Current learning strategies in fire evacuation for seniors and people with disabilities in private seniors' residences and long-term care homes: a scoping review.

Current strategies for teaching evacuation methods in private seniors' residences (PSR) and long-term care (LTCH) homes may pose risks to people with disabilities (PWD) and seniors' physical and psychological health. This study aimed to address the following questions: (1) Which are the current fire evacuation learning strategies used with PWD or seniors? (2) What are the barriers and facilitators for PWD and seniors' during fire evacuation and learning strategies in PSR and LTCH? (3) What is the existing equipment that could be used with PWD seniors?. A scoping review of grey and scientific literature was done in six databases and Google scholar. Additional information was found on Québec government websites. This review identified 13 scientific papers and 22 documents. Twenty barriers (personal = 9, environmental = 11), and 14 facilitators (personal = 4, environmental = 10) were extracted. The current fire evacuation learning strategies currently used can be grouped into three categories: drills; training; promotion of a fire safety plan. Six types of evacuation equipment were found; however, their use has been scarcely documented. Safety for seniors during fire evacuation is still an important issue to be improved. Increasing awareness and creating new practices and tools that consider the strengths and difficulties of seniors seems to be a promising avenue for improving evacuation.

Perspectives of wheelchair users with chronic spinal cord injury following a walking program using a wearable robotic exoskeleton.

PURPOSE: To examine the perspectives of wheelchair users with spinal cord injury (WUSCI) regarding their participation in a 16-week walking program using a wearable robotic exoskeleton (WRE); and explore concerns and expectations regarding potential use of this device and intervention in the context of a home or community-based adapted physical activity program. METHOD: Semi-structured interviews were conducted using a narrative research, 3 weeks post-intervention. Thematic analysis resulted in 6 themes and 21 subthemes. RESULTS: Seven men and 4 women aged between 32 and 72 years were interviewed; 8 of them had a complete SCI. After the walking program, WUSCI reported positive psychological aspects (having fun and motivation) and experiencing improvements in physical aspects (strength, endurance, balance and flexibility, blood circulation and intestinal transit). The structural aspects of the WRE device were acceptable in a lab with research personnel (appearance, size, weight, and comfort). Participants had concerns about safety on uneven surfaces, and possibility of falling. They expressed the desire to use the WRE for more life habits than just walking. CONCLUSION: This is the first study in which WUSCI report that the WRE should be implemented in initial rehabilitation. Lack of availability for community use after rehabilitation remains a concern.

Participation in a walking training program using a wearable robotic exoskeleton, 1-3 times weekly over several weeks, may be well tolerated and provide physical and psychological benefits for wheelchair users with spinal cord injuries.Using a robotic exoskeleton during initial rehabilitation may be well received and help with regaining strength, endurance, balance, and flexibility as well as promoting blood circulation and intestinal transit.The use of the wearable robotic exoskeleton always needs supervision of a clinician for walking and can't be used independently by wheelchair users; there is no possibility for hands free for household tasks (e.g., washing floors, accessing cupboards or reaching shelves, using stairs), and for recreation (e.g., exercising, taking walks, cultural activities, concerts).

Roles and usages of neuro service dogs for caregivers living at home with persons with dementia: An exploratory comparative case study.

The goal of the present study was to examine how canine assistance may support family caregivers and persons with dementia and to document and compare two modalities of home care support. An exploratory comparative case study research design was conducted. Three cases correspond of dyads of a caregiver, a person with mild to moderate dementia, and either a neuro service dog (NSD), a companion dog or no dog. Hypotheses are formulated to capture differences between cases. Recruitment was done in a service dog organisation, through Canadian Alzheimer associations and in records of a hospital. Data were collected through 45-60 minutes telephone interviews that included completion of the Caregiver's Burden Scale and sociodemographic questions. We used an inductive approach with qualitative data. There were five caregivers (mean age 54.8 years) who had an NSD, 28 caregivers (63.6 years) who had a companion dog, and 23 caregivers (63.8 years) without dog. In the category of roles and usages of the dog, 'Socialisation' and 'Help with a sense of direction' were the most addressed roles for dyads with the NSD. For dyads with companion dog and without dog, 'Engagement-and-meaning of life' as well as 'Physical activity with the dog' were the most discussed roles. The 'Sleep or wake up' role was the least discussed role across three cases. In the other categories, they were seven advantages and 10 inconvenients that were mentioned for canine assistance. For home care support, the presence of NSD has more positive impacts on both the person with dementia and their caregiver compared to the presence of a companion dog; the presence of a NSD results in the person with dementia accessing more indoor and outdoor public sites than with a companion dog; and dyads with a dog are informally socially engaged more frequently than those with no dog.

