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Background: Although physical activity (PA) is an important determinant of health, physically disabled individuals tend to have a sedentary lifestyle. The Barriers to Physical Activity Questionnaire for People with Mobility Impairments (BPAQ-MI) is a self-report instrument evaluating PA barriers. This study was intended to evaluate the validity and reliability of the Persian version of BPAQ-MI (P-BPAQ-MI) and to report the prevalence and severity of PA barriers among Persian-speaking individuals. Methods: The translation and back translation of the BPAQ-MI was conducted according to an internationally accepted guideline and tested on 163 participants to assess its reliability and validity. Internal consistency and test–retest reliability were analyzed using Cronbach alpha and Spearman correlation coefficient. Convergent construct validity was established by comparing the scores of P-BPAQ-MI and The Baecke Habitual Physical Activity Questionnaire. Known-groups construct validity was assessed with regard to type of assistive device and sex of the individual. Prevalence and severity of the barriers were reported by computing the percentage and means of "yes" answers. Results: The P-BPAQ-MI domains demonstrated very good internal consistency (Cronbach alpha of.77–.95) and excellent test–retest reliability (Spearman rho of.73–.96) with a significant inverse small correlation with Baecke Habitual Physical Activity Questionnaire indexes. The P-BPAQ-MI successfully discriminated between individuals with different assistive devices and sex. Community Built Environment barriers were the most prevalent and severe. Conclusions: The P-BPAQ-MI is a valid and reliable instrument to assess the PA barriers of people with physical disability. The community barriers were the most frequently reported obstacles to PA. [ABSTRACT FROM AUTHOR]

The retail payments market is developing, and the implementation of digital payments has been one of the trends in consumer finance worldwide. This is the first study to jointly examine the perception of digital payment methods and financial services' role, for consumers with and without disabilities. First, based on a nationwide survey on Internet users in Poland, the authors compared the popularity of selected financial services among consumers, then the perception of characteristics of payment methods. The results revealed that consumers with disabilities use a wide range of payment services, and they are included in digital finance. Moreover, contactless payment cards are used by consumers with disabilities even more often than by consumers on average. The results suggest that the control over finances make digital payments an important empowering tool for consumers with disabilities. Finally, the paper provides recommendations for the banking sector, on strategies for offering digital financial services. Points of Interest: This paper examines the potential of new cashless payment methods as an empowering and assistive technologies for consumers with disabilities. The research found that consumers with disabilities use a wide range of payment services, and contactless payment cards are used by them even more often than by non-disabled people. People with disabilities also perceive payment cards as giving great control over their personal finance. This suggest that new payment methods might be their assistive and empowering tool of everyday life. Consequently, the research recommends that entities designing new payment methods should meet the needs of people with disabilities, because they could be improving their shopping and banking experience with appropriate adjustments. [ABSTRACT FROM AUTHOR]

Introduction: Home automation can deliver important outcomes for people with disabilities, including enhanced independence. Despite the millions of dollars spent on home automation in Australia and other developed nations, to date, there has been no economic evaluation of this type of assistive technology. Method: A social return on investment analysis of home automation study was undertaken. Primary data were collected using qualitative interviews with home automation consumers and other key stakeholders, including occupational therapists, a spinal rehabilitation physician, peer support advocate, and managers and technical personnel from home automation providers (n = 17). The analysis was supported by (1) secondary data from a scoping review on outcomes from home automation and (2) additional literature searches to identify suitable financial proxies and to make estimates of the proportion of home automation users expected to experience each outcome. A scenario approach was used with three home automation scenarios developed with increasing complexity and costs to calculate the social return on investment. Results: Eight outcomes from the use of home automation were identified, including reduced reliance on carers and family members, increased independence, and improved energy and comfort. The social return on investment ranged from $38.80 (low cost) to $15.10 (high cost) for every $1 invested across a 10‐year benefit period, with the financial proxy for reduced care attendant hours contributing the most to the social return ratio. Even the highest cost scenario was repaid in social value within the first year of the benefit period. Conclusion: This study suggests that home automation represents a sound investment and has a significant impact on the overall quality of life of people with disabilities. Focusing on the financial savings in care attendant hours alone should be compelling evidence for funders to recognise home automation's value and continue to fund this assistive technology. Consumer and Community Involvement: A consumer representative was a member of the project steering group, which supported the research team at all stages of the project. Plain Language Summary: When people get injured, their disability can stop them doing things around the home that they used to be able to do. Technology can help people with disabilities do things like open and close doors and turn off taps by pressing a button, so they do not have to wait for someone to help them. This technology can be expensive, but no one has looked at if it is worth the money. We spoke to some people with disabilities who used this type of technology, and they told us their lives were better now they used this technology. For example, they told us they were able to do things for themselves, they did not need carers as much, and they had better mental health. We spoke to businesses about the costs of different types of technology that can be used in the home. We then put a dollar value on the ways people with disabilities told us their lives were better. For example, for better mental health, we worked out how much it would cost to see a psychologist for 1 year. We found that the dollar value of the ways in which people with disabilities' lives were improved was at least 15 times more than the costs of the technology. This study therefore shows that this technology is worth the money and improves the lives of people with disabilities following serious injury. [ABSTRACT FROM AUTHOR]

The social model of disability is predicated upon the dichotomy of disability and impairment, which proves vulnerable to objections. Phenomenological approaches to disability in particular found this sharp distinction contrived, and accordingly implausible. Moreover, the social model ignores lived body of individuals and the inside-out perspective on disability. A phenomenological approach thus places the emphasis on the embodied nature of being-in-the-world. Yet, when it comes to the role of technology in disabled people's life, and in particular assistive technologies, it does not do justice to the role they play, and as a result, technology is treated predominantly as instrumental. In this article, I suggest taking a more systematic approach to technology in disability studies and bringing its role into an interrogation. To that purpose, I will draw from the postphenomenology movement to show how technology may actively mediate individuals' life and, perhaps more importantly, how disability is technologically mediated. [ABSTRACT FROM AUTHOR]

Purpose: Mobility impairments are a common consequence of stroke and spinal cord injury (SCI). Assistive products (APs) such as wheelchairs are often needed for activities and participation. The aim of the study was to explore the provision and use of APs in Germany and to identify associated factors underlying this practice. Materials and methods: Semi-structured interviews were conducted with 19 professionals from outpatient neurorehabilitation services (three general practitioners, five physical therapists, five occupational therapists, one speech therapist, one neuropsychologist, two outpatient nurses, one rehab technician and one social worker), two patient advocates (long-term survivors, each stroke and SCI) and 20 patients (10 each after stroke and SCI with mobility impairment, and first-ever affected). Analysis was performed by qualitative content analysis. Results: Reported experiences were mixed, varying from high satisfaction to unusable APs and unmet needs. Identified factors associated with these experiences were related to care pathways, care coordination, inter-professional collaboration, professionals' knowledge and patient information, cost coverage, and approval procedures. Conclusion: Overall, patients seem satisfied with the APs they receive, but patients with more severe mobility impairments in particular experience deficits in the provision and use of APs. Further research is needed to develop and test strategies for the provision and use of APs. IMPLICATIONS FOR REHABILITATION: Interprofessional collaboration between the multiple stakeholders and the involvement of end users is needed to realise the full potential of specific assistive products (APs). A care pathway should be implemented for the provision of appropriate APs. Professionals' expertise in both APs and end user empowerment needs to be improved. The approval process of the public health insurance should be accelerated and geared more towards the individual needs of patients. [ABSTRACT FROM AUTHOR]

Assistive technology has great potential to help individuals living with chronic health conditions, however devices often fail to align with the unique requirements of users. These results in device abandonment and missed opportunities to benefit people. This exploratory study aims to evaluate the short and longer-term satisfaction, psychological benefit, use and resources involved in co-designed customised assistive devices within a current healthcare service. Individuals with chronic health conditions identified daily living challenges. Eleven individuals completed the trial and were involved throughout the design process. Outcome measures evaluated the impact of the devices provided, healthcare utilisation, help required, and resources used. Nineteen custom assistive devices were produced for twenty-four challenges in daily living identified. At 3-months, eighteen devices were still being used. Daily challenges had become easier for individuals to complete and required less help from informal carers. Individuals were satisfied with the devices and service provided. Improvements in competence, adaptability and self-esteem were sustained long-term. The average clinician's time required to produce a device was 5 h 55 min, with an average cost of £203.79. People with chronic conditions were able to benefit from the co-design process resulting in satisfaction and long-term utilisation of the device, and positive psycho-social benefits. The costs associated with embedding this approach in a healthcare service were calculated. Scaling up the co-design process reduced the associated costs per device compared to previous work. Further work is required to evaluate co-designing across larger samples and explore opportunities to further improve the cost-efficiency. IMPLICATIONS FOR REHABILITATION: By involving users in the design process, healthcare professionals can create devices that better meet users' expectations, preferences and functional needs, thereby increasing overall usability, satisfaction and utilisation long-term of the devices. Incorporating the individual's perspective and needs into the design process enabled users to better understand the solutions that could be produced and thus encouraged users to identify other challenges in daily living they faced where an assistive device could assist them. Through being provided with devices to support them with specific challenges they faced, individuals were able to perform more tasks independently, reducing the need for help from family members and informal carers for the associated tasks. Re-evaluating the solutions generated with other previous research may help identify common design solutions and features to enable further scaling-up of this co-design approach [ABSTRACT FROM AUTHOR]

