搜索结果：Journal of rehabilitation and assistive technologies engineering

Tetraplegia, often resulting from cervical spinal cord injury, may lead to significant motor and sensory loss, severely impacting independence and quality of life (QoL). Assistive technologies, such as wheelchair-mounted robotic arms (WMRAs), offer potential to enhance autonomy in daily living. However, adoption remains limited due to high costs, complex controls, and insufficient end user involvement. Robust evidence on their real-world effectiveness, particularly post hospitalization, is still lacking. This study aims to explore the feasibility, usability, and user experience of a WMRA for individuals with tetraplegia in real-life posthospitalization settings. It aims to evaluate its support in activities of daily living and conduct a preliminary health economic analysis comparing cost-effectiveness and QoL outcomes with standard care. This mixed methods feasibility study will be conducted in posthospitalization settings in Switzerland. Up to 15 participants with upper limb impairments (SCI C0-Th1, AIS A-D) using powered wheelchairs will be recruited. They will use the robotic arm for 6 consecutive days. An equal number of participants will be recruited for the economic analysis group. Quantitative data will be collected at baseline and postintervention via standardized questionnaires (Post-Study System Usability Questionnaire, National Aeronautics and Space Administration Task Load Index, European Quality of Life 5-Dimension 5-Level questionnaire, Visual Analogue Scale, adapted version of the Canadian Occupational Performance Measure, and Client Socio-Demographic and Service Receipt Inventory-European Version), while qualitative feedback will be gathered through an informal questionnaire and semistructured interviews. Feasibility will be assessed through task performance and health economic analysis. The latter will include quality-adjusted life years, which quantify quality and length of life, and modeling the Incremental Cost-Effectiveness Ratio, which compares the cost-effectiveness of the intervention based on cost per quality-adjusted life years gained. Findings will be integrated in line with the convergent parallel mixed methods design. Recruitment began in April 2025 and is ongoing as planned; full feasibility, usability, and economic results will be reported upon study completion. We expect the robotic system to reduce caregiver time and associated costs, while enhancing autonomy, QoL, and mental well-being. Potential technical and recruitment challenges have been identified and mitigation strategies planned. Evaluating real-life use of a WMRAs, this study could support the wider adoption of assistive robotic technologies. This research offers key insights into the feasibility, usability, and economic value of robotic assistance for individuals with tetraplegia and will help inform future development and scale-up studies.

The successful integration of socially assistive robots in geriatric care settings hinges on the attitudes and opinions of healthcare professionals. This study explored their needs, expectations, and perceptions regarding robot use, including facilitating factors and barriers to implementation. Twenty professionals participated in semi-structured interviews that covered topics such as robot applications, perceived value, acceptance criteria, prerequisites for deployment, ethical considerations, and design attributes. These interviews were analyzed using a deductive qualitative approach guided by the European Network for Health Technology Assessment model (version 3.0). Results indicated that professionals generally viewed robots favorably, noting their usefulness in various non-intimate tasks like meal assistance and toileting. Ease of use was identified as a critical factor for robot adoption in geriatric care. Furthermore, the necessity of educating all stakeholders and providing comprehensive training to professionals emerged as essential for successful implementation. The discussions also included financial and ethical issues related to the introduction of these technologies. These findings will contribute to develop guidelines for designing and deploying socially assistive robots that align with the preferences and requirements of geriatric care professionals.

Wrist hand orthoses are widely used in rehabilitation to improve hand function and alleviate pain. However, their use may restrict wrist motion, causing functional disabilities in activities of daily living (ADLs). This study aimed to evaluate the effects of wrist hand orthoses on upper limb activity during daily life, focusing on differences between padded fiberglass and thermoplastic wrist hand orthoses. 35 healthy, right-handed adults wore two types of wrist hand orthoses (padded fiberglass and thermoplastic) for 24 h during daily activities. Upper limb activity was measured using accelerometers, while ADL difficulties were evaluated using the Hand20 questionnaire. Activity levels were compared across no-orthosis, fiberglass, and thermoplastic orthosis conditions. Both wrist hand orthoses significantly reduced upper limb activity (magnitude ratio and use ratio) compared to the no-orthosis condition (p < 0.05). The Hand20 scores indicated greater ADL difficulties under both orthotic conditions, with no significant difference between the two types of orthoses (p > 0.05). Wrist hand orthoses restrict wrist and forearm motions, reduce upper limb activity, and increase perceived ADL difficulties. No significant differences were observed between fiberglass and thermoplastic orthoses, suggesting comparable effects on daily life. Design modifications can improve user comfort and functionality.

