Mobility-impaired Individuals Research Articles

Shortening vehicle access permitting for mobility-impaired individuals to beaches in South Africa's National Parks

Shortening vehicle access permitting for mobility-impaired individuals to beaches in South Africa's National Parks

Experiment-free exoskeleton assistance via learning in simulation.

Exoskeletons have enormous potential to improve human locomotive performance1-3. However, their development and broad dissemination are limited by the requirement for lengthy human tests and handcrafted control laws2. Here we show an experiment-free method to learn a versatile control policy in simulation. Our learning-in-simulation framework leverages dynamics-aware musculoskeletal and exoskeleton models and data-driven reinforcement learning to bridge the gap between simulation and reality without human experiments. The learned controller is deployed on a custom hip exoskeleton that automatically generates assistance across different activities with reduced metabolic rates by 24.3%, 13.1% and 15.4% for walking, running and stair climbing, respectively. Our framework may offer a generalizable and scalable strategy for the rapid development and widespread adoption of a variety of assistive robots for both able-bodied and mobility-impaired individuals.

Piloting the effectiveness of the Workout on Wheels Internet Intervention (WOWii) program among individuals with mobility disabilities

BackgroundDoing any amount of moderate-to-vigorous physical activity yields health benefits. Individuals with mobility disabilities are among the least physically active Americans and limited evidence indicates effective strategies to promote physical activity among this group. ObjectiveExamine whether a 16-week virtual intervention program (Workout on Wheels internet intervention, WOWii) increases exercise engagement among mobility impaired individuals. MethodsParticipants recruited through community organizations that provide services to individuals with disabilities. The WOWii program is comprised of 3 core components: 16 weeks of virtual intervention delivery and access to the WOWii website; staff and peer support; an exercise package that included an activity tracker and heart rate monitor, pedal exerciser, and therabands. ResultsTen people enrolled. Participants demonstrated good program engagement, attending an average of 14.1 ± 2.1 of the 16 virtual meetings and completing an average of 10.6 ± 5.6 weekly activities. Exercise data revealed that participants increased their time spent in aerobic exercise from an average of two days a week performing 32 ± 22 min during week one to an average of five days a week doing 127 ± 143 min in the final WOWii week. Only half continued to exercise over the two months once WOWii virtual meetings ended. ConclusionWOWii program delivery successfully promoted increased exercise participation for people with mobility disabilities over the 16 intervention weeks. Future studies should investigate approaches to promote exercise maintenance beyond program delivery.

A Multicriteria Decision-making Approach to Create Accessible Environments to Empower Mobility-impaired Individuals

Individuals with mobility disabilities can experience numerous health advantages when connecting with nature in various ways, such as passive enjoyment, active participation, or rehabilitative programs. These benefits encompass physical and mental benefits, as well as social gains. However, a range of concerns related to making natural environments accessible to and usable by people with mobility impairments demand the attention of various professionals, including caregivers, landscape architects, rehabilitation therapists, and policymakers. Efforts to promote inclusivity and accessibility aim to remove barriers and create environments where individuals with disabilities can participate fully in education, employment, public life, and social activities. This may involve adapting physical spaces, promoting awareness, providing assistive technology, offering support services, and understanding of disability issues. To enhance the accessibility of public places for disabled people, we must consider multiple criteria and risks. In this article, to address such issues we develop three multicriteria decision-making (MCDM) approaches based on picture cubic fuzzy information. Since aggregation operators (AOPs) play a crucial role in decision-making, we present the aggregation proficiency for picture cubic fuzzy information and develop a series of AOPs, such as picture cubic fuzzy Hamacher order weighted averaging (PCFHOWA), picture cubic fuzzy Hamacher weighted averaging (PCFHWA), picture cubic fuzzy Hamacher hybrid averaging (PCFHHA) operators and present some essential properties of these Opts. After studying their fundamental operations and properties, we utilize these operators to develop multicriteria decision making (MCDM) model with picture cubic fuzzy information. We present the extended TOPSIS method and extended VIKOR mothod for MCDM problems. We present a numerical example related to improving accessibility for disabled people in a public park. The results explore the effectiveness of our proposed methodologies and provide accurate measures to address the uncertainty related to the accessibility of disabled people to public places.

