Assistive Device Users Research Articles

The Indian context: an investigative study of assistive listening device usage and experiences among hearing aid users

Background: Assistive Listening Devices (ALDs) augment the functionality of hearing aids and cochlear implants, facilitating enhanced auditory communication for individuals with hearing impairment and potentially improving their life quality. The limited popularity of ALDs within the Indian context necessitates an investigation into the factors influencing their underutilization. Methods: To address this, a survey assessing ALD awareness among Indian hearing aid users with at least one year of device usage was administered using a questionnaire. A total of 42 responses were collected and subjected to descriptive analysis. Results: The findings of the study revealed a predominant willingness among hearing aid users to discover ALDs and their advantages in daily activities. A segment of the cohort was already conversant with ALDs, whereas a minor fraction showed reluctance towards acquiring additional information. Conclusions: The obtained data indicates a requirement for further comprehensive research with a larger pool of data to understand the breadth of user dispositions and the motivation for the indifferent reception of ALDs in the Indian context.

MHealth devices demonstrate validity and reliability in detecting steps in chronic stroke survivors who rely on assistive devices

PurposeTo assess the concurrent validity and reliability of five mHealth devices (STEPZ, Health, Pacer, Google Fit, and Fitbit Inc.®) in counting steps among individuals with chronic stroke using assistive devices (AD). Our primary objective was to identify significant variations in step counts between AD users and non-users. MethodsIn a cross-sectional study, individuals performed a 2-min walking test while carrying two smartphones (Android OS and iOS) equipped with four different applications (STEPZ, Health, Pacer, and Google Fit), alongside a Fitbit Inc.® device. A visual video recording served as criterion-standard measure for step counting. Each participant completed four walking trials. Two proficient researchers conducted data collection in a controlled environment at a single day. ResultsTwenty-four individuals were included. The devices were valid for individuals in individuals with chronic stroke who used AD (0.52 ≤ r ≥ 0.89), except for Health (iOS). There is no agreement between the criterion-standard and Health (iOS), and all other devices showed adequate reliability (0.107 ≤ CCI [2, 1] ≥ 0.701). There was no difference in stepping counting when the individuals used or not the AD. ConclusionsHealth for iOS is neither valid nor reliable for individuals with chronic stroke who are AD users. There is no difference in step counting were when the individuals with chronic stroke are users or non-users of AD.

Falls in people with mobility limitations: a cross-sectional analysis of a US registry of assistive device users

Purpose of the Article: To (1) summarise the personal and clinical characteristics of persons with disabilities (PwDs) in the US who were evaluated for mobility assistive equipment (MAE) in the functional mobility assessment and uniform dataset (FMA/UDS) and (2) stratify subpopulations of PwD who reported falling versus those who do not report a fall. Materials and Methods: This study was a retrospective, descriptive cohort analysis of adults with disabilities using the FMA/UDS. Data are collected during a user’s initial evaluation for a new mobility device. The sample is intentionally general to be inclusive of all mobility device users. The primary variable of interest was a patient-reported fall within the 3 months leading up to their evaluation for a new mobility device. Subpopulation characteristics were stratified by this binary fall variable. Results and Conclusions: This study provides descriptions of PwDs being evaluated for a new mobility device. There were 11,084 PwDs with 31 different primary diagnoses. During their new mobility device evaluation, 52.2% of PwDs reported at least one fall in the last 3 months. For those who reported a fall, 46.6% of PwDs were using a walking aid or no device at all before the new mobility device evaluation. Additionally, persons with progressively acquired disabilities (i.e., Parkinson’s disease, osteoarthritis and cardiopulmonary disease) reported higher rates of falls than those with congenital disabilities (i.e., cerebral palsy and spina bifida). These findings will influence future studies comparing different types of devices and their influence on falls and user satisfaction.

Assistive device utilization among disabled elderly in China: A cross-sectional study.