Background: Despite the widely recognised benefits of assistive technology (AT) in everyday life, AT abandonment rate due to unmet user needs or expectations is high. World Health Organisation emphasised the importance of evaluating AT outcomes as a top research priority, but comprehensive approaches to assess users' needs and AT impact are still limited. Aim: The research study OMAT (outcomes of mobility assistive technology in rehabilitation pathways) aimed to evaluate the feasibility of a new AT assessment protocol for mobility AT, spanning from an initial evaluation of users' and relatives' needs to a follow-up after real-world use of assistive products (APs). Material and Methods: An observational single-arm study involving 95 AT users was conducted at Fondazione Don Gnocchi (Milan, Italy). The OMAT protocol encompassed baseline assessment, user training, prescription, authorisation, delivery and follow-up. The evaluations blend standard clinical evaluations with validated AT outcome measures for perceived effectiveness of AT, user satisfaction and changes in quality of life. Results: The feasibility of OMAT in clinical settings was established, with 67 user participants completing the protocol. Data showed positive impacts on user satisfaction and perceived AT effectiveness by all participants (users and relatives), with an improvement in the perceived degree of severity in problems. Quality of life outcomes, however, showed mixed results across various domains. Conclusion: OMAT is a feasible protocol for assessing mobility APs in clinical settings, underscoring the importance of involving users in the prescription process and the need for comprehensive AT monitoring mechanisms. This approach could enhance AT service delivery, exceeding the current standards of the Italian-National-Health-Service. Implication for rehabilitation: Personalise assistive technology (AT) based on user needs for higher effectiveness. Include structured follow-up in rehabilitation for better AT outcomes. Enhance patient involvement in AT selection to improve use. Focus on AT's role in enhancing overall quality of life. Use validated tools for AT impact assessment and monitoring. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to assess employment characteristics of individuals with physical disabilities who currently participate in adaptive gaming and determine if there is a positive association between adaptive gaming and employment. Materials and methods: A survey was administered to individuals with disabilities who currently use adaptive video gaming equipment to gather information on demographics, gaming habits, employment characteristics, and subjective benefits of gaming on employment. Results: The study included 606 participants. Over 57% of participants reported full-time or part-time employment. Nearly half of the participants reported using their equipment either most or all of the time to complete tasks related to work. Participants using their equipment to complete work tasks most or all of the time were more likely to be employed full-time (p = 0.0021). Over 75% of participants reported subjective benefits of adaptive video gaming on their employment. Conclusion: Participants in this study had higher rates of employment compared to national averages for individuals with physical disabilities. More frequent use of adaptive gaming equipment for work was associated with a higher likeliness of full-time employment. Most participants who were employed reported subjective benefits of adaptive gaming on employment through improvements in mental health, physical function, and cognition. IMPLICATIONS FOR REHABILITATION: Participation in recreational activities has been shown to be associated with increased rates of employment for individuals with physical disabilities. Employment rates for those who participate in adaptive video gaming were found to be higher compared to individuals with disabilities in the general population. Adaptive video gaming may lead to increased rates of employment through improvement in mental health, physical function, and cognition. [ABSTRACT FROM AUTHOR]

Purpose: Visually impaired people (VIP) find it challenging to understand and gain awareness of their surroundings. Most activities require the use of the auditory or tactile senses. As such, assistive systems which are capable of aiding visually impaired people to understand, navigate and form a mental representation of their environment are extensively being studied and developed. The aim of this paper is to provide insight regarding the characteristics, as well as the advantages and drawbacks of different types of sonification strategies in assistive systems, to assess their suitability for certain use-cases. Materials and methods: To this end, we reviewed a sizeable number of assistive solutions for VIP which provide a form of auditory feedback to the user, encountered in different scientific databases (Scopus, IEEE Xplore, ACM and Google Scholar) through direct searches and cross-referencing. Results: We classified these solutions based on the aural information they provide to the VIP – alerts, guidance and information about their environment, be it spatial or semantic. Our intention is not to provide an exhaustive review, but to select representative implementations from recent literature that highlight the particularities of each sonification approach. Conclusions: Thus, anyone who is intent on developing an assistive solution will be able to choose the desired sonification class, being aware of the advantages/disadvantages and at the same time having a fairly wide selection of articles from the representative class. IMPLICATIONS FOR REHABILITATION: The motivation behind this paper is to provide an overview of sonification strategies in the context of assistive systems for the visually impaired people. Whilst surveys and reviews which provide in-depth insights into assistive technologies and sonification exist, papers which provide a combined view of these topics are rather lacking. The analysis of the selected papers provides insight regarding the characteristics of different types of sonification strategies in assistive systems for visually impaired people and their suitability for certain use-cases. [ABSTRACT FROM AUTHOR]

Although assistive technology (AT) is recognized as a basic human right, access to AT, and particularly electronic aids to daily living (EADL), is limited. We aimed to understand how persons with high level spinal cord injury (SCI) prioritize EADL needs and assess satisfaction and efficacy of self-identified EADL. Thus, in this case series, we recruited three participants with C4, C5 or C6 SCI receiving in-patient SCI rehabilitation. Each received dedicated occupational therapy-based assistance in identifying EADL items within an unrestricted envelope of support ($5000 CDN) for use in maximizing physical independence and supporting their return to community-based living. Items identified were categorized by need (emergency/security; home environment control; or virtual access to the outside world). Each participant selected distinct EADL. Evaluation of selected EADL items indicated very high satisfaction. The selected EADL contributed to participants' returns to employment, community life, or reduced requirements for attendant services. These findings suggest that identification of essential technology should reflect the unique needs of each person and the context in which it will be used. These findings also support use of mainstream technology to meet EADL needs of individuals with limited physical abilities. IMPLICATIONS FOR REHABILITATION: Initial spinal cord injury (SCI) rehabilitation should provide individualized identification and selection of electronic aids for daily living (EADL) for those with very minimal arm and hand function, including mainstream voice-activated technologies, to increase independence and function. Individualized self-selection of EADL, rather than general prescription-based provision of EADL, is most appropriate for identifying key EADL that will enhance function and independence in the community. Support from occupational therapists with expertise in SCI rehabilitation can provide expertise in identifying and setting up EADL, including in the community, to ensure selected EADL function as intended. [ABSTRACT FROM AUTHOR]

Objective: Access to assistive products (APs) is essential to maximising function, participation, and inclusion of persons with disabilities. Challenges to AP access in low- and middle-income countries include stigma, costs, supply, and rehabilitation capacity gaps. This study aimed to examine AT access in the context of a low-resource setting in rural South India. Objectives were to examine rehabilitation professionals' perceptions of AP needs, barriers and facilitators of AP provision, and AT knowledge. Methods: A descriptive study design with a 2-part online survey methodology was utilized. This study was conducted in April-September 2020 at a non-governmental organization (NGO) serving children and adults with disabilities in 3 districts of rural South India. Purposive sampling of NGO's multidisciplinary rehabilitation professionals (N=62) was used. The survey was developed based on WHO's Assistive Products List (APL). Barriers and facilitators were classified according to the principles of AT access. Analyses revealed acceptability, affordability, and availability as the top three barrier themes across disciplines, including poor acceptance by clients/families due to stigma, high AP costs, and a long waitlist for government-provided devices. Acceptability, affordability, and accessibility were the top three facilitator themes, including community awareness, availability of AP funding, client/family education, and AT service provision training. Impact: Our study identified key enabling strategies for AT access, aimed at reducing reported barriers. Enabling AP provision was determined to be multi-factorial, aimed at users/ families, service providers, organizations, communities, and policymakers. Local stakeholder groups are crucial to understanding challenges and opportunities to AP provision within a low-resource context. IMPLICATIONS FOR REHABILITATION: Identified barriers to assistive product (AP) provision in rural South India include poor acceptance by clients/families due to stigma, high AP costs, limited AP availability, and rehabilitation capacity gaps. Suggested facilitators to AP provision in rural South India include improving AP acceptability, affordability, and accessibility through community awareness, client/family education, AP funding and supply, and assistive technology (AT) service provision capacity building. An organisational-level survey based on the WHO's Priority Assistive Products List and the Principles of AT Access can identify local needs, barriers and facilitators. An AT access strategies in resource-limited areas may be developed based on barriers and facilitators identified by local/regional rehabilitation professionals. [ABSTRACT FROM AUTHOR]

