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The air freight supply chain consists of several agents. Among them are truckers, who ship freight between customers and airports, and airlines, who transport the freight in-between airports. Handling agents link the two: they receive freight from truckers, consolidate it and forward it to the airlines and vice versa. They need to organise and execute processes efficiently. Digitalisation offers great potential in this context. Furthermore, handling agents' workers handle most of the freight manually. The resulting elevated levels of physical strain make workers prone to muscular-skeletal disorders. Based on a case study at two handling agents, we first investigate the handling agents' process chain from an economic perspective. We identify shortcomings and present countermeasures with an emphasis on digitalisation. Second, we analyse the physical strain on the workers and evaluate devices that could improve ergonomics. The paper concludes with a discussion of recommended means for economic and ergonomic improvement. [ABSTRACT FROM AUTHOR]

Exoskeletons are wearable devices that can enhance human strength and are used in various fields, such as healthcare and the manufacturing industry. However, poorly designed exoskeletons can strain the muscles and cause injuries to users. The objectives of this review paper are to review the ergonomics factors that contribute to a harmonious user-exoskeleton interaction and to explore the current trends, challenges, and future directions for developing ergonomically designed exoskeletons. In this review, 102 relevant papers published from 2015 to 2023 were retrieved from Web of Science, Scopus, and Google Scholar. These papers were considered in the analysis for gathering relevant information on the topic. The authors identified six ergonomics factors, namely kinematic compatibility, contact pressure, postural control, metabolic cost, cognitive workload, as well as task demands and workplace conditions, that can influence the interaction between users and exoskeletons. By understanding and addressing these ergonomics factors during the design and development process, exoskeleton designers can enhance the user experience and adoption of the devices in daily living activities and industrial applications. [ABSTRACT FROM AUTHOR]

Background: Soft, wearable, powered exoskeletons are novel devices that may assist rehabilitation, allowing users to walk further or carry out activities of daily living. However, soft robotic exoskeletons, and the more commonly used rigid exoskeletons, are not widely adopted clinically. The available evidence highlights a disconnect between the needs of exoskeleton users and the engineers designing devices. This review aimed to explore the literature on physiotherapist and patient perspectives of the longer-standing, and therefore greater evidenced, rigid exoskeleton limitations. It then offered potential solutions to these limitations, including soft robotics, from an engineering standpoint. Methods: A state-of-the-art review was carried out which included both qualitative and quantitative research papers regarding patient and/or physiotherapist perspectives of rigid exoskeletons. Papers were themed and themes formed the review's framework. Results: Six main themes regarding the limitations of soft exoskeletons were important to physiotherapists and patients: safety; a one-size-fits approach; ease of device use; weight and placement of device; cost of device; and, specific to patients only, appearance of the device. Potential soft-robotics solutions to address these limitations were offered, including compliant actuators, sensors, suit attachments fitting to user's body, and the use of control algorithms. Conclusions: It is evident that current exoskeletons are not meeting the needs of their users. Solutions to the limitations offered may inform device development. However, the solutions are not infallible and thus further research and development is required. [ABSTRACT FROM AUTHOR]

An assistive intelligence sensor device is a comprehensive solution aimed at improving the mobility and independence of people with visual or hearing impairments. It integrates an array of advanced hardware components including Node MCU and Arduino board for data processing, GPS module with antenna for accurate location tracking, emergency key switch for instant warning activation, and time of flight sensor for accurate obstacle detection. A vibrator for haptic feedback, a Wi-Fi module for seamless connectivity and a display for visual feedback. Additionally, the device includes a laptop with a Python-coded program for real-time object detection using a camera, which helps identify and classify objects in the user's environment. Leveraging the Blynk IoT app, the device facilitates instant communication with caregivers or emergency responders, ensuring peace of mind and timely assistance when needed. Also, apart from detecting nearby obstacles and providing haptic feedback, the device uses a GPS module to live track the user's location, ensuring safety and security during outdoor navigation. The integration of intelligent software algorithms further enhances the functionality of the device, enabling it to adapt to various environments and user needs. This manuscript provides a comprehensive overview of the device's design, functionality, and potential applications to improve the quality of life of individuals with disabilities. By integrating state-of-the-art hardware components with intelligent software solutions, the Assistive Intelligence sensor device represents a significant advance in assistive technology, empowering users to navigate their surroundings with confidence and independence. [ABSTRACT FROM AUTHOR]

Assistive devices like Standing Wheelchairs (SWC) have remained out of reach of the economically underprivileged even before the pandemic-induced financial downturn, and more so now. This paper describes the mechanical design of a manual user-actuated SWC that is cost-effective (equivalent of USD 210 in India, ex-factory) and has special features that minimise user effort and accommodates varying body weights (50–110 kg) and dimensions (1.52–1.83 m height). The design includes a six-bar mechanism and spring balancing to optimise user effort during operation. The optimised gas spring incorporates adjustability to minimise each user's force for sit-stand-sit transitions. The handle shape is ergonomically designed using kinematic analysis to provide convenient gripping positions for actuation. The design has been customised based on parametric studies to suit varying body weights. Overall, the SWC design provides standing functionality with ease of operation, safety locks, customisability, affordability, outdoor mobility and is aesthetically pleasing. Customisability and the low cost of the device would enhance the accessibility of the SWC to a larger group of eligible users. Manual user-operated standing wheelchair design using a six-bar mechanism Spring balancing used to reduce user effort to self-lift to the standing position Kinematic analysis used to determine convenient handle location for user ease Customisability for wide range of users to ensure correct posture, optimal effort Design refined through multiple iterations using inputs from users and clinicians Design commercialised at an affordable cost, making it accessible to a larger population [ABSTRACT FROM AUTHOR]

This paper presents a system that utilizes vision transformers and multimodal feedback modules to facilitate navigation and collision avoidance for the visually impaired. By implementing vision transformers, the system achieves accurate object detection, enabling the real-time identification of objects in front of the user. Semantic segmentation and the algorithms developed in this work provide a means to generate a trajectory vector of all identified objects from the vision transformer and to detect objects that are likely to intersect with the user's walking path. Audio and vibrotactile feedback modules are integrated to convey collision warning through multimodal feedback. The dataset used to create the model was captured from both indoor and outdoor settings under different weather conditions at different times across multiple days, resulting in 27,867 photos consisting of 24 different classes. Classification results showed good performance (95% accuracy), supporting the efficacy and reliability of the proposed model. The design and control methods of the multimodal feedback modules for collision warning are also presented, while the experimental validation concerning their usability and efficiency stands as an upcoming endeavor. The demonstrated performance of the vision transformer and the presented algorithms in conjunction with the multimodal feedback modules show promising prospects of its feasibility and applicability for the navigation assistance of individuals with vision impairment. [ABSTRACT FROM AUTHOR]

