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This paper focuses on the safety issue for cyclists and pedestrians at unsignalized intersections. The cycling speed needs to be calmed when approaching the intersection. This study proposes and deploys an integrated portable ultra-wideband/inertial navigation system (UWB/INS) to extract cycling trajectories for a cycling safety study. The system is based on open-source hardware and delivers an open-source code for an adaptive Kalman filter to enhance positioning precision for data quality assurance at an outdoor experimental site. The results demonstrate that the system can deliver reliable trajectories for low-mobility objects. To mitigate accident risk and severity, varied cycling speed calming measures are tested at an experimental site. Based on the trajectory data, the statistical features of cycling velocities are evaluated and compared. A new proposed geometric design is found to be most effective when compared with conventional traffic signs.

Introduction: Visual processing deficits in Alzheimer's disease are associated with diminished functional independence. While environmental adaptations have been proposed to promote independence, recent guidance gives limited consideration to such deficits and offers conflicting recommendations for people with dementia. We evaluated the effects of clutter and color contrasts on performances of everyday actions in posterior cortical atrophy and memory-led typical Alzheimer's disease., Methods: 15 patients with posterior cortical atrophy, 11 with typical Alzheimer's disease and 16 healthy controls were asked to pick up a visible target object as part of two pilot repeated-measures investigations from a standing or seated position. Participants picked up the target within a controlled real-world setting under varying environmental conditions: with/without clutter, with/without color contrast cue and far/near target position. Task completion time was recorded using a target-mounted inertial measurement unit., Results: Across both experiments, difficulties locating a target object were apparent through patient groups taking an estimated 50-90% longer to pick up targets relative to controls. There was no evidence of effects of color contrast when locating objects from standing/seated positions and of any other environmental conditions from a standing position on completion time in any participant group. Locating objects, surrounded by five distractors rather than none, from a seated position was associated with a disproportionately greater effect on completion times in the posterior cortical atrophy group relative to the control or typical Alzheimer's disease groups. Smaller, not statistically significant but directionally consistent, ratios of relative effects were seen for two distractors compared with none., Discussion: Findings are consistent with inefficient object localization in posterior cortical atrophy relative to typical Alzheimer's disease and control groups, particularly with targets presented within reaching distance among visual clutter. Findings may carry implications for considering the adverse effects of visual clutter in developing and implementing environmental modifications to promote functional independence in Alzheimer's disease., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Ocal, McCarthy, Poole, Primativo, Suzuki, Tyler, Frost, Crutch and Yong.)

Introduction: Clinical reports describe patients with Alzheimer's disease (AD) exhibiting atypical adaptive walking responses to the visual environment; however, there is limited empirical investigation of such behaviors or factors modulating their expression. We aim to evaluate effects of lighting-based interventions and clinical presentation (visual- vs memory-led) on walking function in participants with posterior cortical atrophy (PCA) and typical AD (tAD)., Methods: Participants with PCA (n = 10), tAD (n = 9), and healthy controls (n = 12) walked to visible target destinations under different lighting conditions within two pilot repeated-measures design investigations (Experiment 1: 32 trials per participant; Experiment 2: 36 trials per participant). Participants walked to destinations with the floorpath interrupted by shadows varying in spatial extent (Experiment 1: no, medium, high shadow) or with different localized parts of the environment illuminated (Experiment 2: target, middle, or distractor illuminated). The primary study outcome for both experimental tasks was completion time; secondary kinematic outcomes were proportions of steps identified as outliers (Experiment 1) and walking path directness (Experiment 2)., Results: In Experiment 1, PCA participants overall demonstrated modest reductions in time taken to reach destinations when walking to destinations uninterrupted by shadows compared to high shadow conditions (7.1% reduction [95% confidence interval 2.5, 11.5; P  = .003]). Experiment 2 found no evidence of differences in task performance for different localized lighting conditions in PCA participants overall. Neither experiment found evidence of differences in task performance between conditions in tAD or control participants overall. Completion time in both patient groups was longer relative to controls, and longer in PCA relative to tAD groups., Discussion: Findings represent a quantitative characterization of a clinical phenomenon involving patients misperceiving shadows, implicating dementia-related cortico-visual impairments. Results contribute to evidence-based design guidelines for dementia-friendly environments., Competing Interests: The authors have no conflicts of interest to declare., (© 2020 The Authors. Alzheimer's & Dementia: Translational Research & Clinical Interventions published by Wiley Periodicals, Inc. on behalf of Alzheimer's Association.)

