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Yilma TM, Mekonone ST, Alene BM, Kibret AK, Alemayehu Z, Addis BM, Menna DW, Davies TC. Assistive technology use and its associated factors among university students with disabilities: a case study in a developing country-mixed study design. Disabil Rehabil Assist Technol 2024; 19:1748-1757. [PMID: 37526478 DOI: 10.1080/17483107.2023.2233981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 06/30/2023] [Indexed: 08/02/2023]
Abstract
PURPOSE Despite the recognized benefits, access to assistive technology (AT) remains limited. Identifying the current usage patterns and unmet needs of AT users could help address the challenges of students with disabilities. Thus, this study aimed to investigate AT use and its associated factors. METHODS An institution-based cross-sectional mixed study was conducted on higher education students with disabilities in Ethiopia. An interviewer-administered questionnaire and an in-depth interview technique were used to collect data. Descriptive statistics and binary logistic regression models were used to analyse the quantitative data, while inductive thematic analysis was undertaken for the qualitative data. RESULTS A total of 233 (74.68%) with (95% CI: 70%-80%) students with disabilities used at least one form of AT. Four themes emerged which include experiences of AT use and disability, benefits and challenges of using AT, perception of the community towards AT, and responsibility for the provision of AT. Students with vision problems or those with severe disability types were most likely to be AT users. CONCLUSION AND RECOMMENDATIONS A significant proportion of students with disabilities had unmet needs for AT. Capacity at universities or rehabilitation centres would enhance access, usage of AT, and the unmet needs of students with disabilities.
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Affiliation(s)
- Tesfahun Melese Yilma
- Department of Health Informatics, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Samuel Tesfaye Mekonone
- Department of Mechanical Engineering, Institute of Technology, University of Gondar, Gondar, Ethiopia
| | - Bruhtesfa Mouhabew Alene
- Department of Biomedical Engineering, Institute of Technology, University of Gondar, Gondar, Ethiopia
| | - Alemu Kassaw Kibret
- Department of Physiotherapy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Zelalem Alemayehu
- Department of Sociology, College of Social Sciences and Humanities, University of Gondar, Gondar, Ethiopia
| | - Birhanu Mulat Addis
- Department of Mechanical Engineering, Institute of Technology, University of Gondar, Gondar, Ethiopia
- Mechanical and Materials Engineering, Queen's University, Canada
| | - Demewoz Woldie Menna
- Department of Civil Engineering, Institute of Technology, University of Gondar, Gondar, Ethiopia
| | - T Claire Davies
- Department of Mechanical and Materials Engineering, Faculty of Engineering and Applied Science, Queen's University, Canada
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Tang R, Zhang X, Yan S, Guan B, Li Y, Luo Q, Lai R, Wan H, Yang Y, Zeng L. Assistive device utilization among disabled elderly in China: A cross-sectional study. Public Health Nurs 2024. [PMID: 38652371 DOI: 10.1111/phn.13329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 03/28/2024] [Accepted: 04/10/2024] [Indexed: 04/25/2024]
Abstract
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.
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Affiliation(s)
- Rong Tang
- Department of Nursing, Chengdu Fifth People's Hospital, Chengdu, Sichuan, China
| | - Xia Zhang
- Department of Geriatrics, Chengdu Fifth People's Hospital, Chengdu, Sichuan, China
| | - Shu Yan
- Medical Affairs Department, Chengdu Fifth People's Hospital, Chengdu, Sichuan, China
| | - Bi Guan
- Department of Nursing, Chengdu Fifth People's Hospital, Chengdu, Sichuan, China
- Department of Geriatrics, Chengdu Fifth People's Hospital, Chengdu, Sichuan, China
| | - Yan Li
- Department of Nursing, Chengdu Fifth People's Hospital, Chengdu, Sichuan, China
| | - Qing Luo
- Department of Geriatrics, Chengdu Fifth People's Hospital, Chengdu, Sichuan, China
| | - Rongmei Lai
- Department of Geriatrics, Chengdu Fifth People's Hospital, Chengdu, Sichuan, China
| | - Haiyan Wan
- Department of Nursing, Chengdu Fifth People's Hospital, Chengdu, Sichuan, China
| | - Yongxue Yang
- Department of Geriatrics, Chengdu Fifth People's Hospital, Chengdu, Sichuan, China
| | - Liangnan Zeng
- Department of Nursing, Chengdu Fifth People's Hospital, Chengdu, Sichuan, China
- Department of Geriatrics, Chengdu Fifth People's Hospital, Chengdu, Sichuan, China
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Maron C, Jendre A, Goble D, Marks C, Haworth J. Acute Knee Crutch Use Provokes Changes to Postural Strategy. Percept Mot Skills 2024:315125241246390. [PMID: 38613514 DOI: 10.1177/00315125241246390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/15/2024]
Abstract
Single-leg knee crutches are a relatively new, hands-free mobility assistive device with benefits over standard axillary crutches. Our main goal in this study was to evaluate balance ability in a healthy population upon first exposure to the knee crutch device. We had 20 healthy individuals (M age = 21.1; SD = 1.5 years) complete baseline static and dynamic balance tests on a force plate, followed by knee crutch fitting, a self-selected duration of ambulation practice, and another round of balance testing while wearing the knee crutch. We used the BTrackS Balance Test (BBT) to measure static balance, and the BTrackS Limits of Stability (BLOS) test to measure dynamic balance, and we created a custom lateral bias score from the BLOS results. On average, participants self-selected 3.1 minutes of ambulation practice. Wearing the knee crutch caused a near doubling of static balance path length and a large reduction in percentile ranking on the BBT. Dynamic balance area was more than halved (p < .001), with lateral bias scores during the BLOS, indicating that participants heavily favored their non-crutched leg (p < .001). Our results indicate that static and dynamic balance were significantly altered when wearing the knee crutch, and participants seemed to switch to a single leg stance strategy. Despite these balance changes, participants were quickly ready and willing to complete independent ambulation and balance testing procedures using the single-leg knee crutch.
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Affiliation(s)
- Christian Maron
- Department of Human Movement Science, Oakland University, Rochester, MI, USA
| | - Aron Jendre
- Department of Human Movement Science, Oakland University, Rochester, MI, USA
| | - Daniel Goble
- Department of Human Movement Science, Oakland University, Rochester, MI, USA
| | - Charles Marks
- Department of Human Movement Science, Oakland University, Rochester, MI, USA
| | - Joshua Haworth
- Department of Human Movement Science, Oakland University, Rochester, MI, USA
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Dupitier EA, Perrier AP, Laforêt P, Pouplin SD. User opinions about connected pressure detection systems to prevent wheelchair-related pressure injuries: an exploratory cross-sectional survey. Assist Technol 2024:1-10. [PMID: 38607290 DOI: 10.1080/10400435.2024.2335944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2023] [Indexed: 04/13/2024] Open
Abstract
About 1% of the world's population uses a wheelchair. Wheelchair use is a well-known risk of pressure injury. A connected pressure detection system could help to prevent this complication that is linked to long durations of sitting, provided that user expectations are understood. The aim of this study was to explore the needs of wheelchair users (WU) regarding connected pressure detection systems to prevent pressure injury. A cross-section survey-based study of WU was conducted, using an anonymous electronic questionnaire posted from July 2019 to June 2020. Eighty-eight people responded. The majority were power wheelchair users (72.7%); one third (33.0%) had already sustained a pressure injury; only 17.0% knew of the existence of pressure detection systems, nevertheless 78.4% believed that they could be useful in daily life. The feature that received the highest rating was a pressure warning alarm (4.2/5 points). The majority (71.6%) preferred reminder-alerts to be set according to their habits and not according to medical guidelines. In conclusion, pressure detecting systems were perceived as useful to prevent pressure injuries by both manual and power wheelchair users. Work is needed to inform potential users of the existence of such systems.
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Affiliation(s)
- Elise A Dupitier
- Rehabilitation Research Team in Neuromotor Disability ERPHAN, Paris-Saclay University, Garches, France
- U 1179 National Institute of Health and Medical Research (INSERM), Paris-Saclay University, Versailles, France
- Medical Department, AFM-Téléthon, Evry, France
| | - Antoine P Perrier
- TIMC Lab, Biomeca Team, National Center for Scientific Research (CNRS), Grenoble Alpes University, Grenoble, France
- Orthopedic surgery, Hospital Group Diaconesses - Croix Saint-Simon, Paris, France
| | - Pascal Laforêt
- U 1179 National Institute of Health and Medical Research (INSERM), Paris-Saclay University, Versailles, France
- Neurology Department, Raymond Poincaré University Hospital, Garches, France
- Garches, Nord-Est-lle-de-France Neuromuscular Reference Center, FHU PHENIX, France
| | - Samuel D Pouplin
- Rehabilitation Research Team in Neuromotor Disability ERPHAN, Paris-Saclay University, Garches, France
- U 1179 National Institute of Health and Medical Research (INSERM), Paris-Saclay University, Versailles, France
- New Technologies Plateform, Raymond Poincaré University Hospital, Garches, France
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Barrett B, Phillips SL, Bulat T, Lind JD, Ballistrea L, Ramrattan A, Friedman Y, Cowan L. Evaluation of a new assistive technology: the StandBar. Disabil Rehabil Assist Technol 2024; 19:671-681. [PMID: 36043947 DOI: 10.1080/17483107.2022.2115565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 08/16/2022] [Indexed: 10/14/2022]
Abstract
PURPOSE Evaluate the potential of a wheelchair assistive technology (StandBar) to promote power wheelchair users' ability to safely stand independently from their power wheelchair and determine the impact of the device use on psychological well-being for both power wheelchair users and their caregivers. MATERIALS AND METHODS A convenience sample of 11 power wheelchair users and caregiver dyads provided study data. Participants included power wheelchair users who were existing StandBar users or currently in training with the StandBar as part of their rehabilitation. Assessments were conducted at baseline and at six-month follow-up and included physiological assessments and functional testing with and without the StandBar. Monthly follow-up phone calls were completed to collect information on adverse events (e.g., falls, hospitalizations, and skin breakdown). A qualitative interview assessed StandBar users' and caregivers' perception at six-month follow-up. RESULTS AND CONCLUSIONS StandBar use provided power wheelchair users a higher level of independence, confidence, and safety. All participants highly recommended StandBar use to others with similar levels of functional impairment. StandBar use allowed many participants the ability to complete functional tasks that were otherwise not possible without assistance. Qualitative interviews reported improved independence and psychological well-being for StandBar users as well as reduced levels of anxiety and burden of care by caregivers. The StandBar is a cost-effective assistive technology that promotes independence and functionality for power wheelchair users and improves the psychological well-being of users and their caregivers. Implications for RehabilitationStandBar allows power wheelchair users to:Minimize negative effects of immobilization.Increase independence for activities of daily living (grooming, hygiene, toileting, transfers) and instrumental activities of daily living (social experiences).Improve their quality of life through increasing independence and confidence.Reduce need for assistance and corresponding caregiver burden.
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Affiliation(s)
- Blake Barrett
- VISN 8 Patient Safety Center of Inquiry, James A. Haley Veterans Hospital and Clinics, Tampa, FL, USA
| | - Sam L Phillips
- VISN 8 Patient Safety Center of Inquiry, James A. Haley Veterans Hospital and Clinics, Tampa, FL, USA
| | - Tatjana Bulat
- VISN 8 Patient Safety Center of Inquiry, James A. Haley Veterans Hospital and Clinics, Tampa, FL, USA
- Department of Internal Medicine, University of South Florida, Morsani College of Medicine, Tampa, FL, USA
| | - Jason D Lind
- VISN 8 Patient Safety Center of Inquiry, James A. Haley Veterans Hospital and Clinics, Tampa, FL, USA
| | - Lisa Ballistrea
- VISN 8 Patient Safety Center of Inquiry, James A. Haley Veterans Hospital and Clinics, Tampa, FL, USA
| | - Anita Ramrattan
- VISN 8 Patient Safety Center of Inquiry, James A. Haley Veterans Hospital and Clinics, Tampa, FL, USA
| | - Yvonne Friedman
- VISN 8 Patient Safety Center of Inquiry, James A. Haley Veterans Hospital and Clinics, Tampa, FL, USA
| | - Linda Cowan
- VISN 8 Patient Safety Center of Inquiry, James A. Haley Veterans Hospital and Clinics, Tampa, FL, USA
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Arellano CJ, Vega D. Exploring How the Arms Can Help the Legs in Facilitating Gait Rehabilitation. Adv Biol (Weinh) 2024:e2300661. [PMID: 38519429 DOI: 10.1002/adbi.202300661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 02/26/2024] [Indexed: 03/24/2024]
Abstract
Inspired by the ideas from the fields of gait rehabilitation, neuroscience, and locomotion biomechanics and energetics, a body of work is reviewed that has led to propose a conceptual framework for novel "self-assistive" walking devices that could further promote walking recovery from incomplete spinal cord injuries. The underlying rationale is based on a neural coupling mechanism that governs the coordinated movements of the arms and legs during walking, and that the excitability of these neural pathways can be exploited by actively engaging the arms during locomotor training. Self-assistive treadmill walking rehabilitation devices are envisioned as an approach that would allow an individual to actively use their arms to help the legs during walking. It is hoped that the conceptual framework inspires the design and use of self-assistive walking devices that are tailored to assist individuals with an incomplete spinal cord injury to regain their functional walking ability.