Only 1 in 10 people with disabilities can access assistive devices, underlining the critical need for low-cost assistive products. This paper describes the design evolution of a manual user-operated standing wheelchair (SWC), translating from prototype to product. The SWC design has been refined over 5 years through multiple iterations based on comments from user trials. The SWC product, Arise, provides standing functionality, facile outdoor mobility, affordability, customisability, and is aesthetically pleasing. A one-time fitting and training ensure optimal effort for operation, correct posture, and comfortable user experience. The SWC accommodates users of different sizes and body weights (up to 110 kg) and minimises user effort with the use of a gas spring. Incorporating discrete adjustments enables customisation while retaining the advantages of mass manufacturing, which is necessary for ensuring affordability. The SWC has been field-tested and well received by over 100 wheelchair users, and Arise was launched recently by the industry partner. It should be noted that RESNA cautions on the use of any standing device without medical consultation. Nevertheless, with appropriate dissemination and awareness, it is anticipated that the affordable SWC product, Arise, will immensely benefit the eligible users and make a difference in their quality of life. Provides standing functionality, outdoor mobility, affordability and customisability Accommodates users of different sizes and body weights in a mass-manufacturable design Ergonomic design reduces net user effort during sit-to-stand, stand-to-sit activity Design iterated and refined based on feedback from over 100 user trials [ABSTRACT FROM AUTHOR]

Featured Application: This paper presents a redesign approach integrating design for additive manufacturing and topology optimisation, which supports the designer in product and process modification. Thanks to the integration of a systematic concept selection-based approach for product optimisation, the method provides an objective assessment of the developed configurations from a functional and production point of view. As a main goal, the method leads to cost and material reduction, without affecting product functionality. All these tools are implemented into a commercial computer aided technologies (CAx) platform, leading to a higher level of integration. The development of additive manufacturing allows the transformation of technological processes and the redesign of products. Among the most used methods to support additive manufacturing, the design can be optimised through the integration of topology optimisation techniques, allowing for creating complex shapes. However, there are critical issues (i.e., definition of product and process parameters, selection of redesign variants, optimised designs interpretation, file exchange and data management, etc.) in identifying the most appropriate process and set-ups, as well as in selecting the best variant on a functional and morphological level. Therefore, to fully exploit the technological potentials and overcome the drawbacks, this paper proposes a systematic redesign approach based on additive manufacturing technologies that integrate topology optimisation and a tool for selecting design variants based on the optimisation of both product and process features. The method leads to the objective selection of the best redesigned configuration in accordance with the key performance indicators (KPIs) (i.e., functional and production requirements). As a case study, the redesign of a medical assistive device is proposed, previously developed in fused filament fabrication and now optimised for being 3D printed with selective laser melting. [ABSTRACT FROM AUTHOR]

Recent advances in machine and deep learning algorithms and enhanced computational capabilities have revolutionized healthcare and medicine. Nowadays, research on assistive technology has benefited from such advances in creating visual substitution for visual impairment. Several obstacles exist for people with visual impairment in reading printed text which is normally substituted with a pattern-based display known as Braille. Over the past decade, more wearable and embedded assistive devices and solutions were created for people with visual impairment to facilitate the reading of texts. However, assistive tools for comprehending the embedded meaning in images or objects are still limited. In this paper, we present a Deep Learning approach for people with visual impairment that addresses the aforementioned issue with a voice-based form to represent and illustrate images embedded in printed texts. The proposed system is divided into three phases: collecting input images, extracting features for training the deep learning model, and evaluating performance. The proposed approach leverages deep learning algorithms; namely, Convolutional Neural Network (CNN), Long Short Term Memory (LSTM), for extracting salient features, captioning images, and converting written text to speech. The Convolution Neural Network (CNN) is implemented for detecting features from the printed image and its associated caption. The Long Short-Term Memory (LSTM) network is used as a captioning tool to describe the detected text from images. The identified captions and detected text is converted into voice message to the user via Text-To-Speech API. The proposed CNN-LSTM model is investigated using various network architectures, namely, GoogleNet, AlexNet, ResNet, SqueezeNet, and VGG16. The empirical results conclude that the CNN-LSTM based training model with ResNet architecture achieved the highest prediction accuracy of an image caption of 83%. [ABSTRACT FROM AUTHOR]

The manual user-operated Arise Standing Wheelchair (SWC) is the end-result of multiple design iterations based on comments from user trials. The Arise SWC provides standing functionality, outdoor mobility, affordability, and customizability. This paper describes a user experience study of the Arise SWC's pre-commercial version. Thirty participants (N = 30, 25 Male, 5 Female) were recruited for the study. All the participants were people with spinal cord injury. The study was conducted over a period of six weeks (five participants per week) within the hospital premises under the supervision of clinical personnel. A 30 min interactive training session involved thirteen activities. During the trial period, the participants were trained to perform twenty-two activities to familiarize themselves with the SWC. The participants were also trained to perform four functional usage activities with the SWC. At the end of the study, participant responses to ten outcome measures were captured using a smiley-based Likert-scale questionnaire. A majority of the participants (93.3%) felt happy when they stood in the SWC. The majority participants (83.3%) preferred the Arise SWC over their current wheelchair. Also, 80% participants anticipated that they could get more work done at home using the standing function of the wheelchair. A one-time fitting and training ensured optimal effort for the SWC operation, correct posture, and comfortable user experience. With proper dissemination and awareness, it is believed that the Arise SWC will benefit eligible users and improve their quality of life. The Arise wheelchair provides standing functionality, outdoor mobility, affordability, and customizability. Study confirms that incorporating standing functionality can improve the quality of life for wheelchair users. The majority of users were happy, felt safe and expected to do more with the standing functionality. Study results support further testing in real world conditions beyond the hospital setting. [ABSTRACT FROM AUTHOR]

