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ObjectiveThe primary objective was to compare the physical capacities of individuals with Long COVID [Long COVID group (LCG)] to those who had COVID-19 but did not develop persistent symptoms [short COVID group (SCG)], and to individuals without a history of COVID-19 [control group (CG)]. The secondary objectives were to provide a comprehensive profile of sociodemographic and COVID-19 history of individuals with Long COVID, considering factors such as sex, gender, hospitalization, time since onset, and comorbidities, and b) identify self-reported and objective clinical measures explaining health-related quality of life (HRQoL) in individuals with Long COVID.MethodsA total of 120 adults were included in each of the groups. Participants completed self-reported assessments covering HRQoL, comorbidities, pain, sleep, and fatigue. Physical assessments included handgrip strength (HGS), Short Physical Performance Battery (SPPB), 6-minute-walk-test (6MWT), perceived exertion during the 6MWT (Modified-Borg Scale), and daily step count during a 7-day period.ResultsMean age (mean [SD]) for LCG, SCG, and CG was 44.2 [11.2], 42.1 [16.4], and 46[15.9], respectively. LCG showed significantly higher pain, comorbidities, and fatigue, along with lower HRQoL and sleep quality compared to the other groups. HGS, SPPB, and 6MWT performance were also significantly lower in LCG, while perceived exertion during 6MWT was higher. Finally, the number of steps per day was significantly lower in LCG. Higher prevalence of obesity and comorbidities were identified among those hospitalized after COVID-19. Fatigue, pain, comorbidities, and Step count were the variables explaining HRQoL for LCG (R2: 0.58; F = 35.9).ConclusionLong COVID individuals, on average 329 [146] days post-infection, experience enduring physical and health-related challenges, with significant implications for their overall well-being.

Individuals with movement disorders often face challenges in writing independently due to factors such as spasticity, lack of precise motor control, muscle weakness, and tremors. This paper aims to develop a handwriting assistive device (HAD) for individuals with movement disorders, to stabilize the motion of user's hand, through initial needs assessment, iterative design, and a preliminary evaluation. The research is scoped to include only initial testing with a small user group, six potential users with movement disorders, providing foundational insights for future refinement. The findings from the initial needs assessment revealed that current assistive technologies do not fully meet handwriting challenges for individuals with motor impairments. The HAD prototype, developed with adjustable damping mechanism and customizable handles to suit different levels of motor control, enabled steadier handwriting in preliminary testing with six participants. Children drew shapes more accurately, and some traced letters they couldn't otherwise. The adult participant showed greater fluidity and legibility, completing tasks 4.81 times faster with the HAD. The qualitative feedback indicated the device's potential to enhance handwriting independence and usability across age groups. Future prospects for this study include developing an electronic version of the HAD, allowing real-time adjustable damping to better support users' voluntary movements while further stabilizing involuntary motions.

Individuals with hemiparetic cerebral palsy (CP) exhibit reduced use of their more affected (MA) arm, yet the factors that influence its use during activities of daily living remain elusive. The objectives of this study were to describe the relative use of the MA arm during an ecological task, examine its relationship with the level of impairment, and investigate its association with performance in various unilateral and bilateral tasks. Methods: Participants took part in two sessions comprising robotic assessments and clinical assessments of motor functions, as well as accelerometry measurement during kitchen tasks. Four variables were derived from accelerometry data. Stepwise regression analyses were used to identify the best contributors to the accelerometry variables among robotic and clinical assessments. Results: Nineteen adults with CP (34.3 years old ± 11.5; MACS I = 7, II = 6, III = 6) were included. The Use Ratio measured during the kitchen tasks ranged between 0.10 and 0.63. The best predictors of all accelerometry metrics were two bilateral assessments (r2 = 0.23–0.64). Conclusions: The importance of assessing bilateral tasks was reaffirmed by the key role played by two bilateral tasks in determining the relative use of the MA arm. The results support the use of intensity-based accelerometry metrics to measure MA arm use.

