Cane Users Research Articles

Proposal for Cane Tip Position to Achieve Both High Stability and Low Joint Torque Using Inverse Dynamics Analysis in T-Cane Gait

T-cane is a primary method used to prevent falls. Although canes effectively increase stability and reduce load, the specific position of the cane tip that maximizes these effects is not yet clear. Furthermore, the cane tip position that enhances effectiveness may also increase the burden on the user. In this study, we used the center of pressure (CoP) as an indicator of stability and shoulder joint adduction torque as an indicator of burden. In this study, we propose a cane tip position that increases the stability of the cane user, but does not increase the burden, through experiment. The experiment involved healthy young male participants. The results confirmed that the CoP increased with the cane tip position. The shoulder joint adduction torque increased with the cane tip position and then remained constant. The results suggest that the participants can walk with higher stability per load when the cane tip was positioned 30 cm in front of the right foot on the ground.

Surface roughness discrimination with the long cane: Effects of cane tips, handle, shaft rigidity, and swinging speed

This study examined the effects of cane tip type, cane tip size, cane shaft rigidity, cane handle material, and cane swing speed on the cane user’s ability to discriminate surfaces of different roughness. A repeated-measures design with block randomization was used for each of the three studies. Blindfolded sighted and visually impaired participants attempted to identify which of the two grooved aluminum plates was rougher by swiping the plates using different cane tips, shafts, handles, and swing speeds. Participants correctly identified the rougher plate at a higher percentage with smaller cane tips (77.6% ± 8.7%) than with larger cane tips (72.1% ± 7.2%), p = .029, r = .54. Pencil tips (76.9% ± 8.4%) were more advantageous than ball tips (72.8% ± 6.5%), p = .028, r = .55. Slower cane swing speed (84.4% ± 2.6%) also allowed the participants to better discriminate the surfaces than faster swing speed (76.6% ± 6.0%), p = .002, r = .80. However, the cane shaft rigidity ( p = .499, r = .22) and cane handle material ( p = .694. w2 = 0.02) did not have a significant effect on the cane user’s ability to discriminate the surfaces of different roughness. Given these findings, a cane user may want to use a smaller and/or cylindrical cane tip as opposed to larger and/or spherical cane tip for better surface texture change detection. In addition, a cane user may not want to swing the cane too wide or walk too fast since wider cane swing and faster walking speed tend to result in faster cane swing speed, which can compromise one’s ability to detect sudden changes in walking surface texture. That being said, an Orientation and Mobility (O&M) specialist should assess each person’s traveling environment when determining which cane tip and swing speed to use in a given situation.

The Cost of Knowing: How Obstacle Alerts Reduce Walking Speeds of Augmented White Cane Users

To ensure safe passage blind travellers utilize mobility aids such as the white cane to preview the space their body will move through. Augmented white canes (AWC) have increased this preview range to reduce collisions, but consequently incurred lower walking speeds. The literature has blamed the slowdown on the AWC provided alerts that are additional to white cane feedback, unnecessary, too complex, and the anticipatory slowdown of their users. Two within-subject studies with six visually impaired and ten blindfolded people compared the white cane to two different AWC preview types (See Figure 1) combined with two ranges to investigate the causes of the slowdowns. The cognitive cost from processing AWC additional and unnecessary alerts and their complexity slowed users down and should be kept to a minimum as they neither helped reduce collisions nor physically detecting obstacles with the cane.

Blind Cane Using 2 Axis Servo with Fuzzy Logic Method

Based on data from the Ministry of Health and the Central Bureau of Statistics, it is known that the number of people with disabilities, especially the visually impaired, is 1-1.5% of the total 237 million Indonesian population, which is around 3.75 million blind people. A tool often used to accommodate them is a cane used to feel the ground if there are downgrade and obstructions in front of them. In this study, researchers developed the previous research on blind cane using a 2 axis servo. It was classified using the Fuzzy Logic programming method, which was processed using the Arduino Nano 328P microcontroller. The results of the test on respondents with visual impairments were that they feel accommodating with the tool because the cane users can easily find obstructions with the Navigation Instruction so that they can easily avoid Static obstructions (Static Objects).

An IoT Machine Learning-Based Mobile Sensors Unit for Visually Impaired People.

