Quantifying Mobility Scooter Performance in Winter Environments.

OBJECTIVES: To quantify mobility scooter performance when traversing snow, ice, and concrete in cold temperatures and to explore possible performance improvements with scooter winter tires. DESIGN: Cross-sectional. SETTING: Hospital-based research institute. PARTICIPANTS: Two drivers (50 and 100 kg) tested 8 scooter models (N=8). Two mobility scooters were used for winter tire testing. INTERVENTIONS: Scooters were tested on 3 different conditions in a random sequence (concrete, 2.5-cm depth snow, bare ice). Ramp ascent and descent, as well as right-angle cornering up to a maximum of 10° slopes on winter conditions, were observed. Winter tire testing used the same slopes with 2 scooters on bare and melting ice surfaces. MAIN OUTCOME MEASURES: Maximum achievable angle (MAA) and tire traction loss for ramp ascent and descent performance. The ability to steer around a corner on the ramp. RESULTS: All scooters underperformed in winter conditions, specifically when traversing snow- and ice-covered slopes (χ2 [2, N=8]=13.87-15.55, P<.001) and corners (χ2 [2, N=8]=12.25, P<.01). Half of the scooters we tested were unable to climb a 1:12 grade (4.8°) snow-covered slope without losing traction. All but 1 failed to ascend an ice-covered 1:12 grade (4.8°) slope. Performance was even more unsatisfactory for the forward downslopes on both snow and ice. Winter tires enhanced the MAA, permitting 1:12 (4.8°) slope ascent on ice. CONCLUSIONS: Mobility scooters need to be designed with winter months in mind. Our findings showed that Americans with Disabilities Act-compliant built environments, such as curb ramps that conform to a 1:12 (4.8°) slope, become treacherous or impassible to mobility scooter users when covered in ice or snow. Scooter manufacturers should consider providing winter tires as optional accessories in regions that experience ice and snow accumulation. Additional testing/standards need to be established to evaluate winter mobility scooter performance further.

Usability Evaluation of a Novel Robotic Power Wheelchair for Indoor and Outdoor Navigation.

OBJECTIVE: To compare the Mobility Enhancement roBotic (MEBot) wheelchair's capabilities with commercial electric-powered wheelchairs (EPWs) by performing a systematic usability evaluation. DESIGN: Usability in effectiveness, efficacy, and satisfaction was evaluated using quantitative measures. A semistructured interview was employed to gather feedback about the users' interaction with MEBot. SETTING: Laboratory testing of EPW driving performance with 2 devices in a controlled setting simulating common EPW driving tasks. PARTICIPANTS: A convenience sample of expert EPW users (N=12; 9 men, 3 women) with an average age of 54.7±10.9 years and 16.3± 8.1 years of EPW driving experience. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Powered mobility clinical driving assessment (PMCDA), Satisfaction Questionnaire, National Aeronautics and Space Administration's Task Load Index. RESULTS: Participants were able to perform significantly higher number of tasks (P=.004), with significantly higher scores in both the adequacy-efficacy (P=.005) and the safety (P=.005) domains of the PMCDA while using MEBot over curbs and cross-slopes. However, participants reported significantly higher mental demand (P=.005) while using MEBot to navigate curbs and cross-slopes due to MEBot's complexity to perform its mobility applications which increased user's cognitive demands. CONCLUSIONS: Overall, this usability evaluation demonstrated that MEBot is a promising EPW device to use indoors and outdoors with architectural barriers such as curbs and cross-slopes. Current design limitations were highlighted with recommendations for further improvement.

Getting a Manual Wheelchair Over a Threshold Using the Momentum Method: A Descriptive Study of Common Errors.

OBJECTIVES: To (1) document the success of learners' attempts to overcome a threshold in a manual wheelchair while using the momentum method; (2) describe the frequency and nature of any errors observed; and (3) compare the characteristics of participants who were or were not successful on their first attempts. DESIGN: Cross-sectional, observational study following Strengthening the Reporting of Observational Studies in Epidemiology guidelines. SETTING: Indoor obstacle course in a rehabilitation center. PARTICIPANTS: Able-bodied students (N=214) learning the threshold skill. INTERVENTION: Participants attempted to get over the Wheelchair Skills Test (WST) threshold (2cm high, 1.5m wide, and 10cm in the line of progression) in a manual wheelchair. MAIN OUTCOME MEASURES: From each participant's video recording of the first attempt, we assigned a WST score for the skill and described any errors noted. RESULTS: The WST scores for the first attempts were "pass" for 16 (7.5%), "pass with difficulty" for 100 (46.7%), and "fail" for 98 (45.8%). Eventually, requiring up to 6 attempts, 203 participants (94.9%) were successful (pass or pass with difficulty). Twenty-six different error types were identified. With the use of logistic regression analysis, the odds ratio of failing on the first attempt for women versus men was 2.71 (95% confidence interval, 1.23-6.00) (P=.0138). CONCLUSIONS: Only about half of able-bodied people learning the threshold skill using the momentum method are successful on their first attempts, although almost all are successful with further practice and feedback. During the first attempts, there are a wide variety of errors, primarily in the popping phase of the skill. Those who are successful on their first attempts are more likely to be men. These findings have implications for the assessment and training of the threshold skill.

