Acceptance of a Digital Assistant (Anne4Care) for Older Adult Immigrants Living With Dementia: Qualitative Descriptive Study.

BACKGROUND: There is a need to develop and coordinate dementia care plans that use assistive technology for vulnerable groups such as immigrant populations. However, immigrant populations are seldom included in various stages of the development and implementation of assistive technology, which does not optimize technology acceptance. OBJECTIVE: This study aims to gain an in-depth understanding of the acceptance of a digital personal assistant, called Anne4Care, by older adult immigrants living with dementia in their own homes. METHODS: This study used a qualitative descriptive research design with naturalistic inquiry. A total of 13 older adults participated in this study. The participants were invited for 2 interviews. After an introduction of Anne4Care, the first interview examined the lives and needs of participants, their expectations, and previous experiences with assistive technology in daily life. Four months later, the second interview sought to understand facilitators and barriers, suggestions for modifications, and the role of health care professionals. Three semistructured interviews were conducted with health care professionals to examine the roles and challenges they experienced in the use and implementation of Anne4Care. Content analysis, using NVivo11, was performed on all transcripts. RESULTS: All 13 participants had an immigration background. There were 10 male and 3 female participants, with ages ranging from 52 to 83 years. Participants were diagnosed with an early-stage form of dementia or acquired brain injury. None of the older adult participants knew or used digital assistive technology at the beginning. They obtained assistance from health care professionals and family caregivers who explained and set up the technology. Four themes were found to be critical aspects of the acceptance of the digital personal assistant Anne4Care: (1) use of Anne4Care, (2) positive aspects of Anne4Care, (3) challenges with Anne4Care, and (4) expectations. Assistance at first increased the burden on health care professionals and families. After the initial effort, most health care professionals and families experienced that Anne4Care reduced their tasks and stress. Contributions of Anne4Care included companionship, help with daily tasks, and opportunities to communicate in multiple languages. On the other hand, some participants expressed anxiety toward the use of Anne4Care. Furthermore, the platform required an internet connection at home and Anne4Care could not be used outside the home. CONCLUSIONS: Although older adult immigrants living with dementia had no previous experience with digital assistive technology specifically, the acceptance of the digital personal assistant, called Anne4Care, by older adult immigrants living with dementia was rather high. The digital assistant can be further developed to allow for interactive conversations and for use outside of one's home. Participation of end users during various stages of the development, refinement, and implementation of health technology innovations is of utmost importance to maximize technology acceptance.

Assistance Device Based on SSVEP-BCI Online to Control a 6-DOF Robotic Arm.

This paper explores the potential benefits of integrating a brain-computer interface (BCI) utilizing the visual-evoked potential paradigm (SSVEP) with a six-degrees-of-freedom (6-DOF) robotic arm to enhance rehabilitation tools. The SSVEP-BCI employs electroencephalography (EEG) as a method of measuring neural responses inside the occipital lobe in reaction to pre-established visual stimulus frequencies. The BCI offline and online studies yielded accuracy rates of 75% and 83%, respectively, indicating the efficacy of the system in accurately detecting and capturing user intent. The robotic arm achieves planar motion by utilizing a total of five control frequencies. The results of this experiment exhibited a high level of precision and consistency, as indicated by the recorded values of ±0.85 and ±1.49 cm for accuracy and repeatability, respectively. Moreover, during the performance tests conducted with the task of constructing a square within each plane, the system demonstrated accuracy of 79% and 83%. The use of SSVEP-BCI and a robotic arm together shows promise and sets a solid foundation for the development of assistive technologies that aim to improve the health of people with amyotrophic lateral sclerosis, spina bifida, and other related diseases.

User Experience Evaluation of a Spinal Surgery Robot: Workload, Usability, and Satisfaction Study.

