Mobility Assistance Research Articles

The i-Walk Lightweight Assistive Rollator: First Evaluation Study.

Robots can play a significant role as assistive devices for people with movement impairment and mild cognitive deficit. In this paper we present an overview of the lightweight i-Walk intelligent robotic rollator, which offers cognitive and mobility assistance to the elderly and to people with light to moderate mobility impairment. The utility, usability, safety and technical performance of the device is investigated through a clinical study, which took place at a rehabilitation center in Greece involving real patients with mild to moderate cognitive and mobility impairment. This first evaluation study comprised a set of scenarios in a number of pre-defined use cases, including physical rehabilitation exercises, as well as mobility and ambulation involved in typical daily living activities of the patients. The design and implementation of this study is discussed in detail, along with the obtained results, which include both an objective and a subjective evaluation of the system operation, based on a set of technical performance measures and a validated questionnaire for the analysis of qualitative data, respectively. The study shows that the technical modules performed satisfactory under real conditions, and that the users generally hold very positive views of the platform, considering it safe and reliable.

Design and evaluation of the Afari: A three-wheeled mobility and balance support device for outdoor exercise

ABSTRACT This article presents the engineering design and preliminary testing of the AfariTM mobility device and the integrated IntracTM activity tracking system. The patented Afari design is a three-wheeled device that assists users of any age with mobility impairments with outdoor exercise and movement in various environments and surfaces. We devised methods for testing of the Afari to ensure safe and flexible mobility assistance and demonstrated a high level of stability and structural integrity suitable for vigorous outdoor exercise. A smartphone-based sensing system, the Intrac, was designed for and integrated with the Afari to monitor the user’s interaction forces and important gait parameters. The Intrac offers a graphical user interface for displaying and sharing measurements with users and providers, and the accuracy of its measurements was validated by testing its individual components. A preliminary subject study showed that the participants could use the Afari for various levels of weight compensation during walking, while the Intrac enabled the measurement of interactive forces on their arms and key gait parameters. The results demonstrate the potential of the Afari and Intrac to provide a safe walking experience in a variety of terrains and continuously monitor users’ gait.

Ensemble Learning Based Brain–Computer Interface System for Ground Vehicle Control

This article establishes a novel electroencephalograph (EEG)-based brain-computer interface (BCI) system for ground vehicle control with potential application of mobility assistance to the disabled. To enable an intuitive motor imagery (MI) paradigm of “left,” “right,” “push,” and “pull,” a driving simulator based EEG data recording and automatic labeling platform is built for dataset making. In the preprocessing stage, a wavelet and canonical correlation analysis (CCA) combined method is used for artifact removal and improving signal-to-noise ratio. An ensemble learning based training and testing framework is proposed for MI EEG data classification. The average classification accuracy of proposed framework is about 91.75%. This approach essentially takes advantage of the common spatial pattern (CSP) with ability of extracting the feature of event-related potentials and the convolutional neural networks (CNNs) with powerful capacity of feature learning and classification. To convert the classification results of EEG data segments into motion control signals of ground vehicle, shared control strategy is used to realize the control command of “left-steering,” “right-steering,” “acceleration,” and “stop” considering collision avoidance with obstacles detected by a single-line LIDAR. The online experimental results on a model vehicle platform validate the significant performance of the established BCI system and reveal the application potential of BCI on the vehicle control and automation.

Multidimensional Effects of Solid and Hinged Ankle-Foot Orthosis in Children With Cerebral Palsy.

To compare the effect of solid (SAFO) and hinged (HAFO) ankle-foot orthoses in children with cerebral palsy spastic diplegia and true equinus and jump gait. Participants were 26 children (13 wore SAFO and 13 wore HAFO) aged 4 to 14 years classified as Gross Motor Function Classification System levels I to III. Children were tested on standardized measures of body structure and function, activity, and participation. Children wearing HAFO reached further in standing than those wearing SAFO. Among children who walked without an assistive device, children wearing HAFO had greater stride length and faster velocity. Mean Gross Motor Function Measure and Pediatric Evaluation of Disability Inventory mobility scores did not differ between groups. The cost-to-benefit ratios showed parents preferred HAFO. Among children with true equinus and jump gait, the effects of HAFO were greater in children who walked without an assistive mobility device.

