ABSTRACT
Objective:To solve the problem of leg shaking caused by the sudden change of angular acceleration at the joint of periodic motion during circular gait training of lower limb rehabilitation robot. Methods:A kind of quasi-circular gait was proposed, which divided the periodic motion into three phases: start phase, middle phase and end phase. The time was equal in the start phase and the end phase, and could be adjusted with the parameter ratio. The joint trajectories of the two phases were planned by quintic polynomial, and the middle phase was still the circular gait joint trajectory. The trajectory of the proposed quasi-circular gait was simulated. Results:The angular velocity was continuously differentiable and 0, the angular acceleration was continuous and 0, and the end-effector trajectory became flat with the increase of ratio. The results on the physical prototype of the lower limb rehabilitation robot were principally consistent with the simulation, and the machine worked smoothly. Conclusion:The proposed variable quasi-circular gait had smooth angular acceleration at the junction of periodic motions, which effectively solved the jitter problem when using circular gait for lower limb rehabilitation training and avoided secondary injury to the patients.
ABSTRACT
Objective:To study the prevalence of people with disability, and the demand, service policies and service system for assistive technology (AT) services in Australia. Methods:Referring to policy recommendation and indicators in World Health Organizaion's Rehabilitation in Health Systems, Australia's assistive technology service policy framework, services development and trend of development were analyzed by the means of content analysis and development research. Results:There are about 4.4 million people with disability in Australia, of which 1.4 million (32%) with severe or profound disabilities. Federal, state and territorial governments have respectively issued legislation, policy and related service project, including the National Disability Strategy, National Disability Agreement, the National Disability Insurance Scheme, National Standards for Disability Services and others assistance programs to support disability services. There are about two million Australians with disabilities received AT services support from the mentioned programme and scheme. Australia provides more than ten thousands kinds of AT appliances per year, covering all kinds of products in WHO's Priority Assistive Products List. Conclusion:Australia has developed a federal National Disability Strategy, AT service policies and standards, and established federal and state AT insurance and financial support programs for people with disabilities based on the unmet needs of AT services, and federal and state networks for AT services have been established, and service coordination mechanisms at federal and state levels have been established through the National Disability Agreement, covering all types of people with demand of AT in Australia. It meets the requirements of the policy recommendations and assessment indicators in the WHO's Rehabilitation in Health Systems policy guidelines involving AT services. The future development areas in AT will focus on the fields of policy development, ICF implementation, service delivery system, upgrading of service quality and standard, and new technology application.
ABSTRACT
Objective:To study the policy framework and core content of assistive technology (AT) services, compare the current status of AT in countries with different levels of development, and discuss the future development of international policies and services of AT. Methods:Based on the policy and theoretical framework of AT of the United Nations (UN) and World Health Organization (WHO), the policy framework and main contents of international AT services were analyzed; the policies, assistive products and service development of AT services in countries with different levels of development worldwide were compared; and the policy and innovative technology development hotspots of international AT were explored. Results:AT service is an important component of rehabilitation services, and the development of AT services is a key step toward achieving the UN Sustainable Development Goal 3, "Ensure healthy lifestyles and promote the well-being of people of all ages". UN and WHO advocated AT services policy. The framework is based on the UN Convention on the Rights of Persons with Disabilities (CRPD) on articles related to AT, and WHO documents of AT and rehabilitation, such as World Report on Disability, the Global Plan of Action on Disability, Rehabilitation in the Health System, and Rehabilitation in the Health System: A Guide to Action, as well as WHA 71.8 on Assistive Technology, Improving Access to Assistive Technology. The core elements of the international AT policy aim to build integrated, people-centered health services, emphasize the integration of AT into the health system and rehabilitation services, establish and develop AT services in six building blocks of WHO health system, thereby improving access to quality AT to achieve universal health coverage. Further in the fields of technology and service innovation, it proposed to establish a 5P model. High-income countries and low- and middle-income countries are facing many difficulties and large differences in AT service policies, assistive product provision, and service coverage. In the future, adoption of the 5P model proposed by WHO for policy and service delivery and technological changes, and the innovation of assistive product development and AT service models will be the hot spots of AT development. Conclusion:The policy on AT at international level is centered on the concept of UN CRPD and is based on prospect of policy documents issued by the UN and WHO on AT services, with the core objective of developing AT services to provide timely, appropriate, and affordable to persons with disabilities, aging, and people needed to improve their health, quality of life and well-being. It proposes to integrate AT into universal health coverage and to deliver AT service through primary health care in order to achieve the UN SDG 3 goal with full coverage of AT. It proposes to integrate AT into rehabilitation services, i.e. leadership and governance, financing, AT professionals, AT delivery, medicine and technology, and health information system monitoring AT services. There are differneces in AT products and AT delivery due to the globel differneces in economic and social development levels and challenges in access to AT services. It is necessary to develop relevant policies, planning and innovations in assistive products and AT services. AT development in the future will focus on the 5P model of AT to implement reforms in the field of product and service delivery as well as technological innovation in order to improve the coverage, availability, accessibility and affordability, integrate AT into the health system within the framework of universal health coverage, achieve full coverage of universal AT services, and enhance the quality of AT and improve consumers' well-being.