Search

Purpose: To provide empirical evidence on learning barriers and facilitators in instructional science and engineering laboratory settings from a national survey on students with physical disabilities (SwD-P). Methods: A nationwide self-report survey, the Full Participation Science and Engineering Accessibility (FPSEA), was disseminated online via Qualtrics. Approximately 1200 organizations and universities across the United States were contacted through purposive sampling. Descriptive statistics were primarily used for the analysis of the results. Results: Survey findings reveal that students experience a wide range of limitations to full participation in the laboratory, from entering the laboratory (25%) to being given passive roles (50%). Additionally, while 66% of respondents indicated that instructors were willing to help SwD-P participate in science and engineering (S&E) laboratories, 16.8% were not willing to do so, and 47% SwD-P felt that practices were not in place to provide accommodations. The survey also reveals a range of facilitators such as elevators, ramps, accessible course materials and peer assistance. Most respondents (74%) also indicated that peers were helpful in completing laboratory tasks. Conclusion: This survey provides empirical evidence that was previously voiced through non-empirical information in the literature. Participants cited barriers such as inappropriate accommodations and instructors' negative viewpoints, as well as gaining access to facilities even after the enactment of the Americans with Disabilities Act (ADA). These findings suggest that while ADA has lessened some barriers to SwD-P, barriers remain in using the laboratory space. The FPSEA survey fills the gap in finding barriers and facilitators to using S&E laboratories from the SwD-P's perspective. Barriers students with disabilities encounter in science and engineering (S&E) laboratory environments remain unclear. The FPSEA survey fills the gap in finding barriers and facilitators to using S&E laboratories from the SwD-P's perspective. The FPSEA survey allows former and current SwD-P to share their experiences using a postsecondary S&E instructional laboratory. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to address the development of the Full Participation Science and Engineering Accessibility (FPSEA) self-report survey that gathers experiences from students with physical disabilities (SwD-P) using a postsecondary laboratory and to evaluate the survey's stability. Methods: Survey items were generated from an extensive literature review and recommendations articulated by experts. Think-aloud sessions and content validity index (CVI) were used to determine survey content validity and help finalize survey items. Individuals with physical disabilities (n = 20) who have taken a postsecondary science or engineering laboratory course completed the survey and took it again 10–14 days apart. The test–retest reliability was assessed using Spearman Rho coefficients for Likert-scale items, Chi-square and Fisher's exact test for the dichotomous items. Missing data completely at random (MCAR) test was computed before reliability data analysis. Results: Each sub-item passed the MCAR test, indicating that the data are missing completely at random and can be imputed to perform the analysis. Reliability analysis was completed on 20 individuals. The FPSEA had good content reliability: the item-level CVI of items kept ranged from 0.86 to 1. The scale-level CVI was 0.94. Stability was demonstrated with adequate Spearman correlation ranged from 0.56 to 0.86. Conclusions: No previous survey had been developed linking SwD-P and the postsecondary science and engineering (S&E) laboratory setting prior to this work. Overall, FPSEA is reliable and stable for reporting the barriers and facilitators to use S&E laboratories from the SwD-P's perspective. The barriers students with disabilities encounter in S&E laboratory environments are largely unknown. The FPSEA survey may help identify barriers and facilitators to using S&E laboratories for SwD-P. The FPSEA Survey allows former and current SwD-P to share their experiences using a postsecondary S&E instructional laboratory. [ABSTRACT FROM AUTHOR]