A Modular Mobile Robotic Platform to Assist People with Different Degrees of Disability

Robotics to support elderly people in living independently and to assist disabled people in carrying out the activities of daily living independently have demonstrated good results. Basically, there are two approaches: one of them is based on mobile robot assistants, such as Care-O-bot, PR2, and Tiago, among others; the other one is the use of an external robotic arm or a robotic exoskeleton fixed or mounted on a wheelchair. In this paper, a modular mobile robotic platform to assist moderately and severely impaired people based on an upper limb robotic exoskeleton mounted on a robotized wheel chair is presented. This mobile robotic platform can be customized for each user’s needs by exploiting its modularity. Finally, experimental results in a simulated home environment with a living room and a kitchen area, in order to simulate the interaction of the user with different elements of a home, are presented. In this experiment, a subject suffering from multiple sclerosis performed different activities of daily living (ADLs) using the platform in front of a group of clinicians composed of nurses, doctors, and occupational therapists. After that, the subject and the clinicians replied to a usability questionnaire. The results were quite good, but two key factors arose that need to be improved: the complexity and the cumbersome aspect of the platform.

Mobility Assistance for People With Cognitive Disabilities: Identifying Implementation Outcomes and Strategies of Innovative Technology

Abstract Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. The Mobility Assistance for People with Cognitive Disabilities (MAPCD) program, including the WayFinder 3 assistive smartphone navigation app and training program, addresses barriers to community mobility and provides supports to both individuals with cognitive deficits and their caregivers. We describe the MAPCD program and examine strategies that facilitated the adoption of the WayFinder 3 app designed to optimize independent community mobility. Primary Author and Speaker: Sarah E. Anderson Additional Authors and Speakers: Lisa Juckett Contributing Authors: Carmen DiGiovine, Sandra A. Metzler, Ashley Stojkov, Bethany Frick, Kaetlyn E. Culter, and Elizabeth Mance

Epilepsy Personal Assistant Device-A Mobile Platform for Brain State, Dense Behavioral and Physiology Tracking and Controlling Adaptive Stimulation.

Epilepsy is one of the most common neurological disorders, and it affects almost 1% of the population worldwide. Many people living with epilepsy continue to have seizures despite anti-epileptic medication therapy, surgical treatments, and neuromodulation therapy. The unpredictability of seizures is one of the most disabling aspects of epilepsy. Furthermore, epilepsy is associated with sleep, cognitive, and psychiatric comorbidities, which significantly impact the quality of life. Seizure predictions could potentially be used to adjust neuromodulation therapy to prevent the onset of a seizure and empower patients to avoid sensitive activities during high-risk periods. Long-term objective data is needed to provide a clearer view of brain electrical activity and an objective measure of the efficacy of therapeutic measures for optimal epilepsy care. While neuromodulation devices offer the potential for acquiring long-term data, available devices provide very little information regarding brain activity and therapy effectiveness. Also, seizure diaries kept by patients or caregivers are subjective and have been shown to be unreliable, in particular for patients with memory-impairing seizures. This paper describes the design, architecture, and development of the Mayo Epilepsy Personal Assistant Device (EPAD). The EPAD has bi-directional connectivity to the implanted investigational Medtronic Summit RC+STM device to implement intracranial EEG and physiological monitoring, processing, and control of the overall system and wearable devices streaming physiological time-series signals. In order to mitigate risk and comply with regulatory requirements, we developed a Quality Management System (QMS) to define the development process of the EPAD system, including Risk Analysis, Verification, Validation, and protocol mitigations. Extensive verification and validation testing were performed on thirteen canines and benchtop systems. The system is now under a first-in-human trial as part of the US FDA Investigational Device Exemption given in 2018 to study modulated responsive and predictive stimulation using the Mayo EPAD system and investigational Medtronic Summit RC+STM in ten patients with non-resectable dominant or bilateral mesial temporal lobe epilepsy. The EPAD system coupled with an implanted device capable of EEG telemetry represents a next-generation solution to optimizing neuromodulation therapy.

