There are no existing guidelines for healthcare teams to evaluate rehabilitation technology and maximize its use in neurologic rehabilitation. By incorporating rehabilitation technologies into neurorehabilitation, therapists can bridge the gap between research and feasible client-centered interventions. Technology use can facilitate evidence-based practice that reflects recent trends in neurorehabilitation. Integration of rehabilitation technology is heavily dependent on the consideration of the barriers to technological adoption at both the organizational level and clinical level. The purpose of this commentary is to describe a theory-driven, systematic process with consideration of facilitators and barriers to technological uptake in neurorehabilitation. This process considers the views of multiple stakeholders to evaluate technology in rehabilitation and make cost-effective decisions, maximize available interventions, prevent technological abandonment, and integrate evidenced-based interventions for neurorehabilitation best practice.

The entitlement to access assistive technology (AT) is fundamental for all individuals. However, challenges encountered during societal crises can significantly impact opportunities for participation and engagement among AT users. Understanding the implications of crises and disasters on AT provision along with their repercussions for end users is crucial. This research endeavors to investigate the experiences of managers overseeing AT provision during crises, using the first wave of the COVID-19 pandemic as a case study. An open-ended questionnaire was distributed to health care managers (n = 18) within AT organizations in Sweden. The responses were analyzed using qualitative content analysis, and four categories derived: Embracing change and navigating new realities, Optimizing strategies due to decreased and limiting prescriptions, Unlocking access and addressing challenges in AT provision, The impact on the staff and their well-being vs effectiveness in the AT organization. The findings indicate that AT organizations have demonstrated remarkable resilience and adaptability in the face of reduced consultations and growing care burden. Despite these challenges, managers have gained valuable insights into developing AT provision more efficiently and sustainably, particularly in digitization. The lessons learned will be critical in ensuring AT provision remains responsive to the needs of patients and society in the future.

ABSTRACT 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.

ABSTRACT Camera Mouse is a freely available software program that visually tracks the movement of facial features to allow individuals with motor impairments to control a computer mouse. The goal of this case study was to provide an evaluation of Camera Mouse as a computer access method as part of a multiple modality communication system for an individual with cerebral palsy. The participant was asked to reproduce sentences and respond to ethical dilemmas for language sampling. Tasks were completed using natural speech and an AAC solution consisting of Camera Mouse paired with an orthographic selection interface and speech synthesis. The participant completed a questionnaire for satisfaction with the introduced assistive technology. Camera Mouse resulted in higher intelligibility than natural speech, while natural speech had a higher rate. She used more complex language with her natural speech. The participant rated Camera Mouse as at least 3/5 on all measures, including 5/5 on weight and safety. The results of this case study suggest Camera Mouse is a promising computer access system for communication supported by the participant’s satisfaction rating, expressive language, and synthesized speech production capabilities.

ABSTRACT 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.

ABSTRACT Crutches are the most prescribed ambulatory assistive device and are used for mobility and maintaining weight-bearing restrictions after injury or surgery. However, standard axillary crutches (SACs) can lead to overuse and other injuries and restrict upper limb movement. Hands-free crutches (HFC) do not restrict upper limb movement but their effect on balance control, with or without commonly prescribed walking boots, is poorly understood. The purpose of this study was to compare the effect of crutch type (SACs vs. HFC) and boot use on whole-body angular momentum (RAM), a measure of balance control. Participant’s balance confidence, pain, comfort, and device preference were assessed. Seventeen participants were evaluated while walking without a crutch (NONE), with SACs, and with an HFC, and walked with and without a walking boot in each crutch condition. The gait pattern used with SACs resulted in significantly greater limb angular velocity (p < .05), and an 84% increase in RAM (p < .001) as compared to the HFC. There were no differences between the SAC and HFC for balance confidence, pain, or comfort, however most (71.1%) participants preferred the HFCs. These results suggest that individuals can better control angular momentum with the HFCs and thus may be less susceptible to loss of balance.

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.

ABSTRACT To support effective alternative access assessment and service delivery for people with motor impairments, we are developing an app called Access Navigator. This paper describes the first stage of the project: the interviews we conducted as part of a discovery process to improve our understanding of user needs. We individually interviewed 8 assistive technology practitioners and 3 clients who use alternative access methods, to learn what practitioners were currently doing in their access assessments, identify opportunities for improving current practice, and understand what the assessment process was like for clients. We extracted 236 relevant quotes from interview transcripts, and clustered the quotes using the affinity wall method, yielding 42 themes. Here we present the 21 highest priority themes, along with the app requirements that support those themes. Results confirmed the need for a tool to support more effective assessments, with emphasis on taking the worry out of access assessments and supporting early success. Results also revealed specific needs such as flexible workflow, personalized test-drive tasks, and a choice of metrics (including client preference). With a richer understanding of user needs, we are in a much better position to design software that can address those needs.

ABSTRACT In the current labor market, assistive technology (AT) is vital to employment for people with blindness or low vision (B/LV), yet we know little about their AT use in the workplace. The purpose of this descriptive study was to increase our knowledge in this area. Participants were 314 employed people with B/LV who completed an online or phone survey about AT used on the job and perceived skill level, satisfaction, and challenges experienced with their workplace AT. Two researchers utilized content analysis to code open-ended responses and descriptive statistics were used to analyze quantitative data. Self-perceived skill levels were moderately high to high for each AT. Satisfaction with AT was generally high, but 15% or more participants expressed dissatisfaction with their AT for five tasks. Dissatisfaction with AT for some work tasks differed noticeably by type of AT being used to accomplish the task. Accessing certain software, websites, or digital documents was the most common challenge experienced, mentioned by 59.1% participants, representing an ongoing problem in the technological workplace environment for people with B/LV. In addition to websites, specific areas that present access or utilization challenges are slide presentation software, PDFs, spreadsheets, virtual meeting software, and printed material.