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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.
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Pessoas com Deficiência , Meios de Transporte , Humanos , Masculino , Pessoas com Deficiência/reabilitação , Pessoa de Meia-Idade , Feminino , Idoso , Adulto , Estados Unidos , Cadeiras de Rodas , Acessibilidade Arquitetônica , Comportamento do Consumidor , Inquéritos e Questionários , Adulto JovemRESUMO
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.
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Cadeiras de Rodas , Masculino , Humanos , Feminino , Animais , Suínos , Adulto , Pessoa de Meia-Idade , Idoso , Estudos Transversais , Desenho de EquipamentoRESUMO
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.
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Pessoas com Deficiência , Tecnologia Assistiva , Cadeiras de Rodas , Idoso , Estados Unidos , Humanos , Desenho de Equipamento , MedicareRESUMO
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.
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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.
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Acessibilidade Arquitetônica/métodos , Desenho de Equipamento/métodos , Robótica , Cadeiras de Rodas , Idoso , Desenho Assistido por Computador , Fontes de Energia Elétrica , Meio Ambiente , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Navegação EspacialRESUMO
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.
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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.
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Fontes de Energia Elétrica , Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Comportamento do Consumidor , Comércio , Supermercados , Adulto JovemRESUMO
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.
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OBJECTIVE: This study aims to enhance the accessibility and quality of mobility assistive technology (MAT) by investigating and bridging knowledge gaps between MAT providers and consumers with ambulatory limitations. DESIGN: A survey was conducted among MAT 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 MAT providers participated, with 60% having received academic or professional training in relevant fields. Analysis revealed significant knowledge gaps between providers and consumers, particularly in AT assessment tools and knowledge sources. Moderate gaps were also observed in areas such as clinical practice guidelines, desired MAT information, and knowledge sources. However, the gaps in other areas were relatively small. CONCLUSION: This study highlights the knowledge gaps between MAT 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 MAT and improve outcomes for individuals with ambulatory limitations.
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PURPOSE: Assistive Technology (AT) devices provide essential means of mobility, employment, communication, social engagement for older adults and people with different disabilities, if prescribed correctly to match users' needs and goals. Regardless of the setting or location, a successful AT service delivery model includes the multidisciplinary collaboration of the people with disabilities and the specialists who have knowledge and expertise in the design and application of AT. In Saudi Arabia, unfortunately, the availability of AT devices is mainly limited to basic mobility and daily living aids such as wheelchairs and seating systems, prosthetics and orthotics, communication devices, low-vision devices, and adapted transportation equipment. The aim of this perspective is to provide clinicians and healthcare professionals in Saudi Arabia with a model for the optimisation of the provision of AT devices decision making regarding AT devices for people with disabilities by adhering to a user-centered team approach throughout the service delivery process. METHOD: The policy, human, activity, assistance, technology, and environment (PHAATE) model is used as a conceptual framework and guideline for this paper. RESULTS AND CONCLUSION: The PHAATE components could serve as a guideline for a wide range of stakeholders in Saudi Arabia (e.g., researchers, product developers, practitioners, clinicians, third-party reimbursement entities, consumers, and educators) when developing service delivery systems.IMPLICATION FOR REHABILITATIONDespite the support and funding resources of AT devices by the Saudi government, there is still the needs to increase awareness and knowledge about AT application and services, as well as optimal service delivery models of AT devices.AT service delivery provision models such as PHAATE model may help clinicians and other medical professionals in Saudi Arabia to make informed decisions about the provision of AT device services.