EXTENDING PRODUCT FAMILY DESIGN METHODS TO PRODUCT-SERVICE-SYSTEM FAMILY DESIGN

AbstractAlthough product family design methods are well established, little research has focused on Product-Service-System (PSS) family design. A PSS family design method is proposed in this paper that parallels methodology for designing product families. Separate platforms are proposed for products and for services. However, couplings between product and service platforms are identified and incorporated into the design method. Design problem formulations are proposed for PSS family platforms and for the PSS family itself, using a module-based approach, in contrast to a platform scaling approach. Alternative methods are investigated and compared for solving these problems. The application domain of Assistive Mobility (AM) is identified as a promising PSS family in this work. If smart technologies are integrated into AM devices, such as manual wheelchairs, powered wheelchairs, walkers, and rollators, then patient diagnosis and treatment, as well as device maintenance, services are enabled with these smart technologies, demonstrating that smart AM devices are a promising PSS family.

The mobile assistance for regulating smoking (MARS) micro-randomized trial design protocol

Smoking is the leading preventable cause of death and disability in the U.S. Empirical evidence suggests that engaging in evidence-based self-regulatory strategies (e.g., behavioral substitution, mindful attention) can improve smokers' ability to resist craving and build self-regulatory skills. However, poor engagement represents a major barrier to maximizing the impact of self-regulatory strategies. This paper describes the protocol for Mobile Assistance for Regulating Smoking (MARS) – a research study designed to inform the development of a mobile health (mHealth) intervention for promoting real-time, real-world engagement in evidence-based self-regulatory strategies. The study will employ a 10-day Micro-Randomized Trial (MRT) enrolling 112 smokers attempting to quit. Utilizing a mobile smoking cessation app, the MRT will randomize each individual multiple times per day to either: (a) no intervention prompt; (b) a prompt recommending brief (low effort) cognitive and/or behavioral self-regulatory strategies; or (c) a prompt recommending more effortful cognitive or mindfulness-based strategies. Prompts will be delivered via push notifications from the MARS mobile app. The goal is to investigate whether, what type of, and under what conditions prompting the individual to engage in self-regulatory strategies increases engagement. The results will build the empirical foundation necessary to develop a mHealth intervention that effectively utilizes intensive longitudinal self-report and sensor-based assessments of emotions, context and other factors to engage an individual in the type of self-regulatory activity that would be most beneficial given their real-time, real-world circumstances. This type of mHealth intervention holds enormous potential to expand the reach and impact of smoking cessation treatments.

A policy review of electric personal assistive mobility devices

This paper reviewed the existing policy implemented to operate Electric Personal Assistive Mobility Device (EPAMD) on roadways, walkways, or sidewalks. The study examined the transportation policy of EPAMD for about 30 countries in the world, 50 states, and the District of Columbia in the U.S.A. The review focused on rules, regulations, and legislative issues related to EPAMD from diverse sources, including government websites and journal articles. The paper identified the gap(s) in the current policies and recommended changes to integrate and safely operate EPAMDs in the transportation system. The outcomes of this research will help the transportation agencies and policymakers to propose and implement the necessary rules and legislation for EPAMDs to improve the operations and safety of all road users.

