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With a rapidly aging population， there is a huge potential demand for rehabilitation and assistive products and services. Especially in the global context where greater attention is given to disadvantaged groups， there is a need to cater to the needs of the elderly in terms of rehabilitation and assistive aid to improve their quality of life. Compared with developed countries， China’s rehabilitation aid industry is still in its early stages of development and needs to move away from traditional equipment manufacturing and integrate with intelligent manufacturing to provide more development possibilities and choices. International cooperation is expected to become one of the future research and development directions for rehabilitation aids. Taking typical cities and countries at home and abroad as examples， this paper explores the development of rehabilitation aids， and calls for the cultivation of more rehabilitation aid professionals to help more people in need.
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@#Exoskeletons are wearable devices that can enhance human strength and are used in various fields, such as healthcare and the manufacturing industry. However, poorly designed exoskeletons can strain the muscles and cause injuries to users. The objectives of this review paper are to review the ergonomics factors that contribute to a harmonious user-exoskeleton interaction and to explore the current trends, challenges, and future directions for developing ergonomically designed exoskeletons. In this review, 102 relevant papers published from 2015 to 2023 were retrieved from Web of Science, Scopus, and Google Scholar. These papers were considered in the analysis for gathering relevant information on the topic. The authors identified six ergonomics factors, namely kinematic compatibility, contact pressure, postural control, metabolic cost, cognitive workload, as well as task demands and workplace conditions, that can influence the interaction between users and exoskeletons. By understanding and addressing these ergonomics factors during the design and development process, exoskeleton designers can enhance the user experience and adoption of the devices in daily living activities and industrial applications.
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A questionnaire-based survey of board-certified rehabilitation physicians was conducted to identify issues in multidisciplinary interprofessional collaboration and to assess the abilities of board-certified rehabilitation physicians needed to develop assistive devices for individuals requiring long-term care. From the 366 responses, it was revealed that they consider “the ability to gain an insight into what patients need from assistive devices” and the “ability to communicate” as essential abilities needed to develop assistive devices. The respondents considered the ability to communicate and convey information important to overcome differences in thought-process between disciplines；the sharing of information, objectives, and knowledge as a requirement for teamwork；and collaboration, including with the patients, to be important. This approach to device development fits well with “design thinking” and “biodesign.” Unfortunately, more than 70％ of the respondents were unfamiliar with these concepts. Therefore, it is necessary to provide opportunities for rehabilitation physicians to learn innovative biodesign approaches.
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A questionnaire-based survey of board-certified rehabilitation physicians was conducted to identify issues in multidisciplinary interprofessional collaboration and to assess the abilities of board-certified rehabilitation physicians needed to develop assistive devices for individuals requiring long-term care. From the 366 responses, it was revealed that they consider “the ability to gain an insight into what patients need from assistive devices” and the “ability to communicate” as essential abilities needed to develop assistive devices. The respondents considered the ability to communicate and convey information important to overcome differences in thought-process between disciplines；the sharing of information, objectives, and knowledge as a requirement for teamwork；and collaboration, including with the patients, to be important. This approach to device development fits well with “design thinking” and “biodesign.” Unfortunately, more than 70％ of the respondents were unfamiliar with these concepts. Therefore, it is necessary to provide opportunities for rehabilitation physicians to learn innovative biodesign approaches.
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@#Introduction: Plain anteroposterior radiograph of the hip plays an important role in diagnosing hip pathology. However, one of the most common mistakes is image distortion because the hip is externally rotated due to natural femoral neck anteversion. Thus, the lower extremities should be internally rotated by 15°–20°. The researchers developed a hip internal rotation assistive device and compared it with conventional radiograph positioning. Materials and methods: A hip internal rotation assistive device was designed. This study consisted of 20 volunteers without clinical hip pathology. The volunteers were informed to do a hip radiograph twice to compare the efficacy of the developed device with a conventional positioning. The thickness of the lesser trochanter (TLT) was measured and interpreted by an orthopedist and a radiologist. Statistical significance and inter- and intra-observer reliabilities were analysed. Results: According to the orthopaedist’s measurement, the mean TLT distance was 4.42 + 3.2mm and 4.97 + 3.16mm for the conventional technique and assistive device, respectively, without statistical significance between both groups (p = 0.05). Consistent with the musculoskeletal radiologist, the mean TLT distance was 4.00 + 2.06mm for the conventional technique and 3.92 + 2.27mm for the assistive device, without statistical significance between both groups (p = 0.56). Intra-observer reliability was 0.900 and 0.898 for the orthopaedist and the radiologist, respectively. Interobserver reliability of the assistive device and conventional technique were 0.800 and 0.588, respectively. Conclusion: The efficacy of the developed device was similar to that of the conventional technique. Inter/intra-observer reliabilities were at a good agreement level in both methods. The developed device would also be useful in clinical applications, especially in decreasing unnecessary radiation exposure of medical personnel.
