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OBJECTIVE: To describe the epidemiology of injuries at the Tokyo 2020 Paralympic Games, including injuries sustained in the new sports of badminton and taekwondo. METHODS: Injury data were obtained daily via the established web-based injury and illness surveillance system (WEB-IISS; 81 countries, 3836 athletes) and local organising committee medical facilities (81 countries, 567 athletes). Univariate unadjusted incidences (injuries per 1000 athlete days with 95% CIs), injury proportion (IP, %) and injury burden (days lost per 1000 athlete days) are reported. RESULTS: A total of 4403 athletes (1853 women, 2550 men) from 162 countries were monitored prospectively during the 3-day pre-competition and 12-day competition periods (66 045 athlete days). 386 injuries were reported in 352 athletes (IP=8.0%) with an incidence of 5.8 per 1000 athlete days (95% CI 5.3 to 6.5). Football 5-a-side (17.2), taekwondo (16.0), judo (11.6) and badminton (9.6) had the highest incidence. There was a higher incidence of injuries in the pre-competition period than in the competition period (7.5 vs 5.4; p=0.0053). Acute (sudden onset) injuries and injuries to the shoulder (0.7) and hand/fingers (0.6) were most common. Injury burden was 10.9 (8.6-13.8), with 35% of injuries resulting in time loss from training and competition. CONCLUSION: Compared with previous Paralympic Games, there was a reduction in injury incidence but higher injury burden at the Tokyo 2020 Paralympic Games. The new sports of taekwondo and badminton had a high injury incidence, with the highest injury burden in taekwondo, compared with other sports. These findings provide epidemiological data to inform injury prevention measures for high-risk sports.
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Introduction: Relatively little is known about students' health and illness. Their effects on academic success have hardly been researched. The aim of the study is to examine associations between health status and study load completed among students. Methods: Of 23,699 students enrolled at the University of Kassel, 3330 participated in the voluntary survey (computer-assisted web interviews) in March 2022. The response rate was 14.1% under conditions of the coronavirus disease 2019 (COVID-19) pandemic. Results: In all, 80.5% of students rated their general health status as very good or good. There were significant differences between men and women in terms of general health status (84.4% vs. 78.6%) and the global activity limitation indicator (GALI). Women were more often than men severely limited in usual activities due to health problems (3.2% vs. 2.6%) or limited but not severely (9.6% vs. 5.7%) for at least the past 6 months. Reported prevalence rates of mental illness were striking. They were higher in women than in men (25.3% vs. 15.4%). Furthermore, 15.1% of students reported that their study load completed was "much less” than required by the study regulations of current degree programs. A multivariate logistic regression analysis revealed that students who were limited in activities of daily life because of a health problem had a significantly increased odds ratio of 1.56 (95%-confidence interval [CI] 1.07–2.27) for a much lower study load, and those students who were severely limited had a significantly increased odds ratio of 2.81 (95%-CI 1.64–4.80). Conclusion: The study identified strong associations between health and study load. It points out the need not only for more health promotion but also for health management for students with disabilities and limitations due to health problems. © 2023, The Author(s).
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Background. Physical activity (PA) is essential for maintaining well-being in adults with disabilities. This population experienced reduced PA during the COVID-19 pandemic; yet, the impact on quality of PA participation remains unclear. Purpose. This secondary analysis explored how pandemic restrictions impacted six experiential dimensions of quality of PA participation among adults with disabilities. Methods. An exploratory sequential mixed-methods design, including semi-structured interviews (n = 10) and self-reported surveys (n = 61), was conducted in May-2020 and February-2021. Quality of PA participation was measured using the Measure of Experiential Aspects of Participation (MeEAP). Participants included community-dwelling adults over 19 years of age (mean 59.2 ± 14.0 years) living with stroke, spinal cord injury, or other physical disabilities. Findings. Directed content analysis identified three themes related to adjusting PA participation for restrictions, motivation barriers, and valuing social support. These themes highlighted five factors, such as resilience, as potential quantitative predictors of quality of PA participation. While paired correlations with MeEAP scores were observed, these factors were not statistically predictive in multiple regression analysis (adjusted R2 = -0.14, F(10,50) = 0.92, p = .53). Implications. The interplay between Meaning, Autonomy, Engagement, and Belongingness dimensions of quality of PA participation was complex, with an emphasized role for mental health, in adults with disabilities.