Neuro Service Dogs Impacts on Community-Dwelling Persons with Mild to Moderate Dementia and Their Caregiver.

Since there were no research data on the use of neuro service dogs (NSD) in 2018, a comparative case study research design was done. The cases comprised of a caregiver with a person with mild to moderate dementia, and either an NSD (n=5), a companion dog (n=28), or no dog (n=23). Monitor activity and online questionnaires were administrated. Interesting qualitative data on the roles of a NSD, advantages and inconvenients were fully described and published. Quantitative data could not confirm that NSD is benefit-cost, neither that it increases quality of sleep or level of exercise, compared to companion dogs.

Intersectoral Development of an Evaluation Tool for the Socio-Professional Rehabilitation Process Adapted to People with Autism.

Since there was no French tool adapted to the reality of people with autism enrolled in a work integration program in Quebec, we have modified the Profile of Rehabilitation and Adaptation in a Work Context for People with Intellectual Disabilities according to the scientific literature on autism. Content validity (n=17) and applicability (n=5) were done with success. Result is an Excel compiler containing 3 informative tabs, 10 tabs on the dimensions of work rehabilitation (59 items) and 4 tabs used to compile the results. Socio-professional practicians are welcomed to use this new tool to pursue construct and internal validity.

Design of Instructional Videos for People with Autism Who Want to Learn About Grocery Store Work: A Community, Business, Educational and Health Partnership.

To facilitate the integration of people with autism into the food industry labour market, this cross sectoral project aimed to design, validate and test instructional videos to concretely demonstrate various tasks in the grocery store, and to probe interest and assess knowledge about these tasks. Results are the delivery of 21 instructional videos validated for individuals with autism and 21 for mentors in grocery.

Teleworking to Support Accommodation, Inclusion, and Health of Aging Workers: Protocol for a Study to Design, Validate, and Test a Reflective Application Guide.

BACKGROUND: Aging workers constitute a growing population in many countries and form an indispensable and qualified resource, especially in the context of the labor shortage. Despite work's many benefits for individuals, organizations, and societies, it also presents several risks and challenges that may lead to occupational injuries. Thus, rehabilitation professionals and managers working with this emerging and unique clientele during their return to work after an absence often lack the tools and skills to support them, especially in the changing world of work that includes the rise of telework. Indeed, as an increasingly present work arrangement, telework has the potential to be used as an accommodation modality that can facilitate inclusion and healthy participation in the workplace. However, the implications of this topic for aging workers require study. OBJECTIVE: This paper presents the protocol of a study that aims to develop a reflective telework application guide to support the accommodation, inclusion, and health of aging workers after an absence from work. Specifically, this study will (1) explore the experience of aging workers, managers, and rehabilitation professionals regarding telework and its impact on accommodation, inclusion, and health; (2) use a validated logic model to design a reflective application guide; and (3) test and evaluate the guide. METHODS: Following a 3-phase developmental research design, individual interviews with aging teleworkers, managers, and rehabilitation professionals will enable the collection of qualitative data to be used in generating a logic model of levers and good practices, leading to the creation of a reflective application guide. Validation of this guide by workers and managers to measure its acceptability and applicability in daily life will precede its implementation. RESULTS: Data collection began in spring 2023 and initial results are expected in fall 2023. This study aims to generate a concrete tool-namely, the reflective telework application guide-that rehabilitation professionals could use to support managers and aging workers during their return to work through the healthy use of telework. All phases of the study include conducting dissemination activities to share the results of the project and increase its sustainability potential (ie, publication through social networks, podcasts, conferences, and scientific publications). CONCLUSIONS: As the first of its kind, this project aims to produce innovative impacts at several levels, including practical, scientific, and societal impacts. In addition, the results will provide healthy solutions to the labor shortage in a changing world of work, where digital and teleworking are becoming increasingly important. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/46114.

