Assistive Technology Devices Research Articles

Situation Model for Situation-Aware Assistance of Dementia Patients in Outdoor Mobility.

Background:Dementia impairs spatial orientation and route planning, thus often affecting the patient’s ability to move outdoors and maintain social activities. Situation-aware deliberative assistive technology devices (ATD) can substitute impaired cognitive function in order to maintain one’s level of social activity. To build such a system, one needs domain knowledge about the patient’s situation and needs. We call this collection of knowledge situation model.Objective:To construct a situation model for the outdoor mobility of people with dementia (PwD). The model serves two purposes: 1) as a knowledge base from which to build an ATD describing the mobility of PwD; and 2) as a codebook for the annotation of the recorded behavior.Methods:We perform systematic knowledge elicitation to obtain the relevant knowledge. The OBO Edit tool is used for implementing and validating the situation model. The model is evaluated by using it as a codebook for annotating the behavior of PwD during a mobility study and interrater agreement is computed. In addition, clinical experts perform manual evaluation and curation of the model.Results:The situation model consists of 101 concepts with 11 relation types between them. The results from the annotation showed substantial overlapping between two annotators (Cohen’s kappa of 0.61).Conclusion:The situation model is a first attempt to systematically collect and organize information related to the outdoor mobility of PwD for the purposes of situation-aware assistance. The model is the base for building an ATD able to provide situation-aware assistance and to potentially improve the quality of life of PwD.

Environmental barriers to participation and facilitators for use of three types of assistive technology devices

ABSTRACTThe aim was to compare the presence of environmental barriers to participation and facilitators for assistive technology (AT) use and study the relation between barriers and AT use in three different AT devices. A cross-sectional survey was conducted. Inclusion criteria were ≥one year of experience as a user of myoelectric prosthesis (MEP), powered mobility device (PMD), or assistive technology for cognition (ATC) and age 20-90 years. Overall, 156 participants answered the Swedish version of the Craig Hospital Inventory of Environmental Factors and a study-specific questionnaire on facilitating factors. Non-parametric tests were used for comparisons. Barriers to participation were lowest in MEP users (md=0.12; p>0.001), and highest in ATC users (md=1.56; p>0.001) with the least support for AT use (p>0.001 - p=0.048). A positive correlation between fewer barriers and higher use of MEP was seen (r=0.30, p=0.038). The greatest barriers to participation were Natural environment, Surroundings and Information, and the most support came from relatives and professionals. Support, training and education are vital in the use of AT. These factors may lead to a more sustained and prolonged use of AT and may enable increased participation. Future research should focus on interventions that meet the needs of people with cognitive disabilities.

Factors Associated With Recommendations for Assistive Technology Devices for Persons With Mobility Limitations Using Workplace Accommodation Services

The objective of this study was to identify the interactions between impairment-related and work-related factors associated with recommendations for specific assistive technology devices (ATDs) for persons with mobility limitations who used workplace accommodation (WA) services. A retrospective and secondary data analysis was conducted on 132 WA service users with mobility limitations in Taipei City from 2008 to 2012 using chi-square automatic interaction detector (CHAID). The CHAID analyses revealed interactions between impairment-related factors (difficulty walking and upper extremity pain) and work-related factors (frequent moving around outdoors), which were significantly associated with the recommendation of powered wheelchairs ( p < .05). Interactions between the impairment-related factor (difficulty walking) and the work-related factor (frequent sitting for long periods of time) were associated with the recommendation of ergonomic chairs ( p < .001) for persons with mobility limitations. By identifying the interactions between impairment-related and work-related factors in recommending workplace ATDs for persons with mobility limitations, this study provides evidence-based ATDs recommendations for persons with mobility limitations.

Exploring Preschool Teachers' and Support Staff's Use and Experiences of Assistive Technology with Children with Disabilities

THIS QUALITATIVE CASE STUDY explored the professional philosophies and experiences of preschool teachers and their support staff regarding the use of assistive technology devices (ATDs) in an early intervention inclusive preschool class. Using face-to-face individual interviews as data collection measures, the researchers aimed to understand these practitioners' teaching philosophies and experiences in terms of how they use ATDs with young children with disabilities in their class. A framework analysis of data identified three themes: establishing values for inclusive education, maintaining positive attitudes to overcoming challenges and orchestrating inclusive learning. The paper concluded that in order for the use of ATDs to thrive and make full impact on all children's learning and development, stronger frameworks for developing the inclusive values, philosophies, professional knowledge and practice principles of preschool teachers and their support staff are needed.