Millions of people suffer from a decline in grip strength and hand function due to conditions such as chronic disease, injuries, and aging. Hand function decline results in difficulties with performing activities of daily living, where grasping, lifting, and releasing objects are essential. There is an increasing demand for assistive gloves to enhance users' hand function and improve their independence. This paper presents the design of a new bidirectional lightweight assistive glove and demonstrates its capabilities through comprehensive experiments using human subjects. The developed glove can provide adequate power augmentation for grasping and releasing objects due to its simple yet effective design using spring steel strips and linear actuators. The glove directly transfers assistive forces to users' fingertips without any complex intermediate mechanism, and its low weight of 196 g promotes its usability. The rigorous experiment design provided a thorough assessment of the developed glove by accounting for both parameters of size and weight of objects and by including subjects with different hand sizes. To quantify the glove's performance, the subjects' muscle activity, their finger and thumb joints' trajectories, and their grasping forces while using the glove were investigated. The glove could generate the necessary grasping forces to assist with lifting common-household objects. The subjects' muscle activity significantly decreased when using the glove for object manipulation. The trajectories of the index finger and thumb joints when using the glove were dependent on the size of objects similar to natural unassisted grasping. The obtained results demonstrate the glove's ability for grip power augmentation of individuals with declining hand strength. [ABSTRACT FROM AUTHOR]

Quality of life for the visually impaired is an urgent worldwide issue that needs to be addressed. Obstacle detection is one of the most important navigation tasks for the visually impaired. In this research, a novel range sensor placement scheme is proposed in this paper for the development of obstacle detection devices. Based on this scheme, two prototypes have been developed targeting at different user groups. This paper discusses the design issues, functional modules and the evaluation tests carried out for both prototypes. [ABSTRACT FROM AUTHOR]

The solution described in this paper allows wheelchair users with reduced mobility or physical disabilities to move independently throughout an aircraft and to board and disembark autonomously. A motorized aircraft seat was developed to substitute current aircraft aisle wheelchairs. The real-scale functional prototype was evaluated in a focus group. The results show that the proposed solution is considered superior to current solutions in nine of twenty requirements and neutral in one of them. There was low agreement among the focus group participants in ten requirements, even though the focus group discussion brought interesting reflections, including positive feedback, critics, and suggestions for further research and development in the field. The design concept consists of a motorized wheelchair that becomes the seat of the aircraft when anchored on a docking platform attached to the aircraft fuselage via a seat track. The manoeuvring is allowed by a rotating mechanism, which solves a critical function that is to enable wheelchair manoeuvring in the narrow aisles of aircraft. A parking assistant system aids the control of the motorized wheelchair. The main benefits of this solution are to reduce seat transfers during the flight experience and to provide more autonomy and comfort for passengers during flights. A motorized aircraft seat was developed to replace traditional aircraft aisle wheelchairs. A real-scale functional prototype was built, tested in an aircraft mockup, and evaluated in a focus group. The main benefits of the proposed solution are to reduce the number of chair transfers during the flight experience and to provide more autonomy for passengers. Additional benefits are to allow the passengers to experience less physical and emotional stresses, to enter the aircraft corridor looking ahead, and to sit in any aisle position in the aircraft. [ABSTRACT FROM AUTHOR]

In this paper, a design optimization approach for assistive devices based on the simulation of the robot and human model is proposed. The proposed human model in the loop (HMIL) approach exploits an augmented human-robot model for interaction analysis, and to evaluate and modify the assistive device effectiveness. In this regard, a lower-limb assistive device (RoboWalk) for elderly and a human skeletal system are modeled and augmented to use the human-robot interaction forces in the proposed HMIL strategy. Due to the particular design of RoboWalk, a complete set of constraints are specified to ensure the solution feasibility and compatibility of the device in different poses. This constrained optimization problem is solved by weighted sum particle swarm optimization (WSPSO) and multi-objective PSO (MOPSO) algorithm. As a result of this optimization, several appropriate sets of design parameters are found to minimize the load on human joints, actuator torque and mass. Among the obtained optimal points, the point minimizing an introduced index is selected as the final design. [ABSTRACT FROM AUTHOR]

It has been observed that people with disability display lower education achievements when compared to normal peer groups. In the world of technology, the learning skill among differently abled students can be enhanced through information technology. People with disabilities have to recognize, understand, navigate and interact with IT so that they can participate equally in the economic and social aspects of society. The technology has been constantly used from mobile phones, to iPads, to laptops and TVs. Mobile devices provide accessibility features, flexibility, portability and customizability for people with disabilities (PwD). As a result of using mobile devices, Mobile Apps have been designed for people with disabilities, which help them connected with the world. In this paper, survey of various mobile apps were discussed which helps in enhancing the learning skill of PwDs. A special mobile app named SHA GYAAN is proposed especially for hearing and speech impaired children. Keeping the needs of students, this mobile application enhances the learning capability of the children between the age group of 3 to 8. This app is intended to facilitate the joyful learning of the children and to evolve and build their learning skills. The major areas covered in this mobile app are Foundation language (Tamil & English), Environmental Science and Mathematics. [ABSTRACT FROM AUTHOR]

Additive Manufacturing technologies are particularly suitable for developing highly customised products, even in rehabilitation and occupational therapy fields. Nowadays it is easy and cheap to design and produce such artefacts, although they require systematic approaches and standardized tests to validate their effectiveness. Therefore, this paper proposes a methodological approach for the application of Additive Manufacturing technologies to the codesign of assistive devices, focusing on rheumatoid or scleroderma patients. These patients present hand and finger disorders that limit simple everyday tasks, and need assistive devices to protect the damaged joints. The commercial assistive devices available on the market generally lack of customisation in dimensions and morphology, or their aspect is too stigmatizing. In order to achieve a better correspondence between patients' needs and assistive devices, we propose to involve the patients in a co-design team, in order to directly transfer their desires and creativity in unconventional solutions. The assistive devices are parametrically modelled and virtually prototyped in order to assess their functionality and customisation, and then additively manufactured. Finally, their effectiveness is tested by patients by means of standardized assessment tests that generate useful feedback. The paper proposes a case study about an assistive device for daily living activities. [ABSTRACT FROM AUTHOR]

Abstract Background Soft, wearable, powered exoskeletons are novel devices that may assist rehabilitation, allowing users to walk further or carry out activities of daily living. However, soft robotic exoskeletons, and the more commonly used rigid exoskeletons, are not widely adopted clinically. The available evidence highlights a disconnect between the needs of exoskeleton users and the engineers designing devices. This review aimed to explore the literature on physiotherapist and patient perspectives of the longer-standing, and therefore greater evidenced, rigid exoskeleton limitations. It then offered potential solutions to these limitations, including soft robotics, from an engineering standpoint. Methods A state-of-the-art review was carried out which included both qualitative and quantitative research papers regarding patient and/or physiotherapist perspectives of rigid exoskeletons. Papers were themed and themes formed the review’s framework. Results Six main themes regarding the limitations of soft exoskeletons were important to physiotherapists and patients: safety; a one-size-fits approach; ease of device use; weight and placement of device; cost of device; and, specific to patients only, appearance of the device. Potential soft-robotics solutions to address these limitations were offered, including compliant actuators, sensors, suit attachments fitting to user’s body, and the use of control algorithms. Conclusions It is evident that current exoskeletons are not meeting the needs of their users. Solutions to the limitations offered may inform device development. However, the solutions are not infallible and thus further research and development is required.

