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Covid-induced lockdowns have increased the importance of technology in education. Though access to technology as well as availability of the internet remain a major concern for a lot of children in the global south, children with intellectual disabilities are disadvantaged even more as most of the e-content is developed keeping in mind the average learner. Unstructured interviews were conducted with children with intellectual disabilities studying in government schools in Haryana as well as their teachers and parents. Thematic analysis of the interviews was conducted to understand the use-patterns of mobile phones by children with intellectual disabilities. Findings suggest that these children are learning to use mobile phones on their own or with some support and are able to navigate the complexities of these smartphones quite well. They use these devices mostly for their entertainment. This paper then reflects on the need and strategies to develop these technologies in ways that they can be used as effective tools for teaching children with intellectual disabilities, especially in the inclusive education system in developing countries. The paper reflects on the need to develop technology and tools using flexible and exploratory designs to enhance the learning processes for children with intellectual disabilities from the lower income strata. This study highlights the importance of being able to use mobile phones by children with intellectual disabilities belonging to low income families. Following this, the article argues for designing of mobile phones suitable for use by children with intellectual disabilities using playfulness and explorations, and Building e-content keeping the elements of playfulness and exploration which can enhance the learnings of this group of students which is often ignored. [ABSTRACT FROM AUTHOR]

Despite the rapid proliferation and emphasis on technology, the use of assistive technology among individuals with varying disabilities and age is different. This situation instigates the need for a systematic review to gain a realistic understanding of prominent issues, research trends and assistive technology applications with minimal bias. Identification of leading researchers and prominent publications in assistive technologies. Subsequently, semantic relation between qualitative and quantitative research literature on assistive technologies was explored to future research directions. A manual search across reputed research databases was done to find out relevant literature from January 2005 to April 2020. In this paper, latent semantic analysis (LSA) was done to develop an information model for achieving defined objectives. A corpus of 367 research papers published during 2005–2020 was processed using LSA. Term frequency, inverse document frequency of high loading terms provided five major topic solutions. Marcia Scherer, Rory Cooper and Stefano Federici are most noticed authors in assistive technology research. "Smart Assistive Technologies" and "Wearable Technologies for Rehabilitation" came out as contemporary research trends within assistive technologies. The manuscript concludes the fact that assistive technologies for rehabilitation are experiencing a transition from standalone mechanical devices towards smart, wearable and connected devices. Customized assistive devices could be programmed for multiple uses. User data privacy and internet dependency of smart assistive technologies must be taken care of while designing smart assistive devices for rehabilitation. Fog devices could eliminate the latency issues associated with cloud-based rehabilitation services. [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]

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]

Background and aim: A Society's view of disability may influence the perception and use of Assistive Technology (AT) products. Semantic cues or cultural coding provide the viewer with a series of visual stimuli to be given or ascribed meaning. Previous research has shown cognitive approaches to visual perception and assignment of meaning vary between diverse cultures. This study reviews the influence of contextual settings on perception, to provide the basis for a debate on the societal perception of communicative content (semantic/meaning) of an AT product; and, the relevance of different cultural cognitive styles. The paper explores, from a cultural viewpoint, the overall understanding of disability internationally. Method: A Semantic Differential (SD) scale was used to obtain views on the image of an attendant wheelchair from nine hundred and ninety-one (991) young adults from the United Kingdom (UK) and Pakistan (PAK), reflecting the individualist and collectivist societies, respectively. This survey follows a previous paper-based study using the same image and protocol. Comparing the two surveys, a consensus of views from the two groups was achieved. Results and conclusion: The responses from the UK group were skewed towards a negative view of disability compared to the Pakistan group. This inferred greater social stigma associated with this AT product in the UK. The combined findings from both surveys provide insights into societal perception of AT products and disability. Areas for future research are suggested, including what visual components of an AT product (graphemes) appear to be associated with positive or negative responses for collectivist and individual societal groups. Assistive Technology (AT) product designers, academics, professionals and stakeholders need to be aware of challenges which are originated from one's socio-cultural environment. AT products convey certain meanings, semantics, which are interpreted by the society and are subjective to a specific cultural setting. •For the effective communication of meanings and values an AT product relies on the visual clues and design features embedded within the design. However, there have been a limited number of studies reviewing this aspect of product semantics. •The survey and associated testing has highlighted the differences in cultural perception towards AT products and demonstrated the importance of effectively designing the semantic attributes of an AT product as well as its function. •The demonstration of the efficacy of methods within the study for exploring the interpretation of semantic attributes of AT products will help designers and developers better understand the perceptions of individual cultures and societal groups. •A better understanding of different cultures and societies will enable designers and clinicians who specify AT products to reduce AT product abandonment; and, the associated stigma around disability. [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]

