The effect of adaptive sports on employment among people with disabilities

Purpose: The purpose of this study is to analyse the role of adaptive sport in predicting employment for individuals with physical disabilities. Method: This study is cross-sectional. We collected survey data on employment and other covariates including education, age, age at disability onset, veteran status and athletic classification from 140 mobility impaired athletes who play either wheelchair rugby or wheelchair basketball. Results: One hundred and thirty-one participants were studied. Our analysis shows that playing an additional year of adaptive sport is associated with an approximately 4% increase in likelihood of employment. Education and duration of disability are found to be positive predictors of employment, while veteran status and severity of injury are negative predictors of employment. Age of disability onset is not found to be a predictor of employment when other controls are included. Conclusions: This result indicates that a substantial economic benefit would result from increased participation in adaptive sport, and therefore may justify additional funding to expand adaptive sport programs.

• Implications for Rehabilitation

• Employment rates are very low among individuals with physical disabilities, despite research indicating extensive benefits from employment.

• Participation in adaptive sport is associated with a higher likelihood of employment.

• Efforts to increase participation in adaptive sport could have a large economic benefit.

     

Application of facial electromyography in computer mouse access for people with disabilities

Purpose. This study develops a newly facial EMG human - computer interface for people with disabilities for controllng the movement of the cursor on a computer screen.

Method. We access the computer cursor according to different facial muscle activity patterns. In order to exactly detect the muscle activity threshold, this study adopts continuous wavelet transformation to estimate the single motor unit action potentials dynamically.

Result. The experiment indicates that the accuracy of using the facial mouse is greater than 80%, and this result indicates the feasibility of the proposed system. Moreover, the subject can improve performance of manipulation by repeated training.

Conclusion. Compared with previous works, the proposed system achieves complete cursor function and provides an inexpensive solution. Although there are still some drawbacks in the facial EMG-based human - computer interface, the facial mouse can provide an alternative among other expensive and complicated assistive technologies.     

Application of facial electromyography in computer mouse access for people with disabilities

Purpose.?This study develops a newly facial EMG human?–?computer interface for people with disabilities for controllng the movement of the cursor on a computer screen.

Method.?We access the computer cursor according to different facial muscle activity patterns. In order to exactly detect the muscle activity threshold, this study adopts continuous wavelet transformation to estimate the single motor unit action potentials dynamically.

Result.?The experiment indicates that the accuracy of using the facial mouse is greater than 80%, and this result indicates the feasibility of the proposed system. Moreover, the subject can improve performance of manipulation by repeated training.

Conclusion.?Compared with previous works, the proposed system achieves complete cursor function and provides an inexpensive solution. Although there are still some drawbacks in the facial EMG-based human?–?computer interface, the facial mouse can provide an alternative among other expensive and complicated assistive technologies.     

Text entry rate of access interfaces used by people with physical disabilities: A systematic review

This study systematically reviewed the research on assistive technology (AT) access interfaces used for text entry, and conducted a quantitative synthesis of text entry rates (TER) associated with common interfaces. We searched 10 databases and included studies in which: typing speed was reported in words per minute (WPM) or equivalent; the access interface was available for public use; and individuals with physical impairments were in the study population. For quantitative synthesis, we used only the TER reported for individuals with physical impairments. Studies also had to report the sample size, and the average and standard deviation for the TER data. Thirty-nine studies met the criteria for quantitative synthesis. Studies involved seven interface types: standard keyboard typing, on-screen keyboard (OSK) with cursor selection, OSK with scanning selection, automatic speech recognition (ASR), Morse code, brain–computer interface (BCI), and other. ASR, standard keyboard, cursor OSK, and scanning OSK had at least four studies and 30 subjects, with TER averaging 15.4, 12.5, 4.2, and 1.7 WPM, respectively. When combined with measurements of a particular client’s text entry performance, the TER from this review can be used within an evidence-based decision-making process for selecting control interfaces.     

Are there differences in factors influencing access and continued use of assistive products for people with intellectual disabilities living in group homes?

Abstract

Background: The World Health Organization has launched a program to promote Global Cooperation on Assistive Technology (GATE) to implement those parts of the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) referring to assistive technology and products. A particular vulnerable group deeply affected by health inequity affecting access to assistive products are people with intellectual disabilities.

Objective: The objective of this study is to understand the barriers and facilitators to effectively access and continuously use essential assistive products for people with intellectual disabilities.

Materials and methods: Face-to-face interviews with 15 adults with a mild to profound intellectual disability and 15 providers of assistive products were conducted to gain insights about current use, needs, knowledge, awareness, access, customization, funding, follow-up, social inclusion, stigma and policies around assistive products and intellectual disability. The technique of constant comparative analysis was used to analyze the data.

