Accessible Autonomous Transportation and Services: Design Considerations From the Perspective of Consumers and Providers.

OBJECTIVE: To understand the priorities and preferences of people with disabilities (PwDs) and older adults regarding accessible autonomous vehicles (AVs) to address existing transportation barriers. DESIGN: Two national surveys, Voice of the Consumer and Voice of the Provider, were conducted to gather feedback from accessible AV consumers and providers, respectively, in the United States. SETTING: This U.S.-based study focused on PwDs and older adults who may face transportation challenges and those who provide or design AV solutions. PARTICIPANTS: The 922 consumers and 45 providers in the surveys encompassed a diverse range of disability types, caregiver roles, and age groups (N = 967). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The main outcomes were consumer usage needs and provider preferences for features in accessible autonomous transportation. Patterns in usage needs and feature preferences through 2-step clustering algorithm were applied subsequent to the descriptive analysis of participant demographics and their responses. RESULTS: Participants strongly preferred AV features enhancing personal transportation, especially for rural medical appointments. Most sought comprehensive AV automated features. Wheelchair users emphasized accessible entrances, particularly for lower-income brackets ($25,000-$49,000). Provider priorities closely aligned with consumer preferences, reinforcing content validity. CONCLUSIONS: The study highlights the importance of prioritizing wheelchair accessibility in AVs and improving access to medical appointments, especially in rural and low-income communities. Implications include developing inclusive AV services for PwDs and underserved populations. The research establishes a foundation for a more equitable and accessible transportation landscape through AV technology integration.

Evaluation of Power Wheelchair Dynamic Suspensions for Tip Prevention in Non-ADA Compliant Surfaces.

OBJECTIVE: To evaluate the driving performance and usability of a mobility enhancement robot (MEBot) wheelchair with 2 innovative dynamic suspensions compared with commercial electric powered wheelchair (EPW) suspensions on non-American with Disabilities Act (ADA) compliant surfaces. The 2 dynamic suspensions used pneumatic actuators (PA) and electro-hydraulic with springs in series electrohydraulic and spring in series (EHAS). DESIGN: Within-subjects cross-sectional study. Driving performance and usability were evaluated using quantitative measures and standardized tools, respectively. SETTING: Laboratory settings that simulated common EPW outdoor driving tasks. PARTICIPANTS: 10 EPW users (5 women, 5 men) with an average age of 53.9±11.5 years and 21.2±16.3 years of EPW driving experience (N=10). INTERVENTION: Not applicable. MAIN OUTCOME MEASURE(S): Seat angle peaks (stability), number of completed trials (effectiveness), Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST), and systemic usability scale (SUS). RESULTS: MEBot with dynamic suspensions demonstrated significantly better stability (all P<.001) than EPW passive suspensions on non-ADA-compliant surfaces by reducing seat angle changes (safety). Also, MEBot with EHAS suspension significantly completed more trials over potholes compared with MEBot with PA suspension (P<.001) and EPW suspensions (P<.001). MEBot with EHAS had significantly better scores in terms of ease of adjustment (P=.016), durability (P=.031), and usability (P=.032) compared with MEBot with PA suspension on all surfaces. Physical assistance was required to navigate over potholes using MEBot with PA suspension and EPW suspensions. Also, participants reported similar responses regarding ease of use and satisfaction toward MEBot with EHAS suspension and EPW suspensions. CONCLUSIONS: MEBot with dynamic suspensions improve safety and stability when navigating non-ADA-compliant surfaces compared with commercial EPW passive suspensions. Findings indicate MEBot readiness for further evaluation in real-world environments.

Participatory Action Design and Engineering of Powered Personal Transfer System for Wheelchair Users: Initial Design and Assessment.