Objective: In this paper we presented a novel shoulder subluxation support that aims to reduce the stress on the passive structures around the shoulder of patients with glenohumeral subluxation and glenohumeral-related shoulder pain. The device applies a force to the upper arm without impeding the functional range of motion of the arm. Our design contains a mechanism that statically balances the arm with two elastic bands. Methods: A technical evaluation study was conducted to assess the performance of the orthosis. Additionally, two patients evaluated the orthosis. Results: The results of the technical validation confirm the working of the balancing mechanism. The pilot study demonstrated that the shoulder support increased the feeling of stability of the shoulder joint and, to a lesser extent, decreased shoulder pain. Furthermore, both patients reported that the orthosis did not impede their range of motion. Conclusion: In this research we developed a shoulder orthosis based on two statically balanced springs that support the shoulder of patients with glenohumeral subluxation that have residual shoulder muscle force. Compared to existing shoulder supports, our design does not impede the range of motion of the arm, and continues to provide a stabilizing force to the shoulder, even if the arm is moved away from the neutral position. Tests with two participants showed promising results. Significance: The device presented in this work could have a significant impact on the shoulder function which may improve rehabilitation outcome and improve the quality of life of patients suffering from glenohumeral subluxation and shoulder pain. [ABSTRACT FROM AUTHOR]

This paper introduces a fully portable, lightweight exosuit-type device for shoulder and elbow assistance. The main motivation of this research was to design a portable upper limb exosuit capable to assist dynamic rehabilitation tasks where patient can involve trunk motions and overground movements (e.g., during pick-and-place tasks). The proposed system provides assistance for shoulder flexion and abduction, as well as for elbow flexion. The mechanism is driven by DC motors which are worn on the wearer's back, and the power is transferred from the actuators to the arm by means of cable-driven transmission. The unique features of the proposed exosuit are the absence of rigid links or joints around the arm, high compliance and portability. This paper describes operating principle and kinematic model of the proposed exosuit and provides force analysis and experimental evaluation of the manufactured device. As the result of this work, we performed a simulation of rehabilitation scenario with the developed wearable prototype. [ABSTRACT FROM AUTHOR]

This paper introduces a novel concept on reading assistive technologies for the blind: the TactoBook, a system that is able to translate entire electronic books (eBooks) to Braille code and to reproduce them in portable electronic Braille terminals. The TactoBook consists of a computer-based translator that converts fast and automatically any eBook into Braille. The Braille version of the eBook is then encrypted as a file and stored in a USB memory drive which is later inserted and reproduced in a compact, lightweight, and highly-portable tactile terminal. In particular, this paper presents a piezoelectric ultrasonic actuation approach to design and implement such portable Braille terminal. Actuating mechanism, design concept, first prototype, and performance results are presented and discussed. [ABSTRACT FROM AUTHOR]

An upper-arm wearable exoskeleton has been designed for the assistance and functional training of humans. One of the goals of this design is to provide passive assistance to a user by gravity balancing, while keeping the transmitted forces to the shoulder joints at a minimum. Consistent with this goal, this paper discusses: analytical gravity balancing design conditions for the structure of the exoskeleton; a possible implementation of these conditions into practical designs; the minimization of transmitted joint forces to the shoulder while satisfying the gravity balancing conditions; the numerical optimization of the system for gravity balancing and minimization of transmitted forces; and the effect of parameter variation on joint moments and joint forces via numerical optimization.An implementation of the design was undertaken using zero-free-length springs. The design idea presented in this paper may be useful in relieving the actuators effort of exoskeletons to support the weight of the arm and therefore the possibility of using small actuators and making the system light and portable or even a stand-alone passive support device can be developed based on these gravity balancing conditions. [ABSTRACT FROM AUTHOR]

Patients with neurological or orthopedic lesions require assistance during therapies with repetitive movements. NURSE (cassiNo-qUeretaro uppeR-limb aSsistive dEvice) is an arm movement aid device for both right- and left-upper limb. The device has a big workspace to conduct physical therapy or training on individuals including kids and elderly individuals, of any age and size. This paper describes the mechanism design of NURSE and presents a numerical procedure for testing the mechanism feasibility that includes a kinematic, dynamic, and FEM (Finite Element Method) analysis. The kinematic demonstrated that a big workspace is available in the device to reproduce therapeutic movements. The dynamic analysis shows that commercial motors for low power consumption can achieve the needed displacement, acceleration, speed, and torque. Finite Element Method showed that the mechanism can afford the upper limb weight with light-bars for a tiny design. This work has led to the construction of a NURSE prototype with a light structure of 2.6 kg fitting into a box of 35 × 45 × 30 cm. The latter facilitates portability as well as rehabilitation at home with a proper follow-up. The prototype presented a repeatability of ±1.3 cm that has been considered satisfactory for a device having components manufactured with 3D rapid prototyping technology. [ABSTRACT FROM AUTHOR]

Aim: Assistive technologies traditionally rely on either powered actuation or passive structures to provide increased strength, support or the ability to perform specific functions. At one end of the spectrum are powered exoskeletons, which significantly increase a user's strength, but require powerful actuators, complex control systems and heavy power sources. At the other end are orthoses, which are generally unpowered and light in weight, relying on the mechanical properties of passive mechanical elements. Ideally, assistive technologies should combine the benefits of both systems and enhance human motion while remaining lightweight and efficient. This paper presents the development of a lightweight unpowered ankle exoskeleton that relies on the spring-like properties of a Pneumatic Artificial Muscle, which is inflated and sealed. Methods: This flexible air-spring is used to harness gait energy and compliment the human ankle torque at push-off. To mechanically validate the proposed exoskeleton design, a prototype was fabricated and experimentally tested. Results: Unlike other existing devices, the proposed unpowered exoskeleton was able to store a significant amount of energy and release it all at once. The timing mechanism worked as intended and triggered the release of 115 N m of torque when the ankle reached a pre-determined angle. Conclusion: Overall, the device demonstrated the ability to provide significant contribution to the ankle torque, timed to release precisely at the push-off phase of the gait cycle. The currently proposed ankle exoskeleton makes use of an unpowered, fully mechanical system to provide walking assistance to users by providing additional torque to the ankle joint. The newly developed assistive device is devised as a solution for persons struggling with mobility issues, and can be used both as a means for rehabilitation or as a permanent assistive devices for patients struggling with long-term disabilities. The device also has potential to be used as a performance enhancing device for ablebodied users by reducing muscle fatigue during extended physical exertion. [ABSTRACT FROM AUTHOR]

