Use of Assistive Technology for Cognition Among People With Traumatic Brain Injury: A Survey Study.

A survey was designed and administered in this study to assess the use of assistive technology for cognition (ATC), especially portable electronic ATC, among veterans with traumatic brain injury (TBI). The aim of the survey was to obtain information on current ATC devices and applications use, users' experience with different features of ATC, and relevant training/support for their ATC. Twenty-nine veterans with TBI participated in this study. Results showed that portable electronic ATC, especially smartphones and a variety of apps, were widely used by the participants to compensate for cognitive limitations. Portable electronic devices such as smartphones and smart pads received higher usability ratings than paper-based tools. More than 75% of participants did not go through a service delivery process for these electronic ATC. The information collected in the study provided a more updated picture of ATC use, especially portable electronic ATC use, among people with TBI. It also potentially informs the future development of ATC and supports the need for training and an appropriate acquisition process of portable electronic ATC devices.

Investigation of the Impact of Sports, Exercise, and Recreation Participation on Psychosocial Outcomes in a Population of Veterans with Disabilities: A Cross-sectional Study.

OBJECTIVE: The aim of this study was to investigate possible effects that participation in sports, exercise, and recreation may have on self-esteem and quality-of-life in service members/veterans with disabilities. DESIGN: Two hundred twenty service members/veterans with disabilities who were participants in one of three annual adaptive sporting events took part in this cross-sectional study. Variables of interest were years of sport, exercise, and recreation participation since the onset of disability as well as the type of activity they engaged in. Main outcome measures were self-esteem and quality-of-life. RESULTS: A positive relationship was found between participant quality-of-life and the number of years spent participating in sports, exercise, and recreation since the onset of their disability. A significant difference was found between pre-event and postevent self-esteem scores. A significant difference was also found in self-esteem scores between the levels of years of participation in sports, exercise, and recreation when averaged across activity type. Finally, there were significant differences found on self-esteem scores between the levels of type of activity averaged across years of participation. CONCLUSIONS: Our results indicate that participation in sports, exercise, and recreation has a positive influence on self-esteem and quality-of-life in individuals with disabilities.

Design and user evaluation of a wheelchair mounted robotic assisted transfer device.

PURPOSE: The aim of this study is to describe the robotic assisted transfer device (RATD) and an initial focus group evaluation by end users. The purpose of the device is to aid in the transfers of people with disabilities to and from their electric powered wheelchair (EPW) onto other surfaces. The device can be used for both stand-pivot transfers and fully dependent transfers, where the person being transferred is in a sling and weight is fully on the robot. The RATD is fixed to an EPW to allow for its use in community settings. METHOD: A functional prototype of the RATD was designed and fabricated. The prototype was presented to a group of 16 end users and feedback on the device was obtained via a survey and group discussion. RESULTS: Thirteen out of sixteen (83%) participants agreed that it was important to develop this type of technology. They also indicated that user, caregiver, and robotic controls were important features to be included in the device. CONCLUSIONS: Participants in this study suggested that they would be accepting the use of robotic technology for transfers and a majority did not feel that they would be embarrassed to use this technology.

Demographic profile of older adults using wheeled mobility devices.

The purpose of this study was to determine whether the use of wheeled mobility devices differed with respect to age, gender, residential setting, and health-related factors among older adults. A total of 723 adults ageing 60 and older are representing three cohorts, from nursing homes, the Center for Assistive Technology, and the wheelchair registry from the Human Engineering Research Laboratories. Wheeled mobility devices were classified into three main groups: manual wheelchairs, power wheelchairs, and scooters. Our results found factors including age, gender, diagnosis, and living settings to be associated with differences in use of manual versus powered mobility devices. Differences in use were also noted for subtypes of manual (depot, standard, and customized) and powered (scooter, standard, and customized) mobility devices, on demographic, living arrangements, and health-related factors. Consideration of demographic, health-related, and environmental factors during the prescription process may help clinicians identify the most appropriate mobility device for the user.

Upper limb nerve entrapment syndromes in veterans with lower limb amputations.