This study aimed to examine the characteristics of assistive device users and influencing factors among disabled elderly in China. A total of 13,510 disabled elderly in Sichuan Province were surveyed. Disability was assessed using the Barthel Activities of Daily Living Scale, mental status, sensory perception, and social engagement evaluation. Univariate analysis and logistic regression analysis were employed to identify the impact factors. The prevalence of assistive device utilization among participants was 79.2% (10,700/13,510, 95% CI 78.5%-79.9%), with the wheelchair being the most commonly used device. Various factors were found to influence the usage of the device, including disability level, somatic disability, age, caregivers, income, caregiver fees, and living situation (p<.05). Additionally, several factors were identified associated with the frequency of device usage, such as somatic disability, education background, income, caregiver fees, living situation, access to acquire assistive devices, duration of assistive device usage, education on assistive devices, and satisfaction level (p<.05). The use of assistive devices among elderly individuals in China is prevalent. There are many factors that affect the use of assistive devices, which can provide a reference for the formulation of policies in the field of assistive devices.

Predictors of fall protection motivation among older adults in rural communities in a middle-income country: A cross-sectional study using the Protection Motivation Theory.

To evaluate factors associated with fall protection motivation to engage in fall preventive behaviour among rural community-dwelling older adults aged 55 and above using the protection motivation theory scale. A cross-sectional study. The study was conducted in a healthcare clinic in Malaysia, using multistage random sampling from November 2021 to January 2022. Three hundred seventy-five older adults aged 55 and older were included in the final analysis. There were 31 items in the final PMT scale. The analysis was performed within the whole population and grouped into 'faller' and 'non-faller', employing IBM SPSS version 26.0 for descriptive, independent t-test, chi-square, bivariate correlation and linear regressions. A total of 375 older participants were included in the study. Fallers (n = 82) and non-fallers (n = 293) show statistically significant differences in the characteristics of ethnicity, assistive device users, self-rating of intention and participation in previous fall prevention programmes. The multiple linear regression model revealed fear, coping appraisal and an interaction effect of fear with coping appraisal predicting fall protection motivation among older adults in rural communities. Findings from this study demonstrated that coping appraisal and fear predict the protection motivation of older adults in rural communities. Older adults without a history of falls and attaining higher education had better responses in coping appraisal, contributing to a reduction in perceived rewards and improving protection motivation. Conversely, older adults from lower education backgrounds tend to have higher non-preventive behaviours, leading to a decline in fall protection motivation. These results contribute important information to nurses working with older adults with inadequate health literacy in rural communities, especially when planning and designing fall prevention interventions. The findings would benefit all nurses, healthcare providers, researchers and academicians who provide care for older adults. Participants were briefed about the study, and their consent was obtained. They were only required to answer the questionnaire through interviews. Older individuals aged fifty-five and above in rural communities at the healthcare clinic who could read, write or understand Malay or English were included. Those who were suffering from mental health problems and refused to participate in the study were excluded from the study. Their personal information remained classified and not recorded in the database during the data entry or analysis.

Paretic propulsion changes with handrail Use in individuals post-stroke

BackgroundRoughly 800,000 people experience a stroke every year in the United States, and about 30% of people require walking assistance (walker, cane, etc.) after a stroke. Gait training on a treadmill is a common rehabilitation activity for individuals post-stroke and handrails are typically used to assist with walking during this training, however individual interaction with these handrails are not usually considered and quantitatively reported. Individuals may exert force onto the handrails to aid with propulsive force, but the relationship between limb propulsive force and handrail propulsive force are not known. Research questionHow do individuals post-stroke alter paretic propulsive force when using an assistive device, such as handrails on a treadmill? MethodsTwenty-one individuals post-stroke (eight current assistive device users and thirteen individuals who do not use an assistive device) walked on a treadmill for 3 min during three conditions: no handrail use, light handrail use (<5% BW) and self-selected handrail use. Three multilevel models were used to compare percent handrail, paretic and nonparetic propulsion between handrail conditions and assistive device groups. ResultsThe handrail propulsive impulse was more during the self-selected handrail condition compared to the light handrail condition (p = 0.002). The assistive device use group and the handrail condition fixed effects significantly improved the model fit for paretic propulsive impulse (p = 0.01). The interaction between assistive device use group and handrail condition significantly improved the model fit for nonparetic propulsive impulse (p < 0.001). SignificanceThese results suggest that handrail use may impact paretic propulsive impulse. Our initial results suggest that if the goal of rehabilitation treadmill training is to increase the paretic propulsive impulse, having the clinician encourage walking with the handrails may be optimal to promote paretic propulsion.

