Assistive technology: The current perspective in India.

The world, today, recognizes the increasing importance of assistive technology (AT) that can reduce the functional limitations of persons with disabilities, individuals with chronic debilitating diseases, and elders. This indicates that at some point, everyone, either temporary or permanent, will require AT to improve their physical and functional abilities, thus contributing to independent living, social inclusion, and education. Besides this, the need for AT will be growing with a majority from low-middle-income countries. The same is true for India though we are not sure how many people have met a need, and unmet need for AT to date, but the requirement will continue to increase. There is a significant gap between needs and access to AT. Recently, the WHO has led many initiatives related to AT services after the 71st World Health Assembly's resolution in 2018, to improve access to AT for its member states. The UN Sustainable Development Goals (SDGs) have pledged that no one should be left behind irrespective of personal characteristics. India, a ratified member state, needs to align with various initiatives undertaken by the WHO and the UN. Despite many challenges, India needs to formulate evidence-based AT policy, planning within the purview of the healthcare delivery system in collaboration with various government and nongovernment sectors, including industries. This article explores the need, access, and potential challenges associated with AT services in India. Finally, we discussed various initiatives on AT in the country and possible recommendations to improve AT services across.

Digital Skills Among Elderly Care Workers.

The aim of our study was to determine the current status of digital skills of elderly care workers (n=169) at well-being services. A survey was sent to elderly services providers in the municipalities (n=15) of North Savo, Finland. Respondents' experience as client information systems users was higher than that as assistive technologies users. Devices supporting independent living were seldom used, but safety devices and alarm monitoring were used daily.

A feasibility study demonstrating that independence, quality of life, and adaptive behavioral skills can improve in children with Down syndrome after using assistive technology.

Enhancing independence and quality of life are key modifiable outcomes that are short- and long-term goals for children with Down syndrome and for their parents. Here we report the outcome of a 4-week feasibility study in a cohort of 26 children with Down Syndrome, 7-17 years old, who used an assistive technology approach that incorporated smart device software and step-by-step pictures (the MapHabit System). Parents reported improvements in children's activities of daily living, quality of life, and independence. They recommended this technology to other families. This report and its findings underscore the feasibility of using assistive technology in children with Down syndrome within home and family settings. A limiting factor is whether participants who did not complete the study, and thus were not included in analyses, might have impacted the study outcomes. The current findings that assistive technology can be used successfully and effectively in family and home settings set the stage for more informative systematic studies using assistive technology for this population. Trial registration: The clinical trial is registered with ClinicalTrials.gov Registration number: NCT05343468.

A cross-sectional study on the need for and utilization of assistive walking devices by people age 55 and older in Shanghai.

We conducted a study to analyze the unmet needs of and risk factors for use of assistive walking devices by the elderly based on sample survey data from Shanghai, China from July to October 2019. Among a total sample size of 11,193 people age 55 and older, 1,947 people (17.39%) needed assistive walking devices, 829 (42.58%) of whom needed but did not use those devices. Multivariate analysis indicated that residence, living alone or cohabitating, indoor handrails, the number of diseases, and IADL were factors influencing the unmet need for assistive walking devices (p < 0.05, respectively). People who lived in community health centers (p = 0.0104, OR = 1.956, 95% CI: 1.171-3.267) and those who lived only with their spouse (p = 0.0002, OR = 2.901, 95% CI: 1.641-5.126) were more likely to have an unmet need for assistive walking devices. People without indoor handrails (p = 0.0481, OR = 0.718, 95% CI: 0.517-0.997), those with 3 or more diseases (p = 0.0008, OR = 0.577, 95% CI: 0.418-0.796), and those with severely impaired IADL (p = 0.0002, OR = 0.139, 95% CI: 0.05-0.386) were less likely to have an unmet need for assistive walking devices. Self-perceived needs of the elderly, the diversity and performance of assistive devices, and the accessibility and affordability of assistive walking devices may lead to unmet needs.

Sound-Based Localization Using LSTM Networks for Visually Impaired Navigation.