Impacts and Identification of Hearing Aid Refurbishing Programs for People with Hearing Loss: A Scoping Review.

This article consists of a scoping review completed to describe the impacts of refurbished hearing aids (HAs) for people with hearing loss, and to identify existing HA refurbishing programs around the world. In this review, JBI methodological guidance for scoping reviews was followed. All types of sources of evidence were considered. Thirty-six sources of evidence were included, 11 articles and 25 web pages. Results suggest that refurbished HAs may improve communication and social participation for individuals with hearing loss and provide monetary savings to them and to governmental agencies. Twenty-five HA refurbishing programs were identified, all based in developed countries and distributing refurbished HAs mostly locally, but also in developing countries. Issues related to refurbished HAs were highlighted, such as potential cross-contamination, quick obsolescence, and repairing problems. Some facilitators for the success of this intervention are to offer accessible and affordable follow-up services, repairs, and batteries, and to ensure awareness and participation of hearing healthcare professionals and citizens with hearing loss. In conclusion, the use of refurbished HAs appears to be a valuable option for low-income people with hearing loss, but it should be included in a more global intervention program to ensure its sustainability.

The Influence of Teleworking in a Pandemic Context on the Work Experience of Individuals with Physical Disabilities: A Quebec Qualitative Study.

The COVID-19 pandemic has led to numerous changes in work environments. Thousands of workers quickly found themselves having to telework without being prepared, which had consequences on their work experience and health. Authors proposed telework practices that promote the healthy work experience of workers in a pandemic context, but less attention has been paid to consider the realities and needs of individuals with physical disabilities. Purpose This study aimed to explore the influence of telework during the pandemic on the work experience of people with physical disabilities. Methods Following an interpretive descriptive research design, interviews were conducted with 16 workers with physical disabilities (i.e., motor, or sensory). The data were analyzed using a thematic analysis strategy. Results The results revealed 15 factors that influence the work experience of teleworkers with physical disabilities. These factors are related to interactions between three spheres of the worker's life: the individual, the organization, and the environment. Ten recommendations are proposed to consider the reality and needs of individuals with physical disabilities in the telework practices. Conclusion Given that telework has expanded since the onset of the COVID-19 pandemic and will likely continue to remain a widespread modality of work delivery, it becomes even more important to expand knowledge about it, to benefit the work experience of teleworkers with physical disabilities.

Integrative Prevention at Work: A Concept Analysis and Meta-Narrative Review.

Purpose The purpose of this study was to conceptualize integrative prevention at work and to identify its operational variables to support its application in occupational rehabilitation. Methods Based on Walker and Avant's specifications for concept analysis, we conducted a systematic five-step procedure (i.e., 1-identification of research question, 2-literature search through meta-narrative review, 3-manuscript selection, 4-extraction, 5-analysis). Results Analysis of information extracted from 20 manuscripts across diverse literature fields allowed to identify that the shared attributes of integrative prevention at work are: (a) coordination of the three levels of prevention, (b) integration of health promotion with prevention, (c) shared understanding of the goal, (d) engagement of stakeholders, and (e) variety of actions. The analysis also identified three antecedents and five consequences, situating the concept within the context of a change process. The results include recommendations for promoting the practical application of the concept. Conclusion The results of this study offer an informative, non-prescriptive, and operational definition of integrative prevention at work that all the stakeholders involved, including occupational rehabilitation professionals, can use.

