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Purpose: Older adults with low vision are a growing population with rehabilitation needs including support with community mobility to enable community participation. Some older adults with low vision choose to use mobility scooters to mobilize within their community, but there is limited research about the use by people with low vision. This paper describes a pilot study and asks the question: what are the experiences of persons with low vision who use mobility scooters? Methods: This study gathered the experiences of four participants with low vision, aged 51 and over, who regularly use mobility scooters. Diverse methods were used including a go-along, a semi-structured interview and a new measure of functional vision for mobility called the vision-related outcomes in orientation and mobility (VROOM). Findings: Four themes were found to describe experiences: autonomy and well-being, accessibility, community interactions and self-regulation. Discussion and implications: This study was a pilot for a larger study examining self-regulation in scooter users. However, as roles emerge for health professionals and scooters, the findings also provide evidence to inform practice, because it demonstrates the complex meaning and influences on performance involved in low vision mobility scooter use. Scooter use supports autonomy and well-being and community connections for individuals with both mobility and visual impairments. Low vision scooter users demonstrate self-regulation of their scooter use to manage both their visual and environmental limitations. Issues of accessibility experienced by this sample affect a wider community of footpath users, emphasizing the need for councils to address inadequate infrastructure. Rehabilitators can support their low vision clients' scooter use by acknowledging issues of accessibility and promoting self-regulation strategies to manage risks and barriers. [ABSTRACT FROM AUTHOR]

This paper affirms the importance of lighting as a technology in the context of people with sight loss. Its importance lies in the ability of appropriate lighting interventions to support independent living and to reduce the likelihood of falls and accidents. The concept of 'assistive lighting' is introduced with a set of tenets by which the merits of different lighting interventions can be considered. The tenets are derived from research on lighting and sight loss, including a thorough review of the literature; and consultation in the period from 2008 to 2010 with over 80 rehabilitation workers and occupational therapists in the United Kingdom. They affirm the need for lighting to be appropriate, sufficient, even, adjustable, sustainable and energy efficient, simple and adaptable. Examples of different lighting interventions are provided and these are considered in relation to the tenets. One of the key outcomes of the research was publication of a guide to good practice on lighting interventions for people with sight loss. [ABSTRACT FROM AUTHOR]

Purpose: Universal design (UD) provides an explanation of good design based on the user perspective, which are outlined through its principles, goals, and related frameworks. The aim of this paper is to provide an overview of the frameworks and methods for UD building evaluations and to describe how close they have come to describing what auniversally designedbuilding is.Methods: Evaluation approaches are reviewed from the existing literature across a number of spatial disciplines, including UD, human geography and urban studies.Results: Four categories of UD evaluation methods are outlined, including (1) checklist evaluations, (2) value-driven evaluations, (3) holistic evaluations, and (4) invisible evaluations.Conclusions: A number of suggestions are made to aid research aimed at developing UD evaluation in buildings. (1) Design standards and guidelines should be contested or validated where possible; (2) evaluation criteria should be contextual; (3) it may be more practical to have separate methodologies for contextualising UD to allow for the creation of an evaluating tool that is practical in use. Additionally, there is a difficulty in establishing a clear basis for evaluating how empathetic buildings are without expanding the methodological horizons of UD evaluation.Implications for RehabilitationFor universal design (UD) evaluation to address human need requires methods that are culturally, temporally, and typologically specific.Practical instruments for measuring UD need to be divorced from but contingent upon methods than can address local specificities.The process of evaluation can provide knowledge that can contest or validate the literature based sources such as design guidelines, or standards.UD evaluation requires constant renewal by searching for new, flexible strategies that can respond to socio-cultural change. [ABSTRACT FROM PUBLISHER]