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Affiliation(s)
- Christopher J Arellano
- Department of Orthopaedic Surgery, University of Arizona, Tucson, AZ, 85724, USA
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, 85721, USA
| | - Daisey Vega
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, 85721, USA
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Bass A, Morin SN, Guidea M, Lam JTAT, Karelis AD, Aubertin-Leheudre M, Gagnon DH. Potential Effects of an Exoskeleton-Assisted Overground Walking Program for Individuals With Spinal Cord Injury Who Uses a Wheelchair on Imaging and Serum Markers of Bone Strength: Pre-Post Study. JMIR Rehabil Assist Technol 2024; 11:e53084. [PMID: 38163294 PMCID: PMC10790203 DOI: 10.2196/53084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 11/20/2023] [Accepted: 11/20/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND As many as 60% of individuals use a wheelchair long term after a spinal cord injury (SCI). This mode of locomotion leads to chronic decline in lower-extremity weight-bearing activities and contributes to the development of severe sublesional osteoporosis and high rates of fragility fracture. Overground exoskeleton-assisted walking programs provide a novel opportunity to increase lower-extremity weight bearing, with the potential to improve bone health. OBJECTIVE The aim of the study is to measure the potential effects of an exoskeleton-assisted walking program on lower-extremity bone strength and bone remodeling biomarkers in individuals with chronic (≥18 months) SCI who use a wheelchair. METHODS In total, 10 participants completed a 16-week exoskeleton-assisted walking program (34 individualized 1-hour sessions, progressing from 1 to 3 per week). Bone mineral density and bone strength markers (dual-energy x-ray absorptiometry: total body, left arm, leg, total hip, and femoral neck and peripheral quantitative computed tomography: 25% of left femur and 66% of left tibia) as well as bone remodeling biomarkers (formation=osteocalcin and resorption=C-telopeptide) were measured before and after intervention and compared using nonparametric tests. Changes were considered significant and meaningful if the following criteria were met: P<0.1, effect size ≥0.5, and relative variation >5%. RESULTS Significant and meaningful increases were observed at the femur (femoral neck bone mineral content, bone strength index, and stress-strain index) and tibia (cortical cross-sectional area and polar moment of inertia) after the intervention (all P<.10). We also noted a decrease in estimated femoral cortical thickness. However, no changes in bone remodeling biomarkers were found. CONCLUSIONS These initial results suggest promising improvements in bone strength markers after a 16-week exoskeleton-assisted walking program in individuals with chronic SCI. Additional research with larger sample sizes, longer interventions (possibly of greater loading intensity), and combined modalities (eg, pharmacotherapy or functional electrical stimulation) are warranted to strengthen current evidence. TRIAL REGISTRATION ClinicalTrials.gov NCT03989752; https://clinicaltrials.gov/ct2/show/NCT03989752. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/19251.
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Affiliation(s)
- Alec Bass
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Centre Intégré Universitaire de Santé et Services Sociaux (CIUSSS) du Centre-Sud-de-l'Île-de-Montréal, Montréal, QC, Canada
| | - Suzanne N Morin
- Department of Medicine, McGill University, Montréal, QC, Canada
| | - Michael Guidea
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Centre Intégré Universitaire de Santé et Services Sociaux (CIUSSS) du Centre-Sud-de-l'Île-de-Montréal, Montréal, QC, Canada
| | - Jacqueline T A T Lam
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Centre Intégré Universitaire de Santé et Services Sociaux (CIUSSS) du Centre-Sud-de-l'Île-de-Montréal, Montréal, QC, Canada
| | - Antony D Karelis
- Department of Exercise Science, Faculty of Sciences, Université du Québec à Montréal, Montréal, QC, Canada
| | - Mylène Aubertin-Leheudre
- Department of Exercise Science, Faculty of Sciences, Université du Québec à Montréal, Montréal, QC, Canada
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, QC, Canada
| | - Dany H Gagnon
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Centre Intégré Universitaire de Santé et Services Sociaux (CIUSSS) du Centre-Sud-de-l'Île-de-Montréal, Montréal, QC, Canada
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Daniel S, Rawat N, Iyer R, Shaikh-Mohammed J, Dash SS, Sarda V, Sujatha S. User experience study of an affordable manual standing wheelchair. Disabil Rehabil Assist Technol 2023; 18:1536-1543. [PMID: 35400287 DOI: 10.1080/17483107.2022.2060350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 03/28/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE The manual user-operated Arise Standing Wheelchair (SWC) is the end-result of multiple design iterations based on comments from user trials. The Arise SWC provides standing functionality, outdoor mobility, affordability, and customizability. This paper describes a user experience study of the Arise SWC's pre-commercial version. METHODS Thirty participants (N = 30, 25 Male, 5 Female) were recruited for the study. All the participants were people with spinal cord injury. The study was conducted over a period of six weeks (five participants per week) within the hospital premises under the supervision of clinical personnel. A 30 min interactive training session involved thirteen activities. During the trial period, the participants were trained to perform twenty-two activities to familiarize themselves with the SWC. The participants were also trained to perform four functional usage activities with the SWC. At the end of the study, participant responses to ten outcome measures were captured using a smiley-based Likert-scale questionnaire. RESULTS A majority of the participants (93.3%) felt happy when they stood in the SWC. The majority participants (83.3%) preferred the Arise SWC over their current wheelchair. Also, 80% participants anticipated that they could get more work done at home using the standing function of the wheelchair. CONCLUSIONS A one-time fitting and training ensured optimal effort for the SWC operation, correct posture, and comfortable user experience. With proper dissemination and awareness, it is believed that the Arise SWC will benefit eligible users and improve their quality of life.IMPLICATIONS FOR REHABILITATIONThe Arise wheelchair provides standing functionality, outdoor mobility, affordability, and customizability.Study confirms that incorporating standing functionality can improve the quality of life for wheelchair users.The majority of users were happy, felt safe and expected to do more with the standing functionality.Study results support further testing in real world conditions beyond the hospital setting.
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Affiliation(s)
- Samson Daniel
- TTK Center for Rehabilitation Research and Device Development (R2D2), Department of Mechanical Engineering, Indian Institute of Technology Madras, Chennai, India
| | - Nidhi Rawat
- Department of Physical Medicine & Rehabilitation, St. John's Medical College & Hospital, Bangalore, India
| | - Rajalakshmi Iyer
- Department of Physical Medicine & Rehabilitation, All India Institute of Medical Sciences, Rishikesh, India
| | - Javeed Shaikh-Mohammed
- TTK Center for Rehabilitation Research and Device Development (R2D2), Department of Mechanical Engineering, Indian Institute of Technology Madras, Chennai, India
| | - Swostik Sourav Dash
- TTK Center for Rehabilitation Research and Device Development (R2D2), Department of Mechanical Engineering, Indian Institute of Technology Madras, Chennai, India
| | - Vivek Sarda
- TTK Center for Rehabilitation Research and Device Development (R2D2), Department of Mechanical Engineering, Indian Institute of Technology Madras, Chennai, India
| | - S Sujatha
- TTK Center for Rehabilitation Research and Device Development (R2D2), Department of Mechanical Engineering, Indian Institute of Technology Madras, Chennai, India
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Dong S, Gallagher J, Jackson A, Levesley M. A Hand-Held Device Presenting Haptic Directional Cues for the Visually Impaired. Sensors (Basel) 2023; 23:8415. [PMID: 37896508 PMCID: PMC10611303 DOI: 10.3390/s23208415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 10/08/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023]
Abstract
Haptic information is essential in everyday activities, especially for visually impaired people in terms of real-world navigation. Since human haptic sensory processing is nonlinear, asymmetric vibrations have been widely studied to create a pulling sensation for the delivery of directional haptic cues. However, the design of an input control signal that generates asymmetric vibrations has not yet been parameterised. In particular, it is unclear how to quantify the asymmetry of the output vibrations to create a better pulling sensation. To better understand the design of an input control signal that generates haptic directional cues, we evaluated the effect of the pulling sensations corresponding to the three adjustable parameters (i.e., delay time, ramp-down step length, and cut-off voltage) in a commonly applied step-ramp input signal. The results of a displacement measurement and a psychophysical experiment demonstrate that when the quantified asymmetry ratio is in a range of 0.3430-0.3508 with an optimised cut-off voltage for our hand-held device, the haptic directional cues are better perceived by participants. Additionally, the results also showed a superior performance in haptic delivery by shear forces than normal forces.
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Affiliation(s)
- Shuhao Dong
- Rehabilitation Robotics Laboratory, School of Mechanical Engineering, University of Leeds, Leeds LS2 9JT, UK; (J.G.); (A.J.); (M.L.)
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Rozevink SG, Hijmans JM, Horstink KA, van der Sluis CK. Effectiveness of task-specific training using assistive devices and task-specific usual care on upper limb performance after stroke: a systematic review and meta-analysis. Disabil Rehabil Assist Technol 2023; 18:1245-1258. [PMID: 34788166 DOI: 10.1080/17483107.2021.2001061] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 10/26/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE Task-specific rehabilitation is a key indicator for successful rehabilitation to improve the upper limb performance after stroke. Assistive robotic and non-robotic devices are emerging to provide rehabilitation therapy; however, the effectiveness of task-specific training programs using assistive training devices compared with task-specific usual care training has not been summarized yet. Therefore, the effectiveness of task-specific training using assistive arm devices (TST-AAD) compared with task-specific usual care (TSUC) on the upper limb performance of patients with a stroke was investigated. To assess task specificity, a set of criteria was proposed: participation, program, relevant, repeated, randomized, reconstruction and reinforced. MATERIALS AND METHODS Out of 855 articles, 17 fulfilled the selection criteria. A meta-analysis was performed on the Fugl-Meyer Assessment scores in the subacute and chronic stages after stroke and during follow-up. RESULTS AND CONCLUSION Both TST-AAD and TSUC improved the upper limb performance after stroke. In the sub-acute phase after stroke, TST-AAD was more effective than TSUC in reducing the upper limb impairment, although findings were based on only three studies. In the chronic phase, TST-AAD and TSUC showed similar effectiveness. No differences between the two types of training were found at the follow-up measurements. Future studies should describe training, device usage and criteria of task specificity in a standardized way to ease comparison.Implications for rehabilitationArm or hand function is often undertreated in stroke patients, assistive training devices may be able to improve the upper limb performance.Task-specific training using assistive devices is effective in improving the upper limb performance after stroke.Task-specific training using assistive devices seems to be more effective in reducing impairment compared with task specific usual care in the subacute phase after stroke, but they are equally effective in the chronic phase of stroke.
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Affiliation(s)
- Samantha G Rozevink
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
| | - Juha M Hijmans
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
| | - Koen A Horstink
- University of Groningen, University Medical Center Groningen, Department of Human Movement Sciences, Groningen, The Netherlands
| | - Corry K van der Sluis
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
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Sarda V, Dash SS, Mohan Varma DS, Shaikh-Mohammed J, Sujatha S. Design of a low-cost, reconfigurable, standing wheelchair with easy and stable sit-stand-sit transition capability. Disabil Rehabil Assist Technol 2023; 18:1056-1065. [PMID: 34644229 DOI: 10.1080/17483107.2021.1978564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 09/03/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Assistive devices like Standing Wheelchairs (SWC) have remained out of reach of the economically underprivileged even before the pandemic-induced financial downturn, and more so now. This paper describes the mechanical design of a manual user-actuated SWC that is cost-effective (equivalent of USD 210 in India, ex-factory) and has special features that minimise user effort and accommodates varying body weights (50-110 kg) and dimensions (1.52-1.83 m height). METHODS The design includes a six-bar mechanism and spring balancing to optimise user effort during operation. The optimised gas spring incorporates adjustability to minimise each user's force for sit-stand-sit transitions. The handle shape is ergonomically designed using kinematic analysis to provide convenient gripping positions for actuation. The design has been customised based on parametric studies to suit varying body weights. RESULTS Overall, the SWC design provides standing functionality with ease of operation, safety locks, customisability, affordability, outdoor mobility and is aesthetically pleasing. CONCLUSIONS Customisability and the low cost of the device would enhance the accessibility of the SWC to a larger group of eligible users.Implications for rehabilitationManual user-operated standing wheelchair design using a six-bar mechanismSpring balancing used to reduce user effort to self-lift to the standing positionKinematic analysis used to determine convenient handle location for user easeCustomisability for wide range of users to ensure correct posture, optimal effortDesign refined through multiple iterations using inputs from users and cliniciansDesign commercialised at an affordable cost, making it accessible to a larger population.
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Affiliation(s)
- Vivek Sarda
- TTK Center for Rehabilitation Research and Device Development (R2D2), Department of Mechanical Engineering, Indian Institute of Technology Madras, Chennai, India
| | - Swostik Sourav Dash
- TTK Center for Rehabilitation Research and Device Development (R2D2), Department of Mechanical Engineering, Indian Institute of Technology Madras, Chennai, India
| | - D S Mohan Varma
- CBCMT, School of Mechanical Engineering, Vellore Institute of Technology, Vellore, India
| | - Javeed Shaikh-Mohammed
- TTK Center for Rehabilitation Research and Device Development (R2D2), Department of Mechanical Engineering, Indian Institute of Technology Madras, Chennai, India
| | - S Sujatha
- TTK Center for Rehabilitation Research and Device Development (R2D2), Department of Mechanical Engineering, Indian Institute of Technology Madras, Chennai, India
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Bayat N, Kim JH, Choudhury R, Kadhim IF, Al-Mashhadani Z, Aldritz Dela Virgen M, Latorre R, De La Paz R, Park JH. Vision Transformer Customized for Environment Detection and Collision Prediction to Assist the Visually Impaired. J Imaging 2023; 9:161. [PMID: 37623693 PMCID: PMC10455554 DOI: 10.3390/jimaging9080161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/28/2023] [Accepted: 08/07/2023] [Indexed: 08/26/2023] Open
Abstract
This paper presents a system that utilizes vision transformers and multimodal feedback modules to facilitate navigation and collision avoidance for the visually impaired. By implementing vision transformers, the system achieves accurate object detection, enabling the real-time identification of objects in front of the user. Semantic segmentation and the algorithms developed in this work provide a means to generate a trajectory vector of all identified objects from the vision transformer and to detect objects that are likely to intersect with the user's walking path. Audio and vibrotactile feedback modules are integrated to convey collision warning through multimodal feedback. The dataset used to create the model was captured from both indoor and outdoor settings under different weather conditions at different times across multiple days, resulting in 27,867 photos consisting of 24 different classes. Classification results showed good performance (95% accuracy), supporting the efficacy and reliability of the proposed model. The design and control methods of the multimodal feedback modules for collision warning are also presented, while the experimental validation concerning their usability and efficiency stands as an upcoming endeavor. The demonstrated performance of the vision transformer and the presented algorithms in conjunction with the multimodal feedback modules show promising prospects of its feasibility and applicability for the navigation assistance of individuals with vision impairment.