In this work, we developed a prototype that adopted sound-based systems for localization of visually impaired individuals. The system was implemented based on a wireless ultrasound network, which helped the blind and visually impaired to navigate and maneuver autonomously. Ultrasonic-based systems use high-frequency sound waves to detect obstacles in the environment and provide location information to the user. Voice recognition and long short-term memory (LSTM) techniques were used to design the algorithms. The Dijkstra algorithm was also used to determine the shortest distance between two places. Assistive hardware tools, which included an ultrasonic sensor network, a global positioning system (GPS), and a digital compass, were utilized to implement this method. For indoor evaluation, three nodes were localized on the doors of different rooms inside the house, including the kitchen, bathroom, and bedroom. The coordinates (interactive latitude and longitude points) of four outdoor areas (mosque, laundry, supermarket, and home) were identified and stored in a microcomputer's memory to evaluate the outdoor settings. The results showed that the root mean square error for indoor settings after 45 trials is about 0.192. In addition, the Dijkstra algorithm determined that the shortest distance between two places was within an accuracy of 97%.

Experimental Evaluation of EMKEY: An Assistive Technology for People with Upper Limb Disabilities.

Assistive technology can help people with disabilities to use computers more effectively and can enable them to access the same information and resources as people without disabilities. To obtain more insight into the factors that can bring about the design of an Emulator of Mouse and Keyboard (EMKEY) to higher levels of user satisfaction, an experimental study was conducted in order to analyse its effectiveness and efficiency. The experimental study involved 27 participants (Mage = 20.81, SD = 1.14) who performed three experimental games under different conditions (using the mouse and using EMKEY with head movements and voice commands). According to the results, the use of EMKEY allowed for the successful performance of tasks such as matching stimuli (F(2,78) = 2.39, p = 0.10, η2 = 0.06). However, the execution times of a task were found to be higher when using the emulator to drag an object on the screen (t(52,1) = -18.45, p ≤ 0.001, d = 9.60). These results indicate the effectiveness of technological development for people with upper limb disabilities; however, there is room for improvement in terms of efficiency. The findings are discussed in relation to previous research and are based on future studies aimed at improving the operation of the EMKEY emulator.

Comprehensive Senior Technology Acceptance Model of Daily Living Assistive Technology for Older Adults With Frailty: Cross-sectional Study.

BACKGROUND: There are considerable gaps between the need for assistive technologies and the actual adoption of these technologies among older adults, although older adults are among the groups that most need assistive technologies. Consequently, research is needed in this area because older adults' technology acceptance and influencing factors may differ depending on their level of frailty. OBJECTIVE: The objective of this study was to compare frail, prefrail, and robust groups of South Korean adults regarding their behavioral intention to use daily living assistive technologies and the affecting factors-namely, technological context factors, health contexts and abilities, and attitudinal factors-based on a comprehensive senior technology acceptance model. METHODS: A nationwide sample of 500 older South Korean adults (aged 55-92 years) was analyzed, and multivariate linear regression analyses of the robust, prefrail, and frail groups were performed. The independent and dependent variables consisted of 3 factors based on previous studies. First, technological context factors consisted of gerontechnology self-efficacy, gerontechnology anxiety, and facilitating conditions. Second, health contexts and abilities consisted of self-reported health conditions, cognitive ability, social relationships, psychological function, and physical function. Third and last, attitudinal factors consisted of behavioral intention to use assistive technologies, attitude toward use, perceived usefulness (PU), and perceived ease of use (PEOU). RESULTS: The results of the analyses showed that technological context factors such as gerontechnology self-efficacy, health contexts and abilities such as self-reported health conditions and psychological function, and attitudinal factors such as attitude toward use, PU, and PEOU had significant effects on behavioral intention to use daily living assistive technologies. In particular, gerontechnology self-efficacy had a significant relationship with behavioral intention to use these technologies in the robust (r=0.120; P=.03) and prefrail (r=0.331; P<.001) groups. Psychological function (life satisfaction) had a significant relationship with behavioral intention to use these technologies in the robust group (r=-0.040; P=.02). Self-reported health conditions had a significant relationship with behavioral intention to use these technologies in the prefrail group (r=-0.169; P=.01). Although each group had a different significant relationship with the variables, attitudinal factors such as attitude toward use affected all groups (robust group: r=0.190; P=.03; prefrail group: r=0.235; P=.006; and frail group: r=0.526; P=.002). In addition, PU and PEOU in the attitudinal factors had a significant relationship with behavioral intention to use assistive technologies in the robust (PU: r=0.160; P=.01; and PEOU: r=0.350; P<.001) and prefrail (PU: r=0.265; P<.001; and PEOU: r=0.120; P=.04) groups. CONCLUSIONS: This study found that the comprehensive senior technology acceptance model of daily living assistive technologies had different associations according to the frailty group. These findings provided insights into the consideration of interventions with daily living assistive technologies for older adults with varying levels of frailty.

