Disability evaluation and impairment rating for the person with an amputation

Impairment rating for the person with an amputation requires a total body assessment in addition to the amputated extremity. In particular, those systems essential for prosthetic wear and function, skin coverage, sensation and motor function, and proximal joint range of motion should be included. Spinal function, pain, and psychologic impairment are frequently involved as secondary issues related to the amputation. All of these systems must be assessed and a determination made whether permanent impairment is present. The final calculation of the impairment rating uses the appropriate body systems and worksheets. Most persons with an amputation will have some appropriate work restrictions applied and all will have future medical needs.     

Future AAC technology needs: consumer perspectives

This article suggests the need for rethinking the role that consumer perspectives will play (and ought to play) in the design and development of future augmentative and alternative communication (AAC) technologies. After carefully defining what they mean by "AAC consumers," "consumer perspectives," and "AAC technologies," the authors consider the extent to which current research has illuminated our understanding of (1) how consumers view AAC technologies and (2) how consumers themselves would define future technology needs. It's not a pretty picture. While it is clear that there already exist specific constructs and methods that could enable researchers and developers to learn more about consumer perspectives, it is equally clear that few, if any, researchers make much use of these constructs and methods. The authors focus specifically on ways that consumer perspective can helpfully infuse participatory action research, technology transfer processes, and ergonomics. In addition, the authors consider how research that investigates the ways in which assistive technologies impact the daily lives of individuals with severe communication impairment also influences public policy issues, which can in turn affect future definitions of AAC technology needs. Throughout the article, the authors advocate for a paradigm shift in the quantity and quality of the collaborations that occur between AAC consumers and AAC researchers, manufacturers, and developers. Augmented communicators and their families have a major stake in all types of research that can affect the design and development of AAC devices and accessories, and the results of this research, in turn, can affect public policy decisions about AAC technologies. This makes it all the more important that AAC consumers be involved at each step of the research and development process.     

Assistive technologies for hearing,and speaking impaired people: a survey

This study presents a novel method for evaluating the scientific research papers in the field of assistive technologies pertaining to different impairment conditions. The objectives are to understand the technologies used for addressing the needs of PWD by identifying relevant criteria for the assessment, explore the implications of these technologies in their lives and identify the gaps among certain technologies in assisting PWD. In this article, we reviewed around 40 research scientific papers in relation to the technologies used to assist PWD in their daily activities. A novel quantitative assessment methodology based on Multi-weighted Scoring Model (MWSM) has been developed. It is based on the judgement of clinical experts according to thirteen well-defined criteria. The proposed method is useful because it assesses the scientific studies related to PWD qualitatively according to efficient research coverage, as well as quantitatively in order to have good comparative judgment. Moreover, this method recognizes the research gap or areas which need further investigation and identifies the research papers that have good coverage of the respective criteria.

• Implications for Rehabilitation

• Human computer interface (HCI) solutions are critical for addressing the main issues facing people with disabilities (PWD) in their life.

• Assessment of scientific research papers according to well-defined criteria that address PWD needs would assist in verifying their suitability for PWDs.

• Novel quantitative assessment methodology is used for assessing these research papers using judgment of experienced researchers according to 13 well-defined criteria that have been weighted according to relevancy to different impairment groups.

• Identifying research papers that have good coverage of defined criteria and knowing the research area that needs further investigation by researchers and developers, would ultimately address the rehabilitation needs for PWD.