Caregivers that assist with wheelchair transfers are susceptible to back pain and occupational injuries. The study describes a prototype of the powered personal transfer system (PPTS) consisting of a novel powered hospital bed and a customized Medicare Group 2 electric powered wheelchair (EPW) working together to provide a no-lift solution for transfers. The study follows a participatory action design and engineering (PADE) process and describes the design, kinematics, and control system of the PPTS and end-users' perception to provide qualitative guidance and feedback about the PPTS. Thirty-six participants (wheelchair users (n = 18) and caregivers (n = 18)) included in the focus groups reported an overall positive impression of the system. Caregivers reported that the PPTS would reduce the risk of injuries and make transfers easier. Feedback revealed limitations and unmet needs of mobility device users, including a lack of power seat functions in the Group-2 wheelchair, a need for no-caregiver assistance/capability for independent transfers, and a need for a more ergonomic touchscreen. These limitations may be mitigated with design modifications in future prototypes. The PPTS is a promising robotic transfer system that may aid in the higher independence of powered wheelchair users and provide a safer solution for transfers.

Test-Retest Reliability of the Electronic Instrumental activities of daily living Satisfaction Assessment (EISA): A Cohort Study.

IMPORTANCE: Currently, no self-report instruments exist for assessing satisfaction with performing instrumental activities of daily living and occupations for people with disabilities using internet-connected assistive devices like accessible smartphones, tablets, laptops, and apps. OBJECTIVE: To assess the test-retest reliability and internal consistency of the Electronic Instrumental activities of daily living Satisfaction Assessment (EISA) self-report outcome tool. DESIGN: Repeated-measures cohort study with a time frame of 7 to 21 days. SETTING: Multicity online recruitment at assistive technology clinics, nongovernmental organizations, advocacy and peer support groups for people with disabilities, and higher education institutions. PARTICIPANTS: Eighty-four participants with disabilities, age 18 yr or older, with a mean age of 43.3 yr (range = 19-75 yr), and 57% female. INTERVENTION: Not applicable. OUTCOMES AND MEASURES: The a priori study hypotheses were that the EISA test-retest reliability scores would be above the minimum acceptable level (Rs > .80) and that internal consistency would be good (Cronbach's α = .70-.90). RESULTS: On the basis of the study data, the EISA, Version 1.0, demonstrated good test-retest reliability (Rs = .81) and excellent internal consistency (Cronbach's α = .88). CONCLUSIONS AND RELEVANCE: The results of the test-retest reliability and internal consistency analyses provide good support for the EISA to be used in clinical settings. What This Article Adds: This article documents the reliability and internal consistency of, to our knowledge, the first-ever self-report instrument for assessing satisfaction with performance of everyday occupations for people with disabilities using internet-connected assistive devices such as smartphones, tablets, laptops, and apps.

Understanding Travel Considerations and Barriers for People with Disabilities to Using Current Modes of Transportation Through Journey Mapping.

This study aimed to apply a journey mapping methodology to identify travel considerations and barriers for people with disabilities (PWDs) at each travel stage, from considering a trip through to arriving at the destination for their current modes of transportation, with the objective of understanding and avoiding "pain points" during a transition to autonomous driving systems. Twenty PWDs, including those with physical, visual, aural, cognitive, and combined physical/visual impairments, participated in a semistructured one-on-one interview. Descriptive statistics were used for demographic information, and qualitative content analysis was used to analyze the transcribed interviews and extract themes. Themes were further organized by the modes of transportation used. The top four themes in considering and planning a trip were third-party assistance availability (private vehicle, public transportation, and paratransit), finding an accessible or suitable parking space (private vehicle), access to a service location (public transportation and paratransit), and transportation schedules (public transportation and paratransit). The top four travel barriers to locating, entering, riding, and exiting transportation and arriving at the destination were vehicle ingress/egress (private vehicle and public transportation), concerns about wheelchair securement (public transportation and paratransit), requiring third-party assistance (private vehicle and public transportation), and accessibility to service locations (public transportation). The study suggests that to mitigate travel considerations and barriers for PWDs, vehicle-specific barriers and infrastructure issues should be addressed simultaneously. We anticipate that the findings will provide insights into the design and development of autonomous vehicles, to better accommodate the needs of PWDs.

Automated Curb Recognition and Negotiation for Robotic Wheelchairs.