Purpose: The purpose of this article is to explore evidence concerning clinical assessment, design and performance testing of mobile shower commodes used by adults with spinal cord injury (SCI). Method: Searches of electronic databases, conference proceedings and key journals were undertaken with no restriction on language or study design. Keywords included spinal cord injury, lesion, sanichair, sanitary chair, shower chair, bowel chair and commode. Results: A total of 20 publications were included in this review. Common approaches to clinical assessments were questionnaires and observational analysis to assess bowel care routines, function and skin integrity. Design features addressed access for bowel care, postural support, transfers, stability, use in wet environments and skin integrity. Objective performance measures addressed requirements for static stability, backward-sloping seat angles, arm supports and seat materials. Conclusions: Evidence reviewed was of low methodological quality and lacking in validated instruments to guide clinical practice. Further high-quality research is needed to identify bathing, showering and personal hygiene tasks affecting mobile shower commodes use and to develop validated clinical assessment tools. Performance testing to published standards is also needed. [ABSTRACT FROM AUTHOR]

For persons with disabilities in low-resource and tropical settings, barriers to mobility and physical activity are steep. The aim of this study was to develop and test two low-cost, durable, sustainable, purpose-built wheelchair prototypes to support wheelchair users in low-resource and tropical settings. These bamboo wheelchairs, nicknamed African Chairs by Ghanaian daily manual wheelchair users who tested the devices, adopt two designs: an urban-targeted and a rural-targeted design. The rural-targeted design incorporated stability as its key design property for the purpose of navigating variable terrain. The urban-targeted design adopted a sleeker, more portable profile for environments that require wheelchair transport in vehicles and the navigation of elevators and ramps. Both designs integrated bamboo-rod skeletons, bonded by hot-glue gun, jointed and wrapped with epoxy-soaked fibers, then upholstered by a local tailor, with basic standard wheel components. An iterative design process incorporated expert consultation as well as user feedback. The final prototypes received positive testing reviews from daily manual wheelchair users in Ghana. These locally-built, safe, economical bamboo wheelchairs have the potential to improve accessibility, provide more independence and reduce immobility-related health risks for many. Persons with disabilities have a right to mobility, maximum independence, and the psychological, emotional, and physical health benefits of physical activity those rights confer. For persons with disabilities in low-resource settings, barriers to mobility and physical activity are steep, due to social stigmatization and the cost and adaptability of equipment. Bamboo wheelchairs have the potential to increase access to mobility and physical activity by allowing wheelchairs to be efficiently produced at cost, according to the user's needs. The aesthetics of bamboo wheelchairs can help reduce social stigma by avoiding the "medicalization" of wheelchairs and other traditional mobility devices. [ABSTRACT FROM AUTHOR]

Participation in outdoor recreation is associated with improvements in mental, emotional, and physical health. Individuals with impairments affecting mobility, such as wheelchair users, face environmental, physical, and social barriers to participation in outdoor recreation. There is limited research on outdoor recreation participation among wheelchair users, especially concerning informal recreational opportunities. Formal programmes that offer access to outdoor recreation are often oversubscribed and also do not enable opportunities to participate more spontaneously. (1) To explore the experiences and impact of participation in outdoor recreation activities by wheelchair users, with an emphasis on more informal activities; and (2) to identify perceived barriers and facilitators to participation in outdoor recreation activities. Semi-structured interviews were the main means of data collection in this interpretive description study; this was supplemented by photographs of activity involvement provided by participants. These data were analysed thematically. Fifteen Canadian wheelchair users participated in the study. Three themes emerged following analysis: (1) Into the Woods explores participants' current outdoor recreation experiences, (2) Ain't No Mountain High Enough looks at the barriers and challenges participants face, and (3) Just Around the Riverbend discusses participants' desired changes to enable their further participation. The study highlighted participants' current experiences, their perceived barriers, and several ways to enhance outdoor recreation participation among wheelchair users, including: developing new adaptations, creating policies, increasing access to affordable equipment and programmes, and reducing barriers in built and natural environments. Wheelchair users participate in a wide variety of outdoor activities. Wheelchair users experience various barriers and challenges when participating in outdoor recreation. Despite recent improvements, environmental changes are needed to allow wheelchair users to access outdoor recreation. Further development of adaptive equipment is needed in order for wheelchair users to access their desired outdoor recreation activities. [ABSTRACT FROM AUTHOR]

