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Appropriate paper-based technology (APT) is used to provide postural support for children with cerebral palsy (CP) in low-resourced settings. This pilot study aimed to evaluate the impact of APT on the children's and families' lives. A convenience sample of children with CP and their families participated. Inclusion was based on the Gross Motor Function Classification System levels IV and V. APT seating or standing frames were provided for six months. A mixed methods impact of APT devices on the children and families included the Family Impact Assistive Technology Scale for Adaptive Seating (FIATS-AS); the Child Engagement in Daily Life (CEDL) questionnaire; and a qualitative assessment from diary/log and semi-structured interviews. Ten children (median 3 years, range 9 months to 7 years). Baseline to follow-up median (IQR) FIATS-AS were: 22.7 (9.3) and 30.3 (10.2), respectively (p=.002). Similarly mean (SD) CEDL scores for "frequency" changed from 30.5 (13.2) to 42.08 (5.96) (p=.021) and children's enjoyment scores from 2.23 (0.93) to 2.91 (0.79) (p=.019). CEDL questionnaire for self-care was not discriminatory; seven families scored zero at both baseline and 6 months. Qualitative interviews revealed three key findings; that APT improved functional ability, involvement/interaction in daily-life situations, and a reduced family burden of care. APT devices used in Kenyan children with non-ambulant CP had a meaningful positive effect on both the children's and their families' lives. Assistive devices are often unobtainable for children with cerebral palsy (CP) in low-income countries. APT is a low cost and sustainable solution to make seating and standing devices for disabled children in Kenya. The regular use of a postural support device enhanced the children's motor skills, ability to function and participate in everyday activities, reduced the burden of care for the families and promoted the children's social interaction. The postural support devices were highly valued and utilised by the children and families in this study. [ABSTRACT FROM AUTHOR]

For children with mobility impairments, without cognitive delays, who want to participate in outdoor activities, existing assistive technology (AT) to support their needs is limited. In this review, we investigate the control and design of a selection of robotic walkers while exploring a selection of legged robots to develop solutions that address this gap in robotic AT. We performed a comprehensive literature search from four main databases: PubMed, Google Scholar, Scopus, and IEEE Xplore. The keywords used in the search were the following: "walker", "rollator", "smart walker", "robotic walker", "robotic rollator". Studies were required to discuss the control or design of robotic walkers to be considered. A total of 159 papers were analyzed. From the 159 papers, 127 were excluded since they failed to meet our inclusion criteria. The total number of papers analyzed included publications that utilized the same device, therefore we classified the remaining 32 studies into groups based on the type of robotic walker used. This paper reviewed 15 different types of robotic walkers. The ability of many-legged robots to negotiate and transition between a range of unstructured substrates suggests several avenues of future consideration whose pursuit could benefit robotic AT, particularly regarding the present limitations of wheeled paediatric robotic walkers for children's daily outside use. Children with lower limb disabilities can benefit from assistive technology designed for daily usage in outdoor surroundings. An extension of existing robotic assistive technology that allows the user to travel safely on irregular surfaces both indoors and outdoors is needed. Approaches used to solve research problems in the field of robotics (outside of the rehabilitation area) can be used to address problems that robotic assistive technology currently faces. There is a need for more research on the development of robotic assistive technology for children with mobility impairments without cognitive delays. [ABSTRACT FROM AUTHOR]

In 2016 WHO launched the priority assistive products list (APL) consisting of 50 products and recommended that using this as a reference, countries should develop their own contextually relevant national APLs. This paper describes the development of Malawi's APL. Two hundred and ninety-six persons with disabilities participated in a rapid Assistive Technology Assessment (rATA) survey. Six focus group discussions (FGDs) with people with various types of disabilities were conducted. The rATA questionnaire and FGDs collected data on assistive products (APs) participants used, APs they needed and the challenges they experienced. Data collection was done in six districts spread across the three regions in Malawi. All age groups were included in the survey. Persons with disabilities aged less than 18 participated but went with their guardians. All persons who participated in this study provided consent. Survey and FGDs results were presented at an APL consensus meeting with policymakers, service providers, disabled peoples' organizations and development partners in the disability sector. Based on the results and further discussions, a consensus was reached on the priority APs for Malawi. More than a third of respondents used wheelchairs (32%), followed by auxiliary crutches (25%), walking sticks (13%), reading glasses (11%), prosthesis (10%), elbow crutches (9%) and orthosis (8%). There is also a high demand for products such as pull-up underwear (incontinence products) (79%), hearing aids (70%), reading glasses (59%) and diapers (63%). After intensive discussions during a consensus meeting, an agreement was reached on the 22 priority APs for Malawi. There is a wide range of APs being used by people with different functional limitations in Malawi. There is also a demand for APs that are not readily available. When developing an APL, the list should include products in use, those in demand, and those recommended by service providers. Following the development of the priority assistive products list (APL) by WHO, member states should develop their own contextually based APL. The development of the APL should be based on research evidence. All key stakeholders including persons with disabilities and other functional limitations, government, and development partners should participate in this process. The APL should be part of the national health system or community services. The Department of Disability and Elderly Affairs in the Ministry of Gender, Community Development, being the Government of Malawi line ministry coordinating disability issues participated actively in this study including inviting participants in the stakeholders' validation workshop. [ABSTRACT FROM AUTHOR]

We aimed to identify assistive technologies that are promising for addressing loneliness in people living with dementia in long-term care. A scoping review was conducted. EBSCO, PubMed, Cochrane Library, and ProQuest were searched from 2000 to 2020. The included studies were selected by three independent researchers and summarised, compared, and categorized according to technology type. Publications were eligible for inclusion when they reported on psychosocial interventions aiming to reduce loneliness and/or social isolation in people with dementia in long-term care settings. Twenty-four papers were included (20 original research papers and four reviews). Most studies were conducted in Australia and Europe. The studies aimed to investigate two different types of assistive technology: social robots, and multimedia computer systems. Most studies focussed on behaviour, engagement, and mood as primary outcomes. Only one study directly aimed to alleviate loneliness. Even though only one study addressed loneliness directly, it became clear that assistive technologies used to apply psychosocial interventions have the potential to impact loneliness in people with dementia in long-term care. However, it remains unclear why loneliness was not included as an outcome and how loneliness could become a key outcome in evaluating assistive technologies. Loneliness among older adults is associated with health risks, such as the development of dementia, depression, and increased mortality. Ambient Assisted Living (AAL) technologies have been studied to address loneliness for older adults; however people with dementia are often excluded from such studies. This diverse group of technologies is shown to have a promising impact on outcomes, such as social engagement, quality of life, and mood, but loneliness was studied less often. More research is needed to discover the potential of assistive technologies for people with dementia living in long-term care. [ABSTRACT FROM AUTHOR]

Information and Communication Technologies have transformed our lives in different social areas, facilitating interpersonal relationships thanks to technological tools. In the specific case of people with disabilities, Assistive Technologies (ATs) break down barriers and increase opportunities to become active members of society with equal opportunities. This paper presents a systematic mapping study that analyzes the current state-of-the-art of ATs proposed in the literature to support the empowering of people with disability. Specifically, this paper focuses on (1) describing a global vision of the scientific literature published in the last 20 years about ATs in the computer science field and (2) identifying research needs, gaps, and trends. For this purpose, an in-depth analysis of 389 primary studies is presented. The information obtained from the mapping process is also constrained. Concretely, 35 ATs versus 22 disabilities are compared, obtaining striking peaks for some disabilities described in the discussion. Finally, the findings show that several areas have been covered only lightly, revealing interesting future directions and challenges for junior researchers. • ATs have the potential to break down barriers for people with disabilities, enabling them to participate more fully in society. This implies a need for rehabilitation programs to incorporate ATs into their strategies to enhance social inclusion. • Given the transformative role of ICT, rehabilitation programs should focus on helping people with disabilities develop the necessary technological skills to utilize ATs effectively. • This work highlights the diversity of ATs and disabilities, suggesting a need for personalized rehabilitation plans that match specific ATs to individual disabilities. • Rehabilitation professionals should be trained to assess and recommend appropriate ATs for each case. Rehabilitation programs should consider incorporating cutting-edge ATs and staying involved in research to contribute to future developments to cover gaps and challenges identified. [ABSTRACT FROM AUTHOR]

This paper presents a review of the existing qualitative research literature concerning people's experience of communicating using augmentative and alternative communication (AAC). The aims of conducting this review were to find out more about the values and outcomes that are important to people about the AAC they use to support their communication. This review was conducted to provide a deeper understanding of these experiences to inform the development of a patient-reported outcome measure (PROM). A qualitative evidence synthesis of existing qualitative research literature was undertaken to explore and appraise current knowledge about the experiences of people who use AAC. From 115 qualitative research reports 19 papers were identified that responded directly to the research question and aims of the review. Data were identified that could be organized within an a priori framework consisting of the constructs of values, outcomes, and context. The review has resulted in a deeper, analytical understanding of the experiences of people who require AAC. The results indicate a set of concepts that can be used to inform the development of a PROM. A PROM can be used to assist clinicians and researchers to better understand the perspectives of people who require AAC and evaluate interventions. The results also encourage professionals to reconsider the terminology and methods used when working alongside people who require AAC and to reflect on the multidimensional factors that influence people's experience of communication. Patient-reported outcome measures (PROMs) can be useful tools to support clinician-patient communication, facilitate shared decision making and establish priorities for rehabilitation. It can be difficult to engage people who have complex communication difficulties in decisions about the important outcomes to them from using augmentative and alternative communication (AAC). This qualitative evidence synthesis provides a deeper understanding of the experiences and perspectives of people who use AAC. The results will be used to inform the development of a PROM which can be used to facilitate shared decision-making, and evaluate AAC interventions from the perspective of the people who use these technologies. [ABSTRACT FROM AUTHOR]