Introduction: Possibilities Project Plus (PPPlus) is a free assistive device (AD) marketplace and research platform for persons with disabilities. The overall aim of PPPlus is to increase access to ADs through an integration of service, research and education. To maximize positive outcomes and reflect community needs a co-design approach informed by guiding principles of Integrated Knowledge Translation (IKT) was adopted, with examination of methods related to Experience Based Co-design. The integrated nature of PPPlus benefits from the use of specific engagement strategies that align with IKT principles to meet project objectives. The extent to which partnership and engagement strategies are specified in the rehabilitation research literature vary greatly and studies that provide information on specific strategies used to operationalize principles are limited. The objective of this manuscript is to provide a description of the co-design approach and the specific strategies that strive to achieve meaningful user engagement. By reflecting on these processes we also report on limitations and strategies for improvement. Methods: The co-design approach is highlighted through specific project activities including a representative governance structure, ongoing environmental scan and iterative Health Equity Impact Assessments (HEIA). The inherent engagement strategies that align with IKT and co-design principles are described. Discussion: The most impactful engagement strategies included early engagement of partners throughout all phases, ensuring project relevance across partners through alignment of objectives with complementary aims, using HEIAs to promote equitable outcomes from diverse stakeholders, the representative governance structure beyond individuals with disabilities and caregivers, and the use of experiences and stories to inform development. Next steps: This examination of specific strategies related to co-design focused on partnership engagement and informed targets for enhancement of the PPPlus initiative. These include being more intentional in developing a more rigorous process for evaluation that includes an assessment of strategies and their impact--especially as related to partner engagement. In addition, ongoing and enhanced efforts will focus on developing knowledge products that bring to life the most salient experience-based user stories emerging from the environmental scan with these being used to drive distinct co-creation events as well as serve other knowledge mobilization purposes (i.e., supporting policy change). [ABSTRACT FROM AUTHOR]

The amount of research on developing exoskeletons for human gait assistance has been growing in the recent years. However, the control design of exoskeletons for assisting human walking remains unclear. This paper presents a novel bio-inspired reflex-based control for assisting human walking. In this approach, the leg force is used as a feedback signal to adjust hip compliance. The effects of modulating hip compliance on walking gait is investigated through joint kinematics, leg muscle activations and overall metabolic costs for eight healthy young subjects. Reduction in the average metabolic cost and muscle activation are achieved with fixed hip compliance. Compared to the fixed hip compliance, improved assistance as reflected in more consistent reduction in muscle activities and more natural kinematic behaviour are obtained using the leg force feedback. Furthermore, smoother motor torques and less peak power are two additional advantages obtained by compliance modulation. The results show that the proposed control method which is inspired by human posture control can not only facilitate the human gait, but also reduce the exoskeleton power consumption. This demonstrates that the proposed bio-inspired controller allows a synergistic interaction between human and robot. [ABSTRACT FROM AUTHOR]

An exoskeleton is defined as a distinctive kind of robot to be worn as an overall or frame, effectively supporting, or in some cases substituting for, the user's own movements. In this paper a new three-dimensional (3D) printed bydgostian hand exoskeleton is introduced and biomedically characterized. The proposed concept is promising, and the described approach combining biomechanical factors and 3D modeling driven by detailed hand exoskeleton patterns may constitute a key future method of ergonomic hand exoskeleton design and validation prior to manufacturing. Despite the aforementioned approach, we should be aware that hand exoskeleton constitutes hand support and rehabilitation robot system developing with the user; thus, certain coordination and continuity of the "hardware" part of the whole system and the training paradigm are essential for therapy efficacy. [ABSTRACT FROM AUTHOR]

This study assessed the effectiveness of a passive back support exoskeleton during a mechanical loading task. Fifteen healthy participants performed a simulated patient transfer task while wearing the Laevo (version 2.5) passive back support exoskeleton. Collected metrics encompassed L5-S1 joint moments, back and abdominal muscle activity, lower body and back kinematics, center of mass displacement, and movement smoothness. A statistical parametric mapping analysis approach was used to overcome limitations from discretization of continuous data. The exoskeleton reduced L5-S1 joint moments during trunk flexion, but wearing the device restricted L5-S1 joint flexion when flexing the trunk as well as hip and knee extension, preventing participants from standing fully upright. Moreover, wearing the device limited center of mass motion in the caudal direction and increased its motion in the anterior direction. Therefore, wearing the exoskeleton partly reduced lower back moments during the lowering phase of the patient transfer task, but there were some undesired effects such as altered joint kinematics and center of mass displacement. Statistical parametric mapping analysis was useful in determining the benefits and hindrances produced by wearing the exoskeleton while performing the simulated patient transfer task and should be utilized in further studies to inform design and appropriate usage. [ABSTRACT FROM AUTHOR]

Individuals with mobility impairments related to age, injury, or disease, often require the help of an assistive device (AD) such as a cane to ambulate, increase safety, and improve overall stability. Instrumenting these devices has been proposed as a non-invasive way to proactively monitor an individual’s reliance on the AD while also obtaining information about behaviors and changes in gait. A critical first step in the analysis of these data, however, is the accurate processing and segmentation of the sensor data to extract relevant gait information. In this paper, we present a highly accurate multi-sensor-based gait segmentation algorithm that is robust to a variety of walking conditions using an AD. A matched filtering approach based on loading information is used in conjunction with an angular rate reversal and peak detection technique, to identify important gait events. The algorithm is tested over a variety of terrains using a hybrid sensorized cane, capable of measuring loading, mobility, and stability information. The reliability and accuracy of the proposed multi-sensor matched filter (MSMF) algorithm is compared with variations of the commonly employed gyroscope peak detection (GPD) algorithm. Results of an experiment with a group of 30 healthy participants walking over various terrains demonstrated the ability of the proposed segmentation algorithm to reliably and accurately segment gait events. [ABSTRACT FROM AUTHOR]