IntroductionChildren with cerebral palsy (CP) exhibit a variety of sensory impairments that can interfere with motor performance, but how these impairments persist into adulthood needs further investigation. The objective of this study was to describe the sensory impairments in adults having CP and how they relate to motor impairments.MethodsNineteen adults having CP performed a set of robotic and clinical assessments. These assessments were targeting different sensory functions and motor functions (bilateral and unilateral tasks). Frequency of each type of impairments was determined by comparing individual results to normative data. Association between the sensory and motor impairments was assessed with Spearman correlation coefficient.ResultsImpairment in stereognosis was the most frequent, affecting 57.9% of participants. Although less frequently impaired (26.3%), tactile discrimination was associated with all the motor tasks (unilateral and bilateral, either robotic or clinical). Performance in robotic motor assessments was more frequently associated with sensory impairments than with clinical assessments. Finally, sensory impairments were not more closely associated with bilateral tasks than with unilateral tasks.DiscussionSomatosensory and visuo-perceptual impairments are frequent among adults with CP, with 84.2% showing impairments in at least one sensory function. These sensory impairments show a moderate association with motor impairments.

This study focuses on the development of a wearable real-time Humming Detector Device (HDD) aimed at enhancing the control of assistive devices through humming. As the need for portable user-friendly tools in assistive technology grows, the HDD offers a non-invasive solution to detect vocal cord vibrations. Vibrations, detected thanks to an accelerometer worn on the neck, are processed in real time using a Fast Fourier Transform (FFT) to identify specific humming frequencies, which are then translated into commands for controlling assistive devices via Bluetooth Low Energy (BLE) transmission. The device was tested with 13 healthy subjects to validate its potential and determine the optimal number of distinct commands that users can achieve. The HDD’s portability and precision make it a promising alternative to traditional voice recognition systems, particularly for individuals with speech impairments.

Objective: The primary objective was to compare the physical capacities of individuals with Long COVID [Long COVID group (LCG)] to those who had COVID-19 but did not develop persistent symptoms [short COVID group (SCG)], and to individuals without a history of COVID-19 [control group (CG)]. The secondary objectives were to provide a comprehensive profile of sociodemographic and COVID-19 history of individuals with Long COVID, considering factors such as sex, gender, hospitalization, time since onset, and comorbidities, and b) identify self-reported and objective clinical measures explaining health-related quality of life (HRQoL) in individuals with Long COVID. Methods: A total of 120 adults were included in each of the groups. Participants completed self-reported assessments covering HRQoL, comorbidities, pain, sleep, and fatigue. Physical assessments included handgrip strength (HGS), Short Physical Performance Battery (SPPB), 6-minute-walk-test (6MWT), perceived exertion during the 6MWT (Modified-Borg Scale), and daily step count during a 7-day period. Results: Mean age (mean [SD]) for LCG, SCG, and CG was 44.2 [11.2], 42.1 [16.4], and 46[15.9], respectively. LCG showed significantly higher pain, comorbidities, and fatigue, along with lower HRQoL and sleep quality compared to the other groups. HGS, SPPB, and 6MWT performance were also significantly lower in LCG, while perceived exertion during 6MWT was higher. Finally, the number of steps per day was significantly lower in LCG. Higher prevalence of obesity and comorbidities were identified among those hospitalized after COVID-19. Fatigue, pain, comorbidities, and Step count were the variables explaining HRQoL for LCG (R 2: 0.58; F = 35.9). Conclusion: Long COVID individuals, on average 329 [146] days post-infection, experience enduring physical and health-related challenges, with significant implications for their overall well-being. [ABSTRACT FROM AUTHOR]

Individuals with hemiparetic cerebral palsy (CP) exhibit reduced use of their more affected (MA) arm, yet the factors that influence its use during activities of daily living remain elusive. The objectives of this study were to describe the relative use of the MA arm during an ecological task, examine its relationship with the level of impairment, and investigate its association with performance in various unilateral and bilateral tasks. Methods: Participants took part in two sessions comprising robotic assessments and clinical assessments of motor functions, as well as accelerometry measurement during kitchen tasks. Four variables were derived from accelerometry data. Stepwise regression analyses were used to identify the best contributors to the accelerometry variables among robotic and clinical assessments. Results: Nineteen adults with CP (34.3 years old ± 11.5; MACS I = 7, II = 6, III = 6) were included. The Use Ratio measured during the kitchen tasks ranged between 0.10 and 0.63. The best predictors of all accelerometry metrics were two bilateral assessments (r2 = 0.23–0.64). Conclusions: The importance of assessing bilateral tasks was reaffirmed by the key role played by two bilateral tasks in determining the relative use of the MA arm. The results support the use of intensity-based accelerometry metrics to measure MA arm use. [ABSTRACT FROM AUTHOR]