This is the second of two papers summarizing studies reporting on the design of electronic graphic symbol-based augmentative and alternative communication (AAC) systems. The aim of this paper was to describe the design approaches used and to determine to what extent the principles of human-centred design (HCD) were reflected in the design approaches and processes used. A scoping review was conducted. A multifaceted search resulted in the identification of 28 studies meeting the selection criteria. Data were extracted relating to four areas of interest, namely, (1) the general characteristics of the studies, (2) features of the systems designed, (3) availability of the systems to the public and (4) the design processes followed. In this paper, findings related to the last area are presented. Design approaches were often inconsistently described. User-centred design was mentioned more often than HCD. Even so, various HCD principles were considered in most studies. Notably, stakeholders were involved in the design process in all studies. However, users were not involved in all studies and stakeholder roles were predominantly informative rather than collaborative. Prototype and product evaluations focussed mostly on usability rather than user experience. Although many design teams were multidisciplinary, engineers and computer scientists predominated. There is a need for designers to be more transparent about the type of design approach used to guide the system design and also to clearly report on design approaches and processes used. The application of HCD to the design of graphic symbol-based AAC systems is still limited. Human-centred design approaches can productively guide the design of electronic graphic symbol-based augmentative and alternative communication (AAC) systems. Creative methods are needed to involve stakeholders with complex communication needs in all phases of the design process. Evaluation of electronic graphic symbol-based AAC systems should consider both usability and user experience. [ABSTRACT FROM AUTHOR]

Smartphones have become a core piece of assistive technology (AT) for people with vision impairment (PVI) around the world. This scoping review sought to provide a comprehensive picture of the current evidence base of smartphones for PVI. Seven electronic databases (CINAHL, Cochrane Library, EMBASE, IEEE Xplore, Scopus, PubMed and Web of Science) were searched for papers published from 2007 to 2021. Peer-reviewed articles published in English which discussed smartphones use by PVI; smartphone technologies designed for PVI or training and learning support on the use of smartphones were included. There were 16,899 records retrieved and 65 articles were included in this review. The majority (48%) of the papers focussed on developing better interfaces and Apps for PVI. Contrastingly, there was a paucity of papers (5%) discussing training or learning support for PVI to use smartphones and Apps effectively, even though it was highlighted to be important. Proper training will ensure that PVI can use this everyday technology as an AT to increase participation, enhance independence and improve quality of life overall. The findings highlighted that smartphones and Apps can be used as effective and affordable AT by PVI. The many recent developments and research interest in smartphone technologies can further support its use. However, good training and learning support on the use of smartphones and Apps by PVI, is lacking. Future research should focus on the development, provision and evaluation of evidence based tailored training and support, especially in low- and middle-income countries. There is a need for more training and learning support for people with vision impairment (PVI) on the use of smartphones and Apps. Individualized and a graded approach to training has been recommended for PVI to learn to use smartphones. When supporting or training people to use smartphones, the person's level of vision impairment as well as their age, are important considerations. Health professionals should be cognizant of the steep learning curve that some PVI may experience when using smartphones and Apps, especially when they switch from a phone with physical buttons to touchscreen. Certain smartphones features are useful to particular vision loss conditions. For example, zoom and magnification are helpful for those with low vision but text input and output, and commands using speech (e.g., Siri and TalkBack) are useful for those who are blind. [ABSTRACT FROM AUTHOR]

This review aims to examine the instruments, approaches, scales, or assessment tools used to evaluate technology acceptance, technology adoption, and usability of information and communication technologies (ICTs) for people living with dementia and their care partners. A systematic literature review was conducted. Studies that explored the use of instruments, approaches, scales, or assessment tools to evaluate the technology acceptance and usability of ICTs for people living with dementia and their care partners were identified through five databases: Medline, EMBASE, CINAHL, Web of Science, and Scopus. We included 74 out of 2182 papers. The most common scales used included the System Usability Scale (SUS) (11%), the ISONORM 9241/10 Questionnaire (4%), and the Post-Study System Usability Questionnaire (PSSUQ) (4%). Most (59%) of the included approaches, however, were bespoke (i.e., created by the authors for a particular study) and were not named. The approaches or tools used to assess technology acceptance, technology adoption, and usability of ICTs that applied to people living with dementia had an average of 15 items and used an average of 5.23 scale points. There is no clear, standardised approach for assessing the technology acceptance, technology adoption, and usability of ICTs for people living with dementia and their care partners. The findings of this review may be used by academics to design and implement improved and more consistent assessment tools to assess technology acceptance, technology adoption, and usability of ICTs for people living with dementia and their care partners. The number of ICTs for people with dementia and their care partners that can be used for rehabilitation is increasing The most commonly recognized assessment tools used in this study were the SUS, ISONORM 9241/10, and PSSUQ questionnaires. For the custom assessment tools, the average number of items included in this study was 15 with five-point bidirectional labelling. There is no clear, standardized approach for assessing the technology acceptance, technology adoption, or usability of ICTs for people with dementia and their care partners. [ABSTRACT FROM AUTHOR]

To address the data gap on efforts to assess use of assistive technology among children with disability in sub-Saharan Africa. Contribute towards efforts examining access to assistive technologies in sub-Saharan Africa. The paper uses data from the 2017 survey on Living conditions among persons with disabilities in Malawi and the 2015-16 Malawi Demographic and Health survey to address the objective of the study. The two datasets were statistically matched through random hot deck technique, by integrating the two datasets using randomly selected units from a subset of all available data donors. Results indicate that statistical matching technique produces a composite dataset with an uncertainty value of 2.2%. An accuracy assessment test of the technique also indicates that the marginal distribution of use of assistive technology in the composite dataset is similar to that of the donor dataset with an Overlap index value of close to 1 (Overlap = 0.997). The statistical matching procedure does enable generation of good data in data constrained contexts. In the current study, this approach enabled measurement of access to assistive products among children with disabilities, in situations where the variables of interest have not been jointly observed. Such a technique can be valuable in mining secondary data, the collection of which may have been funded from different sources and for different purposes. This is of significance for the efficient use of current and future data sets, allowing new questions to be asked and addressed by locally based researchers in poor settings. In resource-poor settings, the technique of statistical matching can be used to examine factors that predict the use of assistive technology among persons with disabilities. The statistical matching technique is of significance for the efficient use of current and future datasets, allowing new questions to be asked and addressed by locally based researchers. [ABSTRACT FROM AUTHOR]

Computerised rehabilitation programs can be used to address cognitive deficits typically caused by multiple sclerosis (MS). However, there are still doubts on their effectiveness, due to mixed results obtained in clinical trials. The objective of this paper is to improve cognitive rehabilitation (CR) practices in MS, by presenting and assessing a MS-specific cognitive rehabilitation software. We conducted a detailed analysis of how CR is carried out in practice in MS rehabilitation centres. From the analysis, we elicited a reference CR process, and identified the essential features a software supporting the process should have. We designed and implemented MS-rehab, a novel MS-specific computerised rehabilitation system having the identified features. We experimented MS-rehab in a pilot study involving eight MS patients. To highlight the improvement with respect to the state of the art, we compared MS-rehab with available professional tools selected using well defined criteria. This paper has three main contributions: (1) the identification of a set of essential features a computerised tool for CR in MS should provide; (2) MS-rehab, a novel CR system designed for MS therapists and patients, which embodies innovative MS specific features; (3) the assessment of MS-rehab efficacy in a pilot study with MS patients. The availability of a MS-specific CR system like MS-rehab fosters the design of more rigorous clinical studies on the effectiveness of computerised rehabilitation in MS. MS-rehab demonstrated its potential and innovativeness as a tool for cognitive rehabilitation in MS. Computerized tools for cognitive rehabilitation (CR) in multiple sclerosis (MS) can be improved by a set of MS-specific features. The availability of advanced home-based cognitive rehabilitation mechanisms is fundamental for supporting standardized cognitive rehabilitation protocols in MS. A MS-specific CR system has given promising results in a pilot study involving MS patients. Hardly do state-of-the-art professional tools include all the required MS specific features. [ABSTRACT FROM AUTHOR]

This paper considers the possibilities of analysing children's own designs to contribute to the design of inclusive paediatric mobility interventions. The aim of this paper is threefold: (1) to develop a framework for child-centred design analysis, (2) to analyse children's designs to explore both quantitative and qualitative insights and (3) to explore how children's voice could be elevated through design research. A Child-centred Design Analysis Framework is developed in an interdisciplinary manner, comprising four dimensions including Child, Content, Context and Format. It is used as a vehicle to analyse and code 130 "Dream Wheelchair" designs by children. The children's "Dream Wheelchair" designs reference a range of features and priorities, which are gathered into themes through the framework, providing insights into children's individual and collective mobility narratives, values and requirements. Themes are explored through a qualitative interdisciplinary lens to understand the nature of children's lived experiences. The framework promotes child-centred framing through extracting meaning from children's own designs. It is suggested that child-centred framing and a rights-respecting approach to assistive technology design research can lead to more appropriate design outcomes and improved user experiences for children with disabilities. The design analysis framework developed and presented in this paper facilitates child-centred framing to elevate children's voice in a design process. Analysis of 130 children's visual and textual designs elicited narratives, values, and requirements around their "Dream Wheelchairs"; these findings contribute insights which can be used for designing inclusive paediatric mobility interventions. This paper invites industry practitioners and design researchers to use a child-centred and rights-respecting approach when designing with or for children. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to analyse and critically reflect on access to Assistive Technology (AT) for persons with disabilities (PWD) in Nepal, India and Bangladesh. This analysis aims to guide the development of a contextualised generic AT service delivery model suitable for these countries, based on the best practices identified. This paper is based on a comprehensive study conducted in Nepal, India and Bangladesh, observing mobility and hearing-related AT service delivery centres run by the government, as well as private and nongovernmental organisations, and interviews with key informants: policymakers (5), AT service providers (20) and AT service users (20) between December 2019 to February 2020. A descriptive, qualitative exploratory study design was followed. A quality assessment framework was used to structure the analysis and interpret the findings. AT service provisions are poorly developed in all three countries. On all quality indicators assessed, the systems show major weaknesses. AT users have very limited awareness about their rights to these services and the availability of AT services, the range of services available is very limited, and eligibility is dependent on medical criteria related to visible and severe disabilities. Lack of accessibility, eligibility, reachability and affordability are the main barriers to access AT services for PWD in Nepal, India and Bangladesh. Increased community level awareness, increased Government funding and a community based, medically informed flexible social model of AT services is a way forward to ensure access to AT services for PWD in these countries. Increased community awareness is necessary to increase access to Assistive Technology Services for Persons with Disabilities. Increased and flexible funding from the Government and philanthropists will improve rehabilitation. Establishment of community based Assistive Technology Services centres will increase access and improve rehabilitation. [ABSTRACT FROM AUTHOR]