Using computed tomography and 3D printing to construct custom prosthetics attachments and devices

BackgroundThe prosthetic devices the military uses to restore function and mobility to our wounded warriors are highly advanced, and in many instances not publically available. There is considerable research aimed at this population of young patients who are extremely active and desire to take part in numerous complex activities. While prosthetists design and manufacture numerous devices with standard materials and limb assemblies, patients often require individualized prosthetic design and/or modifications to enable them to participate fully in complex activities.MethodsProsthetists and engineers perform research and implement digitally designs in collaboration to generate equipment for their patient’s rehabilitation needs. 3D printing allows for these devices to be manufactured from an array of materials ranging from plastic to titanium alloy. Many designs require form fitting to a prosthetic socket or a complex surface geometry. Specialty items can be scanned using computed tomography and digitally reconstructed to produce a virtual 3D model the engineer can use to design the necessary features of the desired prosthetic, device, or attachment. Completed devices are tested for fit and function.ResultsNumerous custom prostheses and attachments have been successfully translated from the research domain to clinical reality, in particular, those that feature the use of computed tomography (CT) reconstructions. The purpose of this project is to describe the research pathways to implementation for the following clinical designs: sets of bilateral hockey skates; custom weightlifting prosthetic hands; and a wine glass holder.ConclusionThis article will demonstrate how to incorporate CT imaging and 3D printing in the design and manufacturing process of custom attachments and assistive technology devices. Even though some of these prosthesis attachments may be relatively simple in design to an engineer, they have an enormous impact on the lives of our wounded warriors.

Wireless sEMG-Based Body-Machine Interface for Assistive Technology Devices.

Assistive technology (AT) tools and appliances are being more and more widely used and developed worldwide to improve the autonomy of people living with disabilities and ease the interaction with their environment. This paper describes an intuitive and wireless surface electromyography (sEMG) based body-machine interface for AT tools. Spinal cord injuries at C5-C8 levels affect patients' arms, forearms, hands, and fingers control. Thus, using classical AT control interfaces (keypads, joysticks, etc.) is often difficult or impossible. The proposed system reads the AT users' residual functional capacities through their sEMG activity, and converts them into appropriate commands using a threshold-based control algorithm. It has proven to be suitable as a control alternative for assistive devices and has been tested with the JACO arm, an articulated assistive device of which the vocation is to help people living with upper-body disabilities in their daily life activities. The wireless prototype, the architecture of which is based on a 3-channel sEMG measurement system and a 915-MHz wireless transceiver built around a low-power microcontroller, uses low-cost off-the-shelf commercial components. The embedded controller is compared with JACO's regular joystick-based interface, using combinations of forearm, pectoral, masseter, and trapeze muscles. The measured index of performance values is 0.88, 0.51, and 0.41 bits/s, respectively, for correlation coefficients with the Fitt's model of 0.75, 0.85, and 0.67. These results demonstrate that the proposed controller offers an attractive alternative to conventional interfaces, such as joystick devices, for upper-body disabled people using ATs such as JACO.

Cross-cultural adaptation of the assistive technology device – Predisposition assessment (ATD PA) for use in Brazil (ATD PA Br)