     

Improving healthcare accessibility through point-of-care technologies

BACKGROUND: The NIH is committed to improving healthcare quality in the US and has set up initiatives to address problems such as the fragmented nature of healthcare provision. A hypothesis has been developed that testing closer to the point at which care is delivered may reduce fragmentation of care and improve outcomes. METHODS: The National Institute of Biomedical Imaging and Bioengineering (NIBIB), the NIH's National Heart, Lung, and Blood Institute, and the National Science Foundation sponsored a workshop, "Improving Health Care Accessibility through Point-of-Care Technologies," in April 2006. The workshop assessed the clinical needs and opportunities for point-of-care (POC) technologies in primary care, the home, and emergency medical services and reviewed minimally invasive and noninvasive testing, including imaging, and conventional testing based on sensor and lab-on-a-chip technologies. Emerging needs of informatics and telehealth and healthcare systems engineering were considered in the POC testing context. Additionally, implications of evidence-based decision-making were reviewed, particularly as it related to the challenges in producing reliable evidence, undertaking regulation, implementing evidence responsibly, and integrating evidence into health policy. RESULTS: Many testing procedures were considered to be valuable in the clinical settings discussed. Technological solutions were proposed to meet these needs, as well as the practical requirements around clinical process change and regulation. From these considerations, a series of recommendations was formulated for development of POC technologies based on input from the symposium attendees. CONCLUSION: NIBIB has developed a funding initiative to establish a Point-of-Care Technologies Research Network that will work to bridge the technology/clinical gap and provide the partnerships necessary for the application of technologies to pressing clinical needs in POC testing.     

Pharmacogenomic genotyping methodologies.

"Personalized medicine" based on an individual's genetic makeup is slowly becoming a reality as pharmacogenomics moves from the research setting to the clinical laboratory. Concordance studies between genotype and phenotype have shown that inherited mutations in several key drug-metabolizing enzymes, such as cytochrome P450 ( CYP ) 2D6 , 2C9 , and 2C19 , result in several distinct phenotypes that lead to different individual responses following drug administration. One of the major driving forces behind pharmacogenomics and its ability to be used effectively are the technologies that are available. A beneficial genotyping test must identify most or all of the mutations that have a significant impact on the expression or function of drug-metabolizing enzymes, transporter proteins, and/or drug receptors. Selection of the appropriate technology will be based on several issues, including prior knowledge of the mutation/polymorphism, sensitivity/specificity, sample requirements, and cost. Since the future volume of pharmacogenomic testing is anticipated to be large, automation of pharmacogenomics will also become increasingly important. This paper provides an overview of current technologies available for assessing polymorphisms on a small- to large-scale basis.     

Tele-rehabilitation service delivery journey from prototype to robust in-home use

Purpose: The purpose of this study is to present a retrospective study on clients with Acquired Brain Injury (ABI) enrolled in a tele-motion-rehabilitation service program for two or more months.

Methods: Data from 82 clients (46 males; 74 with ABI), aged 22–85 years, are reported. The Kinect-based CogniMotion System (ReAbility Online, Gertner Institute, Tel Hashomer, Israel) provided services that included 30-min biweekly sessions. Participants were evaluated prior to and 2 months following the commencement of service with clinical assessments that measured movements and function of the weaker upper extremity and cognitive abilities.

Results: Clients enrolled in the service had intact or mild cognitive impairment, mild-moderate motor impairment but little use of their weak upper extremity for daily activities. They were satisfied with the service and reported high levels of system usability. Post-intervention clinical assessments were performed on about half of the participants after 2 months; significant improvements in active movements of the weak upper extremity, shoulder flexion range of motion and in the Trail Making Test were found (p?Conclusions: The service appears to be feasible for people with ABI and effective in important clinical outcomes related to improvements in upper extremity function.

• Implications for Rehabilitation

• Tele-rehabilitation provided with Microsoft Kinect 3D sensor virtual reality tracking system is feasible for people with Acquired Brain Injury.

• People with Acquired Brain Injury in the chronic stage were satisfied with the tele-rehabilitation service and perceived it as beneficial to improve their motor and cognitive abilities

• The CogniMotion System service appears to be effective in important clinical outcomes related to improvements in upper extremity function.

