Search

Transportation is integral to the employment accessibility and sustainability of people with disabilities. This study aims to identify barriers, facilitators, and solutions to commuting for people with disabilities, drawing from their perspectives as well as those of employers and transportation providers. Through semi-structured individual interviews, insights were gathered from sixteen individuals with disabilities, seven employers, two job integration agents, and four transporters. Qualitative analysis of the interview transcripts revealed factors influencing commuting, including personal attributes and environmental factors. This study underscores the significant impact of environmental factors, particularly the role of social networks and transport infrastructure in either supporting or hindering public transportation use for people with disabilities who commute to work. For example, employers' limited awareness of their employees' commuting challenges contrasts with their recognition of their potential role in supporting it. Training and disability awareness initiatives emerge as pivotal solutions to empower individuals within the social network, including transport personnel, fellow passengers, and employers, to facilitate public transportation use by people with disabilities for work commutes. [ABSTRACT FROM AUTHOR]

Purpose: The Inclusive Society partnership research model aims to promote change in society for people with disabilities by supporting research teams composed of researchers and partner organizations. The objective of this article is to identify the strengths and limitations of this research model. Material and methods: An autoethnography approach was used. Thematic analysis of four methods was undertaken: semi-directed interviews with members of the research teams funded by Inclusive Society (researchers, partners), a focus group with the Inclusive Society's intersectoral collaboration agents, their logbooks, and Inclusive Society's annual reports. Results: Strengths and limitations of the Inclusive Society model were identified through their networking activities, the role and support of the intersectoral collaboration agents and the partnership research program. Conclusions: Networking activities are an essential element of Inclusive Society. They are indispensable for composing intersectoral research teams that will work on answering needs of people with disabilities. Intersectoral collaboration agents are also a strength of the model, but their role could be clarified to better frame what tasks are in their scope of practice and what the research teams could ask from them. Finally, the research program eligibility criteria could be improved to support, among others, the projects' appropriation phases. Networking activities stimulate the creation of intersectoral research teams centered on answering the needs of people with disabilities that are identified in the field Hired facilitators can play an important role in the emergence of research teams, merging the academic and non-academic worlds, and supporting the teams during their research project In participatory research projects, some funding should be reserved to support the partner organization's participation and the appropriation phase of the research projects [ABSTRACT FROM AUTHOR]

To identify partnership research challenges and facilitators, as experienced by members of the Inclusive Society (IS) initiative. A case study was conducted on all partnership research projects conducted between 2017 and 2019 under the IS initiative through surveys, interviews with the IS community, logbooks, and focus group. Thematic analysis and descriptive analysis were undertaken. To work effectively with a diversity of stakeholders, winning conditions must be created for the project from the outset. These include determining the team functioning, project objectives, the expectations of each party, and agreeing on a realistic action plan. Project implementation with concern for sustained stakeholder commitment, good working relationships, and achieving project objectives requires organizational planning that favours partner involvement, shared leadership, agreed methods for communicating, conflict resolution methods, recognition of each participant's expertise, and creating a climate of trust. Upon concluding a partnership research project, it is essential to devote time to implement project results in local environments and to ascertain their usefulness to partners. IS partnership research challenges and facilitators are similar to those identified in past research. Despite this knowledge, challenges persist. Future research could explore tools and practices from other domain to overcome partnership research challenges. Partnership research has the potential to contribute to a more inclusive society for people with disabilities. Challenges and facilitators are identified for the stages of creating, implementing, and completing a partnership research project. Suggested solutions are offered to facilitate the conduct of a partnership research project and to increase the project's chances of success. Partnership research could benefit from using tools from other fields such as community development and social innovation to successfully implement some of the facilitators and overcome specific barriers to partnership research. [ABSTRACT FROM AUTHOR]