Visually impaired people face many challenges that limit their ability to perform daily tasks and interact with the surrounding world. Navigating around places is one of the biggest challenges that face visually impaired people, especially those with complete loss of vision. As the Internet of Things (IoT) concept starts to play a major role in smart cities applications, visually impaired people can be one of the benefitted clients. In this paper, we propose a smart IoT-based mobile sensors unit that can be attached to an off-the-shelf cane, hereafter a smart cane, to facilitate independent movement for visually impaired people. The proposed mobile sensors unit consists of a six-axis accelerometer/gyro, ultrasonic sensors, GPS sensor, cameras, a digital motion processor and a single credit-card-sized single-board microcomputer. The unit is used to collect information about the cane user and the surrounding obstacles while on the move. An embedded machine learning algorithm is developed and stored in the microcomputer memory to identify the detected obstacles and alarm the user about their nature. In addition, in case of emergencies such as a cane fall, the unit alerts the cane user and their guardian. Moreover, a mobile application is developed to be used by the guardian to track the cane user via Google Maps using a mobile handset to ensure safety. To validate the system, a prototype was developed and tested.

Time as a Hidden Curriculum: Qualitative Study of Challenges Faced by Students with Mobility, Speech, and Visual Disabilities in P-12 Settings

Formal education is schedule driven yet time as a hidden curriculum pertaining to students with disabilities is understudied. The authors share different challenges around disability: The first author has a physical disability and is a wheelchair user and teaches disability and equity studies in education, the second author stutters and teaches speech-language pathology, and the third author is blind and is a white cane user and teaches linguistic and disability courses. Informed by personal and educational disability experiences, the authors examine three case scenarios related to the schooling of learners with mobility, speech, and visual disabilities in P-12 settings to understand the interaction of time and curriculum and the impact on their education. Since time as a hidden curriculum can be a barrier for students with physical, speech, and visual disabilities, then there is a need for the reconceptualization of time within the frame of curriculum development to genuinely support the schooling of students with disabilities.

A Comparative Survey of Quality of Life (QOL) for Guide Dog Users and White Cane Users

A Comparative Survey of Quality of Life (QOL) for Guide Dog Users and White Cane Users

Assistive devices and future fall-related injuries among ambulatory adults with spinal cord injury: a prospective cohort study.

Prospective cohort study with two times of measurement. To assess the relationship between use of assistive devices for walking (at baseline) and the number of annual fall-related injuries (at follow-up) among a cohort of ambulatory adults with spinal cord injury (SCI). Medical University in the Southeastern United States. There were 622 ambulatory adults who met the eligibility criteria, 317 of whom completed both baseline and follow-up assessments. The participants completed a mailed self-report assessment (SRA) that measured self-reported number of fall-related injuries in the previous year, and the use of orthopedic equipment (assistive devices) for walking, including cane(s), crutches, walker, and braces, was assessed at both baseline and follow-up. The percentage of at least one self-reported fall-related injury decreased from 22% at baseline to 13% at the follow-up. Walker and cane use at baseline was significantly associated with fall-related injuries at follow-up. Participants using one walking device related to 194% greater number of fall injures, and using multiple device related to 730% greater number of fall injures than those who used no devices. We also found walker users were associated with 214% greater number of fall injures, while cane users were associated with 160% greater number of fall injures. The probability of fall-related injury remained high among persons who are ambulatory after SCI. Health care professionals should be aware of the balance between the goal of ambulation and the potential increased risk of fall-related injuries associated with assistive device use.

Are electronic white canes better than traditional canes? A comparative study with blind and blindfolded participants

Visually impaired individuals often rely on assistive technologies such as white canes for independent navigation. Many electronic enhancements to the traditional white cane have been proposed. However, only a few of these proof-of-concept technologies have been tested with authentic users, as most studies rely on blindfolded non-visually impaired participants or no testing with participants at all. Experiments involving blind users are usually not contrasted with the traditional white cane. This study set out to compare an ultrasound-based electronic cane with a traditional white cane. Moreover, we also compared the performance of a group of visually impaired participants (N = 10) with a group of blindfolded participants without visual impairments (N = 31). The results show that walking speed with the electronic cane is significantly slower compared to the traditional white cane. Moreover, the results show that the performance of the participants without visual impairments is significantly slower than for the visually impaired participants. No significant differences in obstacle detection rates were observed across participant groups and device types for obstacles on the ground, while 79% of the hanging obstacles were detected by the electronic cane. The results of this study thus suggest that electronic canes present only one advantage over the traditional cane, namely in its ability to detect hanging obstacles, at least without prolonged practice. Next, blindfolded participants are insufficient substitutes for blind participants who are expert cane users. The implication of this study is that research into digital white cane enhancements should include blind participants. These participants should be followed over time in longitudinal experiments to document if practice will lead to improvements that surpass the performance achieved with traditional canes.