Purpose of the Article: To (1) summarise the personal and clinical characteristics of persons with disabilities (PwDs) in the US who were evaluated for mobility assistive equipment (MAE) in the functional mobility assessment and uniform dataset (FMA/UDS) and (2) stratify subpopulations of PwD who reported falling versus those who do not report a fall., Materials and Methods: This study was a retrospective, descriptive cohort analysis of adults with disabilities using the FMA/UDS. Data are collected during a user's initial evaluation for a new mobility device. The sample is intentionally general to be inclusive of all mobility device users. The primary variable of interest was a patient-reported fall within the 3 months leading up to their evaluation for a new mobility device. Subpopulation characteristics were stratified by this binary fall variable., Results and Conclusions: This study provides descriptions of PwDs being evaluated for a new mobility device. There were 11,084 PwDs with 31 different primary diagnoses. During their new mobility device evaluation, 52.2% of PwDs reported at least one fall in the last 3 months. For those who reported a fall, 46.6% of PwDs were using a walking aid or no device at all before the new mobility device evaluation. Additionally, persons with progressively acquired disabilities (i.e., Parkinson's disease, osteoarthritis and cardiopulmonary disease) reported higher rates of falls than those with congenital disabilities (i.e., cerebral palsy and spina bifida). These findings will influence future studies comparing different types of devices and their influence on falls and user satisfaction.

Aim: The purpose of this study was to develop, validate and conduct a feasibility study of three remote basic skills assessment modalities for wheelchair service providers (WSP) including an online case study quiz (m1), an in-person skills assessment (m2) and a video conference skills assessment (m3)., Methods: We conducted a literature review; developed and validated 3 basic skills assessments; and conducted a feasibility study of each modality., Results: The literature review revealed that a validated remote basic skills assessment for WSP that reflects all World Health Organization (WHO) 8 wheelchair service provision steps did not exist. We recruited a total of 12 participants for the feasibility study. Two participants dropped out of the study prior to completing a second testing modality. Related to test performance, the results show that our first hypothesis was rejected because only m1 mean score was comparable to the International Society of Wheelchair Professionals (ISWP) Basic Knowledge Test (SD = 0.44). This is in contrast with the Wilcoxon signed-rank test results that show a statistically significant difference between these two modalities. We are therefore not confident that the knowledge test was an appropriate comparison to m1 skills assessment. Hypothesis two was not rejected. The feasibility results reveal 86% success., Conclusion: M1, 2 and 3 have the potential to serve as remote basic skills assessments. However, according to both test performance and feasibility criteria, we believe that m2 has the highest potential to be included in certification processes for basic wheelchair service providers, like the one offered by ISWP.IMPLICATIONS FOR REHABILITATIONA universal remote basic skills assessment that can be accessed across the globe, especially in remote locations where a skilled and experienced provider is not available, is needed.Such test can be an asset to training or professional organisations like ISWP as a way to test WSP competency or to warrant certification.WSP clinical knowledge and skills are essential for the prescription of an appropriate wheelchair to avoid physical harm, abandonment of the device and unnecessary expenses.Properly prescribed wheelchairs allow people with impaired mobility to gain increased ability to perform ADLs, participate in communities, and reduce secondary medical complications such as upper limb repetitive strain injuries, pain, and/or pressure sores.

Study Design: Secondary data analysis of wheelchair failures and service repair logs from a network of wheelchair suppliers., Objective: To determine the frequency of wheelchair caster failures and service repairs across wheelchair manufacturers and models and investigate the relationships between them., Setting: Wheelchair caster failures and service repairs occurred in the community., Methods: Reported caster failure types were classified based on the risk they pose for user injuries and wheelchair damage. Caster failures experienced by users of tilt-in-space and ultralightweight manual wheelchair models and Group 2, 3 and 4 power wheelchair models between January 2017 and October 2019 were analyzed using Chi-Square tests for independence. Correlational analysis of failures and service repairs was performed., Results: A total of 6470 failures and 151 service repairs reported across four manufacturers and five models were analyzed. Failure types were significantly associated with manufacturers and models, respectively. Users of tilt-in-space wheelchairs, who require greater seating support, experienced twice the proportion of high-risk caster failures than the ultralightweight manual wheelchair users. Similarly, Group 3 and 4 power wheelchair users, who have complex rehabilitation needs, experienced 15-36% more high-risk failures than Group 2 users. Service repairs negatively correlated with high-risk manual wheelchair caster failures., Conclusions: Wheelchair users who have greater seating and complex rehabilitation needs are at a higher risk for sustaining injuries and secondary health complications due to frequent caster failures. The study findings call for significant reforms in product quality and preventative maintenance practices that can reduce wheelchair failures and user consequences., (© 2021. The Author(s).)