Purpose: The purpose of this study is to conduct a cross-cultural adaptation of the Assistive Technology Device Predisposition Assessment (ATD PA) for use in Brazil.Method: The selection of the Assistive Technology Device Predisposition Assessment (ATD PA) was determined by previous literature reviews of articles published in 2014 and 2016 in six databases with the terms "assistive device" or "assistive technology" or "self-help device" combined with "evidence-based practice" or "framework" or "measurement scale" or "model and outcome assessment". This review indicated that the conceptual model of Assistive Technology (AT) most discussed in the literature was the Matching Person and Technology (MPT) model, and this finding determined the selection of ATD PA as an assessment within the MPT portfolio of measures. The procedures for cross-cultural adaptation were as follows: Equivalence of Concept, Semantic and Operational. Five experts were asked to translate 725 items and these translations were evaluated and a high level of agreement was demonstrated.Results: The Portuguese version, Avaliação de Tecnologia Assistiva – Predisposição ao Uso – ATD PA Br, was derived from the original version in English (ATD PA).Conclusion: The ATD PA Br will support professionals and people with disabilities in Brazil to better select AT devices according to the clients’ needs.Implications for rehabilitationProvides a systematic way of selecting assistive technology devices for the use of individuals with disabilities according to the Brazilian reality.A systematic way of selecting the assistive technology that can help decrease the abandonment of the assistive technology use.The use of the Matching Person and Technology theorical model and of the assessment ATD PA Br is essential to guide the researches and clinical practice in Brazil.

The influence of assistive technology on occupational performance and satisfaction of leprosy patients with grade 2 disabilities.

We aimed to investigate the feasibility of assistive technology (AT) devices to improve leprosy patients' occupational performances and satisfaction. This is a pretest-posttest design study. The Canadian Occupational Performance Measure was used to assess the occupational performance and satisfaction of five leprosy participants with grade 2 disabilities before and after ten 45-minute interventions using assistive technology devices. The data showed a statistically significant 7-point average improvement (p<0.05) in participants' post-intervention performance and satisfaction scores. Assistive technology devices may be useful therapeutic tools to enhance autonomy/independence and satisfaction of leprosy patients with grade 2 disabilities.

Improvement Plan about Delivery System and Current State on Repairs Service of Assistive Technology Devices for Disabled

Improvement Plan about Delivery System and Current State on Repairs Service of Assistive Technology Devices for Disabled

How would I live with a disability? Expectations of bio-psychosocial consequences and assistive technology use

Purpose: It is widely accepted that social dimensions are crucial when facing a disability. More specifically, a normative incentive to conceal one’s disability, which can lead to abandonment of assistive technology devices (ATD), is often reported. This study seeks to examine this norm.Method: The expected consequences of having a disability were measured using a sample of 549 able-bodied students from three groups.Results: The results showed that the expected consequences of having a disability and therefore the descriptive norms associated with disability were less negative for the participants who were familiar with disability, but higher for sports students. Furthermore, the relation between objective and subjective consequences (having a disability and feeling disabled, respectively) and public and private use of ATD were modelled. The model shows that both higher objective and lower subjective consequences were linked to higher ATD use in public and, indirectly, in private.Conclusion: The present study contributes to the literature on the normative elements related to the use of ATD. Indeed, it shows that when a person makes his/her disability a part of him/herself, she/he is expected to hide it and therefore to avoid using ATD. However, this assessment proves to be context-dependent and calls for the implementation of handicap awareness programs.Implications for RehabilitationIf faced with a disability, expecting to feel disabled and expecting lower objective consequences are linked to lower ATD use.Expected ATD use in private seems to be related to ATD use in public but not to the expected consequences of the disability.Expectations and therefore social norms about having a disability are highly context-dependent which encourages the implementation of handicap awareness programs.

The invisible employee: reasonable accommodation of psychosocial disability in the South African workplace

While many disabilities are observable, and thus are generally accepted by employers as requiring accommodation on the job (eg in the form of assistive technology, duty modifications and medical devices), psychosocial disability is not obvious. In fact, it is sometimes referred to as ‘the invisible disability’.1 This paper considers the challenges faced by people with psychosocial disabilities to access and retain meaningful work. It explores international and national legal frameworks and jurisprudence relating to the rights of persons with disabilities in the workplace, and demonstrates that challenges relating to regulation of disclosure; lack of clarity regarding the provision of reasonable accommodation and the undue hardship limitation; and societal and self-stigma remain significant barriers to the equal participation of persons with psychosocial disabilities in South Africa’s workplaces. I suggest that South Africa is failing to meet some of its obligations in terms of the Convention on the Rights of Persons with Disabilities and that there are weaknesses in the conception of disability inherent to the Employment Equity Act. To conclude, I offer recommendations relating to how these shortcomings might be rectified for the benefit of employees living with psychosocial disabilities.