In vocational education and training of computer literacy as part of vocational rehabilitation, learners often work on problem-solving exercises as self-study assignments, and check if their answers are correct. Sighted learners can get information on their incorrect answers by comparing their answers with the correct answers. However, learners with visual impairments largely depend on their teachers for getting this feedback. To remove this dependence, we designed a self-checking system for learners with visual impairments to verify the correctness of their answers. In this paper, we report the results of a usability study to evaluate whether learners with visual impairments can self-check spreadsheet problem-solving exercises using our system in a teacherless environment. Usability evaluation experiment was conducted using 2 × 2 crossover design with people with visual impairments (n = 11). The participants checked their answers (detected and corrected errors) after working on problem-solving exercises in two ways: (i) manually; and (ii) using our system. The system usability was evaluated by measuring Detection-And-Correction (DAC) ratio as effectiveness, time taken and the number of steps required for DAC as efficiency, and System Usability Scale score as satisfaction. The results show that all the participants could complete the DAC task by using our system, and the time required for DAC task was significantly reduced by using our system as compared to by checking manually. Our system enables learners with visual impairments to self-check problem-solving exercises answers. However, to increase the user satisfaction, the number of required keystrokes needs to be decreased. Vocational rehabilitation for learners with visual impairments to improve their computer literacy is becoming increasingly important. Learners with visual impairments have the potential to acquire computer literacy in a teacherless environment by using simple assistive software like our self-checking system. Simple assistive software for learners with visual impairments like our self-checking system may have a positive effect not only on learners with visual impairments but also on sighted people. Moreover, our system reduces the teaching load of the teachers so that they can be more effective in helping learners with visual impairments. [ABSTRACT FROM AUTHOR]

Seat tilting wheelchair features can increase the comfort and safety of the user. Although many power wheelchairs have tilting mechanisms, they are often designed with a specific wheelchair model in mind. In this study, a design process for seat tilting mechanisms that can be applied to most rear-wheel drive wheelchair models is developed. Equations were developed to describe the geometrical and load constraints that were used to size the electric actuator that powers the system and define its position. Finally, the equations were used to create the seat tilting mechanism of a prototype wheelchair, which was then tested. The equations yielded coherent results which showed that advantageous actuator positions from a load minimization perspective usually require dimensions that cannot be found in commercial actuators. Also, there are positions in which the load increases exponentially, which should be avoided. The tests showed that the system was able to function properly on the prototype wheelchair and that the actuator position affected the time taken for the actuator to execute different parts of the tilting movement. The design process presented here was successful and modelled by general equations that can be applied to most front-wheel drive wheelchairs. It presents a low-cost option for the design of seat tilting systems, which can increase their accessibility. Developing new systems to provide improvements in assistive technologies is fundamental for social reintegration and quality of life improvement. Wheelchairs with a seat stabilization system for moving through inclined terrain can provide greater comfort and safety to the user. Adding low-cost functionalities to wheelchairs is essential to make them more accessible to people, therefore, this paper provides a design method of a new seat stabilization system applied to low-cost wheelchairs. [ABSTRACT FROM AUTHOR]

Assistive devices like Standing Wheelchairs (SWC) have remained out of reach of the economically underprivileged even before the pandemic-induced financial downturn, and more so now. This paper describes the mechanical design of a manual user-actuated SWC that is cost-effective (equivalent of USD 210 in India, ex-factory) and has special features that minimise user effort and accommodates varying body weights (50–110 kg) and dimensions (1.52–1.83 m height). The design includes a six-bar mechanism and spring balancing to optimise user effort during operation. The optimised gas spring incorporates adjustability to minimise each user's force for sit-stand-sit transitions. The handle shape is ergonomically designed using kinematic analysis to provide convenient gripping positions for actuation. The design has been customised based on parametric studies to suit varying body weights. Overall, the SWC design provides standing functionality with ease of operation, safety locks, customisability, affordability, outdoor mobility and is aesthetically pleasing. Customisability and the low cost of the device would enhance the accessibility of the SWC to a larger group of eligible users. Manual user-operated standing wheelchair design using a six-bar mechanism Spring balancing used to reduce user effort to self-lift to the standing position Kinematic analysis used to determine convenient handle location for user ease Customisability for wide range of users to ensure correct posture, optimal effort Design refined through multiple iterations using inputs from users and clinicians Design commercialised at an affordable cost, making it accessible to a larger population [ABSTRACT FROM AUTHOR]

Functional electrical stimulation (FES) can be effective in assisting physical and psychosocial difficulties experienced by people with spinal cord injury. Perceived benefits and barriers of the current and future use of FES within the wider spinal cord injury community is currently unknown. The main objective of this research was to explore the spinal cord injury community's views of the use of FES to decrease disability in rehabilitation programmes. An online and paper questionnaire was distributed to people with spinal cord injury, health care professionals and researchers working in spinal cord injury settings in the United Kingdom. A total of 299 participants completed the survey (152 people with spinal cord injury, 141 health care professionals and 6 researchers). Common views between groups identified were: (1) FES can be beneficial in improving physical and psychosocial aspects and that (2) adequate support and training for FES application was provided to users. Barriers to FES use included a lack of staff time and training, financial cost and availability of the equipment. Sixty three percent of non-users felt they would use FES in the future if they had the opportunity. Users' views were important in identifying that FES application can be beneficial for people with spinal cord injury but also has some resourceful barriers. In order to increase use, future research should focus on reducing the cost of FES clinical service and also address implementation of awareness and training programmes within spinal units and community rehabilitation settings. Users of functional electrical stimulation think that it is beneficial for improving physical and psychosocial limitations after spinal cord injury Barriers to FES use include a lack of staff time and training, financial cost and availability of the equipment have been suggested by people with spinal cord injury and health care professionals Education and implementation programs for health care professionals and people with spinal cord injury are now necessary to increase the awareness about functional electrical stimulation application Reduction of FES cost could also increase its uptake in spinal cord injury clinical services [ABSTRACT FROM AUTHOR]

This study explores the usability, usefulness and user experience of the Forward with Dementia website for people with dementia and family carers, and identifies strategies to improve web design for this population. The website was iteratively user-tested by 12 participants (five people with dementia, seven carers) using the Zoom platform. Data collection involved observations, semi-structured interviews and questionnaires. Integrative mixed-method data analysis was used, informed by inductive thematic qualitative analysis. Users of Version 1 of the website experienced web functionality, navigation and legibility issues. Strategies for desirable web design were identified as simplifying functions, streamlining navigation and decluttering page layouts. Implementation of strategies produced improvements in usability, user experience and usefulness in Version 2, with mean System Usability Scale scores improving from 15 to 84, and mean task completion improving from 55% to 89%. The user journey for people with dementia and carers overlapped, but each group had their own unique needs in the context of web design. The interplay between a website's content, functionality, navigation and legibility can profoundly influence user perceptions of a website. Dementia-related websites play an important role in informing audiences of management strategies, service availability and planning for the progression of dementia. Findings of this study may assist in guiding future web development targeting this population. People with cognitive impairment can provide useful feedback on design and accessibility of websites, and their input should be obtained when developing digital applications for this group. This paper provides practical suggestions for website design features to improve function, legibility and navigation of websites for older people and people living with dementia. [ABSTRACT FROM AUTHOR]

Rehabilitation robots with intent recognition are helping people with dysfunction to enjoy better lives. Many rehabilitation robots with intent recognition have been developed by academic institutions and commercial companies. However, there is no systematic summary about the application of intent recognition in the field of rehabilitation robots. Therefore, the purpose of this paper is to summarize the application of intent recognition in rehabilitation robots, analyze the current status of their research, and provide cutting-edge research directions for colleagues. Literature searches were conducted on Web of Science, IEEE Xplore, ScienceDirect, SpringerLink, and Medline. Search terms included "rehabilitation robot", "intent recognition", "exoskeleton", "prosthesis", "surface electromyography (sEMG)" and "electroencephalogram (EEG)". References listed in relevant literature were further screened according to inclusion and exclusion criteria. In this field, most studies have recognized movement intent by kinematic, sEMG, and EEG signals. However, in practical studies, the development of intent recognition in rehabilitation robots is limited by the hysteresis of kinematic signals and the weak anti-interference ability of sEMG and EEG signals. Intent recognition has achieved a lot in the field of rehabilitation robotics but the key factors limiting its development are still timeliness and accuracy. In the future, intent recognition strategy with multi-sensor information fusion may be a good solution. As a technology, intent recognition can become a part of rehabilitation, assist patients to complete daily life activities, and improve their quality of life. Rehabilitation training equipment for treatment usually adopts a relatively stable prediction method, which aims to stimulate the enthusiasm of users to participate in training. Functionally enhanced rehabilitation aids have high requirements for the timeliness of movement intent recognition, and its purpose is to assist patients to complete activities of daily life. [ABSTRACT FROM AUTHOR]

