Power Wheelchair Research Articles

Towards Developing a Data Management System for Individuals with Upper/Lower Extremities Dysfunctions

<h3>Research Objectives</h3> The data management system was designed to integrate an individual's profile to track their progress and receive the recommended advice from the expert. <h3>Design</h3> Experimental study. <h3>Setting</h3> In the Biorobotics Lab. <h3>Participants</h3> Ten healthy participants (Mean age 27.86 years old). <h3>Interventions</h3> An assistive robotic device performing 19 essential daily tasks was controlled by a participant in a power wheelchair using a finger and chin Joystick along with eye gaze control. After the study, the participants were asked to fill out a user satisfaction survey. <h3>Main Outcome Measures</h3> We assessed the data management system in three modes: (I) Store and visualize data, (II) Track the progress of the participants, and (III) Get recommendations from experts based on the data. <h3>Results</h3> The system was successfully utilized to store, monitor, and visualize the experimental data of everyday life activities while maintaining confidentiality and security. From the results, we can conclude that the data management system has successfully fulfilled its desired goal concerning the fact to monitor individuals with disability remotely and efficiently with their regular improvement. <h3>Conclusions</h3> The successful completion of the data management system ensured the overall quality of care. In our next step, we will test the feasibility and usability of the system with upper/lower extremities dysfunction. <h3>Author(s) Disclosures</h3> The authors have no conflict of interest to declare.

Digital Twin in the Provision of Power Wheelchairs Context: Support for Technical Phases and Conceptual Model

Worldwide, many wheelchair users find it difficult to use or acquire a wheelchair that is appropriate for them, either because they do not have the necessary financial support or because they do not have access to trained healthcare professionals (HCPs), but they are essential for the correct provision of assistive products and user training. Consequently, although wheelchairs are designed to promote the well-being of many users, in many cases, they end up being abandoned or do not provide any benefit, with the chance of causing harm and potentially putting people in danger. This article proposes the creation and use of a Digital Twin (DT) of a Power Wheelchair (PWC) to promote the health of wheelchair users, by facilitating and improving the delivery of remote services by HCPs, as well as to include monitoring services to support timely maintenance. Specifically, a DT is a virtual counterpart that is seamlessly linked to a physical asset, both relying on data and information exchange for mirroring each other. Currently, DT is emerging and being applied to different areas as a promising approach to gather insightful data, which are shared between the physical and virtual worlds and facilitate the means to design, monitor, analyze, optimize, predict, and control physical entities. This article gives an overview of the Digital Twin concept, namely its definition, types, and properties, and seeks to synthesize the technologies and tools frequently used to enable Digital Twins; we also explain how a DT can be used in the technical phases of the PWC provision process and propose a conceptual model highlighting the use of an MDD approach benefiting from a Petri net formalism, which is presented to systematize the development of a PWC DT.

An ecological approach to self-reflections on the inaccessibility of arts and cultural activities to wheelchair users

First, as a fan of live music and a power wheelchair user living with congenital muscular dystrophy, I use critical storytelling to describe my personal experiences of negotiating for accessibility during participation in arts and cultural activities. Second, I reflect broadly on the ableist ideologies that contribute to the inaccessibility of arts and cultural activities, focusing on the narrow scope of target participants, the ableist rationale for accessibility service provision, the inaccessibility of promotional materials and ticketing, segregated seating arrangements, venue inaccessibility, and single-modal performance. Third, I highlight the detrimental impact of the inaccessibility of arts and cultural activities at the organizational, social, intergroup, interpersonal, and individual levels. Finally, I propose future research directions and suggestions for inclusive practice in arts and cultural activities. This paper aims to promote self-empowerment, unravel the manifestations of ableism in arts and cultural activities, and stimulate readers’ critical reflection on in/accessibility of arts and cultural activities.

