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For children with mobility impairments, without cognitive delays, who want to participate in outdoor activities, existing assistive technology (AT) to support their needs is limited. In this review, we investigate the control and design of a selection of robotic walkers while exploring a selection of legged robots to develop solutions that address this gap in robotic AT. We performed a comprehensive literature search from four main databases: PubMed, Google Scholar, Scopus, and IEEE Xplore. The keywords used in the search were the following: "walker", "rollator", "smart walker", "robotic walker", "robotic rollator". Studies were required to discuss the control or design of robotic walkers to be considered. A total of 159 papers were analyzed. From the 159 papers, 127 were excluded since they failed to meet our inclusion criteria. The total number of papers analyzed included publications that utilized the same device, therefore we classified the remaining 32 studies into groups based on the type of robotic walker used. This paper reviewed 15 different types of robotic walkers. The ability of many-legged robots to negotiate and transition between a range of unstructured substrates suggests several avenues of future consideration whose pursuit could benefit robotic AT, particularly regarding the present limitations of wheeled paediatric robotic walkers for children's daily outside use. Children with lower limb disabilities can benefit from assistive technology designed for daily usage in outdoor surroundings. An extension of existing robotic assistive technology that allows the user to travel safely on irregular surfaces both indoors and outdoors is needed. Approaches used to solve research problems in the field of robotics (outside of the rehabilitation area) can be used to address problems that robotic assistive technology currently faces. There is a need for more research on the development of robotic assistive technology for children with mobility impairments without cognitive delays. [ABSTRACT FROM AUTHOR]

This systematic review examines the impact of assistive technology (AT) on educational and psychosocial outcomes for students with disabilities (SWDs) in higher education. Qualitative, quantitative and mixed method studies were identified through systematic searches of five databases: PsycINFO, PubMed, CINAHL, ERIC and Web of Science (Social Science Citation Index). The search was conducted in January 2018. Thematic synthesis was carried out to collate findings across papers and the methodological quality of included papers was assessed using a Mixed Methods Appraisal Tool (MMAT). Twenty-six papers were included for analysis. Four analytic themes were identified; "AT as an enabler of academic engagement"; "barriers to effective AT use can hinder academic engagement"; "the transformative possibilities of AT from a psychological perspective"; and "AT as an enabler of participation". This systematic review identifies that AT can promote educational, psychological and social benefits for SWD. However, AT users and AT officers must be aware of certain factors, such as inadequate AT training, inadequacies of devices, availability of external support and the challenge of negotiating multiple information sources, can hinder effective AT use and thus restrict engagement in the higher education environment. Future AT practices should focus on harnessing the potential of mainstream devices as AT for all students, thus facilitating inclusion and reducing stigma. Students with disabilities face academic, psychological and social challenges within the higher education environment. Assistive technology (AT) use can enable academic engagement and social participation and be transformative from a psychological perspective. Disability support staff in higher education should ensure that the AT needs of students with disabilities are met in order to enhance the educational experience. Harnessing the potential of mainstream devices as AT for all students will facilitate inclusion and reduce stigma. [ABSTRACT FROM AUTHOR]

Information and Communication Technologies have transformed our lives in different social areas, facilitating interpersonal relationships thanks to technological tools. In the specific case of people with disabilities, Assistive Technologies (ATs) break down barriers and increase opportunities to become active members of society with equal opportunities. This paper presents a systematic mapping study that analyzes the current state-of-the-art of ATs proposed in the literature to support the empowering of people with disability. Specifically, this paper focuses on (1) describing a global vision of the scientific literature published in the last 20 years about ATs in the computer science field and (2) identifying research needs, gaps, and trends. For this purpose, an in-depth analysis of 389 primary studies is presented. The information obtained from the mapping process is also constrained. Concretely, 35 ATs versus 22 disabilities are compared, obtaining striking peaks for some disabilities described in the discussion. Finally, the findings show that several areas have been covered only lightly, revealing interesting future directions and challenges for junior researchers. • ATs have the potential to break down barriers for people with disabilities, enabling them to participate more fully in society. This implies a need for rehabilitation programs to incorporate ATs into their strategies to enhance social inclusion. • Given the transformative role of ICT, rehabilitation programs should focus on helping people with disabilities develop the necessary technological skills to utilize ATs effectively. • This work highlights the diversity of ATs and disabilities, suggesting a need for personalized rehabilitation plans that match specific ATs to individual disabilities. • Rehabilitation professionals should be trained to assess and recommend appropriate ATs for each case. Rehabilitation programs should consider incorporating cutting-edge ATs and staying involved in research to contribute to future developments to cover gaps and challenges identified. [ABSTRACT FROM AUTHOR]

This paper presents a review of the existing qualitative research literature concerning people's experience of communicating using augmentative and alternative communication (AAC). The aims of conducting this review were to find out more about the values and outcomes that are important to people about the AAC they use to support their communication. This review was conducted to provide a deeper understanding of these experiences to inform the development of a patient-reported outcome measure (PROM). A qualitative evidence synthesis of existing qualitative research literature was undertaken to explore and appraise current knowledge about the experiences of people who use AAC. From 115 qualitative research reports 19 papers were identified that responded directly to the research question and aims of the review. Data were identified that could be organized within an a priori framework consisting of the constructs of values, outcomes, and context. The review has resulted in a deeper, analytical understanding of the experiences of people who require AAC. The results indicate a set of concepts that can be used to inform the development of a PROM. A PROM can be used to assist clinicians and researchers to better understand the perspectives of people who require AAC and evaluate interventions. The results also encourage professionals to reconsider the terminology and methods used when working alongside people who require AAC and to reflect on the multidimensional factors that influence people's experience of communication. Patient-reported outcome measures (PROMs) can be useful tools to support clinician-patient communication, facilitate shared decision making and establish priorities for rehabilitation. It can be difficult to engage people who have complex communication difficulties in decisions about the important outcomes to them from using augmentative and alternative communication (AAC). This qualitative evidence synthesis provides a deeper understanding of the experiences and perspectives of people who use AAC. The results will be used to inform the development of a PROM which can be used to facilitate shared decision-making, and evaluate AAC interventions from the perspective of the people who use these technologies. [ABSTRACT FROM AUTHOR]

The need for social distancing in order to reduce the prevalence of COVID-19 concomitant with the needs of patients as well as the protection of the patients and service providers which has led to the use of tele health in speech and language therapy. For this reason, we decided to review the studies that focus on tele health in speech and language therapy during the COVID-19 pandemic and the purpose of this study is to investigate the use and satisfaction of tele health in speech and language therapy. We conducted a systematic review of the literature in accordance with the PRISMA statement on google scholar, PubMed, Scopus, Science direct, ProQuest, Web of science, Springer and Cochrane databases between 2020 − 2021. An additional manual search was performed, taking into consideration references of the included papers, through the same eligibility criteria. Two researchers screened the titles and abstracts of articles that met inclusion criteria. The methodological quality of the included papers was evaluated using the Critical Appraisals Skills Program (CASP) checklists. The collection of reviewed articles included 83 articles from different countries, subsequently 8 articles (3 clinical trials and 5 experimental) were selected. The data extracted were: participations, objects, methods, tools and results. According to present study, tele health can be used in diagnosis and treatment of speech-language conditions as well as educating speech and language pathology students. Moreover, these findings showed patients and therapists were more inclined to utilise tele health. Reduced access to in-person rehabilitation care in covid-19 pandemic, along with changes in health care finance and delivery, contributed to an exponential increase in telehealth. Measures of quality and patient satisfaction are unknown in the model of tele rehabilitation. To date, the literature on tele rehabilitation is limited and most commonly describes treatment for an impairment within a specific disease. Beyond infection control, eliminating travel time, incorporating other health care advocates, and convenience delivering care in familiar environments to pediatric patients are all benefits that will be durable outside times of pandemic. For families who live in rural or medically underserved areas and have access to internet and technology, telemedicine is a tool to provide access to medical care. Telemedicine can also increase patient and caregiver satisfaction through reduced travel and clinic wait time and increased potential for appointment time flexibility. Tele rehabilitation medicine provides an opportunity to deliver timely, patient and family-centric rehabilitation care while maintaining physical distancing and reducing potential COVID-19 exposure for our patients, their caregivers and medical providers. Since SLP mostly relies on communication through visual-auditory and perceptual aspects, tele practice could be a proper opportunity to provide care in this field. Given the need for continuous therapy sessions in order to treat speech-language disorders, the application of tele practice may eliminate problems in this area to some extent while preventing the transmission of COVID-19. [ABSTRACT FROM AUTHOR]

To analyse the virtual reality applications in the subjects' neuro-psychomotor functions rehabilitation with motor and/or neuropsychiatric impairment. The search was carried out in nine databases (Scopus, PubMed, Web of Science, ScienceDirect, Cochrane Library, CINAHL, PsycINFO, LILACS, and SciELO), from December 2017 to March 2019. An additional manual search was performed, taking into consideration references of the included papers, through the same eligibility criteria. The methodological quality of the included papers was evaluated using the Physiotherapy Evidence Database (PEDro). One hundred and twenty-two papers were selected by the initial screening, but only 33 studies participated in the final inclusion in the study (11 clinical trials and 14 experimental studies). The data extracted were: the proposed objective, the sample population, the neurological condition treated, the VR modality used in the procedures and the study intervention period. Virtual reality supports the rehabilitation process of neuro-psychomotor functions, allowing potential gains in the patients' recovery. Therefore, its development facilitates its availability and access in the future. It has minimal adverse effects during the virtual therapies performance, such as the presence of vertigo related to cybersickness conditions, suggesting virtual reality as a safe rehabilitation tool, compared to other therapies. Virtual reality use is useful and effective in helping the rehabilitation process of motor, cognitive and psychosocial functions. It plays a role as an adjunctive and complementary therapy in the neuro-psychomotor rehabilitation process to obtain a clinically significant result. [ABSTRACT FROM AUTHOR]