Individuals with movement disorders often face challenges in writing independently due to factors such as spasticity, lack of precise motor control, muscle weakness, and tremors. This paper aims to develop a handwriting assistive device (HAD) for individuals with movement disorders, to stabilize the motion of user's hand, through initial needs assessment, iterative design, and a preliminary evaluation. The research is scoped to include only initial testing with a small user group, six potential users with movement disorders, providing foundational insights for future refinement. The findings from the initial needs assessment revealed that current assistive technologies do not fully meet handwriting challenges for individuals with motor impairments. The HAD prototype, developed with adjustable damping mechanism and customizable handles to suit different levels of motor control, enabled steadier handwriting in preliminary testing with six participants. Children drew shapes more accurately, and some traced letters they couldn't otherwise. The adult participant showed greater fluidity and legibility, completing tasks 4.81 times faster with the HAD. The qualitative feedback indicated the device's potential to enhance handwriting independence and usability across age groups. Future prospects for this study include developing an electronic version of the HAD, allowing real-time adjustable damping to better support users' voluntary movements while further stabilizing involuntary motions. [ABSTRACT FROM AUTHOR]

Purpose: To conduct a systematic review on the impacts of using mechanical assistive devices on function, performance in activities and participation of persons with upper extremity impairments, and to synthesize the strengths and limitations of these devices. Method: Three independent reviewers conducted systematic searches of articles published between 2003 and 2023 in Compendex, Inspec, Embase, PubMed/Medline, IEEE Xplore, and Web of Science, as well as manual searches on the RESNA website for conference papers over the same period. The methodological quality of articles was appraised using the QualSyst tool. Results: From the 34 retained studies, 28 mechanical devices were identified and classified into two categories: (1) mobile arm supports (MASs) designed to perform multiple activities, and (2) devices used to assist with a specific activity of daily living (ADL). Overall, MASs helped users to perform manual activities in elevation and/or against gravity. Specific ADL devices allowed users to perform unique activities requiring fine motor skills such as opening a medicine container. Some of these devices have advantages like portability, adaptability, low cost, and ease of use. Limitations most often reported included interference or mobility restraints. Conclusion: This review synthesizes the impacts of mechanical devices on the three domains of the International Classification of Functioning, Disability and Health (ICF) for individuals with upper extremity impairments. Impacts regarding function and performance in activities were more often measured than participation. Future studies should include outcomes related to participation, as taking this aspect into account might favor successful continued use of assistive devices. IMPLICATIONS FOR REHABILITATION: Mechanical mobile arm supports can compensate for upper extremity muscle weakness and help users to perform diverse activities against gravity, including self-care, productivity and leisure activities. Mechanical assistive devices designed for specific activities of daily living (ADLs) can increase users' ability to perform activities requiring manual dexterity and fine motor skills, such as eating, handwriting, performing personal care or playing a musical instrument. Portability, adaptability, low cost, and ease of use are most often reported as strengths of specific ADL devices, while interference and mobility restrictions are aspects that still need to be reduced with respect to mechanical mobile arm supports. [ABSTRACT FROM AUTHOR]

Introduction Approximately 33% of people who contracted COVID-19 still experience symptoms 12 weeks after infection onset. This persistence of symptoms is now considered a syndrome itself called ‘long COVID’. Evidence regarding long COVID and its cognitive and physical impacts is growing, but the literature is currently lacking objectively measured data to guide towards adapted healthcare trajectories. The objectives are to describe the physical and cognitive impairments experienced by individuals living with long COVID using self-reported and clinical objective measures, and to compare the evolution over time of the physical and cognitive state between adults living with long COVID (at least one physical or cognitive COVID-19 symptom for more than 12 weeks following infection; long COVID group), people who developed COVID-19 but did not experience persistent symptoms (short COVID group) and people who did not develop COVID-19 (control group).Methods and analysis In this longitudinal cohort study, 120 participants will be recruited in each group. Variables will be collected through three evaluation sessions over 6 months (baseline, 3 months, 6 months). Variables include self-administered questionnaires on health-related quality of life, comorbidity, sleep, pain, anxiety, depressive symptoms, fatigue and cognitive function, as well as objective measures of cognitive (attention, memory, executive functioning) and physical (grip strength, balance, gait speed, gait endurance, VO2, frailty) functions. Activity, heart rate and sleep will be monitored with a fitness tracker watch for 7 days following evaluation sessions. Maximum-likelihood analyses of variance (ANOVAs) will be used to compare data at baseline between groups. Repeated measures ANOVAs will be used to compare the longitudinal performance variations across groups of the self-reported and clinical variables.Ethics and dissemination Ethics committees of the CIUSSS de la Capitale-Nationale and CIUSSS de l’Est-de-l’Île-de-Montréal approved the project. Results will be disseminated through clinical and community platforms as well as through peer-reviewed manuscripts and international conferences.Trial registration number NCT05216536.