The walking cane length influences the postural sway of community-dwelling older women.

Mobility-related problems in older people may be relieved by the use of walking canes. However, the influence of the cane length on the postural stability of cane users has not been explored. The objective of this study is to examine the influence of a single-point cane with different lengths on the postural sway of regular cane users, older women during two stance positions, with feet parallel and semi-tandem stance. Eighteen older women, who used a single-point walking cane for at least 6 months, stood on a force plate with feet parallel or in semitandem position for 40 s. They always used a cane that was adjusted to one of three different lengths resulting from the distance between the wrist crease and the floor, named WF, or this distance plus 7.5 or 10 cm. Amplitude and speed of the centre of pressure (COP) and its components (rambling and trembling) in the anterior-posterior and medial-lateral directions and mean vertical force applied to the cane were compared across cane lengths. The amplitude and velocity of COP, rambling and trembling increased with the cane length. This effect was observed for the anterior-posterior with the feet parallel and in the medial-lateral direction with the semi-tandem position. More force was applied on the shorter cane (WF) in semitandem position. Longer canes increased the postural sway in the older women and restricted the body weight loaded on the cane. Improper cane length influences the postural sway particularly in a semitandem stance of regular cane users. This may cause a negative impact on postural stability required in daily life activities. The current findings may contribute to the prescription of this assistive device for older adults.

Biomechanics of Long Cane Use.

The modern long cane has been used by people who are blind for traveling for decades. This article describes parameters surrounding the collection of over 10,000 trials of people walking with the long cane to detect drop-offs or obstacles. The data include 10,069 trials representing 101 different participants in 366 conditions over 11 studies spanning the 9 years from 2007 to 2016. Each of the studies investigated different participant or cane characteristics or both in terms of their effect on either drop-off or obstacle detection. Results of detection performance in these studies appear in other articles. This article describes biomechanical measures derived from 3-D motion analysis equipment used during the studies. Initial treatment of the large data set indicated that participants tended to not center their cane arc laterally on their body, deviating up to about 20 centimeters from midline. Arc widths averaged almost a meter, and arcs were generally centered. Participants were generally poor at being in step or having consistent rhythm. Coverage rates averaged about 85%. Although participants might have demonstrated artificially high skill performance due to being in a research study, data do offer insights into mechanical performance of skills. This survey of the data set indicates that not centering the hand holding the cane does not decrease body coverage less than about 85%. However, further analyses will be conducted to delve more deeply into all aspects of the data. Basic cane skills can be taught with short sessions and massed practice. Novices can acquire basic cane skills on par with cane users who are blind, but individual differences exist and the interplay of biomechanical variables needs to more fully understood.

Weight-Bearing Estimation for Cane Users by Using Onboard Sensors.

Mobility is a fundamental requirement for a healthy, active lifestyle. Gait analysis is widely acknowledged as a clinically useful tool for identifying problems with mobility, as identifying abnormalities within the gait profile is essential to correct them via training, drugs, or surgical intervention. However, continuous gait analysis is difficult to achieve due to technical limitations, namely the need for specific hardware and constraints on time and test environment to acquire reliable data. Wearables may provide a solution if users carry them most of the time they are walking. We propose to add sensors to walking canes to assess user’s mobility. Canes are frequently used by people who cannot completely support their own weight due to pain or balance issues. Furthermore, in absence of neurological disorders, the load on the cane is correlated with the user condition. Sensorized canes already exist, but often rely on expensive sensors and major device modifications are required. Thus, the number of potential users is severely limited. In this work, we propose an affordable module for load monitoring so that it can be widely used as a screening tool. The main advantages of our module are: (i) it can be deployed in any standard cane with minimal changes that do not affect ergonomics; (ii) it can be used every day, anywhere for long-term monitoring. We have validated our prototype with 10 different elderly volunteers that required a cane to walk, either for balance or partial weight bearing. Volunteers were asked to complete a 10 m test and, then, to move freely for an extra minute. The load peaks on the cane, corresponding to maximum support instants during the gait cycle, were measured while they moved. For validation, we calculated their gait speed using a chronometer during the 10 m test, as it is reportedly related to their condition. The correlation between speed (condition) and load results proves that our module provides meaningful information for screening. In conclusion, our module monitors support in a continuous, unsupervised, nonintrusive way during users’ daily routines, plus only mechanical adjustment (cane height) is needed to change from one user to another.