Common electric powered wheelchairs cannot safely negotiate architectural barriers (i.e., curbs) which could injure the user and damage the wheelchair. Robotic wheelchairs have been developed to address this issue; however, proper alignment performed by the user is needed prior to negotiating curbs. Users with physical and/or sensory impairments may find it challenging to negotiate such barriers. Hence, a Curb Recognition and Negotiation (CRN) system was developed to increase user's speed and safety when negotiating a curb. This article describes the CRN system which combines an existing curb negotiation application of a mobility enhancement robot (MEBot) and a plane extraction algorithm called Polylidar3D to recognize curb characteristics and automatically approach and negotiate curbs. The accuracy and reliability of the CRN system were evaluated to detect an engineered curb with known height and 15 starting positions in controlled conditions. The CRN system successfully recognized curbs at 14 out of 15 starting positions and correctly determined the height and distance for the MEBot to travel towards the curb. While the MEBot curb alignment was 1.5 ± 4.4°, the curb ascending was executed safely. The findings provide support for the implementation of a robotic wheelchair to increase speed and reduce human error when negotiating curbs and improve accessibility.

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.

Reflections on recovery, rehabilitation and reintegration of injured service members and veterans from a bio-psychosocial-spiritual perspective

Medical interventions regarding trauma resuscitation have increased survivorship to levels not previously attained. Multiple examples from recent conflicts illustrate the potential return to high-level function of severely injured service members following medical and rehabilitative interventions. This review addresses the goals of rehabilitation, distills hard-won lessons of the last decade of military trauma and rehabilitation, and recommends the use of a bio-psychosocial-spiritual approach to care that can be applied at all tiers of the health care system. Questions on enabling participation in meaningful life activities include the following: Why do some patients do well and others do not? What elements contribute to positive outcomes? What factors relate to suboptimal results? Lessons learned revolve around the importance of considering the physical, psychosocial and spiritual aspects of a person's well-being; empowering patients by fostering self-efficacy; and helping patients find meaning in life events and set high-level goals. A bio-psychosocial-spiritual model from the rehabilitation medicine literature ­ the Canadian Model of Occupational Performance and Engagement ­ is proposed as a guide to the provision of person-centred care and the maximization of a person's functioning posttrauma.

Les interventions médicales de réanimation en traumatologie ont porté les taux de survie à des niveaux encore inégalé. Plusieurs exemples tirés de conflits récents illustrent le retour potentiel à un degré fonctionnel élevé après des interventions médicales et de réadaptation chez des membres des forces armées grièvement blessés. La présente revue expose les objectifs de la réadaptation, résume les dures leçons tirées de la dernière décennie en traumatologie et réadaptation dans le monde militaire et recommande l'utilisation d'une approche de soins bio- et psychosociospirituelle qui peut être appliquée à tous les échelons du système de soins de santé. Les questions concernant la capacité d'un retour à des activités signifiantes incluent : Pourquoi les patients n'obtiennent-ils pas tous les mêmes résultats? Quels éléments contribuent à des résultats positifs? Quels facteurs sont en lien avec des résultats optimaux? Les leçons apprises font ressortir l'importance de tenir compte des dimensions physique, psychosociale et spirituelle des personnes pour assurer leur bien-être, de les rendre autonomes en favorisant une plus grande auto-efficacité et de les aider à trouver du sens dans les événements de la vie et à se fixer des objectifs ambitieux. Un modèle bio- et psychosociospirituel tiré de la littérature en médecine de réadaptation ­ le Modèle canadien de rendement occupationnel et de participation ­ est proposé comme guide pour la prestation de soins centrés sur la personne et la maximisation de son fonctionnement après un traumatisme.

Type and Frequency of Reported Wheelchair Repairs and Related Adverse Consequences Among People With Spinal Cord Injury.