     

Computers in patient education

Nurses in practice have an increasing need to become aware of the computer-based resources available and the evidence regarding their use in the process of patient education. This synthesis of the literature examines research related to computer-based patient education. A particular focus is placed on the nurse clinician's perspective and the role of the nurse as a patient educator in the digital age. Two primary healthcare database resources, MEDLINE and CINAHL, were selected for review of the current literature. A listing of articles related to the use of computer technology in patient education was obtained from both of these databases. The search strategy included exploding the subject heading terms "computer" and "patient education," and included articles from 1971 to 2001. Computer-based patient education is an effective strategy for improving healthcare knowledge and clinical outcomes. Computer-based learning can be tailored to the individual's age and specific learning needs. Furthermore, although access to computer-based resources continues to be a barrier for some, socioeconomic disparities have no reported impact on patients' abilities to use computer-based technologies effectively.     

Motor Recovery of the Ipsilesional Upper Limb in Subacute Stroke

Objective

To investigate the time-related changes in motor performance of the ipsilesional upper limb in subacute poststroke patients by using clinical and kinematic assessments.

Design

Observational, longitudinal, prospective, monocentric study.

Setting

Physical medicine and rehabilitation department.

Participants

Stroke patients (n=19; mean age, 62.9y) were included less than 30 days after a first unilateral ischemic/hemorrhagic stroke. The control group was composed of age-matched, healthy volunteers (n=9; mean age, 63.1y).

Interventions

Clinical and kinematic assessments were conducted once a week during 6 weeks and 3 months after inclusion. Clinical measures consisted of Fugl-Meyer Assessment, Box and Block Test (BBT), Nine-Hole Peg Test (9HPT), and Barthel Index. We used a 3-dimensional motion recording system during a reach-to-grasp task to analyze movement smoothness, movement time, and peak velocity of the hand. Healthy controls performed both clinical (BBT and 9HPT) and kinematic evaluation within a single session.

Main Outcome Measures

BBT and 9HPT.

Results

Recovery of ipsilesional upper arm capacities increased over time and leveled off after a 6-week period of rehabilitation, corresponding to 9 weeks poststroke. At study discharge, patients demonstrated similar ipsilesional clinical scores to controls but exhibited less smooth reaching movements. We found no effect of the hemispheric side of the lesion on ipsilesional motor deficits.

Conclusions

Our findings provide evidence that ipsilesional motor capacities remain impaired at least 3 months after stroke, even if clinical tests fail to detect the impairment. Focusing on this lasting ipsilesional impairment through a more detailed kinematic analysis could be of interest to understand the specific neural network underlying ipsilesional upper-limb impairment.     

Effect of remote ischaemic conditioning on contrast-induced nephropathy in patients undergoing elective coronary angiography (ERICCIN): rationale and study design of a randomised single-centre,double-blind placebo-controlled trial

Background

Contrast-induced nephropathy (CIN), an acute kidney injury resulting from the administration of intravascular iodinated contrast media, is an important cause of morbidity/mortality following coronary angiographic procedures in high-risk patients. Despite preventative measures intended to mitigate the risk of CIN, there remains a need for an effective intervention. Remote ischaemic conditioning (RIC), where non-injurious ischaemia is applied to an arm prior to the administration of contrast, has shown promise in attenuating CIN but its effectiveness in preserving long-term renal function is unknown, which will be studied as part of the effect of remote ischaemic conditioning against contrast-induced nephropathy (ERICCIN) trial. (http://Controlled-trials.com Identifier: ISRCTN49645414.)

Methods

The ERICCIN trial is a single-centre, randomised double-blinded placebo-controlled trial which plans to recruit 362 patients who are at risk of CIN, defined by pre-existent renal impairment (estimated glomerular filtration rate <60 ml/min/1.73 m²), over a period of 2 years. Patients will be randomised to either control or RIC consisting of 4, 5 min 200 mmHg balloon-cuff inflation/deflations, to the upper arm. The primary endpoint will be the development of CIN (>25 % of eGFR, or rise of creatinine of >44 μmol/l) at 48 h. A key secondary endpoint will be whether RIC impacts upon persistent renal impairment over the 3-month follow-up period. Additional secondary endpoints include the measurement of serum neutrophil gelatinase-associated lipocalin and urinary albumin at 6, 48 h and 3 months following administration of contrast.