Purpose: Nature of being accessible to all categories of users is one of the primary factors for enabling the wider reach of the resources published through World Wide Web. The accessibility of websites has been analyzed through W3C guidelines with the help of various tools. This paper presents a multi-tool accessibility assessment of government department websites belonging to the Indian state of Jammu and Kashmir. A comparative analysis of six accessibility tools is also presented with 14 different parameters. Materials and methods: The accessibility analysis tools used in this study for analysis are aChecker, Cynthia Says, Tenon, wave, Mauve, and Hera. These tools provide us the results of selected websites accessibility status on Web Content Accessibility Guidelines (WCAG) 1.0 and 2.0. Results: It was found that there are variations in accessibility analysis results when using different accessibility metrics to measure the accessibility of websites. In addition to this, we have identified the guidelines which have frequently been violated. It was observed that there is a need for incorporating the accessibility component features among the selected websites. This paper presents a set of suggestions to improve the accessibility status of these sites so that the information and services provided by these sites shall reach a wider spectrum of audience without any barrier. Implications for rehabilitation: The following points indicates that this case study of JKGAD websites comes under Rehabilitation focused on Visually Impaired users. Due to the universal nature of web, it should be accessible to all according to WCAG guidelines framed by World Wide Web Consortium. In this paper we have identified multiple accessibility barriers for persons with visual impairment while browsing the Jammu and Kashmir Government websites. Multi-tool analysis has been done to pin-point the potential barriers for persons with visually Impaired. Usability analysis has been performed to check whether these websites are suitable for persons with visual impairment. We provide some valuable suggestions which can be followed by developers and designers to minimize these potential accessibility barriers.Based on aforementioned key points, this article helps the persons with disability especially Visually Impaired Users to access the web resources better with the implementation of identified suggestions. [ABSTRACT FROM AUTHOR]

Purpose:A power tilt wheelchair allows independence in changing body position to address a variety of needs throughout the day; however, literature and clinical practice suggest that actual use varies greatly. This grounded theory study examined how power tilt was used in daily life from the perspectives of adults who used power tilt and therapists who prescribed this technology. Methods:A constant comparative approach was used to collect and analyze interview data from five people who use power tilt and six therapists who prescribe this technology. Results:This paper presents the findings specific to understanding the reasons why power tilt was used, focusing on the relationships between tilt use and (1) the reasons for use, (2) the reasons for prescribing power tilt and (3) the associated amplitudes of tilt. Conclusions:This study advances knowledge related to how power tilt is used in daily life by elucidating that how the reasons for use are conceptualized is complex. The three relationships related to the reason for power tilt use identified in this paper have the potential to influence the quality of communication about power tilt use in clinical practice between therapist and client and in research between researcher and participant.Implications for Rehabilitation:Understanding the inconsistencies and variations in how power tilt is used in daily life is dependent on exploring the reasons beyond the words or terms expressed to describe use.Reasons for tilt use are context dependent, particularly the activity occurring at the time of tilt use, the associated amplitude of tilt and the influence of other reasons occurring at the same time. [ABSTRACT FROM PUBLISHER]

Assistive Technology (AT) product use occurs within a socio-cultural setting. The growth internationally in the AT product market suggests that designers need to be aware of the influences that diverse cultures may have on the societal perception of an AT product through its semantic attributes. The study aimed to evaluate the visual interaction with an AT product by young adults from Pakistan, a collectivist society, and the United Kingdom (UK), an individualist society. A paper-based questionnaire survey was carried out with 281 first-year undergraduate students from the UK and Pakistan to evaluate their perception towards the visual representation of a generic conventional wheelchair image. A semantics differential (SD) scale method was used involving a seven-point bipolar SD scale incorporating sixteen pairs of adjectives defining functional, meaning, and usability attributes of the product. The mean (M) and standard deviation (sd) values were obtained for each pair of adjectives and compared between both groups by employing appropriate parametric tests. The results show that having a diverse cultural background did not appear to have overtly influenced the meanings ascribed to the generic manual wheelchair, which was unexpected. The University 'Internationalist' environment may have influenced the results. Some minor but critical differences were found for some pairs of adjectives (bulky-compact, heavy-light), having p-value less than.05 (p <.05) that related to previous experience of wheelchairs and/or their use. Further studies are planned to investigate and validate outcomes with other student and non-student groups. The semantic attributes of assistive technologies highlight a number of aspects that have implications for those involved in Assistive Technology (AT) product development, manufacturing and marketing. • For online sales, the AT products rely on the web page image to communicate the purpose and attributes of the product. There are limited explorations related to the semantic/communicative attributes of AT product presented in images, as perceived by individuals from diverse cultural backgrounds. • The knowledge towards semantic meaning ascribed to the AT product is important to investigate to provide a perspective that goes beyond practical functions of the AT product towards the communicative function. • Information of comprehending semantics and significance of the AT product from a social (non-users) viewpoint may benefits manufacturers in the development of AT products that best meet the societal needs, preferences and expectations. • A model of best practice, with a focus on semantic manipulation will offer Industrial Designers (ID) internationally with the suitable process and tools to reframe perceptions of disability and enhance acceptance of AT products not only for users, but also for the society around them. [ABSTRACT FROM AUTHOR]