Needs for mobility devices, home modifications and personal assistance among Canadians with disabilities.

BACKGROUND: People with disabilities often require assistive devices, modifications to their home environment, and physical assistance to facilitate mobility. This study examines self-reported met and unmet needs of people with disabilities who use wheeled mobility devices, compared with non-users. DATA AND METHODS: The 2012 Canadian Survey on Disability followed up with 45,442 individuals who reported a disability on the 2011 National Household Survey, and obtained a 75% response rate. Descriptive statistics with variance estimates and 95% confidence intervals were used to compare wheeled mobility device users and non-users. RESULTS: Nearly 10% of wheeled mobility device users identified an unmet need for an additional mobility device. Compared with non-users, they were twice as likely to modify their home with a ramp and three times as likely to install a lift. The prevalence of unmet need for each type of residence adaptation among wheeled mobility device users was at least double that of non-users. Wheeled mobility device users received assistance with an average of 4.4 activities, compared with 2.0 for non-users, and reported an average of 1.9 activities for which assistance was needed but not received. About one in three relied on paid assistance; for 14% of those who paid for assistance, out-of-pocket expenses amounted to $10,000 or more annually, compared with 2% among non-users. INTERPRETATION: Wheeled mobility device users reported a higher prevalence of met and unmet needs for residence modifications than did non-users. They required help with more activities of life on a more frequent basis, with greater dependence on paid individuals, resulting in higher out-of-pocket expenses. Power and manual wheelchair users reported greater needs than did mobility scooter users.

Social Isolation and Physical Barriers in the Houses of Stroke Survivors in Rural China.

OBJECTIVE: To describe the home barriers and social isolation of stroke survivors in the rural areas of China and to explore which home barriers are associated with social isolation. DESIGN: Cross-sectional survey. SETTING: Structured interviews and observation in the participants' homes. PARTICIPANTS: Community-dwelling stroke survivors in the rural areas of China (N=818). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Physical barriers in rural homes were surveyed using a home fall hazards assessment. Social isolation was identified if ≥2 of the following indicators were observed: low frequency of getting out of the home, lacking leisure activities, and living alone in the previous 3 months. RESULTS: The prevalence rates of 18 among 30 home barriers were >20%, and the highest was 93% (lack of handrails in the bathroom). The prevalence of social isolation was 30%. Three home barriers were independently related to social isolation. These were a distant toilet (odds ratio [OR], 2.363; 95% confidence interval [CI], 1.527-3.658; P<.001), unsuitable seating (OR, 1.571; 95% CI, 1.026-2.404; P=.038), and inaccessible light switches (OR, 1.572; 95% CI, 1.064-2.324; P=.023). CONCLUSIONS: Many barriers exist in the houses of stroke survivors in rural China. Some of them are related to social isolation. Eliminating or decreasing home barriers could be a feasible and effective approach to reducing social isolation.

Ramp-related incidents involving wheeled mobility device users during transit bus boarding/alighting.

OBJECTIVES: To estimate the prevalence of wheeled mobility device (WhMD) ramp-related incidents while boarding/alighting a public transit bus and to determine whether the frequency of incidents is less when the ramp slope meets the proposed Americans with Disabilities Act (ADA) maximum allowable limit of ≤9.5°. DESIGN: Observational study. SETTING: Community public transportation. PARTICIPANTS: WhMD users (N=414) accessing a public transit bus equipped with an instrumented ramp. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Prevalence of boarding/alighting incidents involving WhMD users and associated ramp slopes; factors affecting incidents. RESULTS: A total of 4.6% (n=35) of WhMD users experienced an incident while boarding/alighting a transit bus. Significantly more incidents occurred during boarding (6.3%, n=26) than during alighting (2.2%, n=9) (P<.01), and when the ramp was deployed to street level (mean slope=11.4°) compared with sidewalk level (mean slope=4.2°) (P=.01). The odds ratio for experiencing an incident when the ramp slope exceeded the proposed ADA maximum allowable ramp slope was 5.4 (95% confidence interval, 2.4-12.2; P<.01). The odds ratio for assistance being rendered to board/alight when the ramp slope exceeded the proposed ADA maximum allowable ramp slope was 5.1 (95% confidence interval, 2.9-9.0; P<.01). CONCLUSIONS: The findings of this study support the proposed ADA maximum allowable ramp slope of 9.5°. Ramp slopes >9.5° and ramps deployed to street level are associated with a higher frequency of incidents and provision of assistance. Transit agencies should increase awareness among bus operators of the effect kneeling and deployment location (street/sidewalk) have on the ramp slope. In addition, ramp components and the built environment may contribute to incidents. When prescribing WhMDs, skills training must include ascending/descending ramps at slopes encountered during boarding/alighting to ensure safe and independent access to public transit buses.