Fear of Falling in Older Adults Living in a Community-Dwelling Facility: Prevalence and Its Impact on Activity Behavior and Physical Function.

This study examined the prevalence and the impact of fear of falling (FOF) on physical activity (PA), sedentary behavior (PA), and physical function in older adults living in a continuing care retirement community (CCRC). Ninety-three older adults were included and self-reported assessed on PA and SB. Further, participants' physical function was assessed using a collection of measures of valid objective tests. Independent t test was used to compare the dependent variables between FOF groups, and analysis of covariance (ANCOVA) was used to control for assistive device usage. FOF was prevalent in 47.3% of the sample and PA and SB did not differ between FOF groups (p > .05). ANCOVA revealed that performance on several physical function tests remained significantly better (p < .05) for the no FOF group compared to the yes group. Our findings demonstrated similar levels of PA and SB between FOF groups, but worse physical function for older adults reporting FOF.

복지용구 전시체험관 경험을 통한 인식 변화: A 전시체험관을 중심으로

Objective : This study investigated to improve the perception about using assistive devices, the physical function of the elderly, and long-term care insurance through an aging-friendly experience exhibition.&#x0D; Methods : From October 2022 to March 2023, a survey was conducted to investigate how visitors’ perception changed after attending an exhibition program—specifically, after experiencing and learning about assistive devices. Among the 358 visitors, 305 expressed an interest in participating in the survey and were categorized according to whether they or their family members used assistive devices. Using a structured questionnaire, we designed the survey to assess their understanding of the physical function of the elderly, long-term care insurance, and assistive devices; their satisfaction and opinions about the necessity of the experience exhibition; and their satisfaction regarding the products targeting assistive device users or their families. Descriptive statistics, t-test, chi-square test, and multiple linear regression analyses were performed using the STATA 17 program and SAS enterprise 8.2. &#x0D; Results : Overall, the experience exhibition improved visitors’ understanding of long-term care insurance, the physical function of the elderly, and the necessity of assistive devices (p&lt;.0001). Comparisons by groups, determined according to whether assistive devices were used, also showed an overall cognitive improvement following the visit (p&lt;.0001). The assistive device user group showed a relatively high satisfaction of using expensive devices in the order of electric beds, adult walkers, and manual wheelchairs. &#x0D; Conclusion : The results confirmed the effect of the exhibition on improving visitors’ perception about assistive device usage. Based on these results, it is necessary to organize such exhibitions mainly in areas with a high older population so that assistive device users or their families can experience various products and become more educated about the correct use of such devices.

POOR SLEEP HEALTH MAY BUILD THE ONSET OF A FEAR OF FALLING AMONG COMMUNITY-DWELLING OLDER ADULTS

Abstract A greater fear of falling (FOF) predicts activity restrictions, falls, disability, and increases the risk of mortality among older adults. Although poor sleep has been identified as a relevant factor for FOF among older adults, evidence is primarily shown in cross-sectional studies using isolated sleep characteristics. Whether multidimensional sleep health contributes to increase in FOF among older adults who are particularly vulnerable to falls is less well understood. We investigated the longitudinal relationship between sleep health and the incidence of FOF among community-dwelling older adults and how the association differed between those with or without prior falls experiences. Data were from individuals who completed the sleep module in the National Health and Aging Trends Study (2013-2014; n=695). FOF was assessed with a single item. Multidimensional sleep health was measured with self-reported sleep items based on the SATED model (i.e., sleep satisfaction, daytime alertness, timing, efficiency, and duration). Covariates included sociodemographics, assistive device usage, health, and sleep medications. Multiple logistic regression was used to analyze the data. Poor sleep health was associated with the onset of FOF at 1-year follow-up (OR=1.20, 95%CI=1.02-1.41). Moreover, poor sleep health increased the odds of having FOF among individuals without prior falls experiences and elevated the already heightened risks of developing FOF among those who fell at baseline. Improving sleep health may potentially prevent older adults from developing FOF.