People with physical disabilities often require lifetime support and experience challenges to maintain or (re)define their level of independence. Assistive living technologies (ALT) are promising to increase independent living and execution of activities of daily living (ADL). This paper provides a systematic literature review that aims to analyse the present state of the literature about the impact of ALT on perceived independence of people with a physical disability receiving long-term care. Databases Embase, Medline, and Web of Science were searched for eligible studies from 2010 or later. Nine studies were included, of which seven qualitative, one quantitative, and one mixed methods. Quality was generally high. ALT enabled participants to execute ADL. We found six themes for the impact of ALT on perceived independence: feeling enabled, choice and control, feeling secure, time alone, feeling less needy, and participation. ALT appears to impact perceived independence in many ways, exceeding merely the executional aspect of independence. Existing research is limited and quite one-sided. More large-scale studies are needed in order to inform care organisations how to implement ALT, especially considering societal developments and challenges impacting long-term care. People with a physical disability receiving long-term care experience that assistive living technology impacted their independence. Their independence is increased by making them feel enabled, secure, and less needy and increasing their choice and control, time alone, and participation. Most studies focused on the use of environmental control systems by people with spinal cord injury. More research is needed to evaluate long-term effects of diverse assistive living technologies used by people with a physical disability receiving long-term care. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to describe non-participation during the outcome measurement step of the wheeled mobility service delivery process (WMSDP) based on the Functional Mobility Assessment (FMA)-Uniform Dataset (UDS) Registry. The WMSDP is a standard framework for the provision of wheeled mobility devices, and several factors influence the client's experience throughout the process. Patient-reported outcomes are one way to measure the client's experience as part of a quality improvement program. A retrospective descriptive study was conducted on the FMA-UDS Registry to measure the response rate during the outcome measurement step of the WMSDP and describe the reasons an individual did not complete the FMA-UDS. The FMA-UDS was examined at two time points: pre-delivery and post-delivery of the wheeled mobility device. As of September 2, 2021, 10,253 cases have been entered into the FMA-UDS Registry. 2,247 cases were no longer participating pre-delivery, and an additional 3,905 cases were no longer participating post-delivery. The most common reasons for non-participation in the FMA-UDS pre-delivery and post-delivery included: equipment not delivered; provider no longer participating in the FMA-UDS; funding issues; no new equipment; client opted out; loss in contact; deceased; returned equipment; and other. The type and frequency of non-participation in the outcome measurement step of the WMSDP is critical to understanding why individuals participate in outcome measures and provides insight into the barriers and facilitators for the implementation of quality improvement programs. The outcome measurement system provides a structured mechanism for consistent communication between the client and the professionals providing the service, thereby identifying issues earlier in the process and mitigating frustration throughout the wheeled mobility service delivery process. The role of a credentialed professional, specifically an Assistive Technology Professional, in the wheeled mobility service delivery process could emphasize the importance of the follow-up and outcome measurement steps, which may increase the consumers' participation rate and demonstrate the effectiveness of devices and services. Clients who no longer participate in the outcome measurement process do not have the sustained support of the interprofessional team, and possess an increased chance that they will not get their mobility needs met through the health care system. [ABSTRACT FROM AUTHOR]

There is limited evidence on the strategies, resources, and tools shown to improve winter mobility and community participation. This paper describes a multifaceted approach taken to develop an mHealth application that provides information, resources, and strategies to facilitate winter mobility for mobility device users, service providers, community organisations, and researchers. The study was conducted in three phases: (1) A scoping review of peer-reviewed and grey literature was completed to identify literature that reported on tools, strategies, resources, and recommendations used to promote winter mobility; (2) Online asynchronous focus groups were conducted to identify the type of content that mobility device users wanted to include in the web-based application; and (3) A prototype mHealth application was developed based on the findings from the previous phases. Using a rapid prototyping process that included stakeholder review through an online survey, four cycles of application design and development were undertaken. The scoping review identified 23 peer-reviewed studies and limited grey literature on winter mobility strategies, resources and recommendations. Twenty-four participants from across Canada engaged in one of five focus groups. Focus group analysis led to the development of the content categories for the mHealth application. The initial prototype application developed was reviewed by; 27 mobility device users, 16 health care providers, and seven consumer organisation representatives identified areas of strength and further refinement in regard to application design. The approach used in this study provided a method to develop an application based on the ideas, needs, and interests of a variety of stakeholders. Once fully developed, the application has the potential to fill the gaps related to the lack of a unified collection of winter mobility strategies and resources, and open the dialogue on methods to improve winter participation among mobility device users. Despite winter conditions being a common challenge among mobility device users, there is an absence of an organised approach towards helping individuals manage their winter mobility needs. As the development and usage of mHealth applications continues to increase, it is valuable to use methods of designing applications based on the ideas, needs, and interests of a variety of stakeholders. Development of a framework for collating information on winter mobility strategies and resources is the first step towards launching an mHealth application. [ABSTRACT FROM AUTHOR]

Only 1 in 10 people with disabilities can access assistive devices, underlining the critical need for low-cost assistive products. This paper describes the design evolution of a manual user-operated standing wheelchair (SWC), translating from prototype to product. The SWC design has been refined over 5 years through multiple iterations based on comments from user trials. The SWC product, Arise, provides standing functionality, facile outdoor mobility, affordability, customisability, and is aesthetically pleasing. A one-time fitting and training ensure optimal effort for operation, correct posture, and comfortable user experience. The SWC accommodates users of different sizes and body weights (up to 110 kg) and minimises user effort with the use of a gas spring. Incorporating discrete adjustments enables customisation while retaining the advantages of mass manufacturing, which is necessary for ensuring affordability. The SWC has been field-tested and well received by over 100 wheelchair users, and Arise was launched recently by the industry partner. It should be noted that RESNA cautions on the use of any standing device without medical consultation. Nevertheless, with appropriate dissemination and awareness, it is anticipated that the affordable SWC product, Arise, will immensely benefit the eligible users and make a difference in their quality of life. Provides standing functionality, outdoor mobility, affordability and customisability Accommodates users of different sizes and body weights in a mass-manufacturable design Ergonomic design reduces net user effort during sit-to-stand, stand-to-sit activity Design iterated and refined based on feedback from over 100 user trials [ABSTRACT FROM AUTHOR]

Many wheelchair users experience disabilities in stabilising and positioning of the head. For these users, adequate head support is required. Although several types of head supports are available, further development of these systems is needed to improve functionality and quality of life, especially for the group of severely challenged users. For this group, user needs have not been clearly established. In this article, we provide an overview of the state-of-the-art in wheelchair mounted head supports and associated scientific evidence in order to identify requirements for the next generation of head support systems. A scoping review was performed including scientific literature (PubMed/Scopus), patents (Espacenet/Google Scholar) and commercial information. Types of head support and important system characteristics for future head support systems were proposed from consultations with wheelchair users (n = 3), occupational therapists (n = 3) and an expert panel. Forty scientific papers, 90 patents and 80 descriptions of commercial devices were included in the scoping review. The identified head support systems were categorised per head support type. Only limited scientific clinical evidence with respect to the effectiveness of existing head support systems was found. From the user and expert consultations, a need was identified for personalised head support systems that intuitively combine changes in sitting and head position with continuous optimal support of the head to accommodate severely challenged users. This study presents the state-of-the-art in head support systems. Additionally, several important system characteristics are introduced that provide guidance for the development and improvement of head supports. Especially for the group of severely challenged wheelchair users, current head support systems require further development to improve their users' quality of life. The desired system characteristics which are discussed in this review are an important step in the definition of requirements for the next generation of head supports. [ABSTRACT FROM AUTHOR]

To analyse the versatility and adaptability of commercially available exoskeletons for mobility assistance and their adaptation to diverse pathologies through a review of clinical trials in robotic lower limb training. A computer-aided search in bibliographic databases (PubMed and Web of Science) of clinical trials published up to September 2020 was done. To be selected for detailed review, clinical trials had to meet the following criteria: (1) a protocol was designed and approved, (2) participants were people with pathologies, and (3) the trials were not a single case study. Clinical trial data were collected, extracted, and analysed, considering: objectives, trial participants, number of sessions, pathologies involved, and conclusions. The search resulted in 312 potentially relevant studies of seven commercial exoskeletons, of which 135 passed the preliminary screening; and 69 studies were finally selected. Of the 69 clinical trials included in the review about 50% involved Spinal Cord Injury participants, while roughly 25% focussed on stroke and two trials corresponded to patients with both disorders. The rest were composed of neurological diseases and trauma disorders. The use of a single wearable robot for different medical conditions in various diseases is a challenge. Based on this comparative, the properties of the exoskeletons that improve the working ability with different pathologies and patient conditions have been evaluated. Suggestions were made for developing a new lower-limb exoskeleton based on various modules with a distributed control system to improve versatility in wearable technology for different gait pattern progression. Wearable robotic exoskeletons for gait assistance have been analysed from the perspective of adaptation to different diseases. This paper emphasizes the importance of personalized therapies and adaptive assistive technology. Suggestions were made for a new modular exoskeleton capable of addressing the issue of low versatility characterizing currently wearable assistive technology. [ABSTRACT FROM AUTHOR]