The differences in demographics, fear of falling, transfer quality and participation enfranchisement between manual and power wheelchair users with multiple sclerosis and spinal cord injury

Purpose To examine the differences in demographics, fear of falling (FOF), transfer quality and participation enfranchisement between manual and power wheelchair users with multiple sclerosis (MS) and spinal cord injury (SCI). Materials and methods Secondary data analysis including 126 manual or power wheelchair users with MS and SCI (median age, 53.00 years, IQR = 24.00). Demographic information including age, gender, height, weight and disability duration was collected. Body mass index (BMI) was calculated for all participants. Participation enfranchisement was examined using both subscales (Importance and Control) of the enfranchisement scale of the Community Participation Indicator (CPI). FOF was assessed using the Spinal Cord Injury-Falls Concern Scale (SCI-FCS) and transfer quality was assessed using the Transfer Assessment Instrument (TAI) 3.0 and 4.0. Mann–Whitney’s U-tests or independent samples t-tests and chi-square were used to analyse the differences between continuous variables and categorical variables, respectively. Results Fifty-seven percent of participants were manual wheelchair users. There were significant differences in most demographic information except for weight and disability duration. Significant differences were also found for BMI (t = 1.06, p = 0.04), CPI-Importance (U = 1282.50, p < 0.01), CPI-Control (U = 1165.50, p < 0.01) and SCI-FCS (t = 4.08, p < 0.01). Manual wheelchair users outperformed power wheelchair users in all outcomes analysed except the TAI (p = 0.18). Conclusions Power wheelchairs users presented with a higher BMI, reported lower participation enfranchisement, and reported higher levels of FOF compared to manual wheelchair users. The findings may help clinicians to develop targeted rehabilitation goals specific for power and manual wheelchair users with MS and SCI.

Consensus for a power wheelchair training approach for people with cognitive impairments

Purpose Power wheelchairs (PWCs) can enhance independent mobility. The World Health Organization recommends training PWC users. However, current PWC training approaches do not always meet the needs of PWC users with complex mobility and cognitive impairment. The aim was to co-develop an innovative approach to PWC training for individuals with complex mobility and cognitive impairments. Materials and methods A two-phase mixed method research, involving PWC users, clinicians and researchers throughout all aspects of the research, was realized. (1) Interviews and focus groups were used. (2) The Delphi method was followed to refine the PWC training approach. Results Phase 1: Twenty-six stakeholders indicated that PWC training should consider the client as a partner, the learning environment, the proposed activities, interactions with the trainer and intervention format. Phase 2: two hundred and seven participants agreed that the PWC training should be goal directed, should be client-centred and occupation-based, should enhance client–therapist relationships and should be realized in a safe and adapted environment. Conclusions Stakeholders on PWC use came to agreement on key components that should be applied when training people with cognitive impairments.

Older Wheelchair Users Recommend Age-Friendly Design Improvements to a Wheelchair Maintenance App: Mixed Methods Development Study.