Implications

Findings from ERICCIN trial will potentially demonstrate that RIC attenuates contrast-induced acute and chronic kidney injury and influence future clinical practice guidelines in at-risk patients undergoing coronary angiographic procedures.     

首次发作脑梗死患者认知障碍发生率434例分析

背景:出现认知功能障碍是脑卒中生存者功能恢复较差的强预测因子.缺血性脑卒中后认知功能障碍的发生率及可信区间分析对预防脑卒中后发生认知功能障碍及区别老年期认知功能障碍有实用意义.目的:探讨新发缺血性脑卒中患者认知功能障碍的发生率.设计:3个月随访的单因素病例分析.单位:解放军第三军医大学大坪医院野战外科研究所.对象:选择1999-05-08/2000-12-31解放军第三军医大学大坪医院神经内科的急性脑梗死患者434例,男218例,女216例,年龄55～85(70.3±9.5)岁,均为新发脑卒中48 h内入院,并自愿参加此项目.方法:入院时收集患者的人文资料和临床资料.发病后7～10 d和出院后3个月应用简易智能量表(由20题组成,共30项.分为5个方面:定向力、记忆力、计算力及回忆、语言.每项回答正确得1分,回答错误或答不知道评0分,量表总分范围为0～30分)对患者进行认知功能障碍测试.认知功能障碍的诊断标准为脑卒中后3个月简易智能量表分值低于划界值(文盲17分,≤6年受教育水平20分,≥7年受教育水平24分).主要观察指标:①出院后3个月认知功能障碍的发生率.②脑梗死后认知功能障碍患者简易智能量表评分的单因素分析.结果:434例患者均进入结果分析.①出院后3个月434例脑梗死患者中161例被诊断为脑卒中后认知功能障碍,发生率为37.1%(161/434),认知功能正常273例,为62.9%(273/434).②脑梗死后认知功能障碍组的平均年龄明显高于认知功能正常组[(73.0±7.0)岁,(64.5±6.6)岁,t=2.626,P＜0.01].≤6年文化程度者比例显著高于认知功能正常组[45.3%,22.7%,OR=2.823,95%可信区间为1.855～4.297].简易智能量表评分明显低于认知功能正常组[(16.3±8.7)分,(23.4±4.2)分,t=3.352,P＜0.001].结论:老年脑梗死患者认知功能障碍的发生率较高.脑梗死后发生认知功能障碍者年龄明显偏高,接受教育水平明显偏低,提示脑梗死后认知功能障碍与患者的年龄、受教育水平等变量因素有明显的协同效应.     

Technology to promote safe mobility in the elderly

New technologies designed to help prevent adverse events related to the mobility of geriatric patients (ie, patient falls, bed-rail entrapment, patient handling, and wandering) are described. Technology offers the potential to eliminate or mitigate preventable adverse events that interfere with treatment, delay rehabilitation, potentiate impairment, and compromise patient safety. Unchecked, these adverse events can have a negative impact on patient health, functional status, and quality of life. It is not surprising that the elderly constitute the population at highest risk for adverse events, based on poor health, chronic conditions, long hospitalizations, and institutional care. Patient falls are a high-risk, high-volume, and high-cost adverse event. Key technologies to prevent falls and fall-related injuries include hip protectors, wheelchair/scooter safety features, intelligent walkers, fall alarms, and environmental aids. Bed-rail entrapment is a serious adverse event, which includes patients being trapped, entangled, or strangled in beds. New technologies to prevent bed-rail entrapment include new hospital bed designs, height-adjustable low beds, devices to close gaps in legacy beds, and bedside floor mats. Patients with mobility impairments necessitate physical assistance in transfers and other patient-handling tasks, which increases risk for the caregiver and the patient. Featured technologies to prevent patient handling injuries include innovations in floor-based lifts, new ceiling-mounted patient lifts, and improvements in powered standing lifts, new friction-reducing devices, and new patient transport technology. Wandering affects 39% of cognitively impaired nursing home residents and up to 70% of community-residing elderly persons with cognitive impairments. New technologies to prevent adverse events associated with wandering include door alarms and signal-transmitting devices. Nurses in geriatric settings would benefit from exposure to technologies that could improve patient and caregiver safety. To maximize the benefits of technology, it is critical that front-line nursing staff be involved in the testing and selection of devices that will be used in their practice. Further, to reap the full benefits of technology, a careful plan for implementation needs to be developed that would include integrating the new technology with existing infrastructure. Training needs to be provided for all staff who will be using the technology, and efforts to ensure competency over time is needed. A major barrier to widespread use of new technology is cost. Further research is needed to demonstrate the cost effectiveness of these devices. Results from these studies will help to build a business case, demonstrating that initial capital investments will result in cost savings, improved quality of care, and other benefits.     