Effects of Functional Mathematics Instruction with Smartphone Calculator Application on Purchasing Skills within Budgets of Adults with Intellectual Disabilities

Purpose: The purpose of this study was to find out the effects of functional mathematics instruction with smartphone calculator application on purchasing skills within budgets of adults with intellectual disabilities. Method: Three adults with intellectual disabilities participated in the experiment and the multiple probe baseline across subjects design was used. This study used a calculator as an assistive technology device that was an application displayed the calculation process accumulating vertically, which was installed on three participants’ smartphones. This study examined the acquirement of purchasing skills within budget, whether the performance was generalized in other places and with different amount of money and maintained after the intervention. Results: Three participants were able to acquire purchasing skills within budgets and the purchasing skills were generalized in other places with different conditions and were maintained 3 weeks after the intervention. Conclusion: This study provided a new smart learning case which a general application intended for ordinary people can be utilized for enhancing purchasing skills of adults with intellectual disabilities.

Assessing the Psychosocial Impact of Assistive Technology in Children

Abstract Date Presented 4/9/2016 The Children’s Psychosocial Impact of Assistive Devices Scale is a 15-item, self-report outcome measure designed to assess the effects an assistive technology device has on the quality of life of children. Initial statistical analysis indicates good reliability and internal consistency. Primary Author and Speaker: Bob Cunningham Additional Authors and Speakers: Amanda Rzepczynski, Micaela Surdyke, Megan Moldenhauer, Kaitlin Bethel, Della Spratt

A Study on Industrial Accident for Broken Prosthesis: with Focus on July 10. 2014 ruling 2012 du 20991 in Supreme Court of Korea

Background/Objectives: This study is to consider decision of Supreme Court of Korea to acknowledge broken prosthesis is the same with physical injury and to pay worker's compensation reimbursement following industrial accidents. Methods/Statistical Analysis: We analyzed the judgment of the Korean Supreme Court in 2014 of the 'Case No. 2012 du 20991', the case of cancel for disapproval dispose for care of the damaged artificial limb by the Industrial Accident Compensation in 2010. For this, we reviewed legal definition of disability and assistive device based on concerned laws and ICF model, compared prior precedents, and interpreted the final sentence of the Korean Supreme Court. Findings: We suggested the incident happened during job performance had to be counted as an industrial accident. Prostheses are in direct contact and connect with damaged body, and it may alternate deficient parts of body and restore one's body function and appearance. Artificial limbs have considerably different properties compared to assistive technology devices. So, broken prosthesis was not different from any physical injury. Intervention by professional are required to properly use prosthesis for the disabled. Prosthesis is essential products for daily life and job retention of them despite hassle of use. In work performance of the Plaintiff, Prosthesis must be judged as part of body that is responsible for core functions necessary to perform essential duties as a security guard. Korea Workers' Compensation&Welfare Service has duty to support him to continue work life and to return to work. The refusing to reimbursement for the damaged prosthesis may hinder to return to worksite of injured workers. Finally our society will make mistake of lowering the efficiency of public spending. Application/Improvements: We support the ruling for case No. 2012 du 20991 of the Korean Supreme Court. It acknowledged the importance of assistive technology devices for participation and activities for the disabled.