Are ChatGPT and large language models "the answer" to bringing us closer to systematic review automation?

In this commentary, we discuss ChatGPT and our perspectives on its utility to systematic reviews (SRs) through the appropriateness and applicability of its responses to SR related prompts. The advancement of artificial intelligence (AI)-assisted technologies leave many wondering about the current capabilities, limitations, and opportunities for integration AI into scientific endeavors. Large language models (LLM)-such as ChatGPT, designed by OpenAI-have recently gained widespread attention with their ability to respond to various prompts in a natural-sounding way. Systematic reviews (SRs) utilize secondary data and often require many months and substantial financial resources to complete, making them attractive grounds for developing AI-assistive technologies. On February 6, 2023, PICO Portal developers hosted a webinar to explore ChatGPT's responses to tasks related to SR methodology. Our experience from exploring the responses of ChatGPT suggest that while ChatGPT and LLMs show some promise for aiding in SR-related tasks, the technology is in its infancy and needs much development for such applications. Furthermore, we advise that great caution should be taken by non-content experts in using these tools due to much of the output appearing, at a high level, to be valid, while much is erroneous and in need of active vetting.

Methods to assess the effectiveness and acceptance of information and communication technology-based assistive technology for older adults: a scoping review.

An aging society is a growing challenge for families, social and rehabilitation service providers, and economies. Information and communication technology-based assistive technology can bolster the independence of older adults (65 years and above) and reduce their burden on caregivers. Currently, there is no unified methodology to assess the effectiveness and acceptance of these technologies. The present study undertakes a scoping review to (1) identify and characterize the methods for assessing the acceptability and usability of information and communication technology-based assistive technologies, (2) explore the advantages and disadvantages of the assessment methods, (3) determine the possibilities of combining the assessment methods and (4) define the most commonly used assessment method and set of outcome measures. The literature was searched in MEDLINE, Scopus, IEEE Cochrane and Web of Science bibliographic databases using the keywords defined by reviewers for articles in English published between 2011 and 2021. Of the 1696 matches, 31 met the inclusion criteria. It was found that a combination of different assessment methods was common in outcome measurements. Of the 31 studies, assessment methods were combined in 21 studies and multiple questionnaires were used in 11 studies. The most common technique of outcome measurement was the use of questionnaires (81%), conducting interviews (48%) and recording usability-performance measures (39%). The advantages and disadvantages of the assessment methods could not be determined in the selected studies in this scoping review.

State-of-the-Art Review on Wearable Obstacle Detection Systems Developed for Assistive Technologies and Footwear.

Walking independently is essential to maintaining our quality of life but safe locomotion depends on perceiving hazards in the everyday environment. To address this problem, there is an increasing focus on developing assistive technologies that can alert the user to the risk destabilizing foot contact with either the ground or obstacles, leading to a fall. Shoe-mounted sensor systems designed to monitor foot-obstacle interaction are being employed to identify tripping risk and provide corrective feedback. Advances in smart wearable technologies, integrating motion sensors with machine learning algorithms, has led to developments in shoe-mounted obstacle detection. The focus of this review is gait-assisting wearable sensors and hazard detection for pedestrians. This literature represents a research front that is critically important in paving the way towards practical, low-cost, wearable devices that can make walking safer and reduce the increasing financial and human costs of fall injuries.