Mobility Assistants to Support Multi-Modal Routes in Smart Cities: A Scoping Review

Objectives - This study aimed to identify: (i) the current research trends related to mobility assistants to support multi-modal routes in smart cities; (ii) the types of smart cities’ data being used; (iii) the methods applied to assess the proposed solutions; and iv) the major barriers for their dissemination. Methods - An electronic search was conducted in several databases, combining relevant keywords. Then titles and abstracts were screened against inclusion and exclusion criteria. Finally, the full texts of the eligible articles were retrieved and screened for inclusion. Results - A total of 19 articles were included. These articles either propose algorithms to optimize routes planning or presenting specific applications that make use of a broad range of smart cities’ data. Conclusion - The number of included articles is very reduced when compared with the total number of articles related to smart cities, which means that the mobility assistants to support multi-modal routes are still not significant within the smart cities’ research. Moreover, most of the included articles report applications in an early stage of development, which is a major barrier for the respective dissemination.

Biomechanical analysis of an unpowered hip flexion orthosis on individuals with and without multiple sclerosis

BackgroundGait impairment is a common complication of multiple sclerosis (MS). Gait limitations such as limited hip flexion, foot drop, and knee hyperextension often require external devices like crutches, canes, and orthoses. The effects of mobility-assistive technologies (MATs) prescribed to people with MS are not well understood, and current devices do not cater to the specific needs of these individuals. To address this, a passive unilateral hip flexion-assisting orthosis (HFO) was developed that uses resistance bands spanning the hip joint to redirect energy in the gait cycle. The purpose of this study was to investigate the short-term effects of the HFO on gait mechanics and muscle activation for people with and without MS. We hypothesized that (1) hip flexion would increase in the limb wearing the device, and (2) that muscle activity would increase in hip extensors, and decrease in hip flexors and plantar flexors.MethodsFive healthy subjects and five subjects with MS walked for minute-long sessions with the device using three different levels of band stiffness. We analyzed peak hip flexion and extension angles, lower limb joint work, and muscle activity in eight muscles on the lower limbs and trunk. Single-subjects analysis was used due to inter-subject variability.ResultsFor subjects with MS, the HFO caused an increase in peak hip flexion angle and a decrease in peak hip extension angle, confirming our first hypothesis. Healthy subjects showed less pronounced kinematic changes when using the device. Power generated at the hip was increased in most subjects while using the HFO. The second hypothesis was not confirmed, as muscle activity showed inconsistent results, however several subjects demonstrated increased hip extensor and trunk muscle activity with the HFO.ConclusionsThis exploratory study showed that the HFO was well-tolerated by healthy subjects and subjects with MS, and that it promoted more normative kinematics at the hip for those with MS. Future studies with longer exposure to the HFO and personalized assistance parameters are needed to understand the efficacy of the HFO for mobility assistance and rehabilitation for people with MS.

Can we get them moving? The impact of mobility assistance on cross‐country migration of young adults in Europe

AbstractCross‐country migration in Europe can have multiple advantages. Among others, it can function as a buffer against economic downturns that come along with inferior employment and education opportunities, especially for young adults. However, cross‐country mobility of young adults in Europe remains low, as language barriers, the loss of social ties or cultural differences create obstacles for migration. Against this background, Germany has launched a mobility assistance programme that supports young adults from EU member states who wish to enter the dual education system in Germany. To assess the causal impact of this programme, we compare migration flows to Germany from participating and non‐participating countries in a difference‐in‐differences framework. Our results reveal a substantial programme effect that is larger for countries with above‐average youth unemployment rates. These results add to previous migration research and reveal that migration flows are indeed sensitive to policy initiatives aimed at increasing migration.

Clothoidal Local Path Template for Intention Estimation by Assistive Mobile Robots

This work proposes and evaluates various improvements to a circular local path template (LPT) that we have designed in the past to estimate driver intents and to provide navigation assistance to wheelchair drivers. This LPT may also be useful in other mobile robotics applications such as for intuitive teleoperated control, for fast collision checking in path planning or for obstacle avoidance algorithms. The LPT consists of a large but fixed set of paths in the mobile robot’s local neighborhood. Based on an efficient look-up table, the LPT paths’ lengths are adjusted such that they are collisionfree. However, experiments have shown that in dense environments insufficient circular paths are found, which impedes correct intention estimation and thus navigation assistance. In this work, the use of clothoidal paths rather than circular paths is evaluated. This substantially improves the capability to find complex paths in dense areas. Furthermore, we adapt the LPT to deal with dynamic obstacles of random shape using motion prediction estimates of these objects.