Purpose: The research presented demonstrates the disharmony between end user goals and their consideration in service outcomes within ageing-in-place and asks "what can design offer health" within this domain. Methods: Data was collected using semi-structured interviews with various stakeholders within the context of ageing in place. All data are thematically analysed through a theoretical lens of control theory. Results: The results demonstrate a contrast between purported patient-centred care models, and a human-centred design model. This contrast in cultures causes a disconnect between the health practitioners and the end users, with a lack of clarity about the end user's intended engagement within the modification of their environment. Consequently, the goals of older adults are inadequately represented as typical home modification design processes often fail to support the reflection of goals in practice, in turn, restricting client engagement and control. Reviewing occupational therapy practices through the critical lens of control has highlighted opportunities for service improvements. Conclusion: The consideration of co-design methodologies within home modification design is a way to reinforce client engagement and provide better pathways for older adults to remain in control and raise acceptability of modification through a better-informed decision-making process. The following points detail the implications of this research upon the rehabilitation practice and theory: Compliance with recommendations is deeply connected to a person's intrinsic sense of control within the clinical decision-making process. Co-design practices between practitioners and clients provide and novel pathway to achieve truly person-centred care and create better service experiences and clinical outcomes. The human-centred design methodology is highly applicable within clinical practice and provides an opportunity for clinicians to see and learn about their patients through a holistic lens centred around goals and motivations rather than physical impairments. The scoping of health literacy should be inclusive of all service artefacts and touchpoints that a client may encounter throughout the entire duration of experience, this includes design artefacts such as architectural drawings and other home modification designs. [ABSTRACT FROM AUTHOR]

Background: The World Health Organization and the World Bank's "World Report on Disability" reported that over 1 billion people have various kinds of disability worldwide while Indian Census 2011 reported about 26 million in India. The United Nations Convention states, "The Rights of Persons with Disabilities (PwD) include accessibility to Information, Transportation, Environment, Communication Technology and Services". Objective: This article takes forward the reason of making the "EasenAccess" (EnA) Android-based app to empower PwD with wheelchair-accessibility information, communication sentences and sending SOS signals with location. Methods: A survey of 25 most frequented places in New Delhi by common people and tourist with chosen 12 parameters in comparison the Government of India's survey of 100 most important buildings nationally. Results: A statistical analysis and recommendations about areas for improvement, for the Government of India. Conclusions: EasenAccess helps millions of PwD to enable them with freedom of movement for employment and socio-economic activities to lead an independent lifestyle. EasenAccess increases government's access to information about lacunae, gives them an easy way to tabulate the places where more accessibility needs updating, and helps the government in facilitating information flow to the PwD. The Rights of Persons with Disability Act in 2016 covers both the concepts of Universal Design of products, environments and programs; and accessibility. We are exploring with them the ways technology can help bridge the gap between rehabilitation and accessibility. In the higher income countries such as the UK or USA, it is normal for a person to receive training when being given a wheelchair to prevent future injuries. Frequently, even with this, training people develop upper limb injuries, due in part to the high, repetitive loads needed to push a wheelchair. This training is given as part of a package of rehabilitation, which also normally includes adaptations to people's living environments, which will enable them to use their wheelchair indoors. In Accessible Routes from Crowd-based Cloud Services (ARCCS) many NGOs have been able to develop sensors, which are themselves part of the Internet of Things, which when attached to a mobility device extend the ability of that device. Users can interact with the sensor data on their mobile phone via an app. They can also add geo-tagged photo or voice notes to annotate their journey. These can then be shared with other users of the ARCCS system. The system has been developed with a range of wheelchair users and other stakeholders. For example, one such initiative by the Government of India is called "Street Rehab". The aim of Street Rehab is to co-develop a new system for delivering a service for wheelchair users, which puts everyday activities at the heart of the rehabilitation process. To do this, a clear understanding of user needs, available technology and the accessibility of the city are all required. The first step is to understand the current accessibility of Delhi, the next to map this with the rehabilitation and livelihoods requirements of the wheelchair and tricycle users. This approach has led to the development of novel sensors and a data processing chain, which can automatically identify features of the sidewalk or surface, for example, drop curb, camber, and rough terrain. These classifications are then used to help with increasing localization of the person. In addition, the sensors can be used to identify how the pushing techniques of people, who self-propel their wheelchair. They have developed these sensors, as mobile phones alone, while useful if secured in a fixed position, are not adequate when loosely placed in bags or pockets. The aim is to find practical solutions for those who use mobility aids in India to access the services and places they wish to without risk of injury. Injuries can occur due to toppling out of a mobility device, being hit by a vehicle or developing an injury over time due to the demand of pushing/cycling the mobility device. EasenAccess can be a synergistic platform for all such future community based rehabilitation approaches. It can also help compile and collate data for accessibility gaps and rehabilitation issues encountered. EasenAccess app can thus help create an emerging framework, which puts the experience of the wheelchair user at the center but with a clear connection to people who can implement policy change on a broad scale.One that includes local people who will be advocates for creation of accessible maps, and local NGOs to provide hubs of training. These can be linked to a series of YouTube videos and supported via a messaging service, for example, local WhatsApp groups or social media groups, for example, a Facebook Page. With infinite possibilities, as illustrated above, EasenAccess app can create a new technological paradigm for convergence of Accessibility and Rehabilitation. [ABSTRACT FROM AUTHOR]