BACKGROUND: Robotic spine surgery has continued to evolve since its US Food and Drug Administration approval in 2004, with products now including real-time video guidance and navigation during surgery. As the market for robotic surgical devices evolves, it is important to consider usability factors. OBJECTIVE: The primary objective of this study was to determine the user experience of a surgical-assistive robotic device. The secondary objective was to evaluate workload, usability, the After-Scenario Questionnaire (ASQ), and the System Usability Scale (SUS). In addition, this study compares the workload, usability, and satisfaction survey of the device among different occupational groups using the device. METHODS: Doctors (n=15) and nurses (n=15), the intended users of the surgical assistant robot, participated in the usability evaluation. Participants performed essential scenarios for the surgical assistant robot and provided scenario-specific satisfaction (ASQ), workload (NASA Task Load Index), and usability (SUS) scores. RESULTS: Both doctors and nurses had task success rates of 85% or higher for each scenario. ASQ results showed that both doctors and nurses were least satisfied with ease of completing the task of registration (group 1: mean 4.73, SD 1.57 and group 2: mean 4.47, SD 1.8), amount of time it took (group 1: mean 4.47, SD 1.63 and group 2: mean 4.40, SD 2.09), and support information satisfaction (group 1: mean 5.13, SD 1.50 and group 2: mean 5.13, SD 1.89). All participants had low workloads, and the overall Task Load Index score had a P value of .77, which is greater than .05. The SUS results showed that the overall usability mean for doctors was 64.17 (SD 16.52) and the mean for nurses was 61.67 (SD 19.18), with a P value of .84, which is greater than .05, indicating no difference between the 2 groups. CONCLUSIONS: In this study, doctors and nurses evaluated the interaction of the device in a simulated environment, the operating room. By evaluating the use experience and usability of the device with real intended users, we can develop a more effective and convenient user interface.

Categorizing digital data collection and intervention tools in health and wellbeing living lab settings: A modified Delphi study.

BACKGROUND: Health and Wellbeing Living Labs are a valuable research infrastructure for exploring innovative solutions to tackle complex healthcare challenges and promote overall wellbeing. A knowledge gap exists in categorizing and understanding the types of ICT tools and technical devices employed by Living Labs. AIM: Define a comprehensive taxonomy that effectively categorizes and organizes the digital data collection and intervention tools employed in Health and Wellbeing Living Lab research studies. METHODS: A modified consensus-seeking Delphi study was conducted, starting with a pre-study involving a survey and semistructured interviews (N=30) to gather information on existing equipment. The follow-up three Delphi rounds with a panel of living lab experts (R1 N=18, R2 - 3 N=15) from 10 different countries focused on achieving consensus on the category definitions, ease of reading, and included subitems for each category. Due to the controversial results in the 2nd round of qualitative feedback, an online workshop was organized to clarify the contradictory issues. RESULTS: The resulting taxonomy included 52 subitems, which were divided into three levels as follows: The first level consists of 'devices for data monitoring and collection' and 'technologies for intervention.' At the second level, the 'data monitoring and collection' category is further divided into 'environmental' and 'human' monitoring. The latter includes the following third-level categories: 'biometrics,' 'activity and behavioral monitoring,' 'cognitive ability and mental processes,' 'electrical biosignals and physiological monitoring measures,' '(primary) vital signs,' and 'body size and composition.' At the second level, 'technologies for intervention' consists of 'assistive technology,' 'extended reality - XR (VR & AR),' and 'serious games' categories. CONCLUSION: A common language and standardized terminology are established to enable effective communication with living labs and their customers. The taxonomy opens a roadmap for further studies to map related devices based on their functionality, features, target populations, and intended outcomes, fostering collaboration and enhancing data capture and exploitation.

Design guidelines for movement-assistive clothing based on a comprehensive understanding of older adults' needs and preferences.

This study aimed to explore the needs and wants of older adults in the context of movement-assistive clothing (MSC), with a focus on muscle strength and posture correction. A survey was conducted to understand the needs and wants of older adults, considering aspects of functions and designs, and to evaluate the comfort, safety, ease of use, usefulness, and intention of users to purchase and use products. A total of 408 individuals aged > 65 years participated in the study. The data were analyzed using descriptive analyses, such as mean, standard deviation, percentages, Cronbach's alpha, chi-square test, independent t-test, analysis of variance, and regression using IBM SPSS 27.0. Exploratory Factor Analysis was also conducted to test the hypotheses. Open-ended questions were extracted using major themes after color-coding. Based on the results, design recommendations were derived, including the development of pants and innerwear with casual, minimalist styles, featuring achromatic colors, and utilizing stretchy, breathable fabrics. Comfort, safety, ease of use, and usefulness emerged as critical factors influencing the purchase and use of MSC by older adults. This study aimed to establish design guidelines by understanding the needs and wants of older adults and considering the aspects of movement-assistive clothing to relieve musculoskeletal issues. Accordingly, these findings are expected to aid in the creation of wearable suits using flexible fabric artificial muscles for active musculoskeletal correction in older adults.