Purpose: The objectives of this study(1) were threefold: to identify the main topics related to the international debate on Assistive Technology (AT) public policies, to analyze the Brazilian case in light of these topics, and to extract lessons that could be applied in Brazil and other countries to advance progress in the field. Methodology: A qualitative study was conducted through a critical literature review, involving the search for, selection, and analysis of articles indexed in two information source portals and four databases from 2007 to 2023. International and Brazilian laws, reports, and other publications specifically related to AT policies were also included. Results: The analysis of 186 articles and Brazilian documents facilitated the examination of four themes: AT policies from a human rights perspective, public procurement, service delivery systems, and national plans. A subset of 107 publications was then selected for detailed analysis. Discussion: Initiatives such as implementing a national plan, establishing an AT research center, and creating a product catalog are considered virtuous. Enhancing the freedom of choice for products and developing public procurement mechanisms are identified as additional strategies to reinforce protections of human rights in Brazil. Conclusions: Policy dynamics and national and international experiences suggest the potential for expanding initiatives and creating new solutions in Brazil. Universities and other scientific institutions emerge as promising loci for generating new knowledge to support the formulation of AT policies and facilitate their debate and further development. IMPLICATIONS FOR REHABILITATION: Our aim in undertaking this critical literature review was to gain an understanding of the primary topics related to public policies in the field of Assistive Technology (AT). We have found that public procurement, service delivery systems, and national plans are the primary strategies that the State can employ to ensure rights related to AT. [ABSTRACT FROM AUTHOR]

Purpose: This scoping review was conducted to understand the barriers, facilitators, and education and training needs of rehabilitation clinicians in their use of mainstream wireless technologies (MWT) to support people with disabilities and older adults. It was also conducted to understand the functional skills of clients that were targeted with MWT use. Materials and methods: This scoping review was reported using PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) and the Population (or Participants)/Concept/Context) framework. We searched PubMed; ProQuest to access APA PsycINFO; Web of Science Core Collection; and EBSCOhost to access Cumulated Index to Nursing and Allied Health Literature (CINAHL), Ovid MEDLINE ALL, and Education Resources Information Center (ERIC). Articles published between 2015–2022 were retrieved. Results: A total of 90 articles were included. Most interventions were apps, smartphones, and tablets; were geared toward adults; and targeted motor, cognitive and speech skills. An infographic on barriers and facilitators was generated as a decision support tool for clinicians when implementing MWT. The topic, format, timing, and source of information clinicians need are also delineated. Conclusion: MWT such as apps, smartphones and tablets are being used by rehabilitation clinicians to address motor, cognitive, and speech skills, most commonly in adults. Clinicians voice a need for more education and training. Barriers and facilitators exist at the clinician-, technology-, client-, institution-, and policy levels. IMPLICATIONS FOR REHABILITATION: A total of 90 articles from 2015–2022 were included in this scoping review Most interventions were apps, smartphones, and tablets; were geared toward adults; and targeted motor, cognitive and speech skills. An infographic was generated as a decision support tool for clinicians when implementing mainstream wireless technologies in clinical practice. Clinicians' education and training needs with regard to mainstream wireless technologies are broad. Materials on a variety of topics, in different formats, from multiple sources are needed. This review also discusses implications of findings on policy, technology development, and future research. [ABSTRACT FROM AUTHOR]

Purpose: The elderly population faces reduced levels of health and performance, which necessitates the use of rehabilitation assistive technologies to maximize functional independence in daily activities. This study aimed to explain the experiences of the elderly regarding the use of rehabilitation assistive technologies based on the Unified Theory of Acceptance and Use of Technology. Methods: The present study was a qualitative study of the type of content analysis that was conducted in the city of Hamadan in 2022. Participants included 20 elderly aged 60 years or above who were selected as a purposive sample and subjected to individual semi-structured in-depth interviews. Data were analyzed using directed qualitative content analysis based on Hsieh and Shannon's approach. Data were coded using MAXQDA software (MAXQDA Analytics Pro 2020, VERBI GmbH Berlin). Results: According to the results, 260 primary codes were extracted, and they were classified into five predetermined categories of the Unified Theory of Acceptance and Use of Technology, including performance expectancy, effort expectancy, social influence, facilitating conditions, and behavioral intention, as well as two new categories of technology anxiety and perceived need for technology. After extracting 260 primary codes based on the Unified Theory of Acceptance and Use of Technology, 75 sub-categories were identified in 14 main categories. Conclusion: The themes obtained from the study indicate the necessity of providing the required conditions to maintain the complete independence and health of the elderly and strengthen their morale. The results can be helpful in the development of support strategies for family members, healthcare providers, and policymakers. IMPLICATIONS FOR REHABILITATION: Assistive rehabilitation technologies include low-tech assistive technologies. The use of assistive rehabilitation technologies is a potential solution to improve balance, quality of life, and increase activity and functional independence in the elderly. Since peers play a very important role as technology advocates in the intention to accept and use assistive technologies, the expression of the experiences and views of the elderly can encourage and support the use of assistive rehabilitation technologies by other elderly. This study found that the use of assistive rehabilitation technologies by the elderly is a relatively complex issue with various personal, social, economic, cultural and physical aspects. [ABSTRACT FROM AUTHOR]

Purpose: The Speech Accessibility Project (SAP) intends to facilitate research and development in automatic speech recognition (ASR) and other machine learning tasks for people with speech disabilities. The purpose of this article is to introduce this project as a resource for researchers, including baseline analysis of the first released data package. Method: The project aims to facilitate ASR research by collecting, curating, and distributing transcribed U.S. English speech from people with speech and/or language disabilities. Participants record speech from their place of residence by connecting their personal computer, cell phone, and assistive devices, if needed, to the SAP web portal. All samples are manually transcribed, and 30 per participant are annotated using differential diagnostic pattern dimensions. For purposes of ASR experiments, the participants have been randomly assigned to a training set, a development set for controlled testing of a trained ASR, and a test set to evaluate ASR error rate. Results: The SAP 2023-10-05 Data Package contains the speech of 211 people with dysarthria as a correlate of Parkinson's disease, and the associated test set contains 42 additional speakers. A baseline ASR, with a word error rate of 3.4% for typical speakers, transcribes test speech with a word error rate of 36.3%. Fine-tuning reduces the word error rate to 23.7%. Conclusions: Preliminary findings suggest that a large corpus of dysarthric and dysphonic speech has the potential to significantly improve speech technology for people with disabilities. By providing these data to researchers, the SAP intends to significantly accelerate research into accessible speech technology. [ABSTRACT FROM AUTHOR]

Despite the media reports and governments promoting tourism as a fundamental right for everyone, traveling is still not accessible for disabled people. This study has highlighted the need to make tourists with disabilities accessable for inaccessible destinations. Cyborg products in the form of technological implants can make tourists with disabilities accessable for inaccessible destinations. Since tourists with a mobility disability (TMD) will be one of the primary beneficiaries of technological implants, little is known about their acceptance of technological implants during traveling.Therefore, this study assesses the willingness of TMD to use technological implants during traveling through a qualitative research approach. The results from thematic analysis identified two main themes: the use of assistive devices during traveling with four sub-themes (freedom of traveling, physical and attitudinal barriers, cost, and additional assistance and battery issues), and drivers of impaired cyborg tourists with seven sub-themes (independence, improved well-being, convenience/ease of use, social inclusion, positive emotions, motivation, and other issues). The study contributed to the literature by introducing drivers of impaired cyborg tourists along with previously identified concepts. The results also provided implications for the stakeholders of the tourism industry. [ABSTRACT FROM AUTHOR]

Aims: The World Health Organization points out that, by 2030, two billion people will need at least one assistive product. 3D printing can be used to meet the demands when dispensing these products. Purpose: This review aims to map the use of 3D printing in the manufacture of orthoses and prostheses for people with physical disability at rehabilitation centers. Methods: Publications that deal with the use of 3D printing for the manufacture of orthoses and prostheses were used, preferably studies from 2012 to 2022. Results: The majority of studies, 56.25%, were quantitative and 46.25% were evaluative research. None of the studies were characterized as developed at rehabilitation centers. 75% of them had the participation of people with physical disability. The use of 3D printing was, for the most part, for the development of assistive technologies for the upper limbs at 56.25%, while 31.25% were for the lower limbs. Conclusion: The assistive products developed were orthoses and prostheses for the wrist, hands, fingers, upper limbs, writing devices, sockets, knees, and feet. Although there were positive results in their performance, some limitations related to strength, stiffness, and resistance were observed. [ABSTRACT FROM AUTHOR]