The voice is an important tool for people who use it daily in their occupations. However, what technological options are available to such individuals to allow them to monitor or take care of their voices? The purpose of this study is to answer two research questions: (1) What technologies exist to monitor or take care of the voice in occupational voice users? (2) What is the technology readiness level (TRL) of the technologies used to monitor or take care of the voice in occupational voice users? Embase, IEEE, Medline, Proquest, PubMed, Scopus, and Web of Science, A systematic literature review was conducted. Articles that reported results regarding technologies (hardware, software, or mobile apps) that were used to monitor or take care of the voice in occupational voice users were included. After reviewing 4581 abstracts, 10 full text studies were included in the literature review. The technologies found include 30% hardware, 30% hardware plus software, and 50% mobile apps, with an overall TRL mean of 5.3 (SD = 2.3). Further research is necessary for higher validity in the studies and to increase the readiness in the development of current technologies to offer more options for this population. The evidence for the impact of the use of the technologies for occupational voice users is still low There is emerging evidence that mobile apps and artificial intelligence algorithms can be used to investigate vocal disorders or potential risks in occupational voice users More research is required to increase the readiness developmental stage of current technologies for occupational voice users [ABSTRACT FROM AUTHOR]

To offer guidance for future welfare technology research, this review provides an overview of current knowledge gaps and research needs as reported in primary scientific studies addressing the implementation of welfare technology for older people, people with disabilities and informal caregivers. This paper conducted a state-of-the-art review based on systematic searches in 11 databases followed by a descriptive qualitative analysis of 21 selected articles. Knowledge gaps and research needs were identified concerning two categories: research designs and populations and focus of research. The articles reported needs for comparative studies, longitudinal studies, and demonstration trials as well as the development of co-design processes involving technology users. They also called for studies applying a social system theory approach, involving healthy and frail older adults, representative samples of users within and across countries, informal and formal caregivers, inter-and multidisciplinary teams, and care organizations. Moreover, there are reported needs for studies of acquirement, adoption and acceptance of welfare technology, attitudes, beliefs, and context related to welfare technology, caregiver perspectives on welfare technology, services to provide welfare technology and welfare technology itself. There are considerable knowledge gaps and research needs concerning the implementation of welfare technology. They relate not only to the research focus but also to research designs, a social system theory approach and study populations. When planning for the implementation of welfare technology for older people and persons with disabilities, it is important to be aware that necessary evidence and guidance may not always be available in peer-reviewed scientific literature but considerable knowledge gaps and research needs remain. Actors implementing welfare technology are encouraged to include researchers in their projects to study, document and report experiences made, and thereby contribute to building the evidence base and supporting evidence-based implementation. [ABSTRACT FROM AUTHOR]

To identify and describe the aims, methodological approaches, and major findings of studies on the use of STT among secondary pupils (age 12–18) with learning difficulties published from January 2000 to April 2022. This scoping review includes empirical studies published in peer-reviewed journals and grey literature between January 2000 and April 2022. Searches were conducted in April 2022 in three databases: ERIC, PsycINFO and Scopus. In addition, related reviews were manually screened for relevant papers. Eight peer-revied studies and five publications of grey literature were found to meet the inclusion criteria; two studies employed experimental designs, four employed quasi-experimental designs and seven employed explorative designs. Six studies described STT as an assistive technology (a compensatory aid for poor writing performance); two assessed STT as an instructional technology to determine whether it improves overall writing and related skills (e.g., reading). Results suggest that STT may increase pupils' abilities to produce texts with fewer errors, provide help with spelling and improve reading comprehension and word recognition. To date, there is a paucity of high-quality research on the use of STT among adolescents with LD. The scoping review shows that very little research has been conducted on the use of STT for adolescents with learning difficulties in secondary education. Findings from the studies identified five areas of interest: writing related skills, text assessment, writing processes, accuracy of the technology, and participants' experiences. Findings indicate that writing performance among students with learning difficulties improves when using STT. Parents, teachers, and pupils report positive experiences with the technology, particularly for students with severe reading and writing difficulties. There is a great need for more robust research on the use of speech-to-text technology (STT) in educational settings, especially on its effect on writing skills Studies describe STT as either an assistive (a compensatory aid for poor writing performance) or instructional technology (aiming to improve learning in general). It is important that practitioners are aware of the different aims and possible consequences of introducing STT to learners with writing difficulties. STT provides both opportunities and challenges for writers with learning difficulties in secondary education. Findings indicate that writing performance among students with learning difficulties improves when using STT, yet inaccuracy of the technology was presented as one of the main challenges. Parents, teachers, and pupils report positive experiences with the technology, particularly for students with severe reading and writing difficulties. [ABSTRACT FROM AUTHOR]

Age associated cognitive impairments (CIs) result in difficulties with a wide range of daily activities. As the older adult population increases, so does the importance of understanding and supporting the needs and disabilities of those with CIs. The Enhancing Neurocognitive Health, Abilities, Networks, and Community Engagement (ENHANCE) Centre was established with a focus on developing assistive technology to support the socialisation, transportation, and prospective memory needs of older adults with CIs. The extent to which relevant literature in these domains existed was unknown. A scoping review identified existing research meeting the following criteria: participants aged 50+ years classified as having a CI due to mild cognitive impairment (MCI), traumatic brain injury (TBI), or stroke; and a focus on technology-based support for socialisation, transportation, and/or prospective memory activities. Qualitative and quantitative data are reported from relevant studies. In addition to few studies available, it was common for studies to include 20 or fewer participants. Most assessed technology interactions at one time and few studies examined longitudinal use and benefit. While each paper examined one aspect of user-centred design, no technologies were reported that underwent all stages of the user-centred design process, from needs assessment to iterative design and usability testing, to efficacy trial. Gaps highlight notable directions for future research and the important role ENHANCE can play in addressing the needs and disabilities of older adults with CIs. Although older adults with common cognitive impairments often experience challenges in the domains of socialisation, transportation, and/or prospective memory, few studies exist that examine assistive technology solutions in these domains. Additional research with more robust designs and larger sample sizes is needed to discover and assess assistive technology solutions for the needs and disabilities of older adults with mild cognitive impairment (MCI), traumatic brain injury (TBI), and post-stroke cognitive impairment (PSCI). The ENHANCE Centre will employ a systematic process of needs assessments, user testing, and efficacy tests to develop novel technology solutions to support the needs of older adults with common cognitive impairment. [ABSTRACT FROM AUTHOR]

This paper critically reviews and reflects on the processes for providing Assistive Technology (AT) services to Persons with Disabilities (PWD) in Bangladesh, India and Nepal. The aim is to investigate the AT service delivery systems in these countries and suggest improvements where weaknesses are identified. We carried out a descriptive qualitative exploratory study in Bangladesh, India and Nepal by conducting key informant interviews with policymakers (5), AT service providers (22) and mobility and hearing related AT service users (21). We used a directed content analysis approach guided by a seven-point AT service delivery process model to thematically analyse the existing processes for AT service delivery, from first contact through to follow-up and maintenance. AT service delivery processes are sub-optimal in all three countries, and improvements are needed. No common AT service delivery process was found, although there are common features. In general, it is easier for PWDs in India and Nepal to access AT than for those in Bangladesh, but all three countries are failing to live up to their commitments to uphold the human rights of PWDs. Although good elements of AT service delivery processes can be identified, the systems in all three countries are fragmented and generally weak. A more holistic approach of looking at the process of AT service delivery, from first contact right through to follow-up and device maintenance, with a single door service delivery system, free of cost at the point of service is recommended in these countries. Although we found significant weaknesses in AT delivery in all three countries, there are some good AT service delivery practices and opportunities for these countries to learn from one another. A systematic and stepwise approach to assessing current AT service delivery processes in the three countries – examining the delivery system as a whole, from initiation to repair and management – can help identify opportunities to improve the process for (prospective) AT users. A more coherent single door system of AT service delivery will increase the quality and efficiency of the fragmented AT service delivery practices in Bangladesh, India and Nepal. [ABSTRACT FROM AUTHOR]

This research paper examines how contouring of a wheelchair seating base can help prevent pressure sores by distributing pressure over the buttocks. Contouring wheelchair cushioning is already done to some extent and has proved to be beneficial for pressure distribution. We researched the effect of contouring the seating base, and whether contouring the seating base affects effectiveness in pressure distribution and perceived discomfort. 13 healthy participants performed a within-subject experiment with three differently contoured seating bases. Perceived comfort and seating pressure were measured for each condition. Results indicate that a more contoured base is positive for both comfort and increased pressure distribution. Contoured seating bases can provide increased comfort and improved pressure distribution over flat seating bases. Future research should examine the effect of contouring on stability, as well as compare the effects of contoured seating bases and contoured cushions. We evaluated the comfort and pressure characteristics of three differently contoured hard seating bases for a wheelchair. The outcomes of the research shows that providing increased contour to seatings could be beneficial to reduce pressure peaks in the buttocks. Contour in the seating is conventionally created by shaping the cushions, this research shows the possibility of using a hard base underneath a cushion to create the desired contour. [ABSTRACT FROM AUTHOR]

The use of assistive technology (AT) for people with disabilities is well researched and prevalent in education. Growing numbers of students now self-identify as having mental health diagnoses and register for accommodations at post-secondary institutions. The apparent gap in the literature specifically relating to AT support in this population necessitated a more systematic search. This scoping review maps the literature regarding AT interventions to support young adults with mental health disabilities in post-secondary institutions such as universities and colleges. Four major databases were searched for topic keywords. Abstracts and final papers were screened against the inclusion and exclusion criteria, with seven studies identified as relevant. The reported common problems faced by students were academic, psychosocial and cognitive in nature and they affected day-to-day activities. AT identified loosely fit into the categories of note-taking alternatives, smartphones, multimedia presentations to support text material, alternate participation supports, graphic organizers, text-to-speech software, and other AT writing and visualization tools. Future research is needed on outcomes of AT implementation in this population and to explore the apparent lack of awareness of these supports by students and service providers, as evidenced by the limited research identified by this scoping review. There appears to be a gap in access to assistive technology (AT) to students with mental health disabilities, except when the student has concurrent physical or learning disabilities These students have additional barriers as they have little or no prior knowledge of AT, having not been previously identified in high school as needing or receiving AT AT rehabilitation would level the playing field for students with mental health disabilities, making education and student participation more accessible thus improving overall student experience [ABSTRACT FROM AUTHOR]