Assistive technologies (ATs) often have a high-dimensionality of possible movements (e.g., assistive robot with several degrees of freedom or a computer), but the users have to control them with low-dimensionality sensors and interfaces (e.g., switches). This paper presents the development of an open-source interface based on a sequence-matching algorithm for the control of ATs. Sequence matching allows the user to input several different commands with low-dimensionality sensors by not only recognizing their output, but also their sequential pattern through time, similarly to Morse code. In this paper, the algorithm is applied to the recognition of hand gestures, inputted using an inertial measurement unit worn by the user. An SVM-based algorithm, that is aimed to be robust, with small training sets (e.g., five examples per class) is developed to recognize gestures in real-time. Finally, the interface is applied to control a computer’s mouse and keyboard. The interface was compared against (and combined with) the head movement-based AssystMouse software. The hand gesture interface showed encouraging results for this application but could also be used with other body parts (e.g., head and feet) and could control various ATs (e.g., assistive robotic arm and prosthesis).

Upper limb impairments, resulting from various neurological and neuromuscular conditions, significantly impact daily activities and limit social participation. Assistive technologies, particularly dynamic arm supports, offer promising solutions to enhance independence for individuals facing these challenges. This paper presents the development of an affordable dynamic arm support, designed with a focus on static balancing. The support utilizes a four-bar linkage mechanism to allow smooth vertical movement while maintaining the orientation of the armrest. Furthermore, the integration of rotational and prismatic joints enhances the device's adaptability, enabling horizontal movements. Through comprehensive mathematical modeling and prototype testing, we introduce a cost-effective arm support that effectively counterbalances the arm's weight, ensuring ease of movement and stability across various spatial orientations. [ABSTRACT FROM AUTHOR]

This study focuses on the development of a wearable real-time Humming Detector Device (HDD) aimed at enhancing the control of assistive devices through humming. As the need for portable user-friendly tools in assistive technology grows, the HDD offers a non-invasive solution to detect vocal cord vibrations. Vibrations, detected thanks to an accelerometer worn on the neck, are processed in real time using a Fast Fourier Transform (FFT) to identify specific humming frequencies, which are then translated into commands for controlling assistive devices via Bluetooth Low Energy (BLE) transmission. The device was tested with 13 healthy subjects to validate its potential and determine the optimal number of distinct commands that users can achieve. The HDD's portability and precision make it a promising alternative to traditional voice recognition systems, particularly for individuals with speech impairments. [ABSTRACT FROM AUTHOR]

Abstract Myoelectric hand prostheses offer a way for upper-limb amputees to recover gesture and prehensile abilities to ease rehabilitation and daily life activities. However, studies with prosthesis users found that a lack of intuitiveness and ease-of-use in the human-machine control interface are among the main driving factors in the low user acceptance of these devices. This paper proposes a highly intuitive, responsive and reliable real-time myoelectric hand prosthesis control strategy with an emphasis on the demonstration and report of real-time evaluation metrics. The presented solution leverages surface high-density electromyography (HD-EMG) and a convolutional neural network (CNN) to adapt itself to each unique user and his/her specific voluntary muscle contraction patterns. Furthermore, a transfer learning approach is presented to drastically reduce the training time and allow for easy installation and calibration processes. The CNN-based gesture recognition system was evaluated in real-time with a group of 12 able-bodied users. A real-time test for 6 classes/grip modes resulted in mean and median positive predictive values (PPV) of 93.43% and 100%, respectively. Each gesture state is instantly accessible from any other state, with no mode switching required for increased responsiveness and natural seamless control. The system is able to output a correct prediction within less than 116 ms latency. 100% PPV has been attained in many trials and is realistically achievable consistently with user practice and/or employing a thresholded majority vote inference. Using transfer learning, these results are achievable after a sensor installation, data recording and network training/fine-tuning routine taking less than 10 min to complete, a reduction of 89.4% in the setup time of the traditional, non-transfer learning approach.