Mobile Videoconferencing for Occupational Therapists' Assessments of Patients' Home Environments Prior to Hospital Discharge: Mixed Methods Feasibility and Comparative Study.

BACKGROUND: Occupational therapists who work in hospitals need to assess patients' home environment in preparation for hospital discharge in order to provide recommendations (eg, technical aids) to support their independence and safety. Home visits increase performance in everyday activities and decrease the risk of falls; however, in some countries, home visits are rarely made prior to hospital discharge due to the cost and time involved. In most cases, occupational therapists rely on an interview with the patient or a caregiver to assess the home. The use of videoconferencing to assess patients' home environments could be an innovative solution to allow better and more appropriate recommendations. OBJECTIVE: The aim of this study was (1) to explore the added value of using mobile videoconferencing compared with standard procedure only and (2) to document the clinical feasibility of using mobile videoconferencing to assess patients' home environments. METHODS: Occupational therapists assessed home environments using, first, the standard procedure (interview), and then, videoconferencing (with the help of a family caregiver located in patients' homes, using an electronic tablet). We used a concurrent mixed methods design. The occupational therapist's responsiveness to telehealth, time spent on assessment, patient's occupational performance and satisfaction, and major events influencing the variables were collected as quantitative data. The perceptions of occupational therapists and family caregivers regarding the added value of using this method and the nature of changes made to recommendations as a result of the videoconference (if any) were collected as qualitative data, using questionnaires and semistructured interviews. RESULTS: Eight triads (6 occupational therapists, 8 patients, and 8 caregivers) participated. The use of mobile videoconferencing generally led occupational therapists to modify the initial intervention plan (produced after the standard interview). Occupational therapists and caregivers perceived benefits in using mobile videoconferencing (eg, the ability to provide real-time comments or feedback), and they also perceived disadvantages (eg, videoconferencing requires additional time and greater availability of caregivers). Some occupational therapists believed that mobile videoconferencing added value to assessments, while others did not. CONCLUSIONS: The use of mobile videoconferencing in the context of hospital discharge planning has raised questions of clinical feasibility. Although mobile videoconferencing provides multiple benefits to hospital discharge, including more appropriate occupational therapist recommendations, time constraints made it more difficult to perceive the added value. However, with smartphone use, interdisciplinary team involvement, and patient participation in the videoconference visit, mobile videoconferencing can become an asset to hospital discharge planning. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/11674.

Usability of a navigation application for travel in Quebec City with wheeled mobility device and, further validation of the Evaluation of satisfaction with geospatial assistive technology.

PURPOSE: Knowledge of route accessibility is indispensable for "wheeled mobility device" users to travel safely and efficiently; however, current navigation technologies hardly provide adapted information for this population. Aims of the study were to collect data on the usability of a navigation application and to propose a version 1.0 of the Evaluation of satisfaction with geospatial assistive technology (ESGAT), by addressing the criterion, construct and cross-cultural validities. METHOD: A filmed field trial and a methodological study were conducted in parallel. Thirty wheeled mobility device users were filmed planning and making a 10-minute known journey using the HERE WeGo app. The ESGAT, ÉSTGA (French version) and the Computer System Usability Questionnaire were administered. A video observation grid addressed the effectiveness and efficiency during the journey. Descriptive, correlation and multiple match analyses were performed. RESULTS: Fourteen men and 16 women averaging 45.9 years old tried out HERE WeGo; 14 were powered wheelchair users. Usability of the app was moderate (good effectiveness, moderate efficiency and quite satisfied). The criterion validity of the ÉSTGA was good (r = 0.598; p < 0.001). The construct validity was average considering the results for factor 1 (α = 0.789, acceptable), factor 2 (α = 0,586, low) and factor 3 (α = 0.409, unacceptable). The cross-cultural validity (French vs English) was moderate (r = 0.861; p < 0.001). CONCLUSION: ESGAT and ÉSTGA 1.0 questionnaires are now available in English and French with a total mean score (11 items), an informatics subscore (mean of 5 items) and a geomatic subscore (mean of 6 items). Their validation should be pursued with new navigation applications. IMPLICATIONS FOR REHABILITATIONClinicians should ask their clients using a wheeled mobility device to test navigation applications to ensure their safety and complete the Evaluation of satisfaction with geospatial assistive technology (ESGAT 1.0), also available in French.Clinicians should inquire about satisfaction for items addressing informatics (Ease of access, Learnability, Hands-free function, Ease of use, Transportability and Appearance) and items addressing geomatic (Content, Geographic information, Effectiveness, Efficiency, Real-time navigation assistance, Aspect of security).Rehabilitation clinicians should inquire about the efficiency of the navigation app, considering avoiding or announcing potential obstacles such as: travelling on the street for a long portion of the trip and not on the sidewalk; verbal indication too soon or too late; incorrect indication; damaged, and congested sidewalk.