Purpose: This study assessed awareness and availability of assistive facilities in a Nigerian public university. Methods: Study was conducted in Obafemi Awolowo University (OAU), Ile Ife Nigeria using a mixed methods approach. Fifty two students with disability (SWD) were interviewed with a semistructured, self-administered questionnaire. A checklist was used to assess assistive facilities on campus while in-depth interviews (IDI) were conducted with university officials, to assess their perspectives about the availability and use of assistive facilities in the university. Results: Almost three-thirds (57.7%) of SWD were male while more than two-thirds were aged between 21 and 30 years. About seven in 10 (71.1%) respondents, had mobility impairment, while two-fifth had visual impairment (40.8%) and a few had hearing impairment. Only the university's administrative building had a functioning elevator. Slightly more than half (54.5%) of the lecture theatres have public address systems, while only two have special entrances and exits with ramps for SWD. Almost all respondents were unaware of facilities that aid learning (96.2%) and facilities for library use (90.4%). University officials were aware of assistive facilities for SWD but do not know the actual number of SWD. Conclusion: Assistive facilities for SWD on campus are limited. More assistive facilities need to be provided alongside increased awareness about these facilities and a disability register should be open for students on campus. Assistive facilities to aid learning and make SWD more comfortable are required. Universities should have an official policy on students with disabilities and implement it, such a policy should address special considerations for disabled students, such as having an updated register for students with disability, having examination questions in large fonts for students with visual disabilities, giving them extra time for examinations and providing special counselling services for students with disabilities. Awareness about assistive facilities in tertiary institutions for students with disability should be increased so that they can utilize the ones available and demand for such if non-existent. The design of buildings on university campus should be made disability friendly. A disability register should be open for SWD on campus. [ABSTRACT FROM AUTHOR]

Purpose: For off-road mobility, some manual or power assisted devices were conceived to be self-driven by paraplegics while for tetraplegics non power-assisted devices were conceived. These devices require one or more conductors who are subjected to a high physical demand thus potentially creating: precarious safety condition for the user an elevated physical demand of conductors could reduce the care and the attention to give to the user; the time of the outdoor adventure experience of the user could be limited. Methods: To address these issues, an innovative user-centered power assisted off-road wheelchair for the transportation of tetraplegics along mountain trails was developed. The device, structured like a trike, is driven by two healthy conductors; the user is placed in the middle of the frame. A movable seat provides for the transfer from the standard to the off-road wheelchair. An electrical motor, powered by a battery pack, provides for the actuation. All the design and prototype aspects, the control system and experimental tests are detailed. Results: The prototype satisfies mechanical, safety and duration requirements. No physical demand while using the device and for the transfer of the user to the device was identified. Fun and engaging tests were carried out and all the participants were involved. The device has the potential to enhance the quality of life of tetraplegics in terms of new life experiences. The device revealed the real possibility of a full recreational experience, an enhanced participation and a better social integration of tetraplegics. [ABSTRACT FROM AUTHOR]