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Affiliation(s)
- Nasrin Bayat
- Department of Electrical and Computer Engineering, University of Central Florida, Orlando, FL 32816, USA; (N.B.); (Z.A.-M.); (R.L.)
| | - Jong-Hwan Kim
- AI R&D Center, Korea Military Academy, Seoul 01805, Republic of Korea;
| | - Renoa Choudhury
- Department of Mechanical and Aerospace Engineering, University of Central Florida, Orlando, FL 32816, USA; (R.C.); (I.F.K.); (M.A.D.V.); (R.D.L.P.)
| | - Ibrahim F. Kadhim
- Department of Mechanical and Aerospace Engineering, University of Central Florida, Orlando, FL 32816, USA; (R.C.); (I.F.K.); (M.A.D.V.); (R.D.L.P.)
| | - Zubaidah Al-Mashhadani
- Department of Electrical and Computer Engineering, University of Central Florida, Orlando, FL 32816, USA; (N.B.); (Z.A.-M.); (R.L.)
| | - Mark Aldritz Dela Virgen
- Department of Mechanical and Aerospace Engineering, University of Central Florida, Orlando, FL 32816, USA; (R.C.); (I.F.K.); (M.A.D.V.); (R.D.L.P.)
| | - Reuben Latorre
- Department of Electrical and Computer Engineering, University of Central Florida, Orlando, FL 32816, USA; (N.B.); (Z.A.-M.); (R.L.)
| | - Ricardo De La Paz
- Department of Mechanical and Aerospace Engineering, University of Central Florida, Orlando, FL 32816, USA; (R.C.); (I.F.K.); (M.A.D.V.); (R.D.L.P.)
| | - Joon-Hyuk Park
- Department of Mechanical and Aerospace Engineering, University of Central Florida, Orlando, FL 32816, USA; (R.C.); (I.F.K.); (M.A.D.V.); (R.D.L.P.)
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Hutin E, Ghédira M, Vinti M, Tazi S, Gracies JM, Decq P. Comparing the Effect of Implanted Peroneal Nerve Stimulation and Ankle-Foot Orthosis on Gait Kinematics in Chronic Hemiparesis: A Randomized Controlled Trial. J Rehabil Med 2023; 55:jrm7130. [PMID: 37548420 PMCID: PMC10424098 DOI: 10.2340/jrm.v55.7130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 05/31/2023] [Indexed: 08/08/2023] Open
Abstract
OBJECTIVE Impaired ankle dorsiflexion in hemiparesis may be treated with ankle-foot orthosis or functional electrical stimulation. Semi-implanted selective functional electrical stimulation uses independent stimulations of deep and superficial peroneal nerves. The aim of this study was to compare gait kinematics using ankle-foot orthosis or semi-implanted selective functional electrical stimulation over 6 months in hemiparesis. METHODS Subjects with chronic hemiparesis, randomized into ankle-foot orthosis or semi-implanted selective functional electrical stimulation groups, underwent comfortable gait analysis without and with device OFF and ON, before, and 3 and 6 months after treatment onset. The effects of condition, visit and group on gait kinematics (analysis of variance; ANOVA) were analysed. RESULTS A total of 27 subjects were included (ankle-foot orthosis, n = 13; semi-implanted selective functional electrical stimulation, n = 14). The only between-group difference in changes from OFF to ON conditions was a deteriorated ankle dorsiflexion speed with ankle-foot orthosis at month 6 (condition*group, p = 0.04; ankle-foot orthosis, -60%, p = 0.02; semi-implanted selective functional electrical stimulation, non significant). Both groups pooled, from OFF to ON gait speed (+ 0.07 m/s; + 10%), cadence (+ 4%), step length (+ 6%) and peak ankle dorsiflexion (+ 6°) increased, and peak ankle inversion (-5°) and peak knee flexion (-2°) decreased (p < 0.001); finally, peak knee flexion in the OFF condition increased (+ 2°, p = 0.03). CONCLUSION Semi-implanted selective functional electrical stimulation and ankle-foot orthosis similarly impacted gait kinematics in chronic hemiparesis after 6 months of use. Ankle dorsiflexion speed in swing deteriorated markedly with ankle-foot orthosis.
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Affiliation(s)
- Emilie Hutin
- Laboratoire Analyse et Restauration du Mouvement, Service de Rééducation Neurolocomotrice, Hôpitaux Universitaires Henri Mondor, AP-HP, Créteil, France; Service de Neurochirurgie, Hôpitaux Universitaires Henri Mondor, AP-HP, Créteil; Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers ParisTech, Université Paris XIII, Paris, France.
| | - Mouna Ghédira
- Laboratoire Analyse et Restauration du Mouvement, Service de Rééducation Neurolocomotrice, Hôpitaux Universitaires Henri Mondor, AP-HP, Créteil, France; Service de Neurochirurgie, Hôpitaux Universitaires Henri Mondor, AP-HP, Créteil, France
| | - Maria Vinti
- Laboratoire Analyse et Restauration du Mouvement, Service de Rééducation Neurolocomotrice, Hôpitaux Universitaires Henri Mondor, AP-HP, Créteil, France; Service de Neurochirurgie, Hôpitaux Universitaires Henri Mondor, AP-HP, Créteil; Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers ParisTech, Université Paris XIII, Paris, France
| | - Sanaa Tazi
- Laboratoire Analyse et Restauration du Mouvement, Service de Rééducation Neurolocomotrice, Hôpitaux Universitaires Henri Mondor, AP-HP, Créteil, France; Service de Neurochirurgie, Hôpitaux Universitaires Henri Mondor, AP-HP, Créteil, France
| | - Jean-Michel Gracies
- Laboratoire Analyse et Restauration du Mouvement, Service de Rééducation Neurolocomotrice, Hôpitaux Universitaires Henri Mondor, AP-HP, Créteil, France; Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers ParisTech, Université Paris XIII, Paris, France
| | - Philippe Decq
- Laboratoire Analyse et Restauration du Mouvement, Service de Rééducation Neurolocomotrice, Hôpitaux Universitaires Henri Mondor, AP-HP, Créteil, France; Service de Neurochirurgie, Hôpitaux Universitaires Henri Mondor, AP-HP, Créteil; Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers ParisTech, Université Paris XIII, Paris, France
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Park D, Di Natali C, Sposito M, Caldwell DG, Ortiz J. Elbow-sideWINDER (Elbow-side Wearable INDustrial Ergonomic Robot): design, control, and validation of a novel elbow exoskeleton. Front Neurorobot 2023; 17:1168213. [PMID: 37501781 PMCID: PMC10369055 DOI: 10.3389/fnbot.2023.1168213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 06/13/2023] [Indexed: 07/29/2023] Open
Abstract
Musculoskeletal Disorders associated with the elbow are one of the most common forms of work-related injuries. Exoskeletons have been proposed as an approach to reduce and ideally eliminate these injuries; however, exoskeletons introduce their own problems, especially discomfort due to joint misalignment. The Elbow-sideWINDER with its associated control strategy is a novel elbow exoskeleton to assist elbow flexion/extension during occupational tasks. This study describes the exoskeleton showing how this can minimize discomfort caused by joint misalignment, maximize assistive performance, and provide increased robustness and reliability in real worksites. The proposed medium-level control strategy can provide effective assistive torque using three control units as follows: an arm kinematics estimator, a load estimator, and a friction compensator. The combined hardware/software system of the Elbow-sideWINDER is tested in load-lifting tasks (2 and 7 kg). This experiment focuses on the reduction in the activation level of the biceps brachii and triceps brachii in both arms and the change in the range of motion of the elbow during the task. It is shown that using the Elbow-sideWINDER, the biceps brachii, responsible for the elbow flexion, was significantly less activated (up to 38.8% at 2 kg and 25.7% at 7 kg, on average for both arms). For the triceps brachii, the muscle activation was reduced by up to 37.0% at 2 kg and 35.1% at 7 kg, on average for both arms. When wearing the exoskeleton, the range of motion of the elbow was reduced by up to 13.0° during the task, but it was within a safe range and could be compensated for by other joints such as the waist or knees. There are extremely encouraging results that provide good indicators and important clues for future improvement of the Elbow-sideWINDER and its control strategy.
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Bilyea AJ, French SH, Abdullah HA. Modeling contact forces during human-robot interactions for performing activities of daily living. Proc Inst Mech Eng H 2023:9544119231179568. [PMID: 37300488 DOI: 10.1177/09544119231179568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
This study aims to characterize contact forces between humans and tools during activities of daily living (ADL) to provide information to a personal care robot. The study was conducted on non-impaired subjects to capture various static and dynamic force levels when making contact with three different robotic tools, each designed to perform an ADL task: hair brushing, face wiping, and face shaving. The static trial of the study involved 21 participants. Forces were collected at fixed locations for each task and used to develop models for each participant. Extraction of the maximum force levels was performed for both the maximum and desired levels of force. The dynamic trial involved 24 individuals. Participants were asked to maintain a comfortable level of force for the duration of their contact with the tool as the robot moved along its path to perform the ADL task. For the static and dynamic trials, higher forces were observed during hair brushing compared to the other two tasks. It was observed that the hair brushing task force at a specific contact point has an overall maximum of 55.66 N, while the maximum forces detected in the face wiping and face shaving tasks were 36.40 and 11.11 N, respectively. The forces collected were analyzed, and no trends were found relating the contact forces to the gender, height, or weight of the subjects. Based on the analysis of the results, recommendations have been made to enhance the force safety limits for the personal care robot working environment.
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Affiliation(s)
- Aubrianna Jn Bilyea
- Robotics Institute, School of Engineering, University of Guelph, Guelph, ON, Canada
| | - Steven H French
- Robotics Institute, School of Engineering, University of Guelph, Guelph, ON, Canada
| | - Hussein A Abdullah
- Robotics Institute, School of Engineering, University of Guelph, Guelph, ON, Canada
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Tan K, Koyama S, Sakurai H, Kanada Y, Tanabe S. Changes in Distance between a Wearable Robotic Exoskeleton User and Four-Wheeled Walker during Gait in Level and Slope Conditions: Implications for Fall Prevention Systems. Biomimetics (Basel) 2023; 8:213. [PMID: 37366808 DOI: 10.3390/biomimetics8020213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 05/08/2023] [Accepted: 05/20/2023] [Indexed: 06/28/2023] Open
Abstract
When walking with wearable robotic exoskeletons (WRE) in people with spinal cord injury, the distance between the user and the walker is one of the most important perspectives for ensuring safety. The purpose of this study was to clarify the distance between WRE users and four-wheeled walkers (4WW) while walking on level and sloping surfaces. To eliminate the effects of variation in neurological conditions, 12 healthy subjects participated. All participants ambulated using the WRE and the 4WW on level and sloping surfaces. The outcomes were the mean distances between the WRE users and the 4WWs in the level and slope conditions. To examine the influence of uphill and downhill slopes on distance, comparisons were conducted between the uphill or downhill conditions and the respective transitional periods. In the uphill condition, the mean distances were significantly greater than that in the level condition. Conversely, the mean distance moving downhill was significantly shorter than that in the level condition. Changes in the distance between the WRE user and the 4WW might increase the risk of falling forward on an uphill slope and backward on a downhill slope. This study's results will assist in developing a new feedback system to prevent falls.
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Affiliation(s)
- Koki Tan
- Graduate School of Health Sciences, Fujita Health University, Toyoake 470-1192, Aichi, Japan
| | - Soichiro Koyama
- Graduate School of Health Sciences, Fujita Health University, Toyoake 470-1192, Aichi, Japan
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake 470-1192, Aichi, Japan
| | - Hiroaki Sakurai
- Graduate School of Health Sciences, Fujita Health University, Toyoake 470-1192, Aichi, Japan
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake 470-1192, Aichi, Japan
| | - Yoshikiyo Kanada
- Graduate School of Health Sciences, Fujita Health University, Toyoake 470-1192, Aichi, Japan
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake 470-1192, Aichi, Japan
| | - Shigeo Tanabe
- Graduate School of Health Sciences, Fujita Health University, Toyoake 470-1192, Aichi, Japan
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake 470-1192, Aichi, Japan
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Di Natali C, Ortiz J, Caldwell DG. Quasi-passive lower limbs exosuit: an in-depth assessment of fatigue, kinematic and muscular patterns while comparing assistive strategies on an expert subject's gait analysis. Front Neurorobot 2023; 17:1127694. [PMID: 37250670 PMCID: PMC10213774 DOI: 10.3389/fnbot.2023.1127694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 04/06/2023] [Indexed: 05/31/2023] Open
Abstract
Wearable robots are becoming a valuable solution that helps injured, and elderly people regain mobility and improve clinical outcomes by speeding up the rehabilitation process. The XoSoft exosuit identified several benefits, including improvement of assistance, usability, and acceptance with a soft, modular, bio-mimetic, and quasi-passive exoskeleton. This study compares two assistive configurations: (i) a bilateral hip flexion (HA, hips-assistance) and (ii) a bilateral hip flexion combined with ankle plantarflexion (HAA, hips-ankles-assistance) with the main goal of evaluating compensatory actions and synergetic effects generated by the human- exoskeleton interaction. A complete description of this complex interaction scenario with this actuated exosuit is evaluated during a treadmill walking task, using several indices to quantify the human-robot interaction in terms of muscular activation and fatigue, metabolic expenditure, and kinematic motion patterns. Evidence shows that the HAA biomimetic controller is synergetic with the musculature and performs better concerning the other control strategy. The experimentation demonstrated a metabolic expenditure reduction of 8% of Metabolic Equivalent of Task (MET), effective assistance of the muscular activation of 12.5%, a decrease of the muscular fatigue of 0.6% of the mean frequency, and a significant reduction of the compensatory actions, as discussed in this work. Compensatory effects are present in both assistive configurations, but the HAA modality provides a 47% reduction of compensatory effects when considering muscle activation.
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Sarsak HI, von Zweck C, Ledgerd R. Wheeled and Seated Mobility Devices Provision: Quantitative Findings and SWOT Thematic Analysis of a Global Occupational Therapist Survey. Healthcare (Basel) 2023; 11:healthcare11081075. [PMID: 37107909 PMCID: PMC10137666 DOI: 10.3390/healthcare11081075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 04/04/2023] [Accepted: 04/07/2023] [Indexed: 04/29/2023] Open
Abstract
PURPOSE To better understand the global role of occupational therapists and explore facilitators and barriers impacting user access to high quality, affordable wheeled and seated mobility device (WSMD) provision worldwide. METHODS Mixed-method approach utilizing quantitative findings and qualitative strengths, weaknesses, opportunities, and threats (SWOT) analysis of a global online survey. RESULTS A total of 696 occupational therapists from 61 countries completed the survey. Almost 49% had 10 or more years of experience with the provision of WSMDs. WSMD provision had positive, significant associations with attainment of certification (0.000), higher service funding (0.000), higher country income (0.001), standardized training (0.003), continuous professional development (0.004), higher experience (0.004), higher user satisfaction (0.032), custom-made device provision (0.038), higher staff capacity (0.040), and more time working with users (0.050); negative, significant associations were identified with high cost of WSMDs (0.006) and pre-made device provision (0.019). SWOT analysis identified high country income, funding, experience, training, certification from global partners, variety of roles and practice settings, and interdisciplinary teamwork as strengths and opportunities for professional growth, while low country income, lack of time/staff capacity/standardization/support services, and poor access to proper devices were indicated as weaknesses and threats. CONCLUSION Occupational therapists are skilled healthcare professionals and provide a variety of WSMD services. Efforts to build collaborative partnerships, enhance access to occupational therapists and funding options, improve service and standards for WMSD service delivery, and promote professional development will help to overcome challenges and facilitate WSMD provision globally. Promoting practices based on best available evidence for WSMD provision worldwide should be prioritized.