Impact of hippotherapy on the life habits of children with disabilities: a systematic review.

PURPOSE: The aim was to document the effects of hippotherapy on the 12 life habits of children with various disabilities. MATERIALS AND METHODS: A systematic review using PRISMA guidelines was conducted to identify relevant studies. Five databases were consulted. Inclusion criteria were: 2-to-18 years old; therapy provided by a PT, OT or SLP/SLT; variables relevant to life habits as defined by the Human Development Model - Disability Creation Process. Quality was analyzed using a quantitative studies critical review form developed by the McMaster University Occupational Therapy Evidence-Based Practice Research Group. Levels of evidence were evaluated using the Oxford Centre for Evidence-Based Medicine guidelines. RESULTS: The investigations' overall quality ratings were excellent (n = 5 studies), acceptable (n = 10) and poor (n = 8); the evidence levels were 2/high (n = 2), 3/moderate (n = 3) and 4/low (n = 18). This systematic review suggests an observable connection between hippotherapy and improvements in three habits (mobility, communication, interpersonal relationships). CONCLUSION: The findings provide support for hippotherapy as a therapy with a positive impact on three categories of life habits. Further research is warranted for education, housing, nutrition, personal care and recreation (only 3 studies), as well as community and spiritual life, employment, physical fitness and psychological well-being and responsibility (no studies). Implications for rehabilitationOccupational, physical and speech language therapists must continue to intervene with children with developmental delays related to various diagnoses as demonstrated by 15 studies involving hippotherapy rated from acceptable to excellent quality.Given improvements, therapists should pursue hippotherapy in mobility, communication, interpersonal relationships, as established specifically by five studies with moderate to high evidence.Given three studies in hippotherapy, therapists are encouraged to document improvement in other life habits such as education, housing, nutrition, personal care and recreation.

Evaluation of satisfaction with geospatial assistive technology (ESGAT): a methodological and usability study.

PURPOSE: Manual wheelchair users are more vulnerable, in situations such as road crossings, hazardous sidewalks or curbs and crossing of buildings and facilities threshold. Geospatial assistive technology (GAT) can help with route planning. However, it is important to ensure the usability of such products, as well as the satisfaction of persons with reduced mobility. The study's aim was (1) to develop and validate a questionnaire on the satisfaction of GAT, in English and French, and to (2) assess satisfaction, efficacy and efficiency of a GAT with manual wheelchair users following a filmed trial in a dense urban area. METHOD: A methodological study was conducted (development of the questionnaire, assessment of its content validity, feasibility and practicability) followed by a trial and post-observations with the videos. Two questionnaires (English, French) were concurrently validated by two groups of experts (n = 8), and then field-tested by wheelchair users (n = 8), using Google Maps Pedestrian routeing tool. RESULTS: The Evaluation of satisfaction with geospatial assistive technology (ESGAT) consists in a user profile and their experience with the technology, followed by 12 satisfaction criteria rated from 1-not satisfied to 5-very satisfied. Both questionnaires were rated as feasible and practicable to complete. The usability of Google Maps Pedestrian routeing tool was measured as "moderate" by manual wheelchairs since the total satisfaction score at the ESGAT was 3.9/5 (quite satisfied). The items with the lowest score were navigation assistance, hands-free function and security. The GAT was effective (87.5% have completed their destination) but not efficient (37.5% needed help).IMPLICATIONS FOR REHABILITATIONFor manual wheelchair users paired with geospatial assistive technology:• A 10 minutes questionnaire was developed and validated to assess their satisfaction after testing aid in an urban area.• Satisfaction criteria to address are ease of access (service), learnability, hands-free function, ease of use for planning as well for navigating, transportability/ appearance, content, geographic information, effectiveness, efficiency, navigation assistance and security• A field test is necessary to ensure the effectiveness of the technology in avoiding or announcing potential obstacles such as sidewalk crossing ramp, damaged and congested sidewalk; sidewalk tilt (side slopes); thresholds at destination; verbal indication too soon or too late; incorrect indication; the arrow does not indicate the right direction; readjustment of the route needed; a lack of indication; and human intervention needed.