Introduction: People with multiple sclerosis and gait impairment are particularly susceptible to facing restrictions in their participation. This study aims to investigate (a) which contextual factors within the framework of the International Classification of Functioning, Disability and Health (ICF) are relevant for participation from the perspective of people with multiple sclerosis and gait impairment who (intend to) use mobility assistive devices, and (b) how these contextual factors shape the subjective facets of participation, including a sense of connection, efficacy and meaning, based on the social identity approach to health and well‐being. Methods: We conducted a qualitative analysis on data gathered from four online focus group interviews, each involving four to six people with multiple sclerosis and gait impairment who (intend to) use mobility assistive devices (totalling N = 19), and 12 individual online interviews conducted with participants from the focus group interviews. The analysis followed the qualitative content analysis according to Kuckartz. Results: Mobility assistive devices such as walkers, manual wheelchairs and electric wheelchairs/scooters were seen as facilitators that enabled participation in various life situations and enhanced a sense of efficacy by promoting independence. Challenges were encountered in relation to architectural barriers, pathways, weather conditions, public transportation and the lack of integral accessibility to services and systems. Although instrumental support could ease participation, it was also associated with an impaired sense of efficacy. Attitudes, particularly developing an understanding of the experiences of people with multiple sclerosis and gait impairment from others' perspectives, were considered important but often lacking, and discriminatory attitudes were experienced. On the level of personal factors, acceptance of both the mobility assistive devices and the disease itself were seen as facilitators for maintaining involvement in life situations. Conclusions: This study extends the existing literature by shedding light on the interconnectedness of contextual factors within the ICF and various facets of perceived participation, including a sense of connection, efficacy and meaning. These findings provide valuable insights for stakeholders such as urban planners and policymakers in developing inclusive environments that enhance the overall quality of participation for people with multiple sclerosis and gait impairment. Patient or Public Contribution: This study reports on the lived experiences of people with multiple sclerosis and gait impairment who (intend to) use mobility assistive devices. The research team stood in close exchange with project members of the German Multiple Sclerosis Society Lower Saxony, a group representing the interests of people with multiple sclerosis, to design and conduct the focus group interviews. The results from the focus group interviews were the basis for the design of a participatory future workshop in which people with multiple sclerosis and stakeholders involved in the healthcare process collaboratively developed recommendations for improving the provision of mobility assistive devices. Trial Registration: German Clinical Trials Register number: DRKS00025532. [ABSTRACT FROM AUTHOR]

A tactile event-related potential (ERP)-based brain–computer interface (BCI) system is an alternative for enhancing the control and communication abilities of quadriplegic patients with visual or auditory impairments. Hence, in this study, we proposed a tactile stimulus pattern using a vibrotactile stimulator for a multicommand BCI system. Additionally, we observed a tactile ERP response to the target from random vibrotactile stimuli placed in the left and right wrist and elbow positions to create commands. An experiment was conducted to explore the location of the proposed vibrotactile stimulus and to verify the multicommand tactile ERP-based BCI system. Using the proposed features and conventional classification methods, we examined the classification efficiency of the four commands created from the selected EEG channels. The results show that the proposed vibrotactile stimulation with 15 stimulus trials produced a prominent ERP response in the Pz channels. The average classification accuracy ranged from 61.9% to 79.8% over 15 stimulus trials, requiring 36 s per command in offline processing. The P300 response in the parietal area yielded the highest average classification accuracy. The proposed method can guide the development of a brain–computer interface system for physically disabled people with visual or auditory impairments to control assistive and rehabilitative devices. [ABSTRACT FROM AUTHOR]

Purpose: Eye-gaze technology offers professionals a range of feedback tools, but it is not well understood how these are used to support decision-making or how professionals understand their purpose and function. This paper explores how professionals use a variety of feedback tools and provides commentary on their current use and ideas for future tool development.Methods and Materials: The study adopted a focus group methodology with two groups of professional participants: those involved in the assessment and provision of eye-gaze technology (n = 6) and those who interact with individuals using eye-gaze technology on an ongoing basis (n = 5). Template analysis was used to provide qualitative insight into the research questions.Results: Professionals highlighted several issues with existing tools and gave suggestions on how these could be made better. It is generally felt that existing tools highlight the existence of problems but offer little in the way of solutions or suggestions. Some differences of opinion related to professional perspective were highlighted. Questions about automating certain processes were raised by both groups.Conclusions: Discussion highlighted the need for different levels of feedback for users and professionals. Professionals agreed that current tools are useful to identify problems but do not offer insight into potential solutions. Some tools are being used to draw inferences about vision and cognition which are not supported by existing literature. New tools may be needed to better meet the needs of professionals and an increased understanding of how existing tools function may support such development. IMPLICATIONS FOR REHABILITATION: Professionals sometimes make use of feedback tools to infer the cognitive and/or visual abilities of users, although the tools are not designed or validated for these purposes, and the existing literature does not support this. Some eye-gaze feedback tools are perceived as a "black box", leaving professionals uncertain as to how to usefully interpret and apply the outputs. There is an opportunity to improve tools that provide feedback on how well an eye-gaze system is working or how effectively a user can interact with this technology. Professionals identified that tools could be better at offering potential solutions, rather than simply identifying the existence of problems. [ABSTRACT FROM AUTHOR]

Purpose: Throughout the world, mobility devices are usually distributed using product-based business models, where a device is provided to a user, and serviced or replaced when the user returns to the clinic with an issue. Moving to a service-based business model can provide continuous and customised support for the user, and provide the clinicians and manufacturers with better data to base their decisions on. This study reviews papers on assistive technology service-based business models and considerations in designing such a model to optimise economic and social value. It then applies the findings to the mobility device space. Method: A systematic literature search was undertaken in PubMed, Web of Science, and OVID databases to analyse studies that discuss service delivery models used to provide assistive products. Inductive thematic analysis determined the themes, facilitators and barriers associated with providing a service. Findings were applied to mobility device service provision. Results and conclusion: Themes from the 29 relevant papers were grouped into four categories: Access (affordability/availability/education), Utility (customisability/usability/adaptability), Integrity (quality/sustainability/impact), and Compliance (policy/privacy/security). The most common themes were customisability, affordability, availability, and education. There is a need for service-based delivery models to replace conventional product-based models, and many considerations to optimise their design. No publications discussed the design and implementation of a service-based model for mobility device provision that uses modern sensors, software and other digital technologies to optimise the service. Service-based models that use modern digital technologies are new for the mobility device field, but much can be learnt from other fields. IMPLICATIONS FOR REHABILITATION: Service-based business models that make use of modern digital technologies are likely to improve ongoing individual rehabilitation, but they are new for the mobility device field and currently lack research and evidence-based practice. The systematic review found that modern digital technologies like sensors, apps, and AI might be useful for providing ongoing support and more personalised rehabilitation for users of assistive products. To provide ongoing support for end-users, a successful design of service-based business model for assistive products should be accessible, both physically and financially, as well as easy to customise and adapt over time. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the review was to explore current factors affecting the use of a powered wheelchair for an adult person a with a disability. Materials and Methods: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement. Information about the characteristics of the studies (type, setting) and perceived barriers and facilitators to powered wheelchair use were extracted using a data extraction sheet. Data synthesis was achieved using narrative synthesis. The quality of the included studies was assessed using the Standard Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields (SQAC) and the CASP checklist (Critical Appraisal Skills Programme), Centre for Evidence-Based Medicine, SIGN (Scottish Intercollegiate Guidelines Network). Results: Fifteen studies qualified for inclusion in the review. The narrative synthesis produced a conceptual map of reported factors affecting the usability of a powered wheelchair. Conclusions: This review demonstrates that powered wheelchair use is a multifaceted and multidisciplinary phenomenon that is dependent on numerous interconnected factors including individual adjustment, stakeholder cooperation, societal attitudes, functional performance, and environmental features. Based on the review findings, there are several applied learning outcomes and practical applications to the powered wheelchair prescription and provision. IMPLICATIONS FOR REHABILITATION: The rejection, misuse or damage of a powered wheelchair can result in condition deterioration and loss of independence for the user. Adult powered wheelchair prescription, maintenance, and use is a multi-faceted process spanning social, individual, environmental, technical and functional, and organisational factors. Individuals in this stakeholder network should aim to account for these interdisciplinary factors when engaging with people who use powered wheelchairs. [ABSTRACT FROM AUTHOR]