Design for All - Design for Disabled: How important is anthropometry?

BACKGROUND: Design for All or Universal Design is a relatively new domain in Ergonomics. With globally ageing populations, it has however recently gained significant interest. OBJECTIVE: This position paper summarizes the outcomes of a workshop held at the virtual 21st Triennial Congress of the International Ergonomics Association. The paper expands the horizon of traditional Ergonomics into a domain where people are differently abled and establishes a platform for the essential needs of future ergonomic standards which are required to inform inclusive design guidelines, or Design for All, extending the range of users. METHODS: The paper includes contributions from Asian, Australian, European and US workshop participants who are accessibility design experts in their respective geographic regions. The paper summarizes issues related to anthropometry in the Design for All, based on recent work in the US (Access board) and actual developments in various national and international accessibility standardization bodies, such as the Standards Australia/Standards New Zealand, the European Standardization Organization (EN 17210:2021; EN 17161:2019) and the International Organization for Standardization (ISO 21542:2021 and BS ISO 7176-5:2008). CONCLUSIONS: The paper concludes that despite the identification of a significant gap in knowledge of the anthropometry of people with disabilities as far back as 1990, work towards bridging the gap and enabling ergonomic standardization has not progressed since then globally. The lack of standardization in anthropometric data on people with a physical disability continues to complicate provision of data for mobility and accessibility design and hampers accessibility standardization efforts.

Physical and Environmental Barriers to Mobility and Participation in Children With Medical Complexity: A Qualitative Study.

This qualitative study evaluated barriers and facilitators to mobility in the homes of children with medical complexity (CMC) and the subsequent impact on CMC and their families. Eighteen caregivers of CMC were interviewed. Parents described that accessibility barriers impaired delivery of care at home and impacted the child's participation in family life. The most inaccessible areas were stairs and bathrooms. Mobility and transfers became more difficult as children grew larger. Parents and children sustained injuries from performance of activities of daily living (ADLs). When available, durable medical equipment (DME) and home modifications improved home access and typically were funded using insurance and state Title V funds. However, parents reported that larger home modifications, such as bathroom modifications, were cost prohibitive. A pediatrician's inquiry about mobility barriers may reveal crucial information about delivery of home care to CMC. CMC may be referred to rehabilitation specialists to address mobility needs.

Challenges related to self-assessment of active ageing during the Covid-19 pandemic in Sweden.

OBJECTIVE: The aim is to describe and reflect upon potentially pandemic-related impact on self-assessments of active ageing. As part of the baseline data collection in the Prospective RELOC-AGE (ClinicalTrials.gov NCT04765696) study, telephone interviews, including the University of Jyvaskyla Active Aging Scale (UJACAS) were conducted with 820 people 55 years or older listed with an interest of relocation at three housing companies in Sweden. Field notes alongside the interviews focused on two topics: (1) how respondents reasoned and replied to the questions included in the UJACAS; (2) whether there were specific items that seemed to be affected by the pandemic. RESULTS: For four items (Participating in events, Exercising, Maintaining friendships, Getting to know new people), recurrent comments indicated that respondents had been affected by the pandemic situation regarding one or more of the facets in UJACAS: will to act, ability to act, opportunity to act, or frequency or extent of doing the activity. Opportunities to act was most frequently commented on as a factor affected by restricted participation in activities. As Prospective RELOC-AGE is a longitudinal study focused on associations between housing, relocation and active ageing, it is imperative to consider the potential pandemic-related impact on baseline data in future analyses.

A Social-Ecological Approach to Identify Facilitators and Barriers of Home Modifications.

Aging individuals may face difficulty with independently navigating and interacting with their home environment. Evidence-based interventions promoting home modifications are needed to support aging-in-place across the lifespan. This study identified the facilitators and barriers to implementing home modifications from the perspectives of residents and professionals (N = 16). Guided by a social-ecological model, researchers utilized directed content analysis of focus group interviews. While participants discussed facilitators and barriers mainly on the individual level, factors were presented at the relationship, community, and societal level of the model. Overall, the findings suggest a potential for targeted interventions on all levels of the model to promote adoption of home modifications.

Disability inclusion in higher education: knowledge and perceptions of the academic community.