Lessons learned from health system rehabilitation preparedness and response for disasters in LMICs: a scoping review.

INTRODUCTION: Disasters such as earthquakes, conflict, or landslides result in traumatic injuries creating surges in rehabilitation and assistive technology needs, exacerbating pre-existing unmet needs. Disasters frequently occur in countries where existing rehabilitation services are underdeveloped, hindering response to rehabilitation demand surge events. AIMS: The primary aim of this scoping review is therefore to synthesize the evidence on rehabilitation and assistive technology preparedness and response of health systems in LMICs to the demand associated with disasters and conflict situations. A secondary aim was to summarize related recommendations identified in the gathered literature. METHODOLOGY: A scoping review was conducted using the Arksey and O'Malley framework to guide the methodological development. The results are reported in accordance with PRISMA-ScR. Four bibliographic databases were used: CINHAL, Cochrane, Pubmed, Scopus and. Key international organisations were also contacted. The search period was from 2010-2022. Eligible publications were categorized for analysis under the six World Health Organization health systems buildings blocks. RESULTS: The findings of this scoping review suggest that rehabilitation is poorly integrated into health systems disaster preparedness and response in LMICs. Of the 27 studies included in the scoping review, 14 focused on service delivery, 6 on health workforce, 4 on health information systems and 3 on the leadership and governance building block. No study focused on financing nor assistive technology. This review found the most frequently referenced recommendations for actions that should be taken to develop rehabilitation services in disasters to be: the provision early and multi-professional rehabilitation, including the provision of assistive technology and psychological support, integrated community services; disaster response specific training for rehabilitation professionals; advocacy efforts to create awareness of the importance of rehabilitation in disasters; and the integration of rehabilitation into disaster preparedness and response plans. CONCLUSION: Findings of this scoping review suggest that rehabilitation is poorly integrated into health systems disaster preparedness and response in LMIC's, largely due to low awareness of rehabilitation, undeveloped rehabilitation health systems and a lack of rehabilitation professionals, and disaster specific training for them. The paucity of available evidence hinders advocacy efforts for rehabilitation in disaster settings and limits the sharing of experiences and lessons learnt to improve rehabilitation preparedness and response. Advocacy efforts need to be expanded.

The psychosocial impact of eye-gaze assistive technology on everyday life of children and adults.

PURPOSE: This study investigates the psychosocial impact of eye-gaze assistive technology (EGAT) in both children and adults with long-term experience using eye-gaze assistive technology in everyday life, as well as the psychosocial impact as related to duration of use. METHODS: In this descriptive comparative study, 34 adult and 27 child EGAT users participated in a structured individual interview using the Psychosocial Impact of Assistive Devices Scale (PIADS). RESULTS: The participants' age ranged from 5-74 years, 50% were female and 52% had been diagnosed with cerebral palsy. The EGAT had a positive psychosocial impact on competence, adaptability, and self-esteem among adult and child users. Competence was the only subscale with a higher value for adults (p = 0.038), compared to children. The items with the highest impact for the psychosocial aspects were quality of life, ability to participate, and self-esteem. The adults had longer duration of use than children, but for high-, medium-, and low-duration users, the device showed a positive psychosocial impact. CONCLUSIONS: Participants considered EGAT to have high positive impacts for participation and quality of life. The study adds new knowledge in that high positive psychosocial impact may be found even among low-duration users of EGAT, which is important to consider for service providers.

Care-ethical considerations of technology-care-assemblages.

Technology plays a major role in care. Against the background of demographic ageing, the use of assistive technologies to support and relieve carers in their work is becoming more and more important. One sector that is increasingly coming into focus is home care by family caregivers. Here, the use of assistive technologies takes place under specific conditions. The article proposes a care-ethical perspective to understand these conditions. It critically discusses issues of power and participation in the negotiation of care that can be associated with the use of technology and outlines a care-ethical perspective on technocare.