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Affiliation(s)
| | - Claudia von Zweck
- World Federation of Occupational Therapists, 1211 Geneva, Switzerland
| | - Ritchard Ledgerd
- World Federation of Occupational Therapists, 1211 Geneva, Switzerland
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Luger T, Bär M, Seibt R, Rieger MA, Steinhilber B. Using a Back Exoskeleton During Industrial and Functional Tasks-Effects on Muscle Activity, Posture, Performance, Usability, and Wearer Discomfort in a Laboratory Trial. Hum Factors 2023; 65:5-21. [PMID: 33861139 PMCID: PMC9846378 DOI: 10.1177/00187208211007267] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 03/10/2021] [Indexed: 05/30/2023]
Abstract
OBJECTIVE To investigate the effect of using a passive back-support exoskeleton (Laevo V2.56) on muscle activity, posture, heart rate, performance, usability, and wearer comfort during a course of three industrial tasks (COU; exoskeleton worn, turned-on), stair climbing test (SCT; exoskeleton worn, turned-off), timed-up-and-go test (TUG; exoskeleton worn, turned-off) compared to no exoskeleton. BACKGROUND Back-support exoskeletons have the potential to reduce work-related physical demands. METHODS Thirty-six men participated. Activity of erector spinae (ES), biceps femoris (BF), rectus abdominis (RA), vastus lateralis (VL), gastrocnemius medialis (GM), trapezius descendens (TD) was recorded by electromyography; posture by trunk, hip, knee flexion angles; heart rate by electrocardiography; performance by time-to-task accomplishment (s) and perceived task difficulty (100-mm visual analogue scale; VAS); usability by the System Usability Scale (SUS) and all items belonging to domains skepticism and user-friendliness of the Technology Usage Inventory; wearer comfort by the 100-mm VAS. RESULTS During parts of COU, using the exoskeleton decreased ES and BF activity and trunk flexion, and increased RA, GM, and TD activity, knee and hip flexion. Wearing the exoskeleton increased time-to-task accomplishment of SCT, TUG, and COU and perceived difficulty of SCT and TUG. Average SUS was 75.4, skepticism 11.5/28.0, user-friendliness 18.0/21.0, wearer comfort 31.1 mm. CONCLUSION Using the exoskeleton modified muscle activity and posture depending on the task applied, slightly impaired performance, and was evaluated mildly uncomfortable. APPLICATION These outcomes require investigating the effects of this passive back-supporting exoskeleton in longitudinal studies with longer operating times, providing better insights for guiding their application in real work settings.
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Affiliation(s)
- Tessy Luger
- University of Tübingen and University Hospital Tübingen,
Wilhelmstraße, Germany
| | - Mona Bär
- University of Tübingen and University Hospital Tübingen,
Wilhelmstraße, Germany
| | - Robert Seibt
- University of Tübingen and University Hospital Tübingen,
Wilhelmstraße, Germany
| | - Monika A. Rieger
- University of Tübingen and University Hospital Tübingen,
Wilhelmstraße, Germany
| | - Benjamin Steinhilber
- University of Tübingen and University Hospital Tübingen,
Wilhelmstraße, Germany
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Latorre Erezuma U, Zelaia Amilibia M, Espin Elorza A, Cortés C, Irazusta J, Rodriguez-Larrad A. A Statistical Parametric Mapping Analysis Approach for the Evaluation of a Passive Back Support Exoskeleton on Mechanical Loading During a Simulated Patient Transfer Task. J Appl Biomech 2023; 39:22-33. [PMID: 36649717 DOI: 10.1123/jab.2022-0126] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 09/26/2022] [Accepted: 11/18/2022] [Indexed: 01/18/2023]
Abstract
This study assessed the effectiveness of a passive back support exoskeleton during a mechanical loading task. Fifteen healthy participants performed a simulated patient transfer task while wearing the Laevo (version 2.5) passive back support exoskeleton. Collected metrics encompassed L5-S1 joint moments, back and abdominal muscle activity, lower body and back kinematics, center of mass displacement, and movement smoothness. A statistical parametric mapping analysis approach was used to overcome limitations from discretization of continuous data. The exoskeleton reduced L5-S1 joint moments during trunk flexion, but wearing the device restricted L5-S1 joint flexion when flexing the trunk as well as hip and knee extension, preventing participants from standing fully upright. Moreover, wearing the device limited center of mass motion in the caudal direction and increased its motion in the anterior direction. Therefore, wearing the exoskeleton partly reduced lower back moments during the lowering phase of the patient transfer task, but there were some undesired effects such as altered joint kinematics and center of mass displacement. Statistical parametric mapping analysis was useful in determining the benefits and hindrances produced by wearing the exoskeleton while performing the simulated patient transfer task and should be utilized in further studies to inform design and appropriate usage.
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Oleiwi MA, Shah SZA, Bilal H, Zeb A, Ahmad A, Hegazye FA, Chen H. Efficacy of orthotic support in mitigating low back pain and disability in low back pain sufferers. J Back Musculoskelet Rehabil 2023; 36:1111-1125. [PMID: 37355884 DOI: 10.3233/bmr-220200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/26/2023]
Abstract
BACKGROUND Low back pain (LBP) is a prevalent disabling ailment that affects people all over the world. A wide variety of orthotic designs, ranging from lumbosacral corsets to rigid thermoplastic thoraco-lumbosacral orthosis are used for managing LBP. OBJECTIVE Explore and summarize quality literature on the efficacy of orthotic devices in the management of LBP. METHODS A systematic review and meta-analysis of the literature on the efficacy of orthosis in low back pain management conducted using electronic databases. Studies utilizing orthotic management alone or combined with other therapies for 2 weeks or above were included. A meta-analysis was performed on primary and secondary variables using Mean difference (MD), Inverse variance (IV), and fixed effect model with 95% CI, Physiotherapy Evidence Database (PEDro) scale, Cochrane Risk of Bias 2 (RoB2) tool were used to assess the quality of evidence and the risk bias. RESULTS Out of 14671 studies, only 13 Randomized Controlled Trials (RCT) were deemed eligible for inclusion in this study, all level 1 evidence. We found that orthotics could significantly mitigate LBP (P-value < 0.00001). Similarly, a significant reeducation in LBP-associated disability was observed after orthotic intervention (P-value 0.004). CONCLUSION Lumber orthosis plays a significant role in LBP and associated disability mitigations in sufferers of LBP.
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Affiliation(s)
- Malik Abdulkadhim Oleiwi
- Department of Rehabilitation Medicine and Physical Therapy, Institute of Medical Technology, Middle Technical University, Baghdad, Iraq
| | - Sayed Zulfiqar Ali Shah
- TopSupport International Sports Performance and Rehabilitation Center, Shenzhen, Guangdong, China
- Department of Rehabilitation Medicine and Physical Therapy, Institute of Medical Technology, Middle Technical University, Baghdad, Iraq
| | - Hazrat Bilal
- Institute of Physical Medicine and Rehabilitation, Khyber Medical University, Peshawar, Pakistan
| | - Alam Zeb
- Institute of Physical Medicine and Rehabilitation, Khyber Medical University, Peshawar, Pakistan
| | - Ashfaq Ahmad
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | | | - Hong Chen
- Department of Rehabilitation Medicine and Physical Therapy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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22
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Hechinger M, Hentschel D, Aumer C, Rester C. A Conceptual Model of Experiences With Digital Technologies in Aging in Place: Qualitative Systematic Review and Meta-synthesis. JMIR Aging 2022; 5:e34872. [PMID: 36083625 PMCID: PMC9508672 DOI: 10.2196/34872] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 04/25/2022] [Accepted: 06/20/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Older adults with chronic illnesses or dependency on care who strive to age in place need support and care depending on their illness. Digital technology has enabled the possibility of supporting older adults in their wishes to age in place. However, current studies have mainly focused on the solitary evaluation of individual technologies or on evaluating technologies for specific illnesses. OBJECTIVE This study aimed to synthesize research on the experiences of older people from the Western culture with chronic illnesses or care needs and their families with digital technology for aging in place. From the meta-synthesis, a model was derived that can be useful for the development of assistive devices in old age and that can support health care providers and professionals in their work with affected individuals. METHODS A systematic review and qualitative meta-synthesis was performed using an inductive approach, as proposed by Sandelowski and Barroso. We performed a systematic literature search in 6 databases from 2000 to 2019, with an update in 2021 and, in addition, conducted a hand search in 2 databases, relevant journals, and reference lists. The results of each study were analyzed using initial and axial coding, followed by theoretical coding. A conceptual model was derived. RESULTS A total of 7776 articles were identified. Articles were screened independently by 2 authors based on the eligibility criteria. Finally, of the 7776 studies, 18 (0.23%) were included in the meta-synthesis. The derived conceptual model describes older adults with chronic illnesses or dependency on care and their family members in an individual process of reflection and decision-making, starting with the use of a digital device. Older adults live in times of change. They experience stable and unstable times of illness as they are part of a changing digital world. Hence, older adults and their families consider digital technology a solution to their current situation. As they become familiar with a specific digital technology, they refine their needs and demands, gain confidence in its use, and note its advantages and disadvantages. They weigh hopes, needs, demands, and experiences in a process of reflection to decide on convenience and inconvenience. Independent of their decision, they achieve peace of mind either with or without digital technology. This process can restart repeatedly during the illness trajectory of older adults. CONCLUSIONS This study promotes a differentiated understanding of older adults' experiences with digital technology. The conceptual model can be useful for the development of assistive technology in old age. Moreover, it can guide health care professionals in their work with older adults and their families to provide individual counseling to find the appropriate digital technology for their respective situations.
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Affiliation(s)
- Mareike Hechinger
- Deggendorf Institute of Technology, Faculty of Applied Healthcare Science, Deggendorf, Germany
| | - Diana Hentschel
- Deggendorf Institute of Technology, Faculty of Applied Healthcare Science, Deggendorf, Germany
| | - Christine Aumer
- Deggendorf Institute of Technology, Faculty of Applied Healthcare Science, Deggendorf, Germany
| | - Christian Rester
- Deggendorf Institute of Technology, Faculty of Applied Healthcare Science, Deggendorf, Germany
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23
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Klebbe R, Scherzinger S, Eicher C. Assistive Robots for Patients With Amyotrophic Lateral Sclerosis: Exploratory Task-Based Evaluation Study With an Early-Stage Demonstrator. JMIR Rehabil Assist Technol 2022; 9:e35304. [PMID: 35998031 PMCID: PMC9449829 DOI: 10.2196/35304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 05/25/2022] [Accepted: 06/10/2022] [Indexed: 11/13/2022] Open
Abstract
Background Although robotic manipulators have great potential in promoting motor independence of people with motor impairments, only few systems are currently commercially available. In addition to technical, economic, and normative barriers, a key challenge for their distribution is the current lack of evidence regarding their usefulness, acceptance, and user-specific requirements. Objective Against this background, a semiautonomous robot system was developed in the research and development project, robot-assisted services for individual and resource-oriented intensive and palliative care of people with amyotrophic lateral sclerosis (ROBINA), to support people with amyotrophic lateral sclerosis (ALS) in various everyday activities. Methods The developed early-stage demonstrator was evaluated in a task-based laboratory study of 11 patients with ALS. On the basis of a multimethod design consisting of standardized questionnaires, open-ended questions, and observation protocols, participants were asked about its relevance to everyday life, usability, and design requirements. Results Most participants considered the system to provide relevant support within the test scenarios and for their everyday life. On the basis of the System Usability Scale, the overall usability of the robot-assisted services for individual and resource-oriented intensive and palliative care of people with ALS system was rated as excellent, with a median of 90 (IQR 75-95) points. Moreover, 3 central areas of requirements for the development of semiautonomous robotic manipulators were identified and discussed: requirements for semiautonomous human-robot collaboration, requirements for user interfaces, and requirements for the adaptation of robotic capabilities regarding everyday life. Conclusions Robotic manipulators can contribute to increase the autonomy of people with ALS. A key issue for future studies is how the existing ability level and the required robotic capabilities can be balanced to ensure both high user satisfaction and effective and efficient task performance.
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Affiliation(s)
- Robert Klebbe
- Department of Geriatrics and Medical Gerontology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | | | - Cornelia Eicher
- Department of Geriatrics and Medical Gerontology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
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24
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Bär M, Luger T, Seibt R, Gabriel J, Rieger MA, Steinhilber B. Effects of a Passive Back-Support Exoskeleton on Knee Joint Loading during Simulated Static Sorting and Dynamic Lifting Tasks. Int J Environ Res Public Health 2022; 19:9965. [PMID: 36011596 PMCID: PMC9408483 DOI: 10.3390/ijerph19169965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 08/05/2022] [Accepted: 08/10/2022] [Indexed: 06/15/2023]
Abstract
Due to the load shifting mechanism of many back-support exoskeletons (BSEs), this study evaluated possible side effects of using a BSE on knee joint loading. Twenty-nine subjects (25.9 (±4.4) years, 179.0 (±6.5) cm; 73.6 (±9.4) kg) performed simulated static sorting and dynamic lifting tasks, including stoop and squat styles and different trunk rotation postures. Ground reaction force, body posture and the force between the chest and the BSE's contact interface were recorded using a force plate, two-dimensional gravimetric position sensors, and a built-in force sensor of the BSE, respectively. Using these parameters and the subject's anthropometry, median and 90th percentile horizontal (HOR50, HOR90) and vertical (VERT50, VERT90) tibiofemoral forces were calculated via a self-developed inverse quasi-static biomechanical model. BSE use had a variable effect on HOR50 dependent on the working task and body posture. Generally, VERT50 increased without significant interaction effects with posture or task. HOR90 and VERT90 were not affected by using the BSE. In conclusion, utilizing the investigated exoskeleton is likely to induce side effects in terms of changed knee joint loading. This may depend on the applied working task and the user's body posture. The role of these changes in the context of a negative contribution to work-related cumulative knee exposures should be addressed by future research.