OBJECTIVE: To study the awareness and knowledge of members of the academic community and their perceptions related to accessibility in higher education institutions (HEI). METHODS: This is a descriptive, exploratory study. A total of 500 participants from the academic community, including students, professors, and technical-administrative personnel, were invited to respond to a semi-structured questionnaire regarding concepts and information related to people with disabilities and/or reduced mobility, assistive technology, and the broad concepts of accessibility. RESULTS: The participants ranged from 18 to 71 years of age, and there were higher prevalences of females (79.4%), singles (72.2%), and graduate students (73.6%). Based on the questionnaire responses, most participants felt capable of explaining issues regarding accessibility and persons with disabilities/reduced mobility; however, the principles of assistive technology remained relatively unknown. CONCLUSION: Participants were reasonably informed about persons with disabilities, those with reduced mobility, and accessibility concerns; however, the majority could not explain the key elements of assistive technology. This suggests that additional training and disability awareness programmes are necessary.Implications for RehabilitationThe access to the higher education, through the assistive technology resources enables the inclusion and participation of people with disabilities in academic activities.Teacher training is primordial to providing quality and equitable education.The lack of knowledge on this matter can be a barrier to access for rehabilitation, advances in assistive technology, inclusive education and the public policies from people with disabilities.

Home Modification Assessments for Accessibility and Aesthetics: A Rapid Review.

PURPOSE: The purpose of this study was to identify assessments used to evaluate the homes of people with disabilities in terms of accessibility, usability, activities, comfort/satisfaction, and aesthetics. BACKGROUND: The home is increasingly becoming an environment for healthcare as more people desire to age in place. Research indicates home environmental modifications to be beneficial to promote a better person-environment fit, especially when using a standardized assessment approach. There is not a comprehensive list of assessments that address home modifications, adaptations, or interior designs for people with disabilities. METHOD: Researchers conducted a rapid review of articles, with data collection scales, instruments, and procedures for home modifications published between 2000 and 2017. RESULTS: A total of 26 articles met the inclusion criteria, resulting in the identification of 33 distinct assessments, including 18 assessments evaluating the accessibility of home modifications, 3 assessments examining usability, 15 assessments addressing activities of daily living or functional activities, and 5 assessments addressing comfort and/or satisfaction. No assessments for aesthetics were located. CONCLUSION: Researchers developed a list of assessments that could be used for research or practice. Further research is needed to address the lack of assessments focusing on the aesthetics or attractiveness of home modifications, as well as more assessments tailored to specific diagnoses and population groups.

Mapping review of accessible pedestrian infrastructures for individuals with physical disabilities.

BACKGROUND: Due to the ageing population and higher prevalence of individuals living with physical disabilities, there is a critical need for inclusive practices when designing accessible pedestrian infrastructures for ensuring social participation and equal opportunities. PURPOSE: Summarize the physical characteristics of current pedestrian infrastructure design for individuals with physical disabilities (IPD - motor, visual and hearing) found in the scientific literature and assess its quality. MATERIALS AND METHODS: A mapping review of the existing literature on pedestrian infrastructures specifically built for individuals with physical disabilities identifying measurable physical characteristics for their design was done using online databases (Urban Studies Abstracts, Geobase, PubMed, and Cairn and secondary research). Information about accessibility (physical characteristics) of existing pedestrian infrastructures was extracted. The quality of the evidence was assessed using the Guidelines for critical review form - Quantitative studies and Qualitative studies version 2.0 (SAGE Publications, Inc., Thousand Oaks, CA). RESULTS: Of the 1131 articles identified, forty-one articles examined access to bus stops, curb ramps, lighting, pedestrian crossings, ramps, shared spaces, sidewalks and steps. Six articles reported on more than one physical disability. Quality scores were generally low (quantitative: 2-11/15 and qualitative: 1-22/23). Recommended design features differed for the same infrastructure. CONCLUSIONS: While there were a fair number of articles (n = 41) documenting accessible design features of pedestrian infrastructures, the quality of the evidence was low. The review identified knowledge gaps. Although specific design solutions exist, they have not yet been tested among individuals with various or multiple types of physical disabilities to ensure access to pedestrian infrastructures by all. Implications for Rehabilitation Pedestrian infrastructures still pose problems to mobility, limiting social participation and quality of life outcomes for individuals with physical disabilities (motor, visual and hearing). The results of this mapping review show that few articles are concerned with the accessibility of pedestrian infrastructures for more than one type physical disability, which might lead to recommendations that are inadequate for individuals with differing disabilities, few recommendations have been compared, most studies have been performed in environments not representative of northern countries and their quality score was generally low. Health professionals and State Parties have a complementary expertise that should be put to use in the determination and implementation of best design solutions to ensure the respect of the needs of individuals with physical disabilities. This review can thus help them have an idea of what has already been done to identify what needs to be achieved to fill the gap of knowledge required to insure access for individuals with motor, visual as well as hearing disabilities. Rehabilitation profesionals should take part in the assessment of the proposed solutions as well as the development of new designs to fill knowledge gaps.