Wheelchair part failures have doubled over the past decade. Preventative wheelchair maintenance reduces wheelchair failures and prevents user consequences. We are developing a smartphone app called WheelTrak, which alerts users when maintenance is required, to encourage maintenance practices and compliance. This mixed methods study aimed to develop a wheelchair maintenance app using broad stakeholder advice and investigate older adults' interaction experience with the app and their perceived barriers to and facilitators of maintenance. Interviews were conducted with stakeholders, including mobility device users, to generate needs statements and app specifications. The app was designed in 2 stages. Stage 1 involved the development of the app according to the specifications and evaluation of the app interface by lead users. Stage 2 included the revision of the app screens and manual functionality testing. Usability testing and semistructured interviews were conducted with older wheelchair and scooter users. The System Usability Scale was used to measure app usability. Interviews with power and manual wheelchair users (37/57, 65%), wheelchair service providers (15/57, 26%), manufacturers (2/57, 4%), seating and mobility researchers (1/57, 2%), and insurance plan providers (2/57, 4%) informed the needs and specifications of the app technology. The 2-stage development process delivered a fully functional app that met the design specifications. In total, 12 older adults (mean age 74.2, SD 9.1 years; n=10, 83% women; and n=2, 17% men) participated in the usability testing study. Of the 12 participants, 9 (75%) agreed to use WheelTrak for preventative maintenance. WheelTrak scored an average System Usability Scale score of 60.25 (SD 16). Four overarching themes were identified: WheelTrak app improvements, barriers to maintenance, consequences related to mobility device failure, and smart technology use and acceptance. Older adults preferred the simplicity, readability, personalization, and availability of educational resources in the app. Barriers to maintenance pertained to health issues and lack of maintenance knowledge among older adults. Facilitators of maintenance included notification for maintenance, app connectivity with the service provider, reporting of device failure, and the presence of a caregiver for maintenance. This study highlighted age-friendly design improvements to the app, making it easy to be used and adopted by older wheelchair users. The WheelTrak app has close to average system usability. Additional usability testing will be conducted following app revision in the future.

Estimating power wheelchair battery lifespan based on real-world data

Purpose The purpose of this study was to: (1) estimate battery lifespan in power wheelchairs (PWCs) as measured by the length of time until battery replacement occurs and (2) identify factors associated with variability in battery lifespan after device distribution. Materials and methods PWCs distributed between 1 January 2016 and 31 December 2018 were retrieved from the Wheelchair Repair Registry (WRR) and included into this retrospective cohort study. Factors associated with battery lifespan were examined with the stratified Cox proportional hazard model. Results A data set of 1268 PWCs from four different manufacturers was analysed. Five hundred and ten PWCs (40.2%) had one battery replacement with median battery lifespan of 22.3 months. The overall cumulative incidences of battery replacement were 14.5%, 56.2% and 88.2% at the end of the first, second and third year after device distribution, respectively. Among PWC manufacturers, manufacturer C (hazard ratio (HR), 2.63; 95% confidence interval (CI), 1.35–5.12; p = 0.004) and manufacturer D (HR, 3.02; 95% CI, 1.51–6.01; p = 0.002) were associated with shorter battery lifespan. PWCs operated in warmer states (65–75 °F annual temperature averages) were associated with longer battery lifespan. Conclusions Results showed that the median battery lifespan was 22 months. PWC manufacturer and operating climate temperature were associated with variability in battery lifespan. This research has implications to better inform users, providers, manufacturers and payers to be more aware of battery lifespan across PWC types and manufactures to anticipate replacement timelines and avoid adverse situations associated with battery failures. Implications for rehabilitation There are differences in battery lifespan across different power wheelchair (PWC) manufactures. Power wheelchair batteries last longer in warmer operating climates. Future attention needs to be sought towards the types of batteries manufacturers are using for PWC group classifications. These types of studies could be useful to justify reasonable timelines and the costs associated with battery replacements.

Usability Evaluation of Access Ramps in Transit Buses: Preliminary Findings

The research literature on access ramps used in transit vehicles is undermined by inconsistent methodologies used across studies, thus providing an inconclusive evidence base for proposed Federal guidelines that would impose a maximum 1:6 slope for all deployment situations. The current study assessed the usability of ramp slope for mobility aid users. Four access ramp slopes were evaluated, with 27 adults representing three populations: manual wheelchair users, power wheelchair users, and people with vision impairment who use a cane or service animal. The dependent variables included five usability measures. The 1:8 and 1:12 slopes were usable and acceptable for most participants. The data indicate that the 1:4 slope is too steep for safe unassisted boarding and disembarking. Many manual wheelchair users lacked the strength needed for unassisted ascent. Power wheelchair users and people with vision impairment expressed safety concerns about descent of steeper slopes. Conclusive interpretations should be cautiously drawn because the sample size was relatively small and did not include users of scooters or ambulation aids.