장애인보조기구 수리서비스 현황 및 만족도에 관한 연구

본 연구는 국내 장애인보조기구 수리서비스에 대한 현황 및 만족도를 파악하여 수리서비스에 대한 문제점을 알아보고 이를 바탕으로 하여, 효과적인 발전방안을 알아보고자 하는데 그 목적이 있다. 설문조사는 2015년 7월부터 2015년 10월까지 전국에 있는 장애인 750명을 대상으로 시행하였고, 최종 회수된 280부를 분석하였다. 수리의뢰가 많았던 품목은 대부분 이동보조기구였으며 수리 의뢰는 대부분 구입업체와 장애인 보조기구 전문 수리기관에서 시행되었다. 만족도 조사에서 일부 불만족의 사유로는 수리기간이 길고 수리 접수 및 절차의 복잡성으로 나타났다. 장애인보조기구 수리서비스 활성화를 위한 중앙정부의 역할로는 수리지원사업에 대한 홍보 확대, 수리지원 대상품목 및 지원금액 기준마련, 장애인보조기구 수리를 위한 법적 체계 마련이 매우 필요하다는 의견이 많았다. 보다 효과적이고 체계적인 장애인보조기구 수리서비스를 제공하기 위해서는 수리서비스 절차의 체계 확립, 시장가격을 반영한 부품별 수리단가 제시 등이 마련되어야 할 것이다. The purpose of this study is to investigate the satisfaction with repair service of assistive technology devices for the disabled and the current state of the service, find the problems of the repair service, and to seek an effective development plan. This study had been conducted from July to October, 2015, with 750 disabled, and 280 completed questionnaires were returned and analyzed. Among assistive technology devices, the devices that required repair most were mobility devices. Repair was made mostly in purchase agencies and the repair institute. In the satisfaction survey, the causes for somewhat dissatisfaction were long repair time and complicated repair application and procedure. With regard to the central government's roles to active repair service for assistive technology devices, it was found that it was very necessary to expand the promotion of repair support business, come up with the criteria about repair support items and support amount, and establish the legal system to repair assistive technology devices. Therefore, in order to provide more effective and systematic repair service for assistive technology devices, it will be necessary to establish repairing process of assistive technology devices and standardization of costs that repair assistive technology devices.

Assistive Technology in Australia: Integrating theory and evidence into action.

Occupational therapists use a range of strategies to influence the relationship between person, environment and occupation and facilitate people's participation and inclusion in society. Technology is a fundamental environmental factor capable of enabling inclusion, and occupational therapy models articulate a role for assistive technology (AT) devices and services, but there is a gap between theory, research and practice. The context of AT provision in Australia presents systemic barriers that prevent optimal application of AT devices and services for societal health promotion and in individualised solutions. The Integrating Theory, Evidence and Action method (ITEA) was used to answer the question 'How can occupational therapy support AT provision to enable older people and people with disability?' A wide range of sources were systematically analysed to explore the complexities of AT provision in Australia. The International Classification of Functioning, Disability and Health (ICF) and IMPACT2 model are used as frameworks to reconstruct evidence into statements that summarise the theory, process and outcomes of AT provision. Analysis of the influence of the global disability rights and local policies and AT provision systems is used to highlight important aspects for occupational therapists to consider in research and practice. Pragmatic recommendations are provided to enable practitioners to translate theory and evidence into action. AT provision can be improved by focusing on evidence for and congruence between theory, process and outcomes, rather than isolated interventions. Occupational therapists should consider the influence of contextual factors on practice, and work with consumers to improve access and equity in AT provision systems.

Translation and validation of the assistive technology device predisposition assessment in Greek in order to assess satisfaction with use of the selected assistive device

Purpose: To examine the Assistive Technology Device Predisposition Assessment scale and provide evidence of validity and reliability of the Greek version. Methods: We translated and adapted the original instrument in Greek according to the most well-known guidelines recommendations. Field test studies were conducted in a rehabilitation hospital to validate the appropriateness of the final results. Ratings of the different items were statistically analyzed. We recruited 115 subjects who were administered the Form E of the original questionnaire. Results: The experimental analysis conducted revealed a three subscales structure: (i) Adaptability, (ii) Fit to Use, and (iii) Socializing. According to the results of our study the three subscales measure different constructs. Reliability measures (ICC = 0.981, Pearson's correlation = 0.963, Cronbach's α = 0.701) yielded high values. Test-retest outcome showed great stability. Conclusions: This is the first study, at least to the knowledge of the authors, which focuses merely on measuring the satisfaction of the users from the used assistive device, while exploring the Assistive Technology Device Predisposition Assessment - Device Form in such depth. According to the results, it is a stable, valid and reliable instrument and applicable to the Greek population. Thus, it can be used to measure the satisfaction of patients with assistive devices.Implications for RehabilitationThe paper explores the cultural adaptability and applicability of ATD PA – Device Form.ATD PA – Device Form can be used to assess user satisfaction by the selected assistive device.ATD PA – Device Form is a valid and reliable instrument in measuring users’ satisfaction in Greekreality.

