Evidence-Based Implementation of the Family-Centered Model and the Use of Tele-Intervention in Early Childhood Services: A Systematic Review.

BACKGROUND: The purpose of this review is to explore the evidence and efficacy of two trends in early childhood intervention services: the family-centered model and the use of tele-intervention. METHODS: A systematic review was carried out following the PRISMA methodology and using three databases: Web of Science, PubMed and Scopus. The studies included were those aimed at children from 0 to 6 years of age, focused on early intervention, and which alluded to the family-centered model and/or tele-intervention. RESULTS: a total of 33 studies were included. Five main themes were identified: (1) The participation of children and family is facilitated and improved by the family-centered model of care; (2) the feeling of competence, self-efficacy, satisfaction and empowerment in professionals and families have a positive impact on quality of life; (3) the use of tele-intervention as a tool for prevention and intervention; (4) preparation for telepractice can improve the development of commitment; (5) tele-intervention as a possible solution to contextual barriers. CONCLUSIONS: Tele-intervention in pediatrics is presented as a tool inherent to the family-centered model since its implementation involves several common strategies. Future lines of research should explore the use of this tool as a possible solution to contextual barriers.

Aportaciones del método Montessori a la práctica clínica de terapia ocupacional en demencias / Contributions of the Montessori method to the clinical practice of occupational therapy in dementia

Objetivos: identificar el valor terapéutico del Método Montessori en personas con demencia frente a la terapia ocupacional convencional. Métodos: se utilizó una metodología de tipo cualitativa enmarcada dentro del enfoque de la fenomenología, utilizando la técnica de grupos focales para estudiar el fenómeno de estudio. Se llevaron a cabo tres grupos focales, formados por tres terapeutas ocupacionales en cada uno. Se siguió los criterios del Consolidated criteria for reporting qualitative research (COREQ) para el presente estudio. Resultados: el Método Montessori influye en las habilidades de desempeño necesarias para la participación de la persona con demencia en sus ocupaciones diarias, mejorando y/o manteniendo su funcionalidad en las actividades de la vida diaria, especialmente en la alimentación, en las actividades instrumentales y en la participación social. Las terapeutas ocupacionales valoran que el Método Montessori contemple la actividad significativa y es utilizado de manera complementaria en su intervención con este colectivo. Conclusiones: El Método Montessori es una técnica que se utiliza de manera complementaria a otras en la intervención con personas con demencia. Impacta en el desempeño ocupacional de las personas con demencia. Es valorado por las terapeutas ocupacionales por contemplar aspectos como la actividad significativa, la posibilidad de desglosar las tareas, así como la adaptación, el control del error y la naturaleza manipulativa de los materiales y actividades que propone.(AU)

Objective: To identify the therapeutic value of the Montessori Method in people with dementia compared to conventional occupational therapy. Methods: A qualitative methodology framed within the phenomenology approach was extracted, using the focus group technique to study the phenomenon. Three focus groups were selected, formed by three occupational therapists in each one. The Consolidated Criteria for Qualitative Research Reporting (COREQ) are followed for this study. Results: The Montessori Method influences the performance skills necessary for participation of the person with dementia in their daily occupations, improving and/or maintaining their functionality in the activities of daily living, especially in feeding, in instrumental activities and in the social participation. Occupational therapists value that the Montessori Method contemplates meaningful activity, and it is used in a complementary way in their intervention with this group. Conclusions: The Montessori Method is a technique that is used in a complementary way to others in the intervention with people with dementia. It impacts the occupational performance of people with dementia. It is valued by occupational therapists for considering aspects such as significant activity, the possibility of breaking down tasks as well as adaptation, error control and the manipulative nature of the materials and activities it proposes.(AU)

Influencias del confinamiento por COVID-19 sobre la salud mental en estudiantes de grado de terapia ocupacional / Influências do confinamento COVID-19 na saúde mental de estudantes de graduação em terapia ocupacional / Influences of COVID-19 lockdown on mental health in occupational therapy undergrad students