Developing an Immersive Virtual Reality Training System for Novel Pediatric Power Wheelchair Users: Protocol for a Feasibility Study.

BackgroundPower wheelchairs can empower children with physical limitations to gain independence in their everyday lives; however, traditional methods of power wheelchair training are often limited by poor accessibility and safety concerns. Immersive virtual reality technology (IVRT) uses advanced display technology to place users in a fully immersive web-based environment that can support real-time skills training, often requiring less resources and fewer safety concerns than real-world methods. IVRT interventions have shown to be a feasible training option among adult power wheelchair users; however, there is still a need to understand the technical and clinical feasibility of developing an IVRT power wheelchair training tool for the pediatric population.ObjectiveThis proposed study aims to use expert feedback and an iterative design process to develop an IVRT training intervention for pediatric power wheelchair skill development.MethodsThis 3-phase feasibility study will be conducted within the assistive technology unit of a public pediatric hospital. Separate participant groups will be recruited for each phase, consisting of approximately 10 to 15 clinicians (phase 1), 10 pediatric power wheelchair users (phase 2), and 15 to 20 additional pediatric power wheelchair users (phase 3). Phase 1 will be conducted to gather feedback on the baseline IVRT training intervention. Clinicians will test the intervention and assess its usability and acceptability using qualitative and quantitative methods. Phase 1 participants will also be invited back for a subsequent session to reassess a revised version of the training intervention that has been updated based on their previous feedback. Phase 2 and phase 3 will also use mixed methods to gather feedback on the usability, acceptability, and user experience of the IVRT training intervention from current pediatric power wheelchair users. In addition, phase 3 participants will perform a skills transfer assessment to compare power mobility skill performance between the virtual reality and real-life environments. Data gathered in phase 2 will be used to further refine the IVRT intervention, whereas phase 3 data will be used to statistically evaluate the final version.ResultsThis study was approved by the Izaak Walton Killam Health Centre research ethics board in August 2021. Phase 1 testing began in February 2022. The entire study is expected to be completed by 2023.ConclusionsThe results of this study will be used to create an IVRT training intervention for pediatric power wheelchair skill development through an iterative and collaborative design process. Results may also assist in directing future studies in this area.International Registered Report Identifier (IRRID)DERR1-10.2196/39140

P.68 Validation of a composite prognostic score for time to loss of ambulation in Duchenne muscular dystrophy

Loss of ambulation (LoA) is a critical milestone in the progression of Duchenne muscular dystrophy (DMD) that usually occurs by the early teens, with significant variation across individuals. Accurate individualized predictions of time to LoA are valuable for DMD drug development (e.g., enrichment of trial populations and benchmarking of long-term treatment outcomes), as well as for counseling of patients and caregivers (e.g., advance ordering of a power wheelchair, preparing home modifications for accessibility). A composite prognostic score for LoA was previously developed based data from 608 boys and 1,240 years of follow-up across multiple DMD natural history and placebo-arm data sources. Timed function tests, steroid type, height and weight were identified as the most important predictors of LoA. We independently validated this score using data from 226 patients with 819 years of follow-up in the CINRG Duchenne natural history study, which was not used for score development. The previously-defined prognostic groups showed excellent risk stratification in the validation data, with median times to LoA of 1.8, 3.8, 7.8 and >9.0 years across groups, compared with medians of 1.1, 2.1, 4.1 and >9.0 years in the training data. Risk groups were well-differentiated despite the use of different LoA definitions in the training data (inability to walk 10 meters or complete the 6-minute walk test) and validation data (full-time wheelchair dependence), but shifted to later median ages in the validation data. Simplified prognostic scores were also explored using classification and regression trees to identify functional thresholds that best predicted time to LoA. Individualized prediction of time to LoA is possible in DMD, and is most accurate when based on a composite profile of motor function. Calibration of prognostic scores to specific definitions of LoA is important for quantitative accuracy, and for applications in clinical management and drug development.