Purpose:To analyse the effect of a six-month home-based phase III cardiac rehabilitation (CR) specific exercise program, performed in a virtual reality (Kinect) or conventional (booklet) environment, on executive function, quality of life and depression, anxiety and stress of subjects with coronary artery disease. Methods:A randomized controlled trial was conducted with subjects, who had completed phase II, randomly assigned to intervention group 1 (IG1), whose program encompassed the use of Kinect (n = 11); or intervention group 2 (IG2), a paper booklet (n = 11); or a control group (CG), only subjected to the usual care (n = 11). The three groups received education on cardiovascular risk factors. The assessed parameters, at baseline (M0), 3 (M1) and 6 months (M2), were executive function, control and integration in the implementation of an adequate behaviour in relation to a certain objective, specifically the ability to switch information (Trail Making Test), working memory (Verbal Digit Span test), and selective attention and conflict resolution ability (Stroop test), quality of life (MacNew questionnaire) and depression, anxiety and stress (Depression, Anxiety and Stress Scale 21). Descriptive and inferential statistical measures were used, significance level was set at .05. Results:The IG1 revealed significant improvements, in the selective attention and conflict resolution ability, in comparison with the CG in the variable difference M0 − M2 (p = .021) and in comparison with the IG2 in the variable difference M1 − M2 and M0 − M2 (p = .001 andp = .002, respectively). No significant differences were found in the quality of life, and depression, anxiety and stress. Conclusions:The virtual reality format had improved selective attention and conflict resolution ability, revealing the potential of CR, specifically with virtual reality exercise, on executive function.Implications for RehabilitationIn cardiac rehabilitation, especially in phase III, it is important to develop and to present alternative strategies, as virtual reality using the Kinect in a home context.Taking into account the relationship between the improvement of the executive function with physical exercise, it is relevant to access the impact of a cardiac rehabilitation program on the executive function.Enhancing the value of the phase III of cardiac rehabilitation. [ABSTRACT FROM PUBLISHER]

Various factors influence the selection of assistive technology for young children within a context with limited resources, such as South Africa. Rehabilitation professionals are required to weigh up different factors as part of their professional reasoning process when making assistive technology (AT) selections. Insight into the perceived influence of different factors may assist in understanding how professionals make decisions about AT in this context. An online survey with questions designed using best–worst scaling was distributed to rehabilitation professionals throughout South Africa. Factors influencing assistive technology selection included in the best–worst survey were identified in previous phases of a larger project. A total of n = 451 rehabilitation professionals completed the survey by selecting the factors that were most and least influential on their assistive technology provision. Results of the survey were obtained by calculating the number of times each factor was selected as most influential across the entire sample, and across all questions, enabling the researchers to sort the items in terms of the frequency of selection. Even though the rehabilitation professionals that participated in the study provide services in a context with limited resources, assessment and factors pertaining to the assistive technology itself were generally perceived to be of greater influence than environmental factors. It is recommended that these factors be reflected in frameworks and models of AT selection. The family's ability to support the implementation of AT is an important resource that is perceived to influence the selection of AT by an RP. Insight into the mind-set of professionals that are used to selecting AT within settings with limited resources may provide RPs in well-resourced contexts with guidance on how to do more, with less. RPs should aim to determine child preference and attitude towards AT during the AT selection process. RPs should be aware of their own influence on AT selection. Existing AT Selection models should be adapted to clearly reflect the influence of the recommending professional. [ABSTRACT FROM AUTHOR]

Although approximately 45% of adults with Autosomal Recessive Spastic Ataxia of Charlevoix-Saguenay (ARSACS) are permanent wheelchair users, this sub population has been less studied. The purpose of this study was to document wheelchair mobility, motor performance, and participation in a cohort of adult wheelchair users with ARSACS. We recruited 36 manual and powered wheelchair users with ARSACS, aged between 34 and 64 years, for this cross-sectional study. Participants completed measures regarding wheelchair mobility (Wheelchair Skills Test Questionnaire [WST-Q-F], Wheelchair Use Confidence Scale [WheelCon-F] and Wheelchair Outcome Measure [WhOM-F]), motor performance (Scale for the Assessment and Rating of Ataxia [SARA], Disease Severity Index for adults with ARSACS [DSI-ARSACS], Upper Extremity Performance Test for the Elderly [TEMPA], Standardised Finger to Nose Test [SFNT], grip strength, pinch strength, Lower Extremity Motor Coordination Test [LEMOCOT], Berg Balance Scale [BBS], Timed Up and Go [TUG] and 10-meter Walk Test [10mWT]), and participation (Barthel Index, LSA-F and LIFE-H). Results were compared between age groups (≤49 years and ≥50 years), types of wheelchair used, and available reference values. Correlations were computed between wheelchair mobility, upper limb function, and participation. Participants presented limitations regarding wheelchair skills, motor performance, and participation in daily activities. Despite preserved upper limb strength, wheelchair skills, upper and lower limb coordination, standing balance, and functional independence were generally more impaired after 50 years of age and among powered wheelchair users. Significant moderate correlations were found between wheelchair skills and self-efficacy, upper limb strength and coordination, and participation in daily and social activities. This study provided the first data sets describing specific characteristics of manual and powered wheelchair users with ARSACS. It supports a need to offer wheelchair skills training interventions to adults with ARSACS, which could increase their daily and social participation. Adult wheelchair users with ARSACS present with limited wheelchair skills, significantly impaired motor performance, and reduced participation that generally decreases with age. This profile may serve as comparative data for clinicians to anticipate disease progression. This study provides the first data on distinguishing characteristics between PWC users and MWC users with ARSACS. The main characteristics of PWC users include more severe functional limitations and motor impairments, as well as limited grip strength that contrasts with the general preservation of this function among other adults with ARSACS. There is a need to offer and evaluate wheelchair skills training interventions in the future for adults with ARSACS. The general preservation of grip and pinch strength observed in this population suggests a potential for improvement. Considering the associations found between wheelchair mobility and participation, such interventions may increase users' daily and social participation. [ABSTRACT FROM AUTHOR]