Patients with head drop need external support to keep the head up and move it around. Their neck muscles are not strong enough to bring the head back to the neutral configuration from a flexed position. They often use static neck braces to keep the head in the upright configuration. These braces do not allow movement of the head-neck and cause further atrophy to the muscles. In this paper, we present a spring-loaded dynamic neck brace to support the head in a desired equilibrium configuration. The brace is fitted with torsional springs that can provide restoring forces to the head as it is displaced from the equilibrium configuration. The equilibrium configuration is adjustable by preloading the springs. In this paper, we present a mathematical model and validate through experiments with a prototype. The dynamic brace was found to provide sufficient support to the neck in a configuration while also allowing the users to move their head. [ABSTRACT FROM AUTHOR]

This paper presents ALVU (Array of Lidars and Vibrotactile Units), a contactless, intuitive, hands-free, and discreet wearable device that allows visually impaired users to detect low- and high-hanging obstacles, as well as physical boundaries in their immediate environment. The solution allows for safe local navigation in both confined and open spaces by enabling the user to distinguish free space from obstacles. The device presented is composed of two parts: a sensor belt and a haptic strap. The sensor belt is an array of time-of-flight distance sensors worn around the front of a user’s waist, and the pulses of infrared light provide reliable and accurate measurements of the distances between the user and surrounding obstacles or surfaces. The haptic strap communicates the measured distances through an array of vibratory motors worn around the user’s upper abdomen, providing haptic feedback. The linear vibration motors are combined with a point-loaded pretensioned applicator to transmit isolated vibrations to the user. We validated the device’s capability in an extensive user study entailing 162 trials with 12 blind users. Users wearing the device successfully walked through hallways, avoided obstacles, and detected staircases. [ABSTRACT FROM AUTHOR]

Lumbar stabilization exercises are commonly employed in the rehabilitation of patients with low back pain. However, many patients discontinue these exercises, generally calisthenics using various postures or tools, due to the difficulty of providing an appropriate exercise load intensity. This challenge results in an inability to apply the desired strength to the target lumbar muscles and sometimes leads to an excessive load on unintended areas during calisthenics. Consequently, a method that enables patients to exercise continuously and progressively recover is required, specifically one that can target the lumbar muscles with a desired load. To address this issue, we propose a rehabilitation assistive device that quantitatively controls the lumbar spine load. In isometric lumbar stabilization exercises, our method involves precise compensation for gravity. The device, equipped with a series elastic actuator, is positioned beneath the patient in a lying posture. It applies an assistive force in the direction opposite to gravity, enabling precise control of the load on the lumbar region and reducing the vertical load on the spine. To validate the effectiveness of our proposed method, we conducted experiments with 20 healthy subjects across three exercises and analyzed the electromyography signal using nonparametric statistical methods. Our objective was to determine whether the load on the target lumbar muscles could be precisely and gradually controlled. The statistical results indicate that exercises performed using the proposed device produce statistically significant load changes in the target lumbar muscles. [ABSTRACT FROM AUTHOR]

To examine the biomechanical demands of manual wheelchair propulsion, it is crucial to determine the wheelchair user's (WCU) force for propulsion technique parameter calculation. When using a pushrim-activated power-assisted wheelchair (PAPAW) on a wheelchair ergometer, a combined propulsion force from the WCU and PAPAW is exerted. To understand PAPAW's assistance and distinguish the WCU's force application from the force exerted by the PAPAW, both propulsion components must be assessed separately. In this study, a calibration of the PAPAW on an ergometer was developed to achieve this separation. The calibration consists of five steps: (I) Collecting data on force and velocity measured from the ergometer, along with electrical current and velocity from the PAPAW. (II) Synchronizing the velocity signals of the wheelchair ergometer and PAPAW using cross-correlation. (III) Calibrating the PAPAW's electromotors to convert electrical current (mA) to force (N). A product-specific motor constant of 0.30, provided an average ICC of 0.563, indicating a moderate agreement between the raw ergometer data (N) and the motor constant-converted drive-rim (PAPAW) data (from mA to N). (IV) Subtracting the PAPAW's force signal from the ergometer's measured force to isolate forces generated by the WCU. (V) Using markerless motion capture to determine and validate the phase of hand contact with the handrim. This technical note provides an example of PAPAW calibration for researchers and clinicians. It emphasizes the importance of integrating this calibration into the development of PAPAW devices to reveal the complex interaction between PAPAW and WCU during wheelchair propulsion. [ABSTRACT FROM AUTHOR]

Objectives: This is a need assessment study conducted on wheelchair users with limited locomotion ability in the legs in the Ahmedabad urban region in India. The results describe the unmet needs in the indoor and outdoor settings. Even though India is a large country with huge diversity in local climate and terrain and big socio-economic disparity, need assessment studies for assistive technology across various socio-economic or with region specificity are extremely scarce. Accordingly, this study aims to understand the needs and requirements of mobility assistive technology users that are not met by their current devices. Methods: Data from 69 participants having physical disabilities were collected through interviews and 6 of the participants were video-tapped to observe their daily routine. Meanwhile, a qualitative analysis of the collected data was carried out. Results: The analysis highlights problems of participants, such as working in the kitchen, inability to perform everyday indoor tasks, inaccessibility of toilets and public transport, etc. Discussion: A mixture of qualitative and quantitative data analysis showed that the major features that the Indian wheelchair users wanted were the ability to adjust the height of the chair, the ability to reach objects without too much maneuvering of the wheelchair, ease of transfer from wheelchair to toilet seat and back and also meet outdoor needs. Hence, a wheelchair that can be used in both indoor and outdoor settings is one of the most imminent needs for such wheelchair users. [ABSTRACT FROM AUTHOR]

Objectives: To review models and instruments for the selection and advisory process of assistive technology in the rehabilitation field as reported in the current scientific literature. Design: Systematic literature review. Methods: A systematic literature search was conducted in MEDLINE (2003-2007). In a peer-review process with four independent investigators, studies were selected according to predefined inclusion and exclusion criteria. Because of the poor publication situation, non-research sources were included as well. The data extracted and compared are: information concerning the selection process for assistive technology, whether a client-centred approach is used during the selection procedure, the use of models and instruments, and their compatibility with the ICF. Results: The search resulted in 16 papers. None of the studies had an experimental design; nine of the publications were literature reviews. There is a lack of reliable and valid models and instruments for the selection process of assistive technology in the scientific literature. The prevalence of the Matching Person and Technology Model from Scherer (1998) is explicit in the publications. The ICF and ISO 9999 are the only classification systems mentioned in relation to assistive technology, although rarely. Conclusion: This is a poorly developed field resulting in a lack of evidence-based procedures for AT selection. Such procedures are important to increase consumer satisfaction and the efficiency of AT provision. There is clearly a need for further research in this field. [ABSTRACT FROM AUTHOR]