Accessibility information in New Delhi for "EasenAccess" Android-based app for persons with disability: an observational study.

Background: The World Health Organization and the World Bank's "World Report on Disability" reported that over 1 billion people have various kinds of disability worldwide while Indian Census 2011 reported about 26 million in India. The United Nations Convention states, "The Rights of Persons with Disabilities (PwD) include accessibility to Information, Transportation, Environment, Communication Technology and Services". Objective: This article takes forward the reason of making the "EasenAccess" (EnA) Android-based app to empower PwD with wheelchair-accessibility information, communication sentences and sending SOS signals with location. Methods: A survey of 25 most frequented places in New Delhi by common people and tourist with chosen 12 parameters in comparison the Government of India's survey of 100 most important buildings nationally. Results: A statistical analysis and recommendations about areas for improvement, for the Government of India. Conclusions: EasenAccess helps millions of PwD to enable them with freedom of movement for employment and socio-economic activities to lead an independent lifestyle. EasenAccess increases government's access to information about lacunae, gives them an easy way to tabulate the places where more accessibility needs updating, and helps the government in facilitating information flow to the PwD. Implication for Rehabilitation The Rights of Persons with Disability Act in 2016 covers both the concepts of Universal Design of products, environments and programs; and accessibility. We are exploring with them the ways technology can help bridge the gap between rehabilitation and accessibility. In the higher income countries such as the UK or USA, it is normal for a person to receive training when being given a wheelchair to prevent future injuries. Frequently, even with this, training people develop upper limb injuries, due in part to the high, repetitive loads needed to push a wheelchair. This training is given as part of a package of rehabilitation, which also normally includes adaptations to people's living environments, which will enable them to use their wheelchair indoors. In Accessible Routes from Crowd-based Cloud Services (ARCCS) many NGOs have been able to develop sensors, which are themselves part of the Internet of Things, which when attached to a mobility device extend the ability of that device. Users can interact with the sensor data on their mobile phone via an app. They can also add geo-tagged photo or voice notes to annotate their journey. These can then be shared with other users of the ARCCS system. The system has been developed with a range of wheelchair users and other stakeholders. For example, one such initiative by the Government of India is called "Street Rehab". The aim of Street Rehab is to co-develop a new system for delivering a service for wheelchair users, which puts everyday activities at the heart of the rehabilitation process. To do this, a clear understanding of user needs, available technology and the accessibility of the city are all required. The first step is to understand the current accessibility of Delhi, the next to map this with the rehabilitation and livelihoods requirements of the wheelchair and tricycle users. This approach has led to the development of novel sensors and a data processing chain, which can automatically identify features of the sidewalk or surface, for example, drop curb, camber, and rough terrain. These classifications are then used to help with increasing localization of the person. In addition, the sensors can be used to identify how the pushing techniques of people, who self-propel their wheelchair. They have developed these sensors, as mobile phones alone, while useful if secured in a fixed position, are not adequate when loosely placed in bags or pockets. The aim is to find practical solutions for those who use mobility aids in India to access the services and places they wish to without risk of injury. Injuries can occur due to toppling out of a mobility device, being hit by a vehicle or developing an injury over time due to the demand of pushing/cycling the mobility device. EasenAccess can be a synergistic platform for all such future community based rehabilitation approaches. It can also help compile and collate data for accessibility gaps and rehabilitation issues encountered. EasenAccess app can thus help create an emerging framework, which puts the experience of the wheelchair user at the center but with a clear connection to people who can implement policy change on a broad scale.One that includes local people who will be advocates for creation of accessible maps, and local NGOs to provide hubs of training. These can be linked to a series of YouTube videos and supported via a messaging service, for example, local WhatsApp groups or social media groups, for example, a Facebook Page. With infinite possibilities, as illustrated above, EasenAccess app can create a new technological paradigm for convergence of Accessibility and Rehabilitation.