Smartphones have become a core piece of assistive technology (AT) for people with vision impairment (PVI) around the world. This scoping review sought to provide a comprehensive picture of the current evidence base of smartphones for PVI. Seven electronic databases (CINAHL, Cochrane Library, EMBASE, IEEE Xplore, Scopus, PubMed and Web of Science) were searched for papers published from 2007 to 2021. Peer-reviewed articles published in English which discussed smartphones use by PVI; smartphone technologies designed for PVI or training and learning support on the use of smartphones were included. There were 16,899 records retrieved and 65 articles were included in this review. The majority (48%) of the papers focussed on developing better interfaces and Apps for PVI. Contrastingly, there was a paucity of papers (5%) discussing training or learning support for PVI to use smartphones and Apps effectively, even though it was highlighted to be important. Proper training will ensure that PVI can use this everyday technology as an AT to increase participation, enhance independence and improve quality of life overall. The findings highlighted that smartphones and Apps can be used as effective and affordable AT by PVI. The many recent developments and research interest in smartphone technologies can further support its use. However, good training and learning support on the use of smartphones and Apps by PVI, is lacking. Future research should focus on the development, provision and evaluation of evidence based tailored training and support, especially in low- and middle-income countries. There is a need for more training and learning support for people with vision impairment (PVI) on the use of smartphones and Apps. Individualized and a graded approach to training has been recommended for PVI to learn to use smartphones. When supporting or training people to use smartphones, the person's level of vision impairment as well as their age, are important considerations. Health professionals should be cognizant of the steep learning curve that some PVI may experience when using smartphones and Apps, especially when they switch from a phone with physical buttons to touchscreen. Certain smartphones features are useful to particular vision loss conditions. For example, zoom and magnification are helpful for those with low vision but text input and output, and commands using speech (e.g., Siri and TalkBack) are useful for those who are blind. [ABSTRACT FROM AUTHOR]

This review aims to examine the instruments, approaches, scales, or assessment tools used to evaluate technology acceptance, technology adoption, and usability of information and communication technologies (ICTs) for people living with dementia and their care partners. A systematic literature review was conducted. Studies that explored the use of instruments, approaches, scales, or assessment tools to evaluate the technology acceptance and usability of ICTs for people living with dementia and their care partners were identified through five databases: Medline, EMBASE, CINAHL, Web of Science, and Scopus. We included 74 out of 2182 papers. The most common scales used included the System Usability Scale (SUS) (11%), the ISONORM 9241/10 Questionnaire (4%), and the Post-Study System Usability Questionnaire (PSSUQ) (4%). Most (59%) of the included approaches, however, were bespoke (i.e., created by the authors for a particular study) and were not named. The approaches or tools used to assess technology acceptance, technology adoption, and usability of ICTs that applied to people living with dementia had an average of 15 items and used an average of 5.23 scale points. There is no clear, standardised approach for assessing the technology acceptance, technology adoption, and usability of ICTs for people living with dementia and their care partners. The findings of this review may be used by academics to design and implement improved and more consistent assessment tools to assess technology acceptance, technology adoption, and usability of ICTs for people living with dementia and their care partners. The number of ICTs for people with dementia and their care partners that can be used for rehabilitation is increasing The most commonly recognized assessment tools used in this study were the SUS, ISONORM 9241/10, and PSSUQ questionnaires. For the custom assessment tools, the average number of items included in this study was 15 with five-point bidirectional labelling. There is no clear, standardized approach for assessing the technology acceptance, technology adoption, or usability of ICTs for people with dementia and their care partners. [ABSTRACT FROM AUTHOR]

We aimed to identify assistive technologies that are promising for addressing loneliness in people living with dementia in long-term care. A scoping review was conducted. EBSCO, PubMed, Cochrane Library, and ProQuest were searched from 2000 to 2020. The included studies were selected by three independent researchers and summarised, compared, and categorized according to technology type. Publications were eligible for inclusion when they reported on psychosocial interventions aiming to reduce loneliness and/or social isolation in people with dementia in long-term care settings. Twenty-four papers were included (20 original research papers and four reviews). Most studies were conducted in Australia and Europe. The studies aimed to investigate two different types of assistive technology: social robots, and multimedia computer systems. Most studies focussed on behaviour, engagement, and mood as primary outcomes. Only one study directly aimed to alleviate loneliness. Even though only one study addressed loneliness directly, it became clear that assistive technologies used to apply psychosocial interventions have the potential to impact loneliness in people with dementia in long-term care. However, it remains unclear why loneliness was not included as an outcome and how loneliness could become a key outcome in evaluating assistive technologies. Loneliness among older adults is associated with health risks, such as the development of dementia, depression, and increased mortality. Ambient Assisted Living (AAL) technologies have been studied to address loneliness for older adults; however people with dementia are often excluded from such studies. This diverse group of technologies is shown to have a promising impact on outcomes, such as social engagement, quality of life, and mood, but loneliness was studied less often. More research is needed to discover the potential of assistive technologies for people with dementia living in long-term care. [ABSTRACT FROM AUTHOR]

Exoskeleton can assist individuals with spinal cord injuries (SCI) with simple movements and transform their lives by enhancing strength and mobility. Nonetheless, the current utilization outside of rehabilitation contexts is limited. To promote the widespread adoption of exoskeletons, it is crucial to consider the acceptance of these devices for both rehabilitation and functional purposes. This systematic review aims to identify the barriers or facilitators of the use of lower limbs exoskeletons, thereby providing strategies to improve interventions and increase the adoption of these devices. A comprehensive search was conducted in EMBASE, Web of Science, Scopus, Cochrane, and PubMed. Studies reporting barriers and facilitators of exoskeleton use were included. The studies' quality was assessed using the Mixed Methods Appraisal Tool and undertook a thematic content analysis for papers examining the barriers and facilitators. Fifteen articles met the inclusion criteria. These revealed various factors that impact the utilization of exoskeletons. Factors like age, engagement in an active lifestyle, and motivation were identified as facilitators, while fear of falling and unfulfilled expectations were recognized as barriers. Physical aspects such as fatigue, neuropathic discomfort, and specific health conditions were found to be barriers. This systematic review provides a comprehensive overview of the barriers and facilitators to the use of exoskeleton technology. There are therefore still challenges to be faced, efforts must be made to improve its design, functionality, and accessibility. By addressing these barriers, exoskeletons can significantly improve the quality of life of people with SCI. Optimize the use of this technology to adapt as much as possible to individual needs. Offer an in-depth understanding of the challenges that can arise when adopting exoskeletons. Highlight the critical issues with the device, that prevent me from using it outside of clinical contexts. Offer useful information to therapists to select the most suitable patients for the use of the exoskeleton and to customize rehabilitation programs more effectively. [ABSTRACT FROM AUTHOR]

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

This paper provides a review of studies that evaluated technology devices to sustain various forms of mobility in older people with cognitive impairment or dementia and mobility problems (e.g., inability to ambulate or difficulties to orient with consequent failures to reach relevant destinations). A literature search was performed for English language articles indexed in PubMed, PsycINFO, and Web of Science. This search was then supplemented with an ancestral and forward search. The search covered the period ranging between January 2010 and October 2020. Twenty-seven articles were included in the review. They were divided into four groups according to whether they aimed to promote (a) supported ambulation, (b) use of safe power wheelchair, (c) ambulation guided by orientation cues, and (d) ambulation with GPS-based assistance. The studies were coded in terms of the objective pursued, technology used, participants involved, strategies applied to assess the technology, and outcome reported. A variety of technology devices are available to address the mobility problems of older people with cognitive impairment or dementia. The devices' accessibility and usability differ widely. Data on their impact are still largely preliminary and new systematic research is needed. A variety of mobility problems may afflict older people with cognitive impairment or dementia and curtail their opportunities to freely move indoor or outdoor. Technology devices have been developed to (a) promote forms of supported ambulation, (b) facilitate safe use of power wheelchairs, (c) deliver orientation/navigation cues, and (d) ensure tracking and possible assistance. The technology devices differ in terms of accessibility and affordability, with some of them readily available and others at a developmental stage. Data on the effectiveness of the various technology devices in reducing the impact of the mobility problems are still largely preliminary and new systematic research is needed. [ABSTRACT FROM AUTHOR]

Many wheelchair users experience disabilities in stabilising and positioning of the head. For these users, adequate head support is required. Although several types of head supports are available, further development of these systems is needed to improve functionality and quality of life, especially for the group of severely challenged users. For this group, user needs have not been clearly established. In this article, we provide an overview of the state-of-the-art in wheelchair mounted head supports and associated scientific evidence in order to identify requirements for the next generation of head support systems. A scoping review was performed including scientific literature (PubMed/Scopus), patents (Espacenet/Google Scholar) and commercial information. Types of head support and important system characteristics for future head support systems were proposed from consultations with wheelchair users (n = 3), occupational therapists (n = 3) and an expert panel. Forty scientific papers, 90 patents and 80 descriptions of commercial devices were included in the scoping review. The identified head support systems were categorised per head support type. Only limited scientific clinical evidence with respect to the effectiveness of existing head support systems was found. From the user and expert consultations, a need was identified for personalised head support systems that intuitively combine changes in sitting and head position with continuous optimal support of the head to accommodate severely challenged users. This study presents the state-of-the-art in head support systems. Additionally, several important system characteristics are introduced that provide guidance for the development and improvement of head supports. Especially for the group of severely challenged wheelchair users, current head support systems require further development to improve their users' quality of life. The desired system characteristics which are discussed in this review are an important step in the definition of requirements for the next generation of head supports. [ABSTRACT FROM AUTHOR]