Converging visual behavioural and attentional allocation studies within neuroscience have shown culture influences the processing of visual information obtained from the visual field. While attending (reviewing) a visual scene, individuals from a collectivist culture attend more to the context (background) compared to those from an individualist culture who view more the focal object. This highlights the effect of cultural conditioning in terms of holistic and analytical processing of visual information. This study aimed to demonstrate these principles in the context of an assistive product, a wheelchair, highlighting the key visual elements of the form; and, how a congruent background (hospital room) or incongruent (athletics track) influenced cultural bias during visual processing and assigned meaning. A combination of research methods (Semantic Differential Scale and eye-tracking) was used to triangulate the results. A total of 126 adult student participants, (Pakistani/collectivist, n = 57) and the (UK/individualist, n = 69), viewed a visual presentation of a wheelchair with semantically congruent and then an incongruent background and responded via an online questionnaire. A sub-sample completed the survey whilst monitored via eye-tracking. Pakistani respondents used shorter and less frequent fixations on the foreground compared to the responses of their counterparts (UK respondents). The wheel of the wheelchair was highlighted as the prominent form by both groups. Results demonstrate a culture-influenced pattern of visual processing even when the product was displayed against a semantically incongruent background. The findings from this study also validate and extend the outcomes of similar studies revealing a more specific, yet consistent, cultural effect on individuals' visual perception. Finally, the efficacy of triangulated research methods in their relationship to exploring the AT product's semantics was discussed. The knowledge of AT products' semantics will be significant to investigate, for their improved social acceptance, particularly when considered from a diverse cultural standpoint. A model of best practice, focussing on semantics manipulation, will provide AT product designers, practitioners, and those involved in their marketing, Internationally, with a suitable process/tool to positively reframe the perception of these devices. Finally, this research will help product and industrial designers to consider cultural cognitive styles in the design of products for the better adoption of products within the global marketplace. [ABSTRACT FROM AUTHOR]

This study intends to examine the web accessibility of three tourism supply agents (hotels, travel agents and museums). The results obtained contribute to observing whether there are differences in levels of web accessibility among these tourism supply agents and, based on the problems identified, suggest strategies to overcome these problems. To evaluate the level of web accessibility of tourism supply agents, two automatic online tools (AccessMonitor and TAW), which consider Web Content Accessibility Guidelines (WCAG), version 2.0, were used. To identify differences among the supply tourism agents in terms of the level of web accessibility, statistical tests (ANOVA and Kruskal–Wallis) were used. All the tourism supply agents analysed reveal considerable problems related to web accessibility. The perceivable and robust principles are the two principles of WGAG 2.0 with the greatest number of failures. However, differences among the supply agents analysed are observed. Museums present the highest level of web accessibility, while travel agents have the lowest. Therefore, it is necessary to implement improvements in tourism websites to overcome informational constraints that many people with disabilities (PwD) face in tourism activities. Due to the central role of the Internet for people with and without disabilities, this study highlights barriers that should be eliminated to facilitate the travel decision-making process, especially for PwD. Consequently, it can contribute to a greater number of people being able to participate in tourism activities, improving their well-being and rehabilitation. The participation in tourism activities contributes to improve health, quality-of-life and well-being of all people. For people with disabilities (PwD) to be able to travel, without constraints, access to online information needs to be provided. The identification of the level of web accessibility of tourism supply agents provides important guidelines to improve the websites, facilitating the travel tourism planning of PwD. If informational barriers to access tourism activities are eliminated, the participation of PwD in tourism activities will tend to increase, and consequently improvements in their well-being, health and rehabilitation will happen. [ABSTRACT FROM AUTHOR]