Integrated Prevention at Work: Protocol for a Concept Analysis.

BACKGROUND: Integrated prevention at work promises to eliminate the boundaries between primary, secondary, and tertiary prevention actions taken by stakeholders in the world of work. It is receiving increasing attention from the scientific community because of its concerted and harmonized approach, which promotes employment access, return, and healthy long-term continuation. Although promising, integrated prevention is not yet well-defined, which makes it difficult to operationalize. OBJECTIVE: This manuscript exposes the protocol of a study aiming to conceptualize integrated prevention at work on the basis of scientific and experiential knowledge. METHODS: Using a concept analysis research design, data collection has been planned in 2 parts. A meta-narrative literature review will first be conducted to document how integrated prevention has been defined in the literature. Then, phone interviews will be conducted with key informers (ie, managers, workers, ergonomists, occupational therapists, psychologists, physiotherapists, union and insurance representatives) to document their viewpoints and understanding of integrated prevention at work. Qualitative data gathered during these 2 parts of research will be analyzed using template analysis, which allows data from literature and empirical collection to be analyzed simultaneously. The analysis will bring out the points of convergence, divergence, and complementarity between the information gleaned from literature and key informers' experiences to arrive at a conceptualization of integrated prevention at work by identifying its uses, attributes, antecedents, and consequences. As a final step, validation and interpretation with a TRIAGE (Technique for Research of Information by Animation of a Group of Experts) group will be carried out in collaboration with the key informers to identify the tools for the implementation of integrated prevention at work and promote workers' health and safety. RESULTS: This study is expected to offer a contemporary conceptualization of integrated prevention at work that clearly lays out the variables of this concept and elicits the viewpoints of the different stakeholders. CONCLUSIONS: This study will contribute to the advancement of knowledge about the professional injury prevention continuum. The clear identification of the uses, attributes, antecedents, and consequences of integrated prevention at work will offer concrete tools to stakeholders to implement innovative and promising approaches to integrated prevention at work. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/29869.

Impact of the COVID-19 Pandemic on Older Adults: Rapid Review.