Aim: This brief report provides an overview of the development and structure of the Health App Review Tool. Methods: The Health App Review Tool has been designed to assess smart phone health apps according to their compatibility to individuals within the Alzheimer's disease community. Specifically, app features and functions are characterized according to their appropriateness to the needs, abilities, and preferences of potential users. The Health App Review Tool is comprised of two components, the App and User Assessment; each component includes four complementary domains. Items in these domains can be compared between App and User assessments using a scoring key that will produce a match score. The score indicates the level of appropriateness in reference to the app's ability to meet the user's needs. Discussion: The Health App Review Tool was designed using available evidence and stakeholder preference data to ensure a user-centered design. The result was the development of a tool built on evidence and informed by the perceptions and preferences of those within and working with the Alzheimer's disease population. App and User domains include usefulness, complexity, accessibility, and external variables. This unique matching approach is anticipated to significantly impact individualized, client-centered care. We anticipate that this study will serve as a model for future development of technology matching tools for other diagnostic populations. Discussion: The Health App Review Tool was designed using available evidence and stakeholder preference data to ensure a user-centered design. The result was the development of a tool built on evidence and informed by the perceptions and preferences of those within and working with the Alzheimer's disease population. App and User domains include usefulness, complexity, accessibility, and external variables. This unique matching approach is anticipated to significantly impact individualized, client-centered care. We anticipate that this study will serve as a model for future development of technology matching tools for other diagnostic populations., (© The Author(s) 2020.)

Objectives: To evaluate the effectiveness of wheelchair assessment and configuration on pressure injury incidence, mobility, and functioning in a wheelchair., Design: Randomized controlled trial with participants individually randomized into intervention and control groups., Setting: Nursing home., Participants: Nursing home residents aged 60 and older who used wheelchairs and were at risk for pressure injuries (N=258)., Intervention: Treatment and evaluation, individually configured wheelchair and skin protection cushion; control and evaluation, facility-provided wheelchair and skin protection cushion., Measurements: Pressure injury incidence, Nursing Home Life Space Diameter score, Functioning Every Day in a Wheelchair-Capacity (FEW-C) score, and Wheelchair Skills Test (WST) score., Results: No differences in pressure injuries (p=.77) were found. Pelvic rotation (odds ratio (OR)=0.15, 95% confidence interval (CI)=0.03-0.70, p=.02) and Day 14 WST skill score (OR=0.74, 95% CI=0.60-0.91, p=.004) were significant predictors of pressure injuries. Significant differences were observed between groups in change in FEW-C independence scores between before randomization and endpoint (p=.03) and before randomization and 14 days (p=.04)., Conclusion: Participants with individually configured wheelchairs improved more in the safe and effective use of their wheelchairs than residents with facility-provided wheelchairs. The outcomes indicated that nursing home residents functioned safely at a higher level in their wheelchairs if their devices were individually configured using a comprehensive wheelchair and seating assessment process. There was no difference in the incidence of pressure injuries between the two groups., Trial Registration: NCT01275313., (© 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.)