VP.13 Updates on the development of the spinal muscular atrophy - person-reported outcome (SMA-PRO): A caregiver and self-proxy performance measure for child

There is a need for person-reported outcome measures for SMA. The PEDI-CAT is a caregiver-reported measure used to describe functional skill performance. Convergent validity of the PEDI-CAT with SMA phenotypes was established, and Rasch analysis of the full item bank revealed representation of abilities for SMA III and for daily activities for SMA II, but a floor effect for SMA I. Results led to the development of a new measure to include a larger item bank with caregiver and self-proxy options. Goals were 1) To describe the SMA PRO test development, including focus groups and cognitive-testing for item content 2) To describe the development of branching logic for data collection and 3) To report interim results on data collected with the new measure. Clinicians with expertise in SMA participated in 4 focus groups. Clinicians reviewed the results of the Rasch analysis and discussed content, scoring and clarity for the 76 daily activities and 105 mobility items. Thirty mobility and 69 daily activities items were added to address the floor effect and include items for infants and adults. A power wheelchair domain was created with 35 items and illustrations including "maintaining hand on wheelchair joystick while driving on uneven terrain." Illustrations were re-created to increase relevance for adults and children. The new items and illustrations were reviewed and several items were discarded due to perception of redundancy. Clinicians then conducted cognitive interviews with 15 study participants (7 caregivers and 8 adolescents and adults with SMA). A maximum of 30 items with accompanying illustrations were reviewed at each interview with probing questions including, "In your own words, what do you think this question is asking?" and "Does the illustration match the item wording?" Cognitive interview results were collated and items were further edited. The final items and illustrations were added to a database, and branching logic was established based on pre-determined "stopping rules" to minimize the total number of items required for each respondent. Item surveys were sent to participants and caregivers via a secure email, and data was collected prospectively. At the time of this interim study point, 58 surveys had been completed (16 "non-sitters," 38 "sitters" and 25 "walkers") across 4 functional domains. Data collection is underway, and a full analysis will be performed in order to validate the measure.

Functional mobility, employment and safety benefits of seat elevating devices

ABSTRACT Seat-elevating devices (SEDs) allow vertical movement of the seat of a power wheelchair (PWC), so users can perform activities of daily living including transferring and reaching. RESNA’s position papers on SEDs and the wheelchair provision process highlight the benefits of SEDs and the need for outcome measurement. The Functional Mobility Assessment (FMA) is a satisfaction measure to carry out specific tasks including transferring and reaching. The purpose of this retrospective study was to evaluate the relationship between the use of SEDs on the FMA and uniform dataset (UDS) with a sample of 1,733 PWC users. Independent-samples t-tests and Mann–Whitney U tests were used to compare total FMA and individual FMA item scores between those with and without an SED. A univariate linear regression model was used to control for confounding variables and determine if SEDs were a predictor of variance in FMA. Those with SEDs had significantly higher total FMA percentage score (mean = 76.7 ± 20.9) than those without SEDs (mean = 59.6 ± 24.7; t = 11.9, p < 0.001). Those with SEDs had significantly higher reach (U = 99849.0, p < 0.001) and transfer (U = 140587.0, p < 0.001) scores. The functional, vocational, and safety benefits of SEDs should be considered when determining coverage for SEDs. Status of Research Process Study completed. Involvement of Assistive Technology Users Participants were power wheelchair users.