People with Alzheimer's disease (AD) have characteristic problems navigating everyday environments. While patients may exhibit abnormal gait parameters, adaptive gait irregularities when navigating environments are little explored or understood. The aim of this study was to assess adaptive locomotor responses of AD subjects in a complex environment requiring spatial navigation. A controlled environment of three corridors was set up: straight (I), U-shaped (U) and dog-leg (S). Participants were asked to walk along corridors as part of a counterbalanced repeated-measures design. Three groups were studied: 11 people with posterior cortical atrophy (PCA), 10 with typical Alzheimer's disease (tAD) and 13 controls. Spatio-temporal gait parameters and position within the corridors were monitored with shoe-mounted inertial measurement units (IMUs). Hesitant steps were identified from statistical analysis of the distribution of step time data. Walking paths were generated from position data calculated by double integration of IMU acceleration. People with PCA and tAD had similar gait characteristics, having shorter steps and longer step times than controls. Hesitant steps tended to be clustered within certain regions of the walking paths. IMUs enabled identification of key gait characteristics in this clinical population (step time, length and step hesitancy) and environmental conditions (route complexity) modifying their expression.

Objective: Deficits in spatial navigation are characteristic and disabling features of typical Alzheimer's disease (tAD) and posterior cortical atrophy (PCA). Visual cues have been proposed to mitigate such deficits; however, there is currently little empirical evidence for their use., Methods: The effect of visual cues on visually guided navigation was assessed within a simplified real-world setting in individuals with tAD ( n  = 10), PCA ( n  = 8), and healthy controls ( n  = 12). In a repeated-measures design comprising 36 trials, participants walked to a visible target destination (an open door within a built environment), with or without the presence of an obstacle. Contrast and motion-based cues were evaluated; both aimed to facilitate performance by applying perceptual changes to target destinations without carrying explicit information. The primary outcome was completion time; secondary outcomes were measures of fixation position and walking path directness during consecutive task phases, determined using mobile eyetracking and motion capture methods., Results: Results illustrate marked deficits in patients' navigational ability, with patient groups taking an estimated two to three times longer to reach target destinations than controls and exhibiting tortuous walking paths. There were no significant differences between tAD and PCA task performance. Overall, patients took less time to reach target destinations under cue conditions (contrast-cue: 11.8%; 95% CI: [2.5, 20.3]) and were more likely initially to fixate on targets., Interpretation: The study evaluated navigation to destinations within a real-world environment. There is evidence that introducing perceptual changes to the environment may improve patients' navigational ability.

Objectives: The purpose of this study was to investigate technique differences between expert and novice manual wheelchair users during over-ground wheelchair propulsion., Method: Seven experts (spinal cord injury level between T5 and L1) and six novices (non-wheelchair users) pushed a manual wheelchair over level ground, a 2.5% cross slope and up a 6.5% incline (7.2 m length) and 12% incline (1.5 m length). Push rim kinetics, trunk and shoulder kinematics and muscle activity level were measured., Results: During the level and cross slope tasks, the experts completed the tasks with fewer pushes by applying a similar push rim moment over a greater push arc, demonstrating lower muscle activity. During the incline tasks, the experts required fewer pushes and maintained a greater average velocity, generating greater power by applying a similar push rim moment over a greater push arc with greater angular velocity, demonstrating greater trunk flexion and higher shoulder muscle activity., Conclusions: This study identifies experience-related differences during over-ground manual wheelchair propulsion. These differences are particularly evident during incline propulsion, with the experts generating significantly greater power to maintain a higher velocity., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The aim of the study was to investigate if push-rim kinetics could be used as markers of glenohumeral joint demand during manual wheelchair accessibility activities; demonstrating a method of biomechanical analysis that could be used away from the laboratory. Propulsion forces, trunk and upper limb kinematics and surface electromyography were recorded during four propulsion tasks (level, 2.5% cross slope, 6.5% incline and 12% incline). Kinetic and kinematic data were applied to an OpenSim musculoskeletal model of the trunk and upper limb, to enable calculation of glenohumeral joint contact force. Results demonstrated a positive correlation between propulsion forces and glenohumeral joint contact forces. Both propulsion forces and joint contact forces increased as the task became more challenging. Participants demonstrated increases in trunk flexion angle as the requirement for force application increased, significantly so in the 12% incline. There were significant increases in both resultant glenohumeral joint contact forces and peak and mean normalized muscle activity levels during the incline tasks. This study demonstrated the high demand placed on the glenohumeral joint during accessibility tasks, especially as the gradient of incline increases. A lightweight instrumented wheelchair wheel has potential to guide the user to minimize upper limb demand during daily activity.