Results and conclusion: An overview of factors is presented that fit within seven domains for access and eight domains for continuous use of assistive products for people with intellectual disabilities. It illustrates that access and continuous use are influenced by different barriers and facilitators. These different influences should be taken into account in country policies and frameworks that seek to implement the UNCRPD through assistive technology.

• Implications for rehabilitation

• Proactive assessment for assistive products by health professionals is rare and the vast majority of people with intellectual disabilities depend on carers to signal the need .

• A lack of education for carers around available assistive products and the benefits of assistive products for people with intellectual disabilities may lead to an underutilization for this group.

• The paternalistic attitude of care providers towards people with intellectual disabilities limits access and use to certain (high-tech) assistive products.

• The segmented and disjointed aspect of public funding to support assistive products found in this study is a key issue for policymakers who aspire to adhere to implementing the UNCRPD equally in all areas of their country.

     

The impact of mobility assistive technology devices on participation for individuals with disabilities

Aim: This study aims to address the gap in research and contribute to the body of knowledge on the perspectives assistive technology device users have toward their devices. Method: Mixed methods were used to better understand the impact of mobility assistive technology devices (MATDs) on participation for individuals with disabilities. The Functional Mobility Assessment was administered in conjunction with two qualitative questions developed by the research team allowing participants to expound on the impact of their MATD experience. Participants were recruited online via the National Spinal Cord Injury Association website and in-person at Abilities Expo in Atlanta, Georgia, and the International Seating Symposium in Nashville, Tennessee. Results: Results are consistent with findings from prior research regarding accessibility for individuals with disabilities. Corresponding findings were found in both the quantitative and qualitative data and are categorized into several major themes: environment (indoor and outdoor), surface heights, transportation, dependence, independence, quality of life and participation. Conclusion: Quantitative data from this study indicate that users of MATD are satisfied with the way in which their devices enable maneuvering indoors, while qualitative data suggest otherwise. Implications for healthcare practitioners are described and future recommendations are provided.

• Implications for Rehabilitation

• Healthcare professionals should advocate for proper mobility assistive technology devices (MATDs) for their patients in order to enable increased independence, safety and efficiency.

• Healthcare professionals must be cognizant of the impact of the environment and/or environmental barriers when prescribing MATD.

• Additional areas of interest for future research may include investigating the impact of MATD in association with date of onset of disability, according to diagnoses, or specific to length of time since acquiring the device.

     

Technical devices in children with motor disabilities: a review

Abstract

Purpose: To assess the effectiveness of technical devices used in children with motor disabilities. Method: A systematic search of CINAHL Plus, EMBASE, PEDro, Cochrane Library, Isi Web of Knowledge and Scifinder Web was carried out, covering the period between January 2000 and January 2012. The inclusion criteria were: (1) Studies involving a minimum of five children (randomized-clinical trials with control group and experimental group, clinical trials without control group and prospective cohort studies; (2) age range, 0 to 18 years. The methodological quality of the included studies was assessed by the two authors through the application of the PEDro scale. Results: Of the 59 articles identified by the search strategy, 27 articles were considered eligible. The most frequently evaluated devices were ankle and foot orthoses and the most studied pathology was cerebral palsy. The mean score on the PEDro scale was 6.8. Conclusions: The methodological quality of studies needs to be improved and more rigorous research designs should be followed that will allow the effectiveness and quality of movement to be assessed. The satisfaction of the patient and family with the devices should be analyzed in future studies.

• Implications for Rehabiliation

• The study adds an analysis of studies to determine the effectiveness of technical devices in children with motor disabilities and proposals for future studies to assess the long-term outcomes and improve the quality of interventions.

• Therefore, this review proposes to identify:

• The main technical device used in children with motor disability.

• Which types of pathology or motor disorders require technical devices to be used and what devices are available.

• The effects on the child of wearing technical devices.

• The measurements used to determine the effectiveness of technical aids.

     

Sustainability of exercise intervention outcomes among people with disabilities: a secondary review

Background: This review explored the sustainability of health and physical activity-based outcomes following exercise trials that were conducted for people with disabilities, and characterised the influence of technology and behaviour change strategies.

Methods: A total of 132 studies were screened from an existing database.

Results: Only 22 studies featured follow-up periods and met eligibility criteria. At follow-up, studies typically reported at least one significant health outcome that was maintained (n?=?18/21; 86%). However, significant health outcomes accounted for only 32% of the total volume of outcomes that were measured at follow-up. For physical activity-based outcomes, six studies (n?=?6/8; 75%) reported that intervention gains were maintained throughout follow-up. The incorporation of technology or behaviour change strategies appeared to be linked with sustainable intervention effects.