The vulnerable children refer to the special group of children with deviation in the process of children's psychological development and personality formation due to growth dilemmas. This may incur a series of serious social and family problems. The vulnerable children mainly cover the children suffering from children's psychological problems, such as childhood autism, autism, social anxiety and hypersensitivity, fear, depression, and PTSD arising from other factors. At present, the research results at home and abroad mainly focus on the psychological dynamic correlation investigation and solution discussion of a certain kind of difficult factor in the children's psychological development based on statistical data by the experimental methods, such as scale and model, and there is a blind spot in the humanistic orientation theory construction of psychological treatment for vulnerable children, causing the social reflection on children's psychological predicament from the humanistic perspective cannot be performed in related researches and going against searching for universal and integral theoretical paradigm for solving related problems. Sophisticated technologies for the observations have emerged increasingly for enabling the psychological features of vulnerable children through developmental cognitive neuroscience experiments. This paper introduces humanistic art therapy theory, focuses on the construction of a theoretical paradigm, and verifies its effectiveness based on the experimental results on the psychological development of vulnerable children, with an efficient performance. This study mainly refers to children with difficulty in social inclusion and psychological development. The results showed that two kinds of art therapy can obviously improve the psychological disorders of vulnerable children. The goal was to enhance self-cognition, strengthen emotional interaction, and implement positive motivation. [ABSTRACT FROM AUTHOR]

The manual user-operated Arise Standing Wheelchair (SWC) is the end-result of multiple design iterations based on comments from user trials. The Arise SWC provides standing functionality, outdoor mobility, affordability, and customizability. This paper describes a user experience study of the Arise SWC's pre-commercial version. Thirty participants (N = 30, 25 Male, 5 Female) were recruited for the study. All the participants were people with spinal cord injury. The study was conducted over a period of six weeks (five participants per week) within the hospital premises under the supervision of clinical personnel. A 30 min interactive training session involved thirteen activities. During the trial period, the participants were trained to perform twenty-two activities to familiarize themselves with the SWC. The participants were also trained to perform four functional usage activities with the SWC. At the end of the study, participant responses to ten outcome measures were captured using a smiley-based Likert-scale questionnaire. A majority of the participants (93.3%) felt happy when they stood in the SWC. The majority participants (83.3%) preferred the Arise SWC over their current wheelchair. Also, 80% participants anticipated that they could get more work done at home using the standing function of the wheelchair. A one-time fitting and training ensured optimal effort for the SWC operation, correct posture, and comfortable user experience. With proper dissemination and awareness, it is believed that the Arise SWC will benefit eligible users and improve their quality of life. The Arise wheelchair provides standing functionality, outdoor mobility, affordability, and customizability. Study confirms that incorporating standing functionality can improve the quality of life for wheelchair users. The majority of users were happy, felt safe and expected to do more with the standing functionality. Study results support further testing in real world conditions beyond the hospital setting. [ABSTRACT FROM AUTHOR]

Exercise is a safe, evidence-based approach for improving symptoms such as mobility impairment, cognitive dysfunction, and fatigue; however, persons with multiple sclerosis (MS) who use wheelchairs for mobility have been excluded from most research. This paper describes our approach for recruiting ten community advisor board (CAB) members and partnering with them on developing a novel home-based exercise training program for wheelchair users with MS. The exercise training program, which was developed based on initial qualitative research, includes a progressive exercise prescription, equipment, and one-on-one behavioural coaching based on Social Cognitive Theory. The CAB members convened in groups of five people for five meetings online, using virtual conference software. The CAB meetings each lasted approximately 1-hour and notes were transcribed into digital format for data analyses. Content analysis identified elements that aligned with meeting foci (i.e., prescription, equipment, coaching, and outcomes). Feedback was divided into categories to refine the program, specifically modifying, adding, or retaining content and/or activities. CAB member feedback was very positive and emphasised potential additions to the materials presented. The research team proposed implementing modifications based on the CAB member feedback such as adding wrist weights to the equipment options for completing resistance training exercises. The overall CAB feedback was invaluable for assessing the appropriateness of the proposed exercise training program before initiating feasibility testing. This report provides a model and guidance for researchers who seek community-engaged research approaches in creating products and interventions. Community advisory board participation was invaluable in creating and modifying a novel exercise training programmes for wheelchair users with multiple sclerosis (MS). The current study provides a framework for the creation of exercise interventions for subpopulations of persons with MS that may provide substantial rehabilitation benefits such as improved symptoms and quality of life. Health behaviour interventists targeting individuals with disabilities may consider the benefits of recruiting stakeholders from the community in creation of novel programmes. [ABSTRACT FROM AUTHOR]

Explore methods used in peer-reviewed literature for obtaining self-expression of well-being information from children with severe motor and communication impairment (SMCI). A comprehensive search was conducted on 22 August 2019 through academic databases: CINAHL; Embase; MEDLINE; PsycINFO; InSpec; Compendex. Search strategies were informed by keywords under the following areas: (1) population: children with SMCI, (2) assessment methods: alternative to natural speech, paper and pencil report or standardized keyboard use (e.g., eye gaze) and (3) target information: well-being (e.g., quality of life). Studies were excluded if they focused on individuals over 25-years old, exclusively autism or typically developing children. Non-duplicate studies of 10,986 were screened; 49 studies met inclusion criteria. Most studies used high-tech methods of self-expression in a single context (n = 17). Familiar partners play a significant role in self-expression; 18 studies required a familiar partner for children with SMCI to self-express. Thirty-five studies involved children self-expressing to solely adults, in comparison to 14 studies which involved peers. Findings highlight the advancement of high-tech communication devices restricted to application in single contexts. Familiar partner knowledge of children with SMCI has the potential to be shared with others (e.g., respite care providers), enhancing both caregiver and child well-being. Future research that would enhance the literature could explore the assessment of emotional well-being for application in various contexts using multimodal methods. Opportunities for children with SMCI to express their emotional well-being can further influence the understanding and enhancement of participation, social connections, and experiences. Use of lower tech methods of self-expression to obtain information directly from children with severe motor and communication impairment (SMCI) remain more feasible in home and school contexts. By utilizing familiar partners' experiences and knowledge of the child, respite care providers, novel support workers, and others involved in the lives of children with SMCI can become further informed. Current high-tech methods for obtaining the emotional expressions of children with SMCI may benefit from incorporating multimodal approaches including lower tech methods, to be feasibly applied in real world contexts where well-being takes place. Further research on this topic is imperative to enable children with SMCI to self-express their emotional well-being which can enhance participation, activities, social connections, and experiences. [ABSTRACT FROM AUTHOR]

The solution described in this paper allows wheelchair users with reduced mobility or physical disabilities to move independently throughout an aircraft and to board and disembark autonomously. A motorized aircraft seat was developed to substitute current aircraft aisle wheelchairs. The real-scale functional prototype was evaluated in a focus group. The results show that the proposed solution is considered superior to current solutions in nine of twenty requirements and neutral in one of them. There was low agreement among the focus group participants in ten requirements, even though the focus group discussion brought interesting reflections, including positive feedback, critics, and suggestions for further research and development in the field. The design concept consists of a motorized wheelchair that becomes the seat of the aircraft when anchored on a docking platform attached to the aircraft fuselage via a seat track. The manoeuvring is allowed by a rotating mechanism, which solves a critical function that is to enable wheelchair manoeuvring in the narrow aisles of aircraft. A parking assistant system aids the control of the motorized wheelchair. The main benefits of this solution are to reduce seat transfers during the flight experience and to provide more autonomy and comfort for passengers during flights. A motorized aircraft seat was developed to replace traditional aircraft aisle wheelchairs. A real-scale functional prototype was built, tested in an aircraft mockup, and evaluated in a focus group. The main benefits of the proposed solution are to reduce the number of chair transfers during the flight experience and to provide more autonomy for passengers. Additional benefits are to allow the passengers to experience less physical and emotional stresses, to enter the aircraft corridor looking ahead, and to sit in any aisle position in the aircraft. [ABSTRACT FROM AUTHOR]

Task-specific rehabilitation is a key indicator for successful rehabilitation to improve the upper limb performance after stroke. Assistive robotic and non-robotic devices are emerging to provide rehabilitation therapy; however, the effectiveness of task-specific training programs using assistive training devices compared with task-specific usual care training has not been summarized yet. Therefore, the effectiveness of task-specific training using assistive arm devices (TST-AAD) compared with task-specific usual care (TSUC) on the upper limb performance of patients with a stroke was investigated. To assess task specificity, a set of criteria was proposed: participation, program, relevant, repeated, randomized, reconstruction and reinforced. Out of 855 articles, 17 fulfilled the selection criteria. A meta-analysis was performed on the Fugl-Meyer Assessment scores in the subacute and chronic stages after stroke and during follow-up. Both TST-AAD and TSUC improved the upper limb performance after stroke. In the sub-acute phase after stroke, TST-AAD was more effective than TSUC in reducing the upper limb impairment, although findings were based on only three studies. In the chronic phase, TST-AAD and TSUC showed similar effectiveness. No differences between the two types of training were found at the follow-up measurements. Future studies should describe training, device usage and criteria of task specificity in a standardized way to ease comparison. Arm or hand function is often undertreated in stroke patients, assistive training devices may be able to improve the upper limb performance. Task-specific training using assistive devices is effective in improving the upper limb performance after stroke. Task-specific training using assistive devices seems to be more effective in reducing impairment compared with task specific usual care in the subacute phase after stroke, but they are equally effective in the chronic phase of stroke. [ABSTRACT FROM AUTHOR]