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

Knowledge of route accessibility is indispensable for "wheeled mobility device" users to travel safely and efficiently; however, current navigation technologies hardly provide adapted information for this population. Aims of the study were to collect data on the usability of a navigation application and to propose a version 1.0 of the Evaluation of satisfaction with geospatial assistive technology (ESGAT), by addressing the criterion, construct and cross-cultural validities. A filmed field trial and a methodological study were conducted in parallel. Thirty wheeled mobility device users were filmed planning and making a 10-minute known journey using the HERE WeGo app. The ESGAT, ÉSTGA (French version) and the Computer System Usability Questionnaire were administered. A video observation grid addressed the effectiveness and efficiency during the journey. Descriptive, correlation and multiple match analyses were performed. Fourteen men and 16 women averaging 45.9 years old tried out HERE WeGo; 14 were powered wheelchair users. Usability of the app was moderate (good effectiveness, moderate efficiency and quite satisfied). The criterion validity of the ÉSTGA was good (r = 0.598; p < 0.001). The construct validity was average considering the results for factor 1 (α = 0.789, acceptable), factor 2 (α = 0,586, low) and factor 3 (α = 0.409, unacceptable). The cross-cultural validity (French vs English) was moderate (r = 0.861; p < 0.001). ESGAT and ÉSTGA 1.0 questionnaires are now available in English and French with a total mean score (11 items), an informatics subscore (mean of 5 items) and a geomatic subscore (mean of 6 items). Their validation should be pursued with new navigation applications. Clinicians should ask their clients using a wheeled mobility device to test navigation applications to ensure their safety and complete the Evaluation of satisfaction with geospatial assistive technology (ESGAT 1.0), also available in French. Clinicians should inquire about satisfaction for items addressing informatics (Ease of access, Learnability, Hands-free function, Ease of use, Transportability and Appearance) and items addressing geomatic (Content, Geographic information, Effectiveness, Efficiency, Real-time navigation assistance, Aspect of security). Rehabilitation clinicians should inquire about the efficiency of the navigation app, considering avoiding or announcing potential obstacles such as: travelling on the street for a long portion of the trip and not on the sidewalk; verbal indication too soon or too late; incorrect indication; damaged, and congested sidewalk. [ABSTRACT FROM AUTHOR]

Although many barriers remain to the employment of people with disabilities, public transportation can play a key role for integration and retention of people with disabilities in employment. However, research is needed to better understand how public transportation influences access to work for people with disabilities. This study aims to identify public transportation-related barriers and facilitators to the employment of people living with disabilities. A scoping review approach was adopted, with a keyword search through six databases. Studies' characteristics, transportation barriers, and facilitators to employment of people with disabilities were extracted from the selected articles. The results were presented descriptively and narratively. In total, 74 studies were included. Barriers and facilitators were grouped under four themes: (1) public transportation, (2) employment, (3) personal factors, and (4) social network. This review highlights the key role of public transportation in accessing and maintaining employment for people with disabilities. It also reveals gaps in the literature and a need to investigate the issue through the lens of employers, public transportation services, and social environmental facilitators. [ABSTRACT FROM AUTHOR]

Individuals with impaired mobility often require assistance for getting around. The skilled use of a manual wheelchair (MW) is required in order to gain independence while preventing injuries. Training in a virtual reality (VR) setting allows for safe practice of MW skills in a wide range of environments. We developed a low-cost MW simulator which includes visual and haptic feedback. Our objectives were to assess the usability and fidelity of the VR simulator, by clinicians and expert MW users, and to determine whether the addition of haptic feedback would positively improve the user's experience. This mixed method study investigated the sense of presence, overall experience and ease of use of the experience in six MW users, as well as five clinicians (wheeled mobility experts) who practiced in the simulator. Participants reported a positive perception of usefulness, sense of presence, and immersion during the MiWe simulator experience. The addition of haptic feedback to the simulator significantly enhanced fidelity of the overall experience, compared to the no-feedback condition. Our low-cost simulator was well perceived by clinicians and MW users and was considered as a potentially useful tool to complement MW skill training. We developed a low-cost, virtual reality simulator with visual and haptic feedback, for the practice of manual wheelchair skills. Expert clinicians and wheelchair users reported a positive experience after practicing in the wheelchair simulator, in terms of presence, realism and usability. Participants highlighted the potential usefulness of our low-cost simulator in the training of manual wheelchair skills. [ABSTRACT FROM AUTHOR]