The perception of people with physical disabilities about exercising autonomy in a federal university / La percepción de personas con discapacidades físicas con respecto al ejercicio de la autonomía en una universidad federal / Percepção de pessoas com deficiência física acerca do exercício da autonomia em uma universidade federal

ABSTRACT Introduction: preconceptions towards people with disabilities are still present in our society; they arise from ancient behaviors and from the biomedical model, both rooted in human attitudes. Objective: to describe the potentialities/strengths and inabilities/weaknesses faced by people with disabilities to exercise their autonomy and to show the ways in which people with disabilities exercise their autonomy. Method: this is a single-case study with a qualitative approach. Twenty-two individuals with physical disabilities were interviewed, with students and employees from a university in southern Brazil among them. Data analysis was performed by means of the Collective Subject Discourse The comprehensive and interpretive analysis of the meanings that emerged from the participants' statements were associated with the theoretical framework of autonomy by Adela Cortina, Diego Gracia and Lawrence Kohlberg. Results: potentialities/weaknesses can be observed in the exchange spaces and in the information provided by the university. At the same time, inability/weakness is perceived in preconception, welfarism and all the ableism faced by people with disabilities. Conclusions: lack of information is one of the main elements that foster preconception and it is essential to fight against it for the inclusion of people with disabilities.

RESUMEN Introducción: en nuestra sociedad, todavía pueden encontrarse preconceptos con respecto a las personas con discapacidades que derivan de comportamientos de la antigüedad y del modelo biomédico y que están arraigados en las actitudes humanas. Objetivo: describir las potencialidades/fortalezas y las inhabilidades/debilidades afrontadas por las personas con discapacidades para ejercer su autonomía y demonstrar las formas en las que pueden hacerlo. Método: estudio de caso único y con enfoque cualitativo. Se entrevistó a un total de 22 personas con discapacidades, entre ellas, alumnos y empleados de una universidad del sur de Brasil. El análisis de los datos se realizó por medio del Discurso del Sujeto Colectivo. El análisis integral e interpretativo de los significados que emergieron de los testimonios de los participantes se asoció al referencial teórico de autonomía de Adela Cortina, Diego Gracia y Lawrence Kohlberg. Resultados: pueden observarse potencialidades/fortalezas en los espacios de intercambio y en la información que proporciona la Universidad. A la vez que la inhabilidad/debilidad se percibe en el preconcepto, el asistencialismo y en la totalidad del capacitismo al que hacen frente las personas con discapacidades. Conclusiones: la falta de información es uno de los principales elementos que fomentan el preconcepto y es esencial combatirla para la efectiva inclusión de las personas con discapacidades.

RESUMO Introdução: preconceitos com a pessoa com deficiência ainda estão presentes em nossa sociedade, esses são advindos de condutas da antiguidade e do modelo biomédico que estão arraigados nas atitudes humanas. Objetivo: descrever as potencialidades/fortalezas e inabilidades/fragilidades enfrentadas pelas pessoas com deficiência para o exercício da sua autonomia e demonstrar os modos pelos quais as pessoas com deficiência exercem a sua autonomia. Método: trata-se de um estudo de caso único e de abordagem qualitativa. Foram entrevistadas vinte e duas pessoas com deficiência física, dentre elas, alunos e servidores de uma universidade do Sul do Brasil. A análise de dados foi realizada por meio do Discurso do Sujeito Coletivo. A análise compreensiva e interpretativa dos significados emergidos das falas dos participantes foram associadas ao referencial teórico da autonomia de Adela Cortina, Diego Gracia e Lawrence Kohlberg. Resultados: as potencialidades/fortalezas podem ser observadas nos espaços de trocas e informação proporcionados pela universidade. Ao mesmo tempo que a inabilidade/fragilidade é percebida no preconceito, assistencialismo e todo o capacitismo enfrentado pelas pessoas com deficiência. Conclusão: a falta de informação é um dos principais fomentadores do preconceito e combatê-lo é essencial para a inclusão das pessoas com deficiência.

Inclusive design in architectural practice: Experiential learning of disability in architectural education.

BACKGROUND: The built environment can facilitate or impede an individual's ability to participate in society. This is particularly so for people with disability. Architects are well placed to be advocates for design that enhances societal equality. OBJECTIVE: This qualitative study explored architectural design students' perceptions of inclusive design, their reflections resulting from an experiential learning module and the subsequent influence of these on their design practice. METHODS: Twenty four architectural design students participated in focus groups or individual interviews. Data were analyzed thematically. RESULTS: Three themes were evident: 1) Inclusive design was perceived as challenging, 2) Appreciation for the opportunity to learn about the perspectives of people with disabilities, and 3) Change of attitude toward inclusive design. Experiential learning had fostered reflection, changes in attitude and the realization that inclusive design, should begin at the start of the design process. CONCLUSIONS: For equitable access for all people to become reality, experiential learning, coupled with positive examples of inclusive design should be embedded in architectural education.

The accessibility of fitness centers for people with disabilities: A systematic review.