Purpose: The Assistive Technology (AT) Open Platform supports people with disabilities, older people, and developers in co-creating new assistive products outside the business realm. To address dissatisfaction with and non-adoption of commercial assistive products, the National Rehabilitation Centre in South Korea created an AT Open Platform as an open-source AT sharing platform to research and develop appropriate assistive technology suitable for users' needs. The emerging concept of AT Open Platform is new for both assistive product users and developers in South Korea. The Extended Unified Theory of Acceptance and Use of Technology (UTAUT2) was utilised to understand the factors influencing the adoption of the AT Open Platform and to gain further insights on its design and future use. Materials and methods: Interviews were conducted with six potential AT Open Platform users to develop a questionnaire for predicting behavioural intention. Subsequently, we surveyed 175 potential users to validate the UTAUT2. Results: The results revealed that behavioural intention was significantly predicted by social influence, performance expectancy, facilitating conditions, and hedonic motivation. Conclusions: The AT Open Platform should focus on both online and offline platforms to educate and facilitate the co-creation of ATs for assistive product users and makers. This study, which targeted assistive product users and developers, has significant implications for policymakers and future research in using and adopting the AT Open Platform as it reflects the actual voices of the platform's stakeholders. IMPLICATIONS FOR REHABILITATION: To address the issues of dissatisfaction and non-adoption of commercial assistive products, assistive technology platforms are established for the research and development of appropriate assistive technologies suitable for meeting user needs; the results are shared as open-source assistive technology. A survey was conducted with a targeted sample of assistive technology product users and developers. The study results are significant as they represent the perspectives of key stakeholders in the assistive technology platform. The study findings are expected to play an important role in the application and diffusion of the assistive technology platform in South Korea. The survey is the first to illuminate the adoption of an assistive technology platform in South Korea and is an important step towards empowering people with disabilities. [ABSTRACT FROM AUTHOR]

Objective: This study aims to enhance the accessibility and quality of mobility-assistive technology by investigating and bridging knowledge gaps between mobility-assistive technology providers and consumers with ambulatory limitations. Design: A survey was conducted among mobility-assistive technology providers in the United States, consisting of sections on awareness, knowledge importance and desire, and knowledge sources. The responses were compared to data collected from consumers in a previous study. Results: A total of 144 mobility-assistive technology providers participated, with 60% having received academic or professional training in relevant fields. Analysis revealed significant knowledge gaps between providers and consumers, particularly in assistive technology assessment tools and knowledge sources. Moderate gaps were also observed in areas such as clinical practice guidelines, desired mobility-assistive technology information, and knowledge sources. However, the gaps in other areas were relatively small. Conclusions: This study highlights the knowledge gaps between mobility-assistive technology providers and consumers, hindering the optimal utilization and fulfillment of user needs. Providers possess valuable information that consumers may lack, positioning them as primary knowledge sources. Addressing these gaps through targeted interventions, improved communication channels, and enhanced education can enhance the utilization of mobility-assistive technology and improve outcomes for individuals with ambulatory limitations. [ABSTRACT FROM AUTHOR]

Background: Fall risk and incidence increase with age, creating significant physical and mental burden for the individual and their care provider. Lift assistive devices are used in multiple healthcare facilities, but are generally not portable nor self-operational, limiting their use outside of medical supervision. The Raymex™ lift is a novel lift assistance device within a rollator to address these limitations. We aim to gather user-centered feedback on the Raymex™ lift, set up instructions, safety protocols to improve feasibility and usability, and explore the potential usability as a fall recovery or prevention device. Methods: Four older adults, two informal caregivers and 16 formal caregivers (clinicians and continuing care assistants) participated in a focus group. Participants provided feedback on the Raymex™ lift after viewing a demonstration and using the device. Qualitative and quantitative data were analysized using thematic and descriptive analysis respectively. Results: Participants highlighted three major themes: (1) Design features requiring improvement, (2) Positive feedback and suggestions to optimize the Raymex™ lift and (3) Pricing vs. social utility. Participants suggested widening the seat, changing the braking button layout, and lowering the device weight to improve usability. Participants believed the main device feature was fall recovery and had implications for social utility by reducing the need for ambulance visits to the home. Price point led to a concern on affordability for older adults. Conclusion: The feedback gained will advance the development of the Raymex™ lift and may highlight cost-effective design choices for other developers creating related aging assistive technologies. [ABSTRACT FROM AUTHOR]

AbstractPurposeMaterials and methodsResultsConclusions\nIMPLICATIONS FOR REHABILITATIONIn an increasingly technology-driven world, this study explores the accessibility of assistive technology for individuals with intellectual disabilities through assistive technology loan libraries. Assistive technology refers to devices or systems that enhance the ability of individuals with and without disabilities to function and undertake activities of daily living.The study, grounded in the Social Determinants of Health framework, employed multiple methods including both qualitative (interviews) and quantitative (questionnaire) methods, involving 19 participants comprising assistive technology professionals and users.Key findings from the study underscore the pivotal role of assistive technology loan libraries, which lend various assistive devices to individuals, enabling them to try these technologies before making a long-term commitment. However, challenges, such as a restricted variety of devices and extended waiting periods for access were highlighted. The research points to a need for improved training for both staff at the loan libraries and the users of the technology. It also suggests that policy enhancements are required to better align with rapid technological advancements and address the uneven regional distribution of these technologies.Participants in the study highlighted the importance of expanding the range of assistive devices available in these libraries and improving the efficiency of the service they provide. The study advocates for targeted efforts to enhance the effectiveness and accessibility of assistive technology loan libraries, highlighting their critical role in empowering individuals with intellectual disabilities.Assistive Technology (AT) loan libraries significantly enhance access to vital technologies for individuals with intellectual disabilities, enabling trials before purchase.Challenges like limited device variety, extended wait times, and a need for improved staff training must be addressed to optimize loan libraries’ effectiveness.Enhancements in policy, funding, and device availability are crucial to ensure equitable AT access and support rehabilitation goals.Collaboration between AT professionals, users, and policymakers is essential for developing responsive, user-centered AT loan library services.Strengthening awareness and education about AT options can empower users and caregivers, fostering greater independence and participation in daily activities.Assistive Technology (AT) loan libraries significantly enhance access to vital technologies for individuals with intellectual disabilities, enabling trials before purchase.Challenges like limited device variety, extended wait times, and a need for improved staff training must be addressed to optimize loan libraries’ effectiveness.Enhancements in policy, funding, and device availability are crucial to ensure equitable AT access and support rehabilitation goals.Collaboration between AT professionals, users, and policymakers is essential for developing responsive, user-centered AT loan library services.Strengthening awareness and education about AT options can empower users and caregivers, fostering greater independence and participation in daily activities. [ABSTRACT FROM AUTHOR]

Emerging assistive technologies (AT), such as voice assistants (VA), impact the citizenry and organisations. Amongst those affected, there is a group of people with developmental and physical disabilities that have been impacted the most. As the use of technology evolves, more studies analysing the impact of VA on these populations are emerging. However, there is still a dearth of studies congregating results systematically, in which it would be possible to understand the impact of VA technologies on different contexts. Thus, our study aims to understand the applicability and impact of VAs on the lives of people with disabilities and the perspectives of this emerging AT. Drawn on a rigorous systematic literature review using the PRISMA protocol, we included 68 articles for analysis after applying the inclusion and exclusion criteria. We identified seven intertwined themes related to the benefits and challenges of VA technologies. The emergent benefits are the impact on users' ecosystem and well-being and economic and social benefits; conversely, the challenges are inherent issues related to technology, financial and social challenges. We contribute to theory and practice by understanding the impact of VAs on populations with disabilities' ecosystem and well-being at the micro, meso and macro-levels of the phenomena. HIGHLIGHTS: VA technology transforms the way people with disability interact in their ecosystem VA technology positively impacts people with disabilities' well-being and ecosystem VA issues are related to data privacy and technology accessibility Benefits and challenges of the VA adoption touches the micro, meso and macro-levels of the ecosystem Performance analysis, diverse populations and understanding of social aspects, are the trending topics for future research [ABSTRACT FROM AUTHOR]