BACKGROUND: The COVID-19 pandemic has drastically changed the lives of countless members of the general population. Older adults are known to experience loneliness, age discrimination, and excessive worry. It is therefore reasonable to anticipate that they would experience greater negative outcomes related to the COVID-19 pandemic given their increased isolation and risk for complications than younger adults. OBJECTIVE: This study aims to synthesize the existing research on the impact of the COVID-19 pandemic, and associated isolation and protective measures, on older adults. The secondary objective is to investigate the impact of the COVID-19 pandemic, and associated isolation and protective measures, on older adults with Alzheimer disease and related dementias. METHODS: A rapid review of the published literature was conducted on October 6, 2020, through a search of 6 online databases to synthesize results from published original studies regarding the impact of the COVID-19 pandemic on older adults. The Human Development Model conceptual framework-Disability Creation Process was used to describe and understand interactions between personal factors, environmental factors, and life habits. Methods and results are reported following the Preferred Reporting Items for Systematic Reviews and Meta-analyses Statement. RESULTS: A total of 135 records were included from the initial search strategy of 13,452 individual studies. Of these, 113 (83.7%) studies were determined to be of level 4 according to the levels of evidence classification by the Centre for Evidence-Based Medicine. The presence of psychological symptoms, exacerbation of ageism, and physical deterioration of aged populations were reported in the included studies. Decreased social life and fewer in-person social interactions reported during the COVID-19 pandemic were occasionally associated with reduced quality of life and increased depression. Difficulties accessing services, sleep disturbances, and a reduction of physical activity were also noted. CONCLUSIONS: Our results highlight the need for adequate isolation and protective measures. Older adults represent a heterogeneous group, which could explain the contradictory results found in the literature. Individual, organizational, and institutional strategies should be established to ensure that older adults are able to maintain social contacts, preserve family ties, and maintain the ability to give or receive help during the current pandemic. Future studies should focus on specific consequences and needs of more at-risk older adults to ensure their inclusion, both in public health recommendations and considerations made by policy makers.

Hippotherapy and life habits with children with motor deficit and neurodevelopmental impairment: A pilot survey of parents.

PURPOSE: Hippotherapy is used by rehabilitation professionals to assist children with various diagnoses. Despite parents' pivotal decision-making role regarding their children's life and treatment, little is known about their perceptions of hippotherapy's utility. This pilot study explored parents' opinions regarding hippotherapy's impact on their child's life habits, as guided by the Disability Creation Process model. METHODS: A survey was conducted in September/October 2017 with the parents of children with varied diagnoses receiving hippotherapy in Quebec. The survey asked parents to priority rank life habit categories and then grade hippotherapy's service characteristics and impact on children's life habits. Descriptive analysis and proportion tests were used to analyze the data. RESULTS: The parents of 26 children completed the survey. These children were on average seven years old with multiple diagnoses (e.g., autism spectra, developmental delay). A positive impact was perceived for 10 of 12 life habit categories, with a statistically significant association found with Mobility and Interpersonal relationships. It was not possible to calculate the association between the profession involved and hippotherapy effects due to the small sample size. CONCLUSION: This investigation provides some promising results regarding the benefits of hippotherapy for children's life habits.

Advantages of training with an adaptive driving device on a driving simulator compared to training only on the road.

PURPOSE: To compare the advantages of training on a driving simulator versus on the road, when learning to drive with new assistive technologies (AT) in individuals with motor impairments. METHOD: An experimental group (EXP = 16) that trained on a driving simulator was compared to a comparison group (CMP = 16) that received training only on the road. A post-training road test assessed driving performance. Analysis included proportion of participants who successfully completed the on-road driving test, number of training sessions, level of satisfaction, simulator sickness, advantages and discomforts. RESULTS: EXP and CMP were comparable for age (48 ± 17 years), sex (13 M, 3 F), and AT (3 steering wheel knobs with integrated switches, 4 left accelerators, 9 hand controls and steering wheel knobs). No significant difference was observed between groups in the proportion of participants who were found to be fit to drive (EXP: 9/16; CMP: 13/16; p = 0.126) or in the number of sessions completed (EXP: 4.3; CMP: 3.2; p = 0.061). For 6 of the 9 satisfaction variables, participants reported being satisfied/very satisfied with training on a simulator with driving assistive technologies 76% to 100% of the time. EXP was satisfied to have been able to use simulator sessions before going on the road (100%). Participants determined to be fit to drive on an on-road test following simulator training showed no significant difficulty continuing with the training. EXP reported temporary discomfort on the simulator during the initial session (88%). CONCLUSION: Simulators provide some advantages for training drivers with adaptive aids in a safe context.IMPLICATIONS FOR REHABILITATIONAmong individuals with motor impairments who used to drive: All participants reported a high level of satisfaction training on the simulator with assistive technologies.The simulator proved to be an interesting tool for initiating training with new driving AT in a safe environment at no cost to individuals.The few discomforts reported during the first session resolved over time when participants continued with the driving simulator protocol.Occupational therapists noticed that the difficulties observed on the simulator were the same as those observed during on-road testing.The simulator allowed participants to begin to learn how to operate a vehicle with new assistive technology in a safe context.