Assistive robots are tools that people living with upper body disabilities can leverage to autonomously perform Activities of Daily Living (ADL). Unfortunately, conventional control methods still rely on low-dimensional, easy-to-implement interfaces such as joysticks that tend to be unintuitive and cumbersome to use. In contrast, vocal commands may represent a viable and intuitive alternative. This work represents an important step toward providing a viable vocal interface for people living with upper limb disabilities by proposing a novel lightweight vocal command recognition system. The proposed model leverages the MobileNet2 architecture, augmenting it with a novel approach to the self-attention mechanism, achieving a new state-of-the-art performance for Keyword Spotting (KWS) on the Google Speech Commands Dataset (GSCD). Moreover, this work presents a new dataset, referred to as the French Speech Commands Dataset (FSCD), comprising 4963 vocal command utterances. Using the GSCD as the source, we used Transfer Learning (TL) to adapt the model to this cross-language task. TL has been shown to significantly improve the model performance on the FSCD. The viability of the proposed approach is further demonstrated through real-life control of a robotic arm by four healthy participants using both the proposed vocal interface and a joystick.

Work-related upper extremity disorders are costly to society due to resulting medical costs, presenteeism and absenteeism. Although their aetiology is likely multifactorial, physical workplace factors are known to play an important role in their development. Promising options for preventing work-related upper extremity disorders include assistive technologies such as dynamic arm supports designed to follow the movement of the arm while compensating for its weight. The objective of this study was to assess the effects of a dynamic arm support on perceived exertion, muscle activity and movement patterns of the upper limb during repetitive manual tasks in healthy individuals. Thirty healthy right-handed individuals were allocated either a static or a dynamic task to perform with and without a dynamic arm support. During the task, surface electromyographic activity (anterior and middle deltoid, upper trapezius) and upper limb kinematics (elbow, shoulder, sternoclavicular) were measured using surface EMG and inertial sensors. Results showed that the dynamic arm support significantly reduced perceived exertion during the tasks and limited the development of muscular fatigue of the anterior and middle deltoid as demonstrated by EMG signal mean epoch amplitudes and median frequency of the EMG power spectrum. The dynamic arm support also prevented a decrease in shoulder elevation and an increase in total shoulder joint excursion during static and dynamic task, respectively. These results denote the potential benefits of dynamic arm supports in work environments. Further studies should focus on their efficacy, acceptability and implementability in work settings.

Physical disabilities significantly impact individuals' ability to perform activities of daily living (ADL), leading to reduced autonomy and difficulty to accomplish daily living tasks. One such barrier is the difficulty or inability to open doors, preventing access to different rooms in their residence (bathroom, bedroom, etc.), rooms at work, or shopping areas. Existing solutions, such as robotic arms on wheelchairs and door openers mounted at the top of doors, remain expensive, complex to install, and relatively difficult for the target population to use. Addressing this challenge, this study introduces a Robotic Wheel Door Opener System (RWDOS) designed to facilitate the opening and closing of the door. The RWDOS is installed at the bottom of a door and is controlled remotely through a smartphone application. The paper presents the mechanical design and control system along with a cost analysis. It concludes with initial results and outlines the future directions for the project. [ABSTRACT FROM AUTHOR]

Introduction: Children with cerebral palsy (CP) exhibit a variety of sensory impairments that can interfere with motor performance, but how these impairments persist into adulthood needs further investigation. The objective of this study was to describe the sensory impairments in adults having CP and how they relate to motor impairments. Methods: Nineteen adults having CP performed a set of robotic and clinical assessments. These assessments were targeting different sensory functions and motor functions (bilateral and unilateral tasks). Frequency of each type of impairments was determined by comparing individual results to normative data. Association between the sensory and motor impairments was assessed with Spearman correlation coefficient. Results: Impairment in stereognosis was the most frequent, affecting 57.9% of participants. Although less frequently impaired (26.3%), tactile discrimination was associated with all the motor tasks (unilateral and bilateral, either robotic or clinical). Performance in robotic motor assessments was more frequently associated with sensory impairments than with clinical assessments. Finally, sensory impairments were not more closely associated with bilateral tasks than with unilateral tasks. Discussion: Somatosensory and visuo-perceptual impairments are frequent among adults with CP, with 84.2% showing impairments in at least one sensory function. These sensory impairments show a moderate association with motor impairments. [ABSTRACT FROM AUTHOR]