Quantification of User Driving Behavior in Motorized Mobility Scooters using CNN-based Head Pose Estimation Algorithm.

There is a growing concern regarding the driving safety of Motorized Mobility Scooters (MMSs) for the elderly and mobility-impaired individuals. Although various research has made progress in sensor-based driving assistance systems to identify environmental hazards, few studies focus on investigating the impact of user behavior on MMS driving. In this paper, a driving status logging (DSL) system is developed to measure the user's behavior while driving. A cross-correlation analysis is implemented to quantify the temporal relationship between the head movement and steering operation in the driving of MMSs. The preliminary results suggest that the head movement can be used as an appropriate index to predict the intended steering operation in the driving of MMSs. Moreover, the quantified head-steering lag time provides the possibility to identify the hazardous driving pattern of MMS users.Clinical Relevance- The investigation of user behavior has the potential to improve the safety of MMSs. In this study, the user behavior in the driving of MMSs was quantitatively measured using the developed DSL system. Consequently, the temporal relationship between head movement and steering operation was first quantified in MMS-related research. These outcomes provide valuable insights into developing behavioral interventions to address the user's risky behavior patterns, thereby promoting the driving safety of MMSs.

There are unique kinematics during locomotor transitions between level ground and stair ambulation that persist with increasing stair grade

Human ambulation is typically characterized during steady-state isolated tasks (e.g., walking, running, stair ambulation). However, general human locomotion comprises continuous adaptation to the varied terrains encountered during activities of daily life. To fill an important gap in knowledge that may lead to improved therapeutic and device interventions for mobility-impaired individuals, it is vital to identify how the mechanics of individuals change as they transition between different ambulatory tasks, and as they encounter terrains of differing severity. In this work, we study lower-limb joint kinematics during the transitions between level walking and stair ascent and descent over a range of stair inclination angles. Using statistical parametric mapping, we identify where and when the kinematics of transitions are unique from the adjacent steady-state tasks. Results show unique transition kinematics primarily in the swing phase, which are sensitive to stair inclination. We also train Gaussian process regression models for each joint to predict joint angles given the gait phase, stair inclination, and ambulation context (transition type, ascent/descent), demonstrating a mathematical modeling approach that successfully incorporates terrain transitions and severity. The results of this work further our understanding of transitory human biomechanics and motivate the incorporation of transition-specific control models into mobility-assistive technology.

A gait phase prediction model trained on benchmark datasets for evaluating a controller for prosthetic legs.

Powered lower-limb assistive devices, such as prostheses and exoskeletons, are a promising option for helping mobility-impaired individuals regain functional gait. Gait phase prediction plays an important role in controlling these devices and evaluating whether the device generates a gait similar to that of individuals with intact limbs. This study proposes a gait phase prediction method based on a deep neural network (DNN). The long short-term memory (LSTM)-based model predicts a continuous gait phase from the 250 ms history of the vertical load, thigh angle, knee angle, and ankle angle, commonly available on powered lower-limb assistive devices. One unified model was trained using publicly available benchmark datasets containing intact limb gaits for level-ground walking (LGW) and ascending stairs (SA). A phase prediction error of 1.28% for all benchmark datasets was obtained. The model was subsequently applied to a state machine-controlled powered prosthetic leg dataset collected from four individuals with unilateral transfemoral amputation. The gait phase prediction results (a phase prediction error of 5.70%) indicate that the model trained on benchmark data can be used for a system not included in the training dataset with no post-processing, such as model adaptation. Furthermore, it provided information regarding evaluation of the controller: whether the prosthetic leg generated normal gait. In conclusion, the proposed gait phase prediction model will facilitate efficient gait prediction and evaluation of controllers for powered lower-limb assistive devices.