BACKGROUND: Fitness centers could be ideal places for people with disabilities to engage in the recommended levels of physical activity for healthy well-being. However, one of the primary barriers to participation at fitness centers is an inaccessible built environment. OBJECTIVE: This review study aimed to evaluate the accessibility of public indoor fitness centers for people with disabilities. METHODS: We searched electronic databases and web based search engines using keywords and synonyms for fitness centers, people with disability and accessibility. Observational studies that used standardized measures to evaluate fitness centers were included and critically appraised using a modified version of the checklist for randomized and non-randomized studies developed by Downs and Black. We analyzed the data descriptively. This systematic review protocol is registered in PROSPERO (ID:CRD42016043945). RESULTS: A total of 533 fitness centers were evaluated for accessibility across 14 studies. Ten (85%) of the 14 studies were undertaken in the United States of America. Instruments (n = 2) used to evaluate fitness centers were based on the Americans with Disabilities Act compliance legislation and measured domains of physical access (e.g., bathrooms, equipment, parking) and system access (e.g., policies, programs, professional behavior). We calculated weighted percentage mean scores per accessibility domain. The least accessible domain was "hot tubs/whirlpools/saunas/steam rooms" at 33%, with "programs" being the most accessible domain at 68%. CONCLUSIONS: Fitness center accessibility for people with disabilities remains poor. Adopting the principles of universal design in legislation would achieve equitable access for all, thereby allowing people with disabilities to participate actively in their communities with dignity and autonomy.

Análise da acessibilidade e a percepção de pessoas com deficiência em embarcações / Analysis of accessibility and perception of people with disabilities in vessels

Resumo Introdução A Ilha de Marajó, no Estado do Pará, é composta por 16 municípios. Cerca de 20,3% de sua população apresenta algum tipo de deficiência e o principal meio para a saída e chegada da ilha é o transporte aquaviário. Objetivo Analisar a acessibilidade em embarcações que transladam dos municípios da Ilha de Marajó para a capital do Estado. Método Pesquisa quantiqualitativa, descritiva e exploratória com a participação de 23 pessoas com deficiência física e/ou sensorial. Dez embarcações foram analisadas. O estudo está dividido em duas etapas: análise da percepção das pessoas com deficiência por meio de entrevista semiestruturada e análise da acessibilidade das embarcações com uso de checklist baseado na norma NBR 15450:2006. Resultados A maioria dos participantes não considerou as embarcações acessíveis e encontra dificuldades para acessá-las e permanecer nelas. A análise das embarcações mostrou que as médias de conformidade com as normas nos espaços avaliados foram inferiores a 50%. Conclusão Há concordância entre as dificuldades apontadas pelos participantes e a não aplicação da norma NBR 15450:2006, indicando que a ausência da acessibilidade limita o acesso e a mobilidade de indivíduos com deficiência que utilizam os transportes aquaviários na região da Ilha de Marajó. Habitantes da ilha de Marajó (marajoaras) que apresentam deficiência física e/ou sensorial podem ser privados do direito básico de ir e vir, enfrentando barreiras em sua autonomia e independência com relação à mobilidade e outras ocupações que dela dependem.

Abstract Introduction Marajó Island, located in the State of Pará, Brazil, is composed of 16 municipalities. Approximately 20.3% of its population has some type of disability, and the main means of transport to and from the island are vessels. Objective To analyze the accessibility in the vessels used to transport people from the municipalities of Marajó Island to the state capital. Method This is a quantitative-qualitative, descriptive and exploratory research conducted with 23 people with physical and/or sensory disabilities. Ten vessels were assessed. The study is divided into two stages: analysis of the perception of people with disabilities using a semi-structured interview, and analysis of vessel accessibility using a checklist based on the NBR 15450:2006 standard. Results Most participants did not consider the vessels accessible and found difficulties in accessing and remaining on them. The analysis of the vessels showed that the averages of compliance with the norms in the evaluated spaces were <50%. Conclusion There is agreement between the difficulties pointed out by the participants regarding the non-application of the NBR 15450:2006 standard, indicating that the lack of accessibility limits the access and mobility of individuals with disabilities who use water transportation in the Marajó Island region. Residents of Marajó Island with physical and/or sensory disabilities may be deprived of their basic right to come and go, facing barriers in their autonomy and independence regarding mobility and other occupations that depend on it.

Availability and need of home adaptations for personal mobility among individuals with spinal cord injury.