Rehabilitation robots with intent recognition are helping people with dysfunction to enjoy better lives. Many rehabilitation robots with intent recognition have been developed by academic institutions and commercial companies. However, there is no systematic summary about the application of intent recognition in the field of rehabilitation robots. Therefore, the purpose of this paper is to summarize the application of intent recognition in rehabilitation robots, analyze the current status of their research, and provide cutting-edge research directions for colleagues. Literature searches were conducted on Web of Science, IEEE Xplore, ScienceDirect, SpringerLink, and Medline. Search terms included "rehabilitation robot", "intent recognition", "exoskeleton", "prosthesis", "surface electromyography (sEMG)" and "electroencephalogram (EEG)". References listed in relevant literature were further screened according to inclusion and exclusion criteria. In this field, most studies have recognized movement intent by kinematic, sEMG, and EEG signals. However, in practical studies, the development of intent recognition in rehabilitation robots is limited by the hysteresis of kinematic signals and the weak anti-interference ability of sEMG and EEG signals. Intent recognition has achieved a lot in the field of rehabilitation robotics but the key factors limiting its development are still timeliness and accuracy. In the future, intent recognition strategy with multi-sensor information fusion may be a good solution. As a technology, intent recognition can become a part of rehabilitation, assist patients to complete daily life activities, and improve their quality of life. Rehabilitation training equipment for treatment usually adopts a relatively stable prediction method, which aims to stimulate the enthusiasm of users to participate in training. Functionally enhanced rehabilitation aids have high requirements for the timeliness of movement intent recognition, and its purpose is to assist patients to complete activities of daily life. [ABSTRACT FROM AUTHOR]

People with physical disabilities often require lifetime support and experience challenges to maintain or (re)define their level of independence. Assistive living technologies (ALT) are promising to increase independent living and execution of activities of daily living (ADL). This paper provides a systematic literature review that aims to analyse the present state of the literature about the impact of ALT on perceived independence of people with a physical disability receiving long-term care. Databases Embase, Medline, and Web of Science were searched for eligible studies from 2010 or later. Nine studies were included, of which seven qualitative, one quantitative, and one mixed methods. Quality was generally high. ALT enabled participants to execute ADL. We found six themes for the impact of ALT on perceived independence: feeling enabled, choice and control, feeling secure, time alone, feeling less needy, and participation. ALT appears to impact perceived independence in many ways, exceeding merely the executional aspect of independence. Existing research is limited and quite one-sided. More large-scale studies are needed in order to inform care organisations how to implement ALT, especially considering societal developments and challenges impacting long-term care. People with a physical disability receiving long-term care experience that assistive living technology impacted their independence. Their independence is increased by making them feel enabled, secure, and less needy and increasing their choice and control, time alone, and participation. Most studies focused on the use of environmental control systems by people with spinal cord injury. More research is needed to evaluate long-term effects of diverse assistive living technologies used by people with a physical disability receiving long-term care. [ABSTRACT FROM AUTHOR]

The aim of this systematic review was to evaluate the psychometric properties of the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST). Searches were conducted in August 2021 on four electronic databases: MEDLINE, CINAHL, Scopus, and Web of Science. Eligible papers included cross-sectional validation studies evaluating the psychometric properties of all QUEST versions. Cronbach's alpha, intraclass correlation coefficient, and comparison tools were reported. Study quality and risk of bias were assessed using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. Nineteen studies were included in this systematic review. Results showed that the QUEST and QUEST 2.0 were available in 10 languages, and most validation studies analysed this tool in patients using mobility devices in various clinical conditions. One article analysed the child version (QUEST 2.1) in English. The most analysed psychometric property was Cronbach's alpha for internal consistency in 14 out of 19 studies, with values ranging between 0.74 and 0.79. Overall, 17 out of 19 studies were of adequate quality, though responsiveness was never studied. Our systematic review showed that the QUEST and its subsequent versions are reliable and valid measurement instruments to evaluate satisfaction in patients with different disabilities using various assistive technologies. This study provides useful information on the instrument's psychometric properties in different populations and cultures. This systematic review verify the appropriateness of the "Quebec User Evaluation of Satisfaction with Assistive Technology" (QUEST), as a measure of satisfaction; This systematic review allow clinicians to keep up to date with new versions of the tool, new countries of validation and population in which it can be used. This study supports clinicians in making informed decisions when choosing assessment tools. [ABSTRACT FROM AUTHOR]

To analyse the versatility and adaptability of commercially available exoskeletons for mobility assistance and their adaptation to diverse pathologies through a review of clinical trials in robotic lower limb training. A computer-aided search in bibliographic databases (PubMed and Web of Science) of clinical trials published up to September 2020 was done. To be selected for detailed review, clinical trials had to meet the following criteria: (1) a protocol was designed and approved, (2) participants were people with pathologies, and (3) the trials were not a single case study. Clinical trial data were collected, extracted, and analysed, considering: objectives, trial participants, number of sessions, pathologies involved, and conclusions. The search resulted in 312 potentially relevant studies of seven commercial exoskeletons, of which 135 passed the preliminary screening; and 69 studies were finally selected. Of the 69 clinical trials included in the review about 50% involved Spinal Cord Injury participants, while roughly 25% focussed on stroke and two trials corresponded to patients with both disorders. The rest were composed of neurological diseases and trauma disorders. The use of a single wearable robot for different medical conditions in various diseases is a challenge. Based on this comparative, the properties of the exoskeletons that improve the working ability with different pathologies and patient conditions have been evaluated. Suggestions were made for developing a new lower-limb exoskeleton based on various modules with a distributed control system to improve versatility in wearable technology for different gait pattern progression. Wearable robotic exoskeletons for gait assistance have been analysed from the perspective of adaptation to different diseases. This paper emphasizes the importance of personalized therapies and adaptive assistive technology. Suggestions were made for a new modular exoskeleton capable of addressing the issue of low versatility characterizing currently wearable assistive technology. [ABSTRACT FROM AUTHOR]

The voice is an important tool for people who use it daily in their occupations. However, what technological options are available to such individuals to allow them to monitor or take care of their voices? The purpose of this study is to answer two research questions: (1) What technologies exist to monitor or take care of the voice in occupational voice users? (2) What is the technology readiness level (TRL) of the technologies used to monitor or take care of the voice in occupational voice users? Embase, IEEE, Medline, Proquest, PubMed, Scopus, and Web of Science, A systematic literature review was conducted. Articles that reported results regarding technologies (hardware, software, or mobile apps) that were used to monitor or take care of the voice in occupational voice users were included. After reviewing 4581 abstracts, 10 full text studies were included in the literature review. The technologies found include 30% hardware, 30% hardware plus software, and 50% mobile apps, with an overall TRL mean of 5.3 (SD = 2.3). Further research is necessary for higher validity in the studies and to increase the readiness in the development of current technologies to offer more options for this population. The evidence for the impact of the use of the technologies for occupational voice users is still low There is emerging evidence that mobile apps and artificial intelligence algorithms can be used to investigate vocal disorders or potential risks in occupational voice users More research is required to increase the readiness developmental stage of current technologies for occupational voice users [ABSTRACT FROM AUTHOR]

Walking outdoors has many benefits which can improve quality of life for people living with dementia. However, due to the risk of getting lost, many people with dementia are denied the opportunity to be outdoors. There has been increased interest in using global positioning systems (GPS) to facilitate independent outdoor mobility for people with dementia, but this interest has been accompanied by ethical debate focussing on the rights of an individual with dementia to maintain privacy and autonomy. The objective was to establish what people, those with dementia, those who provide support for people with dementia and wider society perceive to be the issues around GPS use. Method: An adapted qualitative systematic review was conducted between November 2018 and December 2018. Medical, social and technological databases were searched for papers with no date restriction. Initial search terms displayed nine hundred and sixty citations. Titles and if necessary abstracts were read to determine which studies might be potentially relevant. Forty papers were identified as potentially relevant and their abstracts and references examined. This produced a further four potential studies. Following application of the exclusion criteria thirty papers were eliminated.Fourteen were accepted, appraised and thematically analyzed. Results: The ethical debate was reflected in the opinions of the study respondents. There was a willingness to relinquish some privacy for safety but people with dementia were not prepared to sacrifice their autonomy—believing they alone should decide whether GPS was appropriate. Conclusion: GPS was felt to have the potential to facilitate independent outdoor walking, but systems need to be tailored to the individual. There is also a need to contradict negative societal perceptions of the ability of people with dementia to live a fulfilled life which is in danger of diminishing GPS's potential to improve quality of life for people with dementia. Whilst dementia is a disabling and incurable disease, taking advantage of technological developments such as GPS can diminish its negative impact. Appropriate development and use of GPSs offers the potential to enable people with dementia to explore the outdoors independently with subsequent improvement in self-confidence, independence and autonomy. Professionals working with people with dementia need to be aware of the GPS technology available and the ethical issues involved to support the use of GPS. [ABSTRACT FROM AUTHOR]

The use of assistive technology (AT) for people with disabilities is well researched and prevalent in education. Growing numbers of students now self-identify as having mental health diagnoses and register for accommodations at post-secondary institutions. The apparent gap in the literature specifically relating to AT support in this population necessitated a more systematic search. This scoping review maps the literature regarding AT interventions to support young adults with mental health disabilities in post-secondary institutions such as universities and colleges. Four major databases were searched for topic keywords. Abstracts and final papers were screened against the inclusion and exclusion criteria, with seven studies identified as relevant. The reported common problems faced by students were academic, psychosocial and cognitive in nature and they affected day-to-day activities. AT identified loosely fit into the categories of note-taking alternatives, smartphones, multimedia presentations to support text material, alternate participation supports, graphic organizers, text-to-speech software, and other AT writing and visualization tools. Future research is needed on outcomes of AT implementation in this population and to explore the apparent lack of awareness of these supports by students and service providers, as evidenced by the limited research identified by this scoping review. There appears to be a gap in access to assistive technology (AT) to students with mental health disabilities, except when the student has concurrent physical or learning disabilities These students have additional barriers as they have little or no prior knowledge of AT, having not been previously identified in high school as needing or receiving AT AT rehabilitation would level the playing field for students with mental health disabilities, making education and student participation more accessible thus improving overall student experience [ABSTRACT FROM AUTHOR]