Colour as an agent to manage depression, anxiety and stress levels of mobility impaired individuals in healthcare facilities: Insights from a Rehabilitation Centre at Ragama, Sri Lanka

Individuals with physical disabilities, especially with impeded mobility have to deal with an array of physical, social, cultural and economic challenges, consequently leading to psychological imbalances, disorders and more inclined to attempt even suicide. Incorporating disabled-friendly design interventions, facilitating optimal healing in their healthcare facilities, is crucial to overcome most of these challenges and ensure their psychological well-being. Within this backdrop, this investigation focused on the impact of interior colours in health care facilities to manage depression, anxiety, and stress levels of disabled individuals. The investigation was executed with reference to wall colour of bedrooms of patients with limb deformities of a selected rehabilitation centre, at Ragama. Three hues (blue, yellow, and green) were tested by installing colour panels on the sidewall of the beds, allowing the patients to be exposed to each colour for three consecutive days. DASS-21 self-report scale was adopted to measure depression, anxiety, and stress levels of the patient. Green colour was found to be significantly supportive in inducing favourable impacts to manage depression, anxiety, and stress levels of patients over blue and yellow. Extending this study to test different tints, shades, and intensities of green colour, incorporating large samples with long-term exposure in an array of health care facilities, is recommended.

Applications of modern digital mapping systems to Assist inclusion of persons with disabilities in geoscience education and research

New and emerging technologies are changing the world as we know it, and how we choose to perform geologic fieldwork is changing as well. Recent developments in hardware and software provide unprecedented opportunities not only for conventional field studies but also for persons traditionally exempt from field-related research because of mobility issues or inability to travel. Geographic Information Systems (GIS) first allowed digital geologic mapping in the field, and these systems remain in widespread use because of ease of use and ease of data duplication for collaboration in work teams or field classes. We present a general 2D workflow based on GIS approaches that affords opportunities for physically disadvantaged individuals that includes cognitive steps driven by the data assembly process in GIS. Most notable is the digitization of linework and exploration of an area with Google Earth Pro (GEP) as steps, outside the field, that allow assessment of an area to formulate hypotheses that can be done by a physically disadvantaged person as well, or better, than those physically capable of field exploration. We then explore emerging technologies including pseudo-3D viewing using image drapes on an elevation model (aka 2.5D method) and true 3D approaches based on Structure-from-Motion photogrammetry that provide a powerful toolbox back at the office or at base camp that does not require physical abilities or direct field access. These 3D tools are potentially transformative for mobility impaired individuals that could allow them to work individually, or as part of a team, to assess field related problems. For all 3 levels of digital mapping (2D, 2.5D and 3D) we emphasize specific workflows designed to help the researcher perform digital geologic mapping with a specific focus on individuals with limited mobility. Some or all of what we suggest here, however, is of benefit to any field geologist and can be used to augment, or completely perform field studies.

Development of an Inexpensive Harnessing System Allowing Independent Gardening for Balance Training for Mobility Impaired Individuals

Balance is key to independent mobility, and poor balance leads to a risk of falling and subsequent injury that can cause self-restriction of activity for older adults. Balance and mobility can be improved through training programs, but many programs are not intensive or engaging enough to sufficiently improve balance while maintaining adherence. As an alternative to traditional balance training, harnessed gardening sessions were conducted in an urban greenhouse as an example of a community activity through which balance and mobility can be trained and/or maintained. An inexpensive multidirectional harness system was developed that can be used as an assistive or rehabilitative device in community, private, and senior center gardens to allow balance or mobility-impaired adults to participate in programming. Two wearable sensor systems were used to measure responses to the system: the Polhemus G4 system measured gardeners’ positions and center of mass relative to the base of support, and ActiGraph activity monitors measured the frequency and intensity of arm movements in garden as compared to home environments. The harnessed gardening system provides a safe environment for intense movement activity and can be used as a rehabilitation device along with wearable sensor systems to monitor ongoing changes.