The purpose of this study was to identify clinician knowledge regarding manual wheelchair (MWC) training in an inpatient rehabilitation (IPR) setting, identify current MWC education provided to new manual wheelchair users (MWUs), and determine how MWC training resources can be developed or modified to promote use among IPR clinicians. Semi-structured interviews were conducted with 20 licenced IPR clinicians who work with MWUs. Using a traditional qualitative research design, researchers completed open, data-driven coding of interview transcripts. Overarching themes were determined through content analysis. Participants included 12 physical therapists, six occupational therapists, one physical therapy assistant, and one occupational therapy assistant. Five themes emerged from the interviews: (1) clinician knowledge, education, and experience (2) current training content (3) training environment, (4) desired programme components (5) barriers to implementation. Participants reported receiving minimal education in school and from their employers on training MWUs. While clinicians expressed the importance of MWU education, they used varying training approaches with little standardization. Participants identified that training protocols for IPR are beneficial if they are quick, straightforward, and flexible. While MWC training occurs during IPR stays, it appears to be inconsistent across facilities, clinicians, and patients, with varying degrees of adherence to evidence-based practices. This is likely due to limited feasibility and awareness of existing MWC training resources. Clinician input gathered from these interviews provides information for how to best integrate MWC training programmes into the rehabilitative process. Findings may inform the development and assessment of more clinically feasible MWC training protocols. New manual wheelchair users must learn numerous wheelchair-related skills in order to participate in everyday life activities. Manual wheelchair education for new users during inpatient rehabilitation is often inconsistent across facilities, clinicians, and patients, with varying degrees of adherence to existing evidence-based practices. Systematic challenges often act as a barrier to the implementation of more comprehensive, structured manual wheelchair training protocols. Manual wheelchair training resources must be concise, flexible, customisable, and easy to follow in order to promote increased implementation among inpatient rehabilitation clinicians. [ABSTRACT FROM AUTHOR]

Neuromotor impairments can affect any part of the body. It leads to many disorders, injuries, or disabilities, conventional rehabilitation is a long, rigorous, and tedious process. There is a need to inculcate new and innovative techniques in rehabilitation processes, to increase individuals' interest and overall performance with such therapies. Virtual Reality is considered a new technology that has the potential to be a useful aid in overcoming therapeutic problems in clinical and home-based environments. However, providing home-based rehabilitation is more practicable, cost-effective, and even safer than in-hospital rehabilitation. In addition, the need for home-based rehabilitation is growing as the number of neuromotor disorders rises and the capacity of acute inpatient rehabilitation decreases. Therefore, the main objective of this study was to assess the efficacy of a home-based Virtual Reality exercise treatment to identify the areas for future rehabilitation research. Data Extraction of 24,257 articles from seven databases were identified and the review is narrowed down and only 45 studies were focussed on efficacy assessment of Virtual Reality in the home environment. The significant outcome of the effective home-based therapy system for the exercise improved functional ability, increasing range of motion, and motivation through Virtual reality-based rehabilitation is inferred. Unlike clinical settings, a home-based system provides efficacious therapy with a controlled environment. This survey facilitates bettering methods and devices for neuromotor disorders. It is a good living long-term problem-solving approach and investigates awareness, needs, and a preferred component of home-based rehabilitation services. VR-based rehabilitation in the home environment has many physical and mental benefits in persons with neuromotor disorders. The most commonly neuromotor disorders considered in the study were Stroke, Spinal Cord Injury, Parkinson's disease, and Cerebral Palsy. Assistive technologies in home environments can compensate for long-term disorders or be used in rehabilitation as an addition to conventional therapy. The study gives an overview of current interventions and how they can be of benefit for a person suffering from neuromotor disorders in the home environment. [ABSTRACT FROM AUTHOR]

To examine the effect of a communication intervention package on expressive communication and visual attention in individuals with Rett syndrome. A modified withdrawal (A-B1-A1-B2-A2) single case experimental design with a direct inter-subject replication across three participants was applied. Three women with Rett syndrome participated. The study took place over a six-week period and comprised 32 sessions with each participant. All sessions were video recorded. During the intervention the communication partner used aided language modelling on a gaze-controlled device in combination with using responsive partner strategies. Expressive communication was assessed as synthesised words per minute and unique synthesised words per minute. Visual attention was assessed as rate of focused gazes (1 s or longer) in interaction. An intervention effect was found on the rate of unique words for all participants. The rate of words increased for two participants when the intervention was introduced but no withdrawal effect could be seen. An intervention effect on visual attention could be seen for one participant. The intervention appeared to have social validity as reported by caregivers. Aided language modelling (ALM), while using responsive partner strategies and a gaze-controlled device may be used with adult individuals with Rett syndrome to increase their rate of expressive communication. Detailed observational measures revealed individual learning patterns, which may provide clinically valuable insights. Adults with Rett syndrome may benefit from access to gaze-controlled devices in combination with responsive partner strategies. Responsive partner communication may be effective for some individuals with Rett syndrome to increase their rate of synthesised utterances. Rate of focused gazes may be considered as an outcome measure for individuals with oculomotor difficulties when introducing aided language modelling. [ABSTRACT FROM AUTHOR]

Age-related macular degeneration (AMD) is a degenerative condition impacting central vision. Evaluating the effectiveness of low vision devices provides empirical evidence on how devices can rehabilitate and overcome deficits caused by AMD. This evidence could help to facilitate discussion on necessary future improvements to vision enhancement technology. A systematic review of the literature was conducted on low vision device use in AMD populations. Relevant peer-reviewed research articles from six databases were screened. The findings of thirty-five studies revealed a significant positive impact of low vision devices leading to improvements in visual acuity, reading performance, facial recognition, and more. While the studies were found to have moderate risks of bias, a GRADE assessment of the evidence suggested the certainty of the evidence was low-moderate. Simple hand-held low vision devices (e.g., magnifiers) appear to currently have greater preferential support than newer visual enhancement technology (e.g., head mounted devices). Financial, comfort or usability reasons may influence preferences more than performance-based findings. However, there is a lack of studies examining newer technologies in AMD populations, which future research should address. Moreover, given the presence of bias across the studies and limited controlled experiments, confidence in the results may be low. Most studies indicated that low vision devices have positive impacts on reading and visual performance. But, even though they are reported to be a valuable asset to AMD populations, more rigorous research is required to draw conclusive evidence. Low vision devices can improve patient outcomes (e.g., vision, reading ability) for age-related macular degeneration populations. A multidisciplinary combination of low vision devices and rehabilitative services (i.e., eccentric viewing training, counselling, education) may enhance quality of life. [ABSTRACT FROM AUTHOR]

Little is known regarding what assistive technology (AT) exists and how it is used in welfare services for people with intellectual disabilities (ID). This study aimed to explore healthcare staff's perspectives and insights regarding AT in daily support and welfare services for people with ID. We also sought to explore the associations between the use of AT and workplace-related factors and background characteristics (e.g., gender, age, and experience). Three focus group discussions were conducted with 11 informants (8 women, 3 men) working in home-based and day services. Also, 176 healthcare staff (43 men, 133 women) who worked in municipal home-based services and day services completed a questionnaire comprised of background questions and 14 items with a five-point answer scale. Number of years using AT was positively associated with a positive attitude and use of AT among the staff. Staff were mainly positive towards AT and believed that it could represent various possibilities in the everyday lives of people with ID and their own service delivery. However, the staff expressed uncertainties and ethical concerns regarding AT, and they experienced a lack of knowledge, focus, and awareness about technology in services for this group. The quantitative results mainly showed positive associations between believing in AT's usefulness and using it in services for people with ID. The findings indicate that providing equipment and resources, personal interests, and staff attitudes are essential factors in successfully implementing AT for people with ID. Healthcare staff have a positive attitude towards using AT for people with intellectual disabilities, but they also perceive uncertainty and ethical concerns. The staff believe that there is a broad range of AT devices and systems available that can support the independence and participation of people with intellectual disabilities. The staff need to receive more training and technical supports from their workplace and AT-related experience is associated positively with the use of assistive technology by the staff. [ABSTRACT FROM AUTHOR]

Although studies addressing barriers to and facilitators of implementation of welfare technology have been published, no systematic review synthesising evidence on such factors has been found. The purpose of this study was therefore to identify and synthesise existing primary research on facilitators and barriers that influence the implementation of welfare technology for older people, people with disabilities and informal caregivers. A systematic search in 11 databases was performed using predefined inclusion and exclusion criteria to identify empirical studies that assess the implementation of welfare technology for older people, people with disabilities or informal caregivers. The search identified 33 publications with quantitative, qualitative and mixed method designs. The reported findings were thematically synthesised and conceptualised into themes. Six themes of facilitators and barriers that influence the implementation of welfare technology emerged: capacity, attitudes and values, health, expectations, participation and identity and lifestyle. These were presented from five perspectives: older persons and persons with disabilities, informal caregivers, health and care personnel, organisation and infrastructure and technology. The findings may be used as a means to structure the planning and evaluation of implementation processes of welfare technologies for older persons and persons with disabilities and to understand the complexities of implementation. This knowledge generates deepened insights and structures to guide and evaluate the implementation processes of welfare technologies and engenders an understanding of the complexities of implementation. When planning for the implementation of welfare technology for older people and persons with disabilities, it is important to consider capacity, attitudes and values, health, expectations, participation, and identity and lifestyle. Using the result from the study facilitates deepened insights and structures for evaluation of implementation processes of welfare technologies and brings an understanding of the complexities of implementation. Welfare technology should be available, safe, usable and fit the user's daily lives. Implementable welfare technology should focus on needs, but also consider design and possible experienced stigma related to the identity of being a welfare technology user. [ABSTRACT FROM AUTHOR]