Explore methods used in peer-reviewed literature for obtaining self-expression of well-being information from children with severe motor and communication impairment (SMCI). A comprehensive search was conducted on 22 August 2019 through academic databases: CINAHL; Embase; MEDLINE; PsycINFO; InSpec; Compendex. Search strategies were informed by keywords under the following areas: (1) population: children with SMCI, (2) assessment methods: alternative to natural speech, paper and pencil report or standardized keyboard use (e.g., eye gaze) and (3) target information: well-being (e.g., quality of life). Studies were excluded if they focused on individuals over 25-years old, exclusively autism or typically developing children. Non-duplicate studies of 10,986 were screened; 49 studies met inclusion criteria. Most studies used high-tech methods of self-expression in a single context (n = 17). Familiar partners play a significant role in self-expression; 18 studies required a familiar partner for children with SMCI to self-express. Thirty-five studies involved children self-expressing to solely adults, in comparison to 14 studies which involved peers. Findings highlight the advancement of high-tech communication devices restricted to application in single contexts. Familiar partner knowledge of children with SMCI has the potential to be shared with others (e.g., respite care providers), enhancing both caregiver and child well-being. Future research that would enhance the literature could explore the assessment of emotional well-being for application in various contexts using multimodal methods. Opportunities for children with SMCI to express their emotional well-being can further influence the understanding and enhancement of participation, social connections, and experiences. Use of lower tech methods of self-expression to obtain information directly from children with severe motor and communication impairment (SMCI) remain more feasible in home and school contexts. By utilizing familiar partners' experiences and knowledge of the child, respite care providers, novel support workers, and others involved in the lives of children with SMCI can become further informed. Current high-tech methods for obtaining the emotional expressions of children with SMCI may benefit from incorporating multimodal approaches including lower tech methods, to be feasibly applied in real world contexts where well-being takes place. Further research on this topic is imperative to enable children with SMCI to self-express their emotional well-being which can enhance participation, activities, social connections, and experiences. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to answer two research questions: (1) What is the clinical evidence for the reported outcomes in studies on electronic pillboxes for older adults? and (2) What is the technology readiness level (TRL) of the electronic pillboxes used, or intended to be used, for older adults? Methods: The scholarly literature was systematically searched and analyzed. Articles were included if they reported results about electronic pillboxes that were used or intended to be used for older adults' medication. Results: Clinical studies used commercially well-established electronic pillboxes with a high TRL. New electronic pillboxes in development had a low TRL. The discovered outcome was mainly adherence to medication. The overall mean adherence to medication regimens for all the studies using an electronic pillbox was higher than the gold standard of a good adherence level cut-off point (mean adherence 88.8%>80%). However, we found a large variation in this variable (SD = 10.7). With regard to an older adult population's adherence to medication regimens, for the outcome variable of those who had undergone a kidney transplant, the clinical evidence that electronic pillboxes have a positive impact was strong (1b); for those with a chronic hepatitis C medical condition, the clinical evidence was medium (3), and for those with arterial hypertension and multiple chronic (diabetes and hypertension) medical conditions, the clinical evidence was weak (5). Conclusion: More research is needed in this area using designs that provide greater validity. Electronic pillboxes with multiple reminders such as the "voice of a friend" or relative, which implies that electronic pillboxes which adopt "a social role" are advisable. An unequal level of clinical evidence that electronic pillboxes have a positive impact on the adherence outcome variable was found. For new electronic pillboxes still in development that specifically take into account older adults' needs, the TRL is still low; as a result, they could not be tested in real settings. [ABSTRACT FROM AUTHOR]

Digital technologies have a great potential to improve the quality of life of people with dementia. However, this group is usually not involved in their development and dissemination. A consumer-directed role in the delivery of digital technologies could allow this group to regain autonomy and certain independence. This article aims to conceptualise the components of the Consumer Direction theory in the context of digital technologies and people with dementia. A literature review was conducted. We searched for studies within the aforementioned context in five relevant databases, covering the years 2012–2020. Identified studies were screened and assessed for inclusion. The data were categorised using two-stage qualitative content analysis. Forty articles were included. The results provide definitions of the four components of the Consumer Direction theory in the context of this study. Namely, what it means for people with dementia to be (1) in control of technology use, (2) offered a variety of technological options, (3) informed and supported regarding the use and training of digital technologies, and (4) actively participating in systems design. These can lead to the empowerment of people with dementia. The four theoretical components of the Consumer Direction theory are conceptualised differently in the context of this study. By providing new definitions, this paper contributes to research and practice. We expect the definitions to be deployed by researchers, practitioners, and policymakers for the creation of a more consumer-directed delivery of digital technologies to people with dementia. Digital technologies have a great potential to improve the quality of life of people with dementia. A consumer-directed role in the delivery of digital technologies could empower people with dementia and give them the opportunity to take control over the offered services as well as maintain a degree of independence. The Consumer Direction theory and its components should be conceptualised differently in the context of digital technologies and people with dementia than in previous contexts that used the theory. The new definitions can be utilised by researchers, practitioners and policymakers for the creation of a more consumer-directed delivery of digital technologies to people with dementia. [ABSTRACT FROM AUTHOR]

More than 80% of people living with Amyotrophic Lateral Sclerosis (plwALS) develop difficulties with their speech, affecting communication, self-identity and quality of life. Automatic speech recognition technology (ASR) is becoming a common way to interact with a broad range of devices, to find information and control the environment. ASR can be problematic for people with acquired neurogenic motor speech difficulties (dysarthria). Given that the field is rapidly developing, a scoping review is warranted. This study undertakes a scoping review on the use of ASR technology by plwALS and identifies research gaps in the existing literature. Electronic databases and relevant grey literature were searched from 1990 to 2020. Eleven research papers and articles were identified that included participants living with ALS using ASR technology. Relevant data were extracted from the included sources, and a narrative summary of the findings presented. Outcomes and Results: Eleven publications used recordings of plwALS to assess word recognition rate (WRR) word error rate (WER) or phoneme error rate (PER) and appropriacy of responses by ASR devices. All were found to be linked to severity of dysarthria and the ASR technology used. One article examined how speech modification may improve ASR accuracy. The final article completed thematic analysis of Amazon.com reviews for the Amazon Echo and plwALS were reported to use ASR devices to control the environment and summon assistance. There are gaps in the evidence base: understanding expectations of plwALS and how they use ASR technology; how WER/PER/WRR relates to usability; how ASR use changes as ALS progresses. Devices that people can interact with using speech are becoming ubiquitous. As movement and mobility are likely to be affected by ALS and progress over time, speech interaction could be very helpful for accessing information and environmental control. However, many people living with ALS (plwALS) also have impaired speech (dysarthria) and experience trouble using voice interaction technology because it may not understand them. Although advances in automated speech recognition (ASR) technology promise better understanding of dysarthric speech, future research needs to investigate how plwALS use ASR, how accurate it needs to be to be functionally useful, and how useful it may be over time as the disease progresses. [ABSTRACT FROM AUTHOR]

Assistive technology can provide a key tool to enabling independence, greater inclusion and participation in society for individuals with chronic conditions. This potential is currently not always realized due to barriers to accessing and using assistive technology. This review aims to identify the common barriers to acquiring and using assistive technology for users with chronic conditions through a systematic meta-synthesis. This differs from other systematic reviews by applying a transdiagnostic approach to identify if barriers are common across chronic conditions. A systematic literature search of five scientific databases (PubMed, SCOPUS, PsycINFO, CINAHL and Medline) was conducted to identify relevant qualitative studies. The search was conducted in November 2019. For the identified articles, thematic content analysis was conducted and the methodological quality was evaluated using the Critical Appraisal Skills Programme (CASP) checklist for qualitative research. Forty papers met the inclusion criteria and were included in the analysis. Fifty-one descriptive themes grouped into six overarching analytical themes were identified from the studies. The analytical themes identified were: the design and function of the assistive technology, service provision, information and awareness, psychological barriers, support network and societal barriers. The barriers are interconnected and common across different health conditions. More involvement in personalized care for developing strategies, adaptation of home technologies and provision of assistive technology could overcome the service provision and design barriers to assistive technology. Accessible information and providing greater awareness will be important to overcoming information, psychological and societal barriers to assistive technology. Individuals with chronic conditions face complex barriers to acquiring and using assistive technology as a result of the devices themselves, their individual context, the healthcare context where assistive technology is provided and wider societal barriers. The provision of assistive technology needs to change away from the traditional medical model of the "expert" clinician and instead focus on more user involvement to deliver personalised care that utilises the users lived knowledge and experiences. Assistive technology provision should be considered alongside how to adapt everyday mainstream technology to meet user needs; the provision of devices should encourage creative problem solving rather then relying on pre-defined prescription lists of assistive technology. [ABSTRACT FROM AUTHOR]