Poor sleep health predicts the onset of a fear of falling among community-dwelling older adults

IntroductionA greater fear of falling predicts disability, falls, and mortality among older adults. Although poor sleep has been identified as a relevant risk factor for fear of falling among older adults, evidence is primarily shown in cross-sectional studies using isolated sleep characteristics. Less is known about whether prior fall experiences change the sleep health-fear of falling link among older adults. We investigated the longitudinal relationship between sleep health and the incidence of fear of falling among community-dwelling older adults and how the association differed between those with or without prior fall experiences. MethodsData were from individuals who completed the sleep module in the National Health and Aging Trends Study (2013-2014; n = 686). Fear of falling was assessed with a single item. Multidimensional sleep health was measured with self-reported sleep items based on the SATED model (ie, sleep satisfaction, daytime alertness, timing, efficiency, and duration). Covariates included sociodemographics, assistive device usage, health, risky behavior, and sleep medications. Multiple logistic regression was used to analyze the data. ResultsPoor sleep health was associated with the onset of fear of falling at 1-year follow-up (odds ratios=1.20, 95% confidence interval=1.02-1.41). Moreover, poor sleep health increased the odds of having fear of falling among individuals without prior falls experiences and elevated the already heightened risks of developing fear of falling among those who fell at baseline. ConclusionsGiven that fear of falling and experiencing a fall each increase the risk of the other occurring in the future, improving sleep health may prevent older adults from stepping into the vicious cycle of fear of falling and falls.

Hurdling Barriers: Exploring Inaccessibility in Higher Education Institutions for Mobility Assistive Device Users

This article explores the challenges faced by students with disabilities using mobility assistive devices (i.e. wheelchairs or crutches) in a large public sector urban higher education institution. Cities are characterized by rapid pace and complex infrastructure including buildings, roads, and public spaces that present unique obstacles that hinder these individuals' mobility and overall experience. For this qualitative study, the locale chosen was a large public sector university, and data was collected from 10 students with disabilities who use wheelchairs and other mobility assistive devices and reside in the campus student accommodation. The data was collected through in-depth interviews and analyzed using thematic analysis. The findings indicate that the infrastructure on campus is not accommodating for students with disabilities who use mobility aids, which directly and indirectly impacts their educational experiences. In addition, the university lacks a uniform policy for providing services and allocating resources for students with disabilities. The participants believe that the university is indifferent to their needs; however, the facilities and behaviors within departments vary and at times can be quiteenabling. This study contributes to the ongoing dialogue on enhancing accessibility, inclusivity, and equity within our urban educational landscapes.

Hurdling Barriers: Exploring Inaccessibility in Higher Education Institutions for Mobility Assistive Device Users

This article explores the challenges faced by students with disabilities using mobility assistive devices (i.e. wheelchairs or crutches) in a large public sector urban higher education institution. Cities are characterized by rapid pace and complex infrastructure including buildings, roads, and public spaces that present unique obstacles that hinder these individuals' mobility and overall experience. For this qualitative study, the locale chosen was a large public sector university, and data was collected from 10 students with disabilities who use wheelchairs and other mobility assistive devices and reside in the campus student accommodation. The data was collected through in-depth interviews and analyzed using thematic analysis. The findings indicate that the infrastructure on campus is not accommodating for students with disabilities who use mobility aids, which directly and indirectly impacts their educational experiences. In addition, the university lacks a uniform policy for providing services and allocating resources for students with disabilities. The participants believe that the university is indifferent to their needs; however, the facilities and behaviors within departments vary and at times can be quite enabling. This study contributes to the ongoing dialogue on enhancing accessibility, inclusivity, and equity within our urban educational landscapes

Social Determinants of Hip Fractures in Elderly Patients–A Case-Control Study

Aim: Hip fractures are common orthopedic traumas and are known as a problem in terms of public health, particularly among the elderly. Preventing fractures and determining risk factors are critical in reducing morbidity, mortality, and social and economic burden. The purpose of this study was to examine the social determinants affecting hip fractures. &#x0D; Material and Methods: This case-control study was conducted with a case group of 108 (36.1%) patients and a control group of 191 (63.9%). Hip fracture status was selected as the dependent variable in the study. The independent variables were marital status, place of residence, single-story or multi-story residence, use of stairs, use of assistive devices, cohabitants, working status, chronic disease status, education status, fixed income status, health insurance, family history of hip fractures, fractures in the last five years, getting help in daily work, smoking, fear of falling, and perception of general health status.&#x0D; Results: Marital status, cohabitants, chronic disease status, having a fixed income, having health insurance, fear of falling, and perception of general health differed to a significant extent between the case and control groups. Nonetheless, no statistically significant difference was found between the groups regarding their places of residence, living in whether single-story or multi-story residences, the use of stairs, assistive device usage, active employment status, education status, family history of hip fractures, fractures in the last five years, getting help in daily work, and smoking.&#x0D; Conclusion: Social factors affect the risk of hip fracture. Clinicians should be alert to the importance of this issue and raise the awareness of elderly patients.