Conclusions: Overall, some evidence demonstrated that post-intervention effects were sustainable. However, the strength of the evidence was weak and several existing gaps in knowledge were identified. Moreover, most studies did not focus on sustainability, but instead emphasised short-term effects of exercise participation on health and physical activity outcomes. Study findings call for greater research and programme efforts to maintain health, function, and physical activity behaviour after supports provided by research studies are removed.

• Implications for rehabilitation

• Short-term exercise programmes may require additional strategies designed specifically to enhance the sustainability of exercise outcomes and physical activity participation.

• Incorporating technology within exercise interventions may enhance the likelihood of sustaining health and function outcomes.

• Exercise programmes framed within behaviour change theory can equip individuals with the appropriate strategies necessary to maintain their physical activity participation.

     

重庆市残疾人辅助器具需求分析

目的:调查重庆市残疾人辅助器具的需求情况,为辅助器具配送和补助政策的制定提供客观依据.方法:以2006年全国第2次残疾人抽样调查重庆市的4990名残疾人为研究对象,调查其辅助器具需求现状.结果:重庆市残疾人的辅助器具需求比例较高,而且辅助器具是许多残疾人生活中必不可少的,目前提供的服务不能满足其需要.结论:残疾人能借助辅助器具独立参与社会生活,应重视残疾人辅助器具配送工作,以提高其生存质量.     

Assistive technology effects on the employment outcomes for people with cognitive disabilities: A systematic review

Purpose.?This systematic review examines the effects of assistive technology (AT) use on employment outcomes for people with cognitive disabilities (CD). AT is a necessary tool for gaining and maintaining skills for people with CD. Research suggests that AT can assist this population in performing tasks with greater ease and independence.

Method.?A literature search was conducted to examine the evidence supporting AT use in the workforce. Search criteria included: subjects with CD, use of an AT tool or device and participation in a vocational training program or active employment. The search results yielded nine articles focused on AT interventions used in vocational settings for people with CD.

Results.?AT interventions demonstrated positive outcomes on job performance. Positive outcomes were measured as a higher rate of accuracy and task completion, increased independence and generalization of skills. We found a trend in the literature over the past 25–30 years, moving from low- to high-tech visual and auditory cuing systems.

Conclusion.?Future research should focus on producing evidence to support the use of AT tools for this population, and provide guidelines for incorporating them in vocational training programs in schools and community settings.     

Adaptive equipment use by people with motor neuron disease in Australia: a prospective,observational consecutive cohort study

Purpose: People with motor neuron sisease require adaptive equipment to enhance life quality. This study aimed to examine total and concurrent equipment items prescribed with phenotype consideration.

Methods: A prospective, observational consecutive cohort study was undertaken. Data regarding Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised, phenotype, symptom onset and Functional Independence Measure (inpatients only) was recorded. Equipment utilized was coded by therapist as: speech devices; transfer devices; mobility devices (including power wheelchairs); orthoses; activities of daily living equipment; assisted technology and home modification equipment.

Results: Two hundred and seventy-three people with motor neuron disease participated, mean age 67?years, mean amyotrophic Lateral Sclerosis Functional Rating Scale-Revised score 32, a moderate level of disability. Equipment items per participant ranged from 0 to 20, median 5. The electric lift recliner chair was the most commonly used equipment item, used by 51.2% of the cohort. There was a statistically significant difference in equipment use between flail leg and bulbar (Md 11, 3 items, respectively; p?=?.005), and flail leg and cervical phenotypes (Md 11, 3.5 items respectively; p?=?.009).

Conclusions: People with motor neuron disease have high equipment needs to optimize quality of life. Information regarding phenotype relative to equipment requirement, and most frequently prescribed equipment items can assist health-care providers anticipate equipment needs, burden and intensity for those with motor neuron disease.

• Implications for rehabilitation

• People with motor neuron disease have high concurrent equipment needs.

• Electric recliner lift chairs are the most frequently prescribed equipment item by those with motor neuron disease.

• There is variation in concurrent equipment needs relative to motor neuron disease phenotype.

     

Smartphone technology for fostering goal-directed ambulation and object use in people with moderate Alzheimer’s disease

Abstract

Purpose: This study was aimed at assessing a smartphone-based intervention to help 11 individuals with moderate Alzheimer’s disease and ambulation problems to manage goal-directed, walker-assisted ambulation and object use (i.e., to reach specific destinations and put away objects at those destinations independently).