Background: Low ridership of public transit buses among wheeled mobility device users suggests the need to identify vehicle design conditions that are either particularly accommodating or challenging. The objective of this study was to determine the effects of low-floor bus interior seating configuration and passenger load on wheeled mobility device user-reported difficulty, overall acceptability and design preference. Methods: Forty-eight wheeled mobility users evaluated three interior design layouts at two levels of passenger load (high vs. low) after simulating boarding and disembarking tasks on a static full-scale low-floor bus mockup. Results: User self-reports of task difficulty, acceptability and design preference were analyzed across the different test conditions. Ramp ascent was the most difficult task for manual wheelchair users relative to other tasks. The most difficult tasks for users of power wheelchairs and scooters were related to interior circulation, including moving to the securement area, entry and positioning in the securement area and exiting the securement area. Boarding and disembarking at the rear doorway was significantly more acceptable and preferred compared to the layouts with front doorways. Conclusion: Understanding transit usability barriers, perceptions and preferences among wheeled mobility users is an important consideration for clinicians who recommend mobility-related device interventions to those who use public transportation. In order to maximize community participation opportunities for wheeled mobility users, clinicians should consider potential public transit barriers during the processes of wheelchair device selection and skills training. Usability barriers experienced by wheeled mobility device users on transit vehicles differ by mobility device type and vehicle configurations. Full-scale environment simulations are an effective means of identifying usability barriers and design needs in people with mobility impairments and may provide an alternative model for determining readiness for using fixed route buses or eligibility for paratransit. [ABSTRACT FROM AUTHOR]

Purpose: The number of mobility aid users continues to rise as the population ages. While mobility aid users rely on public transport due to its affordability, evidence suggests access can be difficult. This study aims to describe people who use mobility aids to access public transport and the role of public transport access in influencing mobility aid choice. Methods: Sixty-seven mobility aid users participated in telephone surveys which predominantly used a structured quantitative format. Data were analysed descriptively and any additional comments were simply categorized. Results: Thirty-six participants were female (54%), with a total sample mean age of 58.15 years (SD = 14.46). Seventy-two percent lived in metropolitan areas, 48% lived alone, and the sample experienced a variety of conditions including spinal cord injury (37%) and arthritis (18%). Sixty-four percent of all respondents used two or more mobility aids including powered wheelchairs, scooters and walking frames. The most important features when choosing a mobility aid were reliability, turning ability and size. Fifty-two percent of all respondents strongly agreed that public transport is generally accessible. Conclusions: While work continues to ensure that public transport vehicles and stations are fully accessible, mobility aid users must manage current infrastructure and access a system which has been shown through this research to have many limitations. Mobility aid users, vendors and health professionals need to work together to identify mobility aids that fulfil needs, and are reliable and safe, so that mobility aid users are both "visible and seen" when accessing the public transport network. Some mobility aid users experience difficulties accessing and using public transport and further research is required to ensure the whole public transport network is fully accessible to people using mobility aids. Many people have more than one seated mobility aid, suggesting people can choose different aids for different purposes and environments. Health professionals may need to increase their involvement in assisting individuals to select and use mobility aids. [ABSTRACT FROM AUTHOR]