This study aimed to examine simple locomotion and eye behaviour of individuals with Posterior Cortical Atrophy (PCA) and typical Alzheimer's disease (tAD) within a simulated real-world environment. Posterior cortical atrophy (PCA) is a neurodegenerative condition characterised by parietal, occipital and occipito-temporal tissue loss and progressive impairment of higher-order visual function in contrast to relatively spared memory and language. Targeted types of locomotion were walking in a series of corridors, up or down stairs, and across an open room with or without the presence of an obstacle. Eye tracking measures and inertial moment units (IMU) were used in this experiment, and resultant acceleration of left foot and fixation duration were extracted. Findings from three participants are presented as a case series: one control, one PCA and one tAD patient. The averaged resultant acceleration of PCA patient was the slowest in all types of locomotion, especially in stairs. The averaged resultant accelerations of PCA and tAD participants were slower than the control participant. The PCA participant had longer mean fixation durations than the tAD and control participants, however, mean fixation duration was similar between tAD and control participants. Results may help characterise locomotion and eye behaviour in PCA and tAD and may suggest ways to support effective diagnosis and assessment of disease progression.

There is a need to develop an assisting device which can be adapted to the individual capabilities of elderly attendants, which would allow them to maintain a level of fitness when pushing a wheelchair, while minimising the risk of injury to them. Furthermore there is a need to reduce the overall energy consumption of the device in keeping with the current trends of reducing carbon emissions. The control system for attendants pushing wheelchairs that reduces the energy needed by the assisting device is an increasing trend of optimisation of assistive technology devices to individual capabilities to ensure less energy expenditure of the attendant. The control parameters for existing assisting systems for attendant wheelchair propulsion are difficult to optimise for individual capabilities. We focus on the individual propelling performance, and propose an assisting control method based on the force velocity relationship of the individual. Our proposed assisting controller generates an assisting force when the attendant's propelling force exceeds an assisting boundary defined by the force velocity relationship. In this paper, we tested the performance of the assisting controller based on force velocity (FV) relationship using simulation. The simulation used an attendant wheelchair model with parameters determined from experiments. From the simulated results of the assisting force trajectories, the FV assisting system worked as we defined. The FV assisting system used less energy consumption than the existing proportional assisting systems. Also the FV assisting system would have a limit of maximum attendant propelling power, so the distribution between the attendant force and the assisting force can be easily adjusted to the individual's force velocity relationship. Our proposed FV assisting system would be useful as it would allow an optimised system based on individual capabilities to be created for rehabilitation/training systems, which would allow optimum energy consumption when propelling a wheelchair.

The purpose of this study is to develop a wireless FES rehabilitation system to assist effective improvement of the lower limbs. In this report, a prototype system combined with foot drop correction and gait evaluation using wireless surface electrical stimulator and the wireless inertial sensors was developed and tested with a right hemiplegic subject. For gait evaluation, lower limb joint angles and segment angles were estimated by the Kalman filter from the data measured with wireless inertial sensors. Electrical stimulation was applied to the common peroneal nerve or the tibialis anterior muscle by detecting stimulus timing automatically from the data of wireless inertial sensor attached on the shank of the hemiplegic side. The maximum joint angle of ankle dorsiflexion of the paralyzed side at the swing phase was increased approximately to the value of the healthy side by applying the electrical stimulation. The developed system was performed well in foot drop correction and the measured data of the inertial sensors showed the characteristics and difference of paralyzed side with and without electrical stimulation using the segment angles and joint angles.

The aim of this study was to investigate the mechanical power of the ankle plantar flexion. The investigated power of the ankle plantar flexion would help to improve effectively the FES walking system using the ankle plantar flexion for patients and aged people in slow walking. The subjective pain by electrical stimulation sometimes becomes the burden to use the FES system. We also investigated the relationship between the mechanical power in ankle plantar flexion by electrical stimulation and the subjective pain. We developed the device to measure the ankle movement by electrical stimulation against load resistance torque. The device consisted of pads to support a single lower leg, a rotational footplate with a large pulley and a vertical weight to generate the load resistance torque, and a monophasic electrical stimulator via surface electrodes. Our results showed the proportional relationship between the mechanical power of the ankle plantar flexion and the subjective pain by electrical stimulation. To generate the same level in the ankle plantar flexor power 2.75 W under the maximum voluntary exertion, the subjective pain by electrical stimulation exceeded 70, which means the feeling of crying at the Face Pain Scale. This result would help the better design of the FES walking system using the ankle plantar flexion for patients and aged people.