Abstract Background People with chronic shoulder pain have been shown to present with motor adaptations during arm movements. These adaptations may create abnormal physical stress on shoulder tendons and muscles. However, how and why these adaptations develop from the acute stage of pain is still not well‐understood. Objective To investigate motor adaptations following acute experimental shoulder pain during upper limb reaching. Methods Forty participants were assigned to the Control or Pain group. They completed a task consisting of reaching targets in a virtual reality environment at three time points: (1) baseline (both groups pain‐free), (2) experimental phase (Pain group experiencing acute shoulder pain induced by injecting hypertonic saline into subacromial space), and (3) Post experimental phase (both groups pain‐free). Electromyographic (EMG) activity, kinematics, and performance data were collected. Results The Pain group showed altered movement planning and execution as shown by a significant increased delay to reach muscles EMG peak and a loss of accuracy, compared to controls that have decreased their mean delay to reach muscles peak and improved their movement speed through the phases. The Pain group also showed protective kinematic adaptations using less shoulder elevation and elbow flexion, which persisted when they no longer felt the experimental pain. Conclusion Acute experimental pain altered movement planning and execution, which affected task performance. Kinematic data also suggest that such adaptations may persist over time, which could explain those observed in chronic pain populations.

Developmental coordination disorder (DCD) impairs motor skills in children, particularly handwriting, which is a significant part of school activities and personal development. Current robotic assistants often lack a fully physical interaction or tangible result, thereby limiting their effectiveness in coordination development similar to handwriting. To address this gap, a robotic assistant capable of physical input and output could enhance development. This paper presents the development of a robotic handwriting assistant to aid children with DCD. The prototype is a planar robot controlled via a joystick capable of covering an 8.5" by 11" paper sheet. The paper provides insight into the causal real-world context of the prototype's development and discusses the designs considerations, the conception and the control. It concludes with intial results and the future for the project. [ABSTRACT FROM AUTHOR]

People living with cerebral palsy (CP) exhibit motor and sensory impairments that affect unimanual and bimanual functions. The importance of sensory functions for motor control is well known, but the association between motor and sensory functions remains unclear in people living with CP. The objective of this systematic review was to characterize the relationship between sensory deficits and upper limb motor function in individuals living with CP. Methods: Five databases were screened. The inclusion criteria were: (1) including people living with CP, (2) reporting measurements of upper limb motor and sensory functions. A qualitative analysis of the studies’ level of evidence was done. Results: Thirty-three articles were included. Twenty-five articles evaluated tactile functions, 10 proprioceptive functions and 7 visual functions; 31 of the articles reported on unimanual functions and 17 of them reported on bimanual functions. Tactile functions showed a moderate to high association; it was not possible to reach definitive conclusions for proprioceptive and visual functions. Conclusions: The heterogeneity of the results limits the ability to draw definitive conclusions. Further studies should aim to perform more comprehensive assessments of motor and sensory functions, to determine the relative contribution of various sensory modalities to simple and more complex motor functions.

Assistive devices are designed to enhance individuals with disabilities' functional abilities. The rise of 3D printing technology enabled the production of individualized assistive devices (IADs). A REHAB-LAB is intended for IAD provision involving technical referents and occupational therapists. This study aimed to develop the REHAB-LAB logic model; to explore its fidelity and desirability; and to explore the characteristics of arising initiatives of IAD production. The REHAB-LAB logic model development involved stakeholders throughout the research process. A pragmatic multimethod approach followed two phases 1) logic model development and 2) exploration of its fidelity and desirability. The REHAB-LAB logic model presented the resources (equipment, space, human) required to implement IAD provision in a rehabilitation center, and the expected deliverables (activities and outputs). The REHAB-LAB logic model highlights the interdisciplinarity of IAD provision including occupational therapists, doctors, engineers, managers, and technical referents and places the users at the center of the IAD production. Results confirmed the fidelity and desirability of the REHAB-LAB logic model. The REHAB-LAB logic model can be used as a reference for future healthcare organizations wishing to implement an IAD provision. This research highlighted the interest of IAD provision based on the REHAB-LAB model involving users and transdisciplinary practices [ABSTRACT FROM AUTHOR]