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25
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Steinhilber B, Seibt R, Rieger MA, Luger T. Postural Control When Using an Industrial Lower Limb Exoskeleton: Impact of Reaching for a Working Tool and External Perturbation. Hum Factors 2022; 64:635-648. [PMID: 32988243 PMCID: PMC9136386 DOI: 10.1177/0018720820957466] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 08/14/2020] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To investigate postural control related to a lower limb exoskeleton (Chairless Chair) when (a) reaching for a working tool, and (b) an external perturbation occurs. BACKGROUND Lower limb exoskeletons aiming to reduce physical load associated with prolonged standing may impair workers' postural control and increase the risk of falling. METHOD Forty-five males were reaching for an object (3-kg dumbbell) at the lateral end of their reaching area without the exoskeleton in upright standing (STAND) and with the exoskeleton at a high (EXOHIGH.SEAT) and low sitting position (EXOLOW.SEAT). The task was performed with the object placed in three different angles (120°, 150°, and 180°) in the transversal plane. The minimum absolute static postural stability (SSABS.MIN) as the shortest distance (mm) of the center of pressure to the base of support border was measured (zero indicates risk of falling). Additionally, eight subjects were standing without the exoskeleton or sitting on it (EXOHIGH.SEAT and EXOLOW.SEAT) while being pulled backward. The tilting moment when subjects lost their balance was assessed. RESULTS SSABS.MIN was lower when using the exoskeleton (p < .05) but still about 17 mm. The location of the object to be reached had no influence. Tilting moments of less than 30 nm were sufficient to let people fall backward when sitting on the exoskeleton (50 nm for STAND). CONCLUSION Impairments in postural control by the exoskeleton may not be relevant when reaching laterally for objects up to 3 kg. When an external perturbation occurs, the risk of falling may be much higher; irrespective of factors like uneven or slippery flooring. APPLICATION The risk of falling using the exoskeleton seems to be low when reaching laterally for an object of up to 3 kg. In situations where, for example, a collision with coworkers is likely, this exoskeleton is not recommended.
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26
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Schmalz T, Colienne A, Bywater E, Fritzsche L, Gärtner C, Bellmann M, Reimer S, Ernst M. A Passive Back-Support Exoskeleton for Manual Materials Handling: Reduction of Low Back Loading and Metabolic Effort during Repetitive Lifting. IISE Trans Occup Ergon Hum Factors 2022. [PMID: 34763618 DOI: 10.1080/24725838.2021.2005720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OCCUPATIONAL APPLICATIONSGlobalization and eCommerce continue to fuel unprecedented growth in the logistics and warehousing markets. Simultaneously, the biggest bottleneck for these industries is their human capital. Where automation and robotic solutions fail to deliver a return on investment, humans frequently take over handling tasks that place harmful loads and strains on the body. Occupational exoskeletons can reduce fatigue and strain by supporting the lower spine and are designed to prevent work-related musculoskeletal disorders and other injuries. They are a mid- to long-term investment for industries to improve ergonomic conditions in workplaces, with the potential for reducing absences from work, sick days logged, and workers compensation claims. To examine the effectiveness of the newly introduced Paexo Back exoskeleton, a study was completed with 10 participants who completed manual load handling tasks with and without the exoskeleton. Key findings include significant reductions in metabolic effort and low back loading when the exoskeleton is worn.
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Affiliation(s)
- Thomas Schmalz
- Ottobock SE & Co. KGaA/Clinical Research & Services - Biomechanics, Göttingen, Germany
| | - Anja Colienne
- Private University of Applied Science, Göttingen, Germany
| | | | | | | | - Malte Bellmann
- Ottobock SE & Co. KGaA/Clinical Research & Services - Biomechanics, Göttingen, Germany
| | - Samuel Reimer
- Ottobock SE & Co. KGaA/Business Development Industrials, Duderstadt, Germany
| | - Michael Ernst
- Ottobock SE & Co. KGaA/Clinical Research & Services - Biomechanics, Göttingen, Germany
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27
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Yang MH, Jhan CJ, Hsieh PC, Kao CC. A Study on the Correlations between Musculoskeletal Disorders and Work-Related Psychosocial Factors among Nursing Aides in Long-Term Care Facilities. Int J Environ Res Public Health 2021; 19:255. [PMID: 35010514 PMCID: PMC8750889 DOI: 10.3390/ijerph19010255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/18/2021] [Accepted: 12/20/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND Among the nursing aides employed at long-term care facilities (LTCFs), those with musculoskeletal disorders (MSDs) are most likely to experience disability or develop an intention to leave. The purpose of this study was to investigate the association of work-related psychological factors among nursing aides in LTCFs with MSDs in Taiwan. METHODS Purposive sampling was used in this cross-sectional study to enrol 308 nursing aides from residential LTCFs in Taiwan as research subjects. A demographic and job background survey, a job content questionnaire (JCQ), and the Nordic musculoskeletal questionnaire (NMQ) were used to collect data. RESULTS Lower job control associated with higher psychological job demands, and lower social support was associated with more severe MSDs for the nursing aides (p < 0.001). Among the MSDs reported by nursing aides in LTCFs, lower back pain was the most serious. In addition, nationality, age, exercise habits, chronic diseases, worksite, lack of rest time, lack of assistive devices, low coworker support, and high psychological job demands were significant factors affecting MSDs. In total, 42.1% of the variance in MSDs among nursing aides in LTCFs was explained. CONCLUSIONS Work-related psychological factors among nursing aides in LTCFs have an important association with MSDs. For nursing aides, coworker support should be improved, and their psychological demands at work should be reduced.
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Affiliation(s)
- Man-Hua Yang
- Institute of Clinical Nursing, College of Nursing, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan;
| | - Chao-Jie Jhan
- Institute of Clinical Nursing, School of Nursing, National Yang Ming University, Taipei 11221, Taiwan;
| | - Pei-Chi Hsieh
- Department of Nursing, Hungkuang University, Taichung 43304, Taiwan;
| | - Chieh-Chun Kao
- Department of Nursing, Ching Kuo Institute of Management and Health, Keelung 20301, Taiwan
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28
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Osiński D, Łukowska M, Hjelme DR, Wierzchoń M. Colorophone 2.0: A Wearable Color Sonification Device Generating Live Stereo-Soundscapes-Design, Implementation, and Usability Audit. Sensors (Basel) 2021; 21:7351. [PMID: 34770658 DOI: 10.3390/s21217351] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 10/29/2021] [Accepted: 11/01/2021] [Indexed: 11/20/2022]
Abstract
The successful development of a system realizing color sonification would enable auditory representation of the visual environment. The primary beneficiary of such a system would be people that cannot directly access visual information—the visually impaired community. Despite the plethora of sensory substitution devices, developing systems that provide intuitive color sonification remains a challenge. This paper presents design considerations, development, and the usability audit of a sensory substitution device that converts spatial color information into soundscapes. The implemented wearable system uses a dedicated color space and continuously generates natural, spatialized sounds based on the information acquired from a camera. We developed two head-mounted prototype devices and two graphical user interface (GUI) versions. The first GUI is dedicated to researchers, and the second has been designed to be easily accessible for visually impaired persons. Finally, we ran fundamental usability tests to evaluate the new spatial color sonification algorithm and to compare the two prototypes. Furthermore, we propose recommendations for the development of the next iteration of the system.
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29
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Ramadan B, Fink W, Nuncio Zuniga A, Kay K, Powers N, Fuhrman C, Hong S. VISTA TM: Visual Impairment Subtle Touch Aid TM - a range detection and feedback system for sightless navigation. J Med Eng Technol 2021; 46:59-68. [PMID: 34711120 DOI: 10.1080/03091902.2021.1988167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
We devised a low-tech, low-cost, robust, and minimally obtrusive navigational travelling aid to be paired with and bolster standard white cane use for people with visual impairments. The device combines ultrasonic range detection with proportional vibrational output. The navigational aid was devised using a sensing belt equipped with independent ultrasonic sensors for distance measurements. Sensors were mounted using adjustable mobile clips to allow for user variability. The sensing belt was connected to a stimulation belt affixed to the ribcage. The stimulation belt used vibrating motors with vibration proportional to the distance between the belt wearer and surrounding obstacles sensed by corresponding ultrasonic sensors. The device was validated through preliminary testing on blindfolded, but fully sighted, persons and one blind person (all authors) in navigating a novel environment without supplemental aid. Testing sessions varied from 45 to 90 min. In preliminary tests, the devised ultrasonic-sensor-belt and vibration-actuator-equipped belt combination was capable of informing users of surrounding obstacles in real-time while navigating a hallway with several turns.
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Affiliation(s)
- Bassil Ramadan
- Department of Neuroscience and Cognitive Science, University of Arizona, Tucson, AZ, USA.,Visual and Autonomous Exploration Systems Research Laboratory, College of Engineering, University of Arizona, Tucson, AZ, USA
| | - Wolfgang Fink
- Visual and Autonomous Exploration Systems Research Laboratory, College of Engineering, University of Arizona, Tucson, AZ, USA
| | - Andres Nuncio Zuniga
- Visual and Autonomous Exploration Systems Research Laboratory, College of Engineering, University of Arizona, Tucson, AZ, USA
| | - Kristena Kay
- Department of Neuroscience and Cognitive Science, University of Arizona, Tucson, AZ, USA.,Visual and Autonomous Exploration Systems Research Laboratory, College of Engineering, University of Arizona, Tucson, AZ, USA
| | - Nick Powers
- Department of Neuroscience and Cognitive Science, University of Arizona, Tucson, AZ, USA.,Visual and Autonomous Exploration Systems Research Laboratory, College of Engineering, University of Arizona, Tucson, AZ, USA
| | - Connor Fuhrman
- Visual and Autonomous Exploration Systems Research Laboratory, College of Engineering, University of Arizona, Tucson, AZ, USA
| | - Sunggye Hong
- Department of Disability and Psychoeducational Studies, University of Arizona, Tucson, AZ, USA
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Abe H, Nishiyama K, Yamamoto Y, Okanuka T, Yonezawa Y, Matsumoto K. Impact of Alternate Gait Training Using Knee-Ankle-Foot Orthoses with Oil Damper Ankle Hinge in Patients with Subacute Severe Hemiplegia. Brain Sci 2021; 11:brainsci11111430. [PMID: 34827429 PMCID: PMC8615545 DOI: 10.3390/brainsci11111430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 10/13/2021] [Accepted: 10/23/2021] [Indexed: 11/30/2022] Open
Abstract
Patients with severe hemiplegia along with knee instability require knee–ankle–foot orthoses (KAFOs) for gait training. However, in these patients, it is unclear which type of walking training is more effective to improve gait function. Providing alternate gait training (AGT) improves walking function in patients with spinal cord injury, but it is still unclear whether this is effective in hemiplegic stroke patients. In this study, we defined “unified AGT” as AGT performed with the same therapeutic concept by physiotherapists. We then investigated whether AGT improved gait function quicker than our traditional gait training in hemiplegic stroke patients. We enrolled 15 subjects with severe hemiplegia and knee instability who had undergone unified AGT using KAFOs with hinged oil dampers at the ankles, and 30 historical control (HC) subjects who had undergone traditional gait training. We used multiple comparison and survival analyses to analyze the differences in the functional independence measure (FIM) gait score changes between the two groups. The multiple comparison revealed a significant increase (p < 0.05) in the FIM gait score compared with its initial score in the subjects with unified AGT. However, this improvement was not seen in the HC subjects. Additionally, the survival analysis of time taken to recover revealed a significant difference between the subjects with unified AGT and HC subjects (p < 0.05). These findings suggest that unified AGT using a KAFO facilitates gait improvement in patients with severe hemiplegia and knee instability.
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Affiliation(s)
- Hiroaki Abe
- Department of Physical Therapy, Fukushima Medical University School of Health Sciences, 10-6, Sakaemachi, Fukushima 960-8516, Japan
- Correspondence: ; Tel.: +81-24-581-5545
| | - Kazutaka Nishiyama
- Department of Rehabilitation, Kita-Fukushima Medical Center, 23-1 Aza-higashi, Hakozaki, Date, Fukushima 960-0502, Japan; (K.N.); (Y.Y.)
| | - Yuichi Yamamoto
- Department of Rehabilitation, Kita-Fukushima Medical Center, 23-1 Aza-higashi, Hakozaki, Date, Fukushima 960-0502, Japan; (K.N.); (Y.Y.)
| | - Toru Okanuka
- Department of Rehabilitation Medicine, Kohnan Hospital, 4-20-1, Nagamachi-Minami, Taihaku-ku, Sendai 982-8523, Miyagi, Japan;
| | - Yasuhito Yonezawa
- Pacific Supply Co, Ltd., 1-12-1, Goryou, Daito, Osaka 574-0064, Japan; (Y.Y.); (K.M.)
| | - Koji Matsumoto
- Pacific Supply Co, Ltd., 1-12-1, Goryou, Daito, Osaka 574-0064, Japan; (Y.Y.); (K.M.)
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31
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Altman K, Glumm S, Stainton K, Herlache-Pretzer E, Webster S, Winkle MY. Impacts of Mobility Dogs on Kinematics during Ambulation: A Quantitative Study. Vet Sci 2021; 8:250. [PMID: 34822623 DOI: 10.3390/vetsci8110250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 10/12/2021] [Accepted: 10/22/2021] [Indexed: 11/17/2022] Open
Abstract
While prior research has explored various physiological consequences associated with assistive device use for ambulation, limited research has specifically explored the impact of mobility dog partnership on human kinematics. This descriptive study examined the impact of mobility dog partnership on kinematics of individuals in the normal young adult population. Sixteen participants were video recorded while walking in a straight line for 3.7 m (12 feet) under three different conditions (ambulating with no device, ambulating with a standard cane on the left side, and ambulating with a mobility dog on the left side). Differences between joint angles under each of the conditions were analyzed. Statistically significant differences were found in left elbow flexion when comparing ambulating with a cane versus ambulating with no device; left shoulder abduction when comparing ambulating with a cane versus ambulating with a mobility dog, ambulating with a mobility dog versus no device, and ambulating with a cane versus no device; and left hip extension when comparing ambulating with a mobility dog versus no device, and when ambulating with a mobility dog versus a cane. These findings suggest that providers should evaluate and monitor potential negative impacts of assistive devices such as mobility dogs on human kinematics.