OBJECTIVE: To investigate the frequency and types of wheelchair repairs and associated adverse consequences. DESIGN: Convenience cross-sectional sample survey. SETTING: Nine Spinal Cord Injury Model Systems Centers. PARTICIPANTS: People with spinal cord injury who use a wheelchair >40h/wk (N=591). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Number of repairs needed and resulting adverse consequences, number and types of repairs completed, and location where main repair was completed in the previous 6 months. RESULTS: There were 591 participants responded to the survey, 63.8% (377/591) of them needed ≥1 repair; of these, 27.6% (104/377) experienced ≥1 adverse consequence, including 18.2% (69/377) individuals who were stranded. Of those who needed repairs, 6.9% did not have them completed (26/377). Repairs completed on the wheels and casters were the most frequent repair to manual wheelchairs, whereas repairs to the electrical and power and control systems were the most frequent type of repair on power wheelchairs. Forty percent (79/201) of manual wheelchair users reported completing repairs at home themselves compared with 14% (21/150) of power wheelchair users. Twelve percent of the variance in the odds of facing an adverse consequence because of a wheelchair breakdown can be described as a function of occupation, funding source, and type of wheelchair. CONCLUSIONS: Wheelchair repairs are highly prevalent. There are differences in types of repairs and who completes the repairs based on the type of wheelchair. Wheelchair breakdowns result in adverse consequences for users, and there is a deficit between repairs needed and those completed, highlighting the need for interventions that address these problems.

Estimation of Energy Expenditure for Wheelchair Users Using a Physical Activity Monitoring System.

OBJECTIVE: To develop and evaluate energy expenditure (EE) estimation models for a physical activity monitoring system (PAMS) in manual wheelchair users with spinal cord injury (SCI). DESIGN: Cross-sectional study. SETTING: University-based laboratory environment, a semistructured environment at the National Veterans Wheelchair Games, and the participants' home environments. PARTICIPANTS: Volunteer sample of manual wheelchair users with SCI (N=45). INTERVENTION: Participants were asked to perform 10 physical activities (PAs) of various intensities from a list. The PAMS consists of a gyroscope-based wheel rotation monitor (G-WRM) and an accelerometer device worn on the upper arm or on the wrist. Criterion EE using a portable metabolic cart and raw sensor data from PAMS were collected during each of these activities. MAIN OUTCOME MEASURES: Estimated EE using custom models for manual wheelchair users based on either the G-WRM and arm accelerometer (PAMS-Arm) or the G-WRM and wrist accelerometer (PAMS-Wrist). RESULTS: EE estimation performance for the PAMS-Arm (average error ± SD: -9.82%±37.03%) and PAMS-Wrist (-5.65%±32.61%) on the validation dataset indicated that both PAMS-Arm and PAMS-Wrist were able to estimate EE for a range of PAs with <10% error. Moderate to high intraclass correlation coefficients (ICCs) indicated that the EE estimated by PAMS-Arm (ICC3,1=.82, P<.05) and PAMS-Wrist (ICC3,1=.89, P<.05) are consistent with the criterion EE. CONCLUSIONS: Availability of PA monitors can assist wheelchair users to track PA levels, leading toward a healthier lifestyle. The new models we developed can estimate PA levels in manual wheelchair users with SCI in laboratory and community settings.

Interrater Reliability of the Power Mobility Road Test in the Virtual Reality-Based Simulator-2.

OBJECTIVE: To assess interrater reliability of the Power Mobility Road Test (PMRT) when administered through the Virtual Reality-based SIMulator-version 2 (VRSIM-2). DESIGN: Within-subjects repeated-measures design. SETTING: Participants interacted with VRSIM-2 through 2 display options (desktop monitor vs immersive virtual reality screens) using 2 control interfaces (roller system vs conventional movement-sensing joystick), providing 4 different driving scenarios (driving conditions 1-4). Participants performed 3 virtual driving sessions for each of the 2 display screens and 1 session through a real-world driving course (driving condition 5). The virtual PMRT was conducted in a simulated indoor office space, and an equivalent course was charted in an open space for the real-world assessment. After every change in driving condition, participants completed a self-reported workload assessment questionnaire, the Task Load Index, developed by the National Aeronautics and Space Administration. PARTICIPANTS: A convenience sample of electric-powered wheelchair (EPW) athletes (N=21) recruited at the 31st National Veterans Wheelchair Games. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Total composite PMRT score. RESULTS: The PMRT had high interrater reliability (intraclass correlation coefficient [ICC]>.75) between the 2 raters in all 5 driving conditions. Post hoc analyses revealed that the reliability analyses had >80% power to detect high ICCs in driving conditions 1 and 4. CONCLUSIONS: The PMRT has high interrater reliability in conditions 1 and 4 and could be used to assess EPW driving performance virtually in VRSIM-2. However, further psychometric assessment is necessary to assess the feasibility of administering the PMRT using the different interfaces of VRSIM-2.