Everyday information and communication technologies (EICTs) are increasingly being used in our society, for both general and health-related purposes. This study aims to compare how older adults with cognitive impairment perceive relevance and level of EICT challenge between eHealth use and general use. This cross-sectional study includes 32 participants (65–85 years of age) with cognitive impairment of different origins (due to e.g., stroke or dementia). The Short Everyday Technology Use Questionnaire+ (S-ETUQ+) was used, providing information about the relevance of EICTs and measuring the EICT level of challenge. Data were analysed with descriptive statistics, standardized z-tests and Fisher's exact tests. The significance level was set to p <.05. The result shows that the perceived amount of relevant EICTs for eHealth use was lower in all 16 EICTs compared to those of general use. About the perceived level of challenge, a significant difference was detected in one of the seven included EICTs between eHealth use and general use. In this sample, all EICTs were perceived as having lower relevance for eHealth use compared to general use, suggesting that the purpose of using an EICT affects the perceived relevance of it. Also, once an EICT is perceived as relevant and used for eHealth purposes, there seem to be little to no differences in perceived challenge compared to the same EICT used for general purposes. All stakeholders, including health care providers, need to be aware of the hindrances that come with digitalization, making it challenging to many citizens to make use of digital solutions. It is of great importance that social services including eHealth services be tailored to suit the individual/target group. Older adults may need support and an introduction to EICTs to discover the potential relevance of the specific device and/or service. [ABSTRACT FROM AUTHOR]

Persons with profound intellectual disability (PID) are mostly not able to use assistive technology (AT) independently. Caregivers play an important mediating role in implementing AT in the daily life of persons with PID. Both first-order barriers, extrinsic to caregivers, and second-order barriers, intrinsic to caregivers, influence the attitudes and behaviors of caregivers with regard to AT-use. It could be asked if increased knowledge on and experience with AT may impact the effect of first- and second-order barriers. This study investigated how knowledge and experience influence the professional caregivers' beliefs about which factors may impact the AT use in persons with PID and their intentions to use AT for persons with PID. A questionnaire on the experienced limitations and successes in using AT was developed. The questionnaire was send to professionals working with or responsible for persons with PID in various countries in Europe. In total the answers of 195 respondents were included in this study. This study's results demonstrate that AT is used for various reasons in persons with PID, mostly to support communication and interaction or for fun or relaxation. Based on the answers of the respondents can be concluded that both experience and knowledge of caregivers seem to influence first- and second-order barriers. Besides, a possibility to overcome the second-order barriers is to provide professionals with possibilities to increase their knowledge and experience. AT for persons with PID is mostly used for communication and interaction or for fun and relaxation. Professional caregivers belief that AT-use may positively influence various aspects in the life of persons with PID, especially communication and interaction, active engagement and participation in activities, and self-esteem of the person. Caregivers need to have sufficient experience in order to rate the barriers of AT-use as less limited in the group of persons with PID. In order to overcome the barriers experienced in implementing AT in persons with PID, knowledge of caregivers is essential. [ABSTRACT FROM AUTHOR]

Pelvic asymmetry in the sagittal and horizontal planes among prosthesis users is related to the strength of the abdominal and back muscles. Considering that lumbosacral pathologies and pain in long-term transfemoral prosthesis users can cause asymmetric pelvic motion, it is necessary to investigate pelvic asymmetry caused by prosthetic components. The aim was to compare the gait symmetry of the pelvis of active transfemoral amputees using different types of prosthetic knee joints (Non-microprocessor-controlled prostheses (NMCPs) and microprocessor-controlled prostheses (MCP) knees). The two patient groups comprised eight transfemoral amputees: four patients had NMCP joints (Turkish products), and four patients had MCP knees. The reference group consisted of ten normal volunteers. In this work, the 3-D motion of the pelvis, hip, knee and ankle was assessed using the VICON system. The results revealed that during stance, the kinematics of pelvic movement in the amputee group differed from those of the control group in terms of the total excursion anterior pelvic tilt (APT) and maximum and minimum degrees of APT (p <.05). We evaluated the graphics of the NMCP and MCP knee joints and found that the prosthesis-side APT was closer to that of the control group during the stance phase among the NMCP users, while the APT of the MCP users was closer to that of the control group during the swing phase. The investigated MCP benefitted the patients considerably. The NMCP did not provide as much walking as the MCP but produced less APT. The MCP may not provide symmetrical pelvic motion during all phases of the gait cycle. In transfemoral amputees using MCP, focusing on pelvis in walking training will contribute to pre-prosthetic and post-prosthetics rehabilitation. The NMCP knee joint may be closer in terms of APT. [ABSTRACT FROM AUTHOR]