This paper presents clinical results from the use of MONItor-noMAD (MONIMAD), which is a reactive robotized interface for lower limb rehabilitation of patients suffering from cerebellar disease. The first problem to be addressed is the postural analysis of sit-to-stand motion. Experiments with healthy subjects were performed for this purpose. Analysis of external forces shows that sit-to-stand transfer can be subdivided into several phases: preacceleration, acceleration, start rising, and rising. Observation of center of pressure, ground forces, and horizontal components force on handles yields rules that identify the stability of the patient and adjust the robotic interface motion to the human voluntary movement. These rules are used in a fuzzy-based controller implementation. The controller is validated on experiments with diseased patients at Bellan Hospital, Paris, France. [ABSTRACT FROM AUTHOR]

This paper presents a novel pin-matrix tactile-display device that exhibits some advantageous features for the blind: low cost, lightweight, compactness, and high portability. The prototype consists of 64 tactile pins actuated by shape memory alloys with 2.6-mm spatial resolution (Braille-like). Unlike existing devices, the full display weighs only 200 g, and its compact dimensions make it easy to carry. A technical overview of the system is presented, as well as preliminary results on shape recognition, to evaluate its performance on tactile rendering. [ABSTRACT FROM AUTHOR]

Purpose. The previously published 'Framework for the conceptual modelling of assistive technology device (ATD) outcomes' assumes antecedent factors that inform it and influence its component variables. This paper proposes a model of factors influencing consumer predispositions and provider practices related to procuring a particular ATD, which is the starting point in the framework. Method. The relevant literature on a variety of factors that influence specific ATD selection is summarized. Results. The decision that a particular ATD is an appropriate and desirable support for an individual is the result of a process which is affected by a broader societal climate that determines, in part, unique personal climates which then foster unique provider and consumer perspectives predisposing each to the selection of a particular ATD. Conclusions. The proposed 'Framework for modelling the selection of ATDs' can contribute to clinical practice and outcomes research by highlighting factors important to consider prior to ATD selection. [ABSTRACT FROM AUTHOR]

In this paper, we report on the evaluation strategy and the results that were obtained from the final end-user evaluation process of an innovative robotic assistive device supporting mobility. More specifically, the paper deals with the evaluation of the MOBOT robotic rollator as regards to the system’s overall performance and its individual assistive characteristics and functionalities, as implemented in respect to (i) the provided cognitive assistance, and (ii) the adopted audio-gestural human-robot communication model. User evaluation was designed on the basis of an extensive survey of scales and methodologies widely reported in the relevant literature. The actual evaluation phase exploited the QUEST 2.0, ATDPA-Device Form, and PYTHEIA scales to measure the subjective satisfaction of the users. The PYTHEIA scale, in particular, was structured in order to fill the gaps that were identified during the study of previously existing tools for measuring assistive device user satisfaction. The scale was applied for the first time during the reported evaluation process. An analysis of the results showed that MOBOT was ranked very high by end users in all of the aspects addressed by the three employed assessment scales, thus providing significant evidence for positive acceptance of any industrialized outcome of the current prototype in the assistive robots market. [ABSTRACT FROM AUTHOR]

Background: Adults with Duchenne muscular dystrophy (DMD) can benefit from devices that actively support their arm function. A critical component of such devices is the control interface as it is responsible for the human-machine interaction. Our previous work indicated that surface electromyography (sEMG) and force-based control with active gravity and joint-stiffness compensation were feasible solutions for the support of elbow movements (one degree of freedom). In this paper, we extend the evaluation of sEMG- and force-based control interfaces to simultaneous and proportional control of planar arm movements (two degrees of freedom).Methods: Three men with DMD (18-23 years-old) with different levels of arm function (i.e. Brooke scores of 4, 5 and 6) performed a series of line-tracing tasks over a tabletop surface using an experimental active arm support. The arm movements were controlled using three control methods: sEMG-based control, force-based control with stiffness compensation (FSC), and force-based control with no compensation (FNC). The movement performance was evaluated in terms of percentage of task completion, tracing error, smoothness and speed.Results: For subject S1 (Brooke 4) FNC was the preferred method and performed better than FSC and sEMG. FNC was not usable for subject S2 (Brooke 5) and S3 (Brooke 6). Subject S2 presented significantly lower movement speed with sEMG than with FSC, yet he preferred sEMG since FSC was perceived to be too fatiguing. Subject S3 could not successfully use neither of the two force-based control methods, while with sEMG he could reach almost his entire workspace.Conclusions: Movement performance and subjective preference of the three control methods differed with the level of arm function of the participants. Our results indicate that all three control methods have to be considered in real applications, as they present complementary advantages and disadvantages. The fact that the two weaker subjects (S2 and S3) experienced the force-based control interfaces as fatiguing suggests that sEMG-based control interfaces could be a better solution for adults with DMD. Yet force-based control interfaces can be a better alternative for those cases in which voluntary forces are higher than the stiffness forces of the arms. [ABSTRACT FROM AUTHOR]

This paper presents the modular design and control of a novel compliant lower limbmulti-joint exoskeleton for the rehabilitation of ankle kneemobility and locomotion of pediatric patients with neurological diseases, such as Cerebral Palsy (CP). The device consists of an untethered powered knee–ankle–foot orthosis (KAFO), addressed as WAKE-up (Wearable Ankle Knee Exoskeleton), characterized by a position control and capable of operating synchronously and synergistically with the human musculoskeletal system. The WAKE-up mechanical system, control architecture and feature extraction are described. Two test benches were used to mechanically characterize the device. The full system showed a maximum value of hysteresis equal to 8.8% and a maximum torque of 5.6 N m/rad. A pre-clinical use was performed, without body weight support, by four typically developing children and three children with CP. The aims were twofold: 1) to test the structure under weight-bearing conditions and 2) to ascertain its ability to provide appropriate assistance to the ankle and the knee during overground walking in a real environment. Results confirm the effectiveness of the WAKE-up design in providing torque assistance in accordance to the volitionalmovements especially in the recovery of correct foot landing at the start of the gait cycle. [ABSTRACT FROM AUTHOR]