Systematic evaluation and meta-analysis of the effects of digital noise reduction (DNR) algorithms on speech intelligibility, sound quality and listening effort in adult populations. Systematic review and meta-analysis. Six databases were searched for experimental studies published from 2000 to 2017 in English using the following search terms: "hearing aid" and "noise reduction". A total of 264 unique hits were obtained; out of which, 16 studies were included. The population effect was estimated for speech intelligibility and other subjective measures. From six studies, the population effect estimated for speech intelligibility measures was small (r = 0.28) with zero population variance. Sample size variance accounted for all the effect size variations found across studies. The population effect for subjective measures was medium (r = 0.46 ± 0.10) as calculated from seven studies. Based on a criterion of moderate evidence, this meta-analysis did not reveal a consistent improvement in speech intelligibility with DNR in adult population. The subjective outcome measures (e.g., acceptable noise level and sound quality judgment) showed a moderate positive effect of DNR. The findings of the study will provide useful clinical information in follow up visits in audiologic rehabilitation. The meta-analysis of DNR informs clinicians to create realistic expectations in hearing aid users. This paper summarizes the available data on different outcome measures such as speech intelligibility, listening effort and sound quality. The results of this meta-analysis will help clinical audiologists in devising hearing aid orientation and counseling. [ABSTRACT FROM AUTHOR]

Purpose:The purpose of this study is to examine the extent and type of robots used for the rehabilitation and education of children and young people with CP and ASD and the associated outcomes. Methods:The scholarly literature was systematically searched and analyzed. Articles were included if they reported the results of robots used or intended to be used for the rehabilitation and education of children and young people with CP and ASD during play and educative and social interaction activities. Results:We found 15 robotic systems reported in 34 studies that provided a low level of evidence. The outcomes were mainly for children with ASD interaction and who had a reduction in autistic behaviour, and for CP cognitive development, learning, and play. Conclusion:More research is needed in this area using designs that provide higher validity. A centred design approach is needed for developing new low-cost robots for this population. Implications for rehabilitationIn spite of the potential of robots to promote development in children with ASD and CP, the limited available evidence requires researchers to conduct studies with higher validity.The low level of evidence plus the need for specialized technical support should be considered critical factors before making the decision to purchase robots for use in treatment for children with CP and ASD.A user-entered design approach would increase the chances of success for robots to improve functional, learning, and educative outcomes in children with ASD and CP. We recommend that developers use this approach.The participation of interdisciplinary teams in the design, development, and implementation of new robotic systems is of extra value.We recommend the design and development of low-cost robotic systems to make robots more affordable. [ABSTRACT FROM PUBLISHER]

Background: Safe patient handling practices reduce injury risk for healthcare workers (HCW) and patients, but may conflict with goals of rehabilitation and person-centred care by minimizing (a) active participation in transfers and (b) autonomy and dignity while using mechanical lifts. Active assist transfer devices (AATDs) have potential to address both safety and support needs for appropriate clients. Purpose: What is the scope and nature of the evidence to support the use of AATD for improving transfer safety for patients and caregivers in both hospital and community settings? Methods: Scoping review of peer-reviewed and Gray literature, using systematic search strategies and multiple reviewers for identifying papers and extracting data. Findings: Twenty-nine peer-reviewed publications, and 12 other documents (policy, technical) were included in the review. Half focused on HCW safety in the hospital setting, with only seven addressing patient safety in the community. Generally, literature was of low quality, with no controlled trials to support the benefit of this equipment, and often represented a nursing care perspective. However, positive outcomes reported included safety, satisfaction, and equipment utilization. Implications: There is a need for rigorous research on use of AATDs in the community comparing rehabilitation outcomes across other forms of transfer equipment. Other important targets include injury risk for family caregivers, and potential to support early discharge. At present, utilization of AATDs within the rehabilitation field will continue to rely on best judgement of the care team. Implementation of AATDs should be considered a compelling target for practice-based research and quality improvements. The use of active assist transfer devices is associated with their availability in the in-patient hospital setting. The use of active assist transfer devices is associated with positive patient experience, such as increased patient satisfaction and dignity. Improved patient adherence and cooperation with healthcare workers during mobilization and rehabilitation may follow. Most current evidence is focused on caregiver safety outcomes and is in support of decreased injury rates with increased active assist transfer device use. There is a limited amount of evidence focusing on the rehabilitation outcomes with active assist transfer device use. With current evidence, the use of AATDs should be used at the discretion of the care team. [ABSTRACT FROM AUTHOR]

Aim: The aim of this review paper is to summarize recent developments and research in robotics, relevant to the field of ankle rehabilitation, to overview new findings and determine the actual state of the art. Method: The literature search was performed using scientific and medical databases (Scopus, PubMed and Web of Science) and other websites related to robots used in the area of ankle rehabilitation, analysing studies from 1950s to present. Information about the mechanical and kinematic specifications, actuation and stage of development was extracted from the selected literature. Results: Several types of rehabilitation robots have been considered, and they were classified depending on their architecture and design features. We we found that, regardless of the differences in architectures, only a few of them have been commercialized. The majority of rehabilitation robots designs allows plantarflexion-dorsiflexion movements. Unless some exceptions, most of the wearable robots do not allow the adduction-abduction movement. Neither the physical appearance of the robot nor the user's perception towards it has not regularly been taken into account in the design stage. This limits the possibility of successful commercialization. Conclusions: Up to the present moment, the main challenges in the field of robot rehabilitation are the lack of unique rehabilitation protocols capable to fulfil the needs of all types of patients and the additional resources to measure the effectiveness of proposals that have not yet been commercialized. Nonetheless, we have mentioned above three areas were the challenges in design are more pressing. The first one is the robot architecture, which still presents some incommodities nowadays to emulate the ankle joint movement in a natural way. Thus, the displacements experienced by the axes in the joint must be adaptable to each patient and a wide range of pathologies. Moreover, many proposals are not been conceived to the purpose of commercialization, and even less to become an object of personal use. This review states that the use of robotic devices for ankle rehabilitation is a consolidated paradigm in the ankle's rehabilitation. Platform-based robots allow to do complex and specialized spatial movements and these architectures endow the device with high stiffness, a balanced force distribution and better adaptability to the mechanical properties of human ankle joints. Unless some exceptions, most of the wearable robots do not allow the adduction-abduction movement. For a full integration of these technologies in the ankle's rehabilitation field, more clinical evaluations are needed. Regardless of the potential of robotic devices in rehabilitation, only a few of them have been commercialized. [ABSTRACT FROM AUTHOR]

Purpose:The purpose of this study is to identify the objective physical activity (PA) measurement tools and outputs that are used within Multiple Sclerosis (MS) literature. Methods:A systematic search strategy on eight databases (2000–2016) using keywords associated with MS and PA. Results:This review includes 32 papers. Uni-axial accelerometers were the most popular objective PA tool in this review (68%). Pedometers (14%) and multi-sensor systems (3%) were the second and third most common. PA outputs included activity counts per day, steps per day, energy expenditure per day, minutes of moderate-vigorous PA (MVPA), minutes of light PA and daily dynamic activity. Both activity counts per day (n = 21 studies), and steps per day (n = 11 studies) were most commonly used representing 78%. Conclusion:Uni-axial accelerometers and pedometers are the most popular PA measurement tools used in MS literature. However, developments in the field mean that most new sensors are tri-axial, and multi-sensor systems are also available. Researchers should use devices with published validation information, and should utilize the detail on activity patterns available from accelerometer measurement instead of expressing a single unit such as activity counts or step counts per day. Attention to capturing the duration, frequency, intensity and energy expended during daily PA is warranted. Implications for RehabilitationThe review reports that accelerometers were the research tool most frequently reported in the literature, though there were differences in device type and in how activity data was extracted from the stored information.The majority of research studies of physical activity levels in Multiple Sclerosis fail to provide an adequate range of activity outcomes, frequently using outcomes which do not allow simple cross-comparisons with other populations. [ABSTRACT FROM PUBLISHER]

Background:Clinical guidelines recommend that, in order to minimize upper limb injury risk, wheelchair users adopt a semi-circular pattern with a slow cadence and a large push arc. Objectives:To examine whether real time feedback can be used to influence manual wheelchair propulsion biomechanics. Review methods:Clinical trials and case series comparing the use of real time feedback against no feedback were included. A general review was performed and methodological quality assessed by two independent practitioners using the Downs and Black checklist. The review was completed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guidelines. Results:Six papers met the inclusion criteria. Selected studies involved 123 participants and analysed the effect of visual and, in one case, haptic feedback. Across the studies it was shown that participants were able to achieve significant changes in propulsion biomechanics, when provided with real time feedback. However, the effect of targeting a single propulsion variable might lead to unwanted alterations in other parameters. Methodological assessment identified weaknesses in external validity. Conclusions:Visual feedback could be used to consistently increase push arc and decrease push rate, and may be the best focus for feedback training. Further investigation is required to assess such intervention during outdoor propulsion. Implications for RehabilitationUpper limb pain and injuries are common secondary disorders that negatively affect wheelchair users’ physical activity and quality of life.Clinical guidelines suggest that manual wheelchair users should aim to propel with a semi-circular pattern with low a push rate and large push arc in the range in order to minimise upper limbs’ loading.Real time visual and haptic feedback are effective tools for improving propulsion biomechanics in both complete novices and experienced manual wheelchair users. [ABSTRACT FROM PUBLISHER]