Cross-cultural perspectives on intelligent assistive technology in dementia care: comparing Israeli and German experts' attitudes.

BACKGROUND: Despite the great benefits of intelligent assistive technology (IAT) for dementia care - for example, the enhanced safety and increased independence of people with dementia and their caregivers - its practical adoption is still limited. The social and ethical issues pertaining to IAT in dementia care, shaped by factors such as culture, may explain these limitations. However, most studies have focused on understanding these issues within one cultural setting only. Therefore, the aim of this study was to explore and compare the attitudes of Israeli and German dementia experts toward IAT in dementia care, to contribute to a more cultural-comparative perspective. METHODS: Semi-structured interviews were conducted with 35 experts (15 Israelis and 20 Germans) in key roles in health and community services for people with dementia as well as in the fields of dementia and IAT (e.g., computer science, electrical/biomedical engineering, ethics, nursing, and gerontology). Thematic content analysis was used to analyze the data. FINDINGS: Israeli and German experts identified the same social accelerators in the development and implementation of IAT in dementia care (i.e., changes in family structure and social digitization) and benefits of adopting IAT (e.g., enhancing the safety of people with dementia and increasing their independence). However, there were differences in inhibitor/risk assessments between the two groups. Namely, economic considerations and the cognitive capacity of people with dementia were identified by both groups as inhibitors, while Israeli experts additionally reported stigma and ageism. Whereas both groups agreed that IAT might reduce human connection, and that the technology is not yet reliable enough, German experts highlighted concerns regarding privacy; in contrast, Israeli experts prioritized safety over privacy. CONCLUSIONS: Our research findings allow for the identification of relevant similarities but also important differences between German and Israeli experts' perspectives. As such, an important basis has been provided for a more in-depth discussion regarding where, why, and how culturally-sensitive technology development is needed.

Reducing the Burdens of Paid Caregivers of Older Adults by Using Assistive Technology: A Scoping Review.

BACKGROUND: Paid caregivers are needed to support older adults, but caregiver burden contributes to high turnover rates. Assistive technologies help perform activities of daily living (ADLs) and can reduce caregiver burden, but little is known about how they impact paid caregivers. OBJECTIVE: This scoping review provides an overview of evidence on using assistive technology to reduce burdens on paid caregivers working with older adults. DESIGN: The review was conducted from May to August 2022. The eligibility criteria included: (1) publication within 5 years in peer-reviewed journals, (2) investigation of assistive technology, (3) main participants include paid caregivers supporting older adults, and (4) describing impacts on caregiver burden. Searches were conducted in 6 databases, generating 702 articles. The charted data included (1) country of study, (2) participant care roles, (3) study design, (4) main outcomes, and (5) types of assistive technology. Numerical description and qualitative content analysis of themes were used. RESULTS: Fifteen articles reporting on studies in 9 countries were retained for analysis. Studies used a variety of quantitative (8/15), qualitative (5/15), and mixed (2/15) methods. Technologies studied included grab bars and handrails, bidet seats, bed transfer devices, sensor and monitoring systems, social communication systems, and companion robots. Articles identified benefits for reducing stress and workload, while paid caregivers described both positive and negative impacts. CONCLUSIONS: Literature describing the impact of assistive technology on paid caregivers who work with older adults is limited and uses varied methodologies. Additional research is needed to enable rigorous evaluation of specific technologies and impacts on worker turnover.

Identifying causes of vision loss and assistive technology needs among patients attending rehabilitation clinic of a tertiary care center in North India.