Essential tremor is a disorder that causes involuntary oscillations in patients both while they are engaged in actions and when maintaining a posture. Such patients face serious difficulties in performing daily living activities such as meal movement. We have been developing an electromyogram (EMG)-controlled exoskeleton to suppress tremors to support the movements of these patients. The problem is that the EMG signal of the patients is modulated by the tremor signal as multiplicative noise. In this paper, we proposed a novel signal processing method to demodulate patients' EMG signals. We modelled the multiplicative tremor signal with a powered sine wave and the tremor signal in the EMG signal was removed by dividing the modelled tremor signal into the EMG signal. To evaluate the effectiveness of the demodulation, we applied the method to a real patient's EMG signal, extracted from biceps brachii while performing an elbow flexion. We quantified the effect of the demodulation by root mean square error between two kinds of muscle torques, an estimated torque from the EMG signal and calculated torque from inverse dynamics based on the motion data. The proposed method succeeded in reducing the error by approximately 15-45% compared with using a low-pass filter, typical processing for additive noise, and showed its effectiveness in the demodulation of the patients' EMG signal. [ABSTRACT FROM AUTHOR]

Sit-to-stand is a common activity in daily life. It is difficult for the elderly and patients with lower limb disorders to complete this motion due to limb pain, muscle weakness, partial loss of motor control function, and physical defects in joints. An STS assistive device is a piece of automated medical equipment that can facilitate rehabilitation training for patients with lower limb disorders and improve their lower limb function. In this paper, we introduce a 3-DOF series type STS assistive device. First, we selected 26 healthy adults to carry out an STS transfer experiment, and we obtained the trajectory and velocity of each joint and the law of plantar pressure during STS motion. Second, based on the above kinematics and dynamics law, a 3-DOF series mechanism was designed. Through forward and inverse kinematics analysis, the relationship between the end-effector and the linear actuator was established. The trajectory planning of the end-effector was carried out according to the natural STS transfer trajectory, and the law of the linear actuator was obtained. The trajectory planning was verified by ADAMS. Finally, the Arduino controller was used to build the control system of the STS assistive device, and the prototype experiment was carried out. [ABSTRACT FROM AUTHOR]

Hand exoskeleton robots have been developed as rehabilitation robots and assistive devices. Based on the material used, they can be soft or hard exoskeletons. Soft materials such as fabric can be used as a component of the wearable robot to increase comfortability. In this paper, we proposed an affordable soft hand exoskeleton based on fabric and motor-tendon actuation for hand flexion/extension motion assistance in daily activities. On-off control and PI compensator were implemented to regulate finger flexion and extension of the soft exoskeleton. The controllers were embedded into a microcontroller using Simulink software. The input signal command comes from the potentiometer and electromyography (EMG) sensor to drive the flexion/extension movement. Based on the experiments, the proposed controller successfully controlled the exoskeleton hand to facilitate a user in grasping various objects. The proposed soft hand exoskeleton is lightweight, comfortable, portable, and affordable, making it easily manufactured using available hardware and open-source code. The developed soft exoskeleton is a potential assistive device for a person who lost the ability to grasp objects.

In the elderly, there have been reports of above 10% of the population being diagnosed with pathological tremor. Some patients find the conventional medical solutions, which primarily include medications and surgery, insufficient to treat their conditions. Technologies to mechanically suppress tremor have been proposed as a potential alternative. Robotic solutions for suppressing human tremor typically revolve around identifying and isolating the tremor motion component. This study proposes instead to only estimate the intentional movement and reject any disturbance that interferes with such an intended movement. By designing the control feedback such that motions other than the voluntary are rejected, the tremor component is attenuated. The controller components include an outer-loop admittance feedback loop and an internal velocity feedback loop. Additionally, a state feedback is utilized to improve the velocity tracking. To test the proposed approach, a benchtop tremor simulation device (TSD) was developed. The TSD consists of two motors, which, respectively, simulate the motion of a human joint and the suppressing action of a mechanical suppression system. A parametric stability analysis of the proposed tremor-suppression strategy is presented. A motion profile recorded from a person with tremor is used as human input in the TSD to experimentally validate the proposed tremor rejection strategy. Spectral analysis results show a 99.8% tremor reduction; the power reduction related to the voluntary movement is instead negligible (0.18%). Tracking of a velocity profile results in a small root-mean-square (rms) error (0.58 rad/s). The paper concludes by comparing the proposed approach to others presented in the literature. [ABSTRACT FROM PUBLISHER]

In this paper, we propose a novel system in which a human and a device work in unison on a single task with the aim to simultaneously support human cognitive and physical functions. In this system, the cognitive and physical burdens of the task are shared between the human and device, with the human understanding the entire task and performing rough upstream actions. Additionally, the device understands the surrounding environment, objects, and the human and executes detailed downstream actions. A prototype device was developed to assist in solving silhouette puzzles that abstract and generalize cognitive and physical tasks. The prototype is a pen-shaped device held in the user’s hand. The device picks up puzzle pieces and rotates them to the appropriate position. A display is placed in front of the user and provides feedback information for communication between the system and user. Experiments showed that the proposed device reduced the time required to solve these puzzles. Furthermore, the work was found to be accurate with no errors, and the time required was stable with no irregularities. The subjective evaluation results using the NASA Task Load Index showed that the proposed system can decrease mental load and burden. Moreover, it was confirmed that the human and device must communicate with each other to work simultaneously on one task. In conclusion, the proposed device can support human cognitive and physical functions simultaneously.

Currently, several outdoor navigation and orientation electronic traveling aid (ETA) solutions for visually impaired (VI) people are commercially available or in active development. This paper's survey of blind experts has shown that after outdoor navigation, the second most important ETA feature for VI persons is indoor navigation and orientation (in public institutions, supermarkets, office buildings, homes, etc.). VI persons need ETA for orientation and navigation in unfamiliar indoor environments with embedded features for the detection and recognition of obstacles (not only on the ground but also at head level) and desired destinations such as rooms, staircases, and elevators. The development of such indoor navigation systems, which do not have Global Positioning System (GPS) locational references, is challenging and requires an overview and evaluation of existing systems with different navigation technologies. This paper presents an evaluation and comparison of state-of-the-art indoor navigation solutions, and the research implications provide a summary of the critical observations, some insights, and directions for further developments. The paper maps VI needs in relation to research and development (R&D) trends using the evaluation criteria deemed most important by blind experts. [ABSTRACT FROM AUTHOR]