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Pessoas com Deficiência , Tecnologia Assistiva , Cadeiras de Rodas , Humanos , Idoso , Arábia Saudita , Pessoal de SaúdeRESUMO
This study investigated the changes in caregiver burden during the coronavirus disease 2019 (COVID-19) pandemic. The study sample included 827 caregivers for older adults (65+) from the National Health and Aging Trends Study (NHATS) COVID-19 data set. We used paired t-tests to analyze data. The caregivers' assistance in basic and instrumental activities of daily living for care recipients, as well as the amount of time they provided, increased significantly (all ps < .001) during the pandemic compared with before. Approximately, 40% of caregivers reported changes in the amount of assistance they provided during the pandemic. Financial, emotional, and physical difficulties among caregivers have increased, with emotional difficulties being the most frequently reported. The majority of caregivers reported not utilizing any social services during the pandemic. The pandemic may have heightened the caregiver burden. It is important to ensure that caregivers have access to and utilize social services in a physically and psychologically safe manner.
Plain Language Summary Title: The changes in caregiver burden during the COVID-19 pandemic.Plain Language Summary: We investigated the changes in caregiver burden during the coronavirus disease 2019 (COVID-19) pandemic with 827 caregivers for older adults (65+). The findings showed that the pandemic may have heightened the caregiver burden. It is important to ensure that caregivers have access to and utilize social services in a physically and psychologically safe manner.
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BACKGROUND: Current clinical practice guidelines (CPG) recommend periodic pressure redistribution (PR) to alter sitting pressure and reduce the risk of developing pressure injuries (PI). Individuals who have strength and trunk stability are asked to perform PR such as wheelies, leaning laterally, and forward-leaning to minimize the duration of pressure acting on the same region of the body. OBJECTIVE: Our long-term objective is to build upon previous research and development to create a more effective device for improving PR training and adherence to CPG among manual wheelchair users (MWU). Through this study, we employed a participatory action design and engineering (PADE) approach in developing the hardware and user interface to increase the likelihood of eventually yielding a device effective for both MWU and clinicians. PARTICIPANTS: Focus Groups: Ten clinicians - 6 physical therapists, 3 occupational therapists, and one registered nurse, and 10 MWU with spinal cord injuries (SCI) who reported using their wheelchairs 40-80â h per week. Five-Day Assessment: Five male MWU with SCI who had been wheelchair users for 18.5 ± 16.2 years. Four-Week Investigation: The 7 participants with SCI were 5 males and 2 females, who had been wheelchair users for 24.7 ± 17.0 years. METHODS: A PADE approach was used to improve upon a manual wheelchair virtual coaching system for people with SCI. The system comprises a seat support instrumented with force sensors, software algorithms to detect PR, and a smart phone app for user interface. The methods included three stages: multiple focus groups, a five-day evaluation phase with participants using their own wheelchairs in their homes and communities, and a 4-week assessment with improvements made based on the 5-day results by users with their own wheelchairs in their homes and communities. RESULTS: The focus groups yielded guidance for ergonomics, user interface, charging frequency, and key dimensions and mass. The 5-day study identified mechanical, electrical, and connectivity challenges, which were resolved before the 4-week study. The 4-week trial suggested that participants performed PR less frequently than clinically recommended and provided an indication of the types of maneuvers that they performed. CONCLUSION: A prototype manual wheelchair virtual coaching system was developed using a PADE process. The system was able to detect and record PR in home and community environments. Following improvements identified in this study, a future version will be tested with additional users to determine whether it can improve adherence to PR guidance.
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Traumatismos da Medula Espinal , Cadeiras de Rodas , Feminino , Humanos , MasculinoRESUMO
BACKGROUND: Pressure injuries from prolonged sitting are a significant problem for wheelchair users incurring high costs in healthcare expenditures and reducing quality-of-life. There is a need to improve pressure relief training and adherence in a variety of settings. OBJECTIVE: To identify effective common wheelchair pressure relief (PR) manoeuvres based on changes to users' seated centre of pressure (CoP) and seated weight. PARTICIPANTS: 20 individuals who use manual wheelchairs as their primary means of mobility. METHODS: Participants performed 5 types of PR including seated push-ups, leftward, rightward, forward, and backward leans-while sitting in a wheelchair equipped with a custom instrumented seat pan support. Data were analysed using both clustering and decision tree approaches to identify types of PR. RESULTS: Both clustering and decision tree approaches were able to identify and classify PR though neither could accurately distinguish between forward and backward PR. CONCLUSION: Changes in the centre of pressure and the total weight on the wheelchair's seat can be used to automatically characterise type, amplitude and duration of pressure relief manoeuvres. Building such a classification and quality assessment scheme into an algorithm could enable a virtual coaching system to track users' pressure relief behaviour and make suggestions to improve adherence with clinical recommendations.IMPLICATIONS FOR REHABILITATIONMultiple bending beam load cells can be used to measure wheelchair users' seated centre of pressure independent of type of cushion used.Both cluster analysis and decision tree algorithms can classify commonly practiced pressure reliefs by measuring changes to the centre of pressure and total weight on the wheelchair's seat.The combination of force sensing for centre of pressure determination and either algorithm could serve as the basis for an application to coach wheelchair users to do effective pressure reliefs.