An Orthotic Joint Design for Enhancing Ankle Mobility With Ankle Foot Orthoses Use

Abstract Articulated ankle foot orthoses (AFOs) are prescribed to treat drop-foot, a common neuromuscular weakness observed after a stroke. These assistive devices prevent the toe from dragging during swing (drop-foot) by providing a resistive moment at the ankle. However, existing ankle joint designs for articulated AFOs introduce additional gait pathologies as they also constrain ankle mobility during stance. A novel ankle joint for AFOs to prevent drop-foot during swing and improve ankle mobility during stance was developed, thereby reducing compensatory knee motion during stance. The design intent was to mimic the unconstrained kinematic response of a nonpathologic ankle at initial contact while preventing drop-foot during swing. The design incorporated two modes of operation: locked during swing for support and unlocked during stance for enhanced range of motion. Proof of concept testing with able-bodied subjects was conducted to test walking ability over level ground based on kinetic and kinematic parameters. The comparative tests confirmed the ability of the novel design to prevent drop-foot and its potential for enhanced ankle mobility during stance. Preliminary results indicate that the novel ankle joint should be refined to facilitate smooth and consistent unlocking but can be safely used in its current form with mobility impaired individuals.

“The fact that I can be in front of others, I am used to being a bit behind”: how assistive activity technology affects participation in everyday life

Purpose This article explores the experiences of mobility-impaired individuals participating in leisure-time physical activities through the use of assistive activity technology (AAT). Its purpose is to highlight how these experiences affect participation in everyday life. This article provides new knowledge about the participation of this population in leisure-time physical activities. Methodology Qualitative, semi-structured interviews were analysed according to the stepwise-deductive–inductive approach. During the analysis, self-determination theory (SDT) emerged as a theoretical tool for understanding how social context affects motivation as an interacting concept in the participation of leisure-time physical activity (LTPA). Findings Individuals with mobility impairments who use AAT for leisure-time physical activities experience opportunities to participate in ordinary and valued activities that allow them to improve their social positions. Further, use of AAT provided the informants with opportunities to alter their daily routines, enjoy time on their own and enhance their personal awareness. Having opportunities to use AAT independently is experienced as a recognition of their individuality. Thus, this article highlights a new aspect of participation as performing a socially valued activity in solitude. Conclusions How technology provides opportunities for social interaction influences the informants’ experiences and motivation to use technology. LTPA through the use of AAT promotes mastery and personal dignity, thereby revealing a new aspect of participation as being involved in an independent activity. IMPLICATIONS FOR REHABILITATION The allocation system for assistive activity technology requires knowledge about personal motivation for assistive activity technology use and the connection between leisure-time physical activity and social participation. Additional education about and understanding of motivational factors for assistive technology use is needed.

Patobulinto negalios priėmimo klausimyno (ADS-R) lietuviškos versijos psichometriniai rodikliai: žvalgomasis tyrimas

The internal consistency reliability and structure-related validity of the Lithuanian version of the Acceptance of Disability Scale – Revised (ADS-R), a 32-item instrument originally developed to assess an individual’s adaptation to disability, was the focus of the research study. The translated instrument was completed by 274 mobility impaired individuals aged from 18 to 80. In this pilot study, it was found that the Lithuanian version of ADS-R had preliminary sufficient internal consistency reliability and structure-related validity similar to those reported by the authors of the original instrument. However, this Lithuanian version still needs further studies with a larger sample and more specific disability representation for exploring the psychometric properties more thoroughly. Nevertheless, in that there are few instruments on adaptation that have already been translated and used with the Lithuanian population, the authors believe that this pilot study is a very important first step in the process of creating a valid and reliable instrument.