Purpose: To conduct a literature review identifying barriers and facilitators students with physical disabilities (SwD-P) may encounter in science and engineering (S&E) laboratories., Method: Publications were identified from 1991 to 2015 in ERIC, web of science via web of knowledge, CINAHL, SCOPUS, IEEEXplore, engineering village, business source complete and PubMed databases using search terms and synonyms for accommodations, advanced manufacturing, additive manufacturing, assistive technology (AT), barriers, engineering, facilitators, instructor, laboratory, STEM education, science, students with disabilities and technology., Results: Twenty-two of the 233 publications that met the review's inclusion criteria were examined. Barriers and facilitators were grouped based on the international classification of functioning, disability and health framework (ICF). None of the studies directly found barriers or facilitators to SwD-P in science or engineering laboratories within postsecondary environments. The literature is not clear on the issues specifically related to SwD-P., Conclusion: Given these findings, further research (e.g., surveys or interviews) should be conducted to identify more details to obtain more substantial information on the barriers that may prevent SwD-P from fully participating in S&E instructional laboratories. Implications for Rehabilitation Students with disabilities remain underrepresented going into STEM careers. A need exist to help uncover barriers students with disabilities encounter in STEM laboratory. Environments. Accommodations and strategies that facilitate participation in STEM laboratory environments are promising for students with disabilities.

Purpose: Currently, there is no internationally accepted way to measure the competency of wheelchair service professionals. The International Society of Wheelchair Professionals aims to develop a Wheelchair Service Provision - Basic Test as a preliminary step towards establishing a certification process., Method: A team of wheelchair service provision experts developed test questions and conducted alpha and beta testing in order to validate them. Low-performing test items were eliminated. A pilot test was then conducted, which focused on developing a pass score, determining language barriers and validating the test as a measure of competency., Results: 90 participants completed one of three versions of the Wheelchair Service Provision - Basic Test. A pass score of 70% was established and 135 questions were accepted for the final test. Analysis of variance indicated there was a difference in scores based on language (p = 0.001), but not based on experience level. This result motivated translation in to the United Nations' official languages., Conclusions: The results indicate that the Wheelchair Service Provision - Basic Test is a valid method for measuring basic competency of wheelchair professionals. Additionally, researchers recommend a skills assessment to help to ensure only qualified wheelchair professionals receive the certificate. Implications for Rehabilitation Identify key steps in contextually appropriate test development. Describe the components of a contextually appropriate, reliable, and valid test for basic wheelchair service provision. Identify methods used for contextually appropriate test validation.

Spinal deformities are common in people who require the use of a wheelchair for mobility as a result of spinal cord injuries and other disabilities. Sitting positions vary between individuals with disabilities who use wheelchairs and individuals without disabilities. In individuals with spinal cord injury, spinal deformities can result in the development of back contours that deviate from the shape of standard rigid back support shells. The purpose of this study was to distinguish and classify various back contours of wheelchair users by utilizing digital anatomic scanning technology in order to inform the future development of back supports that would enhance postural support for those with spinal deformities. The three dimensional (3D) locations of bony landmarks were digitized when participants were in position, using a mechanical wand linked to the FastScan(tm) system commonly used to measure surface contours. Raw FastScan(tm) data were transformed according to bony landmarks. A total of 129 individuals participated in this study. A wide range of back contours were identified and categorized. Although participant characteristics (e.g., gender, diagnosis) were similar amongst the contour groups; no one characteristic explained the contours. Participants who were seated in a forward lean position had a higher amount of pelvic obliquity compared to those seated in an upright position; however, participants' back contour was not correlated with pelvic obliquity. In conclusion, an array of different back shapes were classified in our cohort through 3D laser scanning technology. The methods and technology applied in this study could be replicated in future studies to categorize ranges of back shapes in larger populations of people with spinal cord injuries. Preliminary evidence indicates that customized postural support may be warranted to optimize positioning and posture when a standard rigid shell does not align with contours of a person's back. To optimize positioning, a range of contoured rigid backrests as well as height and angle adjustability are likely needed., (Copyright © 2016 IPEM. Published by Elsevier Ltd. All rights reserved.)