Paralympic sport is characterized by the pursuit of better performance in sports played by people with disabilities. In wheelchair rugby, assistive technology (AT) equipment is used to enhance athletic performance. Assess the AT requirements of wheelchair rugby players, identify the psychosocial factors that contribute to their performance and AT use and assess user satisfaction with the recommended and implemented AT. Descriptive explanatory case study with a quantitative approach that included four athletes from the Brazilian national wheelchair rugby squad, who answered the Athletes with Disabilities Questionnaire, the AT Device Predisposition Assessment (ATD PA-BR) and Quebec User Evaluation of Satisfaction with AT (QUEST version 2.0). Statistical analysis consisted of frequencies and percentages, as well as the scores for each instrument. Items required: harnesses, gloves and cooling vests. The AT improved athletic performance and increased the overall satisfaction score from 1.6 to 4.8 after intervention. The factors considered to determine AT success were safety, comfort and effectiveness, and the positive psychosocial factors identified were support from family and friends and sufficient income to participate in the sport. The study achieved its objectives and the use of a conceptual model, standardized assessments and working in conjunction with the athletes and their trainers were essential. It is hoped that the baseline presented in this study can be used in future research in the fields of AT or parasports. Present the intervention of the occupational therapist in Assistive Technology (AT) for paralympic athletes; Identify personal and contextual factors in the use of AT in parasports (attitudes, support and services); Present satisfaction with the AT device in parasport before and after intervention; Present satisfaction with the AT service provided by the occupational therapist based on the Matching Person and Technology (MPT) model. Understand the objectives of AT in wheelchair rugby. Understand the use of the MPT conceptual model and application of the AT Predisposition Assessment (ATD PA-BR) to recommend and monitor AT use in the para-athlete population. Know the AT devices used and customized by wheelchair rugby athletes. [ABSTRACT FROM AUTHOR]

Deep learning systems have improved performance of devices through more accurate object detection in a significant number of areas, for medical aid in general, and also for navigational aids for the visually impaired. Systems addressing different needs are available, and many manage effectively the detection of static obstacles. This research provides a review of deep learning systems used with navigational tools for the visually Impaired and a framework for guidance for future research. We compare current deep learning systems used with navigational tools for the visually impaired and compile a taxonomy of indispensable features for systems. Challenges to detection. Our taxonomy of improved navigational systems shows that it is sufficiently robust to be generally applied. This critical analysis is, to the best of our knowledge, the first of its kind and will provide a much-needed overview of the field. Deep learning systems can provide lost cost solutions for the visually impaired. Of these, convolutional neural networks (CNN) and fully convolutional neural networks (FCN) show great promise in terms of the development of multifunctional technology for the visually impaired (i.e., being less specific task oriented). CNN have also potential for overcoming challenges caused by moving and occluded objects. This work has also highlighted a need for greater emphasis on feedback to the visually impaired which for many technologies is limited. [ABSTRACT FROM AUTHOR]

Objective: To involve people living with amyotrophic lateral sclerosis (plwALS) in the scoping and identification of research priorities related to the changes in ALS communication including the use of augmentative and alternative communication (AAC). Methods: Two focus groups of plwALS at early and late stages of change to speech intelligibility were carried out as a patient and participant involvement exercise. The transcriptions of these groups were analyzed thematically and compared between groups. Results: Aspects of anticipation, preparation, adaptation and partnership were identified as key to dealing with communication change as a result of ALS. In particular the involvement of partners was clearly significant, as was the impact on them as well as the plwALS. PlwALS successfully contributed to focus groups and the process of group discussion about communication itself appeared constructive. Conclusions: Research and new interventions should focus further on how to support the partners of plwALS. Future research with plwALS should place AAC strategies and technology in the context of wider communication and investigate how best to support the anticipation, preparation and adaptation to communication change. Specific areas of research need relating to this support are suggested. People living with ALS (plwALS) are rarely involved in setting the research agenda in the areas of speech and augmentative and alternative communication (AAC). Enabling plwALS to contribute to research, even those with no speech, is feasible with appropriate support. Feedback indicates that communication change and AAC are experienced in different ways by plwALS. Research and intervention should focus on how to support the anticipation, preparation and adaptation to communication change for plwALS. [ABSTRACT FROM AUTHOR]

Objectives: The objective of this research was to identify and conceptualize barriers and strategies for effective implementation of information communication technology (ICT) training for older adults. Methods: A grounded theory approach was used to collect and analyze qualitative data from 61 participants in three stakeholder groups: older-adult ICT trainees, care providers and ICT trainers. Results: Care providers expressed older adults' reluctance, lack of affinity, fears and socio-contextual attributes as barriers to overcome with ICT training. ICT trainers highlighted motivation, trainer–trainee relationship, patience, self-reliance and mutual value as strategic themes. ICT trainees elucidated occupational accomplishment, challenges and a sense of competence as themes from their experience with training. Discussion: While digital literacy and skill building have traditionally been the key focus of ageing-centred ICT training, a deeper approach to address internal (personal) and external (socio-contextual) barriers, as conceptualized in the study finding, is vital in yielding successful outcomes. Information communication technology (ICT) is a vital resource for older adults to age-in-place and for health professionals in delivery of tele-rehabilitation. Family members and care providers realize the scope of ICT for ageing-in-place but raise doubts on the inherent motivation and abilities of older adults to adopt ICT. On the other hand, older adults who engage in one-on-one ICT training value their new-found sense of accomplishment and competence in using the Internet and social media. Graduate students who provided the training greatly appreciate their own learning experience, and stress the need for mutual trust, patience and simplicity in teaching ICT. A major precursor to imparting digital literacy and skills in older adults who lack ICT exposure is to help them overcome deep-seated attitudinal and socio-contextual barriers through a one-on-one approach. [ABSTRACT FROM AUTHOR]