An Adaptive Pedaling Assistive Device for Asymmetric Torque Assistant in Cycling.

Dynamic loads have short and long-term effects in the rehabilitation of lower limb joints. However, an effective exercise program for lower limb rehabilitation has been debated for a long time. Cycling ergometers were instrumented and used as a tool to mechanically load the lower limbs and track the joint mechano-physiological response in rehabilitation programs. Current cycling ergometers apply symmetrical loading to the limbs, which may not reflect the actual load-bearing capacity of each limb, as in Parkinson's and Multiple Sclerosis diseases. Therefore, the present study aimed to develop a new cycling ergometer capable of applying asymmetric loads to the limbs and validate its function using human tests. The instrumented force sensor and crank position sensing system recorded the kinetics and kinematics of pedaling. This information was used to apply an asymmetric assistive torque only to the target leg using an electric motor. The performance of the proposed cycling ergometer was studied during a cycling task at three different intensities. It was shown that the proposed device reduced the pedaling force of the target leg by 19% to 40%, depending on the exercise intensity. This reduction in pedal force caused a significant reduction in the muscle activity of the target leg (p < 0.001), without affecting the muscle activity of the non-target leg. These results demonstrated that the proposed cycling ergometer device is capable of applying asymmetric loading to lower limbs, and thus has the potential to improve the outcome of exercise interventions in patients with asymmetric function in lower limbs.

Recent Developments in Haptic Devices Designed for Hearing-Impaired People: A Literature Review.

Haptic devices transmit information to the user, using tactile stimuli to augment or replace sensory input. People with limited sensory abilities, such as vision or hearing can receive supplementary information by relying on them. This review analyses recent developments in haptic devices for deaf and hard-of-hearing individuals by extracting the most relevant information from each of the selected papers. The process of finding relevant literature is detailed using the PRISMA guidelines for literature reviews. In this review, the devices are categorized to better understand the review topic. The categorization results have highlighted several areas of future research into haptic devices for hearing-impaired users. We believe this review may be useful to researchers interested in haptic devices, assistive technologies, and human-computer interaction.

A Critical Review on Factors Affecting the User Adoption of Wearable and Soft Robotics.

In recent years, the advent of soft robotics has changed the landscape of wearable technologies. Soft robots are highly compliant and malleable, thus ensuring safe human-machine interactions. To date, a wide variety of actuation mechanisms have been studied and adopted into a multitude of soft wearables for use in clinical practice, such as assistive devices and rehabilitation modalities. Much research effort has been put into improving their technical performance and establishing the ideal indications for which rigid exoskeletons would play a limited role. However, despite having achieved many feats over the past decade, soft wearable technologies have not been extensively investigated from the perspective of user adoption. Most scholarly reviews of soft wearables have focused on the perspective of service providers such as developers, manufacturers, or clinicians, but few have scrutinized the factors affecting adoption and user experience. Hence, this would pose a good opportunity to gain insight into the current practice of soft robotics from a user's perspective. This review aims to provide a broad overview of the different types of soft wearables and identify the factors that hinder the adoption of soft robotics. In this paper, a systematic literature search using terms such as "soft", "robot", "wearable", and "exoskeleton" was conducted according to PRISMA guidelines to include peer-reviewed publications between 2012 and 2022. The soft robotics were classified according to their actuation mechanisms into motor-driven tendon cables, pneumatics, hydraulics, shape memory alloys, and polyvinyl chloride muscles, and their pros and cons were discussed. The identified factors affecting user adoption include design, availability of materials, durability, modeling and control, artificial intelligence augmentation, standardized evaluation criteria, public perception related to perceived utility, ease of use, and aesthetics. The critical areas for improvement and future research directions to increase adoption of soft wearables have also been highlighted.