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Nazari V, Pouladian M, Zheng YP, Alam M. A Compact and Lightweight Rehabilitative Exoskeleton to Restore Grasping Functions for People with Hand Paralysis. Sensors (Basel) 2021; 21:6900. [PMID: 34696113 DOI: 10.3390/s21206900] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 10/14/2021] [Accepted: 10/15/2021] [Indexed: 11/16/2022]
Abstract
Millions of individuals suffer from upper extremity paralysis caused by neurological disorders including stroke, traumatic brain injury, or spinal cord injury. Robotic hand exoskeletons can substitute the missing motor control and help restore the functions in daily operations. However, most of the hand exoskeletons are bulky, stationary, and cumbersome to use. We have modified a recent existing design (Tenoexo) to prototype a motorized, lightweight, fully wearable rehabilitative hand exoskeleton by combining rigid parts with a soft mechanism capable of producing various grasps needed for the execution of daily tasks. Mechanical evaluation of our exoskeleton showed that it can produce fingertip force up to 8 N and can cover 91.5° of range of motion in just 3 s. We further tested the performance of the developed robotic exoskeleton in two quadriplegics with chronic hand paralysis and observed immediate success on independent grasping of different daily objects. The results suggested that our exoskeleton is a viable option for hand function assistance, allowing patients to regain lost finger control for everyday activities.
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Abstract
Electrical stimulation has been used for many years to treat spasticity in children with cerebral palsy and some improvements have been noted. Building on the benefits of electrical stimulation, a new assistive device, a suit with imbedded electrodes designed to reduce spasticity through electrical stimulation of the antagonistic muscles, has been tested.Aim: The aim of this study was to describe experiences from children with cerebral palsy and their parents regarding the use of the suit. Methods: Individual interviews were conducted with six children 5 to 10 years of age and their parents. The interviews were transcribed and analyzed using a qualitative content analysis. Results: The analysis resulted in three themes: (1) the suit's impact on image, (2) changes that make a difference and (3) dealing with a desire for change. Each of the themes included subthemes. Conclusion: All children reported some impact on their body and self and/or in some activities after the use of the suit. The parents also saw improvements during the trial period. However, the results are inconclusive and a larger study is needed to determine if the suit is useful from a longer perspective and whether it can affect activity and participation in daily activities for children with spasticity.
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Affiliation(s)
- Birgitta Nordstrom
- Department of Research and Development, Region Norrbotten, Luleå, Sweden.,Department of Health Sciences, Luleå University of Technology, Luleå, Sweden
| | - Maria Prellwitz
- Department of Health Sciences, Luleå University of Technology, Luleå, Sweden
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34
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Chizhik D, Hejrati B. Development and comprehensive evaluation of a new spring-steel-driven glove for grasping assistance during activities of daily living. Proc Inst Mech Eng H 2021; 236:259-268. [PMID: 34425685 DOI: 10.1177/09544119211039905] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Millions of people suffer from a decline in grip strength and hand function due to conditions such as chronic disease, injuries, and aging. Hand function decline results in difficulties with performing activities of daily living, where grasping, lifting, and releasing objects are essential. There is an increasing demand for assistive gloves to enhance users' hand function and improve their independence. This paper presents the design of a new bidirectional lightweight assistive glove and demonstrates its capabilities through comprehensive experiments using human subjects. The developed glove can provide adequate power augmentation for grasping and releasing objects due to its simple yet effective design using spring steel strips and linear actuators. The glove directly transfers assistive forces to users' fingertips without any complex intermediate mechanism, and its low weight of 196 g promotes its usability. The rigorous experiment design provided a thorough assessment of the developed glove by accounting for both parameters of size and weight of objects and by including subjects with different hand sizes. To quantify the glove's performance, the subjects' muscle activity, their finger and thumb joints' trajectories, and their grasping forces while using the glove were investigated. The glove could generate the necessary grasping forces to assist with lifting common-household objects. The subjects' muscle activity significantly decreased when using the glove for object manipulation. The trajectories of the index finger and thumb joints when using the glove were dependent on the size of objects similar to natural unassisted grasping. The obtained results demonstrate the glove's ability for grip power augmentation of individuals with declining hand strength.
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Affiliation(s)
- Daniel Chizhik
- Biomechanics and Biorobotics Lab, Department of Mechanical Engineering, University of Maine, Orono, ME, USA
| | - Babak Hejrati
- Biomechanics and Biorobotics Lab, Department of Mechanical Engineering, University of Maine, Orono, ME, USA
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Ceccarelli M, Riabtsev M, Fort A, Russo M, Laribi MA, Urizar M. Design and Experimental Characterization of L-CADEL v2, an Assistive Device for Elbow Motion. Sensors (Basel) 2021; 21:5149. [PMID: 34372386 PMCID: PMC8347154 DOI: 10.3390/s21155149] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 07/26/2021] [Accepted: 07/28/2021] [Indexed: 12/04/2022]
Abstract
An experimental characterization is presented for an improved version of a wearable assistive device for elbow motion. The design is revised with respect to requirements for elbow motion assistance, looking at applications both in rehabilitation therapies and exercising of elderly people. A laboratory prototype is built with lightweight, portable, easy-to-use features that are verified with test results, whose discussion is also provided as a characterization of operating performance.
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Affiliation(s)
- Marco Ceccarelli
- LARM2: Laboratory of Robot Mechatronics, University of Rome “Tor Vergata”, 00133 Rome, Italy
| | - Mykhailo Riabtsev
- Department of Mechanical Engineering, University of the Basque Country (UPV/EHU), E-48013 Bilbao, Spain; (M.R.); (M.U.)
| | - Axel Fort
- Département Génie Mécanique et Systèmes Complexes, Institut PPRIME, Université de Poitiers, 86073 Poitiers, France; (A.F.); (M.A.L.)
| | - Matteo Russo
- Faculty of Engineering, University of Nottingham, Nottingham NG8 1BB, UK;
| | - Med Amine Laribi
- Département Génie Mécanique et Systèmes Complexes, Institut PPRIME, Université de Poitiers, 86073 Poitiers, France; (A.F.); (M.A.L.)
| | - Monica Urizar
- Department of Mechanical Engineering, University of the Basque Country (UPV/EHU), E-48013 Bilbao, Spain; (M.R.); (M.U.)
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Lonini L, Shawen N, Hoppe-Ludwig S, Deems-Dluhy S, Mummidisetty CK, Eisenberg Y, Jayaraman A. Combining Accelerometer and GPS Features to Evaluate Community Mobility in Knee Ankle Foot Orthoses (KAFO) Users. IEEE Trans Neural Syst Rehabil Eng 2021; 29:1386-1393. [PMID: 34252030 PMCID: PMC8363134 DOI: 10.1109/tnsre.2021.3096434] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Orthotic and assistive devices such as knee ankle foot orthoses (KAFO), come in a variety of forms and fits, with several levels of available features that could help users perform daily activities more naturally. However, objective data on the actual use of these devices outside of the research lab is usually not obtained. Such data could enhance traditional lab-based outcome measures and inform clinical decision-making when prescribing new orthotic and assistive technology. Here, we link data from a GPS unit and an accelerometer mounted on the orthotic device to quantify its usage in the community and examine the correlations with clinical metrics. We collected data from 14 individuals over a period of 2 months as they used their personal KAFO first, and then a novel research KAFO; for each device we quantified number of steps, cadence, time spent at community locations and time wearing the KAFO at those locations. Sensor-derived metrics showed that mobility patterns differed widely between participants (mean steps: 591.3, SD =704.2). The novel KAFO generally enabled participants to walk faster during clinical tests ( ∆6 Minute-Walk-Test=71.5m, p=0.006). However, some participants wore the novel device less often despite improved performance on these clinical measures, leading to poor correlation between changes in clinical outcome measures and changes in community mobility ( ∆6 Minute-Walk-Test - ∆ Community Steps: r=0.09, p=0.76). Our results suggest that some traditional clinical outcome measures may not be associated with the actual wear time of an assistive device in the community, and obtaining personalized data from real-world use through wearable technology is valuable.
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Boggs D, Hydara A, Faal Y, Okoh JA, Olaniyan SI, Sanneh H, Ngett A, Bah I, Aleser M, Denis E, McCormick I, Bright T, Bell S, Kim M, Foster A, Kuper H, Burton MJ, Mactaggart I, Polack S. Estimating Need for Glasses and Hearing Aids in The Gambia: Results from a National Survey and Comparison of Clinical Impairment and Self-Report Assessment Approaches. Int J Environ Res Public Health 2021; 18:6302. [PMID: 34200769 PMCID: PMC8296105 DOI: 10.3390/ijerph18126302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 05/24/2021] [Accepted: 05/25/2021] [Indexed: 12/11/2022]
Abstract
Few estimates are available of the need for assistive devices (ADs) in African settings. This study aimed to estimate population-level need for glasses and hearing aids in The Gambia based on (1) clinical impairment assessment, and (2) self-reported AD awareness, and explore the relationship between the two methods. The Gambia 2019 National Eye Health Survey is a nationally representative population-based sample of 9188 adults aged 35+ years. Participants underwent standardised clinical vision assessments including the need for glasses (distance and near). Approximately 25% of the sample underwent clinical assessment of hearing and hearing aid need. Data were also collected on self-reported awareness, need and access barriers to vision and hearing ADs. Overall, 5.6% of the study population needed distance glasses (95% CI 5.0-6.3), 45.9% (95% CI 44.2-47.5) needed near glasses and 25.5% (95% CI 22.2-29.2) needed hearing aids. Coverage for each AD was very low (<4%). The agreement between self-report and clinical impairment assessment for AD need was poor. In conclusion, there is high prevalence and very low coverage for distance glasses, near glasses and hearing aids in The Gambia. Self-report measures alone will not provide an accurate estimate of AD need.
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Affiliation(s)
- Dorothy Boggs
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK; (T.B.); (H.K.); (I.M.); (S.P.)
| | - Abba Hydara
- Sheikh Zayed Regional Eye Care Centre, Kanifing, The Gambia; (A.H.); (J.A.O.); (S.I.O.); (H.S.); (A.N.); (I.B.); (M.A.)
| | - Yaka Faal
- Ear Nose and Throat Unit, Edward Francis Small Teaching Hospital, Banjul, The Gambia;
| | - John Atta Okoh
- Sheikh Zayed Regional Eye Care Centre, Kanifing, The Gambia; (A.H.); (J.A.O.); (S.I.O.); (H.S.); (A.N.); (I.B.); (M.A.)
| | - Segun Isaac Olaniyan
- Sheikh Zayed Regional Eye Care Centre, Kanifing, The Gambia; (A.H.); (J.A.O.); (S.I.O.); (H.S.); (A.N.); (I.B.); (M.A.)
| | - Haruna Sanneh
- Sheikh Zayed Regional Eye Care Centre, Kanifing, The Gambia; (A.H.); (J.A.O.); (S.I.O.); (H.S.); (A.N.); (I.B.); (M.A.)
| | - Abdoulie Ngett
- Sheikh Zayed Regional Eye Care Centre, Kanifing, The Gambia; (A.H.); (J.A.O.); (S.I.O.); (H.S.); (A.N.); (I.B.); (M.A.)
| | - Isatou Bah
- Sheikh Zayed Regional Eye Care Centre, Kanifing, The Gambia; (A.H.); (J.A.O.); (S.I.O.); (H.S.); (A.N.); (I.B.); (M.A.)
| | - Mildred Aleser
- Sheikh Zayed Regional Eye Care Centre, Kanifing, The Gambia; (A.H.); (J.A.O.); (S.I.O.); (H.S.); (A.N.); (I.B.); (M.A.)
| | | | - Ian McCormick
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK; (I.M.); (S.B.); (M.K.); (A.F.); (M.J.B.)
| | - Tess Bright
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK; (T.B.); (H.K.); (I.M.); (S.P.)
| | - Suzannah Bell
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK; (I.M.); (S.B.); (M.K.); (A.F.); (M.J.B.)
| | - Minjung Kim
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK; (I.M.); (S.B.); (M.K.); (A.F.); (M.J.B.)
| | - Allen Foster
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK; (I.M.); (S.B.); (M.K.); (A.F.); (M.J.B.)
| | - Hannah Kuper
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK; (T.B.); (H.K.); (I.M.); (S.P.)
| | - Matthew J. Burton
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK; (I.M.); (S.B.); (M.K.); (A.F.); (M.J.B.)
- National Institute for Health Research Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London EC1V 9EL, UK
| | - Islay Mactaggart
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK; (T.B.); (H.K.); (I.M.); (S.P.)
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK; (I.M.); (S.B.); (M.K.); (A.F.); (M.J.B.)
| | - Sarah Polack
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK; (T.B.); (H.K.); (I.M.); (S.P.)
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Prasanth H, Caban M, Keller U, Courtine G, Ijspeert A, Vallery H, von Zitzewitz J. Wearable Sensor-Based Real-Time Gait Detection: A Systematic Review. Sensors (Basel) 2021; 21:2727. [PMID: 33924403 PMCID: PMC8069962 DOI: 10.3390/s21082727] [Citation(s) in RCA: 75] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 03/26/2021] [Accepted: 04/08/2021] [Indexed: 11/16/2022]
Abstract
Gait analysis has traditionally been carried out in a laboratory environment using expensive equipment, but, recently, reliable, affordable, and wearable sensors have enabled integration into clinical applications as well as use during activities of daily living. Real-time gait analysis is key to the development of gait rehabilitation techniques and assistive devices such as neuroprostheses. This article presents a systematic review of wearable sensors and techniques used in real-time gait analysis, and their application to pathological gait. From four major scientific databases, we identified 1262 articles of which 113 were analyzed in full-text. We found that heel strike and toe off are the most sought-after gait events. Inertial measurement units (IMU) are the most widely used wearable sensors and the shank and foot are the preferred placements. Insole pressure sensors are the most common sensors for ground-truth validation for IMU-based gait detection. Rule-based techniques relying on threshold or peak detection are the most widely used gait detection method. The heterogeneity of evaluation criteria prevented quantitative performance comparison of all methods. Although most studies predicted that the proposed methods would work on pathological gait, less than one third were validated on such data. Clinical applications of gait detection algorithms were considered, and we recommend a combination of IMU and rule-based methods as an optimal solution.