Engaging the hearts and minds of clinicians in outcome measurement - the UK rehabilitation outcomes collaborative approach

Purpose: This article explores the rationale for choosing the instruments included within the UK Rehabilitation Outcomes Collaborative (UKROC) data set. Using one specialist neuro-rehabilitation unit as an exemplar service, it describes an approach to engaging the hearts and minds of clinicians in recording the data. Key messages and implications: Measures included within a national data set for rehabilitation should be psychometrically robust and feasible to use in routine clinical practice; they should also support clinical decision-making so that clinicians actually want to use them. Learning from other international casemix models and benchmarking data sets, the UKROC team has developed a cluster of measures to inform the development of effective and cost-efficient rehabilitation services. These include measures of (1) "needs" for rehabilitation (complexity), (2) inputs provided to meet those needs (nursing and therapy intervention), and (3) outcome, including the attainment of personal goals as well as gains in functional independence. Conclusions: By integrating the use of the data set measures in everyday clinical practice, we have achieved a very high rate of compliance with data collection. However, staff training and ongoing commitment from senior staff and managers are critical to the maintenance of effort required to provide assurance of data quality in the longer term. [Box: see text].     

Clinical features of multiple myeloma

The International Myeloma Working Group (IMWG) has recently proposed a new classification of asymptomatic myeloma and symptomatic myeloma. The distinction between asymptomatic and symptomatic myeloma depends on the presence or absence of the myeloma-related organ or tissue impairment (ROTI) defined by the IMWG. Based on the definition, some patients without clinical symptoms may fall into the "symptomatic" group because of insidious organ impairment by myeloma. Or others with clinical symptoms may fall into "asymptomatic" group, if no organ impairment is proven to be myeloma related. Recognition of the clinical features developed by ROTI is not only important for the diagnosis of symptomatic myeloma but also for the immediate institution of effective treatment. Immediate and proper management of the clinical features of symptomatic myeloma patients will have a great impact on quality of life and survival.     

Biomechanical variables related to walking performance 6-months following post-stroke rehabilitation

Background

Body-weight supported treadmill training has been shown to be effective in improving walking speed in post-stroke hemiparetic subjects, and those that have shown improvements generally maintain them after the completion of rehabilitation. However, currently no biomechanical variables are known to be related to those who will either continue to improve or regress in their self-selected walking speed during the 6-month period following rehabilitation. The objective of this study was to identify those biomechanical variables that are associated with subjects who continue (or did not continue) to improve their self-selected walking speed following the completion of rehabilitation.

Methods

Experimental kinematic and kinetic data were recorded from 18 hemiparetic subjects who participated in a 6-month follow-up study after completing a 12-week locomotor training program that included stepping on a treadmill with partial body weight support and manual assistance. Pearson correlation coefficients were used to determine which biomechanical variables evaluated during the post-training session were related to changes in self-selected walking speed from post-training to a 6-month follow-up session.