Importance: There is a critical gap between the potential of smart home technologies to enhance the lives of people with physical disabilities (PwPD) and their limited use because of complex interfaces, high costs, technical issues, and insufficient institutional support. Objective: To bridge this gap and ensure that PwPD can fully benefit from smart home advancements to improve their daily living and quality of life by developing a smart home modification program. Design: A Delphi survey involving three rounds was conducted with experts in disability and smart home technologies. Setting: Online survey. Participants: Thirty multidisciplinary health care experts. Outcomes and Measures: Experts rated the level of relevance in smart home modification with each survey. Consensus was set at ≥75%, content validity (CVR) was ≥.33, and convergence was ≤.5. Results: The first Delphi result selected 26 items, and the second included 59 items after adjusting for values that fell below a CVR of.33. In the third Delphi survey, 59 items were selected. The final Delphi study had an average CVR of.96 and a coefficient of variation of.10. The last survey's consensus point was.92, indicating a high level of agreement among participants. Conclusions and Relevance: On the basis of expert consensus, the study provides a validated framework for smart home modifications to aid PwPD. Plain-Language Summary: This research highlights the role of smart home adaptations to promote responsible, independent living for people with physical disabilities. There is a critical gap between the potential of smart home technologies to improve the lives of people with physical disabilities and their limited use because of complex interfaces, high costs, technical issues, and insufficient institutional support. The study authors developed a smart home modification program with the goal of closing this gap and to ensure that people with physical disabilities can fully benefit from smart home advancements to improve their daily living and quality of life. Based on expert ratings, the study findings provide a validated framework that occupational therapists can use to recommend smart home modifications to help people with physical disabilities. The framework can also be used by occupational therapists to identify people who may need more extensive environmental modifications and interventions. The study authors developed a smart home modification program to improve daily living and quality of life for people with physical disabilities. [ABSTRACT FROM AUTHOR]

As the global prevalence of motor disabilities continues to rise, there is a pressing need for advanced solutions in physical rehabilitation. This systematic review examines the progress and challenges of implementing robotic technologies in the motor rehabilitation of patients with physical disabilities. The integration of robotic technologies such as exoskeletons, assistive training devices, and brain–computer interface systems holds significant promise for enhancing functional recovery and patient autonomy. The review synthesizes findings from the most important studies, focusing on the clinical effectiveness of robotic interventions in comparison to traditional rehabilitation methods. The analysis reveals that robotic therapies can significantly improve motor function, strength, co-ordination, and dexterity. Robotic systems also support neuroplasticity, enabling patients to relearn lost motor skills through precise, controlled, and repetitive exercises. However, the adoption of these technologies is hindered by high costs, the need for specialized training, and limited accessibility. Key insights from the review highlight the necessity of personalizing robotic therapies to meet individual patient needs, alongside addressing technical, economic, social, and cultural barriers. The review also underscores the importance of continued research to optimize these technologies and develop effective implementation strategies. By overcoming these challenges, robotic technologies can revolutionize motor rehabilitation, improving quality of life and social integration for individuals with motor disabilities. [ABSTRACT FROM AUTHOR]

The purpose of this study was to assess disability identity among Spanish- and English-speaking individuals of Mexican descent. This was an online, cross-sectional study with self-report measures. One-hundred thirty-six persons of Mexican descent (i.e., first, second, and third generation) addressed three research questions: (a) What is the relationship between disability identity and specific types of disability factors? (b) Do differences in disability identities exist across gender? (c) Do differences in disability identities exist across household language use? Participants with chronic conditions, assistive devices, and mental health conditions answered no to the disability identity question. More women with chronic conditions, who used assistive devices, or with mental health conditions denied a disability identity compared with men. Individuals from Spanish-speaking households were more likely to report a mental health diagnosis and deny disability identity compared with those from English-speaking households. English-only surveys that use a single disability identity question will undercount Mexican Americans who are more comfortable with or are predominantly speaking Spanish. There are subtle changes in meaning and emphasis from English to Spanish. This may represent the need to increase cultural competence for health professionals, including the level and preference of linguistically appropriate services, and identify the need for translating materials and intervention protocols. Policies related to mental health and disability should be available in Spanish to increase information related to mental illnesses that potentially qualify as a disability. [ABSTRACT FROM AUTHOR]

This article illuminates how understandings of disability is negotiated through use of assistive activity technologies, when people with physical impairment use this kind of technology in their social and physical environment. A qualitative data design was adopted involving interviews with 44 adults with mobility impairments using assistive activity technology. The study was conducted in Mid-Norway. In analysing the findings, this study adopted the stepwise deductive-inductive approach with social constructivism as a theoretical basis. Furthermore, a relational understanding of disability and the cyborg metaphor are used to explain how disability and assistive activity technology are embodied, as well as social and material matters. The article shows how aspects in the social construction of disability are changed when people using assistive activity technology become subjects for new and positive interpretations. The understanding of disability changes meaning according to the use of different technologies, between different people and in different contexts. To understand disability, we need to explore how people ascribe meaning to both the material and the social aspects of disability. The use of assistive activity technology led to new opportunities to participate in valued physical activities, and to negotiate new perceptions of disability. The understanding of disability and assistive activity technology use is an intertwined interpretation of human bodies, technology, and activity. [ABSTRACT FROM AUTHOR]

In this article, we consider the intersection of cognitive motor dissociation (CMD) and artificial intelligence (AI), hence when CMD meets AI. In covert consciousness, there is a discordance between the observed behavior, the traditional bedside mode of assessment, and the response to volitional commands as depicted by neuroimaging or EEG studies. This alphabet soup of acronyms represents both the promise and peril of nascent technology in covert consciousness. On the diagnostic side, there is the complexity and uncertainty of identifying the discordance between cognitive activity and overt behavior. On the therapeutic side, when AI is used to generate speech, there is the possibility of misrepresenting the thoughts and intentions of those who are otherwise voiceless. This concordance of factors makes the application of AI to CMD worthy of deeper consideration. We offer this analysis in the spirit of anticipatory governance, a prudential process by which one plans to prevent or mitigate unintended consequences of novel technology. We first consider the normative challenges posed by CMD for clinical practice, neuroethics, and the law. We then explore the history of covert consciousness and the relationship of severe brain injury to the right-to-die movement, before introducing three biographies of brain injury that highlight the potential impact of disability bias or ableism in clinical practice, assistive technology, and translational research. Subsequently, we explore how AI might give voice to conscious individuals who are unable to communicate and the ethical challenges that this technology must overcome to promote human flourishing drawing upon what Nussbaum and Sen have described as a "capabilities approach" to promote normative reasoning. [ABSTRACT FROM AUTHOR]

People with disability often require long-term support within the home. Advances in technology have made home automation more readily available to support people living with disability. However, few studies describe the perspectives of people using home automation. The aim of this study was to explore the experience of individuals living with long term serious disability using home automation. A phenomenological approach was adopted. In-depth, semi-structured interviews were conducted. Data were analysed using an inductive approach to identify themes. Two overarching categories of themes were identified: 'benefits' and 'challenges'. Benefits captured the outcomes experienced by people living with disability using home automation and the impact upon their lives. Participants described several challenges with using home automation such as self-advocating to receive home automation, long waiting periods in the assessment and installation process, frustrations when home automation did not work, and the challenges experienced from being without home automation. This research identified the benefits and challenges of home automation experienced by people with long term serious disability. The findings can be used to understand the importance of home automation and the impact it has upon the lives of people living with disability. It is recognised that home automation can have a positive impact upon the lives of people living with disability. Funding for home automation is a complicated process with long waiting times. This process needs to be readdressed in order for people to receive home automation in a timely manner to prevent negative experiences. Home automation within the community could support people living with disability to access the community more. It is important to develop facilities and communities that are accessible and inclusive for people with disabilities. [ABSTRACT FROM AUTHOR]

Can assistive technologies (ATs) support aging in place for people with dementia and disability? In seeking to go beyond the persistent institutional care delivery paradigm, this proof-of-concept study tested the feasibility of home care delivery using sensors and remote communication devices. This article reports the collaborative efforts among care professionals, care recipients and family caregivers in their private home environment and the impact of in-home passive remote monitoring (PRM) system on the users. The purpose of this study was to investigate the usability and impact of a PRM system combining in-house passive remote monitoring and an interactive communication function. In order to realize AT-supported, person-centered aging in place, a new care delivery model was designed, developed and tested for the duration of 12 weeks. The study was conducted with 5 older people (1 with severe disability and 4 with dementia), their primary family carers with 15 care professionals as users. The findings indicate that there were some technical issues. However, the overall assessment of the system performance was positive, and the users expressed favorable views regarding its preventive and interactive nature. The importance of team-based care delivery, adjusted to fit the PRM equipment, was also highlighted. Faced with the challenge of meeting the increasing demand for person-centered care with limited resources, there will be a greater need for better integration of improved ATs. The study indicates ATs' potential for enhancing the quality of life for those involved in caregiving, while stressing the significance of stakeholders' engagement, skills and teamwork. This proof-of-concept study tested the feasibility of a home care delivery system using sensors and remote communication device for those with dementia and disabilities. A home care delivery system was successfully created for 12 weeks by collaborative efforts among care professionals, care recipients and family caregivers in their private home environment. The introduction of in-home passive remote monitoring system increased the possibility of the older adults being able to live independently, and enabled rehabilitation at home. The users had favourable views regarding the system's preventive and interactive nature and highlighted a greater need for better integration of improved assistive technology in long-term care and rehabilitation. [ABSTRACT FROM AUTHOR]