Evaluation of a new assistive technology: the StandBar

Purpose Evaluate the potential of a wheelchair assistive technology (StandBar) to promote power wheelchair users’ ability to safely stand independently from their power wheelchair and determine the impact of the device use on psychological well-being for both power wheelchair users and their caregivers. Materials and methods A convenience sample of 11 power wheelchair users and caregiver dyads provided study data. Participants included power wheelchair users who were existing StandBar users or currently in training with the StandBar as part of their rehabilitation. Assessments were conducted at baseline and at six-month follow-up and included physiological assessments and functional testing with and without the StandBar. Monthly follow-up phone calls were completed to collect information on adverse events (e.g., falls, hospitalizations, and skin breakdown). A qualitative interview assessed StandBar users’ and caregivers’ perception at six-month follow-up. Results and conclusions StandBar use provided power wheelchair users a higher level of independence, confidence, and safety. All participants highly recommended StandBar use to others with similar levels of functional impairment. StandBar use allowed many participants the ability to complete functional tasks that were otherwise not possible without assistance. Qualitative interviews reported improved independence and psychological well-being for StandBar users as well as reduced levels of anxiety and burden of care by caregivers. The StandBar is a cost-effective assistive technology that promotes independence and functionality for power wheelchair users and improves the psychological well-being of users and their caregivers. Implications for Rehabilitation StandBar allows power wheelchair users to: Minimize negative effects of immobilization. Increase independence for activities of daily living (grooming, hygiene, toileting, transfers) and instrumental activities of daily living (social experiences). Improve their quality of life through increasing independence and confidence. Reduce need for assistance and corresponding caregiver burden.

"Back into Life-With a Power Wheelchair": Learning from People with Severe Stroke through a Participatory Photovoice Study in a Metropolitan Area in Germany.

Severe stroke leads to permanent changes in everyday life. Many stroke survivors depend on support in community mobility (CM). This leads to restrictions and limited social participation. A power wheelchair (PWC) can enable independent CM and reduce such restrictions. This participatory study focused on how people with severe stroke experience their CM in a PWC in Berlin/Germany and what changes they want to initiate. A research team of five severe stroke survivors and two occupational therapists examined the question using photovoice. Stroke survivors took photos of their environment, presented, discussed, and analyzed them at group meetings to identify themes, and disseminated their findings at exhibitions and congresses. The photos emphasize the significance of and unique relationship to the PWC for the self-determined expression of personal freedom. As a complex, individualized construct, CM requires an accessible environment and diverse planning strategies by PWC users to arrive at their destination and overcome suddenly occurring obstacles. Desired changes stress CM independent of external help, increased social esteem, and active involvement in the provision of assistive devices. Voices of severe stroke survivors need to be heard more in healthcare and research to ensure the possibility of equal social participation.

Evaluating surface EMG control of motorized wheelchairs for amyotrophic lateral sclerosis patients

BackgroundThis study evaluated a novel control method for patients unable to independently control powered wheelchairs. Patients with amyotrophic lateral sclerosis often require a wheelchair but struggle with sufficient hand dexterity required for joystick control making them a population that needs this type of control method.MethodsThe study employed a novel control mechanism, using electromyography surface sensors applied to temporalis muscles able to measure the myoelectric voltage. Pattern and magnitude control of muscle contraction allowed for steering intention recognition and were used to manipulate their power wheelchair joystick. Four patients ages 51 to 69, two female and two male with amyotrophic lateral sclerosis, conducted Wheelchair Skills Test developed by Dalhousie University and were surveyed on the experience’s Clinical Global Impression of Change.ResultsFindings showed independent steering was capable for patients without hand function and provided recommendations for improved human-machine interface. All patients demonstrated the ability to engage the system, with varying precision, for driving their wheelchair in a controlled environment.ConclusionsThree patients in the pilot trial reported the highest score of clinical global impression of change, all of whom had lost independent control of their wheelchair joystick. Patient four retained impaired hand dexterity for joystick control and reported negative impression of change, comparatively. Feedback from the study will be leveraged to improve training outcomes.Trial registration Subjects provided signed informed consent according to the Declaration of Helsinki to enter the study that was approved by the Mayo Clinic Institutional Review Board in Rochester, Minnesota. The study is registered on ClinicalTrials.gov under identifier NCT04800926 as of March 14, 2021 retrospectively registered.