PURPOSE: Investigating the causes of visual loss and the best corrected visual acuity (BCVA) is crucial for identifying avoidable eye problems and planning appropriate rehabilitation and assistive technology (AT) services. The study aimed to identify various causes of vision loss and determine AT required for vision rehabilitation (VR). METHODS: The electronic records of patients who attended the VR clinic at a tertiary eyecare for the past 2 years were reviewed. Information such as demographics, BCVA, and causes of visual impairment were retrieved from the records. BCVA was categorized into better than or equal to 1/60 and less than <1/60 for AT services. RESULTS: In total, 1723 patients, mostly male (71.2%), visited the rehabilitation clinic from 2018 to 2019. Around 58.6% of patients belonged to the age group 16-49 years, whereas 25.6% were less than 15 years old. The most frequent eye problems were retinal disorders (63.5%), followed by retinitis pigmentosa (15.2%) and rod-cone dystrophy (4.7%). In contrast, congenital disorders were the most common cause of vision loss among younger groups. Approximately 36.0% of patients had <1/60 blindness and 16.6% had ≥1/60. Around 17.1% of patients would benefit from large prints (near vision acuity N18-N12). CONCLUSION: Early detection and timely management will prevent a significant proportion of patients from developing irreversible vision loss. Around one-third of patients would benefit from visual substitution AT.

From assistive to inclusive? A systematic review of the uses and effects of technology to support people with pervasive support needs.

BACKGROUND: Although particular technologies can enhance the quality of life (QoL) of people with profound intellectual and multiple disabilities (we use the term pervasive support needs), their objectives and outcomes are understudied. A systematic literature review was therefore conducted to explore this topic. METHOD: A search of four databases yielded 64 studies. Data were extracted on their general characteristics, methods and sample characteristics as well as the technology types, QoL domains and application within ecological systems. A narrative synthesis was subsequently developed. RESULTS: Most of the studies applied assistive technology (AT) and focused on personal development and self-determination on an individual level. CONCLUSIONS: Technology can enhance the QoL of people with pervasive support needs. There are indications that although MT and UD-based technology are used in practice, few studies have examined these technologies. Therefore, there is a knowledge gap regarding the kinds of technology that are used in practice.

Barriers and facilitators to health technology adoption by older adults with chronic diseases: an integrative systematic review.

BACKGROUND: In recent years, healthcare systems have progressively adopted several technologies enhancing access to healthcare for older adults and support the delivery of efficient and effective care for this specific population. These technologies include both assistive technologies designed to maintain or improve the independence, social participation and functionality of older people at home, as well as health information technology developed to manage long-term conditions. Examples of such technologies include telehealth, wearable devices and mobile health. However, despite the great promise that health technology holds for promoting independent living among older people, its actual implementation remains challenging. METHODS: This study aimed to conduct an integrative systematic review of the research evidence on the factors that facilitate or hinder the adoption of different types of technology by older individuals with chronic diseases. For this purpose, four electronic databases (PsycArticles, Scopus, Web of Science and PubMed) were queried to search for indexed published studies. The methodological quality of the selected papers has been assessed using the Mixed Methods Appraisal Tool (MMAT). RESULTS: Twenty-nine articles were selected, including 6.213 adults aged 60 or older. The studies have been synthesised considering the types of technological interventions and chronic diseases, as well as the main barriers and facilitators in technology acceptance. The results revealed that the majority of the selected articles focused on comorbid conditions and the utilisation of telemedicine tools. With regard to hindering and facilitating factors, five main domains were identified: demographic and socioeconomic, health-related, dispositional, technology-related and social factors. CONCLUSION: The study results have practical implications not only for technology developers but also for all the social actors involved in the design and implementation of healthcare technologies, including formal and informal caregivers and policy stakeholders. These actors could use this work to enhance their understanding of the utilisation of technology by the ageing population. This review emphasises the factors that facilitate technology adoption and identifies barriers that impede it, with the ultimate goal of promoting health and independent living.

Worldwide Survey on Digital Assistive Technology (DAT) Provision.