The objective of this study was to carry out a systematic review and meta-analysis of available literature on the relationships between spasticity, proprioception and motor function of the upper limb post-stroke. Using the terms: stroke; movement; proprioception; spasticity; rehabilitation; and upper limb, a systematic search was conducted on Scopus, PubMed and Web of Science from database inception to November 2023. A study must have assessed two of spasticity, proprioception, or motor function of the upper limb post-stroke to be included. Random-effects meta-analyses were conducted to investigate changes in time and strength of correlations between variables. Fifty-two studies were included. Over time, spasticity increased (OR = 0.5, p = 0.0475); proprioception and motor function impairments decreased (OR = 3.15, p < 0.0001; OR = 3.21, p < 0.0001, respectively). The correlation between spasticity and proprioception was weak (r = 0.33, p = 0.0283); between proprioception and motor function was moderate (r = 0.45, p < 0.0001); and between spasticity and motor function was moderate (r = 0.55, p < 0.0001). Despite the limitation of heterogeneity in the available evidence, relationships between variables were illustrated. Moderate correlations between proprioception and both spasticity and motor function suggest proprioception should be an important target for personalised rehabilitation interventions.

The need for Artificial Intelligence (AI) in gerontology education is underscored by the potential benefits it offers in addressing loneliness and supporting social connection among older adults in long-term care (LTC) homes. While the workforce in LTC is often overburdened, AI-enabled service robots present possible solutions to enhance residents' quality of life. However, the incorporation of AI and service robots in current gerontology curricula is lacking, and the views of students on this subject remain largely unexamined. This study aims to fill this gap by capturing the perspectives of university students regarding the deployment of an AI robot, Aether, in LTC environments. In this qualitative study, we conducted focus groups with 22 university students. Our thematic analysis identified three themes: (1) Aether's anticipated usage in geriatric care: companionship support and complementing the work of staff; (2) Challenges in using Aether: technical and emotional challenges; and (3) Solutions and future possibilities: expanding functionalities and integrating personalization features. Students expressed a positive outlook on the role of AI-enabled robots while also highlighting the necessity of addressing ethical and practical considerations. To effectively integrate AI technology in gerontology education, it is essential to understand and incorporate student perspectives, attitudes, and opinions.

Electrical stimulation of the spinal cord may improve rewiring of the affected pathways. Immediate modulation of stimulation parameters, and its effects of it on kinematics and electromyographic variables is unclear. This study piloted the safety and feasibility of the Reynolds Innovative Spinal Electrical Stimulation (RISES) technology with a focus on its novel closed-loop setting. This personalized, task-specific non-invasive stimulation system enables real-time stimulation parameter modulation and supports multi-data acquisition and storage. Four SCI participants underwent a clinical trial coupled with activity-based training. Primary safety outcome measures included adverse events (AEs) and skin integrity; secondary measures were vital signs, pain, and fatigue assessed at the pre, mid, and post-stimulation sessions. The trial included open-loop and closed-loop blocks of transcutaneous spinal cord stimulation (tSCS). Results showed no serious adverse events, with skin integrity unaffected. Vital signs and pain showed no significant differences across session timepoints. Fatigue levels differed significantly with post-session > mid-session > pre-session. Comparisons between open-loop and closed-loop blocks showed no significant differences in setup time, vital signs, pain, or fatigue. Average stimulation duration per task was significantly longer for open-loop (467.6 sec) than Closed-loop (410.8 sec). RISES, demonstrated safety and feasibility. Further work will focus on clinical efficacy.