Probabilistic Fleet Sizing and Routing Problem to Minimize Mobility Disparities

The objective of this paper is to develop an analytical model to analyze the mobility behavior of a target population and to minimize the disparities. The analysis is conducted using household travel survey data collected from 7993 residents of five boroughs of New York City, where citizens with mobility impairments are considered as our target population. The study starts by quantifying the existing gap in the patterns of the mobility-impaired individuals and the base population followed by the generation of new activities in the agenda of the target population using the patterns of their nearest neighbors in the base population. Activities are generated based on copula sampling method. Attributes of activities forming the new agenda of the target population are the inputs that will be used for the design of an optimum ridesharing system. By integrating probabilistic models with the existing routing models, we develop a methodology to identify the optimum fleet size, optimum route, and optimum schedule such that all requests of the physically impaired travelers are fulfilled within a reasonable wait time for ride requesters.

The Importance of Educational Level and Occupation to Adjustment to Disability Among Mobility Impaired People

Every disability results in array of reactions ranging from negative affectivity to successful acceptance of disability among mobility impaired people. Previous studies suggest that educational level and occupation are potential variables affecting adjustment to disability but there is a lack of research analysing how these variables are related to individual’s reactions to disability.
 The aim of the study was to assess the importance of educational level and occupation to adjustment to disability among mobility impaired people.
 The study sample included 275 mobility impaired individuals, aged between 18 and 79. Their adjustment to disability was assessed using two questionnaires: 1) Reactions to Impairment and Disability Inventory (Livneh & Antonak, 1990), measuring six emotional reactions to disability: denial, depression, internalized anger, externalized hostility, acknowledgement and adjustment; 2) Acceptance of disability scale (Linkowski, 1971).
 The results revealed that individuals with higher educational level reported less internalized anger and externalized hostility compared to individuals with lower educational level. In addition, employed individuals expressed less depression and internalized anger and greater adjustment than unemployed individuals. Individuals who were students at the time reported less depression and greater denial, acknowledgement and adjustment to disability compared to those who were unemployed. Students also perceived greater externalized hostility than employed individuals. The results of linear regression indicated that employment and student status but not disability related variables significantly explained the variance of acceptance of disability.

Foot and Ankle Joint Biomechanical Adaptations to an Unpredictable Coronally Uneven Surface.

Coronally uneven terrain, a common yet challenging feature encountered in daily ambulation, exposes individuals to an increased risk of falling. The foot-ankle complex may adapt to improve balance on uneven terrains, a recovery strategy which may be more challenging in patients with foot-ankle pathologies. A multisegment foot model (MSFM) was used to study the biomechanical adaptations of the foot and ankle joints during a step on a visually obscured, coronally uneven surface. Kinematic, kinetic and in-shoe pressure data were collected as ten participants walked on an instrumented walkway with a surface randomly positioned ±15 deg or 0 deg in the coronal plane. Coronally uneven surfaces altered hindfoot-tibia loading, with more conformation to the surface in early than late stance. Distinct loading changes occurred for the forefoot-hindfoot joint in early and late stance, despite smaller surface conformations. Hindfoot-tibia power at opposite heel contact (@OHC) was generated and increased on both uneven surfaces, whereas forefoot-hindfoot power was absorbed and remained consistent across surfaces. Push-off work increased for the hindfoot-tibia joint on the everted surface and for the forefoot-hindfoot joint on the inverted surface. Net work across joints was generated for both uneven surfaces, while absorbed on flat terrain. The partial decoupling and joint-specific biomechanical adaptations on uneven surfaces suggest that multi-articulating interventions such as prosthetic devices and arthroplasty may improve ambulation for mobility-impaired individuals on coronally uneven terrain.

Human-directed coordinated control of an assistive mobile manipulator

This paper considers the control of a mobile manipulator with the end-effector commanded by a human user. The motivation is to empower mobility impaired individuals to tackle certain activities of daily living. The prototype robotic system consists of a redundant articulated arm mounted on a mobile base. The human user specifies the desired motion of certain degrees of freedom, such as the translation or rotation of the arm end-effector. An optimization-based control algorithm determines the full arm and base motion to minimize deviation from the human intent while satisfying certain equality and inequality constraints. These constraints may involve physical requirements of the system, e.g., collision avoidance and joint limits, and human user consideration, such as intuitiveness of the combined arm and base motion. This constraint optimization problem is strictly convex and may be efficiently solved as a quadratic problem. We demonstrate the effectiveness of the algorithm in simulation and experimentation, using a dual-arm Baxter robot mounted on a wheelchair as a prototype testbed. Human user commands the end-effector of one of the arms using a 3-degree-of-freedom interface, either a sip-puff or a joystick type of device. We demonstrate effective object retrieval and placement in an environment with obstacles.