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COVID-19 , Disabled Persons , Occupational Therapy , Humans , Adult , Middle Aged , Aged , Pandemics , COVID-19/epidemiology , Exercise/psychology , Disabled Persons/psychologyABSTRACT
Objective: To identify surveys that included questions about disability during the COVID-19 pandemic, in the period 2020-2021; and based on this, to determine what actions the countries of Latin America and the Caribbean implemented in the areas of education, health, and social protection that explicitly included the population with disabilities. Methods: Documents from the national statistics institutes of the countries of the region were reviewed, as well as the Socioeconomic Impact Assessment platform and webpages of international institutions such as the World Bank, the United Nations Development Program, and the Economic Commission for Latin America and the Caribbean, seeking to identify national or regional surveys implemented during 2020 and the first half of 2021. Additionally, a documentary analysis was conducted of the measures implemented in the health, education, and social protection sectors in response to the COVID-19 pandemic. These documents were studied to determine whether the population with disabilities was explicitly mentioned. Results: Twenty-three countries in Latin America and the Caribbean collected information from statistical surveys during 2020-2021. Of these, only four (Colombia, Costa Rica, Mexico, and Peru) included questions on disability in their national surveys and although some specific surveys were conducted for the population with disabilities, in the region there is a general lack of associated data on this population during the pandemic. Only 10 countries explicitly included the population with disabilities in health measures, 12 in education, and 13 in social protection. Conclusions: The lack of data on the population with disabilities in the countries of Latin America and the Caribbean during the COVID-19 pandemic shows that this population remains invisible in information collection processes. This is associated with the low number of countries that explicitly included the population with disabilities in policies implemented to mitigate the impact of the pandemic.
Objetivo: Identificar pesquisas que incluíram perguntas sobre deficiência realizadas no período de 2020-2021 da pandemia de COVID-19 e, a partir dessa informação, determinar as ações em saúde, educação e assistência social empreendidas nos países da América Latina e do Caribe e que incluíram explicitamente pessoas com deficiência. Métodos: Documentação obtida dos institutos nacionais de estatística dos países da Região, da plataforma Socioeconomic Impact Assessment (avaliação do impacto socioeconômico) e de sites de organismos internacionais (como Banco Mundial, Programa das Nações Unidas para o Desenvolvimento e Comissão Econômica para a América Latina e o Caribe) foi analisada com o objetivo de identificar as pesquisas nacionais ou regionais realizadas em 2020 e no primeiro semestre de 2021. Também foi realizada uma pesquisa documental da regulamentação para ações em saúde, educação e assistência social destinadas a enfrentar a pandemia de COVID-19, com vistas a identificar a menção explícita de pessoas com deficiência. Resultados: Vinte e três países da América Latina e do Caribe fizeram a coleta de dados estatísticos em pesquisas realizadas no período 2020-2021. Apenas quatro países incluíram perguntas sobre deficiência em pesquisas nacionais: Colômbia, Costa Rica, México e Peru. Apesar de ter havido pesquisas direcionadas para pessoas com deficiência, a Região em geral carece de dados relativos à situação dessa população na pandemia. Somente 10 países empreenderam ações em saúde com a inclusão explícita de pessoas com deficiência, 12 em educação e 13 em assistência social. Conclusões: A falta de dados sobre a situação das pessoas com deficiência nos países da América Latina e do Caribe durante a pandemia de COVID-19 demonstra a invisibilidade deste segmento populacional nos processos de coleta de dados. Como resultado, um número reduzido de países incluiu explicitamente as pessoas com deficiência nas políticas implementadas para o enfrentamento da pandemia.