Nonambulatory, visually impaired individuals mostly rely on caregivers for their day-to-day mobility needs. The Drive-Safe System (DSS) is a modular, semiautonomous smart wheelchair system aimed at providing independent mobility to people with visual and mobility impairments. In this project, clinical evaluation of the DSS was performed in a controlled laboratory setting with individuals who have visual impairment but no mobility impairment. Their performance using DSS was compared with their performance using a standard cane for navigation assistance. Participants rated their subjective appraisal of the DSS by using the National Aeronautics and Space Administration-Task Load Index inventory. DSS significantly reduced the number and severity of collisions compared with using a cane alone and without increasing the time required to complete the task. Users rated DSS favorably; they experienced less physical demand when using the DSS, but did not feel any difference in perceived effort, mental demand, and level of frustration when using the DSS alone or along with a cane in comparison with using a cane alone. These findings suggest that the DSS can be a safe, reliable, and easy-to-learn and operate independent mobility solution for visually impaired wheelchair users.

Objectives: To determine the efficacy of skin protection wheelchair seat cushions in preventing pressure ulcers in the elderly nursing home population., Design: Clinical trial with participants assigned at random to a skin protection or segmented foam cushion. Two hundred thirty-two participants were recruited between June 2004 and May 2008 and followed for 6 months or until pressure ulcer incidence., Setting: Twelve nursing homes., Participants: Nursing home residents aged 65 and older who were using wheelchairs for 6 or more hours per day and had a Braden score of 18 or less and a combined Braden activity and mobility score of 5 or less. Participants were recruited from a referred sample., Intervention: All participants were provided with a fitted wheelchair and randomized into skin protection (SPC, n=113) or segmented foam (SFC, n=119) cushion groups. The SPC group received an air, viscous fluid and foam, or gel and foam cushion. The SFC group received a 7.6-cm crosscut foam cushion., Measurements: Pressure ulcer incidence over 6 months for wounds near the ischial tuberosities (IT ulcers) were measured. Secondary analysis was performed on combined IT ulcers and ulcers over the sacrum and coccyx (sacral ulcers)., Results: One hundred eighty participants reached a study end point, and 42 were lost to follow-up. Ten did not receive the intervention. There were eight (6.7%) IT ulcers in the SFC group and one (0.9%) in the SPC group (P=.04). There were 21 (17.6%) combined IT and sacral ulcers in the SFC group and 12 (10.6%) in the SPC group (P=.14)., Conclusion: Skin protection cushions used with fitted wheelchairs lower pressure ulcer incidence for elderly nursing home residents and should be used to help prevent pressure ulcers., (© 2010, Copyright the Authors. Journal compilation © 2010, The American Geriatrics Society.)

Some individuals with disabilities are denied powered mobility because they lack the visual, motor, and/or cognitive skills required to safely operate a power wheelchair. The Drive-Safe System (DSS) is an add-on, distributed, shared-control navigation assistance system for power wheelchairs intended to provide safe and independent mobility to such individuals. The DSS is a human-machine system in which the user is responsible for high-level control of the wheelchair, such as choosing the destination, path planning, and basic navigation actions, while the DSS overrides unsafe maneuvers through autonomous collision avoidance, wall following, and door crossing. In this project, the DSS was clinically evaluated in a controlled laboratory with blindfolded, nondisabled individuals. Further, these individuals' performance with the DSS was compared with standard cane use for navigation assistance by people with visual impairments. Results indicate that compared with a cane, the DSS significantly reduced the number of collisions. Users rated the DSS favorably even though they took longer to navigate the same obstacle course than they would have using a standard long cane. Participants experienced less physical demand, effort, and frustration when using the DSS as compared with a cane. These findings suggest that the DSS can be a viable powered mobility solution for wheelchair users with visual impairments.

This document, approved by the Rehabilitation Engineering & Assistive Technology Society of North America (RESNA) Board of Directors in March 2007, shares typical clinical applications and provides evidence from the literature supporting the use of wheelchair standers.