The focus of research using technological innovations such as robotic devices has been on interventions to improve upper extremity function in neurologic populations, particularly patients with stroke. There is a growing body of evidence describing rehabilitation programs using various types of supportive/assistive and/or resistive robotic and virtual reality-enhanced devices to improve outcomes for patients with neurologic disorders. The most promising approaches are task-oriented, based on current concepts of motor control/learning and practice-induced neuroplasticity. Based on this evidence, we describe application and feasibility of virtual reality-enhanced robotics integrated with current concepts in orthopaedic rehabilitation shifting from an impairment-based focus to inclusion of more intense, task-specific training for patients with upper extremity disorders, specifically emphasizing the wrist and hand. The purpose of this paper is to describe virtual reality-enhanced rehabilitation robotic devices, review evidence of application in patients with upper extremity deficits related to neurologic disorders, and suggest how this technology and task-oriented rehabilitation approach can also benefit patients with orthopaedic disorders of the wrist and hand. We will also discuss areas for further research and development using a task-oriented approach and a commercially available haptic robotic device to focus on training of grasp and manipulation tasks.Implications for RehabilitationThere is a growing body of evidence describing rehabilitation programs using various types of supportive/assistive and/or resistive robotic and virtual reality-enhanced devices to improve outcomes for patients with neurologic disorders.The most promising approaches using rehabilitation robotics are task-oriented, based on current concepts of motor control/learning and practice-induced neuroplasticity.Based on the evidence in neurologic populations, virtual reality-enhanced robotics may be integrated with current concepts in orthopaedic rehabilitation shifting from an impairment-based focus to inclusion of more intense, task-specific training for patients with UE disorders, specifically emphasizing the wrist and hand.Clinical application of a task-oriented approach may be accomplished using commercially available haptic robotic device to focus on training of grasp and manipulation tasks. [ABSTRACT FROM PUBLISHER]

Stroke is the main cause of long-term disability and happens mostly in the older population. Stroke affected patients experience either of the cognitive, visual or motor losses and recovery requires time and patience as they have to do physical exercises every day and at times repetitively. There are various types of stroke rehabilitation exercises focussing on technological solutions that include therapies performed using games. Motion-based games are popular in encouraging participants to perform repetitive tasks without being getting bored. Therefore, in this study, we have explored studies that included the use of games for stroke rehabilitation to understand the design principles and characteristics of the games used for these purposes. A number of medical respositories were searched for relevant articles in a window of 2008-2018. 18 studies were chosen for the scoping review depending on the inclusion criteria, and design principles used in these studies are analysed and evaluated. We present main findings from our review concerning the attributes of existing games for stroke rehabilitation such as meaningful play, handling of failures, emphasising challenge, and the value of feedback. We conclude with a list of design recommendations that future serious game developers can consider while designing interfaces for stroke patients. This review exhibits that the usage of gaming technologies is a very effective interactive mechanism for stroke based rehabilitation. Further our review also shows that serious games provide an avenue and opportunity for customized and highly contextualized gameplay Our review also suggests that effective features to incorporate into serious games for rehabilitation includes; facilitating challenge and recovery from errors. [ABSTRACT FROM AUTHOR]

To review the rating scales used to evaluate usability and quality of mobile health applications, and to compare their purpose, content, and intended target users (i.e., patients, caregivers, or researchers). We conducted a systematic review of the literature in accordance with the PRISMA statement on Medline, CINAHL, PsycINFO, IEEE Explore databases, as well as a review of the grey literature to identify rating scales used to evaluate usability and quality of mobile health applications (m-health apps), between January 1, 2000 and July 31, 2018. Two researchers screened the titles and abstracts of articles that met inclusion criteria, and retrieved usability and quality rating scales from the articles. We identified 24 usability scales and 25 quality rating scales in 87 peer-reviewed articles. We identified only one quality rating scale designed for non-expert users (i.e., patients or caregivers). None of the studies used a theoretical framework for app evaluation to support the scales. The validity of existing quality rating scales is yet to be investigated. Existing usability and quality rating scales are targeted at professionals, not end users who are patients or caregivers. Rating scales that are usable by all end-users would make mobile health apps accessible and meaningful to consumers. The number of mobile health applications on app stores that can be used for rehabilitation is increasing. Most healthcare providers lack the training to identify m-health apps with high quality to be used in rehabilitation. This study has reviewed the current rating scales that can help clinicians and care providers rate the quality of m-health apps and identify the ones that are most appropriate for their practice. [ABSTRACT FROM AUTHOR]

Purpose: Rehabilitation professionals have little information concerning lower limb exoskeletons for people with paraplegia. This study has four objectives: (1) Outline the characteristics of the exoskeletons’ design and their usefulness evidence as assistive mobility devices in the community for the Rewalk™, Mina, Indego®, Ekso™ (previously known as the eLEGS™) and Rex®; (2) document functional mobility outcomes of using these exoskeletons; (3) document secondary skills and benefits achieved with these exoskeletons, safety, user satisfaction and applicability in the community; and (4) establish level of scientific evidence of the selected studies.Method: A systematic review of the literature (January 2004 to April 2014) was done using the databases PubMed, CINAHL and Embase and groups of keywords associated with “exoskeleton”, “lower limb” and “paraplegia”.Results: Seven articles were selected. Exoskeleton use is effective for walking in a laboratory but there are no training protocols to modify identified outcomes over the term usage (ReWalk™: 3 months, Mina: 2 months and Indego®: 1 session). Levels of evidence of selected papers are low.Conclusions: The applicability and effectiveness of lower limb exoskeletons as assistive devices in the community have not been demonstrated. More research is needed on walking performance with these exoskeletons compared to other mobility devices and other training contexts in the community.Implications for rehabilitationCharacteristics of the exoskeletons’ design and their usefulness evidence as assistive mobility devices in the community are addressed for the Rewalk™, Mina, Indego®, Ekso™ and Rex® ReWalk™, Indego® and Mina lower limb exoskeletons are effective for walking in a laboratory for individuals with complete lower-level SCI.The ReWalk™ has the best results for walking, with a maximum speed of 0.51 m/s after 45 sessions lasting 60 to 120 min; it is comparable to the average speed per day or per week in a manual wheelchair.The level of scientific evidence is low. Other studies are needed to provide more information about performance over the longer term when walking with an exoskeleton, compared to wheelchair mobility, the user’s usual locomotion, the use of different exoskeletons or the training context in which the exoskeleton is used. [ABSTRACT FROM PUBLISHER]

Over one billion people with disabilities (PWDs) and older adults with mobility impairment are currently in need of assistive technology devices (ATDs) and only 10% of those population have ordinarily access to them. The need for advancement in mobility-assistive technology is growing to address the gap in ATDs provision globally. The purpose of this review is to identify potential future areas of development and research in mobility-assistive technology. Publications were identified using scientific and medical electronic databases. Also, a limited grey literature search was conducted to muster a variety of sources. A combination of keyword search terms was used, corresponding to the medical subject heading (MeSH) terms. A total of 392 articles were identified, of which 75 were selected for detailed review. Twenty-eight articles were identified that met the review's inclusion criteria. Future areas of research for mobility-assistive technology were identified by grouping the publications into four main categories. The findings of this review identified several areas of research and development in ATDs in general and mobility-assistive technology, in particular, with special attention to the importance of engaging users and stakeholders in the process of research and design. It is apparent that users' needs and priorities vary between regions within countries. The majority of studies were noted to mainly identify consumers' perspectives on a national basis. The authors, therefore, suggest that further research should be conducted on a global level to determine the knowledge and perspectives concerning future research and development needs and priorities in mobility-assistive technologies. Despite the benefits derived from the use of ATDs, only 10% of people with disabilities have access to them. Increasing access, quality and affordable ATDs in all countries is global demand. Identifying mobility consumers' needs and priorities would help in enhancing their quality of life by translating research into new technologies that meet their environment and culture needs. Users' involvement in research and design process is a crucial approach to re-shape the future research agenda. [ABSTRACT FROM AUTHOR]

Novel developments in the robotics field have produced systems that can support person wheelchair transfers, maximize safety and reduce caregiver burden. The purpose of this study was to identify and describe these systems, their usability (or satisfaction), the context for which they have been or can be used and how they have been evaluated to determine evidence for their effectiveness. Available research on Person Transfer Assist Systems (PTAS) was systematically gathered using similar standards to the PRISMA guidelines. The search terms were derived from common terms and via exploring similar review articles. Initial search terms displayed 1330 articles and by using the inclusion/exclusion criteria 96 articles were selected for abstract review. After full- text reviewing 48 articles were included. 29 articles concerned research in robotic transfer systems, 10 articles used both ceiling and floor-mounted lifts and 9 articles used only floor-mounted lifts as an intervention/control group. The results of this analysis identified a few usability evaluations for robotic transfer prototypes, especially ones comparing prototypes to existing marketed devices. Robotic device research is a recent development within assistive technology. Whilst usability evaluations provided evidence that a robotic device will provide better service to the user, the sample number of subjects used are minimal in comparison to any of the intervention/control group articles. Experimental studies between PTASs are required to support technological advancements. Caregiver injury risk has been the focus for most of the comparison articles; however, few articles focus on the implications to the person. Ceiling mounted lifts are preferred over floor-based lifts due to lower injury rates. Many robotic transfer systems have been developed; however, there is a paucity of quantitative and qualitative studies. Based on the results of this review, rehabilitation settings are recommended to use ceiling over floor assist systems, and it is recommended to provide training on using devices to assist with patient transfers to lower the risk of injuries. [ABSTRACT FROM AUTHOR]

Modified ride-on cars (MROC) are a low-cost option to provide self-directed mobility to children with mobility limitations, in lieu of or as a precursor to other powered mobility devices. We appraised evidence to (1) describe and categorize MROC study characteristics, (2) synthesize existing knowledge of children's use of MROCs and (3) frame outcomes within the International Classification of Functioning, Disability and Health (ICF) framework. Articles were identified through four electronic databases: Medline, CINAHL, PsycNET, and Web of Science. We included all published, peer-reviewed studies involving MROC use. Relevant data were extracted, and articles were appraised using the American Academy of Cerebral Palsy and Developmental Medicine criteria for group and single-subject designs. 23 studies met inclusion criteria of 204 titles identified from 1980 to 2021. Study designs included case studies, case series, group designs, and qualitative research, but only three studies were rated evidence level III or higher. Children with a range of disabilities used MROCs across multiple settings, including the home, hospital, and community, though use and adherence varied widely. Positive impacts were reported on a range of outcomes related to the ICF framework, with an emphasis on activity and participation. MROC studies have primarily addressed activity and participation, with most studies suggesting increased functional mobility and social interactions due to MROC use. More robust research designs with larger samples are needed in order to develop evidence-based strategies for MROC use. Physical and occupational therapists may consider using MROCs as a therapeutic tool or accessible play opportunity as part of a multi-modal approach to increase children's mobility, family engagement, and participation in community life. Personal (e.g., child's enjoyment) and environmental factors (e.g., caregiver attitudes and stress) must be considered when developing plans of MROC use. [ABSTRACT FROM AUTHOR]