Disparities may disproportionately exist for those with disabilities when using mobile devices, which are critical for independence in activities such as socialization and leisure. Prior 3D printing studies in rehabilitation have not focused on mobile device access to everyday preferred activities. This study examined user satisfaction, self-rated performance and satisfaction with daily activities while using the mobile device, and the feasibility of customized 3D printed assistive devices. The design was a one-group, quantitative pre-test to post-test study of individuals (n = 10) residing in long-term care with a physical disability due to a neurological condition. Satisfaction with the 3D printed device, as compared to the previously used assistive device, was significantly higher (p = 0.005), as well as improvements in self-rated daily activity performance (p = 0.016) and satisfaction (p = 0.037), with acceptability and satisfaction of the intervention. Findings suggest that 3D printing is feasible with a potential increase in user satisfaction through a customization process that is client centred. Recommendations for settings interested in providing customized 3D printed assistive devices, and for future studies, include client centred integration and educational support on mobile device usage during activities, familiarity with common customization and modification requests, and adjusting timelines to the facility's service delivery capacity. [ABSTRACT FROM AUTHOR]

Rehabilitation professionals prescribe patients with suitable powered mobility aids (PMAs) based on patient characteristics, e.g., age and mobility. However, there is paucity of literature examining patient characteristics associated with PMA types in Asian contexts. This research aims to study (i) characteristics of Singapore PMA users and (ii) correlations between characteristics and two PMA types – motorised wheelchairs and powered scooters. It is hypothesised that patients' age, mobility status and medical conditions have correlations with PMA types. A cross-sectional, retrospective study design was used to investigate characteristics of patients (age ≥ 21 years) at Tan Tock Seng Hospital Occupational Therapy Seating Clinic between 2017 and 2019. Comparisons of proportions of motorised wheelchair users versus powered scooter users based on characteristics were analysed using Chi-square test. Subsequently, statistically significant patient characteristics were selected for a multiple logistic regression. Among 352 patients, 21% and 79% were prescribed motorised wheelchairs and powered scooters, respectively. Patients aged 61–90 years were twice those aged 21–60 years. Males were double of females. Patients of (i) an older age, (ii) more ambulant, (iii) independent in transfers and (iv) in activities of daily living (ADLs), were more likely powered scooter users. Conversely, patients of (i) a younger age, (ii) less ambulant, (iii) require assistance in transfers and (iv) in ADLs were more likely motorised wheelchair users. Patients' gender and caregiver status showed no statistically significant correlations with PMA types. Rehabilitation professionals could consider patients' age, mobility status, transfer status and ADL status when prescribing PMA for Asian populations. Guide rehabilitation professionals in making clinical decisions on the type of powered mobility aid (PMA) to prescribe based on patients' characteristics. Aid in the development of future guidelines for rehabilitation professionals in prescription of PMAs. [ABSTRACT FROM AUTHOR]

Standard manual wheelchairs (MWCs) are inefficient and pushrim propulsion may cause progressive damage and pain to the user's arms. We describe a wheel for a MWC with a novel propulsion mechanism. The wheel has two modes of operation called "Standard" mode and "Run" mode. In Run mode, the wheelchair is propelled forward by pushing a compliant handle forward and then pulling it back, both strokes contributing to forward propulsion. We report the propulsive force and preliminary testing on a rough outdoor circuit by three able-bodied participants. In Run mode, the peak applied force is reduced to 30% and the maximum force gradient is reduced to 10% of that for standard pushrim propulsion, for the same work output. The travel time for the 1.06 km outdoor circuit is about 60% of that for a brisk walk and about 40% of that for pushrim propulsion. At a propulsion speed of 1 m/s, the cardiovascular effort in Run mode is 56% of that for pushrim propulsion. Automatic hill-hold in Run mode improves safety when ascending slopes. The mechanism has three gears so that it can be used by people with widely varying strength and fitness. Folding the handle away converts the operation to Standard mode with the conventional pushrim propulsion, supplemented by three gears. Despite the increased weight, width and friction, the bimodal geared wheels facilitate wheelchair travel on challenging paths. This may bring significant improvement to the quality of life of MWC users. The novel bimodal geared propulsion may benefit users with impaired upper extremity function. The push–pull propulsion on handles is less strenuous than pushrim propulsion and may reduce repetitive strain injuries. Run mode has significantly reduced peak force and force gradient compared with standard pushrim propulsion, for equal work. The bimodal geared propulsion facilitates outdoor travel, providing exercise that may benefit the user's strength and health. [ABSTRACT FROM AUTHOR]

This article delves into Kurt Vonnegut's "Harrison Bergeron" to examine the profound implications of assistive technologies within the context of normativity. While Vonnegut's narrative unfolds in a dystopian future where "desistive devices" are used to enforce equality, Vonnegut's insights subtly underscore the intricate facets of othered-being that challenge the normativity of assistive technologies. Drawing from the insights of crip studies, this examination argues that assistive technologies often perpetuate and idealize normative bodymind ideals, presenting a consistent framing of the normative human. Through a discourse analysis, this study demonstrates how assistive technologies, despite their variability in individual experiences, embody a normative rationality of human, mindbody existence. These technologies, rather than accommodating diversity, tend to impose a particular standard of "normalcy." In conclusion, the analysis proposes a departure from this normative trajectory. It advocates for a future direction in assistive technologies that fosters and embraces "aberrant-being." By challenging established norms and persistently questioning the constructs of normativity, assistive technologies can evolve to engage with aberrant-being and enliven cripped-embodiment. This exploration paves the way for a more inclusive and diverse future in assistive technology, where human differences are cherished rather than subdued. This piece highlights the need for a critical examination of the normative underpinnings within the field of assistive technologies, emphasizing that these technologies often perpetuate societal norms and may inadvertently limit the diverse experiences of individuals with disabilities. It calls for a shift in the design and implementation of assistive technologies, advocating for a more individualized approach that moves beyond accommodationism and grapples with the multiplicity of beingness that disability invokes. By drawing from the insights of crip studies and the critique of normativity in Kurt Vonnegut's "Harrison Bergeron," this piece invites the field of assistive technologies to challenge established norms, embrace othered invocations of being, and embrace the rich tapestry of human experiences, regardless of their deviation from traditional notions of ability and functionality. [ABSTRACT FROM AUTHOR]

Background: To examine the prevalence of toileting disability among older adults in India and its association with broad aspects of the physical and social environment. Methods: We use data from the inaugural wave of the Longitudinal Ageing Study in India and focus on adults aged 65 and older (N = 20,789). We draw on the disablement process model and existing frameworks to identify environmental factors and other risk factors that may be associated with toileting disability. Hierarchical logistic regressions are implemented to analyze the health impacts from physical and social environment characteristics. Results: One in five older Indian adults had difficulties with toileting, and the prevalence rate of this functional disability varied across sub-national regions. We find that low neighborhood trust was associated with an increased likelihood of toileting disability, as was the use of assistive mobility devices. The negative effects of these social and external environment characteristics hold when we stratified the sample by rural and urban residency. Also, older adults in urban areas without access to toilets and using shared latrines had higher odds of being disabled in terms of toileting. Other factors important in explaining toileting disability among older adults included poor self-rated health, arthritis, currently working, living in the East or West region, and having functional limitations. Conclusions: Poor person-environment fit can compromise older adults' ability to perform self-care tasks. Policymakers need to look beyond the physical environment (e.g., dedicating resources to construct toilet facilities) to adopt a more holistic, multi-faceted approach in their sanitation policies. Improving the safety of neighborhood surroundings in which shared latrines are located and the availability of accessible toilets that cater to those with mobility impairments can help improve independence in toileting among older adults. [ABSTRACT FROM AUTHOR]

Abstract\nIMPLICATIONS FOR REHABILITATIONIndividuals with disabilities face psychological, environmental, and resource-related barriers to participating in exercise and sports. The lack of participation in exercise observed in the disability community poses great concern to this population’s health. This review discusses commercially available adaptive equipment and technology for exercise and sports that help people with disabilities circumvent barriers to exercise. The methods section highlights various categories of adaptive tools and their cost, accessibility, ease of learning, and progress level to help people with disabilities determine points of entry to fitness that align with their needs. Additionally, fitness-related businesses, fitness device developers, and researchers can leverage the discussed findings to understand gaps in this field to further advance adaptive equipment and technology and help facilitate widespread use. The paper serves as a comprehensive resource to researchers, entrepreneurs, and consumers to guide developing, accessing, and marketing adaptive exercise technology.A majority of people with disabilities experience barriers to participating in exercise and sports which can drastically affect their physical and mental well-being.Although there are commercially available adaptive equipment and technologies for exercise and sports, limited accessibility, cost, and lack of options for various disabilities can hinder participation in physical activities.There are many developments needed in terms of technology and programs that can address issues faced by the disability community regarding exercise and sports participation.A majority of people with disabilities experience barriers to participating in exercise and sports which can drastically affect their physical and mental well-being.Although there are commercially available adaptive equipment and technologies for exercise and sports, limited accessibility, cost, and lack of options for various disabilities can hinder participation in physical activities.There are many developments needed in terms of technology and programs that can address issues faced by the disability community regarding exercise and sports participation. [ABSTRACT FROM AUTHOR]