Project based Engineering Graphics Instruction in a Content and Language Integrated Flipped Classroom

Objectives: To enhance the first-year engineering students’ conceptual understanding of Basic Engineering Graphics. Methods: The mixed research was observational and unpaired; it was done during January 2020, as an interdisciplinary collaborative project between the departments of English and Mechanical Engineering. It involved two English language teachers, two mechanical engineering teachers, and seventy-first year B.Tech students of Dr. MGR Educational and Research Institute, Chennai. A pilot survey helped teachers understand students’ difficulties in learning Engineering Graphics; so different approaches like the bilingual, content and language integrated learning and the project-based content instruction with videos and Flipped learning through mobile assistance were introduced. Students watched videos on isometric projections and drawings in their mobile phones. They checked their understanding of them with the text book reading in peer company. The classrooms were utilised for peer discussions and teachers’ clarifications. Findings: The project as a group activity offered scope for peer interaction that the students were cognitively stimulated for better understanding of isometric projections. A post evaluation of the drawings, presentation by the students and a post interview found the bilingual and Content and Language Integrated Learning approach has stimulated the cognition of the net-generation learners while exploiting their interest in the mobile phones through flipped classroom. The process of learning exemplified the principle of cooperative learning among students and the cooperative work of teachers of different disciplines (i.e.) subject and language teachers. Novelty/Applications: Teaching engineering graphics with the assistance of language teachers and in a flipped classroom was a novel approach. Keywords: Engineering graphics; isometric projections; content and language integrated learning; Flipped learning

Virtual Landmark-Based Control of Docking Support for Assistive Mobility Devices

This work proposes an autonomous docking control for nonholonomic constrained mobile robots and applies it to an intelligent mobility device or wheelchair for assisting the user in approaching resting furniture such as a chair or a bed. We defined a virtual landmark inferred from the target docking destination. Then, we solve the problem of keeping the targeted volume inside the field of view (FOV) of a tracking camera and docking to the virtual landmark through a novel definition that enables to control for the desired end-pose. In this article, we proposed a nonlinear feedback controller to perform the docking with the depth camera's FOV as a constraint. Then, a numerical method is proposed to find the feasible space of initial states where convergence could be guaranteed. Finally, the entire system was embedded for real-time operation on a standing wheelchair with the virtual landmark estimation by 3D object tracking with an RGB-D camera and we validated the effectiveness in simulation and experimental evaluations. The results show the guaranteed convergence for the feasible space depending on the virtual landmark location. In the implementation, the robot converges to the virtual landmark while respecting the FOV constraints.

Effects of a powered mobility summer camp as perceived by school staff: a qualitative study

Purpose Powered mobility has a positive effect on social skills, self-esteem and overall development of children with motor impairments, but almost all previous studies were conducted with pre-school children. The aim of this study was to explore change beyond mobility following a therapeutic powered mobility summer camp for school-aged children and adolescents with severe cerebral palsy, as perceived by school staff. Materials and methods The participants in the therapeutic camp, which ran for 3 weeks, 5 days a week, three times over the summers 2018–2019, were children ages 7–19 (median age 11) with severe cerebral palsy who needed assistance in mobility and had limited hand function. Following the intervention, 19 semi-structured audio-recorded interviews were conducted with school staff, then transcribed and thematically analyzed using an inductive qualitative descriptive design with a phenomenological theoretical framework. Results Four overarching themes were identified: (1) “Every step you take: mastering new, sometimes unexpected, skills”, (2) “Break on through to the other side: changes in behaviour”, (3) “Make new friends (but keep the old): Boosting social behaviour” and (4) “I’m a believer: The journey through self-efficacy to empowerment”. Conclusions The interviews showed the immediate positive influence of powered mobility for children who previously did not have independent mobility, following an intensive intervention. Changes in initiative, empowerment, social relationships and behaviour highlight the importance of self-generated mobility, regardless of whether independence was achieved. School-aged children with severe cerebral palsy seem to benefit from an intensive powered mobility intervention in areas other than mobility skills themselves. IMPLICATIONS FOR REHABILITATION Powered mobility intervention seems to encourage activity and initiation among children and youth with severe CP. This research adds to the understanding of the effect powered mobility can have on social interaction and communication. Powered mobility might be a means to allow development, in addition to being an important end.