Purpose: The firmness and stability of indoor and outdoor surfacing are critical to the accessibility and safety of all environments for people with mobility impairments and/or who use mobility devices. ASTM F1951 laboratory test procedures include pass/fail criteria for determining playground surface accessibility by comparing the work to propel up a 1:14 (7.1%) grade ramp to that of the test surface in a wheelchair. A portable instrumented surface indenter (ISI) was developed to validate that accessibility results obtained in the laboratory are maintained in the field where the surface is installed and used.Methods: Accessibility measurements have been made on indoor and outdoor surfaces tested in the laboratory using both the ASTM F1951 and the ISI over 13 years. Correlations between these two methods were calculated.Results: A strong correlation has been demonstrated for the sum of the ISI firmness and stability results compared to the sum of the ASTM F1951 straight propulsion and turning results (R2=0.9006).Conclusions: The portable ISI can be used to verify that the firmness and stability of an installed surface in the field correlates to the accessibility results of the surface tested in the laboratory concurrently according to ASTM F1951 and the ISI. Implications for Rehabilitation The Instrumented Surface Indenter (ISI) allows for surfaces in all environments to be tested for firmness and stability, which is critical for wheelchair user safety, especially during rehabilitation when learning to use a wheelchair.The ISI allows for surfaces in all environments to be tested for firmness and stability, which increases access to all indoor and outdoor surfaces, thereby improving the quality of life for people who have mobility impairments and/or use mobility devices, such as canes, crutches, walkers, and wheelchairs.Using the ISI to test the firmness and stability of installed playground surfaces increases access to playgrounds for children with mobility impairments, facilitating developmentally critical peer-play opportunities for children who use mobility devices.Using the ISI to test the firmness and stability of installed playground surfaces increases access to playgrounds for people with mobility impairments, allowing adults who use a mobility device to supervise and play with children in their lives. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to describe the results of focus groups held during the Independent Wheelchair Transfer (IWT) Workgroup. The aims were to facilitate exchange of ideas on (1) the impact of the built environment on the wheelchair transfer process within the community (i.e. moving from wheelchair to and from other surfaces (e.g. furniture, toilet seat, bath bench, car seat) to participate in daily activities), (2) wheelchair users' needs during transfers in the built environment, and (3) future research directions.Method: Live web-based conferencing using Adobe Connect technology (Clarix Technologies, Inc., Pittsford, NY) was utilized to conduct three focus groups composed of experts in the field of assistive technology. Investigators independently reviewed focus group meeting transcripts and used qualitative methods to identify main themes.Result: Thirty-one experts in assistive technology and related fields participated in focus groups. Nine main themes were found including the effect of transfer skills training, space considerations in the built environment, wheelchair configuration, and the interaction between the built environment, user preferences, and transfer techniques. All groups raised issues about the transfer process in areas of the built environment with limited access, the effect of wheelchair users' transfer techniques, and user preferences during transfers.Conclusions: The area of independent transfers is multi-faceted and several factors require consideration when contemplating environmental changes to improve accessibility for wheelchair users. Obvious opportunity exists for research which could lead to advances in transfer technology, environments, and techniques for wheelchair users.Implications for RehabilitationTremendous opportunities for research collaborations in the field of assistive technology:To develop new terminology to describe wheelchair transfers.To improve the design of the built environment for wheelchair users.To investigate wheelchair transfer training techniques. [ABSTRACT FROM PUBLISHER]

Purpose: This study aimed to evaluate end user perspectives of four existing home access solutions (HAS) and a newly designed experimental device (the ARISE). Method: A crosssectional design was used to evaluate the ARISE prototype against other HAS. Specifically, participants trialed stairs, a ramp, a platform lift (PL), a stair glide and the ARISE, after which they completed questionnaires aimed at soliciting their perspectives of these solutions. The time taken by participants to use each HAS was also collected. Results: Five HAS design features were deemed as important by 90% of participants: ease of use, ability to use independently, reliability, safety and security. Time taken to use each HAS from fastest to slowest was: stairs, the ARISE, ramp, PL and stair glide. The ARISE prototype was rated as the first or second most preferred device by the most number of participants, followed by the PL, then the ramp. Conclusions: Results from this study provide greater understanding of user perspectives of HAS. End user feedback on a novel prototype device has provided valuable insight into its usability and function, which should not only guide future development of this device, but also provide direction for other innovations around home access. [ABSTRACT FROM AUTHOR]

Purpose: The 3D interior design software (3DIDS) is a technology, which primarily allows users to simulate their homes and visualize any changes prior to implementing them. This feasibility study aimed to examine occupational therapists' perceptions about the clinical utility of the 3DIDS. A secondary aim was to explore the attitudes of occupational therapists towards technology in general. Method: Three focus groups were conducted with 25 occupational therapists working with older people in the UK. The qualitative data were analysed using inductive thematic analysis. Results: The three main themes that were identified were usage and attitudes of technology, opportunities for realistic application of the 3DIDS and related threats and benefits for the occupational therapy profession. Occupational therapists had a positive attitude towards technology. They suggested that the 3DIDS could be used in discharge planning and in rehabilitation. They viewed it as a tool that could enhance their status within the health care profession and improve communication, but not as a tool that should replace the role of the occupational therapist. Conclusions: This research offers new and important findings about the utilization of the 3DIDS by occupational therapists and provides information as to where this technology should be trialled. [ABSTRACT FROM AUTHOR]