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Affiliation(s)
- Hari Prasanth
- ONWARD, Building 32, Hightech Campus, 5656 AE Eindhoven, The Netherlands;
- Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft, The Netherlands
| | - Miroslav Caban
- Institute of Bioengineering, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland; (M.C.); (A.I.)
- ONWARD, EPFL Innovation Park Building C, 1015 Lausanne, Switzerland; (U.K.); (J.v.Z.)
| | - Urs Keller
- ONWARD, EPFL Innovation Park Building C, 1015 Lausanne, Switzerland; (U.K.); (J.v.Z.)
| | - Grégoire Courtine
- Center for Neuroprosthetics and Brain Mind Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), 1015 Lausanne, Switzerland;
- Department of Neurosurgery, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), 1011 Lausanne, Switzerland
- Department of Clinical Neuroscience, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), 1011 Lausanne, Switzerland
- Defitech Center for Interventional Neurotherapies (.NeuroRestore), CHUV/UNIL/EPFL, 1011 Lausanne, Switzerland
| | - Auke Ijspeert
- Institute of Bioengineering, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland; (M.C.); (A.I.)
| | - Heike Vallery
- Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft, The Netherlands
- Department of Rehabilitation Medicine, Erasmus MC, 3000 CA Rotterdam, The Netherlands
| | - Joachim von Zitzewitz
- ONWARD, EPFL Innovation Park Building C, 1015 Lausanne, Switzerland; (U.K.); (J.v.Z.)
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Flodström C, Viklund Axelsson SA, Nordström B. A pilot study of the impact of the electro-suit Mollii® on body functions, activity, and participation in children with cerebral palsy. Assist Technol 2021; 34:411-417. [PMID: 33151822 DOI: 10.1080/10400435.2020.1837288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Electrical stimulation has been used to treat spasticity in children with cerebral palsy. Building on the benefits of electrical stimulation, a new assistive device, electro-suit Mollii® with imbedded electrodes has been tested. The aim of the study was to evaluate the possible effect of Mollii® on body function, activity and participation in self-selected activities. Six children, five to ten years of age, used the electro-suit for one hour, every other day for three months. The impact was evaluated after four weeks and after three months by measuring passive range of motion (ROM), muscle tone, pain, gross motor function and participation. All participants improved in the total score for Canadian Occupational Performance Measure (COPM), three of them showed significant clinical improvements. Pain was reduced for children who estimated pain when the study started. There were also small changes in Electro-suit Mollii® had a positive impact on activity and participation in self-selected activities among the children in this study. Further studies with more children over a longer time are necessary to evaluate the impact and usefulness over time.
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Affiliation(s)
- Camilla Flodström
- Department of Research and Development, Region Norrbotten, Luleå, Sweden
| | - Sari-Anne Viklund Axelsson
- Department of Research and Development, Region Norrbotten, Luleå, Sweden.,Department of Health Sciences, Luleå University of Technology, Luleå, Sweden
| | - Birgitta Nordström
- Department of Research and Development, Region Norrbotten, Luleå, Sweden.,Department of Health Sciences, Luleå University of Technology, Luleå, Sweden
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Hojjati Najafabadi A, Amini S, Farahmand F. Improving sit-to-stand transition by the saddle- assistive device in the spinal cord injury: A case study. Proc Inst Mech Eng H 2021; 235:735-742. [PMID: 33757341 DOI: 10.1177/09544119211003370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Physical problems caused by fractures, aging, stroke, and accidents can reduce foot power; these, in the long term, can dwindle the muscles of the waist, thighs, and legs. These conditions provide the basis for the invalidism of the harmed people. In this study, a saddle-walker was designed and evaluated to help people suffering from spinal cord injury and patients with lower limb weakness. This S-AD works based on body weight support against the previously report designs. This saddle-walker consisted of a non-powered four-wheel walker helping to walk and a powered mechanism for the sit-to-stand (STS) transfer. A set of experiments were done on the STS in the use of the standard walker and the saddle-assistive device(S-AD). A comparison of the results showed that this device could reduce the vertical ground reaction force (GRF) of the legs up to 70%. Using this device could help a wide range of patients with lower limb weakness and SCI patients in changing from sitting to standing.
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Affiliation(s)
| | - Saeid Amini
- Department of Mechanical, University of Kashan, Kashan, Iran
| | - Farzam Farahmand
- Department of Mechanical, Sharif University of Technology, Tehran, Iran
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Abstract
PURPOSE Only 1 in 10 people with disabilities can access assistive devices, underlining the critical need for low-cost assistive products. This paper describes the design evolution of a manual user-operated standing wheelchair (SWC), translating from prototype to product. METHODS The SWC design has been refined over 5 years through multiple iterations based on comments from user trials. The SWC product, Arise, provides standing functionality, facile outdoor mobility, affordability, customisability, and is aesthetically pleasing. A one-time fitting and training ensure optimal effort for operation, correct posture, and comfortable user experience. The SWC accommodates users of different sizes and body weights (up to 110 kg) and minimises user effort with the use of a gas spring. Incorporating discrete adjustments enables customisation while retaining the advantages of mass manufacturing, which is necessary for ensuring affordability. RESULTS The SWC has been field-tested and well received by over 100 wheelchair users, and Arise was launched recently by the industry partner. CONCLUSIONS It should be noted that RESNA cautions on the use of any standing device without medical consultation. Nevertheless, with appropriate dissemination and awareness, it is anticipated that the affordable SWC product, Arise, will immensely benefit the eligible users and make a difference in their quality of life.Implications for RehabilitationProvides standing functionality, outdoor mobility, affordability and customisabilityAccommodates users of different sizes and body weights in a mass-manufacturable designErgonomic design reduces net user effort during sit-to-stand, stand-to-sit activityDesign iterated and refined based on feedback from over 100 user trials.
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Affiliation(s)
- Javeed Shaikh-Mohammed
- TTK Center for Rehabilitation Research and Device Development (R2D2), Department of Mechanical Engineering, Indian Institute of Technology Madras, Chennai, India
| | - Swostik Sourav Dash
- TTK Center for Rehabilitation Research and Device Development (R2D2), Department of Mechanical Engineering, Indian Institute of Technology Madras, Chennai, India
| | - Vivek Sarda
- TTK Center for Rehabilitation Research and Device Development (R2D2), Department of Mechanical Engineering, Indian Institute of Technology Madras, Chennai, India
| | - S Sujatha
- TTK Center for Rehabilitation Research and Device Development (R2D2), Department of Mechanical Engineering, Indian Institute of Technology Madras, Chennai, India
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Bellenfant KB, Robbins GL, Rogers RR, Kopec TJ, Ballmann CG. Effects of Dominant and Nondominant Limb Immobilization on Muscle Activation and Physical Demand during Ambulation with Axillary Crutches. J Funct Morphol Kinesiol 2021; 6:jfmk6010016. [PMID: 33572237 PMCID: PMC7931098 DOI: 10.3390/jfmk6010016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 02/02/2021] [Accepted: 02/04/2021] [Indexed: 11/29/2022] Open
Abstract
The purpose of this study was to investigate the effects of how limb dominance and joint immobilization alter markers of physical demand and muscle activation during ambulation with axillary crutches. In a crossover, counterbalanced study design, physically active females completed ambulation trials with three conditions: (1) bipedal walking (BW), (2) axillary crutch ambulation with their dominant limb (DOM), and (3) axillary crutch ambulation with their nondominant limb (NDOM). During the axillary crutch ambulation conditions, the non-weight-bearing knee joint was immobilized at a 30-degree flexion angle with a postoperative knee stabilizer. For each trial/condition, participants ambulated at 0.6, 0.8, and 1.0 mph for five minutes at each speed. Heart rate (HR) and rate of perceived exertion (RPE) were monitored throughout. Surface electromyography (sEMG) was used to record muscle activation of the medial gastrocnemius (MG), soleus (SOL), and tibialis anterior (TA) unilaterally on the weight-bearing limb. Biceps brachii (BB) and triceps brachii (TB) sEMG were measured bilaterally. sEMG signals for each immobilization condition were normalized to corresponding values for BW.HR (p < 0.001) and RPE (p < 0.001) were significantly higher for both the DOM and NDOM conditions compared to BW but no differences existed between the DOM and NDOM conditions (p > 0.05). No differences in lower limb muscle activation were noted for any muscles between the DOM and NDOM conditions (p > 0.05). Regardless of condition, BB activation ipsilateral to the ambulating limb was significantly lower during 0.6 mph (p = 0.005) and 0.8 mph (p = 0.016) compared to the same speeds for BB on the contralateral side. Contralateral TB activation was significantly higher during 0.6 mph compared to 0.8 mph (p = 0.009) and 1.0 mph (p = 0.029) irrespective of condition. In conclusion, limb dominance appears to not alter lower limb muscle activation and walking intensity while using axillary crutches. However, upper limb muscle activation was asymmetrical during axillary crutch use and largely dependent on speed. These results suggest that functional asymmetry may exist in upper limbs but not lower limbs during assistive device supported ambulation.
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Dittli J, Hofmann UAT, Bützer T, Smit G, Lambercy O, Gassert R. Remote Actuation Systems for Fully Wearable Assistive Devices: Requirements, Selection, and Optimization for Out-of-the-Lab Application of a Hand Exoskeleton. Front Robot AI 2021; 7:596185. [PMID: 33585573 PMCID: PMC7876397 DOI: 10.3389/frobt.2020.596185] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 11/06/2020] [Indexed: 01/26/2023] Open
Abstract
Wearable robots assist individuals with sensorimotor impairment in daily life, or support industrial workers in physically demanding tasks. In such scenarios, low mass and compact design are crucial factors for device acceptance. Remote actuation systems (RAS) have emerged as a popular approach in wearable robots to reduce perceived weight and increase usability. Different RAS have been presented in the literature to accommodate for a wide range of applications and related design requirements. The push toward use of wearable robotics in out-of-the-lab applications in clinics, home environments, or industry created a shift in requirements for RAS. In this context, high durability, ergonomics, and simple maintenance gain in importance. However, these are only rarely considered and evaluated in research publications, despite being drivers for device abandonment by end-users. In this paper, we summarize existing approaches of RAS for wearable assistive technology in a literature review and compare advantages and disadvantages, focusing on specific evaluation criteria for out-of-the-lab applications to provide guidelines for the selection of RAS. Based on the gained insights, we present the development, optimization, and evaluation of a cable-based RAS for out-of-the-lab applications in a wearable assistive soft hand exoskeleton. The presented RAS features full wearability, high durability, high efficiency, and appealing design while fulfilling ergonomic criteria such as low mass and high wearing comfort. This work aims to support the transfer of RAS for wearable robotics from controlled lab environments to out-of-the-lab applications.
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Affiliation(s)
- Jan Dittli
- Rehabilitation Engineering Laboratory, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Urs A. T. Hofmann
- Rehabilitation Engineering Laboratory, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Tobias Bützer
- Rehabilitation Engineering Laboratory, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Gerwin Smit
- Department of BioMechanical Engineering, Delft University of Technology, Delft, Netherlands
| | - Olivier Lambercy
- Rehabilitation Engineering Laboratory, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Roger Gassert
- Rehabilitation Engineering Laboratory, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
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Pesenti M, Antonietti A, Gandolla M, Pedrocchi A. Towards a Functional Performance Validation Standard for Industrial Low-Back Exoskeletons: State of the Art Review. Sensors (Basel) 2021; 21:808. [PMID: 33530377 DOI: 10.3390/s21030808] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/20/2021] [Accepted: 01/21/2021] [Indexed: 12/26/2022]
Abstract
While the research interest for exoskeletons has been rising in the last decades, missing standards for their rigorous evaluation are potentially limiting their adoption in the industrial field. In this context, exoskeletons for worker support have the aim to reduce the physical effort required by humans, with dramatic social and economic impact. Indeed, exoskeletons can reduce the occurrence and the entity of work-related musculoskeletal disorders that often cause absence from work, resulting in an eventual productivity loss. This very urgent and multifaceted issue is starting to be acknowledged by researchers. This article provides a systematic review of the state of the art for functional performance evaluation of low-back exoskeletons for industrial workers. We report the state-of-the-art evaluation criteria and metrics used for such a purpose, highlighting the lack of a standard for this practice. Very few studies carried out a rigorous evaluation of the assistance provided by the device. To address also this topic, the article ends with a proposed framework for the functional validation of low-back exoskeletons for the industry, with the aim to pave the way for the definition of rigorous industrial standards.
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Longatelli V, Antonietti A, Biffi E, Diella E, D'Angelo MG, Rossini M, Molteni F, Bocciolone M, Pedrocchi A, Gandolla M. User-centred assistive SystEm for arm Functions in neUromuscuLar subjects (USEFUL): a randomized controlled study. J Neuroeng Rehabil 2021; 18:4. [PMID: 33407580 PMCID: PMC7789525 DOI: 10.1186/s12984-020-00794-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 12/01/2020] [Indexed: 12/16/2022] Open
Abstract
Background Upper limb assistive devices can compensate for muscular weakness and empower the user in the execution of daily activities. Multiple devices have been recently proposed but there is still a lack in the scientific comparison of their efficacy. Methods We conducted a cross-over multi-centric randomized controlled trial to assess the functional improvement at the upper limb level of two arms supports on 36 patients with muscular dystrophy. Participants tested a passive device (i.e., Wrex by Jaeco) and a semi-active solution for gravity compensation (i.e., Armon Ayura). We evaluated devices’ effectiveness with an externally-assessed scale (i.e., Performance of the Upper Limb-PUL-module), a self-perceived scale (i.e., Abilhand questionnaire), and a usability scale (i.e., System Usability Scale). Friedman’s test was used to assess significant functional gain for PUL module and Abilhand questionnaire. Moreover, PUL changes were compared by means of the Friedman’s test. Results Most of the patients improved upper limb function with the use of arm supports (median PUL scores increase of 1–3 points). However, the effectiveness of each device was related to the level of residual ability of the end-user. Slightly impaired patients maintained the same independence without and with assistive devices, even if they reported reduced muscular fatigue for both devices. Moderately impaired patients enhanced their arm functionality with both devices, and they obtained higher improvements with the semi-active one (median PUL scores increase of 9 points). Finally, severely impaired subjects benefited only from the semi-active device (median PUL scores increase of 12 points). Inadequate strength was recognized as a barrier to passive devices. The usability, measured by the System Usability Scale, was evaluated by end-users “good” (70/100 points) for the passive, and “excellent” (80/100 points) for the semi-active device. Conclusions This study demonstrated that assistive devices can improve the quality of life of people suffering from muscular dystrophy. The use of passive devices, despite being low cost and easy to use, shows limitations in the efficacy of the assistance to daily tasks, limiting the assistance to a predefined horizontal plane. The addition of one active degree of freedom improves efficacy and usability especially for medium to severe patients. Further investigations are needed to increase the evidence on the effect of arm supports on quality of life and diseases’ progression in subjects with degenerative disorders. Trial registration clinicaltrials.gov, NCT03127241, Registered 25th April 2017. The clinical trial was also registered as a post-market study at the Italian Ministry of Health.