Modified ride-on cars (MROC) are a low-cost option to provide self-directed mobility to children with mobility limitations, in lieu of or as a precursor to other powered mobility devices. We appraised evidence to (1) describe and categorize MROC study characteristics, (2) synthesize existing knowledge of children's use of MROCs and (3) frame outcomes within the International Classification of Functioning, Disability and Health (ICF) framework. Articles were identified through four electronic databases: Medline, CINAHL, PsycNET, and Web of Science. We included all published, peer-reviewed studies involving MROC use. Relevant data were extracted, and articles were appraised using the American Academy of Cerebral Palsy and Developmental Medicine criteria for group and single-subject designs. 23 studies met inclusion criteria of 204 titles identified from 1980 to 2021. Study designs included case studies, case series, group designs, and qualitative research, but only three studies were rated evidence level III or higher. Children with a range of disabilities used MROCs across multiple settings, including the home, hospital, and community, though use and adherence varied widely. Positive impacts were reported on a range of outcomes related to the ICF framework, with an emphasis on activity and participation. MROC studies have primarily addressed activity and participation, with most studies suggesting increased functional mobility and social interactions due to MROC use. More robust research designs with larger samples are needed in order to develop evidence-based strategies for MROC use. Physical and occupational therapists may consider using MROCs as a therapeutic tool or accessible play opportunity as part of a multi-modal approach to increase children's mobility, family engagement, and participation in community life. Personal (e.g., child's enjoyment) and environmental factors (e.g., caregiver attitudes and stress) must be considered when developing plans of MROC use. [ABSTRACT FROM AUTHOR]

Route planning is key support, which can be provided by navigation tools for the blind and visually impaired (BVI) persons. No comprehensive analysis has been reported in the literature on this topic. The main objective of this study is to examine route planning approaches used by indoor navigation tools for BVI persons with respect to the route determination criteria, how user context is integrated, algorithms adopted, and the representation of the environment for route planning. A systematic review was conducted covering the period 1982–July 2018 and thirteen databases. From the 1709 articles that resulted from the initial search, 131 were selected for the study. Route length was the sole factor used to determine the best route in the majority of the studies. Routes with less obstacles, less turns, more landmarks and close to walls were selected by the other studies. User variations were considered in few studies. Unique needs of the BVI persons were addressed by few novel algorithms which had integrated multiple parameters and BVI-friendly route modelling. Differences between the navigation capabilities of the sighted and the BVI community were not a major concern when deciding the optimum routes in the majority of BVI indoor navigation tools. How to trade-off between factors affecting optimum routes, and how to model suitable routes in complex buildings needs to be studied further, looking from the user perspective. Navigation differences between sighted and blind and vision-impaired (BVI) communities are not concerned frequently when planning routes in indoor navigation tools of BVI persons. Selecting routes avoiding areas difficult to traverse, close to walls, having landmarks, and less turns are some approaches used to address the unique needs of the BVI community. Assisting for recovery from veering and real-time obstacle detouring are useful features offered by these tools. Identifying and prioritizing different factors contributing to better routes, concerning user variations, and adopting multi-objective route optimization will help to develop improved route planning methodologies for BVI indoor navigation tool [ABSTRACT FROM AUTHOR]

The aim of this study was to assess wheelchair skills of persons with physical disabilities who attended the first Wheelchair Skills and Empowerment Camp in Morocco and their satisfaction with manual wheelchairs provided for the camp activities. 19 persons (13 male and 6 female) with physical disabilities took part in the project. The average time since injury or illness was 24 years. To assess wheelchair skills/user satisfaction, the researchers used the Queensland Evaluation of Wheelchair Skills test and the Quebec User Evaluation of Satisfaction with assistive Technology. Study participants improved their overall wheelchair mobility skills (p = 0.002; d = 0.20), especially their ability to ascend and descend a ramp (p = 0.012; d = 0.67). The participants reported significantly greater satisfaction with the new provided wheelchairs in comparison to their own wheelchairs in regard to five satisfaction items; i.e., ease in adjusting (p = 0.011; d = 0.96), safety and security (p = 0.014; d = 0.97), durability (p = 0.037; d = 0.81), ease to use (p = 0.045; d = 0.87), and comfort (p = 0.006; d = 1.03). Findings of this study indicate that persons with physical disabilities in Morocco need structured training in wheelchair skills and better-quality wheelchairs. The study also confirmed that community peer-based programmes in low-resource countries can play a significant role in rehabilitation of persons with physical disabilities, even many years after their injury or illness. The One World project educated local persons with disabilities and government officials about the need for buying appropriate wheelchairs and for providing them according to the World Health Organization guidelines. 19 persons who use wheelchairs participated in 6-days of wheelchair skills training sessions, which were led by three peer mentors who use a wheelchair: two with spinal cord injury, and one with polio complications. The 19 participants, who had lived with their disabilities on average for 24 years, advanced their general wheelchair mobility skills, which was assessed through a practical test. The results confirmed that community peer-based programmes in low-resource countries are important for improving wheelchair skills not only when beginning rehabilitation but even after individuals live many years with a disability. [ABSTRACT FROM AUTHOR]

To describe a novel 3-dimensional (3D) exergames system and the results of a clinical feasibility study of stroke survivors needing in-home rehabilitation. The customisable Personalized In-home eXErgames for Rehabilitation (PIXER) system captures the user's image, generates a live model, and incorporates it into a virtual exergame. PIXER provides a recording system for home exercise programs (HEPs) by adapting virtual objects, customizes the exergame and creates a digital diary. Ten persons with stroke, performed HEPs with PIXER for 1 month, and without PIXER for 2 additional months. In-game performance data, measures of physical functioning (PF) including Stroke Impact Scale (SIS), Timed Up & Go (TUG) and Goal Attainment (GA) Scale obtained at baseline, 1- and 3 months were evaluated. Seventy percent of participants completed the 1-month timepoint, 50% completed all timepoints. In-game data: Number of repetitions completed; Anomalies reported; and Percentage of bubbles hit showed positive trends. Compared to baseline, all SIS physical functioning (PF) scores were higher at 1 month, TUG scores showed no overall improvement and GA scale scores were 77% at 3 months. It is feasible for community-dwelling patients to perform HEP after stroke using PIXER, a novel, exergames system, and potentially improve their function. Home Exercises performed using a novel, 3-dimensional, customizable Personalized In-home eXErgames for Rehabilitation (PIXER) system is feasible for community-dwelling patients after stroke. In-game performance data obtained in this clinical pilot study showed positive trends of improvement in several study participants. PIXER has potential to improve functional outcomes for community-dwelling adults with stroke. [ABSTRACT FROM AUTHOR]

Stroke, spinal cord injury and other neuromuscular disorders lead to impairments in the human body. Upper limb impairments, especially hand impairments affect activities of daily living (ADL) and reduce the quality of life. The purpose of this review is to compare and evaluate the available robotic rehabilitation and assistive devices that can lead to motor recovery or maintain the current motor functional level. A systematic review was conducted of the literature published in the years from 2016–2021, to focus on the most recent rehabilitation and assistive devices available in the market or research environments. A total of 230 studies published between 2016 and 2021 were identified from various databases. 107 were excluded with various reasons. Twenty-eight studies were taken into detailed review, to determine the efficacy of robotic devices in improving upper limb impairments or maintaining the current level from getting worse. It was concluded that with a good strategy and treatment plan; appropriate and regular use of these robotic rehabilitation and assistive devices do lead to improvements in current conditions of most of the subjects and prolonged use may lead to motor recovery. Stroke, accidents, spinal cord injuries and other neuromuscular disorders lead to impairments. Upper limb impairments have a tremendous adverse affect on ADL and reduces quality of life drastically. Advancement in technology has led to the designing of many robotic assistive and rehabilitation devices to assist in motor recovery or aid in ADL. This review analyses different available devices for rehabilitation and assistance and points out that use of these devices in time does help in motor recovery. Most of the studies reviewed showed improvements for the user. Future devices should be more portable and easier to use from home, [ABSTRACT FROM AUTHOR]

Children with severe, multiple disabilities often need to use switches to control their assistive technology. We developed the Switch Access Measure (SAM) to address the lack of validated functional activity-based measures to evaluate children's success using their prescribed switch(es). This goal-based performance measure evaluates switching ability on 16 skills items (6 motor, 2 visual, and 8 process). This study investigated SAM's reliability and confidence in scoring. Two occupational therapists with switch access intervention experience were trained as SAM study assessors. They independently scored SAM (inter-rater reliability) while viewing 20 study assessment videos where each child undertook at least one goal-based switching activity with their technology, and rated confidence in scoring for each SAM item. The SAM's two developers independently scored these videos as an inter-rater reliability benchmark. Each study assessor re-scored a subset of 10 videos 2–3 weeks later (intra-rater reliability). SAM Total score inter-rater reliability was excellent for the two study assessors (ICC =0.82) and the two SAM developers (ICC = 0.95). Inter-rater reliability was lowest (moderate) for Motor Subsection for the assessors, but still excellent for the developers. Intra-reliability for both groups of raters was excellent for Total and Subsection scores. Assessors' confidence in scoring was high (mean of 84.7% and 86.8% respectively) across items/participants. SAM is sufficiently reliable for clinical use, permitting clinicians, after SAM training and certification, to include it in their assessments and in development of switch access intervention plans for children with severe, multiple disabilities. For practitioners new to the field of switching technology, the SAM will provide a comprehensive understanding of all the components of successful switch use that need consideration when working with those needing switch access technologies. For all practitioners in this area, the SAM offers a consistent language to support clear communication among professionals, families, clients and their support networks. The SAM also gives quantifiable and reliable data to back clinical decision making, particularly important to support the case for funding of these technologies. Use of the SAM will prompt discussions with clients, families and carers and lead to better understanding of strengths and challenges, thus enhancing collaborative working relationships in the pursuit of achieving the best possible outcomes for those needing to use switch access technologies. [ABSTRACT FROM AUTHOR]