Although studies addressing barriers to and facilitators of implementation of welfare technology have been published, no systematic review synthesising evidence on such factors has been found. The purpose of this study was therefore to identify and synthesise existing primary research on facilitators and barriers that influence the implementation of welfare technology for older people, people with disabilities and informal caregivers. A systematic search in 11 databases was performed using predefined inclusion and exclusion criteria to identify empirical studies that assess the implementation of welfare technology for older people, people with disabilities or informal caregivers. The search identified 33 publications with quantitative, qualitative and mixed method designs. The reported findings were thematically synthesised and conceptualised into themes. Six themes of facilitators and barriers that influence the implementation of welfare technology emerged: capacity, attitudes and values, health, expectations, participation and identity and lifestyle. These were presented from five perspectives: older persons and persons with disabilities, informal caregivers, health and care personnel, organisation and infrastructure and technology. The findings may be used as a means to structure the planning and evaluation of implementation processes of welfare technologies for older persons and persons with disabilities and to understand the complexities of implementation. This knowledge generates deepened insights and structures to guide and evaluate the implementation processes of welfare technologies and engenders an understanding of the complexities of implementation. When planning for the implementation of welfare technology for older people and persons with disabilities, it is important to consider capacity, attitudes and values, health, expectations, participation, and identity and lifestyle. Using the result from the study facilitates deepened insights and structures for evaluation of implementation processes of welfare technologies and brings an understanding of the complexities of implementation. Welfare technology should be available, safe, usable and fit the user's daily lives. Implementable welfare technology should focus on needs, but also consider design and possible experienced stigma related to the identity of being a welfare technology user. [ABSTRACT FROM AUTHOR]

Route planning is key support, which can be provided by navigation tools for the blind and visually impaired (BVI) persons. No comprehensive analysis has been reported in the literature on this topic. The main objective of this study is to examine route planning approaches used by indoor navigation tools for BVI persons with respect to the route determination criteria, how user context is integrated, algorithms adopted, and the representation of the environment for route planning. A systematic review was conducted covering the period 1982–July 2018 and thirteen databases. From the 1709 articles that resulted from the initial search, 131 were selected for the study. Route length was the sole factor used to determine the best route in the majority of the studies. Routes with less obstacles, less turns, more landmarks and close to walls were selected by the other studies. User variations were considered in few studies. Unique needs of the BVI persons were addressed by few novel algorithms which had integrated multiple parameters and BVI-friendly route modelling. Differences between the navigation capabilities of the sighted and the BVI community were not a major concern when deciding the optimum routes in the majority of BVI indoor navigation tools. How to trade-off between factors affecting optimum routes, and how to model suitable routes in complex buildings needs to be studied further, looking from the user perspective. Navigation differences between sighted and blind and vision-impaired (BVI) communities are not concerned frequently when planning routes in indoor navigation tools of BVI persons. Selecting routes avoiding areas difficult to traverse, close to walls, having landmarks, and less turns are some approaches used to address the unique needs of the BVI community. Assisting for recovery from veering and real-time obstacle detouring are useful features offered by these tools. Identifying and prioritizing different factors contributing to better routes, concerning user variations, and adopting multi-objective route optimization will help to develop improved route planning methodologies for BVI indoor navigation tool [ABSTRACT FROM AUTHOR]

Stroke, spinal cord injury and other neuromuscular disorders lead to impairments in the human body. Upper limb impairments, especially hand impairments affect activities of daily living (ADL) and reduce the quality of life. The purpose of this review is to compare and evaluate the available robotic rehabilitation and assistive devices that can lead to motor recovery or maintain the current motor functional level. A systematic review was conducted of the literature published in the years from 2016–2021, to focus on the most recent rehabilitation and assistive devices available in the market or research environments. A total of 230 studies published between 2016 and 2021 were identified from various databases. 107 were excluded with various reasons. Twenty-eight studies were taken into detailed review, to determine the efficacy of robotic devices in improving upper limb impairments or maintaining the current level from getting worse. It was concluded that with a good strategy and treatment plan; appropriate and regular use of these robotic rehabilitation and assistive devices do lead to improvements in current conditions of most of the subjects and prolonged use may lead to motor recovery. Stroke, accidents, spinal cord injuries and other neuromuscular disorders lead to impairments. Upper limb impairments have a tremendous adverse affect on ADL and reduces quality of life drastically. Advancement in technology has led to the designing of many robotic assistive and rehabilitation devices to assist in motor recovery or aid in ADL. This review analyses different available devices for rehabilitation and assistance and points out that use of these devices in time does help in motor recovery. Most of the studies reviewed showed improvements for the user. Future devices should be more portable and easier to use from home, [ABSTRACT FROM AUTHOR]

Objective: To review the literature comparing use of anterior and posterior walkers (PW’s) by children with cerebral palsy (CP) to determine which walker type is preferable.Methods: Electronic databases were searched using pre-defined terms by two independent reviewers. Reference lists of included studies were hand searched. Studies published between 1985 and 2016 comparing use of anterior and PW’s by children with CP were included. All study designs and outcomes were accepted. Risk of bias was assessed using the “Quality assessment standard for a cross-over study”. Quality of evidence was evaluated using GRADE.Results: Six studies were analysed. All studies had small sample sizes. A total of 4/6 studies were randomized. A total of 4/6 had high risk of bias. Outcomes included velocity, pelvic tilt, hip flexion, knee flexion, step length, stride length, cadence, double stance time, oxygen cost and participant/parental preference. Velocity, trunk flexion/pelvic tilt, and stability may be improved by using a PW, however, GRADE quality was very low for all outcomes and there was heterogeneity between studies. The majority of participants and parents preferred the PW.Conclusions: Heterogeneity and low quality of existing evidence prevented recommendation of one walker type. Well-designed studies with adequate power are needed to inform clinical recommendations. Implications for rehabilitation Clinical recommendations cannot be made for whether anterior or posterior walkers are preferable for children with cerebral palsy based on the existing evidence.Velocity, trunk flexion/pelvic tilt, and stability may be improved by using a posterior walker.The majority of walking aid users and their parents preferred posterior walkers.Adequately powered studies designed to minimize bias are needed. [ABSTRACT FROM AUTHOR]

This article reviews the instructional strategies used by assistive technologies and maps their problem manifestation and effectiveness for children with learning disabilities. The objective of this article is to investigate the most common types of assistive tools used in learning to study their attributes, limited to the needs of learners with the condition of dyslexia, dysgraphia and dyscalculia. It studies currently available low, mid and high-level assistive learning technologies available to deal with problems faced by these learners. Assistive tools studied in this article range from simple hardware tools to multi-sensory software. A simple analytical framework by interlinking, Problem Manifestation, Underpinned Implication, Instructional Strategy and Cognitive Strength Developed (PISC) is formulated to examine the tools. Five assistive tools types (non-electronic products, low-tech products, mid-tech products, high-tech products apps and learning software) for each learning disability are identified, analysed and associated learning implication is studied under PISC framework. This helps to map the problems and learning style of learning disabled and analyses the underpinned implication along with the corresponding development of skills (cognitive, affective or psychomotor) by these assistive technologies. Performance of identified assistive tool types using PISC framework is analysed. Findings are reported and discussed. Available assistive tools are not learning disability specific. So, in order to differentiate the learning path of a Learning Disabled learner from that of a Non-Learning Disabled learner, study is conducted under four attributes of PISC framework: Problem Manifestation, Underpinned Implication, Instructional Strategy and Cognitive Strength. Available assistive tools in the field of remedial education are found to be problem centric and only able in dealing with single academic learning need of a learner with specific learning difficulty. The mapping of the available assistive technologies under PISC framework provides a detailed structure for the selection of most suited assistive tool as per learning requirement of a learner with learning disability. This study also conclude the non- availability of the High-tech assistive tools and Educational Software specifically designed for learners with learning disability. [ABSTRACT FROM AUTHOR]

Social participation is an important aspect of health and well-being across the lifespan, but older adults might encounter some barriers, which has been highlighted in the current Covid-19 pandemic situation, where technology has become the primary way to maintain contact with family and friends. In fact, technology can serve both as a facilitator and barrier to social participation in later life, and this issue needs to be further understood. To identify the barriers and facilitators encountered by older adults in using technology to promote social participation. A systematic review was conducted. Studies were included if they were peer-reviewed, written in English or French, included participants 50 years or older, included technology to promote social participation, and reported potential barriers or facilitators regarding such technologies. Four databases were included: MEDLINE, CINAHL, PsychINFO and, ERIC. Each study was reviewed by two independent reviewers. The quality of the study was appraised using the Crowe Critical Appraisal Tool. Seventeen studies were included in this report. Four main themes emerged from the data: perceived benefits of the technology, self-confidence and knowledge about using the technology efficiently and safely, affordability of the technology, and ability of the technology to adapt to the physical and cognitive declines in later life. These findings can help health care professionals to make better decisions when deciding to recommend technology for their older clients. Acceptance of technology to promote social participation in later life is a multi-complex process. There is no "one size fits all" approach, a person-centered intervention must be used. When introducing new technologies, using an adapted/tailored training approach could potentially increase self-efficacy in using technology. Rehabilitation professionals' misconceptions concerning the use of technology in later life can be a barrier to acceptance. It's important to be aware of our own believes and attitudes in this context. [ABSTRACT FROM AUTHOR]