Resumen Introducción Los años de universidad son un periodo de desarrollo crucial para la transición de la adolescencia a la adultez, por eso existe una creciente preocupación sobre la salud mental de los estudiantes. El COVID-19 puso en situación de vulnerabilidad a esta población, con aumento del riesgo de depresión, ansiedad o estrés. Objetivo Aunque los estudios sobre los efectos de la pandemia y sus consecuencias sobre la salud mental se publican de manera exponencial, existen pocos centrados en estudiantes de ciencias de la salud. Por ello, se enfoca esta temática en estudiantes de Grado en Terapia Ocupacional para explorar los efectos sobre la salud mental en la etapa de confinamiento inicial. Método Partiendo de la hipótesis de que el confinamiento ha podido poner en situación vulnerable a los estudiantes universitarios, se realizó un estudio cuantitativo longitudinal con estudiantes del Grado de Terapia Ocupacional en base a los cuestionarios General Health Questionnaire (GHQ-28), Patient Health Questionnaire (PHQ-9), Escala de Felicidad Subjetiva (SHS) y la Escala de Desesperanza de Beck. Resultados Los resultados mostraron una mejoría en las diferentes escalas entre los años 2019 y 2020, con relaciones estadísticamente significativas entre el estado de confinamiento y una reducción del riesgo de depresión a su finalización. Conclusiones Esta relación sugiere dudas sobre la temporalidad y la medición de los resultados siendo posible queque el confinamiento tuviera aspectos positivos en algunas de las dimensiones de la salud mental, dada su relación con la falta de aislamiento social en muchos casos, el establecimiento de rutinas y la reincorporación a la docencia presencial.

Resumo Introdução Os anos universitários são um período de desenvolvimento crucial para a transição da adolescência para a idade adulta, razão pela qual é crescente a preocupação com a saúde mental dos estudantes. A COVID-19 coloca esta população numa situação vulnerável, com risco acrescido de depressão, ansiedade ou stress. Objetivo Embora estudos sobre os efeitos da pandemia e suas consequências na saúde mental sejam publicados de forma exponencial, poucos são os voltados para estudantes de ciências da saúde. Por este motivo, aborda-se esta temática em alunos de graduação em terapia ocupacional para explorar os efeitos na saúde mental em fase inicial de confinamento. Método Partindo da hipótese de que o confinamento tem sido capaz de colocar estudantes universitários em situação de vulnerabilidade, foi realizado um estudo quantitativo longitudinal com estudantes do Curso Graduação em Terapia Ocupacional com base no General Health Questionnaire (GHQ-28), Patient Health Questionnaire (PHQ-9), Escala de Felicidade Subjetiva (SHS) e Escala de Desesperança de Beck. Resultados Os resultados mostraram uma melhora nas diferentes escalas entre os anos de 2019 e 2020, com relações estatisticamente significativas entre o estado de confinamento e a redução do risco de depressão ao final. Conclusão Esta relação sugere dúvidas sobre a temporalidade e a mensuração dos resultados, sendo possível que o confinamento tenha tido aspectos positivos em algumas das dimensões da saúde mental, dada sua relação com a falta de isolamento social, em muitos casos, o estabelecimento de rotinas e o retorno ao ensino presencial.

Abstract Introduction The university years are a crucial period of development for the transition from adolescence to adulthood, which is why there is a growing concern for the mental health of students. COVID-19 places this population in a vulnerable situation, with an increased risk of depression, anxiety, or stress. Objective Although studies on the effects of the pandemic and its consequences on mental health are published exponentially, few studies focus on students in health sciences. Therefore, we aimed the approach of these issues regarding undergraduates from the Degree of Occupational Therapy to explore the effects of the national lockdown on mental health. Method Based on the hypothesis that confinement may have made university students vulnerable, a quantitative longitudinal study was conducted with students of the Occupational Therapy Degree based on the General Health Questionnaire (GHQ-28), Patient Health Questionnaire (PHQ-9), Subjective Happiness Scale (SHS) and Beck's Scale of Hopelessness (BSH). Results The results showed an improvement in the different scales between 2019 and 2020, with statistically significant relationships between the state of confinement and a reduction in the risk of depression at its end. Conclusions This relationship suggests doubts about the temporality and measurement of the results since it is possible that confinement had positive aspects in some of the dimensions of mental health, given its relationship with the lack of social isolation in many cases, the establishment of routines and the return to face-to-face teaching.

Impact of Burnout on Daily Activities from an Occupational Therapy Perspective: A Serial Mediation Model with the IDA Scale.

BACKGROUND: Burnout syndrome is one of the most frequent health complications among workers. Acknowledging the work perspective as something basic and essential in a person's life means that this disorder can have huge implications in their most basic daily activities. METHODS: A cross-sectional, quantitative observational design was conducted with data from Spanish workers. A serial mediation model was applied to study the relationship between daily activities and burnout syndrome. For this purpose, the IDA scale was developed. CONCLUSIONS: The results show us that peoples' work situation has an impact on their daily life. There is quantitative evidence of the impact on daily life occupations and how it further decreases the levels of health and well-being of the person, on their independence and, consequently, on their quality of life.