Purpose: To profile and compare the seating and powered characteristics and functions of electrically powered wheelchairs (EPWs) in a general user population including equipment costs. Method: Case notes of adult EPW users of a regional NHS service were reviewed retrospectively. Seating equipment complexity and type were categorized using the Edinburgh classification. Powered characteristics and functions, including control device type, were recorded. Results: 482 cases were included; 53.9% female; mean duration EPW use 8.1 years (SD 7.4); rear wheel drive 88.0%; hand joystick 94.8%. Seating complexity: low 73.2%, medium 18.0%, high 8.7%. Most prevalent diagnoses: multiple sclerosis (MS) 25.3%, cerebral palsy (CP) 18.7%, muscular dystrophy (8.5%). Compared to CP users, MS users were significantly older at first use, less experienced, more likely to have mid-wheel drive and less complex seating. Additional costs for muscular dystrophy and spinal cord injury users were 3-4 times stroke users. Conclusions: This is the first large study of a general EPW user population using a seating classification. Significant differences were found between diagnostic groups; nevertheless, there was also high diversity within each group. The differences in provision and the equipment costs across diagnostic groups can be used to improve service planning. Implications for Rehabilitation: At a service planning level, knowledge of a population's diagnostic group and age distribution can be used to inform decisions about the number of required EPWs and equipment costs. At a user level, purchasing decisions about powered characteristics and functions of EPWs and specialised seating equipment need to be taken on a case by case basis because of the diversity of users' needs within diagnostic groups. The additional equipment costs for SCI and MD users are several times those of stroke users and add between 60 and 70% of the cost of basic provision. [ABSTRACT FROM AUTHOR]

Wheelchair breakdowns increase the risk of injury and limit the mobility of wheelchair users. In the endeavour to meet the enormous global need for wheelchairs, manufacturers of wheelchairs for low-resource settings face a cost–benefit tension between affordability and durability. Field studies are needed to provide feedback on durability. Four manufacturers provided cadres of wheelchairs to the organization providing rehabilitation to students at a boarding school for children with disabilities in a low-resource area. The Wheelchair Components Questionnaire for Condition was used to evaluate wheelchair maintenance condition at several time intervals after fitting. Because the maintenance regime was not identical for the four wheelchair types, wheelchair types were not compared. Analysis of variance indicated differences in condition across time and between wheelchair components. Tukey’s simultaneous comparison of means indicated that across the entire group, brakes, seats, casters and foot rests received lower ratings than frame. Preliminary data after each iteration of this study were provided to manufactures and resulted in responsive design changes.Implications for RehabilitationLongitudinal studies with the Wheelchair Components Questionnaire for Condition (WCQc) have enabled manufacturers to make responsive design improvements. Additional studies could be done with other wheelchair types to result in responsive positive design changes for those wheelchairs as well.The WCQc can be used in studies on wheelchair condition even when records of repair history are not reliably available, a situation which is not uncommon in low-resource areas.Data sets collected at an individual clinic uses the WCQc could focus attention on wheelchair components needing regular repair. With that data in mind, the maintenance regime could be modified to respond and in so doing improve wheelchair condition and reduce loss of mobility or risk of injury.Organizations involved in funding wheelchairs for a particular location could use data from longitudinal studies done with the WCQc at that location to inform purchasing decisions. [ABSTRACT FROM PUBLISHER]

Purpose:Studies have shown that marker-less motion detection systems, such as the first generation Kinect (Kinect 1), have good reliability and potential for clinical application. Studies of the second generation Kinect (Kinect 2) have shown a large range of accuracy relative to balance and joint localization; however, few studies have investigated the validity and reliability of the Kinect 2 for upper extremity motion. This investigation compared reliability and validity among the Kinect 1, Kinect 2 and a video motion capture (VMC) system for upper extremity movements. Design:One healthy, adult male performed six upper extremity movements during two separate sessions. All movements were recorded on the Kinect 1, Kinect 2 and VMC simultaneously. Data were analyzed using MATLAB (Natick, MA), Microsoft Excel (Redmond, WA), and SPSS (Armonk, NY). Results:Results indicated good reliability for both Kinects within a day; results between days were inconclusive for both devices due to the inability to exactly repeat the desired movements. Range of motion (ROM) magnitudes for both Kinects were different from the VMC, yet patterns of motion were very highly correlated for both devices. Conclusion:Simple transformations of Kinect data could bring magnitudes in line with those of the VMC, allowing the Kinects to be used in a clinical setting.Implications for RehabilitationThe clinical implications of the investigation support the notion that the Kinects could be used in the clinical setting if an understanding of their limitations exists.Using the Kinects to make assessments with a given data collection session is acceptable. Using the Kinects to make comparisons across different days such as before or after an intervention should be approached with caution.The Kinect 2 provides a more cost effective option compared to the VMC. Additionally, the Kinect is more portable, requires less time to set-up, and takes up less space, thus increasing its overall usability compared to the VMC. [ABSTRACT FROM PUBLISHER]