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Objective: To examine the emerging evidence on developmental disability type and frequency in the population affected by COVID-19, identifying more frequent forms of categorization, incidence/prevalence and comorbidities.Methods: For this scoping review, we searched for observational studies in the MEDLINE (PubMed), Scopus (Elsevier), ISI Web of Science (Clarivate), LILACS (VHL) and grey literature databases. As eligibility criteria, studies should present results of developmental disability (DD) occurrence in people with COVID-19, allowing comparison with the general population, or between groups of disabilities. Two independent reviewers mapped the information using a previously elaborated data extraction instrument. Two other researchers verified the data and assisted in table elaboration to present the results.Results: There was a diversity of terminologies used to categorize DD. People with DD and comorbidities that represent a higher risk for COVID-19 required hospitalization more frequently than the general population. Out of a total of 4930 studies, 14 were selected for assessment. Of these, 5 articles were longitudinal studies.Conclusion: In people with DD, COVID-19 had higher morbidity, lethality and mortality rates in younger age groups, in the poorest population, in the institutionalized population, requiring life support technologies and specialized care. The vulnerability of people with DD to COVID-19 depends on disease type and severity and the presence of comorbidities, highlighting the need for attention in diagnosis and preventive measures, such as vaccination.
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The necessity of modern intensive care units (ICU) based on IoT is becoming obvious as a result of the population boom and, most notably, coronavirus disease (COVID-19). The continual monitoring of patients' vital indicators (Blood Pressure, ECG, Heart Rate, Blood Saturation, Body Temperature) is one of the most important aspects of an ICU. Existing improvements in informatics, signal processing, or engineering, which potentially reduce the pressure on ICUs, have yet to be implemented. It's possible due to a lack of user participation in research and development. This manuscript focuses on the improvement of a completely integrated system where the doctors can directly connect to patients through the Smart Portable ICU, and physicians can access the patients. Thus, the crucial boundaries of a patient to the concerned specialist at a far-off position have been resolved simply and helpfully. Thus, the specialist can attend to the patient remotely and infuse lifesaving drugs from the distant area if necessary. © 2022 IEEE.
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BACKGROUND: The COVID-19 pandemic has led to widespread changes in the way people work. Some of these changes represent the same kinds of work modifications or adjustments that have often been requested as workplace accommodations, and which may improve labour market and employment outcomes for people with disabilities. OBJECTIVE: The aim of this scoping review was to examine the literature on workplace accommodations in the pandemic and their impacts and implications for people with disabilities. METHODS: Following a search of six international databases, articles were selected by two reviewers, and data were abstracted in accordance with scoping review methodology. A thematic analysis was used to report the relevant findings. RESULTS: Thirty-seven articles met the inclusion criteria, and three main themes were identified: positive impacts of pandemic-related workplace accommodations on people with disabilities (e.g., improved accessibility, reduced stigma around workplace accommodations, rapid implementation of workplace accommodations, opportunities for advocacy); negative impacts (e.g., worsened physical and mental health, new accommodation needs); and action needed and recommendations (e.g., revisit legislation and policy on accommodations, ensure representation of people with disabilities). Overall, our review identified a mixed assessment of the impacts of pandemic-related accommodations on people with disabilities. However, there was a broader consensus regarding the importance of learning from the experiences of the pandemic to improve workplace accommodation policies in the future. CONCLUSIONS: The pandemic may present opportunities for improving workplace accommodation policies, but our review also highlights the need for more research examining how workplace changes due to the COVID-19 pandemic have impacted people with disabilities.
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OBJECTIVES: To describe the characteristics of individuals receiving outpatient rehabilitation for post-acute sequelae of SARS-CoV-2 infection (PASC). Further, to examine factors associated with variation in their psychological and cognitive functioning and health-related quality of life. DESIGN: Observational study. SETTING: Outpatient COVID-19 recovery clinic at a large, tertiary, urban health system in the US. PARTICIPANTS: COVID-19 survivors with persistent sequelae (N=324). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Multivariable logistic and linear regression models were used to examine factors associated with COVID survivors' experience of severe anxiety, severe depression, post-traumatic stress disorder (PTSD), cognitive impairment, and self-reported health-related quality of life. RESULTS: About 38% of survivors seeking care for their persistent COVID symptoms suffered from severe anxiety, 31.8% from severe depression, 43% experiencing moderate to severe PTSD symptomology, and 17.5% had cognitive impairment. Their health-related quality of life was substantially lower than that of the general population (-26%) and of persons with other chronic conditions. Poor and African American/Black individuals experienced worse psychological and cognitive sequelae after COVID19 infection, even after controlling for age, sex, initial severity of the acute infection, and time since diagnosis. CONCLUSIONS: Evidence of consistent disparities in outcomes by the patients' race and socioeconomic status, even among those with access to post-acute COVID rehabilitation care, are concerning and have significant implications for PASC policy and program development.