OBJECTIVE: To identify the availability and unmet need of home adaptations (HAs) among the Swiss population with spinal cord injury (SCI). DESIGN: Cross-sectional study. SETTING: Swiss Spinal Cord Injury Community Survey 2012. PARTICIPANTS: Individuals aged 16 or older with chronic SCI living in Switzerland. INTERVENTIONS: Not applicable. OUTCOME MEASURES: The availability of ten HAs (self-report) was analyzed by sex, age, living situation, indoor mobility, SCI severity, SCI etiology and time since SCI. The unmet need (self-report of not having a HA but needing it) of HAs was analyzed by financial hardship. RESULTS: Among the 482 study participants (mean age 55.2 years, standard deviation 15.0 years, 71.6% males), 85.1% had at least one HA. The most frequent HA was a wheelchair accessible shower (62.7%). Availability of HAs markedly varied with indoor mobility (e.g. 38.4% of participants using a wheelchair had a stair lift compared to 17.4% of those walking) and with SCI severity (e.g. 54.8% of those with complete paraplegia had a wheelchair accessible kitchen worktop compared to 26.0% of those with incomplete paraplegia). Unmet need was highest for adjustable kitchen worktops (78.7% of those with a need) and adjustable kitchen cabinets (75.7%) and lowest for wheelchair accessible showers (9.4%) and grab bars next to the toilet (8.5%). No significant differences in unmet need were found when stratifying for financial hardship. CONCLUSION: Availability of HAs is dependent on indoor mobility and SCI severity. There is a considerable degree of unmet need for selected HAs, which couldn't be explained by financial hardship.

Architectural accessibility and perception of falls of elderly people in the peridomicile: mixed method / Accesibilidad arquitectónica y percepción de caídas del anciano en el peridomicilio: método mixto / Acessibilidade arquitetônica e percepção de quedas de idosos no peridomicílio: método misto

ABSTRACT Objective: To describe contents, structure and origin of social representations about falls by elderly people, the peridomiciliary structural conditions that predispose to falls, and to relate the implications of these empirical evidence on the routine of the elderly in the architectural context. Method: Convergent mixed method by triangulation. Qualitative approaches(structural, n=195 and procedural, n=40of the Theory of Social Representations) and quantitative (descriptive sectional, n=183) were used. Elderly people enrolled in primary care were interviewed at home in 2018. Analysis techniques: categorical-thematic, prototypical, statistical, and deductive according to Leininger. Results: Categories of analysis: 1) Peridomicile: fall scenario and 2) Aging and vulnerability: risk of falls in peridomicile. The following environmental characteristics were precursors to falls: uneven floors, holes, unevenness and objects in the pathway. Feelings and behaviors allocated in the possible central core are associated, justifying falls, and determining their causes. Conclusion: There was an association between the peridomiciliary architectural environment and the predictive characteristics of the risk of falls.

RESUMEN Objetivo: Describir contenido, estructura y origen de las representaciones sociales sobre las caídas de los ancianos, las condiciones estructurales peridomiciliares que predisponen a las caídas; y relacionar las implicaciones de estas evidencias empíricas sobre el cotidiano de los ancianos en el contexto arquitectónico. Método: Mixto convergente por triangulación. Enfoque cualitativo: estructural (n=195) y procedimental (n=40) de la Teoría de las Representaciones Sociales y cuantitativo: descriptivo seccional (n=183). Se entrevistó en domicilio a ancianos inscritos en atención primaria (2018). Técnicas de análisis: categórico-temático, prototípico, estadístico y deductivo según Leininger. Resultados: Categorías de análisis: 1) Peridomicilio: escenario de caída y 2) Envejecimiento y vulnerabilidad: riesgo de caídas en peridomicilio. Las siguientes características ambientales fueron precursoras de caídas: pisos irregulares, agujeros, desniveles y objetos en el camino. Se asocian sentimientos y comportamientos alojados en el posible núcleo central, justificando las caídas y apuntando a sus causas. Conclusión: Hubo asociación entre el ambiente arquitectónico peridoméstico y las características predictivas del riesgo de caídas.

RESUMO Objetivo: Descrever conteúdos, estrutura e origem das representações sociais sobre queda apresentadas por pessoas idosas e condições estruturais peridomiciliares que predispõem à queda e relacionar as implicações dessas evidências empíricas na rotina de idosos no contexto arquitetônico. Método: Misto convergente por triangulação. Utilizaram-se as abordagens qualitativa (estrutural, n=195 e processual, n=40 da Teoria das Representações Sociais) e quantitativa (seccional descritiva, n=183). Foram entrevistados idosos no domicílio adscritos à atenção primária, em 2018. Técnicas de análise: categorial-temática, prototípica, estatística e dedutiva segundo Leininger. Resultados: Categorias de análise: 1) Peridomicílio: cenário de queda e 2) Envelhecimento e vulnerabilidade: risco de queda no peridomicílio. Apresentaram-se como características ambientais precursoras de quedas: pisos irregulares, buracos, desníveis e objetos no percurso. Sentimento e comportamentos alocados no possível núcleo central se associam, justificando as quedas e objetivando suas causas. Conclusão: Evidenciou-se a associação entre o ambiente arquitetônico peridomiciliar e as características preditoras do risco de quedas.