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Pressão , Cadeiras de Rodas , Humanos , Suporte de CargaRESUMO
The QLX is a low-profile automatic powered wheelchair docking system (WDS) prototype developed to improve the securement and discomfort of wheelchair users when riding in vehicles. The study evaluates the whole-body vibration effects between the proposed QLX and another WDS (4-point tiedown system) following ISO 2631-1 standards and a systematic usability evaluation. Whole-body vibration analysis was evaluated in wheelchairs using both WDS to dock in a vehicle while riding on real-world surfaces. Also, participants rated the usability of each WDS while driving a wheelchair and while riding in a vehicle in driving tasks. Both WDSs showed similar vibration results within the vibration health-risk margins; but shock values below health-risk margins. Fifteen powered wheelchair users reported low task load demand to operate both WDS; but better performance to dock in vehicles with the QLX (p = 0.03). Also, the QLX showed better usability (p < 0.01), less discomfort (p's < 0.05), and greater security compared to the 4-point tiedown while riding in a vehicle (p's < 0.05). Study findings indicate that both WDS maintain low shock exposure for wheelchair users while riding vehicles, but a better performance overall to operate the QLX compared to the 4-point tiedown system; hence enhancing user's autonomy to dock in vehicles independently.
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PURPOSE: This study aimed to explore the requirements for accessible Autonomous Vehicles (AVs) and AV services from a consumer perspective, focusing on people with disabilities (PwDs) and older adults. METHODS: Two national surveys were conducted, capturing current transportation trends and AV priorities. Participants (n = 922) with disabilities and older adults were included in the analysis. RESULTS: Transportation choices exhibited significant divergence based on the underlying causes of disabilities, showcasing distinct inclinations and impediments within each category. AV services, encompassing family conveyance and package delivery, proved integral, but their specific desirability fluctuated in accordance with the nature of disabilities. Notably, medical appointments emerged as the foremost AV utilisation requirement, particularly pronounced among individuals with hearing impairments. Preferences for orchestrating AV rides and the preferred vehicle types displayed disparities linked to the various disability classifications. The employment of mobile applications, websites, and text messages were preferred mediums for arranging rides. Features such as automated route guidance and collision prevention garnered unanimous precedence among AV attributes. Key priorities, spanning wheelchair accessibility, user profiles, and seamless communication with AVs, were universally emphasised across all participant clusters. The study indicated a moderate comfort level with AV deployment, implying the potential for favourable reception within the population of PwDs and older adults. CONCLUSION: The study highlights the significance of considering diverse needs in accessible AV development of vehicle and infrastructure and policies.
The findings inform evidence-based interventions and programmes that prioritise accessibility needs, promoting social inclusion and equitable transportation solutions.Continued research and advocacy are essential for successful autonomous vehicle integration, catering to the needs of all individuals.