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ISSUE ADDRESSED: COVID-19 vaccination is the cornerstone of managing Australia's COVID-19 pandemic and the success of the vaccination program depends on high vaccination coverage. This paper examined differences in COVID-19 vaccination coverage and vaccine hesitancy for people with disability, long-term health conditions, and carers - subgroups that were prioritised in Australia's vaccination program. METHODS: Using data from 2400 Australians who participated in two waves of the Taking the Pulse of the Nation survey in April and May 2021, we described vaccination coverage and hesitancy among people with disability, severe mental health conditions, severe long-term health conditions, frequent need for assistance with everyday activities, and carers. RESULTS: Vaccination coverage was estimated to be 8.2% in the population overall and was similar for people with disability, those with frequent need for assistance, and carers. It was higher for people with severe long-term health conditions (13.4%) and lower for people with severe mental health conditions (4.3%). Vaccine hesitancy was high overall (35.6%) and was similarly high across the priority groups, with only small differences for people with disability, severe long-term health conditions and frequent need for assistance. CONCLUSIONS: This study highlights a lack of difference in vaccination coverage for people with disability, long-term health conditions, and carers compared to the general population. So what? Sub-optimal vaccination coverage for people in the priority groups leaves many people at significant risk of serious disease or death if exposed to COVID-19, particularly in light of easing of disease-control restrictions across Australia and the emergence of new variants.
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PURPOSE: Mobile health (mHealth) technology has increased dramatically in the wake of the pandemic. Less research has focused on people with mobility impairing (PMI) disabilities. This study determined the prevalence of mHealth use among PMI adults during the COVID-19 escalation and examines demographic, health and COVID-19 concerns correlates. METHODS: PMI adults (N = 304) completed an online survey investigating mHealth use and COVID-19 concerns related to food access in June of 2020. Smartphone and mHealth use were measured with an adapted version of the survey used in the Pew Internet & American Life project. Descriptive and multivariable analyses were conducted to determine associations of demographics, health status, and COVID-19 concerns with mHealth use. About two-thirds (N = 201) of the sample were mHealth users (owned a smartphone and engaged in health-promoting behaviors with the smartphone; e.g., sought online information, tracked health behaviors, used patient portals). RESULTS: Having hypertension was associated with higher mHealth use, and having higher COVID-19 concerns about food access was associated with higher mHealth use. Those who used mHealth were also more engaged with smartphone apps for communication, services, and entertainment. Only the association between educational attainment and mHealth use remained significant after adjusting for other covariates in multivariable logistic regression models. DISCUSSION: PMIs continue to need support in the use of mHealth technology to help maximize access to potentially important tools for rehabilitation and health management. There is a need to continue to investigate mHealth and its applications for people with disabilities.Implications for RehabilitationMany people with mobility impairing disabilities may be missing opportunities for mHealth rehabilitation and healthcare.COVID-19 has widened existing gaps in access and use of mHealth technology among people with mobility impairing disabilities.Focused education is needed to help people with disabilities exploit the full range of services of their smartphones to increase access to care, social connectivity, and other important goods and services to enhance rehabilitation and health management.
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Purpose: People with disabilities may be at higher risk for COVID-19 infection and death as a result of their impairments and/or medical conditions, and systemic inequities and disadvantages. People with disabilities are also a very heterogenous group, with many people with disabilities being multiply marginalized. The aim of this study was to examine differences in COVID-19 diagnosis and vaccination between people with and without disabilities, and to explore sociodemographic differences in COVID-19 diagnosis and vaccination among the disability community itself. Methods: To do so, we analyzed secondary United States Census Bureau data from 444,422 people (52,890 adults with disabilities and 391,532 adults without disabilities) about COVID-19 diagnosis, vaccination, and sociodemographics. Frequency person-weights were applied. Results: In this study, 19.3% of adults with disabilities were diagnosed with COVID-19 during the pandemic compared to 16.7% of adults without disabilities. People with disabilities were 1.20 times more likely to be diagnosed with COVID-19 than adults without disabilities. Among people with disabilities, the following groups were more likely to be diagnosed with COVID-19: people with cognitive disabilities; cisgender women; Black people; Hispanic people; people with some college or associate's degrees; people with employer and/or private insurance; and people who lived in larger households. There was not a significant difference in vaccination between people with and without disabilities; however, there were vaccination disparities among the disability community. Conclusions: Many of the people with disabilities who were more likely to face health care disparities prior to the pandemic were also more likely to be diagnosed with COVID-19 during the pandemic.