Method: The study was carried out according to a non-concurrent multiple baseline design across participants. Two measures were recorded, that is, the number of target responses performed correctly (with each target response consisting of reaching a destination and putting away an object), and the number of observation intervals with indices of enjoyment/appreciation (e.g., smiles and positive comments). During baseline, the participants were provided with a walker and three objects that were to be transported to and put away at specific destinations. During the intervention, the participants also had the smartphone-based technology that provided them with instructions about the destinations and objects, praise, and preferred stimulation.

Results: During baseline, the mean frequency of correct target responses was virtually zero. The mean frequency of intervals with indices of enjoyment/appreciation ranged from zero to close to one. During the intervention, the mean frequencies for the two measures were slightly below three and just over three, respectively. The maximum frequencies possible were three and four, respectively.

Conclusions: A smartphone-based intervention may be suitable to foster goal-directed, walker-assisted ambulation and object use as well as enjoyment/appreciation in participants like those involved in this study.

• IMPLICATIONS FOR REHABILITATION

• A smartphone-based intervention may be used to promote goal-directed, walker-assisted ambulation and object use as well as indices of enjoyment/appreciation in persons with moderate Alzheimer disease.

• The technology for such intervention might involve (a) a smartphone with Android operating system, light sensor, Bluetooth v4.0, and MacroDroid, (b) Bluetooth headphones or earpieces, and (c) battery-powered light sources.

• The technology may provide the participants with instructions about the destinations to reach and the objects to put away at those destinations, and with praise and brief periods of preferred stimulation at the target destinations.

• The technology may be considered easy to access, friendly for the participants, and suitable for use by staff within daily contexts.

     

Understanding factors that influence participation in physical activity among people with a neuromusculoskeletal condition: a review of qualitative studies

Purpose: This review aims to describe the factors that influence participation in physical activity (PA) in people with neuromusculoskeletal (NMS) conditions. Methods: A systematic search of six databases was conducted. Articles were included if the study qualitatively explored factors that influence participation in PA by individuals with a NMS condition. Fifteen peer-reviewed articles published between 2003 and 2013 were analysed for common themes and critically appraised. Results: Results were categorised using the International Classification of Functioning, Disability and Health framework. The most common demotivators reported for the three areas of functioning, body function and structures, activities and participation were lack of walking balance, muscle weakness, pain, stiffness, bladder and blower problems, depression, thermoregulation and fear of injury. Fluctuating symptoms and fatigue were mentioned as demotivators in all of the progressive conditions. Maintaining independence, function and weight, and the prevention of secondary conditions were the leading motivators reported in this domain. Most common environmental barriers include accessibility, costs, transport and insufficient information and knowledge from health professionals. Social support is a consistent determinate of PA and is reported as a facilitator in every study. The most common personal demotivators include lack of motivation, feelings of self-consciousness and embarrassment in public, anxiety, frustration and anger. Personal motivators include goal setting and achieving, enjoyment, feeling good, feeling “normal”, motivation and optimism, redefining self and escapism from everyday boundaries. Conclusions: Individuals with NMS conditions report complex common barriers, facilitators, demotivators and motivators to participation in PA. The way these factors influence participation in PA is unique to the individual; therefore, it is necessary to adopt an individually tailored approach when designing interventions.

• Implications for Rehabilitation

• Individuals with neuromusculoskeletal conditions report common factors that influence participation in physical activity.

• It is the characteristics, attitude and beliefs of an individual that determine the way in which these factors influence participation in physical activity.

• Health professionals should be guided by the International Classification of Functioning, Disability and Health framework when assessing individuals, as the model will ensure all major factors of interest with regard to disability and physical activity behaviour are considered.

• Interventions to promote participation in physical activity in people with neuromusculoskeletal conditions require an individual approach that facilitates the assessment and management of an individual’s barriers to physical activity.

• A multi-disciplinary approach may be required to address factors that influence participation in physical activity. Health professionals must be informed about other areas of expertise and draw on this when necessary.

     

Toward automatic adjustment of keyboard settings for people with physical impairments

Purpose. We are developing a software system called IDA (Input Device Agent), whose goal is to optimally configure input devices for people with physical impairments. This study assessed IDA's ability to recommend three keyboard parameters in response to measurements of typing performance: repeat rate, repeat delay, and use of StickyKeys.

Method. Twelve typists with physical impairments participated. The study employed a repeated measures design. Each participant typed six sentences in each of four keyboard conditions: default settings, IDA-recommended repeat settings, StickyKeys On, and a repeat of default settings.