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Objective@#To investigate the activities of daily living and the use of assistive devices among disabled people demanding assistive devices in Jiading Township, Jiading District, Shanghai Municipality, so as to provide the evidence for the implementation of rehabilitation interventions and the selection of assistive devices for the disabled people living in the community.@*Methods@#The disabled people demanding assistive devices were sampled from 17 communities in Jiading Township in January 2020. A face-to-face questionnaire survey was conducted to collect participants'age, gender, type of disability, provision and use of assistive devices. The activities of daily living were evaluated using the Activities of Daily Living Scale, and the difference in the frequency of assistive device use was compared among the disabled people with different activities of daily living.@*Results@#A total of 377 questionnaires were allocated, and 328 valid questionnaires were recovered, with an effective recovery rate of 87.00%. The respondents included 187 men ( 57.01% ) and 141 women (42.99%), and had a mean age of ( 71.78±13.86 ) years. Among all respondents, limb disability was predominant (248 people, 75.61%), and 84.45% (277 people) were provided with assistive devices. Assessment of activities of daily living showed complete self-care in 85 respondents ( 25.91% ), functional decline in 39 respondents ( 11.89% ) and functional dysfunction in 204 respondents ( 62.20% ). The proportion of functional dysfunction was predominantly detected among disabled people at ages of 80 years and older ( 79.63% ) ( P<0.05 ). Of the disabled people with assistive devices, 139 people used the devices daily ( 50.18% ), and the proportion of daily use of assistive devices was significantly higher in people with functional dysfunctions than in those with complete self-care ( 59.33% vs. 29.41%; P<0.05 ). In addition, no need was identified as the predominant cause of non-provision of assistive devices ( 29 people, 56.86% ). @*Conclusions@#Functional dysfunction of daily living is highly prevalent among the disabled people demanding assistive devices in Jiading Township, in whom the elderly are predominant, and the proportion of assistive device use is high among people with functional dysfunctions. The provision of assistive devices recommends to be improved based on assessment of activities of daily living.
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Objective:To sort out the assistive device social security policy of Japan. Methods:The assistive devices social security policy for the older adults and the disabled in Japan was summarized in term of four dimensions: who, what, how to deliver and how to fund. Results:Japanese assistive device social security policy covered most of disabled groups according to the legal protections, delivering a variety of assistive devices products and services. Meanwhile, it has tried to avoid over expenditure through ways of lump-sum control, unit price and quantity control, users self-pay and strict evaluation system. For the service delivery system, the evaluators were strictly neutral, while the providers were in market. The funding came from user-payments, public finance and insurances, etc. Conclusion:Japan has established a mature social security policy system and service system for assistive devices, which can be used as a reference for China.
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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.
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Objective:To investigate the awareness, use, price acceptance, satisfaction, feedback on quality problems, compliance and access methods of assistive devices for the old adults in Dongcheng, Beijing. Methods:From April to December, 2017, 166 homecare old adults from six communities of Dongcheng, Beijing accepted assistive devices after adaption, and were taught how to use. They were followed up once half a month for six months to investigate activities of daily living, satisfaction, awareness and expectation for their assistive devices. Results:There were 22% of them never used their assistive devices. For those assistive devices had been used, 62% were mobile products, 48% were homecare products, 44% were visual products, 20% were hearing products, and 4% were other products. The score of Quebec User Evaluation of Satisfaction with Assistive Technology was (4.04±0.46) in total, with 2% abandoning. Practicalness, good quality, multi-function and high performance-cost were the most important factors in mind to buy the assistive products. Common quality problems were infirmness of assembly (43%), rough appearance (27%), damaged parts (15%), hidden danger (13%), unsuitable size (3%), poor reliability (3%) and lack of structural strength (3%). The ways to obtain assistive devices included self-purchase (80%), government adaptation (13%), family and friends giving (6%), and lease (0%). Conclusion:Assistive devices can improve quality of life for the old adults. They prefer to choosing assistive devices of multi-function, cost-effective, for daily living, communication and homecare. Professional fitting, regular visit and maintenance can increase the satisfaction, and reduce abandonment of assistive devices. Assistive devices leasing service may help to promote the access of assistive devices.