One of the most important factors affecting quality of life is recreation, due to its positive role in social and physical health. Adaptive recreation can be difficult to access, largely because market availability for adaptive equipment, outside of assistive devices for daily living tasks, is extremely limited. The purpose of this project is to develop an open-source repository of affordable Sport and Recreation Activity Assistive Technology in response to idea submissions from the disability community. Prototypes are developed using predominantly 3D printing coupled with commonly available assembly materials, a fabrication approach that allows for rapid and reasonably affordable development of custom solutions. Each prototype follows a defined project methodology: need identification, design (prototyping and evaluation), fabrication testing, and dissemination. To date, several devices have been designed and made available with full documentation, including swim paddles, an attachment for a miniature golf club, billiards stick handles, a game piece mover, a cornhole bag adaptation, an arm prosthetic vehicle shifter adaptor, and a curling stone push stick attachment. All device designs, part files, bills of materials, and assembly instructions are accessible through a publicly available repository so that end users or their support networks can download and fabricate the devices themselves.

Medial knee osteoarthritis (KOA) is a prevalent degenerative joint disease causing pain and functional impairment. Off-loading knee braces reduce pain but may decrease muscle activity, leading to weakness. Integrating local muscle vibration (LMV) into off-loading braces may enhance muscle activation and clinical outcomes. To design a portable LMV system synchronized with gait phases and compare its efficacy to a conventional off-loading brace in patients with medial KOA. In this randomized clinical trial, 16 patients with medial KOA were assigned to either an LMV-equipped off-loading brace group or a conventional brace group for 4 weeks. Clinical outcomes (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC], Visual Analog Scale [VAS]) and biomechanical parameters (knee adduction moment [KAM1, KAM2], impulse, range of motion [ROM], cadence, stride length) were assessed pre- and post-intervention using validated questionnaires and a motion analysis system. The LMV-equipped brace group demonstrated a significantly greater reduction in KAM impulse (-24.79% vs. -7.68%, p=0.050) and improved knee ROM (p=0.048) compared to the conventional brace group. Significant improvements in WOMAC (p=0.001) and VAS (p=0.011) scores were observed in the LMV group, indicating enhanced functional status and pain relief. The LMV-equipped off-loading brace provides superior biomechanical (KAM impulse, ROM) and clinical outcomes compared to conventional braces, offering a promising intervention for medial KOA.

The Study was done to examine the use, non-use, the quality of clinical advice, challenges in acquiring AFOs (Ankle Foot Orthosis), and user satisfaction, using a WHO based Rapid Assistive Technology Assessment (rATA) and Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST) questionnaire. The cohort (n = 100) consisted mainly of males (71%) and residents of city (82%). It was found that 98 subjects were under advice from healthcare providers to use an AFO but only 59 subjects were using AFO at present. Common complaints were pain, fitting related and social stigma among users. The majority of the subjects (87%) paid for their AFOs. It was found that the majority of the subjects were "more or less satisfied" with the device however 59% strongly agree that they dislike the appearance of their AFO and 37% were completely dissatisfied with the accessibility of their home and surroundings while using the AFO. It is evident that we should work on improving the design and fit of the orthosis so that the acceptance and satisfaction improves. This study also explores the possibility of usage of rATA for the specific assistive Technology (like AFO in this context) assessment. It was observed that patients often have high expectations regarding a cure with the use of an AFO. Therefore, it is essential for service providers to explain that the AFO is intended to improve function rather than provider a cure. This mismatch of understanding may contribute to dissatisfaction by patients using AFOs, hence user education is essential along with technology provision.

This study aimed to explore the relationship between training volume during 4&#xa0;weeks of robot-assisted arm training (RAAT) and changes in arm-and hand function, grip strength, gross motor skills, spasticity, and daily activities. Twenty participants, >18&#xa0;years of age, in subacute phase following stroke, with impaired arm function admitted to Sunnaas Rehabilitation Hospital, completed 4&#xa0;weeks robot-assisted arm training (45&#xa0;min, 3-5 times a week). Before and after this intervention, the participants' arm and hand function, grip strength, gross motor dexterity, spasticity and activities of daily living were assessed. The key findings of this study indicated no association between training volume and improvements in arm and hand function, grip strength, gross motor dexterity, spasticity, or activities of daily living. Also, no significant associations between changes in arm and hand function and age, gender, or affected side. However, subgroup analysis showed significant improvements in arm-hand function for participants with shorter time post-stroke (p = 0.01) and better initial arm and hand function (p < 0.0001). These findings highlight the importance of early initiation and individualized treatment based on initial function when using robot-assisted arm training in stroke survivors.