A Systematic Literature Review on Service Composition for People with Disabilities: Taxonomies, Solutions, and Open Research Challenges.

Integrating smart heterogeneous objects, IoT devices, data sources, and software services to produce new business processes and functionalities continues to attract considerable attention from the research community due to its unraveled advantages, including reusability, adaptation, distribution, and pervasiveness. However, the exploitation of service-oriented computing technologies (e.g., SOC, SOA, and microservice architectures) by people with special needs is underexplored and often overlooked. Furthermore, the existing challenges in this area are yet to be identified clearly. This research study presents a rigorous literature survey of the recent advances in service-oriented composition approaches and solutions for disabled people, their domains of application, and the major challenges, covering studies published between January 2010 and October 2022. To this end, we applied the systematic literature review (SLR) methodology to retrieve and collate only the articles presenting and discussing service composition solutions tailored to produce digitally accessible services for consumption by people who suffer from an impairment or loss of some physical or mental functions. We searched six renowned bibliographic databases, particularly IEEE Xplore, Web of Science, Springer Link, ACM Library, ScienceDirect, and Google Scholar, to synthesize a final pool of 38 related articles. Our survey contributes a comprehensive taxonomy of service composition solutions, techniques, and practices that are utilized to create assistive technologies and services. The seven-facet taxonomy helps researchers and practitioners to quickly understand and analyze the fundamental conceptualizations and characteristics of accessible service composition for people with disabilities. Key findings showed that services are fused to assist disabled persons to carry out their daily activities, mainly in smart homes and ambient intelligent environments. Despite the emergence of immersive technologies (e.g., wearable computing), user-service interactions are enabled primarily through tactile and speech modalities. Service descriptions mainly incorporate functional features (e.g., performance, latency, and cost) of service quality, largely ignoring accessibility features. Moreover, the outstanding research problems revolve around (1) the unavailability of assistive services datasets, (2) the underspecification of accessibility aspects of disabilities, (3) the weak adoption of accessible and universal design practices, (4) the abstraction of service composition approaches, and (5) the rare experimental testing of composition approaches with disabled users. We conclude our survey with a set of guidelines to realize effective assistive service composition in IoT and cloud environments. Researchers and practitioners are advised to create assistive services that support the social relationships of disabled users and model their accessibility needs as part of the quality of service (QoS). Moreover, they should exploit AI/ML models to address the evolving requirements of disabled users in their unique environments. Furthermore, weaknesses of service composition solutions and research challenges are exposed as notable opportunities for future research.

Exploring the acceptability of the 'smart cane' to support mobility in older cancer survivors and older adults: A mixed methods study.

INTRODUCTION: Approximately 25% of older cancer survivors (i.e., ≥ 65 years, with cancer history) use ≥1 mobility device, surpassing usage by other older adults. Few tools exist for older "survivors" to regain function or follow lifestyle recommendations. Our goal was to explore opportunities to leverage technology-enabled mobility devices, such as the "smart cane," to support mobility goals in these survivors. The research objective was to assess perceptions related to acceptability, usability and preferences of participants regarding technology-enabled mobility devices in everyday life. MATERIALS AND METHODS: We used a convergent mixed-methods design, analyzing quantitative data followed by qualitative focus groups. A pre-survey derived from the Senior Technology Acceptance Model assessed the acceptability of technology-enabled devices among participants, who also participated in one of three focus groups delivered via Zoom. The Zoom sessions included facilitated 90-min discussions and video demonstration of the smart cane. Focus group sessions were recorded and transcribed verbatim and thematic content analysis was conducted. RESULTS: We recruited 12 older US survivors. Participants were 58% female, aged 68-86, and 16% non-White. From a pre-survey of participants, 83% said that they liked the idea of technology-enhanced mobility device and 100% said they thought they could be skillful at using a technology-enabled device if training was provided. Though participants were enthusiastic about the smart cane overall and felt the smart cane supported independence for older adults, the themes revealed concerns about safety, accessibility and technology support, as well as the concern for negative impact on self-image due to use of a mobility device. There was a strong preference for working with clinical professionals as the most trusted sources for referrals, if a smart cane was suggested. DISCUSSION: Older survivors in our sample found the smart cane very acceptable, and supportive of independence for older adults with cancer and other conditions. Participants also provided many insights that revealed additional research needed to support access, safety and usability for older adults, older survivors and caregivers, especially by partnering with clinical professionals.