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Affiliation(s)
- Valeria Longatelli
- NeuroEngineering And medical Robotics Laboratory, NearLab, Department of Electronics, Information, and Bioengineering, Politecnico di Milano, Via Giuseppe Colombo 40, 20133, Milan, Italy
| | - Alberto Antonietti
- NeuroEngineering And medical Robotics Laboratory, NearLab, Department of Electronics, Information, and Bioengineering, Politecnico di Milano, Via Giuseppe Colombo 40, 20133, Milan, Italy
| | - Emilia Biffi
- Scientific Institute IRCCS E. Medea, Via Don Luigi Monza 20, 23842, Bosisio Parini, Italy
| | - Eleonora Diella
- Scientific Institute IRCCS E. Medea, Via Don Luigi Monza 20, 23842, Bosisio Parini, Italy
| | - Maria Grazia D'Angelo
- Scientific Institute IRCCS E. Medea, Via Don Luigi Monza 20, 23842, Bosisio Parini, Italy
| | - Mauro Rossini
- Valduce Hospital, Villa Beretta Rehabilitation Center, Via Nazario Sauro 17, 23845, Costa Masnaga, Italy
| | - Franco Molteni
- Valduce Hospital, Villa Beretta Rehabilitation Center, Via Nazario Sauro 17, 23845, Costa Masnaga, Italy
| | - Marco Bocciolone
- Department of Mechanical Engineering, Politecnico di Milano, Via Giuseppe La Masa 1, 20156, Milan, Italy
| | - Alessandra Pedrocchi
- NeuroEngineering And medical Robotics Laboratory, NearLab, Department of Electronics, Information, and Bioengineering, Politecnico di Milano, Via Giuseppe Colombo 40, 20133, Milan, Italy
| | - Marta Gandolla
- NeuroEngineering And medical Robotics Laboratory, NearLab, Department of Electronics, Information, and Bioengineering, Politecnico di Milano, Via Giuseppe Colombo 40, 20133, Milan, Italy. .,Department of Mechanical Engineering, Politecnico di Milano, Via Giuseppe La Masa 1, 20156, Milan, Italy.
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Steinhilber B, Luger T, Schwenkreis P, Middeldorf S, Bork H, Mann B, von Glinski A, Schildhauer TA, Weiler S, Schmauder M, Heinrich K, Winter G, Schnalke G, Frener P, Schick R, Wischniewski S, Jäger M. The use of exoskeletons in the occupational context for primary, secondary, and tertiary prevention of work-related musculoskeletal complaints. IISE Trans Occup Ergon Hum Factors 2020; 8:132-144. [PMID: 33140996 DOI: 10.1080/24725838.2020.1844344] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OCCUPATIONAL APPLICATIONS This guideline includes 20 recommendations and four key statements that achieved consensus or strong consensus regarding the application of exoskeletons in the workplace for the prevention of musculoskeletal complaints and diseases, the general use and implementation of exoskeletons, and recommendations for risk assessment. The guideline is intended for company physicians, occupational physicians, ergonomists, occupational safety specialists, and employers, and serves as information for all other actors in practical occupational safety. Due to the lack of evidence from the scientific literature, the recommendations and key statements are the result of expert discussions that were conducted at a consensus conference in accordance with the Regulations of the Association of the Scientific Medical Societies in Germany, moderated by an external consultant.
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Affiliation(s)
- Benjamin Steinhilber
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, Tübingen, Germany
| | - Tessy Luger
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, Tübingen, Germany
| | - Peter Schwenkreis
- Neurological University Hospital, BG University Hospital Bergmannsheil GmbH, Bochum, Germany
| | - Stefan Middeldorf
- Centre for Orthopaedics, Schön Clinic Bad Staffelstein, Bad Staffelstein, Germany
| | - Hartmut Bork
- St. Josef-Stift Sendenhorst Hospital for Orthopaedic Surgery and Rheumatology, Sendenhorst, Germany
| | - Bernhard Mann
- Institute for Sociology, University of Koblenz-Landau, Koblenz-Metternich, Germany
| | - Alexander von Glinski
- Surgical University Hospital and Polyclinic, BG University Hospital Bergmannsheil, Bochum, Germany
| | - Thomas A Schildhauer
- Surgical University Hospital and Polyclinic, BG University Hospital Bergmannsheil, Bochum, Germany
| | | | - Martin Schmauder
- Institute of Material Handling and Industrial Engineering, Technical University Dresden, Dresden, Germany
| | - Kai Heinrich
- Institute for Occupational Safety and Health of the German Social Accident Insurance, Sankt Augustin, Germany
| | - Gabriele Winter
- (BG) German Social Accident Insurance Institution for Commercial Transport, Postal Logistics and Telecommunication, Darmstadt, Germany
| | - Gerhard Schnalke
- Outpatient Rehabilitation Center Braunschweig, Braunschweig, Germany
| | - Peter Frener
- (BG) German Social Accident Insurance Institution for the Woodworking and Metalworking Industries, Düsseldorf, Germany
| | - Ralf Schick
- (BG) German Social Accident Insurance Institution for the Trade and Logistics Industry, Mannheim, Germany
| | | | - Matthias Jäger
- Leibniz Research Centre for Working Environment and Human Factors, Dortmund University of Technology, Dortmund, Germany
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Best KL, Beaudoin M, Routhier F. Technical quality of online resources for mobility device training. Disabil Rehabil Assist Technol 2020; 17:228-233. [PMID: 32521184 DOI: 10.1080/17483107.2020.1775316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Purpose: Training is recommended to improve safe and effective use of mobility aids. The internet offers a large amount of information and it can be difficult to identify resources with good quality. This project aimed to create a catalogue of online educational resources for mobility device training. The objective of this study was to identify and assess the quality of existing online educational resources for mobility device training for individuals with physical disabilities and caregivers.Methods: A Google search was conducted in October 2016 and replicated in January 2018. Resources were included if they were educational, were available in English or French, provided instruction or training in mobility aid use, were free of charge, and were targeted towards mobility device users or their caregivers. Resources were assessed using a modified version of the Journal of the American Medical Association (JAMA) benchmarks for the evaluation of technical quality.Results: Two hundred and seventy-one resources were included in the final analysis. Two resources were added by the research team for a total of 273 resources. The average JAMA quality score per mobility device varied between 3 (for crutches) and 5 (for knee scooters) out of 6, and weighted average was 3.6. The two resources added by the research team obtained a JAMA quality score of 6. 58 resources were retained for the catalogue.Conclusions: The results suggest that the technical quality of online educational resources for mobility device training could be improved. A need for higher quality resources for device users and caregivers was identified.Implications for rehabilitationThe overall technical quality of online educational resources for mobility device training for users and caregivers is low.A Mobility Device Training Catalogue is freely available and summarizes the highest quality online resources found on mobility device training.The Mobility Device Training Catalogue is intended for use by users and caregivers, but it may also provide clinicians with a tool that may be shared with their clients.
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Affiliation(s)
- Krista L Best
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, Canada.,Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de service sociaux de la Capitale-Nationale, Quebec City, Canada
| | - Maude Beaudoin
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de service sociaux de la Capitale-Nationale, Quebec City, Canada
| | - François Routhier
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, Canada.,Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de service sociaux de la Capitale-Nationale, Quebec City, Canada
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Baltrusch SJ, Houdijk H, van Dieën JH, van Bennekom CAM, de Kruif AJTCM. Perspectives of End Users on the Potential Use of Trunk Exoskeletons for People With Low-Back Pain: A Focus Group Study. Hum Factors 2020; 62:365-376. [PMID: 31914327 DOI: 10.1177/0018720819885788] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVE The objective of this study was to identify criteria to be considered when developing an exoskeleton for low-back pain patients by exploring the perceptions and expectations of potential end users. BACKGROUND Psychosocial, psychological, physical load, and personality influence incidence of low-back pain. Body-worn assistive devices that passively support the user's trunk, that is exoskeletons, can decrease mechanical loading and potentially reduce low-back pain. A user-centered approach improves patient safety and health outcomes, increases user satisfaction, and ensures usability. Still, previous studies have not taken psychological factors and the early involvement of end users into account. METHOD We conducted focus group studies with low-back pain patients (n = 4) and health care professionals (n = 8). Focus group sessions were audio-recorded, transcribed, and analyzed, using the general inductive approach. The focus group discussions included trying out an available exoskeleton. Questions were designed to elicit opinions about exoskeletons, desired design specifications, and usability. RESULTS Important design characteristics were comfort, individual adjustability, independency in taking it on and off, and gradual adjustment of support. Patients raised concerns over loss of muscle strength. Health care professionals mentioned the risk of confirming disability of the user and increasing guarded movement in patients. CONCLUSION The focus groups showed that implementation of a trunk exoskeleton to reduce low-back pain requires an adequate implementation strategy, including supervision and behavioral coaching. APPLICATION For health care professionals, the optimal field of application, prevention or rehabilitation, is still under debate. Patients see potential in an exoskeleton to overcome their limitations and expect it to improve their quality of life.
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Affiliation(s)
- Saskia J Baltrusch
- 100506 Rehabilitation Center Heliomare, Wijk aan Zee and Vrije Universiteit Amsterdam, The Netherlands
| | - Han Houdijk
- 100506 Rehabilitation Center Heliomare, Wijk aan Zee and Vrije Universiteit Amsterdam, The Netherlands
| | | | - Coen A M van Bennekom
- Rehabilitation Center Heliomare, Wijk aan Zee and University of Amsterdam, The Netherlands
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Macul VC, Antonacio PO, Tajima YS, Silva DD, Cruz LAB, Zancul E. Design and development of a motorized aircraft seat to substitute aisle wheelchairs. Disabil Rehabil Assist Technol 2020; 16:910-917. [PMID: 32293213 DOI: 10.1080/17483107.2020.1749895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
PURPOSE The solution described in this paper allows wheelchair users with reduced mobility or physical disabilities to move independently throughout an aircraft and to board and disembark autonomously. MATERIALS AND METHODS A motorized aircraft seat was developed to substitute current aircraft aisle wheelchairs. The real-scale functional prototype was evaluated in a focus group. The results show that the proposed solution is considered superior to current solutions in nine of twenty requirements and neutral in one of them. There was low agreement among the focus group participants in ten requirements, even though the focus group discussion brought interesting reflections, including positive feedback, critics, and suggestions for further research and development in the field. RESULTS The design concept consists of a motorized wheelchair that becomes the seat of the aircraft when anchored on a docking platform attached to the aircraft fuselage via a seat track. The manoeuvring is allowed by a rotating mechanism, which solves a critical function that is to enable wheelchair manoeuvring in the narrow aisles of aircraft. A parking assistant system aids the control of the motorized wheelchair. CONCLUSIONS The main benefits of this solution are to reduce seat transfers during the flight experience and to provide more autonomy and comfort for passengers during flights.IMPLICATIONS FOR REHABILITATIONA motorized aircraft seat was developed to replace traditional aircraft aisle wheelchairs.A real-scale functional prototype was built, tested in an aircraft mockup, and evaluated in a focus group.The main benefits of the proposed solution are to reduce the number of chair transfers during the flight experience and to provide more autonomy for passengers.Additional benefits are to allow the passengers to experience less physical and emotional stresses, to enter the aircraft corridor looking ahead, and to sit in any aisle position in the aircraft.
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Affiliation(s)
- Víctor Cussiol Macul
- Industrial Engineering Department, Polytechnic School, University of Sao Paulo, São Paulo, Brasil
| | - Pedro Orii Antonacio
- Mechatronics Engineering Department, Polytechnic School, University of Sao Paulo, São Paulo, Brasil
| | - Yuri Spuras Tajima
- Mechanical Engineering Department, Polytechnic School, University of Sao Paulo, São Paulo, Brasil
| | - Denilton Donizetti Silva
- Electrical Engineering Department, Polytechnic School, University of Sao Paulo, São Paulo, Brasil
| | | | - Eduardo Zancul
- Industrial Engineering Department, Polytechnic School, University of Sao Paulo, São Paulo, Brasil
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Alabdulkarim SA, Farhan AM, Ramadan MZ. Development and Investigation of a Wearable Aid for a Load Carriage Task. Int J Environ Res Public Health 2020; 17:ijerph17030749. [PMID: 31991625 PMCID: PMC7037516 DOI: 10.3390/ijerph17030749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 01/16/2020] [Accepted: 01/21/2020] [Indexed: 12/04/2022]
Abstract
Anterior load carriage tasks are common and can lead to musculoskeletal disorders such as lower back pain. The objectives of this study were to develop a wearable carriage aid and examine its effectiveness on physical demands while considering the potential moderating influence of the carried load. The study consisted of two within-subject factors: device and load. For the former, two levels were tested: with and without the device worn. For the latter, two loads were examined: 15 and 30% of each individual’s body mass. Sixteen participants walked on a treadmill for five minutes at a constant speed for each condition. Physical demands were quantified using objective (EMG-based) and subjective (discomfort) measures. Wearing the device reduced static and median anterior deltoid, trapezius, and biceps brachii muscle activations. Increasing the carried load increased most physical demand measures. Two significant Device×Load interactions were observed; for the anterior deltoid and trapezius median activation measures, the influence of increasing load was lower when the device was worn. While slightly increasing perceived discomfort in the lower back, wearing the device reduced shoulder, neck, and hand/wrist discomfort. While the study demonstrated a potential for the device, future work is required under more realistic and diverse testing conditions.
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