Background: Individuals with spinal cord injuries (SCI) face substantial mobility challenges that affect their independence and quality of life. Traditional medial linkage reciprocal gait orthoses (MLRGO) often lack efficiency in enhancing mobility and stability. This study introduces the Advanced MLRGO, designed to overcome these limitations and improve walking function for SCI patients. Material and methods: The Advanced MLRGO was developed using orthopedic engineering and biomechanics principles, with detailed simulations performed in COMSOL Multi-physics to evaluate force distribution and resistance. A clinical trial involving five individuals with SCI was conducted to compare the performance of the Advanced MLRGO against the Prime-Walk orthosis and the standard MLRGO. Results: Results showed that the MLRGO system significantly improved walking speed (p = 0.03) and distance traveled (p = 0.04) compared to the Prime-Walk. The Advanced MLRGO also exhibited notable enhancements over the standard MLRGO, showing increased walking speed (p = 0.033) and distance (p = 0.026), as well as reduced donning time (p = 0.048). Conclusion: These findings indicate that the Advanced MLRGO significantly enhances mobility and independence for individuals with thoracic SCI. Future research should focus on improving doffing efficiency and assessing individual user experiences to maximize these benefits.

Exercise and participation in sport can have physical, psychological, and social benefits to persons with disabilities. The high cost ($5,000 to $12,000 USD) and long lead times of sport wheelchairs, however, is a barrier to participation. The objective of this study was to develop an affordable kirigami inspired rugby wheelchair made from sheet metal instead of tubes. Three prototypes of varying seat widths were designed, fabricated, and evaluated by 11 participants. Participants performed common drills in the prototype that best matched their hip width, and each provided feedback via a structured interview. The participants reported overall favorable reviews and cited the adjustability, repairability, and implications of this wheelchair on decreasing the barrier of entry to sport as its best features. Participants also identified areas for improvement, such as seat material and caster size. Future study should examine safety, durability, and performance during training and competition scenarios.

The ability to grasp objects has a significant impact on the independence of individuals following a stroke, a spinal cord injury, or for those who are living with amyotrophic lateral sclerosis. In most cases, physical rehabilitation is not sufficient to regain the hand function necessary for day-to-day life. Hand orthoses capable of providing grasping assistance in activities of daily living are therefore crucial to a more independent lifestyle. However, most available options struggle to offer an acceptable balance between cost, size, weight and functionality, resulting in limited use in practice. This article presents a low-cost, 3D-printed hand orthosis that relies solely on mechanical elements to aid in finger flexion. An underactuated, flexible design for the fingers with nylon strips as spring blades was used to achieve a design that costs only 27% of the price of comparable commercially available options, as well as being very lightweight and easily customizable. It was also demonstrated that rigid thumb supports allowed the orthosis to be used in the majority of daily grasping tasks. Finally, the use of the proposed mechanism was shown to be able to provide up to 4&#xa0;N of flexion assistance to the finger when using a medium wrap grip.

The study investigated the present state of awareness, unmet needs, and barriers faced by participants using wheelchairs in a tertiary care hospital in India. This sequential explanatory mixed-method study explored the participants' experiences in two parts. Part one presents the result analysis of user experience and wheelchair service provision using rATA (n=100). Part two presents a thematic analysis of 100 in-depth semi-structured interviews. The study and interviews define barriers to wheelchair access provision, including assessment, prescription, customization, training, wheelchair maintenance, and follow-up. The study reported that most participants procured their wheelchairs from the private sector (35%) while 10% received them from the public sector. The main reasons for not having the appropriate wheelchair were affordability (78%), lack of support (64%), and lack of awareness (41%), while road/transport accessibility (63%) and home accessibility (53%) were the main obstacles for the wheelchair non-use. The study provided insights into wheelchair provision and user satisfaction within healthcare delivery system. Integration of Wheelchair service and delivery into the health care system can strengthen the rehabilitation health system per the WHO guidelines.