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PURPOSE: Existing automated vehicle transportation guidelines and regulations have minimal guidance to address the specific needs of people with disabilities. Accessibility should be at the forefront to increase autonomy and independence for people with disabilities. The purpose of this research is to better understand potential facilitators and barriers to using accessible autonomous transportation. METHODS: Focus groups were conducted with key stakeholders derived from people with disabilities (n = 5), travel companions/caregivers (n = 5), and transportation experts or designers (n = 11). RESULTS: The themes include describing stakeholder perceptions across all three groups by identified themes: autonomous vehicle assistive technology, autonomy vs automation, cost, infrastructure, safety & liability, design challenges, and potential impact. CONCLUSION: Specific gaps and needs were identified regarding barriers and facilitators for transportation accessibility and evidence-based guidance. These specific gaps can help to formulate design criteria for the communication between, the interior and exterior of accessible autonomous vehicles.
Accessible and affordable autonomous transportation may increase mobility and the autonomy of people with disabilities to travel spontaneously.Autonomous vehicles and services should be designed to accommodate various types of disabilities such as multimodal and multilingual device communication.Safety and liability regulatory protocols need to be developed for incidents and emergencies.Wheelchair user, especially people who use powered devices, would need systems for ingress/egress, docking, and occupant restraints.
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The objectives of this study were: to identify the factors that are associated with prescription of wheeled mobility devices for older adults, and to determine the effect that living setting has on the types of devices that older adults receive. Retrospective medical chart review at the Center for Assistive Technology on 337 older individuals. These individuals were aged >60 years, and each of them received a new wheeled mobility device from the center during 2007 or 2008. Data were analyzed in three tiers: tier 1 (manual versus powered mobility devices); tier 2 (motorized scooters versus power wheelchairs); and tier 3 (customized versus standard power wheelchairs). For tier 1, the factor associated with higher odds for receipt of manual wheelchairs versus powered were: cognitive limitations (OR = .03). For tier 2, diagnosis of cardio-vascular and pulmonary conditions were associated with prescription of motorized scooters (OR = 3.9). For tier 3, neurological conditions (OR = 3.1), male gender (OR = .37), institutional living (OR = .23), and lower age (OR = .96) were associated with receipt of customized power wheelchairs. This study objectively describes factors associated with prescription of wheeled mobility for older adults. This information can aid in development of guidelines and improving standards of practice for prescription of wheelchairs for older adults.
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Prescrições , Cadeiras de Rodas , Idoso , Feminino , Habitação , Humanos , Masculino , Pessoa de Meia-Idade , Cadeiras de Rodas/classificaçãoRESUMO
PURPOSE: Motorized shopping carts found at grocery and retail stores provide mobility for those who have difficulty walking through the store or pushing a regular cart. The purpose of this study was to understand the usage of motorized carts in grocery stores and pilot test an air-powered cart to determine its feasibility as a replacement for electric-powered carts as well as identify areas for improvement and preferred users. METHODS: Users were asked to complete an online survey that assessed their shopping characteristics and experience using the motorized cart. K-Means clustering determined user demographics who chose to use the air-powered carts versus the electric-powered carts. Open-ended comments for improvements were also collected. RESULTS: A total of 65 participants were provided informed consent, 60 participants met inclusion criteria and completed the survey. A majority of the air-powered (N = 29, 91%) and electric-powered (N = 11, 73%) cart users had a positive experience. Clustering found age and type of mobility device owned were significant whether participants chose the air-powered or electric-powered carts. Most suggested improvements for the air-powered carts were better braking, higher speed and a bigger basket while a longer battery life was most suggested for electric-powered carts. CONCLUSIONS: Motorized shopping carts are used by a wide variety of individuals. Individuals aged 54 or younger and do not own a mobility device chose to use air-powered more than electric-powered carts. The functional capabilities of the air-powered carts demonstrated their potential to serve as practical replacements for electric-powered carts found in grocery and retail stores.Implications for rehabilitationThe availability and reliability of motorized shopping carts at retail stores are integral for individuals with physical impairments to complete their shopping needs.The development of novel assistive devices such as air-powered carts provides improved experiences and quality of life.Integrating end-user feedback during the design of assistive technologies is paramount for meeting actual needs.