Game-based intradialytic non-weight-bearing exercise training on gait speed and balance in older adults with diabetes: a single-blind randomized controlled trial

Older adults with diabetes receiving hemodialysis have impaired gait speed and balance compared to the general population, which have been associated with increased risks of falls and mortality. This study evaluated the effectiveness of a game-based intradialytic exercise training program (iExergame) on improving gait speed and balance. This was a single-blind randomized controlled trial. The intervention group (IG) received iExergame training using real-time audiovisual feedback with wearable inertial sensors. The control group (CG) received conventional training without any technology. Both trainings were intradialytic, non-weight-bearing, and used ankle range of motion. Gait and balance parameters were collected at baseline and 4-week follow-up. Data from 70 adults (age 64.2 ± 9.0 years) were analyzed. Compared to the CG, the IG showed greater changes between baseline and 4-week follow-up in several parameters. Gait parameters included faster speeds and longer stride lengths, particularly during dual task walking (p < 0.050). Balance parameters included reductions in center of mass (p = 0.004), ankle (p < 0.001), and hip (p = 0.010) sways during semi-tandem stance, particularly in users of assistive devices. iExergame training could improve gait speed and balance in this population and might be an option to increase intradialytic exercise adherence while reducing burdens of exercise administration.

The Development of an Interview Questionnaire and Guide for the Sustainable Use of Assistive Devices among the Disabled in Korea

Assistive device use has increased in recent years in Korea following the expansion of disability categories, increase in acquired disabilities, and an aging society. Although assistive devices can improve the quality of life by aiding social participation and removing physical restrictions, some devices are simply not used after users receive them via public distribution projects. Understanding assistive device usage after distribution is crucial to improve their service and supported products by disability type. This study constructed an interview questionnaire and interview guide for investigating the reason for (not) using the assistive device, and the necessity of assistive devices according to time point after disability. The aim was to establish a foundation for accumulating systematic and in-depth data. The interview questionnaire was developed primarily for frequent device users across 15 physical disability types. The terms used in the questionnaire were systematically defined, and interview items were derived based on assistive device-related questionnaires from the extant literature. The final interview questionnaire and guide were then refined after pilot test (N = 4) and expert (N = 2) consultations. The data accumulated by utilizing the interview questionnaire and interview guide developed in this study can improve the service support system for assistive devices by disability type and improvements by assistive devices in the future. This can help improve users’ quality of life by providing a more appropriate and enhanced assistive device.

Bail-out Ablation of Ventricular Tachycardia Electrical Storm in a Patient with a Durable Left Ventricular Assist Device.

The therapeutic strategy for sustained ventricular tachycardia (VT) during left ventricular assist device usage remains unclear. We encountered a patient with durable left ventricular assist device who presented sustained VT. Electrophysiological mapping was able to be established appropriately owing to the robust mechanical hemodynamics support despite inter-device interference. The three-dimensional activation map of clinically documented VT demonstrated that the propagation exited from the right ventricular apex through the critical isthmus located at the epicardium or interventricular septum, which was successfully treated by catheter ablation at the exit site. Further experiences like ours should be accumulated to establish a therapeutic strategy.

Factors Influencing Utilization of Assistive Devices by Tibetan Seniors on the Qinghai-Tibet Plateau: Based on Research Strategy of Triangulation.