Stability and Workload of the Virtual Reality-Based Simulator-2.

OBJECTIVE: To assess the stability of clinicians' and users' rating of electric-powered wheelchair (EPW) driving while using 4 different human-machine interfaces (HMIs) within the Virtual Reality-based SIMulator-version 2 (VRSIM-2) and in the real world (accounting for a total of 5 unique driving conditions). DESIGN: Within-subjects repeated-measures design. SETTING: Simulation-based assessment in a research laboratory. PARTICIPANTS: A convenience sample of EPW athletes (N=21) recruited at the 31st National Veterans Wheelchair Games. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Composite PMRT scores from the Power Mobility Road Test (PMRT); Raw Task Load Index; and the 6 subscale scores from the Task Load Index developed by the National Aeronautics and Space Administration (NASA-TLX). RESULTS: There was moderate stability (intraclass correlation coefficient between .50 and .75) in the total composite PMRT scores (P<.001) and the users' self-reported performance scores (P<.001) among the 5 driving conditions. There was a significant difference in the workload among the 5 different driving conditions as reflected by the Raw Task Load Index (P=.009). Subanalyses revealed this difference was due to the difference in the mental demand (P=.007) and frustration (P=.007) subscales. Post hoc analyses revealed that these differences in the NASA-TLX subscale scores were due to the differences between real-world and virtual driving scores, particularly attributable to the conditions (1 and 3) that lacked the rollers as a part of the simulation. CONCLUSIONS: Further design improvements in the simulator to increase immersion experienced by the EPW user, along with a standardized training program for clinicians to deliver PMRT in VRSIM-2, could improve the stability between the different HMIs and real-world driving.

Immediate Biomechanical Implications of Transfer Component Skills Training on Independent Wheelchair Transfers.

OBJECTIVE: To evaluate the immediate effects of transfer training based on the Transfer Assessment Instrument (TAI) on the upper limb biomechanics during transfers. DESIGN: Pre-post intervention. SETTING: Biomechanics laboratory. PARTICIPANTS: Full-time manual wheelchair users (N=24) performed 5 transfers to a level height bench, while their natural transfer skills were scored using the TAI, and their biomechanical data were recorded. INTERVENTION: Participants with 2 or more component skill deficits were invited to return to receive personalized transfer training. MAIN OUTCOME MEASURES: TAI part 1 summary scores and biomechanical variables calculated at the shoulder, elbow, and wrist joints were compared before and immediately after transfer training. RESULTS: Sixteen of the 24 manual wheelchair users met the criteria for training, and 11 manual wheelchair users came back for the revisit. Their TAI part 1 summary scores improved from 6.31±.98 to 9.92±.25. They had significantly smaller elbow range of motion, shoulder resultant moment, and rates of rise of elbow and wrist resultant forces on their trailing side during transfers after training (P<.05). On the leading side, shoulder maximum internal rotation and elevation angles, and shoulder resultant moments and rates of rise of shoulder resultant force and moment decreased after training (P<.04). CONCLUSIONS: The TAI-based training showed short-term beneficial biomechanical effects on wheelchair users' upper limbs, such as better shoulder positioning and lower joint loadings. If the skills are practiced longer-term, they may help protect the upper limbs from developing pain and injuries.

Upper limb joint kinetics of three sitting pivot wheelchair transfer techniques in individuals with spinal cord injury.