OBJECTIVE: To examine the prevalence and severity of upper limb entrapment syndromes in a sample of veterans with lower limb amputations. DESIGN: A descriptive survey, pilot study. SETTING: 2008 National Disabled Veterans Winter Sports Clinic. PARTICIPANTS: Twenty participants with various lower limb amputations. METHODS: All study participants completed a questionnaire that included symptoms of both upper limbs, medical history, time since amputation, medication history, use of assistive technology, and wheelchair characteristics. A physical examination and electrodiagnostic testing were then performed on each participant. The physical examination included an assessment of bilateral upper limb weakness or sensory abnormalities, thenar/hypothenar atrophy, deep tendon reflexes, Tinel test of the wrist and elbow, and the Phalen maneuver. All nerve conduction studies were performed by an American Board of Electrodiagnostic Medicine-certified physiatrist. OUTCOME MEASURES: Correlation between symptoms, examination findings, and electrodiagnostic findings with the participant's demographic data in the questionnaire. RESULTS: Twenty participants (19 men and 1 woman) were enrolled in the study, with a total of 38 upper limbs evaluated. The mean age of the study population was 59 +/- 13 years, with an average of 23 years since the amputation. Sixteen (80%) of 20 participants had electrodiagnostic findings consistent with median neuropathy across the wrist (26/38 affected limbs, 6 participants with unilateral and 10 with bilateral findings), and 14 (70%) of 20 participants had ulnar entrapment neuropathy across the elbow (22/38 affected limbs, 6 participants with unilateral and 8 with bilateral findings). Several participants (6 of 20, 30%) were found to have electrodiagnostic evidence of ulnar entrapment neuropathy across the wrist (10 of 38 affected limbs, 2 participants unilateral and 4 bilateral findings). CONCLUSION: A high number of veterans with lower limb amputations presented with upper limb nerve entrapment syndromes. Careful attention to these nerve entrapment syndromes in lower limb amputees is necessary because the symptoms may be confounded by other chronic pain-related disorders.

Quantification of activity during wheelchair basketball and rugby at the National Veterans Wheelchair Games: A pilot study.

To date, no published data exists on distances and speeds traveled by rugby or basketball players during game play. The purpose of this study was to provide quantitative information of selected characteristics of wheelchair basketball and rugby game play. A miniaturized data logger was used to collect the distance traveled, average velocity, activity time, and number of starts and stops during basketball and rugby games. Participants were recruited prior to wheelchair basketball and rugby tournaments during the 2007 and 2008 National Veterans Wheelchair Games. Inclusion criteria were age 18 years or older and been participating in wheelchair basketball or rugby. The wheelchair rugby athletes on average traveled 2364.78 +/- 956.35 meters at 1.33 +/- 0.25 m/sec with 242.61 +/- 80.31 stops and starts in 29.98 +/- 11.79 min of play per game. The wheelchair basketball athletes on average traveled 2679.52 +/- 1103.66 m at 1.48 +/- 0.13 m/sec with 239.78 +/- 60.61 stops and starts in 30.28 +/- 9.59 min of play per game. Previous research has not reported basketball or rugby game play variables such as these, making this data set unique. The information could be used by players and coaches to create training protocols to better prepare for game conditions.

Psychosocial impact of participation in the National Veterans Wheelchair Games and Winter Sports Clinic.

PURPOSE: The purpose of this study was to determine the characteristics of individuals who participate in the National Veterans Wheelchair Games (NVWG) and the Winter Sports Clinic (WSC) for veterans with disabilities. In addition, it was of interest to determine how these events had impacted their lives. METHOD: Participants were recruited at the 20th Winter Sports Clinic, held in Snowmass Colorado and the 26th National Veterans Wheelchair Games held in Anchorage, Alaska. Data of interest included demographic, sport participation information, community integration, self-esteem, and quality of life. A secondary data analysis was completed to determine how comparable individuals who attended the NVWG/WSC were to individuals who did not participate in these events. RESULTS: The 132 participants were a mean age of 47.4 + 13.4 and lived with a disability for an average of 13.4 + 12.1. Participants felt that the NVWG/WSC increased their knowledge of sports equipment (92%), learning sports (89%), mobility skills (84%), and acceptance of disability (84%). The majority of participants stated that the NVWG/WSC improved their life. Of those who participated at the NVWG/WSC, they tended to be more mobile, but have increased physical and cognitive limitations as measured by the CHART when compared to the non-attendees. CONCLUSIONS: Recommending veterans participate in events such as the NVWG and WSC can provide psychosocial benefits to veterans with disabilities.

The development of a nationwide registry of wheelchair users.

This paper provides an overview of the development of a wheelchair users registry and subsequently describes a population of individuals who use wheelchairs. The characteristics of Americans who permanently use wheelchairs and scooters are currently unknown. As the result of developing a Registry of individuals who use wheeled mobility devices for systematic recruitment for research studies, this study provides a description of a nationwide sample of over 1000 individuals who used wheelchairs or scooters for their daily mobility. The Registry is predominantly Caucasian (83%), 63% male, with a mean age of 50 years. Some 54% used manual wheelchairs for an average of 16 years. When quality of wheelchairs was compared, results indicated those in more customizable manual wheelchairs were significantly more likely to be younger. Males were significantly more likely to receive more customizable, heavy duty power wheelchairs than females. The Wheelchair Users Registry provides an organized and systematic way to maintain contact with previous research participants. Expected to grow in size, the Registry may enable an even more diverse pool of subjects interested in participating in research studies.