Results. Two participants had significant problems with inadvertent key repeats, when using the default repeat settings. For those two participants, use of the IDA-recommended repeat settings reduced the number of repeated characters by 96% and significantly improved text entry rate and typing accuracy. IDA recommended StickyKeys for six participants, each of whom had at least one problem related to modifying keys without StickyKeys. Use of StickyKeys for these individuals eliminated their modifier-related errors and significantly improved typing speed. IDA did not recommend StickyKeys for the six participants who demonstrated no need for it.

Conclusions. The results indicate that IDA can provide useful assistance with repeat settings and StickyKeys.     

Evaluation of Feasibility of a Balance and Strength Training Program for New Users of a Wheeled Walker in an Outpatient Rehabilitation Clinic

Purpose: The aims were to: 1) evaluate the feasibility of conducting an exercise intervention with new users of wheeled walkers above the age 65 years and; 2) determine if combined balance and muscle strength training affects balance and muscle strength compared to a control group. Methods: The intervention consisted of balance and strength training twice a week for 12 weeks. Feasibility of the study such as recruitment process, physiotherapists' adherence, and the participants' compliance were evaluated. Other outcome measures included balance and muscle strength. Results: The evaluation showed that the time to conduct and execute data collection was feasible. The recruitment rate was low and the instructor training too limited in how to progress the intervention. Balance and muscle strength showed no significant difference between groups. Conclusion: Strategies for recruiting participants and improving training of PTs who administered the intervention are important considerations for future clinical studies of this population.     

Relationship between use of technology and employment rates for people with physical disabilities in Australia: Implications for education and training programmes

This study examined the impact of computer and assistive device use on the employment status and vocational modes of people with physical disabilities in Australia. A survey was distributed to people over 15 years in age with physical disabilities living in the Brisbane area. Responses were received from 82 people, including those with spinal cord injuries, cerebral palsy and muscular dystrophy. Of respondents 46 were employed, 22 were unemployed, and 12 were either students or undertaking voluntary work. Three-quarters of respondents used a computer in their occupations, while 15 used assistive devices. Using logistic regression analysis it was found that gender, education, level of computer skill and computer training were significant predictors of employment outcomes. Neither the age of respondent nor use of assistive software were significant predictors. From information obtained in this study guidelines for a training programme designed to maximize the employability of people with physical disabilities were developed.     

Assistive technology needs,functional difficulties,and services utilization and coordination of children with developmental disabilities in the United States

Assistive technology (AT) enhances the ability of individuals with disabilities to be fully engaged in activities at home, at school, and within their communities—especially for children with developmental disabilities (DD) with physical, sensory, learning, and/or communication impairments. The prevalence of children with DD in the United States has risen from 12.84% in 1997 to 15.04% in 2008. Thus, it is important to monitor the status of their AT needs, functional difficulties, services utilization, and coordination.

Using data from the 2009–2010 National Survey on Children with Special Health Care Needs (NS-CSHCN), we conducted bivariate and multivariate statistical analysis, which found that 90% or more of parents of both children with DD and other CSHCN reported that their child’s AT needs were met for vision, hearing, mobility, communication, and durable medical equipment; furthermore, children with DD had lower odds of AT needs met for vision and hearing and increased odds for meeting AT needs in mobility and communication.

Our findings outline the current AT needs of children with DD nationally. Fulfilling these needs has the potential to engender positive lifelong effects on the child’s disabilities, sense of independence, self-confidence, and productivity.     

肢体残疾人自我效能感、照顾质量与生活质量的关系

目的 探讨肢体残疾人自我效能感、照顾质量和生活质量的现状及三者间关系。方法 2019年1月至2020年12月,整群分层随机抽样选取山东省357例肢体残疾人,采用一般资料调查表、世界卫生组织残疾人生活质量量表、自我效能感量表、世界卫生组织残疾人照顾质量量表进行网络问卷调查。结果 共回收调查问卷357份,其中有效问卷350份。肢体残疾人的生活质量为(115.00±20.70)分,自我效能感(23.33±5.78)分,照顾质量(50.43±10.56)分。肢体残疾人的生活质量及其各领域均与自我效能感呈正相关(r> 0.282, P <0.01),与照顾质量、照顾信息的获得、照顾的给予和照顾的环境维度呈正相关(r> 0.369,P <0.01)。就业情况、自我效能感和照顾质量总分是肢体残疾人生活质量的影响因素(t> 4.386, P <0.001);就业情况、自我效能感、照顾的给予和照顾的环境是生活质量生理领域、心理领域和环境领域的影响因素(t> 2.926, P <0.01);主要照顾者为父母、就业情况、自我效能感、照顾的给予和照顾的环境是生活...