Self-Selection of Bathroom-Assistive Technology: Development of an Electronic Decision Support System (Hygiene 2.0).

BACKGROUND: A clinical algorithm (Algo) in paper form is used in Quebec, Canada, to allow health care workers other than occupational therapists (OTs) to make bathroom adaptation recommendations for older adults. An integrated knowledge transfer process around Algo suggested an electronic version of this decision support system (electronic decision support system [e-DSS]) to be used by older adults and their caregivers in search of information and solutions for their autonomy and safety in the bathroom. OBJECTIVE: This study aims to (1) create an e-DSS for the self-selection of bathroom-assistive technology by community-dwelling older adults and their caregivers and (2) assess usability with lay users and experts to improve the design accordingly. METHODS: On the basis of a user-centered design approach, the process started with content identification for the prototype through 7 semistructured interviews with key informants of various backgrounds (health care providers, assistive technology providers, and community services) and 4 focus groups (2 with older adults and 2 with caregivers). A thematic content transcript analysis was carried out and used during the creation of the prototype. The prototype was refined iteratively using think-aloud and observation methods with a clinical expert (n=1), researchers (n=3), OTs (n=3), older adults (n=3), and caregivers (n=3), who provided information on the usability of the e-DSS. RESULTS: Overall, 4 themes served as the criteria for the prototype of the electronic Algo (Hygiene 2.0 [H2.0]): focus (safety, confidentiality, well-being, and autonomy), engage, facilitate (simplify, clarify, and illustrate), and access. For example, users first pay attention to the images (engage and illustrate) that can be used to depict safe postures (safety), illustrate questions embedded in the decision support tool (clarify and illustrate), and demonstrate the context of the use of assistive technology (safety and clarify). CONCLUSIONS: The user-centered design of H2.0 allowed the cocreation of an e-DSS in the form of a website, in line with the needs of community-dwelling older adults and their caregivers seeking bathroom-assistive technology that enables personal hygiene. Each iteration improved usability and brought more insight into the users' realities, tailoring the e-DSS to the implementation context.

Parkinsonian Symptoms, Not Dyskinesia, Negatively Affect Active Life Participation of Dyskinetic Patients with Parkinson's Disease.

Background: The impact of slight-to-moderate levodopa-induced dyskinesia (LID) on the level of participation in active life in patients with Parkinson's disease (PD) has never been objectively determined. Methods: Levels of LID, tremor and bradykinesia were measured during best-ON state in 121 patients diagnosed with PD and having peak-dose LID using inertial sensors positioned on each body limb. Rigidity and postural instability were assessed using clinical evaluations. Cognition and depression were assessed using the MMSE and the GDS-15. Participation in active life was assessed in patients and in 69 healthy controls using the Activity Card Sort (ACS), which measures levels of activity engagement and activities affected by the symptomatology. Outcome measures were compared between patients and controls using ANCOVA, controlling for age or Wilcoxon-Mann-Whitney tests. Spearman correlations and multivariate analyses were then performed between symptomatology and ACS scores. Results: Patients had significantly lower activity engagement than controls and had significantly affected activities. LID was neither associated with activity engagement nor affected activities. Higher levels of tremor, postural instability, cognitive decline and depression were associated with lower activity engagement and higher affected activities. Multivariate analyses revealed that only tremor, postural instability and depression accounted significantly in the variances of these variables. Discussion: Slight-to-moderate LID had little impact compared to other symptoms on the level of participation in active life, suggesting that other symptoms should remain the treatment priority to maintain the level of participation of patients in an active lifestyle.