STUDY DESIGN: Repeated measures design. OBJECTIVE: This study compared the upper extremity (UE) joint kinetics between three transfer techniques. SETTING: Research laboratory. METHODS: Twenty individuals with spinal cord injury performed three transfer techniques from their wheelchair to a level tub bench. Two of the techniques involved a head-hips method with leading hand position close (HH-I) and far (HH-A) from the body, and the third technique with the trunk upright (TU) and hand far from body. Motion analysis equipment recorded upper body movements and force sensors recorded their hand and feet reaction forces during the transfers. RESULTS: Several significant differences were found between HH-A and HH-I and TU and HH-I transfers indicating that hand placement was a key factor influencing the UE joint kinetics. Peak resultant hand, elbow, and shoulder joint forces were significantly higher for the HH-A and TU techniques at the trailing arm (P < 0.036) and lower at the leading arm (P < 0.021), compared to the HH-I technique. CONCLUSION: Always trailing with the same arm if using HH-A or TU could predispose that arm to overuse related pain and injuries. Technique training should focus on initial hand placement close to the body followed by the amount of trunk flexion needed to facilitate movement.

Improving Target Acquisition for Computer Users With Athetosis.

Prior work has highlighted the challenges faced by people with athetosis when trying to acquire on-screen targets using a mouse or trackball. The difficulty of positioning the mouse cursor within a confined area has been identified as a challenging task. We have developed a target acquisition assistance algorithm that features transition assistance via directional gain variation based on target prediction, settling assistance via gain reduction in the vicinity of a predicted target, and expansion of the predicted target as the cursor approaches it. We evaluated the algorithm on improving target acquisition efficiency among seven participants with athetoid cerebral palsy. Our results showed that the algorithm significantly reduced the overall movement time by about 20%. Considering the target acquisition occurs countless times in the course of regular computer use, the accumulative effect of such improvements can be significant for improving the efficiency of computer interaction among people with athetosis.

On the Move pad - a portable multipurpose pad: User feedback.

CONTEXT/OBJECTIVE: Hard-shell toilet seats may compromise safety and hinder the participation of individuals at risk for pressure injuries (PIs) when using these facilities away from home in public, hotel, or family/friend restrooms. Moreover, people often add "wash-cloths" for additional padding for comfort, and to reduce the risk of PIs due to pressure or shearing on their wheelchairs surfaces. This study investigated the utilization of portable pads, initially designed for toilet use but adaptable to various places and contexts, while examining pad usability. DESIGN: A cross-sectional descriptive survey design. SETTING: Inpatient care, outpatient care, and community setting. PARTICIPANTS: 45 individuals at risk of PIs. RESULTS: Participants extended the use of these pads beyond toilets, employing them as wheelchair armrest and leg rest pads in other settings. Feedback from a customized questionnaire indicated high levels of usefulness (8.5/10) and ease of use (9.1/10) attributed to the pads. Among the features, the top three favored were ease of use, comfort/cushioning, and function. Participants expressed a desire for a variety of sizes and colors to enable versatile usage and suggested incorporating a pocket for storing small items. CONCLUSIONS AND RELEVANCE: Individuals at risk of PIs require cushioning not only on hard-shell toilet seats, but also for additional padding, protection and enhancing the use of wheelchairs. Rehabilitation professionals can play a crucial role in educating and training both clients and caregivers to understand PI prevention, enabling them to effectively leverage the pads in appropriate situations, thereby enhancing their comfort in their wheelchairs during social engagement.

Evaluation of Electric and Air-Powered Shopping Scooters in Grocery Stores.

OBJECTIVE: The purpose of this study was to further previous research and gather additional information regarding the usage of motorized shopping scooters as well as feedback for improvements to an air-powered scooter. METHODS: Online surveys were used to assess individuals' shopping characteristics and experience using the motorized scooters and to gather feedback from store employees regarding their experience. K-Means clustering analysis was used to determine user demographics who chose to use the air-powered scooter versus the electric-powered scooter while shopping. RESULTS: A total of 127 individuals provided informed consent, 65 individuals from site 1 and 62 individuals from site 2. One hundred twenty participants met the inclusion criteria and completed the survey. K-Means clustering found that age, type of personal mobility device, shopping bill total, and frequency using a motorized shopping scooter to be significant factors in whether individuals chose to use an air-powered scooter or electric-powered scooter. CONCLUSIONS: Motorized shopping scooters are in high demand and used by a wide variety of individuals, yet electric-powered scooters are commonly unavailable because of having dead batteries or all the devices being in use. Air-powered scooters may serve as a practical replacement for the current electric-powered scooters found in grocery and retail stores.

Perceptions and assessment of a novel robotic wheelchair transfer system.