Cross-Cultural Validation of Quebec User Satisfaction with Assistive Technology 2.0 for Spanish Population (QUEST-2.0 ES).

BACKGROUND: Assistive technologies (ATs) are resources to promote the independence and participation of people with a disability. The use of standardized tools, based on outcome measures, is essential for guaranteeing high-quality rates. The Quebec User Evaluation of Satisfaction with AT-2.0 (QUEST) is a scale to assess the satisfaction of people using any AT. OBJECTIVES: To translate and culturally validate the QUEST-2.0 for the Spanish population (QUEST 2.0-ES). METHODS: A validation cross-design and descriptive study. The test-retest reliability, validity, and internal consistency of QUEST 2.0-ES were studied. It was divided into two phases: Sample 1 was formed by 26 persons; in sample 2, 30 persons participated. The conditions included neurological conditions, amputations, rare diseases, and deafness. RESULTS: Thirty-five men and 21 women participated in total. The majority of AT used were those for mobility. QUEST 2.0-ES analysis showed internal consistency values between the test (α = 0.87) and retest versions (α = 0.89). The internal consistency was high for AT (test, α = 0.83; retest, α = 0.87) and Service (test, α = 0.80; retest, α = 0.80). The temporal reliability (1-2 weeks) for test-retest was 0.88. CONCLUSION: QUEST 2.0-ES showed good psychometric properties in terms of validity and test-retest reliability, and it is a good tool to assess the user's satisfaction with ATs and services.

Difference between Impacts of COVID-19 on Women and Men's Psychological, Social, Vulnerable Work Situations, and Economic Well-Being.

The SARS-CoV-2 virus changed social reality worldwide, affecting people's health and work life, particularly their anxiety levels. The purpose of this study is to verify the situation of women in terms of anxiety and social determinants in Spain during the pandemic. The sample consisted of 4686 people (3500 women and 1186 men). The tools used were the State-Trait Anxiety Inventory (STAI) and an ad hoc questionnaire to assess the work and mental situation of the participants. The results indicate a higher rate of anxiety among women than among men and reveal a relationship between higher levels of anxiety and more vulnerable work situations in terms of higher unemployment rates, contract changes, etc. Furthermore, there was a higher percentage of women than men in the sectors where the health crisis has had a greater impact and presence, with repercussions on the physical, mental, and social health of the entire population and especially on women. It is necessary to take into account the social determinants of health, not only at the structural level, in terms of the socio-economic and political contexts, to avoid and limit the axes of inequality such as gender.

Musculoskeletal Diseases and Disorders in the Upper Limbs and Health Work-Related Quality of Life in Spanish Sign Language Interpreters and Guide-Interpreters.

Disorders in the upper limbs are common among sign language interpreters and are related with different risk factors, among which are the difficulties of interpreting work in the educational setting, posture, and emotional together with physical stress. The aim of this study was to inquire about the different musculoskeletal disorders and diseases present in a group of sign language interpreters, and to examine its relationship with the work-related quality of life. A battery of four instruments was administered to 62 sign language interpreters, composed of a sociodemographic data and musculoskeletal disease questionnaire, a health-related quality of life measurement scale (SF-36), a measurement scale of the impact of fatigue (MFIS), and an instrument for assessing hand-function outcomes (MHOQ). All the study participants had presented some kind of musculoskeletal pathology during their work career, such as tendinitis, overuse syndrome, and repetitive strain injury. In addition, many of the participants present difficulties in occupational performance that affect their daily activities. A high percentage, close to 70%, of the interpreters suffer from musculoskeletal disorders, serious enough to modify their activities and affect both the quality of their work as interpreters and their quality of life, with important mediating variables being the number of diseases; physical, cognitive, and social fatigue; and satisfaction with the hand function.