The purpose of this study was to establish the test-retest reliability and content validity of an outcomes tool designed to measure the effectiveness of seating-mobility interventions on the functional performance of individuals who use wheelchairs or scooters as their primary seating-mobility device. The instrument, Functioning Everyday With a Wheelchair (FEW), is a questionnaire designed to measure perceived user function related to wheelchair/scooter use. Using consumer-generated items, FEW Beta Version 1.0 was developed and test-retest reliability was established. Cross-validation of FEW Beta Version 1.0 was then carried out with five samples of seating-mobility users to establish content validity. Based on the content validity study, FEW Version 2.0 was developed and administered to seating-mobility consumers to examine its test-retest reliability. FEW Beta Version 1.0 yielded an intraclass correlation coefficient (ICC) Model (3,k) of .92, p < .001, and the content validity results revealed that FEW Beta Version 1.0 captured 55% of seating-mobility goals reported by consumers across five samples. FEW Version 2.0 yielded ICC(3,k) = .86, p < .001, and captured 98.5% of consumers' seating-mobility goals. The cross-validation study identified new categories of seating-mobility goals for inclusion in FEW Version 2.0, and the content validity of FEW Version 2.0 was confirmed. FEW Beta Version 1.0 and FEW Version 2.0 were highly stable in their measurement of participants' seating-mobility goals over a 1-week interval.

Objective: To compare the durability, value, and reliability of selected electric powered wheelchairs (EPWs), purchased in 1998., Design: Engineering standards tests of quality and performance., Setting: A rehabilitation engineering center., Specimens: Fifteen EPWs: 3 each of the Jazzy, Quickie, Lancer, Arrow, and Chairman models., Interventions: Not applicable., Main Outcome Measures: Wheelchairs were evaluated for durability (lifespan), value (durability, cost), and reliability (rate of repairs) using 2-drum and curb-drop machines in accordance with the standards of the American National Standards Institute and Rehabilitation Engineering and Assistive Technology Society of North America., Results: The 5 brands differed significantly (P

Background: The INDEPENDENCE 3000 IBOT Transporter (IBOT) is an electronically stabilizing mobility device for people with disabilities. It operates in 4 functions: Standard, Balance (raised on 2 rear wheels), 4 Wheel (for inclines, curbs, and uneven terrain), and Remote (for loading into a vehicle)., Objective: The purpose of this study was to observe the IBOT at use in the home and in the community., Methods: Data were obtained via observations by trained clinicians, data recorded from a computerized data logger, and reports from each expert., Participants: Participants included 10 unimpaired nonwheelchair users (6 men, 4 women) and 4 expert wheelchair users (men with spinal cord injuries, T7-L1). The participants used the IBOT to perform a variety of activities, including holding eye-level discussions with colleagues and shopping by balancing on 2 wheels, going up and down steep ramps, traversing outdoor surfaces (eg, grass, dirt trails), and climbing curbs., Observations: The Balance and 4-Wheel functions were helpful and worked well. The IBOT required attention to control in the Standard function. The seat height was too high for most tables and desks, and the IBOT was challenging to use in the bathroom., Conclusion: The IBOT is a functional mobility device that expands the options of wheelchair users. It is most useful outdoors and where there is sufficient space to use its unique Balance function.

Objective: This quantitative study describes the transition from manual to powered mobility and its influence on occupational performance (organization of daily tasks, assumption of responsibility, roles, interests) and feelings of competence, adaptability, and self-esteem., Method: The Occupational Performance History Interview (OPHI) was used with a convenience sample of 8 participants with both static and progressive conditions to measure retrospectively changes in occupational performance after the change from a manual wheelchair to a powered mobility device (PMD). The Psychosocial Impact of Assistive Device Scale (PIADS) was used to measure participants' perceptions of the impact of the PMD on their competence, adaptability, and self-esteem., Results: A comparison of the pretest and posttest means on the OPHI scores showed a significant improvement in occupational performance (p = .001) after the introduction of PMDs. The PIADS scores showed a positive impact of 2 or greater for 75% of the participants on 19 of 26 items. Scores were similar to scores in a PIADS database of persons with comparable conditions. No significant relationship between occupational performance and psychosocial impact was demonstrated., Conclusion: Results suggest that the transition to a PMD enhances occupational performance, competence, adaptability, and self-esteem for persons with severe mobility impairments.