This review aimed to collate and summarize available research literature about wheelchair service provision education available to healthcare professional students, healthcare personnel and educators across low- to high-resourced settings. The Joanna Briggs Institute methodological steps for scoping reviews were followed. Included studies were mainly sourced from Medline, Embase, CINAHL, Scopus, Academic Search Complete and ProQuest. Independent title, abstract and full-text screening with defined inclusion and exclusion criteria was performed. All screening and extraction were performed independently by two authors. A thematic approach was used to synthesize results. Data extracted from included studies were charted according to a template that we created. The study quality was also appraised. A total of 25 articles were included (11, 36% from high-income settings) with 12 (48%) observational studies and 13 (52%) experimental studies. The literature addressed three main topics: (1) assessing wheelchair service provision knowledge, (2) implementing training interventions using in-person, online and/or hybrid learning approaches and (3) describing current wheelchair service provision education globally. The most frequently reported training programs used were the Wheelchair Skills Program and the World Health Organization Wheelchair Service Training Package – Basic Level. Limited information has been published about the integration of wheelchair content into the curricula of professional rehabilitation programs. Efforts to build international partnerships, improve the quality and currency of training programs and build resources that can assist educators in the integration of wheelchair-related content into professional rehabilitation programs should be prioritized. This is the first review that examined and synthesized the current state of wheelchair service provision education for rehabilitation students and personnel across low- to high-income countries. Findings from this review indicate that there is limited information about the integration of wheelchair-related content into professional rehabilitation programs. Efforts to build international partnerships, standardize wheelchair service provision content and evaluation and integrate training into professional rehabilitation programs worldwide should be prioritized. [ABSTRACT FROM AUTHOR]

The use of assistive technology in mental health has gained an increased interest over the last decades. A growing number of studies have investigated diverse applications of technological interventions for rehabilitation of children with neurodevelopmental disorders. This article presents a map of the technological devises applied as therapeutic instruments. The research question of this review was which technological applications could be referred as an educational instrument for the management of children with autism spectrum disorders (ASDs), intellectual disability and attention deficit disorder. The articles included in this review were collected after a structured literature search in electronic databases using keywords such as "Assistive Technology", "technology devices", "robots", "Autism Disorder", "Intellectual Disabilities" and "Mental Retardation". Assistive technology with the most up-to-date devices and applications helps children with intellectual disability and ASDs enhance cognitive skills and improve challenging behaviour, social communication and academic performance. Different technological tools are used to foster attention span and improve time management skills in children with attention deficit syndrome. It is important that therapists choose the instrument that will offer the best approach towards the goal that is set. Future research could provide evidence based data, evaluating each specific methodology and tailoring each therapeutic approach specifically to a case. Technology creates environments in which children could practice and learn in a safer, more predictable and pleasant manner. Assistive Technologies provide the opportunity for better acquisition of selfhelp skills and the power of social interaction for individuals with disabilities. By mapping out the wide array of Assistive Technology that is available today, future applications for rehabilitation of children with neurodevelopmental disorders could help extend therapeutic strategies out of the clinical and school settings and into the home, thereby incorporating the family and emphasizing personalization. Future studies could develop a model for the choice and use of each tool, tailoring each therapeutic approach specifically to each case. [ABSTRACT FROM AUTHOR]

To systematically evaluate the efficacy of exergames in individuals with major neurocognitive disorder. PubMed, EMBASE and PEDro were systematically searched from inception until October 2019 for randomised and clinical controlled trials. Methodological quality of the trials was assessed with the PEDro rating scale or Risk of Bias in Nonrandomised Studies of Interventions-I (ROBINS-I), when appropriate. Grading of Recommendations Assessments, Development and Evaluation (GRADE) was used to assess the overall quality of the evidence. Eight trials, all of moderate to high methodological quality (i.e., PEDro score of 6 or higher or a Robins-I moderate quality score) were included. The overall quality of evidence was moderate to high according to the GRADE criteria. Improvements in gait, mobility and balance and beneficial effects on activities of daily living performance, cognitive function, fear of falls, quality of life and mood following exergaming were reported. Heterogeneity in outcome measures, intervention characteristics and included participants precluded a meta-analysis. The current literature is of moderate to high quality and demonstrates that exergames have a wide range of physical and mental benefits in people with major neurocognitive disorder. More controlled trials are however needed to confirm the existing evidence before exergames can be recommended in treatment guidelines for people with major neurocognitive disorder. Exergames have many physical and mental benefits in people with major neurocognitive disorder Exergaming can enhance gait, mobility and balance in people with major neurocognitive disorder Evidence for beneficial cognitive effects of exergaming is emerging [ABSTRACT FROM AUTHOR]

We provide an overview of some biomedical technologies able to relieve everyday impairments in neurological patients. Two literature searches from 2009 to 2020 were conducted using PubMed, Embase, Cinahl and Scopus. The studies meeting the criteria for eligibility constituted 224 of the 6257 identified studies. The first literature search resulted in the identification of 53 different neurological impairments. The following impairments were selected as the most general: six motor (walking/gait abnormality, paralysis/paresis, hypertonia, dystonia, tremor and ataxia), three cognitive (memory, attention/concentration and executive dysfunction), two sensory (visual and hearing impairments) and three uncategorized impairments (communication impairments, sleep abnormalities and seizures/epilepsies). The second literature search resulted in the identification of 22 biomedical technologies able to compensate or rehabilitate the neurological impairments. This review identified some of the common neurological impairments across diseases and showed that technology can be beneficial for neurological patients by helping them with everyday living. The review also found that different aspects such as personal aspects of the intended users (e.g., impairments) and physical and environmental context of the task play an essential role in the usefulness of the technology. Neurological diseases are globally the leading cause of disability, whereby there is a great need for rehabilitation of neurological impairments. Assistive technology can compensate for permanent impairments or be used in rehabilitation as an alternative to usual therapy or an adjunct to increase overall therapy time. This study provides an overview of existing assistive technology and how patients with neurological impairments can benefit from technology. [ABSTRACT FROM AUTHOR]

Virtual reality (VR) are user-computer interface platforms that implement real-time simulation of an activity or environment, allowing user interaction via multiple sensory modalities. VR therapy may be an effective intervention for improving cognitive function following stroke. The aim of this systematic review was to examine the effectiveness of exercise-based VR therapy on cognition post-stroke. Electronic databases were searched for terms related to "stroke", "virtual reality", "exercise" and "cognition". Studies were included if they: (1) were randomized-controlled trials; (2) included VR-based interventions; (3) included individuals with stroke; and (4) included outcome measures related to cognitive function. Data from included studies were synthesised qualitatively and where possible, random effects meta-analyses were performed. Eight studies involving 196 participants were included in the review, of which five were included in meta-analyses (n = 124 participants). Studies varied in terms of type (combination of VR therapy and conventional therapy, combination of VR therapy and computer-based cognitive training, VR therapy alone) and duration of interventions (20–180 min), sample size (n = 12–42), length of the interventions (4–8 weeks), and cognitive outcomes examined. VR therapy was not more effective than control for improving global cognition (n = 5, SMD = 0.24, 95%CI:−0.30,0.78, p =.38), memory (n = 2 studies, SMD= 0.00, 95%CI: −0.58, 0.59, p =.99), attention (n = 2 studies, MD = 8.90, 95%CI: −27.89, 45.70, p =.64) or language (n = 2 studies, SMD = 0.56, 95%CI: −0.08,1.21, p =.09). VR therapy was not superior to control interventions in improving cognition in individuals with stroke. Future research should include high-quality and adequately powered trials examining the impact of virtual reality therapy on cognition post-stroke. Virtual reality therapy is a promising new form of technology that has been shown to increase patient satisfaction towards stroke rehabilitation. Virtual reality therapy has the added benefits of providing instant feedback, and the difficulty can be easily modified, underscoring the user-friendliness of this form of rehabilitation. Virtual reality therapy has the potential to improve various motor, cognitive and physical deficits following stroke, highlighting its usefulness in rehabilitation settings. [ABSTRACT FROM AUTHOR]

Rates of prosthetic device abandonment are dramatically high; however, the reasons behind abandonment are less understood. A scoping review was conducted to explore the current state of the literature on why individuals abandon upper limb prosthetic devices and consider how these reasons have evolved historically. A systematic search of the literature identified 123 articles. After reviewing the articles using predetermined inclusion and exclusion criteria, nine relevant articles were included in the final review. The included articles covered passive, body-powered and myoelectric prosthetic devices. Across time, reasons for abandonment could be broadly categorized into comfort and function. Weight, temperature and perspiration were among the most common and persistent comfort-related reasons for abandonment. Regarding function, studies-reported abandonment was attributed to key concerns about control and sensory feedback, whereby participants may feel more functional without their device. In agreement with the previous literature, lack of comfort and function remain persistent reasons for upper limb prosthesis abandonment. Up-to-date research on reasons for abandonment of upper limb prosthetic devices is lacking, and recent prosthesis advancements have not been included in studies of device use, adoption and abandonment. Therefore, future work should explore reasons for abandonment in contemporary upper limb prosthetic devices. By understanding the reasons for prosthetic device abandonment, clinicians, therapists and researchers can use this information to proactively mitigate future upper limb prosthetic device abandonment. Findings from this review can be used to guide future prosthetic device development to improve these areas of concern and satisfy user needs. By understanding the reasons for prosthetic device abandonment, clinicians, therapists and researchers can use this information to proactively mitigate future upper limb prosthetic device abandonment. The findings from this review can be used to guide future prosthetic device development to improve areas of concern and satisfy user needs. [ABSTRACT FROM AUTHOR]