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Objective To explore a training system of high level professionals with international vision and meeting the develop-ment of assistive technology in China. Methods The training system was constructed in the theory framework of International Classification of Functioning, Disability and Health,and work process-oriented. Results and Conclusion A curriculum system with tree-type modes and a practice system with three-level and multi-form of assistive technology specialty were constructed,that was recognized by industry and society in the developing.
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Objective To analyze the service mode of electric manned climbing machine,to develop services of high-price electric assis-tive device(AD).Methods March to April,2013,and December,2014 to January,2015,33 stakeholders were interviewed about the service policy,utilization,the history of service modes and service elements of electric manned climbing machine 2012 to 2014.5W2H method was used to analyze the modes of service in term of resource,management,service,assurance,to study their pros and cons.Results There were three modes of service in climbing machine:subsidy adaptation,volunteer service from community and government purchasing service.The basic service included receiving demand,audit,service and evaluation,that is being adjusted to improve the service capabilities.Conclusion No service mode is the most optimal,but feasible.
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Objective To understand the development situation and existing problems of personnel allocation of assistive device institu-tions during the"Twelfth Five-Year"period in Shanghai,China.Methods A questionnaire was designed and a census was conducted to ob-tain the personnel allocation data from district and street level assistive institutions in 2010 and 2014 about age,education background,ma-jor and years of working, etc. Results During the comparison between 2010 and 2014, there was significant difference only on years of working from district level(P<0.01),and there were significant differences on age,education background,major and years of working from street level (χ2≥43.603, P<0.001). The personnel structures in urban districts and suburban districts were significantly different between 2010 and 2014(χ2≥16.166,P<0.001).Conclusion During the"Twelfth Five-Year"period,the construction of talents for assistive device in-stitutions got remarkable achievement in Shanghai,but it is still necessary to strengthen professional training and reduce the difference of structure.
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@#Objective To analyze the effect of assistive device adaption on quality of life of people with disabilities in 2 districts in Shanghai. Methods A survey on disabled people's quality of life was conducted in 2 districts in Shanghai in September, 2011. A total of 326 people with disabilities completed the SF-12 Questionnaire. Results Assistive device adaption significantly improved their quality of life (P< 0.001). The shorter the years of being disabled was, and the lower the income was, the better the improvement of physical health and psychological health was. Conclusion An early-intervention and constant-revisit service system should be established. More attention should be paid to the low-income family which has disabled members. It is needed to improve the tools for assessment of quality of life of people with disabilities.
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@#Objective To study the effects of assistive devices adaption on activities of disabled persons in 2 districts in Shanghai. Methods 326 disabled persons who accepted the assistive devices adaption in 2 districts in Shanghai in September, 2011, were investigated with the self-designed questionnaire. Results Limb disability was the most of these disabled people, and 2/3 of them stayed in disabled condition more than 10 years. More than 70% of them agreed that assistive devices adaption improved their activities and more than 80% of them were satisfied with the effect of barrier-free remodification. Limb disabled persons benefited from the significant improvement of activities. Conclusion Assistive devices adaption is important to improve the activities of disabled persons.
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@#Objective To carry out the function evaluation and clinical adaptation service of assistive devices for a bilateral wrist-palm disarticulation case in the framework of International Classification of Functioning, Disability and Health (ICF). Methods By evaluating dysfunction and actual demand of the case, assistive devices were selected and applied in daily living, home, education and employment to achieve corresponding accessibility in activities and participation. Results and Conclusion The framework of ICF is important in evaluation of limb dysfunction and adaptation of assistive devices.