Findings

Following the completion of rehabilitation, the majority of subjects increased or retained (i.e., did not change) their self-selected walking speed from post-training to the follow-up session. Post-training step length symmetry and daily step activity were positively related to walking speed improvements.

Interpretation

Motor control deficits that lead to persistent step length asymmetry and low daily step activity at the end of rehabilitation are associated with poorer outcomes six months after completion of the program.     

Short-duration robotic therapy in stroke patients with severe upper-limb motor impairment

Chronic motor deficits in the upper limb (UL) are a major contributor to disability following stroke. This study investigated the effect of short-duration robot-assisted therapy on motor impairment, as measured by clinical scales and robot-derived performance measures in patients with chronic, severe UL impairments after stroke. As part of a larger study, 15 individuals with chronic, severe UL paresis (Fugl-Meyer < 15) after stroke (minimum 6 mo postonset) performed 18 sessions of robot-assisted UL rehabilitation that consisted of goal-directed planar reaching tasks over a period of 3 weeks. Outcome measures included the Fugl-Meyer Assessment, the Motor Power Assessment, the Wolf Motor Function Test, the Stroke Impact Scale, and five robot-derived measures that reflect motor control (aiming error, mean speed, peak speed, mean:peak speed ratio, and movement duration). Robot-assisted training produced statistically significant improvements from baseline to posttreatment in the Fugl-Meyer and Motor Power Assessment scores and the quality of motion (quantified by a reduction in aiming error and movement duration with an increase in mean speed and mean:peak speed ratio). Our findings indicate that robot-assisted UL rehabilitation can reduce UL impairment and improve motor control in patients with severe UL paresis from chronic stroke.     

Integrating medical,assistive, and universally designed products and technologies: assistive technology device classification (ATDC)

Introduction: ISO26000:2010 International Guidance Standard on Organizational Social Responsibility requires that effective organizational performance recognize social responsibility, including the rights of persons with disabilities (PWD), engage stakeholders and contribute to sustainable development. Millennium Development Goals 2010 notes that the most vulnerable people require special attention, while the World Report on Disability 2011 identifies improved data collection and removal of barriers to rehabilitation as the means to empower PWD. Background: The Assistive Technology Device Classification (ATDC), Assistive Technology Service Method (ATSM) and Matching Person and Technology models provide an evidence-based, standardized, internationally comparable framework to improve data collection and rehabilitation interventions. The ATDC and ATSM encompass and support universal design (UD) principles, and use the language and concepts of the International Classification of Functioning, Disability and Health (ICF). Purpose: Use ATDC and ICF concepts to differentiate medical, assistive and UD products and technology; relate technology “types” to markets and costs; and support provision of UD products and technologies as sustainable and socially responsible behavior. Conclusion: Supply-side and demand-side incentives are suggested to foster private sector development and commercialization of UD products and technologies. Health and health-related professionals should be knowledgeable of UD principles and interventions.

Implications for Rehabilitation

• An ICF-based classification that differentiates medical, assistive and universally designed technology has important applications to rehabilitation practice and public policy.

• Connecting individual needs associated with diminished functioning to appropriate technology supports efficient and effective rehabilitation practice, with improved individual and societal outcomes.

• Connecting aggregate needs (markets) to appropriate technology provides a data collection framework to support evidence-based and socially responsible public policy.

     

An investigation of factors affecting the performance of wheelchair transfers

Abstract

Purpose: Being able to transfer in and out of their wheelchair is an important task for wheelchair users that can be affected by a variety of different factors. The aim of this study was to investigate the interplay between personal characteristics, wheelchair users’ transferring technique and the other factors that can affect the performance of wheelchair transfers.

Method: A cross-sectional survey study was designed to recruit wheelchair users, aged 18 or older, performing sitting-pivot or standing-pivot wheelchair transfers, independently or with assistance.