Estudio piloto sobre el efecto de la telerehabilitación en la calidad de vida de personas mayores con deterioro cognitivo / Pilot study on the effect of telerehabilitation in quality of life among elderly people with cognitive impairment

Introducción: Los procesos de atención a personas mayores han presentado cambios debido al confinamiento sanitario causado por el COVID-19, por esta razón la telerehabilitación se impulsa como una estrategia para continuar los procesos de rehabilitación cognitiva a personas mayores. Objetivo: evaluar la percepción de la calidad de vida de personas mayores con deterioro cognitivo que se encuentran en telerehabilitación, comparado con la calidad de vida de personas mayores con deterioro cognitivo sin telerehabilitación. Método: se realizó un estudio descriptivo para identificar los cambios en la calidad de vida de personas mayores con procesos de telerehabilitación. Se emplearon los instrumentos Quality of Life in Alzheimer's Disease y la escala GENCAT. Resultados: el estudio descriptivo mostró cambios favorables en la calidad de vida de las personas mayores que estuvieron en el proceso de telerehabilitación, mientras que el grupo control presentó cambios negativos. Conclusiones: este estudio permite evidenciar los cambios en la calidad de vida de personas mayores con deterioro cognitivo que participa en un proceso de telerehabilitación durante el confinamiento sanitario. Estos cambios favorables se presentaron en las dimensiones de bienestar emocional, bienestar material, inclusión social y derechos.

Introduction: the processes of care for elderly have presented changes, due to the sanitary confinement caused by COVID-19 pandemic. For this reason, telerehabilitation is promoted as a strategy to continue the processes of cognitive rehabilitation for the elderly. Aim: To evaluate quality of life perceptions among older people with cognitive impairment, who received telerehabilitation, compared with quality of life of older people with cognitive impairment without Telerehabilitation. Method: a descriptive study to identify changes in quality of life of older people receiving tele-rehabilitation processes. Assessment instruments used were: Quality of Life in Alzheimer's Disease and the GENCAT scale. Results: this descriptive study showed favorable changes in quality of life of the elderly who were in the telerehabilitation process, while the control group presented negative changes. Conclusions: this study offers evidence on the changes in the quality of life for elderly people with cognitive impairment who participate in a telerehabilitation process during sanitary confinement. These favorable changes occurred in the dimensions of emotional well-being, material well-being, social inclusion and rights.

Estudio sobre el uso de tecnologías de la información y comunicación en personas mayores / Study on the use of information and communication technologies in elderly people

Objetivos: las Tecnologías de la Información y la Comunicación tienen un desarrollo exponencial, formando parte de nuestra vida cotidiana; no obstante, esta incorporación de las tecnologías al día a día se está produciendo a tal velocidad que genera desigualdades entre diferentes grupos de edad como las personas mayores. El objetivo fue indagar sobre el uso de las Tecnologías de la Información y Comunicación en personas mayores, en Porto do Son (La Coruña, España). Métodos: La muestra quedó formada por 237 personas, 57,8 % mujeres y 42,2 % hombres, con una edad media de 74,8 años (SD=6,85). Se empleó un cuestionario sociodemográfico y el Cuestionario Sobre el Uso de Tecnologías-Consumidor. Resultados: se encontraron como factores predictores de uso de tecnologías: el acercamiento a estas mediante cursos de alfabetización digital y a través de un amigo; la percepción por parte de las personas mayores de que las actividades que realizan les resultan satisfactorias y de que la tecnología les acerca a la gente, y usar tecnología concreta en la vida diaria. No se obtuvieron datos significativos con respecto a la influencia de las características personales/sociales. Se observó una relación directa entre el uso de tecnologías y el nivel cultural e inversa con la edad. Conclusiones: la mayor diferencia en la percepción del uso de tecnología por parte de la población adulta se produce a favor de los grupos con menor edad y un nivel cultural superior. (AU)

Objective: Information and Communication Technologies have an exponential development, forming part of our daily life; however, this incorporation of technologies into everyday life is taking place at such speed that it generates inequalities between different age groups such as the elderly. The objective was to investigate the use/non-use of Information and Communication Technologies in the elderly, in Porto do Son. Methods: The sample was made up of 237 people, 137 women and 100 men, with a mean age of 74.8 years (SD=6.85). A sociodemographic questionnaire and the Questionnaire on the Use of Technologies-Consumer were used.Results: The predictive results of the use of technologies were found: the approach to these through digital literacy courses and through a friend; the satisfactory perception of all their common activities and that technology brings them closer to people and the concrete use of technology in daily life. No significant data was obtained regarding the influence of personal/social characteristics on the use/non-use of Information and Communication Technologies.Conclusions: The greatest difference in the perception of the use of technology by the adult population occurs in favor of younger groups and a higher cultural level. (AU)

Developing an International Occupational Therapy Service: Perspectives and Implications.