Indoor Signs Detection for Visually Impaired People: Navigation Assistance Based on a Lightweight Anchor-Free Object Detector.

Facilitating the navigation of visually impaired people in indoor environments requires detecting indicating signs and informing them. In this paper, we proposed an indoor sign detection based on a lightweight anchor-free object detection model called FAM-centerNet. The baseline model of this work is the centerNet, which is an anchor-free object detection model with high performance and low computation complexity. A Foreground Attention Module (FAM) was introduced to extract target objects in real scenes with complex backgrounds. This module segments the foreground to extract relevant features of the target object using midground proposal and boxes-induced segmentation. In addition, the foreground module provides scale information to improve the regression performance. Extensive experiments on two datasets prove the efficiency of the proposed model for detecting general objects and custom indoor signs. The Pascal VOC dataset was used to test the performance of the proposed model for detecting general objects, and a custom dataset was used for evaluating the performance in detecting indoor signs. The reported results have proved the efficiency of the proposed FAM in enhancing the performance of the baseline model.

Safety Concerns in Mobility-Assistive Products for Older Adults: Content Analysis of Online Reviews.

BACKGROUND: Older adults who have difficulty moving around are commonly advised to adopt mobility-assistive devices to prevent injuries. However, limited evidence exists on the safety of these devices. Existing data sources such as the National Electronic Injury Surveillance System tend to focus on injury description rather than the underlying context, thus providing little to no actionable information regarding the safety of these devices. Although online reviews are often used by consumers to assess the safety of products, prior studies have not explored consumer-reported injuries and safety concerns within online reviews of mobility-assistive devices. OBJECTIVE: This study aimed to investigate injury types and contexts stemming from the use of mobility-assistive devices, as reported by older adults or their caregivers in online reviews. It not only identified injury severities and mobility-assistive device failure pathways but also shed light on the development of safety information and protocols for these products. METHODS: Reviews concerning assistive devices were extracted from the "assistive aid" categories, which are typically intended for older adult use, on Amazon's US website. The extracted reviews were filtered so that only those pertaining to mobility-assistive devices (canes, gait or transfer belts, ramps, walkers or rollators, and wheelchairs or transport chairs) were retained. We conducted large-scale content analysis of these 48,886 retained reviews by coding them according to injury type (no injury, potential future injury, minor injury, and major injury) and injury pathway (device critical component breakage or decoupling; unintended movement; instability; poor, uneven surface handling; and trip hazards). Coding efforts were carried out across 2 separate phases in which the team manually verified all instances coded as minor injury, major injury, or potential future injury and established interrater reliability to validate coding efforts. RESULTS: The content analysis provided a better understanding of the contexts and conditions leading to user injury, as well as the severity of injuries associated with these mobility-assistive devices. Injury pathways-device critical component failures; unintended device movement; poor, uneven surface handling; instability; and trip hazards-were identified for 5 product types (canes, gait and transfer belts, ramps, walkers and rollators, and wheelchairs and transport chairs). Outcomes were normalized per 10,000 posting counts (online reviews) mentioning minor injury, major injury, or potential future injury by product category. Overall, per 10,000 reviews, 240 (2.4%) described mobility-assistive equipment-related user injuries, whereas 2318 (23.18%) revealed potential future injuries. CONCLUSIONS: This study highlights mobility-assistive device injury contexts and severities, suggesting that consumers who posted online reviews attribute most serious injuries to a defective item, rather than user misuse. It implies that many mobility-assistive device injuries may be preventable through patient and caregiver education on how to evaluate new and existing equipment for risk of potential future injury.