The non-visual image of the city: how blind and visually impaired white cane users conceptualize urban space

ABSTRACT Using the methodology of in-depth interviews, this article explores how blind and visually impaired white cane users conceptualize urban space. The study presented in the article showed that the city is conceived, even without visual mechanisms, through landmarks, paths, edges, nodes and districts, i.e. the types of elements in the city image defined by Kevin Lynch. However, spatial representations of blind people are produced on the basis of spatial experience that is proximal and not distal, as was the case with Lynch. The article discusses elements of the non-visual image of the city that are constructed through direct touch and white cane use. Drawing on Lefebvre’s stance on the interconnectedness of the body, practice and representational spaces, the author argues that the white cane is not just an aid that facilitates the mobility of blind people and helps to navigate in the urban space. As part of the ‘practico-sensory totality’ of the body, it also influences the ways in which the city is experienced and conceived.

Feasibility of Automated Mobility Assessment of Older Adults via an Instrumented Cane.

This study explored the feasibility of automated characterization of functional mobility via an Instrumented Cane System (ICS) within an older adult sample of cane users. An off-the-shelf offset cane was instrumented with inertial, force, and ultrasound sensors for noninvasive data collection. Eighteen patients from a neurological out-patient rehabilitation clinic and nine independently mobile controls participated in standard clinical evaluations of mobility using the ICS while under the care of an attending physical therapist. Feasibility of the ICS was gauged through two studies. The first demonstrated the capability of the ICS to reliably collect meaningful usage metrics, and the second provided preliminary support for the discriminability of high and low falls risk from system-reported metrics. Specifically, the cane significantly differentiated patients and controls (p < 0.05), and a measure of the variation in rotational velocity was associated with total scores on the Functional Gait Assessment (partial r = 0.61, p < 0.01). These findings may ultimately serve to complement and even extend current clinical assessment practices.

Factors Influencing Cane Use for the Management of Knee Osteoarthritis: A Cross-Sectional Survey.

To investigate demographic, symptom-related, and cognitive determinants of cane use for knee osteoarthritis (OA) and prioritize the factors that could facilitate cane use in people with no previous cane use. A survey of people ages ≥45 years with a clinical diagnosis of knee OA was conducted. The survey consisted of the following two sections: 1) demographic and cognitive determinants of cane use assessed via subscales of the Cane Cognitive Mediator Scale, and 2) 19 statements, underpinned by the Behaviour Change Wheel theoretical framework, relating to factors that could facilitate regular cane use. Logistic regression was used to examine determinants of cane use, while a priority pairwise ranking activity (1000minds software) determined the rank order of the 19 statements that could facilitate cane use. A total of 529 people completed Part 1 (80% females; 35% cane users) and 231 people completed Part 2. Age (odds ratio [OR] 1.06, 95% confidence interval [95% CI] 1.03- 1.09), body mass index (BMI) (OR 1.03, 95% CI 1.01-1.06), knee pain ≥3 years (OR 2.62, 95% CI 1.63-4.21) and numeric rating scale pain level while walking (OR 1.19, 95% CI 1.09-1.30) were significant independent determinants of cane use. In people who had never used a cane, statements relating to cane-use technique, fitting, knowledge of benefits, and motivation were ranked highest overall. Independent determinants of cane use include older age, higher BMI, greater pain duration, and greater severity of knee pain. Strategies targeting an individual's capability and motivation to use a cane may increase cane use among people with knee OA.

