pointed to highly varied experiences among participants, including instances of positive, negative, and absence of effects from the use of JACO. Participants’ feedback fell within two broad categories, Human Assistance, and Cost and Use of Resources. Conclusion This study provides nuanced and varied insight into the spectrum of the social impact of using JACO as perceived by users and their caregivers, highlighting the importance of considering each user as an individual with unique experiences and needs.

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  • Research Article
  • Cite Count Icon 9
  • 10.1080/10400435.2023.2219294
The experiences and perceptions of health-care professionals regarding assistive technology training: A systematic review
  • Jun 29, 2023
  • Assistive technology : the official journal of RESNA
  • Sharon Manship + 5 more

ABSTRACT Worldwide, there is an increasing demand for assistive technologies (ATs) that can support people to live independently for longer. Health-care professionals (HCPs) often recommend AT devices, however there exists a lack of availability of devices and appropriate training in the field. This systematic review aimed to synthesize the available evidence into the experiences and training needs of HCPs in relation to AT. Six electronic databases were searched without date restrictions: MEDLINE, PsycINFO, SPP, SSCI, CINAHL, and ASSIA. Journal handsearching, searching reference lists of included studies and relevant reviews, and contacting experts in the field of AT were also conducted. Findings were analyzed using narrative synthesis. Data from 7846 participants from 62 studies were synthesized, eliciting perceived challenges in access to and provision of training, resulting in knowledge gaps across disciplines and geographic locations. Mechanisms to mitigate these issues included ongoing support following training and tailoring education to meet individual needs since comprehensive training is essential to maintain and improve competence, knowledge, and confidence. Further research is required to explore the impact and effectiveness of AT training for HCPs to ensure that users of devices are supported to live independent and healthy lives.

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  • 10.1007/s12369-025-01242-5
Healthcare Robotics Control for Upper Limb Paralysis in Neuromuscular Diseases: User-Centered Design for Responsible Technology Development
  • Apr 15, 2025
  • International Journal of Social Robotics
  • Felix Tirschmann + 9 more

Abstract Neuromuscular diseases (NMDs) result in a progressive loss of motor functions and necessitate a wide range of technological aids to help paralyzed patients perform activities of daily living. A requirements analysis revealed that robotic assistance possesses the potential to exert a significant impact on the quality of life for NMD patients. Nevertheless, patients may experience major difficulties executing and steering robot actions. Consequently, a manufacturer-independent robot control system was developed to support patient care with an intuitive graphical user interface. The clinical characteristics of the potential users highlight the paradigmatic character of this vulnerable group for robotic assistance as evidenced during the development stages of the requirements analysis, in interim and final evaluations, as well as for the empirical identification of ethical and social implications. Under the restrictive conditions of the COVID-19 pandemic, a remote control approach offered the technical solution to conduct studies with NMD patients, while protecting them from infection risks. Research and development for robotic assistance promise to positively impact on severely physically disabled patients and their caregivers.

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  • Cite Count Icon 1
  • 10.1080/09638288.2024.2375056
Clinician perceptions of a novel wearable robotic hand orthosis for post-stroke hemiparesis
  • Jul 8, 2024
  • Disability and Rehabilitation
  • Lauren Winterbottom + 5 more

Purpose Wearable robotic devices are currently being developed to improve upper limb function for individuals with hemiparesis after stroke. Incorporating the views of clinicians during the development of new technologies can help ensure that end products meet clinical needs and can be adopted for patient care. Methods In this cross-sectional mixed-methods study, an anonymous online survey was used to gather clinicians’ perceptions of a wearable robotic hand orthosis for post-stroke hemiparesis. Participants were asked about their clinical experience and provided feedback on the prototype device after viewing a video. Results 154 participants completed the survey. Only 18.8% had previous experience with robotic technology. The majority of participants (64.9%) reported that they would use the device for both rehabilitative and assistive purposes. Participants perceived that the device could be used in supervised clinical settings with all phases of stroke. Participants also indicated a need for insurance coverage and quick setup time. Conclusions Engaging clinicians early in the design process can help guide the development of wearable robotic devices. Both rehabilitative and assistive functions are valued by clinicians and should be considered during device development. Future research is needed to understand a broader set of stakeholders’ perspectives on utility and design.

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  • Disability and Rehabilitation: Assistive Technology
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  • Disability and Rehabilitation: Assistive Technology
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Collaboration between occupational therapists and family caregivers is essential during home assessments and modifications. The shift to videoconferencing-based assessments suggests increased family caregiver involvement, but the specifics of this change are unclear. To investigate family caregiver involvement during videoconferencing-based home assessments and subsequent modifications from the perspective of occupational therapists. This descriptive qualitative study involved virtual, semistructured individual interviews with participants who were recruited through purposeful and snowball sampling. Data analysis followed a descriptive thematic analysis methodology with an inductive approach. All interviews were conducted virtually at each participant's preferred time and location. Fifteen occupational therapists from the Veterans Health Administration (VHA) with experience in videoconferencing-based home assessments and subsequent modifications for rural veterans. Four key themes were identified: (1) increased active involvement of family caregivers during the home assessment process, (2) circumstances that require family caregiver involvement for videoconferencing, (3) family caregiver-related factors affecting outcomes, and (4) strategies for effective family caregiver involvement. The findings suggest that veterans' family caregivers play a more active role during videoconferencing-based home assessments than they do during traditional in-person assessments. This increased involvement may lead to a higher workload for VHA occupational therapists, who should now train caregivers, and for family caregivers themselves, who need to perform tasks previously handled by occupational therapists during home visits. To address this challenge, occupational therapists can leverage the insights extracted from this study. Plain-Language Summary: Occupational therapists often collaborate with family caregivers to assess the safety and accessibility of clients in their homes, recommending changes to the home environment accordingly. However, occupational therapy practitioners do not fully understand how much family caregivers are involved in videoconferencing-based home assessments, which is a new remote method, and subsequent modifications to client interventions. In this study, we explored, through interviews with 15 occupational therapists from the Veterans Health Administration (VHA), how family caregivers are involved in videoconferencing-based home assessments and subsequent modifications that are made to client interventions. We found that family caregivers have a greater responsibility for additional tasks during videoconferencing compared with traditional in-person assessments, including conducting measurements typically handled by occupational therapists. This understanding will help VHA occupational therapists adjust their practices to improve service delivery and reduce the workload for both occupational therapists and family caregivers.

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Objective: The Comprehensive ICF Core Set for Multiple Sclerosis (MS) is an application of the International Classification of Functioning, Disability and Health (ICF) and represents the typical spectrum of problems in functioning of People with MS (PwMS). The objective of this study was to validate this ICF Core Set from the perspective of occupational therapists (OTs). Method: In a three-round Delphi study, OTs were asked about problems and resources of PwMS, as well as environmental aspects treated by OTs. Statements were linked to the ICF and compared with the categories included in the Comprehensive ICF Core Set for MS. Results: Sixty-one OTs from 21 countries agreed on 71 categories that are included in the Comprehensive ICF Core Set for MS (19 Body Functions, 40 categories of Activities and Participation, 12 Environmental Factors). Eleven ICF categories were identified as not-yet-included ICF categories in the Comprehensive ICF Core Set for MS (6 Body Functions, 2 categories of Activities and Participation, 3 Environmental Factors). Conclusion: This study contributes to the validity of the ICF categories included in the Comprehensive ICF Core Set. It outlines which areas of functioning and health are relevant for PwMS from the perspective of OTs and consequently should be assessed.

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