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OBJECTIVE: To investigate the ability of spinal cord injury (SCI) patients in the use mobile cellular devices, especially the smartphone. METHODS: Seventeen people with motor complete cervical SCI participated in the study. The assist-devices deemed most fitting were introduced to the patients: a mouth stick, multifunctional splint, activities of daily living (ADL) splint, universal cuff or none of the above. To determine the effective devices, a Multi-Directional Click Test (MDCT), Phone Number Test (PNT), and individual satisfaction inquiry were used. The most appropriate assist device was selected by MDCT. Subsequently PNT and individual satisfaction inquiry were performed with the conventional model and compared. RESULTS: Those with C4 cord injury chose mouth stick. Those with C5 cord injury chose multifunctional splint (3 people) and ADL splint (2 people). Those with C6 cord injury chose universal cuff (3 people) or bare hands only. Those with C7 cord injury chose universal cuff (3 people). With a smartphone, all participants were able to complete the PNT. With a conventional model, only twelve participants (71%) were able to complete the same test. While it took 26.8+/-6.8 seconds with a conventional model to complete PNT, the same test took 18.8+/-10.9 seconds to complete with a smartphone (p<0.05). Overall, participants expressed higher satisfaction when using a smartphone. CONCLUSION: The results offer a practical insight into the appropriate assist devices for SCI patients who wish to use mobile cellular devices, particularly smartphones. When the SCI patients are given the use of a smartphone with the appropriate assist devices, the SCI patients are expected to access mobile cellular device faster and with more satisfaction.
Subject(s)
Humans , Activities of Daily Living , Smartphone , Hand , Mouth , Self-Help Devices , Spinal Cord Injuries , SplintsABSTRACT
OBJECTIVE: To investigate the ability of spinal cord injury (SCI) patients in the use mobile cellular devices, especially the smartphone. METHODS: Seventeen people with motor complete cervical SCI participated in the study. The assist-devices deemed most fitting were introduced to the patients: a mouth stick, multifunctional splint, activities of daily living (ADL) splint, universal cuff or none of the above. To determine the effective devices, a Multi-Directional Click Test (MDCT), Phone Number Test (PNT), and individual satisfaction inquiry were used. The most appropriate assist device was selected by MDCT. Subsequently PNT and individual satisfaction inquiry were performed with the conventional model and compared. RESULTS: Those with C4 cord injury chose mouth stick. Those with C5 cord injury chose multifunctional splint (3 people) and ADL splint (2 people). Those with C6 cord injury chose universal cuff (3 people) or bare hands only. Those with C7 cord injury chose universal cuff (3 people). With a smartphone, all participants were able to complete the PNT. With a conventional model, only twelve participants (71%) were able to complete the same test. While it took 26.8+/-6.8 seconds with a conventional model to complete PNT, the same test took 18.8+/-10.9 seconds to complete with a smartphone (p<0.05). Overall, participants expressed higher satisfaction when using a smartphone. CONCLUSION: The results offer a practical insight into the appropriate assist devices for SCI patients who wish to use mobile cellular devices, particularly smartphones. When the SCI patients are given the use of a smartphone with the appropriate assist devices, the SCI patients are expected to access mobile cellular device faster and with more satisfaction.
Subject(s)
Humans , Activities of Daily Living , Smartphone , Hand , Mouth , Self-Help Devices , Spinal Cord Injuries , SplintsABSTRACT
At this Center, we directly interviewed 393 applicants for prostheses, orthotics, or other assistive devices in the last year and assessed their activities of daily living (ADL) using the functional independence measure (FIM). By investigating the relationship between the FIM scores and the prescription of prostheses, orthotics, or other assistive devices, we analyzed ADL in persons prescribed for assistive devices at a rehabilitation counseling center for persons with disabilities. This analysis revealed that there were some ADL patterns on the occasion of preparing medical writings and prescriptions. The FIM scores were totally good with upper or lower limb prostheses. In the case of computer based communication systems, there appeared a specific pattern wherein cognitive ratings except “expression” were good. Some patterns in ADL covering a combination of physical aspects and cognitive ones were found with the lower limb prostheses. ADL patterns were found to be overlapping among seating systems, wheelchairs and powered wheelchairs. Some patterns were seen in active usage for locomotion, some in usage with low physical and cognitive aspects, and others in different usages. From the viewpoint of ADL, some prescription grounds became clear, and it was shown that these grounds could be one of the guidelines used for the indication of assistive devices.