Context-aware Target Apps Selection and Recommendation for Enhancing Personal Mobile Assistants

Users install many apps on their smartphones, raising issues related to information overload for users and resource management for devices. Moreover, the recent increase in the use of personal assistants has made mobile devices even more pervasive in users’ lives. This article addresses two research problems that are vital for developing effective personal mobile assistants: target apps selection and recommendation . The former is the key component of a unified mobile search system: a system that addresses the users’ information needs for all the apps installed on their devices with a unified mode of access. The latter, instead, predicts the next apps that the users would want to launch. Here we focus on context-aware models to leverage the rich contextual information available to mobile devices. We design an in situ study to collect thousands of mobile queries enriched with mobile sensor data (now publicly available for research purposes). With the aid of this dataset, we study the user behavior in the context of these tasks and propose a family of context-aware neural models that take into account the sequential, temporal, and personal behavior of users. We study several state-of-the-art models and show that the proposed models significantly outperform the baselines.

Voice in Human–Agent Interaction

Social robots, conversational agents, voice assistants, and other embodied AI are increasingly a feature of everyday life. What connects these various types of intelligent agents is their ability to interact with people through voice. Voice is becoming an essential modality of embodiment, communication, and interaction between computer-based agents and end-users. This survey presents a meta-synthesis on agent voice in the design and experience of agents from a human-centered perspective: voice-based human–agent interaction (vHAI). Findings emphasize the social role of voice in HAI as well as circumscribe a relationship between agent voice and body, corresponding to human models of social psychology and cognition. Additionally, changes in perceptions of and reactions to agent voice over time reveals a generational shift coinciding with the commercial proliferation of mobile voice assistants. The main contributions of this work are a vHAI classification framework for voice across various agent forms, contexts, and user groups, a critical analysis grounded in key theories, and an identification of future directions for the oncoming wave of vocal machines.

Digital and Economic Determinants of Healthcare in the Crisis-Affected Population in Afghanistan: Access to Mobile Phone and Socioeconomic Barriers.

Despite recent progress in Afghanistan’s health system from the support of international donors and NGOs, protracted conflicts combined with a series of natural disasters have continued to present substantial health risks. Extreme poverty has still aggravated social determinants of health and financial barriers to healthcare. Little is known about the context-specific factors influencing access to healthcare in the crisis-affected population. Using a subset of data from ‘Whole of Afghanistan Assessment (WoAA) 2019’, this study analyzed 31,343 households’ data, which was collected between 17 July and 19 September 2019 throughout all 34 provinces in Afghanistan. The outcome measured was access to care in the healthcare facility, and multivariable binary logistic regression models were used to identify the specific factors associated with access to healthcare. Of 31,343 households exposed to complex emergencies in Afghanistan, 10,057 (32.1%) could not access healthcare facilities when one was needed in last three months. The access to healthcare was significantly associated with displacement status, economic factors such as employment status or total monthly income, and the distance to healthcare facilities. Significant increase in healthcare access was associated with factors related to communication and access to information, such as awareness of humanitarian assistance availability and mobile phone with a SIM card, while disability in cognitive function, such as memory or concentration, was associated with poorer healthcare access. Our findings indicate that the crisis-affected population remains vulnerable in access to healthcare, despite the recent improvements in health sectors. Digital determinants, such as access to mobile phone, need to be addressed along with the healthcare barriers related to poverty and household vulnerabilities. The innovative humanitarian financing system using mobile communication and cash transfer programs would be considerable for the conflict-affected but digitally connected population in Afghanistan.