Occupational therapists have long been involved in assistive technology (AT) provision worldwide. AT is recognized by the World Health Organization (WHO) to enhance functioning, independence, and autonomy and ultimately promote well-being for people living with disabilities. With the digitalisation of societies, the everyday lives and occupations of individuals are changing, becoming more reliant on digital solutions. The development of digital assistive technology (DAT) also offers opportunities for people with disabilities to access, interact, and pilot the digital world. However, we do not know how occupational therapists are involved in DAT provision worldwide. A survey was conducted in the global occupational therapist's community in June 2022 to describe DAT provision and the factors influencing it. Occupational therapy practitioners were included (n = 660) in the analysis. In DAT provision, occupational therapists mostly provide advice to people, assess their needs, provide instruction or training, prescribe DAT, and fit DAT to people and their environment. The clients served through DAT provision are most frequently people with neurological impairments, chronic illnesses, sensory impairments, and older people. The reasons for providing DAT focus on education, work, school, and leisure. It is expected that DAT provision will enhance independence, self-esteem, occupational participation, and social relationships. Issues faced by occupational therapists when providing DAT are costs of product and funding schemes, sufficient knowledge, and access to knowledge sources. Survey respondents are mostly from Western countries with access to the Internet and the digital world, including having digital literacy, highlighting the digital divide that exists between world regions and countries, but also within countries worldwide. There is a need to continue research to better understand the issues related to digitalisation and the digital participation of people living with disabilities.

Impact of digital assistive technologies on the quality of life for people with dementia: a scoping review.

BACKGROUND: Digital assistive technologies (DATs) have emerged as promising tools to support the daily life of people with dementia (PWD). Current research tends to concentrate either on specific categories of DATs or provide a generic view. Therefore, it is of essence to provide a review of different kinds of DATs and how they contribute to improving quality of life (QOL) for PWD. DESIGN: Scoping review using the framework proposed by Arksey and O'Malley and recommendations from Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. DATA SOURCES: Cochrane, Embase, PubMed, Scopus and Web of Science (January 2013 to May 2023). ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Completed scientific literature with a primary focus on DATs for PWD, perspectives of caregivers, family members or healthcare workers in relation to a PWD, people living in diverse settings and all severities of dementia. DATA EXTRACTION AND SYNTHESIS: Screening and data extraction were conducted, followed by quantitative and qualitative analyses using thematic analysis principles and Digital Therapeutics Alliance categories for DAT grouping. RESULTS: The literature search identified 6083 records, with 1056 duplicates. After screening, 4560 full texts were excluded, yielding 122 studies of different designs. The DATs were categorised into digital therapeutics (n=109), patient monitoring (n=30), digital diagnostics (n=2), care support (n=2) and health system clinical software (n=1). These categories were identified to impact various aspects of QOL: preserving autonomy, engagement, and social interaction, health monitoring and promotion, improving activities of daily living, improving cognition, maintaining dignity, managing behavioural and psychological symptoms of dementia and safety/surveillance. CONCLUSIONS: Various DATs offer extensive support, elevating the QOL of PWD. Digital therapeutics are predominantly used for ageing-in-place and independent living through assistance with daily tasks. Future research should focus on less-represented digital health technology categories, such as care support, health & wellness or software solutions. Observing ongoing DAT developments and their long-term effects on QOL remains essential.

Building Entrepreneurial Mindset: Motivating Curiosity, Connections, and Creating Value in an Assistive-Device Design Project.

Developing entrepreneurial mindset (EM) can help students understand the bigger picture, recognize opportunities, and learn from mistakes to create value. The purpose of this work was to promote EM development in a required junior-level mechanical engineering course. A pre-existing assistive device project was adapted to incorporate entrepreneurial-minded learning activities requiring students to demonstrate curiosity, make connections, and create value. The project was completed across the entire semester. Students created photojournals and participated in activities to build empathy for project clients. Value propositions were developed and presented before the course content was applied to design and evaluate assistive devices. At the conclusion of the project, the students reported high self-efficacy with the EM-related project objectives.

Adopting the service system view toward successful implementation of assistive technologies.

This study aims to provide an overview of the service system view (SSV), and the current status of its adoption for the development and implementation of assistive technology (AT). The role of ATs in the global aging scenario is anticipated; however, their diffusion is cumbersome. The SSV captures stakeholders, technologies, and their interactions as integrated systems. Based on this perspective, several approaches for designing long-term care services have been proposed that would be helpful for the successful implementation of ATs. However, the existing geriatrics and gerontology literature seldom addresses these topics. Based on a literature review, this study first illustrates the challenges of using ATs in the real world. The existing literature highlights the sociotechnical challenges of utilizing ATs, such as the changes required in care work and resistance to them. To overcome the challenges, three approaches associated with the SSV have been introduced: service design, service engineering and living labs. This paper also introduces recent national projects in Japan that have adopted these approaches. As the importance of the SSV is growing for the successful implementation of ATs, the ability to adopt the SSV and its approaches is anticipated. In relation to geriatrics and gerontology studies, the impact on older adults' quality of life, as well as the economic effect, needs to be analyzed in future research. Geriatr Gerontol Int 2024; 24: 74-80.