Fatigue in the mothers of children with cerebral palsy

Purpose: To evaluate fatigue in the mothers of children with cerebral palsy (CP), and to determine its associations with clinical parameters of CP, depression and quality of life (QoL). Method: Ninety children (50 girls and 40 boys) with spastic CP and their mothers were included. Control group comprised mothers of healthy children. Gross motor function classification system (GMFCS) was used for determining functional status. Spasticity was evaluated by using modified Ashworth scale. Fatigue symptom inventory (FSI) was used for assessing maternal fatigue, Nottingham health profile (NHP) for maternal QoL, and Beck Depression Scale (BDS) for maternal depression. Results: Mothers of children with CP scored significantly higher in all FSI subgroups (intensity of fatigue, duration of fatigue and interference with QoL), all NHP subgroups and BDS (p < 0.05) when compared with controls. FSI was found to be correlated with BDS and all subgroups of NHP (p < 0.01). No association was found between FSI and clinical parameters of children with CP including age, gender, type of CP, tonus and functional impairment (p > 0.05). Conclusions: Our findings indicate that fatigue levels of mothers with CP children are higher than those with healthy children and associated with depression and deterioration in QoL in terms of physical, social and emotional functioning. This should be considered while designing a family centred rehabilitation programme for children with CP.Implications for RehabilitationCaring for a child with cerebral palsy has psychological, social and financial impacts on familiesand is associated with increased levels of fatigue among mothers.The capacity of current programs and services needs to be strengthened to accommodate theneeds of children with CP and their mothers in order to reduce fatigue of mothers.New programs need to be developed to provide psychosocial support for the mothers andto reduce their fatigue as they continue to care for their children.Provision of assistive technology devices (particularly suitable wheelchairs) will be useful inreduction of fatigue levels of mothers.

Medical and Assistive Health Technology: Meeting the Needs of Aging Populations.

To identify policy gaps in the delivery and availability of assistive health technology (AHT) and medical devices (MD) for aging populations, particularly in low- and middle-income countries (LMICs). The findings presented in this paper are the results of several narrative overviews. They provide a contextual analysis of the conclusions and evidence from WHO commissioned research and expert consultations in 2013 and 2014, as well as a synthesis of literature reviews conducted on AHT and MD. Practical, life-enhancing support for older people through AHT, MD, and related health and social services is a neglected issue. This is particularly so in LMICs where the biggest increases in aging populations are occurring, and yet where there is commonly little or no access to these vital components of healthy aging. Health technologies, especially medical and assistive health technology, are essential to ensure older people's dignity and autonomy, but their current and potential benefits have received little recognition in LMICs. Viewing these technologies as relevant only to disabled people is an inadequate approach. They should be accessible to both older adults with disabilities and older adults with functional limitation. Many countries need much greater official awareness of older adults' needs and preferences. Such attitudinal changes should then be reflected in laws and regulations to address the specificities of care for older people.

An evaluation framework to measure usability of Assistive Technology at workplace: A demonstration study

BACKGROUND:Assistive Technology (AT) devices are vastly used by individuals with disabilities in their workplace to accommodate their disability and enable productivity. However, barriers and gaps with integration and use of AT in workplace are well documented in literature. OBJECTIVE:This research study demonstrates the application of a systematic evaluation framework, the Usability Scale for Assistive Technology-Workplace, to examine the usability of work-related AT devices for employees, employers, and vocational rehabilitation providers to identify gaps and optimize the implementation of AT. The framework is fundamentally driven by the employee’s vocational context and range of work-related tasks, and comprehensively accounts AT devices and related accommodations that address each task. METHODS:Five employees with different motor and sensory impairments are presented as case scenarios to highlight the application of the evaluation framework. RESULTS:By using the evaluation framework, it was found that the employees in general were successful in the use of AT devices and rated their productivity as high. However, some unique as well as common barriers were also reported and pertained to technical knowledge and training, reliability and compatibility of the AT devices, and limitations in accessibility. CONCLUSION:Future research is required to derive and establish a standardized evaluation tool using the framework.