This study aimed to investigate clinical stakeholders' acceptance of an immersive wheelchair simulator as a potential powered wheelchair skills training tool. Focus groups, conducted in four rehabilitation centers, were used to obtain a rich understanding of participants' experiences and beliefs. Then, a cross-sectional survey of the simulator acceptability for clinical practice was created. Twenty-three rehabilitation therapists and clinical program directors participated in the focus groups and thirty-three responded to the survey. Participants generally expressed that use of the simulator would be complementary to training in an actual powered wheelchair, and that it could be useful for challenging situations in rehabilitation centers (e.g. anxious clients; when there is uncertainty around their potential to drive a powered wheelchair; tasks that cannot be assessed in a real-life environment). They also provided suggestions to improve the simulator (e.g. more feedback during tasks; possibility of adjusting control settings such as speed and sensitivity; possibility of adding varied control interfaces). Feedback received from key stakeholders clearly indicated that the wheelchair simulator would be complementary to training provided in a real context of use. However, some important limitations must be addressed to improve the simulator and promote its adoption by clinical programs, therapists and clients. [ABSTRACT FROM AUTHOR]

Many children with physical disabilities lack independent mobility. Powered mobility can be a viable option, but to become proficient drivers, children need opportunities to practice. As is often the case, practice powered wheelchairs are scarce and direct therapy hours dedicated to powered mobility are often limited. Hence, alternative options are needed to enable safe, unsupervised practice. Simulator-based learning has been shown to be an effective training method for powered mobility and other skill-based tasks for adults. The goal of this study was to compare two training methods of powered mobility, powered wheelchair (control group) versus simulator-based (experimental group) practice to determine whether simulation is a feasible and effective method for youth. Participants included 30 children and adolescents (23 males, 13 females) with cerebral palsy and other neuromuscular diseases, aged 6–18. Data were collected and compared at baseline and after 12 weeks of home-based practice via a powered wheelchair or a simulator. Powered mobility ability was determined by the Powered Mobility Program (PMP), the Israel Ministry of Health's Powered Mobility Proficiency Test (PM-PT) and the Assessment of Learning Powered Mobility (ALP). All participants practiced for the required amount of time and both groups reported a similar user experience. Both groups achieved significant improvement following the practice period as assessed by the PMP and PM-PT assessments, with no significant differences between them. A significant improvement was found in the ALP assessment outcomes for the powered wheelchair group only. This is the first study, to our knowledge, that compares two different wheelchair training methods. Simulator-based practice is an effective training option for powered mobility for children with physical disabilities aged 6–18 years old, demonstrating that it is possible to provide driving skill practice opportunities safe, controlled environments. [ABSTRACT FROM AUTHOR]

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

Many people living with neurological disorders, such as cerebral palsy, stroke, muscular dystrophy or dystonia, experience upper limb impairments (muscle spasticity, loss of selective motor control, muscle weakness or tremors) and are unable to eat independently. This article presents the development of a new device to assist with eating, aimed at stabilizing the movement of people who have movement disorders. The design was guided by insights gathered through focus groups, with occupational therapists and engineers, about the challenges faced by individuals who have movement disorders and difficulty in eating autonomously. The proposed assistive device prototype is designed to be fixed on a table and to support a spoon. The mechanism is designed so that the spoon maintains a position parallel to the ground for the user. Dampers and inertia allow stabilizing the user's motion. A preliminary trial with five individuals living with cerebral palsy is presented to assess the prototype's performance and to guide future iterations of the prototype. Task completion time generally decreased and movement fluidity generally improved when using the assistive device prototype. The prototype showed good potential in stabilizing the spoon for the user and improving movement fluidity. [ABSTRACT FROM AUTHOR]