Hand assistive device with suction cup (HADS) technology for poststroke patients.

A stroke is a neurological disease that primarily causes paralysis. Besides paraplegia, all other types of paralysis affect the upper extremity. Advanced technologies, such as wearable devices and rehabilitation regimens, are also being developed to enhance the functional ability of a stroke person to grasp and release daily living objects. In this research, we developed a rehabilitation functional assist device combining a flexion and extension mechanism with suction cup technology (hybrid technology) to help post-stroke patients improve their hand grip strength in day-to-day grasping activities. Ten poststroke hemiplegia patients were studied to test the functional ability of the impaired hand by wearing and not wearing the device. The outcomes were validated by three standard clinical tests, such as the Toronto Rehabilitation Institute - Hand Functional Test (TRI-HFT), the Chedoke Arm Hand Activity Inventory (CAHAI-9), and the Fugl-Meyer Assessment (FMA) with overall score improvements of 14.5 ± 3.8-25 ± 2.2 (p = 0.005), 5.4 ± 2.8-10 ± 1.6 (p = 0.008), and 9.6 ± 2.6-17 ± 2.4 (p = 0.005) respectively. The p-value for each of the three evaluations was less than 0.05, indicating significantly improved results and the average feedback score of the participants was 3.8 out of 5. The proposed device significantly increased impaired hand functionality in post-stroke patients. The subjects could complete some of the grasping tasks that they could not grasp without the device.Clinical trial registrationThe Clinical Trial Registry of India approved the work CTRI/2022/02/040495 described in this manuscript.

Rehabilitation in primary care for an ageing population: a secondary analysis from a scoping review of rehabilitation delivery models.

BACKGROUND: The world population is ageing rapidly. Rehabilitation is one of the most effective health strategies for improving the health and functioning of older persons. An understanding of the current provision of rehabilitation services in primary care (PC) is needed to optimise access to rehabilitation for an ageing population. The objectives of this scoping review are a) to describe how rehabilitation services are currently offered in PC to older persons, and b) to explore age-related differences in the type of rehabilitation services provided. METHODS: We conducted a secondary analysis of a scoping review examining rehabilitation models for older persons, with a focus on PC. Medline and Embase (2015-2022) were searched to identify studies published in English on rehabilitation services for people aged 50 + . Two authors independently screened records and extracted data using the World Health Organization (WHO)'s operational framework, the Primary Health Care Systems (PRIMASYS) approach and the WHO paper on rehabilitation in PC. Data synthesis included quantitative and qualitative analysis. RESULTS: We synthesised data from 96 studies, 88.6% conducted in high-income countries (HICs), with 31,956 participants and identified five models for delivering rehabilitation to older persons in PC: community, home, telerehabilitation, outpatient and eldercare. Nurses, physiotherapists, and occupational therapists were the most common providers, with task-shifting reported in 15.6% of studies. The most common interventions were assessment of functioning, rehabilitation coordination, therapeutic exercise, psychological interventions, and self-management education. Environmental adaptations and assistive technology were rarely reported. CONCLUSIONS: We described how rehabilitation services are currently provided in PC and explored age-related differences in the type of rehabilitation services received. PC can play a key role in assessing functioning and coordinating the rehabilitation process and is also well-placed to deliver rehabilitation interventions. By understanding models of rehabilitation service delivery in PC, stakeholders can work towards developing more comprehensive and accessible services that meet the diverse needs of an ageing population. Our findings, which highlight the role of rehabilitation in healthy ageing, are a valuable resource for informing policy, practice and future research in the context of the United Nations Decade of Healthy Ageing, the Rehab2030 initiative and the recently adopted WHA resolution on strengthening rehabilitation in health systems, but the conclusions can only be applied to HICs and more studies are needed that reflect the reality in low- and middle-income countries.