Standing power wheelchairs and their use by children and youth with mobility limitations: an interrupted time series

Standing power wheelchairs (PWSDs) expand positioning and mobility options for individuals with motor impairments. Although more available, little is known about how PWSDs are used in everyday life. Purpose to describe children’s use of PWSDs in the first three months post-wheelchair delivery and the impacts on satisfaction with participation in daily life. Materials and Methods An interrupted time series of purposefully sampled children aged 5–18 years who were receiving a PWSD. The Wheelchair Outcome Measure for Young People (WhOM-YP) documented satisfaction with patient-reported meaningful participation outcomes. Data loggers objectively measured wheelchair mobility outcomes including distance travelled, bouts of mobility, and duration. Data were measured over two sessions pre-wheelchair-delivery and at one week, one month and three months post-wheelchair-delivery. Results Six children aged 7–18 years participated, four diagnosed with cerebral palsy, two with spina bifida. Analyses of individual data illustrated positive change in overall WhOM-YP satisfaction scores after PWSD provision though change varied across time, as did, distance, bouts of mobility and duration of use. Participants identified 14 in-home and 16 out-of-home unique participation outcomes, although several commonalities existed. Conclusion PWSDs hold promise for increasing children’s satisfaction with participation in daily life, in addition to possibly increasing mobility outcomes. IMPLICATIONS FOR REHABILITATION For children with mobility limitations, PWSDs may promote participation in daily life and increased mobility. Data logger technology provides valuable information about children’s PWSD use and how this varies over time. Benefits and challenges exist with implementing PWSD and data logger technologies. When implementing PWSD use, it is critical to consider context, training and support needs of clients and caregivers.

"What Do You Need? What Are You Experiencing?" Relationship Building and Power Dynamics in Participatory Research Projects: Critical Self-Reflections of Researchers.

Participatory approaches create opportunities for cooperation, building relationships, gaining knowledge, rethinking, and eventually changing power structures. From an international perspective, the article looks at the historical development of different participatory approaches in which building relationships and managing the balance of power between persons engaged in participatory research are central. The authors present and critically reflect on four research projects to show how they understood and implemented participatory research in different ways and what they have learned from their respective experiences. The “PaSuMi” project worked in the context of addiction prevention with migrants and provides a glimpse into different contexts of participatory research. The initiator of the study “Back into life—with a power wheelchair” works with post-stroke individuals who use the assistive device in community mobility and reflects on the shifting and intertwining roles of participants. In the research project “Workshops for implementation of expanded community nursing”, new professional roles for nurses in community nursing were developed; here limitations to participation and ways to deal with them are illustrated. Finally, the “DIPEx” project deals with challenges of enabling participation of persons with multiple sclerosis via narrative interviews on the experience of health and illness. All examples underline the necessity of a permanent reflection on relationships and power dynamics in participatory research processes.

Feasibility and clinical applicability of a novel power wheelchair training approach

Purpose To evaluate the feasibility and the clinical applicability of administering the COMET (cognition, occupation, mobility, evaluation and training) intervention. Materials and methods A pilot research was conducted with adults who were being considered for power wheelchair (PWC) provision, or who were recently provided a PWC, and who had been identified to benefit from a PWC training. The COMET intervention applies a goal directed, client-centred and occupation-based approach. Feasibility and applicability indicators were collected for: process, resources, management and treatment. Indicators were evaluated as “successful/unsuccessful”. Clinical outcomes included the Goal Attainment Scale (GAS), the Canadian Occupational Performance Measure (COPM), the Power mobility Indoor Driving Assessment (PIDA) and the Wheelchair Skills Test (WST). Results Four females (62.5 ± 3.5 years) with cognitive impairment participated in the study. Among the 13 indicators, 10 were successfully achieved. Indicators that did not meet the criteria for success were adherence rate, safety and treatment for the PIDA. Two adverse events were reported, with one minor injury. Participants demonstrated better than expected results on the GAS, the COPM scores and the WST. However, only two reported an improvement beyond 4% of the PIDA. Conclusions With few modifications, the COMET intervention and the study protocol will be feasible and applicable in clinical practice. Individuals with complex cognitive and mobility impairment demonstrated abilities to learn PWC use. Further investigation of the COMET intervention is required to evaluate its efficacy. Implications for rehabilitation A novel power wheelchair (PWC) training approach adapted to individual with complex mobility and cognitive impairments was developed: the COMET (cognition, occupation, mobility, evaluation and training) intervention. The COMET intervention applies a goal directed, client-centred and occupation-based approach. With minor modifications, the COMET intervention may be feasible and clinically applicable to train individuals with complex motor and cognitive impairments how to use a PWC. Further evaluation of the COMET intervention and lager control trialsare suggested.