Mali is one of the poorest countries in sub-Saharan Africa. Limited infrastructure renders access to health care difficult. There is a need to establish functional ways to improve Malian people's health and treat disability. From this point of view, our project aims to implement a remote occupational therapy service for the beneficiaries of the Kalana clinic in Mali through international cooperation. Using a spiral iterative model, a proposal for a remote occupational therapy service was developed and refined for a multidisciplinary context. The International Classification of Functioning, Disability, and Health (ICF) was used as a means to work from a multidisciplinary approach to treat all needs. The results are exemplified with a case report and qualitative impressions of the services.

A collaborative escape room as gamification strategy to increase learning motivation and develop curricular skills of occupational therapy students.

BACKGROUND: This study presents an experiment regarding the introduction of gamification strategies in occupational therapy courses. Based on previous studies, the objective is to adapt the idea of recreational escape rooms to educational environments of health sciences like occupational therapy to increase student motivation and promote game-based learning and key skills, such as teamwork. METHODS: Computer software was created for a collaborative escape room which allows on-line simultaneous play of up to 24-30 students. It was tested three times in an occupational therapy degree program with 75 students and it was based on two different subjects, although it can be adapted to others. The escape room was evaluated using feedback surveys and comparing students' performances before and after the game. Descriptive exploratory statistical analysis was performed using SPSS version 24. RESULTS: An appropriate use of educational escape rooms can have significant positive impacts on students' engagement and learning. Students were found to prefer using gamification tools in their learning. Their degrees of satisfaction exceeded their expectations. CONCLUSIONS: Educational escape rooms may have a positive impact on students' motivation and a statistically significant improvement of test scores after playing was found. Comments from the feedback surveys were used to improve successive versions of the software and design of the game. TRIAL REGISTRATION: T.F.G. n° 2020.038 (Research Ethics Committee of the Principality of Asturias).

Psychosocial Impact of Assistive Devices and Other Technologies on Deaf and Hard of Hearing People.

Deaf and hard of hearing people use a variety of assistive devices and technologies as a strategy to mitigate, counter or compensate for life difficulties resulting from hearing loss. Although outcome measures are commonly used with hearing aids, few studies have explored the perceived psychosocial impact of other assistive devices and technologies or the factors leading to their abandonment or lack of use. Therefore, the main aim of this study was to assess the psychosocial impact of different assistive devices on deaf and hard of hearing people using the Psychosocial Impact of Assistive Devices Scale. The sample was made up of 291 individuals, 176 women and 115 men, with an average age of 56.12 years (standard deviation (SD) = 25.11), who were all users of different assistive devices. Overall, the results of the study showed that the use of assistive devices had a positive psychosocial impact, although this impact varied slightly depending on the specific type of device. Moreover, a relationship was identified between the psychosocial impact and the probability of future abandonment of a hearing aid or a cochlear implant. The results point to the importance of considering the psychosocial impact derived from the use of a device as a relevant variable in the adoption process of assistive technologies for deaf and hard of hearing people.

Psychometric Properties of the Spanish Version of Psychosocial Impact of Assistive Devices Scale in a Large Sample of People With Neuromuscular, Neurological, or Hearing Disabilities.

Assistive technology (AT) is any device, software, or equipment designed for and used by individuals with disabilities to engage in everyday activities and achieve independence. However, the usefulness of those technology-based or supported treatments is a complex issue that has led to the development of various conceptual models for assistive technology outcomes research and practice as well as different assessment tools that help to explore the effect of technology on people's lives. One of those instruments is the Psychosocial Impact of Assistive Device Scale (PIADS), a 26-item questionnaire that measures the psychosocial impact of interventions, using assistive devices in three quality-of-life domains: competence, adaptability, and self-esteem. PIADS scale has been translated and adapted to several languages, and it has been successfully used to measure AT outcomes in different disability profiles to predict abandonment or even as a relevant determinant of future adoption of eHealth. Quinteiro (2010) adapted PIADS to Spanish for the first time, although no studies have yet been published to systematically study its psychometric properties. Therefore, the purpose of this study was to evaluate measurement properties of the Spanish version of PIADS scale by means of a dataset obtained from its application to a large sample (n = 417) of people with neuromuscular, neurological, or hearing disabilities that used different assistive devices. The results will provide valuable indicators about the measurement quality of the Spanish PIADS scale and will help to promote the use of reliable and valid AT outcome assessment tools for research and clinical purposes.

A Q-method approach to perceptions of professional reasoning in occupational therapy undergraduates.