Increasingly, geriatric institutions are adopting video calling services to promote social interactions between residents and their loved ones. However, a gap persists between the technologies used and the needs and abilities of older users. Interactive Televisions (iTVs) could be part of the solution as they provide a familiar and accessible way to strengthen the relationship between residents and their environment (family, friends, professionals). User tests were conducted to evaluate the ability of older adults (OAs) from different place of living to use iTV. A total of 32 user tests were carried out with OAs living at home, in residential facilities (RFs), and in nursing homes (NHs) between November 2022 and June 2023. The quantitative analysis revealed mixed opinions on the iTV's usability. OAs living at home tended to produce less errors and needed less help to successfully use video calling and messaging functionalities of the iTV than others. However, participants in NHs required more repetitions to benefit from a learning effect, unlike participants in RFs and at home. This study proposed another approach to user testing, based on cognitive psychology methods. Based on the analysis of the critical stages, ergonomic recommendations were identified.

The LSU Community Playground Project (LSUCPP) collaborates with communities (especially the true experts at play, the children) to design and build playgrounds that reflect "the soul of the community." One member of the LSUCPP undertook a research project in an effort to design better playgrounds for use by children who are visually impaired or blind. A recommendation from this research was to provide a 3D-printed tactile map of each play area, such that children who were visually impaired or blind could feel the location and type of equipment and ground surfaces prior to entering a playground, which would enable them to play independently. In this paper, we tell the story of how engineering students and faculty collaborated with children with visual impairments or blindness and their teachers and professional staff to co-design and build a 3D printed tactile map at the Louisiana School for the Visually Impaired (LSVI). Specifically, we detail how we co-designed this artifact, the ways in which the artifact developed due to this inclusive approach, briefly present the design, and discuss how engineers engaged in the design of assistive technologies can put inclusive design principles and community-based design processes into action.

The rapid expansion of virtual reality (VR) technology has led to the development of low-friction, slip-style omnidirectional treadmills (OTs), which have great promise for implementation into VR-based gait rehabilitation protocols. However, previous work indicates that use of these treadmills leads to unique gait patterns that may differ from overground gait, and there is a lack of research examining how OT gait differs from a conventional, belt-driven treadmill (CT). Thus, the purpose of this study was to characterize spatiotemporal and electromyographic gait patterns on an OT and to compare them with overground and CT walking. Fourteen healthy participants walked in these three conditions in both the real-world and in VR, as well as at fixed and preferred paces. Results indicate that use of the CT promoted significantly longer stride lengths (mean = 1.838 m) and reduced variability (coefficient of variation (CV) = 14.7%) compared to overground walking (mean = 1.578 m, CV = 21.4%). Moreover, the use of CT in VR at a fixed pace led to reduced biceps femoris (CV = 20.4%) and medial gastrocnemius (CV = 14.9%) variability compared to overground walking (biceps femoris CV = 26.4%, medial gastrocnemius CV = 22.2%), while use of the OT demonstrated variability similar to that of overground walking across measures. These results indicate that the user-driven aspect of OTs may elicit gait patterns more similar to overground walking than traditional belt-driven treadmills.

The mobility of people with severe visual impairment is limited affecting their comfort and productivity. There are about 45 million people who are blind with global financial burden and annual global cost of productivity estimated to be USD411 billion according to World Health Organization report of 2024. The contributions of the people who are visually impaired to the gross domestic product (GDP) can be enhanced deploying technology. A novel sensory substitution device that enables people who are visually impaired or blind to fairly hear objects in place of seeing objects is proposed. The wearable echolocation device was developed using three ultrasonic sensors, one placed in the right, left, and middle of the goggle with each connected to a buzzer. Audible compass is implemented in the circuitry to guide the user on the direction while walking. In this configuration, the user is guided and alerted of any obstacle within the field of coverage and so can navigate to any desired destination unaided without relying on internet. The developed prototype is easy to use and does not require complex training. The echolocation device was tested by ten enrolled people that are visually impaired or blind who validated its effectiveness and efficiency. The device is comparatively low cost, noninvasive, energy efficient and mass producible.

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