Control of a Wheelchair-Mounted 6DOF Assistive Robot With Chin and Finger Joysticks.

Throughout the last decade, many assistive robots for people with disabilities have been developed; however, researchers have not fully utilized these robotic technologies to entirely create independent living conditions for people with disabilities, particularly in relation to activities of daily living (ADLs). An assistive system can help satisfy the demands of regular ADLs for people with disabilities. With an increasing shortage of caregivers and a growing number of individuals with impairments and the elderly, assistive robots can help meet future healthcare demands. One of the critical aspects of designing these assistive devices is to improve functional independence while providing an excellent human–machine interface. People with limited upper limb function due to stroke, spinal cord injury, cerebral palsy, amyotrophic lateral sclerosis, and other conditions find the controls of assistive devices such as power wheelchairs difficult to use. Thus, the objective of this research was to design a multimodal control method for robotic self-assistance that could assist individuals with disabilities in performing self-care tasks on a daily basis. In this research, a control framework for two interchangeable operating modes with a finger joystick and a chin joystick is developed where joysticks seamlessly control a wheelchair and a wheelchair-mounted robotic arm. Custom circuitry was developed to complete the control architecture. A user study was conducted to test the robotic system. Ten healthy individuals agreed to perform three tasks using both (chin and finger) joysticks for a total of six tasks with 10 repetitions each. The control method has been tested rigorously, maneuvering the robot at different velocities and under varying payload (1–3.5 lb) conditions. The absolute position accuracy was experimentally found to be approximately 5 mm. The round-trip delay we observed between the commands while controlling the xArm was 4 ms. Tests performed showed that the proposed control system allowed individuals to perform some ADLs such as picking up and placing items with a completion time of less than 1 min for each task and 100% success.

Wheelchair Assistance and Guidance Using IOT

A Smart Wheelchair is a Power Wheelchair with numerous sensors, assistive technology, and computers built in that allow a disabled person to travel around freely and safely. People with disabilities, such as impairments, handicaps, and life-altering injuries, are the users. The conventional wheelchairs are being increasingly replaced by these new models. Only 5 to 15% of the 70 million disabled individuals worldwide, according to the World Health Organization (WHO), have access to wheelchairs. As a result, we must supply a cost-effective Smart that uses cutting-edge components and technology while keeping costs to a minimum. They have embraced a number of technologies, including artificial intelligence, where they created an autonomous wheelchair that used machine learning principles to travel. Some of them have also used the Internet of Things to manage the wheelchair using a voice recognition system. This report will outline an inexpensive Smart Wheelchair-based Arduino Nano microcontroller and Internet of Things (IoT) technology that has a number of features to help disabled people, particularly poor people who cannot afford an expensive Smart Wheelchair, get the assistance they need to complete daily tasks without help. As a result of this project, a variety of disabled people will be able to afford smart wheelchairs. It will be powered by Arduino Nano, ESP-12e module for Wi-Fi access, MPU6050 for fall detection with voice message notification using IFTTT platform, obstacle detection with buzzer and LED for hazard detection, voice recognition system, and joysticks for wheelchair control.