BACKGROUND: Professional reasoning provides a firm basis for the development of teaching and assessment strategies to support the acquisition of skills by healthcare students. Nevertheless, occupational therapy educators should use diverse methods of learning assessment to examine student learning outcomes more fully with an evaluation that supports the overall complexity of the process, particularly learners' subjective experience. The aim of this article is to identify the range of perspectives among occupational therapy undergraduates regarding terms or concepts that are key for improving their professional reasoning. METHODS: Q-methodology was used to address the aim of the study. A concourse relating to a series of ideas, phrases, terminology, and concepts associated with various studies on professional reasoning in occupational therapy, specifically on students in this field, was generated. The terms that had the clearest evidence, the most relevance or the greatest number of citations in the literature were collected (n = 37). The P-set was assembled by non-probabilistic sampling for convenience. It comprised undergraduate university students in occupational therapy. Factor analysis was conducted using Ken-Q Analysis v.1.0.6, reducing the number of Q-sets to smaller groups of factors representing a common perspective. RESULTS: Through statistical analysis of the Q-sorts of 37 occupational therapy students, 8 default factors were identified. The four factors in accordance with the selection criteria were rotated by varimax rotation to identify variables that could be grouped together. Each viewpoint was interpreted, discussed and liked to different aspects of professional reasoning in occupational therapy. CONCLUSIONS: The observed perceptions were linked to the various aspects of professional reasoning that have been widely discussed in the occupational therapy literature. For most of the students, there was a strong correspondence between the narrative, interactive and conditional aspects of the various components.

Influence of Psychological Factors on the Success of the Ultra-Trail Runner.

The aim of this study was to analyze the psychological variables of runners of ultra-trail mountain races and their association with athletic performance and success. The sample was made up of 356 mountain runners, 86.7% men and 13.2% women, with a mean age of 42.7 years and 5.7 years of experience. Using pre- and post-race questionnaires, data were collected regarding mental toughness, resilience, and passion. The performance of each runner in the race was also recorded. The results showed very high values in the psychological variables analyzed compared with other sports disciplines. Completion of the race (not withdrawing) and the elite quality of the runners were presented as the most relevant indicators in the processes of resilience, mental toughness, and obsessive passion. Differences were noted between the pre- and post-race results, suggesting that the competition itself is a means of training those psychological factors that are essential to this sports discipline. It can be concluded that psychological factors are decisive to athletic performance and race completion in mountain ultra-marathon races.

Psychosocial impact of mobility assistive technology on people with neurological conditions.

INTRODUCTION: A wide range of products are available to assist mobility, and it is, therefore, of great importance to obtain empirical information regarding the expected impact of the use of these products based on outcome measures. People affected by neurological disorders often use products to assist mobility such as wheelchairs (both manual self-propelled wheelchairs and externally propelled chairs such as electric wheelchairs), walkers, walking sticks, etc. It is important to conduct an assessment of the psychosocial impact of these products on the lives of affected people. METHODS: We performed this assessment using the Psychosocial Impact of Assistive Devices Scale (PIADS) and a socio-demographic questionnaire. RESULTS: The results showed greater psychosocial benefits relating to the use of electric wheelchairs in comparison with walking sticks or manual, non-self-propelled chairs. Moreover, significant differences are present in the three subscales of the PIADS in relation to variables such as age, training in the use of assistive technology (AT) and funding. CONCLUSION: Therefore, we conclude that the use of AT should be promoted among this group as a way to improve their adaptability, competency and self-esteem, and to reduce limits on participation deriving from the physical and contextual barriers faced by this collective.Implications for rehabilitationAmong the assessment of different mobility AT displaying a higher score in the three subscales of the PIADS amongst people using electric wheelchairs than among those using non-self-propelled manual wheelchairs. On the other hand, we found that the walker has a significant score only in the competence subscale. Canes, for example the stick 4-p is significant in the three subscales, or the walking cane in terms of competence. Despite the fact that crutches and walking sticks obtained the lowest score in this study.Not only the assessment is necessary, but also the adjustment of AT to the person who is going to use it, as well as some training on how to use it. Only 23.8% of the participants received training in the use of their main assistive device in this study.The results seem to indicate that for elder users, the score on adaptability with the AT is lower. That may result in future lines of research in usability and improving in terms of the needs of end-users and these AT since a high percentage of people with neurological conditions are elder people.The application of specific scales such as PIADS that helps to measure the use and capacity of the AT prescribed to patients with neurological disease provides more informed clinical reasoning.