A technique to record the sedentary to walk movement during free living mobility: A comparison of healthy and stroke populations

BackgroundHesitation between moving from a sedentary posture (lying/sitting) to walking is a characteristic of mobility impaired individuals, as identified from laboratory studies. Knowing the extent to which this hesitation occurs during everyday life would benefit rehabilitation research. This study aimed to quantify this transition hesitation through a novel approach to analysing data from a physical activity monitor based on a tri-axial accelerometer and compare results from two populations; stroke patients and age-matched unimpaired controls. MethodsStroke patients living at home with early supported discharge (n=34, 68.9YO±11.8) and age-matched controls (n=30, 66.8YO±10.5) wore a physical activity monitor for 48h. The outputs from the monitor were then used to determine the transitions from sedentary to walking. The time delay between a sedentary posture ending and the start of walking classified four transition types: 1) fluent (<=2s), 2) hesitant (>2s<=10s), 3) separated (>10s) and 4) a change from sedentary with no registered walking to a return to sedentary. ResultsControl participants initiated walking after a sedentary posture on 92% of occasions. Most commonly (43%) this was a fluent transition. In contrast stroke patients walked after changing from a sedentary posture on 68% of occasions with only 9% of transitions classed as fluent, (p<0.05). Discussion/ conclusionA new data analysis technique reports the frequency of walking following a change in sedentary position in stroke patients and healthy controls and characterises this transition according to the time delay before walking. This technique creates opportunities to explore everyday mobility in greater depth.

Examining the Perceptions of Mobility-Impaired Travelers: an Analysis of Service Expectations, Evaluations, and Travel Barriers

This study examines tourism experiences of mobility-impaired individuals, their evaluations and expectations from tourism service providers, and their satisfaction with the services provided. Data were collected from a sample of respondents in Eskisehir, Turkey. The findings suggest that health is not the main barrier to travel; instead, income is found to be one of the most important factors affecting the travel patterns of the mobility impaired. Additionally, while the respondents are found to have a generally favorable evaluation of hotel attributes, transportation services are found to present a significant barrier to travel. Implications and recommendations for strategic tourism management are provided.

Geocrowdsourcing and accessibility for dynamic environments

A consequence of modern society’s increasing reliance on digital communication is the concurrent multiplication and narrowing of information streams, with many channels of digital information, but channels which are difficult or impossible for some individuals to access. Blind and visually-impaired individuals are often left out of this communication, unless accommodations are carefully planned and made to present the information in a usable form. The context of this research is the realm of assistive geotechnology, where web mapping technology and geographic information systems are used to provide access to enabling information and services. This paper presents research on the development of tools to provide transient obstacle information to blind, visually-impaired, and mobility-impaired individuals through crowdsourcing, and research on the general accessibility of local pedestrian networks under constraints presented by transient and permanent navigation obstacles. We discuss the social and technological dynamics associated with the creation and use of our crowdsourcing system and present our effort for comprehensive quality assessment. We conclude that crowdsourcing is a crucial technique for successful deployment of assistive geotechnology, particularly those that involve navigation, wayfinding, and travel in public space. We find that many public health services and other important resources cannot be accessed dependably without the use of crowdsourcing and other techniques for capturing dynamic, changing environmental conditions. More broadly, this paper concludes by addressing the progression of user-generated and crowdsourced content from static data contributions to dynamic place-based services and the enabling role of assistive geotechnology in providing access and help to blind, visually-impaired, and mobility-impaired individuals.