Results: Forty-two usable surveys were returned. Transferring technique is usually determined by the individual’s impairment. In turn, transferring technique will greatly affect the perceived difficulty of different types of wheelchair transfers and, the number of transfers that people will perform in a day. The presence of upper limb pain increased the difficulty reported for certain types of transfers while the use of assistive technologies appears to be only partially successful in facilitating the performance of wheelchair transfers.

Conclusion: This study highlights the complexity of the factors included in the performance of wheelchair transfers. Findings from this survey can be utilized to broaden the boundaries of future research.

• Implications for rehabilitation

• Transferring technique is usually determined by the individual?s impairment. In turn, transferring technique will greatly affect the perceived difficulty of different types of wheelchair transfers and, the number of transfers that people will perform in a day.

• The performance of wheelchair transfers exacerbate the painful symptomatology of the person, regardless of their medical condition or transferring technique. The presence of pain increases the reported difficulty of wheelchair trasnfers.

• Use of assistive technologies during transfers is linked to the increased body weight of the person, while the choice of the type of assistive technology seems to be dependent of the transferring technique used by the person. Overall, available ATs are only moderately effective in enabling people to perform wheelchair transfer and they can be cause of frustration for the users due to their high cost and limited functionality.

     

Visual and hearing impairment in elderly patients hospitalized for rehabilitation following hip fracture

In a prospective study, we assessed the prevalence and significance of visual and hearing impairment in 896 patients who were hospitalized for rehabilitation following hip fracture. Visual impairment was defined as visual acuity equal to worse than 6/60 in the better of the two eyes. Hearing impairment was defined as mean decibel level equal to or higher than 60 in the better of the two ears. Visual impairment was found in 210 patients (23.4%) and hearing impairment was found in 231 patients (25.8%). Simultaneous visual and hearing impairment was seen in 72 patients (8%). In univariate analysis, the absolute efficacy of rehabilitation was significantly lower in patients with visual impairment compared to those without (p = 0.00001) and in patients with hearing impairment compared to those without (p = 0.002). However, in multivariate analysis, visual, but not hearing, impairment was found to be independently associated with the absolute efficacy of rehabilitation (p = 0.001). In light of these results, we propose that in the first phase of rehabilitation, patients' visual acuity needs to be optimized.     

A rapid review of the effect of assistive technology on the educational performance of students with impaired hearing

Abstract

Purpose: To review the knowledge base regarding assistive technology (AT) and the education of people with a hearing impairment. Also, evaluating to what extent has the use and/or impact of AT for individuals with a hearing impairment been determined through evidence-based research in post-school education.

Materials and method: Literature pertaining to the effect of AT on the educational performance of students with impaired hearing in the post-school sector was examined for the period from 1998 to 2018 (20 years). A total of 477 articles that contained evidence-based research and reports on the effect of AT in practice were located and reviewed.

Results: It was found that, of the 20 studies that met all the inclusion criteria, only seven provided promising, evidence-based reports on the impact of assistive hearing technology on educational performance.

Conclusion: This review concluded that the limited research speaks to the positive impact of AT on educational outcomes. Additionally, for students with a hearing impairment to be able to receive high-quality AT that will enhance their educational success, more evidence-based research on the efficacy of hearing AT needs to be conducted, especially as newer technologies emerge in this technological era.

• Implications for rehabilitation

• The use of appropriate hearing assistive technology (AT) is a key facilitator within the educational environment and has a positive impact on the educational outcomes for students studying at college or university.

• This rapid review revealed the need to develop a body of scientifically based research that examines the relationship between academic achievement of participation by deaf learners and the use of AT – this is needed to develop a more comprehensive understanding of the benefits and limitations of educational technologies, especially as newer technologies emerge in this technological era.

• This study further highlights the need for more concrete research on the effectiveness of hearing-related AT so that the case can be made for students with hearing impairment to receive high quality, appropriate AT that will enhance their educational success.

• Ultimately, it is hoped that this article elicits the need for much more investigation into this topic to work towards finding solutions that lead to increased participation of deaf learners in the higher education arena, as well as providing evidence-based results to inform future policy and practice.