Purpose: Functional electrical stimulation (FES) is effective in assisting people with multiple sclerosis (pwMS) with gait. Previous studies have investigated the effects of FES in pwMS with slow self-selected walking speeds (SSWS). This study reports on the effect of the Odstock Dropped Foot Stimulator (ODFS) on the speed and oxygen (O2) cost of gait in pwMS walking at a range of SSWS.Methods: Twenty pwMS (mean age 50.4 ± 7.3 years) currently using FES walked at their SSWS for 5 min with and without FES. O2cost of gait was measured using a gas analysis system, and gait speed was calculated. Data were analysed for all participants, and comparisons were made between those with a SSWS < and >0.8 m/s (walking speed required for community ambulation).Results: Significant improvements in the speed and O2cost of gait were seen using FES in the group with SSWS <0.8 m/s (n = 11,p = 0.005). When participants’ SSWS >0.8 m/s, no difference in gait speed was noted, and a significant increase in O2cost of gait using FES (n = 9,p = 0.004) was noted.Conclusion: FES has a different effect on the speed and O2cost of gait dependent on the SSWS of pwMS. This requires further investigation.Implications for RehabilitationFunctional electrical stimulation (FES) used for foot drop is effective in improving the speed and oxygen cost of walking in pwMS walking at SSWS <0.8 m/s.FES does not seem to have a beneficial effect on the speed and oxygen cost of walking in pwMS walking at SSWS >0.8 m/s.Further research is needed to understand the possible mechanisms involved so that FES for foot drop can be efficiently prescribed. [ABSTRACT FROM PUBLISHER]

Purpose: The African Disability Scooter (ADS) was developed for lower limb amputees, to improve mobility and provide access to different terrains. The aim of this study was to test the efficiency of the ADS in Africa over different terrains.Method: Eight subjects with a mean age of 12 years participated. Energy expenditure and speed were calculated over different terrains using the ADS, a prosthetic limb, and crutches. Repeated testing was completed on different days to assess learning effect.Results: Speed was significantly faster with the ADS on a level surface compared to crutch walking. This difference was maintained when using the scooter on rough terrain. Oxygen cost was halved with the scooter on level ground compared to crutch walking. There were no significant differences in oxygen consumption or heart rate. There were significant differences in oxygen cost and speed between days using the scooter over level ground, suggesting the presence of a learning effect.Conclusions: This study demonstrates that the ADS is faster and more energy efficient than crutch walking in young individuals with amputations, and should be considered as an alternative to a prosthesis where this is not available. The presence of a learning effect suggests supervision and training is required when the scooter is first issued.Implications for RehabilitationThe African Disability Scooter:is faster than crutch walking in amputees;is more energy efficient than walking with crutches;supervised use is needed when learning to use the device;is a good alternative/adjunct for mobility. [ABSTRACT FROM PUBLISHER]

Purpose: We present the development and evaluation of a robust hand tracker based on single overhead depth images for use in the COACH, an assistive technology for people with dementia. The new hand tracker was designed to overcome limitations experienced by the COACH in previous clinical trials.Methods: We train a random decision forest classifier using ∼5000 manually labeled, unbalanced, training images. Hand positions from the classifier are translated into task actions based on proximity to environmental objects. Tracker performance is evaluated using a large set of ∼24 000 manually labeled images captured from 41 participants in a fully-functional washroom, and compared to the system’s previous colour-based hand tracker.Results: Precision and recall were 0.994 and 0.938 for the depth tracker compared to 0.981 and 0.822 for the colour tracker with the current data, and 0.989 and 0.466 in the previous study.Conclusions: The improved tracking performance supports integration of the depth-based tracker into the COACH toward unsupervised, real-world trials.Implications for RehabilitationThe COACH is an intelligent assistive technology that can enable people with cognitive disabilities to stay at home longer, supporting the concept of aging-in-place.Automated prompting systems, a type of intelligent assistive technology, can help to support the independent completion of activities of daily living, increasing the independence of people with cognitive disabilities while reducing the burden of care experienced by caregivers.Robust motion tracking using depth imaging supports the development of intelligent assistive technologies like the COACH.Robust motion tracking also has application to other forms of assistive technologies including gaming, human–computer interaction and automated assessments. [ABSTRACT FROM PUBLISHER]