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Health Inequities , Social Determinants of Health , Australia , Health Policy , Health Status Disparities , HumansABSTRACT
A most life-threatening situation caused by a novel coronavirus has been unfolding over the last 2years at breakneck speed. The general public is desperate to learn more about how the current situation with COVID-19 is unfolding, including statistics on the number of people who have been affected, as well as news about deaths, recovery rates, and the various ages of people who have been affected across India, particularly those with disabilities and the elderly. This chapter is intended to combine the COVID-19 demand and proceeds with the available statistics onto a single platform. The virus has spread across the globe, and much of the information in the public domain is not accurate. It also affects people adversely if information is unreliable, and so there should be dependable and trustworthy data that individuals can use and rely on in such perilous situations. COVID HUB, a valuable smart application, will provide the public with the accurate information that they deserve. This suggested handy application includes data on the number of people impacted, death rates, recovery rates, and the numbers of elderly and differently abled people affected. The information sources for this new smart app are observed through the application program interface, which obtains data from a remote source, maps its key points and values, and aligns them in a data center. Once the app is started automatically by the system, the application program interface call is made. If COVID symptoms are detected in one or more of the neighboring states, this function collects all of the phone numbers to be dialed from each state. Dart is used for implementation of this COVID HUB. Flutter, which supports both Android and iOS, as well as being a tool chain, coding platform, SDK management, and Dart extensions, are all included in this implementation. © 2022 Elsevier Inc. All rights reserved.
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This special issue consists of 12 papers that explore how synergistic connections between COVID-19 and many health and well-being variables unfolded across the world with different vulnerable populations, including survivors of sexual assault, people with disabilities, college students, Black Americans, caregivers, survivors of domestic violence, pregnant women, and people living in low-income neighborhoods.
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BACKGROUND: There is a paucity of data to assess the impact of the COVID-19 pandemic on persons with disabilities (PwDs) in India. About 27.4 million cases were reported as of 27 May 2021. The continuing pandemic in the form of subsequent waves is expected to have negative repercussions for the disabled globally, particularly in India, where access to health, rehabilitation, and social care services is very limited. Therefore, this study aimed to assess the impact of the COVID-19 pandemic and lockdown restrictions on PwDs in India. OBJECTIVE: To determine the level of disruption due to COVID-19 and the associated countrywide lockdown restrictions on PwD in India during the first wave. METHODS: Using a cross-sectional, mixed-methods approach, data were collected from a representative sample of 403 persons with disabilities in 14 states in India during the COVID-19 first wave at two different points in time (Lockdown and post-lockdown phase). Factors associated with the negative impact were examined using the Chi-square test for associations. The paired comparisons between 'lockdown' with the 'post-lockdown' phase are presented using McNemar's test and the marginal homogeneity test to compare the proportions. Additionally, a subsample of the participants in the survey was identified to participate in in-depth interviews and focus group discussions to gain in-depth insights on the study question and substantiate the quantitative findings. The framework approach was used to conduct a thematic analysis of the qualitative data. RESULTS: About 60% of the PwDs found it difficult to access emergency medical services during the lockdown, and 4.6% post lockdown (p < 0.001). Likewise, 12% found it difficult to access rehabilitation services during the lockdown, and 5% post lockdown (p = 0.03). About 76% of respondents were apprehensive of the risk of infection during the lockdown, and this increased to 92% post lockdown (p < 0.001). Parents with children were significantly impacted due to lockdown in the areas of Medical (p = 0.007), Rehabilitation (p = 0.001), and Mental health services (p = 0.001). The results from the qualitative study supported these quantitative findings. PWDs felt that the lockdown restrictions had negatively impacted their productivity, social participation, and overall engagement in everyday activities. Access to medicines and rehabilitation services was felt to be extremely difficult and detrimental to the therapeutic benefits that were gained by them during the pre-pandemic time. None of the pandemic mitigation plans and services was specific or inclusive of PWDs. CONCLUSIONS: COVID-19 and the associated lockdown restrictions have negatively impacted persons with disabilities during the first wave in India. It is critical to mainstream disability within the agenda for health and development with pragmatic, context-specific strategies and programs in the country.