BACKGROUND: Approximately 7.4% of Canadians over the age of 15 report being blind or partially sighted; this impacts their daily functioning in public spaces [1]. Technological advances have included the proliferation of self-serve kiosk in many consumer settings. However, absent from discussions of community accessibility is the experiences of Canadians who are blind or partially sighted. OBJECTIVE: To better understand the experiences of this population with self-serve kiosks. METHODS: A descriptive cross-sectional study design was used to analyze survey data collected as part of a survey by Canadian National Institute for the Blind (CNIB) of people who are blind, Deafblind partially sighted about their use of self-serve kiosks. 731 participants were surveyed, representing a response rate of 3.5% across Canada. RESULTS: 64.14% of participants faced barriers in completing a task using self-serve technology. Human assistance was required to complete the tasks in most instances. 65.74% of participants reported they did not enjoy using self-serve kiosks and 60.90% of participants reported they would not continue to use self-serve kiosks in the future. CONCLUSIONS: The findings highlight a need to promote accessibility in the creation and implementation of self-serve kiosks in order to further their use and decrease exclusion of people who are blind and partially sighted. [ABSTRACT FROM AUTHOR]

BACKGROUND: Various models, frameworks, and systems have been established to support persons with disabilities in accessing assistive technology (AT). This paper highlights the commonalities and complementary aspects of these resources for the optimal selection of the most appropriate AT for a particular user. The selection process considers the user characteristics, abilities, needs, and environment. However, it does not provide a specific methodology for tailoring this technology to individual users. OBJECTIVE: This study reports on the experience of an interdisciplinary team formed in 2001 to develop user-tailored AT. The team established a systematic methodology, detailed as a step-by-step protocol. METHODS: A survey was conducted to validate the protocol's effectiveness and assess the impact of user-tailored AT. Participants included users and stakeholders. Quantitative data were requested and complemented with qualitative information. RESULTS: Eighty-one participants were involved, with 92.6% reliant on augmentative and alternative communication (AAC) systems. A user-tailored AT was developed for this cohort, with a sustained usage rate of 56.4%. Quantitative analysis revealed a 40% reduction in reported difficulties, and Individually Prioritized Problem Assessment (IPPA) scores demonstrated a corresponding 40% improvement in overall effectiveness. The qualitative data corroborated these findings, highlighting positive user feedback and underlining the significance of family support and interdisciplinary collaboration. CONCLUSIONS: The proposed methodology offers a step-by-step protocol that complements current models and frameworks and aims to guide individuals and teams that develop user-tailored AT for persons with disabilities. Additionaly, this study reflects the importance of applying user-tailored AT to improve the quality of life of persons with disabilities. [ABSTRACT FROM AUTHOR]

According to Dr. Margaret Chan [29], approximately 15% of the world's population faces significant challenges in life due to severe disabilities. The majority of these individuals have mobility impairments, significantly impacting their mobility and self-care abilities. Two main groups affected by these disabilities are individuals with Amyotrophic Lateral Sclerosis (ALS) and those who have had a stroke. In a study referenced as [28], it was revealed that ALS accounts for 80% of cases involving severe mobility impairments. The incidence rates of ALS and stroke are reported to be 4/100,000 people and 600/100,000–1,000/100,000 people, respectively. In Vietnam, the ALS incidence rate is approximately 2–3 cases per 100,000 people, while over 200,000 individuals suffer from strokes each year. Roughly 25–30% of individuals with mobility impairments are at risk of experiencing communication difficulties, which can manifest as speech difficulties, slurred speech, or aphasia [20]. In addition to limited mobility and communication challenges, interacting with the living environment poses a significant obstacle for these individuals. Therefore, in addition to assistive communication systems, it is crucial to develop an effective and user-friendly control system for home IoT devices which enable people with severe mobility impairments to gain greater independence in their daily lives. This study presents the development and testing of an assistive IoT smart control system that allows individuals with severe mobility impairments to control familiar electronic devices using their eyes and brain. The test results demonstrate the realistic and feasible nature of the proposed system. Users rated the system above 2.78 out of 5.00 according to the HMI questionnaire. The score for attitudes, which reflects users' trust in the system, was 3.76 out of 5.00. Therefore, the proposed approach holds promise in assisting individuals with severe mobility disabilities to effectively interact with the IoT devices in their surroundings. [ABSTRACT FROM AUTHOR]

The study aim was to determine the risk of Manual patient handling (MPH) in Shahroud public hospitals, Iran. A cross-sectional study was performed in Imam Hossein (IHospital) and Bahar (BHospital) with 21 wards. MPH risk assessment was performed using MAPO (Movement and Assistance of Hospital Patient) index. The ratio of operator to disabled patient (NC/Op and PC/Op), lifting, minor aid, wheelchair, environmental, and training factor are evaluated to calculate MAPO index. Among studied wards 57%, 33.3%, and 9.5%, respectively, were in the high, moderate, and low risk exposure level. The maximum MAPO score were 16.7 in CCU of IHospital. Emergency ward of BHospital had the highest score of 9.8 and PC/OP ratio 17.5. The most risk factors were minor aid (90.5%), lifting factor (71.4%), and PC/OP (66.7%). Immediate ergonomic action is recommended. [ABSTRACT FROM AUTHOR]

This study aims to identify and evaluate the attributes of assistive products for people with locomotor disabilities using the refined Kano model. Thirty experts from various disciplines (product engineers and designers engineers, rehabilitation professionals, and users of assistive technology with locomotor disabilities) participated in the study. They were asked to complete a survey based on the Kano model questionnaire, which included functional and dysfunctional questions for each attribute. The findings reveal that performance, accessibility, functionality, and repairability are one-dimensional characteristics, while quality, modularity, intuitiveness, and aesthetics are attractive attributes. Affordability and durability are identified as must-be attributes. Subsequently, an importance scale was created on a 5-point Likert scale to further analyze the attributes based on the refined Kano model. The results indicate that functionality, quality, aesthetics, affordability, repairability, and durability are the vital attributes. Following this, a case study was conducted based on these attributes, focusing on the two most commonly used products in India: the ALIMCO basic manual wheelchair and the KARMA basic manual wheelchair. By incorporating identified attributes, manufacturers can establish marketing strategies that promote sustainable product development and enhance assistive product satisfaction among individuals with locomotor disabilities. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to examine the characteristics of assistive device users and influencing factors among disabled elderly in China. Methods: A total of 13,510 disabled elderly in Sichuan Province were surveyed. Disability was assessed using the Barthel Activities of Daily Living Scale, mental status, sensory perception, and social engagement evaluation. Univariate analysis and logistic regression analysis were employed to identify the impact factors. Results: The prevalence of assistive device utilization among participants was 79.2% (10,700/13,510, 95% CI 78.5%–79.9%), with the wheelchair being the most commonly used device. Various factors were found to influence the usage of the device, including disability level, somatic disability, age, caregivers, income, caregiver fees, and living situation (p <.05). Additionally, several factors were identified associated with the frequency of device usage, such as somatic disability, education background, income, caregiver fees, living situation, access to acquire assistive devices, duration of assistive device usage, education on assistive devices, and satisfaction level (p <.05). Conclusions: The use of assistive devices among elderly individuals in China is prevalent. There are many factors that affect the use of assistive devices, which can provide a reference for the formulation of policies in the field of assistive devices. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to explore 10-year trends in the use of Assistive Technology (AT). Using 2006 and 2015 Behavioral Risk Factor Surveillance System (BRFSS) data, univariate analysis were performed, and the rate of change was calculated. In both 2006 and 2015 data, a higher per cent of Blacks were using AT compared to Whites and Hispanics (p <.001); however, the rate of increase indicate that Blacks had the lowest per cent change (23.9%) compared to Whites (26.8%) and Hispanics (27.3%). Results indicated that AT use is statistically more prevalent in women, individuals who are not married (e.g. divorce, widowed, separated), the veteran population, lower educational attainment levels (e.g. some high school or less), lower income levels, the ageing population, unemployed (e.g. out of work, retired, unable to work) and individuals with limited functioning because of a disability. Similarly, individuals who have healthcare coverage, and individuals with concerns with medical costs used AT more. Even though most factors yielded higher utilisation rates when comparing 2006 to 2015 data, the rate of change had varying 'speeds' of improvement. [ABSTRACT FROM AUTHOR]