Various accelerometry protocols have been used to quantify upper extremity (UE) activity, encompassing diverse epoch lengths and thresholding methods. However, there is no consensus on the most effective approach. The aim of this study was to delineate the optimal parameters for analyzing accelerometry data to quantify UE use in individuals with unilateral cerebral palsy (CP). Methods: A group of adults with CP (n = 15) participated in six activities of daily living, while a group of children with CP (n = 14) underwent the Assisting Hand Assessment. Both groups performed the activities while wearing ActiGraph GT9X-BT devices on each wrist, with concurrent video recording. Use ratio (UR) derived from accelerometry and video analysis and accelerometer data were compared for different epoch lengths (1, 1.5, and 2 s) and activity count (AC) thresholds (between 2 and 150). Results: In adults, results are comparable across epoch lengths, with the best AC thresholds being ≥ 100. In children, results are similar across epoch lengths of 1 and 1.5 (optimal AC threshold = 50), while the optimal threshold is higher with an epoch length of 2 (AC = 75). Conclusions: The combination of epoch length and AC thresholds should be chosen carefully as both influence the validity of the quantification of UE use. [ABSTRACT FROM AUTHOR]

Dynamic arm supports (DAS) can assist individuals with severe upper limb disabilities who use a wheelchair to accomplish their daily activities. The objective of this case series was to assess the potential of a DAS to improve power wheelchair (PWC) control in real-life contexts and to describe the integration process. A secondary objective was to explore factors that may influence the DAS integration process. This case series includes four participants fitted with the Kinova DAS O110. A one-year follow-up was planned for each participant with qualitative and quantitative data collection to assess DAS outcomes. Assessment methods were selected to cover the three vantages of assistive technology outcomes assessment: effectiveness, subjective well-being, and social significance. Among the four participants, one used the DAS to help with his wheelchair control for at least 12 months (successful integration). For him, the DAS led to significantly improved wheelchair skills and an important positive psychosocial impact. He was, however, only able to use the DAS for PWC control (no effects on other daily activities), and could not use it in some contexts because the device increased his PWC width. As for the other participants, they stopped using the DAS for different reasons, including a DAS-related adverse event. This study demonstrated that a wheelchair-bound DAS has the potential to improve PWC use, but successful integration requires specific factors. The service delivery process and the environmental accessibility are crucial for the successful integration of such a device and to avoid safety issues. No study deeply assessed the impacts of dynamic arm support on power wheelchair control, and the associated facilitators and obstacles. A wheelchair-bound dynamic arm support has the potential to improve power wheelchair control for individuals with upper limb disabilities and to lead to positive psychosocial impacts if some conditions conductive to successful integration are met. The service delivery process and the environmental accessibility appear as crucial aspects for the successful integration of a new device, such as dynamic arm support and avoiding safety issues. [ABSTRACT FROM AUTHOR]

Background: Fatigue impacts motor performance and upper limb kinematics. It is of interest to study whether it is possible to minimize the potentially detrimental effects of fatigue with prevention programs. Objective: To determine the effect of task-specific training on upper limb kinematics and motor performance when reaching in a fatigued state. Methods: Thirty healthy participants were recruited (Training group n = 15; Control group n = 15). Both groups took part in two evaluation sessions (Day 1 and Day 5) during which they performed a reaching task (as quickly and accurately as possible) in two conditions (rested and fatigued). During the reaching task, joint kinematics and motor performance (accuracy and speed) were evaluated. The Training group participated in three task-specific training sessions between Day 1 and Day 5; they trained once a day, for three days. The Control group did not perform any training. A three-way non-parametric ANOVA for repeated measures (Nonparametric Analysis of Longitudinal Data; NparLD) was used to assess the impact of the training (Condition [within subject]: rested, fatigued; Day [within subject]: Day 1 vs. Day 5 and Group [between subjects]: Training vs. Control). Results: After the training period, the Training group significantly improved their reaching speed compared to the Control group (Day x Group p <.01; Time effect: Training group = p <.01, Control group p =.20). No between-group difference was observed with respect to accuracy. The Training group showed a reduction in contralateral trunk rotation and lateral trunk flexion in Day 2 under the fatigue condition (Group x Day p <.04; Time effect: Training group = p <.01, Control group = p <.59). Conclusion: After the 3-day training, participants demonstrated improved speed and reduced reliance on trunk compensations to complete the task under fatigue conditions. Task-specific training could help minimizing some effects of fatigue. [ABSTRACT FROM AUTHOR]