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COVID-19 , Disabled Persons , COVID-19/epidemiology , Child , Communicable Disease Control , Cross-Sectional Studies , Disabled Persons/rehabilitation , Humans , India/epidemiology , PandemicsABSTRACT
This review article discusses the following: (1) infectious diseases and the Sustainable Development Goals, (2) pandemic proofing and the SDGs, (3) climate change and food insecurity, (4) antibiotics and antibiotic resistance, (5) vaccines, prevention, and vaccine hesitancy, (6) plastics, waste, and pollution. Therefore, it is increasingly clear that the pandemic is disproportionately impacting the most vulnerable of our communities: the elderly, persons with preexisting conditions, and persons living with disabilities, as well as communities of color, immigrants, our prison population, and front-line workers, who often have low income. Promoting respect for cultural diversity (SDG16) within a human-rights-based approach helps facilitate cultural understanding and peace, prevents conflicts, and protects the rights of marginalised groups.
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This issue contains five articles dealing with: the perceived competence of therapeutic recreation interns during the COVID-19 pandemic;therapeutic recreation service delivery for adults with intellectual and/or developmental disabilities in community-based settings;the impact of COVID-19 countermeasures on individuals with intellectual and developmental disabilities and the role of recreation therapy interventions;the use of virtual reality in therapeutic recreation for individuals with intellectual and/or developmental disabilities;and the National Council for Therapeutic Recreation Certification's response to COVID-19 related to certification standards, interpretive guidelines, and financial assistance programs.
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Children and adolescents with physical disabilities have motor and social-emotional challenges that interfere with their health-related quality of life and put them at greater risk of developing secondary conditions. Moreover, services that provide them therapies are more likely to be restricted, especially for the low-income population. There must be broader actions towards health promotion, offering not only means for physical habilitation and rehabilitation but for social and emotional improvements as well. This goal is attainable by adaptive sports and recreational activities where physical conditioning is accompanied by an improvement in self-esteem and social benefits. With the COVID-19 pandemic and social isolation, children and adolescents with physical disabilities were even further deprived of assistance. Our aim was to report the efforts of a non-governmental sports organization in maintaining physical and psychological care through virtual consultations and to analyze the perceptions of those affected by the process. Level of evidence IV; case series .
Crianças e adolescentes com deficiência física apresentam desafios motores e socioemocionais que interferem na qualidade de vida relacionada à saúde e os colocam em maior risco de desenvolver doenças secundárias. Além disso, estão mais sujeitos a restrições de serviços adequados que ofereçam terapias, principalmente para a população de baixa renda social. Torna-se necessário oferecer ações voltadas para a promoção da saúde em um sentido mais amplo, oferecendo não só meios de habilitação e reabilitação física, mas também de ganhos sociais e emocionais. Este objetivo pode ser atingido com esportes adaptados e atividades recreativas nos quais o condicionamento físico é acompanhado por ganhos em autoestima e benefícios sociais. Com a pandemia de COVID-19 e o isolamento social, crianças e adolescentes com deficiência física ficaram ainda mais privados de assistência. Relatamos aqui o esforço de uma organização não-governamental esportiva em manter o atendimento físico e psicológico por meio de consultas virtuais, e avaliamos as percepções das partes interessadas no processo. Nível de evidência IV; série de casos .
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In the modern era computers are becoming faster, smarter and better. Their usage is rising in the fields such as medicine, business administration, education etc. So there is a need for simplifying the operability and usability of a computer. Digital virtual assistants are known for easing the interaction with computers. Since most of the digital virtual assistants use voice as mode of communication deaf and dumb persons are finding it difficult to use virtual assistants on their devices. This research work attempts to propose a voice and gesture based virtual assistant that can be used by disabled as well as non disabled persons to perform common tasks on their computers. The main aim of this research paper is to develop natural human-machine interaction. Input to the virtual assistant is the user's choice. Users can choose to communicate using voice and gestures or operate a mouse pointer using gestures. In thee proposed system, gestures are recognized even in low light conditions. So, the proposed system is very much helpful in all day conditions. It can be of great help in times like Covid-19 pandemic to be contact free as well as for people with disabilities. © 2022 IEEE.