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Qualidade de Vida , Tecnologia Assistiva , Humanos , Pessoa de Meia-Idade , Projetos Piloto , Reprodutibilidade dos Testes , SupermercadosRESUMO
OBJECTIVE: To evaluate ultralight folding manual wheelchairs (UFMWs) in order to produce comparative data on their strength, durability, stability and cost-benefit, and to determine progress of wheelchairs by comparing these results to results of past studies. DESIGN: Engineering testing using American National Standards Institute (ANSI) and Rehabilitation Engineering and Assistive Technology Society of North America (RESNA) standards. SETTING: Laboratory testing of UFMW stability, and static, impact and fatigue strength performance with three devices using ANSI/RESNA standardized tests. PARTICIPANTS: The three wheelchair models were the TiLite Aero X (Permobil, Lebanon, TN), Sunrise Medical Quickie 2 (Fresno, CA) and Ki Mobility Catalyst 5 (Stevens Point, WI). INTERVENTIONS: ANSI/RESNA standardized tests. MAIN OUTCOME MEASURES: Mass and critical measurements, static stability, static strength, impact strength, fatigue strength and cost analysis. RESULTS: The ultralight folding wheelchairs continued to outperform their lightweight and rigid framed counterparts. According to these data, the quality of ultralight wheelchairs has not declined over the past 10 years. The Ki Catalyst did not pass strength and durability testing, while the TiLite Aero X and Sunrise Medical Quickie 2 surpassed these tests. CONCLUSIONS: This result exemplifies the need for ongoing research to identify whether wheelchairs satisfy ANSI/RESNA testing requirements and highlights the importance of creating a resource data set. This is particularly important when numerous other wheelchairs fail to meet minimum ANSI/RESNA requirements.Implications for RehabilitationFolding frame wheelchairs offer benefits such as transportability and convenience that may benefit certain wheelchair users, assuming their durability is sufficient and they provide similar benefits vs. other wheelchair construction.Previous studies have shown that folding wheelchairs perform meet the minimum requirements of standardized testing, and it is important to see if durability has increased, decreased or remained the same over the years. Other wheelchair types have remained stagnant with respect to durability and are less likely to meet the minimum durability requirements.Durable devices will improve a wheelchair user's quality of life by reducing downtime while waiting for repairs, and also reduce the likelihood of injury due to component failure.
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Cadeiras de Rodas , Análise Custo-Benefício , Desenho de Equipamento , Análise de Falha de Equipamento , Humanos , Qualidade de VidaRESUMO
INTRODUCTION: The RATD represents a novel methodology to reduce strain, manoeuvring, and cognitive load a caregiver experiences when conducting transfers on a mannequin. However, caregivers who used this new technology report suggested adjustments regarding the robot's human machine interface and shape as to improve transfer efficiency and comfort for care recipients. The purpose of this study was to test a redesigned RATD and compare its ergonomics during a transfer to those of a mechanical floor lift. METHODS: This was cross sectional protocol. As opposed to prior research which used a mannequin, caregivers in this study (N = 28) partnered with, and transferred, a mobility device user (N = 28) at three unique surfaces. Information about task demand and usability was collected from surveys after use of each device at each surface. RESULTS: Results indicated reduced physical demand (p = .004) and discomfort frequency (p = .01) in caregivers conducting the transfers with the RATD compared to the mechanical floor lift. Care recipients reported no significant differences between both transfer devices. Critiques with the interface, the harness and sling, and the robot's rigidity indicated more work is needed before introducing this technology to a larger market. Conclusions: The RATD represents a promising new intervention for transferring and handling care recipients who use wheelchairs. However, while caregivers report reduced physical demand and discomfort, more work is required to advance the ease of the human machine interface, the amount of space allowed for the robot to operate, and the ability of the care recipient to operate the technology independently.IMPLICATIONS FOR REHABILITATIONCaregivers report significant physical and mental stress while transferring clients in and out of a wheelchair.Clinical standard transfer equipment is limited in the space which it can be used.Robots, particularly those portable and powered, have the ability to not only make the transfer experience safer, but also expand the applications this equipment can provide.