To investigate the current situation of assistive device (AD) usage among seniors in Tibet, China, and explore its influencing factors. A mixed-methods design was used. Cognition, attitude, behavior, and preference toward ADs were assessed by a self-designed questionnaire. Additionally, participants responded to the open-ended questions. Anderson's behavior model analyzed the impacts of the prerequisite factors, enabling factors, and demand factors influencing the utilization of ADs by Tibetan seniors. Of the 211 Tibetan seniors, 149 (70.6%) Tibetan seniors expressed the willingness to utilize ADs. Binary Logistic regression analysis showed that one prerequisite factor: age; one enabling factor: care situation, and one demand factor: dysfunctional condition were factors influencing the utilization of ADs. Qualitative comments described: psychological, physical environment, and social support factors were the main influencing factors. This study presents the current situation to utilize ADs by Tibetan seniors on the Qinghai-Tibet Plateau, incorporates Anderson's behavioral model for quantitative analysis, and combines qualitative research to explore the facilitating and hindering factors, to provide reference and basis for the development of ADs for seniors and policy formulation. The sample size of this study is relatively small and limited to ethnic groups, and we plan to increase the sample size and include more ethnic groups in the future study.

Perception of Prosody in Hearing-Impaired Individuals and Users of Hearing Assistive Devices: An Overview of Recent Advances.

Prosody perception is an essential component of speech communication and social interaction through which both linguistic and emotional information are conveyed. Considering the importance of the auditory system in processing prosody-related acoustic features, the aim of this review article is to review the effects of hearing impairment on prosody perception in children and adults. It also assesses the performance of hearing assistive devices in restoring prosodic perception. Following a comprehensive online database search, two lines of inquiry were targeted. The first summarizes recent attempts toward determining the effects of hearing loss and interacting factors such as age and cognitive resources on prosody perception. The second analyzes studies reporting beneficial or detrimental impacts of hearing aids, cochlear implants, and bimodal stimulation on prosodic abilities in people with hearing loss. The reviewed studies indicate that hearing-impaired individuals vary widely in perceiving affective and linguistic prosody, depending on factors such as hearing loss severity, chronological age, and cognitive status. In addition, most of the emerging information points to limitations of hearing assistive devices in processing and transmitting the acoustic features of prosody. The existing literature is incomplete in several respects, including the lack of a consensus on how and to what extent hearing prostheses affect prosody perception, especially the linguistic function of prosody, and a gap in assessing prosody under challenging listening situations such as noise. This review article proposes directions that future research could follow to provide a better understanding of prosody processing in those with hearing impairment, which may help health care professionals and designers of assistive technology to develop innovative diagnostic and rehabilitation tools. https://doi.org/10.23641/asha.21809772.

Readout chip with RISC-V microprocessor for hybrid pixel detectors

Hybrid single-photon counting pixel detectors have recently been widely used for X-ray and ionizing particle detection in medicine, high-energy physics, and material science. Many different chips have been developed for the readout of the semiconductor pixel sensor. Typically, developed ASICs have very limited digital logic and do not provide substantial data processing. In this paper, we present the readout chip that integrates the readout channels matrix with a RISC-V-based microprocessor SoC. The designed device has been prototyped in an FPGA and sent to production in a CMOS 40 nm process. Integration of a pixel matrix with the RISC-V-based central processing unit significantly improved the detector functionality. It enabled the device to work independently without external assistive device usage and execute many algorithms, e.g., calibration, threshold scanning, and data filtering, on-chip. Communication between the CPU and the pixel matrix was carried out through the dedicated Pixel Matrix Controller with the CPU standard I/O operations usage. This specialized peripheral consists of a coprocessor responsible for precise matrix control, a data converter for data conversion acceleration, and control and status registers connected to the core data bus. Many algorithms have been developed and tested, one of which is the intelligent real-time filtering of regions of interest.

ROLE OF ASSISTIVE DEVICES IN THE REHABILITATION OF PHYSICALLY HANDICAPPED CHILDREN IN SOUTHERN PUNJAB

This study was conducted to explore the Role of Assistive Devices in The Rehabilitation of Physically Handicapped Children in Southern Punjab. This research was descriptive in its nature. In this study the total sample consisted 170 Senior and Junior Teachers of special education, Instructor Physical Education (IPE) and Physical Education Teachers (PET) working with physically handicapped children. It was concluded that the assistive devices proved helpful to minimize the level of disability of children with physical impairment. The results reflect that according to the parents of children with physical disabilities, the usage of assistive devices played a positive role for the rehabilitation of the children with physical impairment. Services of the professionals such as, Physiotherapist, Psychologist, Instructor Physical Education (IPE) or Physical Education Teacher (PET) should provide in the all institutions of physically disabled children. Keywords: Assistive Devices, Rehabilitation, Physically Handicapped Children, Southern Punjab.