Obstacle Detection with the Long Cane: Effect of Cane Tip Design and Technique Modification on Performance

The purpose of this study was to investigate the effect of cane tip design and cane technique modification on obstacle detection performance as they interact with the size, height, and position of obstacles. A repeated-measures design with block randomization was used for the study. In experiment one, participants attempted to detect obstacles with either a marshmallow tip or a bundu basher tip. In experiment two, participants were asked to detect obstacles using either the constant-contact technique or a modified constant-contact technique. As predicted, the obstacle detection rate with the bundu basher tip (M = 66.1%, SD = 7.4%) was significantly higher than that with the marshmallow tip (M = 54.6%, SD =6.8%), F(1, 11) = 24.19, p < .001, r = .83. However, contrary to our hypothesis, the obstacle detection rate with the modified constant-contact technique (M =56.0%, SD = 7.4%) was significantly lower than that with the constant-contact technique (M = 61.3%, SD = 5.2%), F(1, 13) = 6.49, p = .024, r = .58. In addition, participants detected the obstacles that were positioned at the center of their walking path (M = 61.9%, SD = 6.6%) at a significantly higher rate than those positioned slightly off to the side (M = 55.4%, SD = 7.3%), F(1, 13) =10.73, p = .006, r = .67. A bundu basher tip was more advantageous than the marshmallow tip for detecting obstacles. Given the findings of the study, cane users and orientation and mobility (O&M) specialists should consider using or recommending a bundu basher tip (or a similar tip that has an increased contact area with the walking surface), particularly when the traveling environment often presents unexpected obstacles that may trip the cane user.

Walking Distance Estimation Using Walking Canes with Inertial Sensors.

A walking distance estimation algorithm for cane users is proposed using an inertial sensor unit attached to various positions on the cane. A standard inertial navigation algorithm using an indirect Kalman filter was applied to update the velocity and position of the cane during movement. For quadripod canes, a standard zero-velocity measurement-updating method is proposed. For standard canes, a velocity-updating method based on an inverted pendulum model is proposed. The proposed algorithms were verified by three walking experiments with two different types of canes and different positions of the sensor module.

Effect of cane length and swing arc width on drop-off and obstacle detection with the long cane.

A repeated-measures design with block randomization was used for the study, in which 15 adults with visual impairments attempted to detect the drop-offs and obstacles with the canes of different lengths, swinging the cane in different widths (narrow vs wide). Participants detected the drop-offs significantly more reliably with the standard-length cane (79.5% ± 6.5% of the time) than with the extended-length cane (67.6% ± 9.1%), p <.001. The drop-off detection threshold of the standard-length cane (4.1 ± 1.1 cm) was also significantly smaller than that of the extended-length cane (6.5±1.8cm), p <.001. In addition, participants detected drop-offs at a significantly higher percentage when they swung the cane approximately 3 cm beyond the widest part of the body (78.6% ± 7.6%) than when they swung it substantially wider (30 cm; 68.5% ± 8.3%), p <.001. In contrast, neither cane length (p =.074) nor cane swing arc width (p =.185) had a significant effect on obstacle detection performance. The findings of the study may help orientation and mobility specialists recommend appropriate cane length and cane swing arc width to visually impaired cane users.

Connected cane: Tactile button input for controlling gestures of iOS voiceover embedded in a white cane

ABSTRACTAccessibility of assistive consumer devices is an emerging research area with potential to benefit both users with and without visual impairments. In this article, we discuss the research and evaluation of using a tactile button interface to control an iOS device’s native VoiceOver Gesture navigations (Apple Accessibility, 2014). This research effort identified potential safety and accessibility issues for users trying to interact and control their touchscreen mobile iOS devices while traveling independently. Furthermore, this article discusses the participatory design process in creating a solution that aims to solve issues in utilizing a tactile button interface in a novel device. The overall goal of this study is to enable visually impaired white cane users to access their mobile iOS device’s capabilities navigation aids more safely and efficiently on the go.

Design of Cane Mechanism for Walking Aid of Visually Impaired Person

This paper presents a sensor-based cane mechanism for walking aid of the visually impaired person. We also describe an approach to decide properly the length of the specified cane mechanism. The cane mechanism has some sensors to identify the possibility of a collision between the cane user and an object and/or a person, and a signal processing unit that enables the user to recognize such a collision is attached in the mechanism. Thus, the walker using this cane can recognize in advance the possibility of such a collision in his walking process. Consequently, it is helpful for the visually impaired person to walk on a pedestrian road safely. The feature of the proposed cane mechanism and its availability have been shown through experimental works in a typical walking environment.