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      Recent trends in assistive technology for mobility

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          Abstract

          Loss of physical mobility makes maximal participation in desired activities more difficult and in the worst case fully prevents participation. This paper surveys recent work in assistive technology to improve mobility for persons with a disability, drawing on examples observed during a tour of academic and industrial research sites in Europe. The underlying theme of this recent work is a more seamless integration of the capabilities of the user and the assistive technology. This improved integration spans diverse technologies, including powered wheelchairs, prosthetic limbs, functional electrical stimulation, and wearable exoskeletons. Improved integration is being accomplished in three ways: 1) improving the assistive technology mechanics; 2) improving the user-technology physical interface; and 3) sharing of control between the user and the technology. We provide an overview of these improvements in user-technology integration and discuss whether such improvements have the potential to be transformative for people with mobility impairments.

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          Most cited references 26

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          Upper-limb prosthetics: critical factors in device abandonment.

          To investigate the roles of predisposing characteristics, established need, and enabling resources in upper-limb prosthesis use and abandonment. A self-administered, anonymous survey was designed to explore these factors. The questionnaire was available online and in paper format and was distributed through healthcare providers, community support groups, and one prosthesis manufacturer. Two hundred forty-two participants of all ages and levels of upper-limb absence completed the survey. Of participants, 20% had abandoned prosthesis use. Predisposing factors, namely, origin of limb absence, gender, bilateral limb absence, and, most importantly, level of limb absence, proved influential in the decision not to wear prostheses. Enabling resources such as the availability of health care, cost, and quality of training did not weigh heavily on prosthesis rejection, with the exception of the fitting time frame and the involvement of clients in the prosthesis selection. Conversely, the state of available technology was a highly censured factor in abandonment, specifically in the areas of comfort and function. Perceived need emerged as a predominant factor in prosthesis use. Future research should focus on continued development of more comfortable and functional prostheses, particularly for individuals with high-level or bilateral limb absence. Improved follow-up, repair, and information services, together with active involvement of clients in the selection of prostheses meeting their specific goals and needs, is recommended.
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            Predictors of assistive technology abandonment.

            Technology abandonment may have serious repercussions for individuals with disabilities and for society. The purpose of this study was to determine how technology users decide to accept or reject assistive devices. Two hundred twenty-seven adults with various disabilities responded to a survey on device selection, acquisition, performance, and use. Results showed that 29.3% of all devices were completely abandoned. Mobility aids were more frequently abandoned than other categories of devices, and abandonment rates were highest during the first year and after 5 years of use. Four factors were significantly related to abandonment--lack of consideration of user opinion in selection, easy device procurement, poor device performance, and change in user needs or priorities. These findings suggest that technology-related policies and services need to emphasize consumer involvement and long-term needs of consumers to reduce device abandonment and enhance consumer satisfaction.
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              A brain controlled wheelchair to navigate in familiar environments.

              While brain-computer interfaces (BCIs) can provide communication to people who are locked-in, they suffer from a very low information transfer rate. Further, using a BCI requires a concentration effort and using it continuously can be tiring. The brain controlled wheelchair (BCW) described in this paper aims at providing mobility to BCI users despite these limitations, in a safe and efficient way. Using a slow but reliable P300 based BCI, the user selects a destination amongst a list of predefined locations. While the wheelchair moves on virtual guiding paths ensuring smooth, safe, and predictable trajectories, the user can stop the wheelchair by using a faster BCI. Experiments with nondisabled subjects demonstrated the efficiency of this strategy. Brain control was not affected when the wheelchair was in motion, and the BCW enabled the users to move to various locations in less time and with significantly less control effort than other control strategies proposed in the literature.
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                Author and article information

                Journal
                J Neuroeng Rehabil
                J Neuroeng Rehabil
                Journal of NeuroEngineering and Rehabilitation
                BioMed Central
                1743-0003
                2012
                20 April 2012
                : 9
                : 20
                Affiliations
                [1 ]Department of Neurological Surgery, The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, 1095 NW 14th Terrace, Miami, FL, 33136, USA
                [2 ]Department of Mechanical & Aerospace Engineering, University of Florida, 231 MAE-A Building, P.O. Box 116250, Gainesville, FL, 32611, USA
                [3 ]Department of Physical Medicine & Rehabilitation, University of Pittsburgh School of Medicine, 3471 5th Ave, Suite 201, Pittsburgh, PA, 15260, USA
                [4 ]Rehabilitation Medicine Department, NIH Clinical Center, 10 Center Drive, Bethesda, MD, 20892, USA
                [5 ]Department of Physical Therapy and Rehabilitation Science, University of Maryland, 100 Penn Street, Baltimore, MD, 21201, USA
                [6 ]National Institute of Biomedical Imaging and Bioengineering/NIH, 6707 Democracy Blvd, Bethesda, MD, 20892-5477, USA
                [7 ]Department of Mechanical & Aerospace Engineering, Department of Anatomy and Neurobiology, Department of Biomedical Engineering, University of California, 4200 Engineering Gateway, Irvine, CA, 92697-3875, USA
                [8 ]Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, 6425 Penn Avenue, Suite 400, Pittsburgh, PA, 15206, USA
                1743-0003-9-20
                10.1186/1743-0003-9-20
                3474161
                22520500
                Copyright ©2012 Cowan et al.; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                Categories
                Review

                Neurosciences

                assistive technology, disability, robotics

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