OBJECTIVES: Wheelchair transfers risk injury to users and caregivers. Conventional transfer devices are injury-prone and time inefficient. The Powered Personal Transfer System (PPTS), utilizing a modified Electric Powered Wheelchair (EPW) and a hospital bed, provides a no-lift solution for bed-to-wheelchair transfers. Objective 1: Assess PPTS workload compared to existing methods. Objective 2: Evaluate PPTS EPW in daily mobility tasks. Objective 3: Perform Rehabilitation Engineering and Assistive Technology Society of North America (RESNA) wheelchair standards testing for PPTS EPW stability and performance. METHODS: Fifteen professional and family caregivers, experienced in assisting EPW users, performed transfers between the bed and EPW using the PPTS. Subsequently, participants drove the PPTS EPW providing ratings on the ease of performing mobility tasks. Wheelchair testing was conducted following RESNA standards. SETTING: : Simulated bedroom in a laboratory setting. RESULTS: Participants reported low workload demands for employing the PPTS and indicated a preference for the PPTS over existing transfer devices/methods. Ease of performing everyday mobility tasks was not significantly different between the modified PPTS and the commercially available original manufacturer equipment EPW (p > 0.05). RESNA wheelchair standards testing confirmed that the PPTS EPW preserves functionality, stability and performance when compared to similar commercially available EPWs. CONCLUSION: The PPTS demonstrated promise in offering a practical, low demanding, and safe solution for transfers. It has the potential to enhance user and caregiver safety by reducing the incidence of caregiver injuries associated with assisting in transfer tasks. In addition to its efficiency and ease of use, it is an advancement in assistive technology for wheelchair transfers.

Discovering Provider Awareness of Mobility Assistive Technologies and Clinical Guidelines-A Comparative Analysis With Consumer Responses.

OBJECTIVE: This study aims to enhance the accessibility and quality of mobility-assistive technology by investigating and bridging knowledge gaps between mobility-assistive technology providers and consumers with ambulatory limitations. DESIGN: A survey was conducted among mobility-assistive technology providers in the United States, consisting of sections on awareness, knowledge importance and desire, and knowledge sources. The responses were compared to data collected from consumers in a previous study. RESULTS: A total of 144 mobility-assistive technology providers participated, with 60% having received academic or professional training in relevant fields. Analysis revealed significant knowledge gaps between providers and consumers, particularly in assistive technology assessment tools and knowledge sources. Moderate gaps were also observed in areas such as clinical practice guidelines, desired mobility-assistive technology information, and knowledge sources. However, the gaps in other areas were relatively small. CONCLUSIONS: This study highlights the knowledge gaps between mobility-assistive technology providers and consumers, hindering the optimal utilization and fulfillment of user needs. Providers possess valuable information that consumers may lack, positioning them as primary knowledge sources. Addressing these gaps through targeted interventions, improved communication channels, and enhanced education can enhance the utilization of mobility-assistive technology and improve outcomes for individuals with ambulatory limitations.

Current State, Needs, and Opportunities for Wearable Robots in Military Medical Rehabilitation and Force Protection.

Despite advances in wearable robots across various fields, there is no consensus definition or design framework for the application of this technology in rehabilitation or musculoskeletal (MSK) injury prevention. This paper aims to define wearable robots and explore their applications and challenges for military rehabilitation and force protection for MSK injury prevention. We conducted a modified Delphi method, including a steering group and 14 panelists with 10+ years of expertise in wearable robots. Panelists presented current wearable robots currently in use or in development for rehabilitation or assistance use in the military workforce and healthcare. The steering group and panelists met to obtain a consensus on the wearable robot definition applicable for rehabilitation or primary injury prevention. Panelists unanimously agreed that wearable robots can be grouped into three main applications, as follows: (1) primary and secondary MSK injury prevention, (2) enhancement of military activities and tasks, and (3) rehabilitation and reintegration. Each application was presented within the context of its target population and state-of-the-art technology currently in use or under development. Capturing expert opinions, this study defines wearable robots for military rehabilitation and MSK injury prevention, identifies health outcomes and assessment tools, and outlines design requirements for future advancements.