In recent years, several problems in the field of assistive device have been lifted. To manage the development Beslutsstöd (Decision support) has emerged as a systematic working method. Beslutsstöd is designed as a guideline and serves as a tool for physical therapists and occupational therapists in the prescription process of assistive devices. Beslutsstöd thereby aims to improve the quality and effectiveness of the prescribing process of assistive device in the organization of the municipalities. An implementation evaluation about how the implementation of Beslutsstöd in the municipalities did proceed has not been done. Neither is there any set plan for how the implementation of Beslutsstöd will proceed in the municipalities. Therefore, the evaluation's main question is: how did municipalities proceed to implement Beslutsstöd in order to develop and ensure the quality of their work regarding prescribing assistive device. Two central questions are if success factors and/or obstacles of certain significance can be detected throughout the implementation process of Beslutsstöd, if so, which? We also asked whether the respondents perceive that the local goals for implementing Beslutsstöd have been reached. The evaluation showed that the implementation processes in the three municipalities differ. Four components have distinguished as particularly significant in all municipalities in relation to success factors and obstacles. These are motivation, information, a gradually approach and the ability of the municipality to adapt Beslutsstöd towards their organization or vice versa. Two municipalities have successfully implemented Beslutsstöd and therefor reached their goals. One municipality did not succeed in fulfilling their goals and is not practicing Beslutsstöd today.

Suffering from a hearing impairment or deafness has major consequences on the individual's social life. Today, there exist various aids, but there are some challenges with these, like availability, reliability and high cognitive load when the user trying to focus on both the aid and the surrounding context. To overcome these challenges, one potential solution could make use of a combination of Augmented Reality (AR) and speech-to-text systems, where speech is converted into text that is then presented in AR glasses. However, in AR, one crucial problem is the legibility and readability of text under different environmental conditions. Moreover, different types of AR-glasses have different usage characteristics, which implies that a certain type of glasses might be more suitable for the proposed system than others. For speech-to-text systems, it is necessary to consider factors such as accuracy, latency and robustness when used in different acoustic environments and with different speech audio.  In this master thesis, two different AR-glasses are being evaluated based on the different characteristics of the glasses, such as optical, visual and ergonomic. Moreover, user tests are conducted with 23 normal hearing individuals to evaluate the legibility and readability of text under different environmental contexts. Due to the pandemic, it was not possible to conduct the tests with hearing impaired individuals. Finally, a literature review is performed on speech-to-text systems available on the Swedish market.   The results indicate that the legibility and readability are affected by several factors, such as ambient illuminance, background properties and also how the text is presented with respect to polarity, opacity, size and number of lines. Moreover, the characteristics of the glasses impact the user experience, but which glasses are preferable depends on the individual's preferences.   For the choice of a speech-to-text system, four speech-to-text APIs available on the Swedish market were identified. Based on our research, Google Cloud Speech API is recommended for the proposed system. However, a more extensive evaluation of these systems would be required to determine this. / Speech-to-Text System using Augmented Reality for People with Hearing Deficits

Previous literature has indicated that nursing personnel face the second highest rate of occupational injury and illness. Assistive equipment, such as lift and transfer aids, has helped lower work task demands and reduce back stress on patient handlers. However, limited attention has been paid to the safety, comfort and dignity of the patient in postoperative care. Research on the efficacy of self-transfer aids for patients who require limited or no assistance by nursing personnel is insufficient. Ratings of comfort and security have only been evaluated for nursing home residents in a pilot field study, in which residents rated assistive devices as generally equal to or more secure and comfortable than manual transfer methods. The first study reports the laboratory evaluation of bed rising with the use of two self-transfer aids and bed rising unassisted. The objective was to determine muscle activity during bed rising tasks with and without the use of a bed assistive device using surface electromyography (EMG). Twenty male (n = 9; age, 33.7 ± 8.0 years) and female (n = 11; age, 34.5 ± 23.9 years) participants, with normal body mass index (BMI) ranging from 18.4 to 24.9, took part in the study. Mean and peak activity was recorded from three abdominal muscle sites. The results indicated bed rising with the use of a self-transfer device significantly reduced muscle activity compared to bed rising unassisted. Anchoring the devices at a higher height and elevating the torso further reduced muscle activity. Although no differences were observed between devices using EMG, results from the usability survey and final ranking indicated favorable ratings for the ABNOSTRAINTM prototype compared to the Bed Pull-up. A second study was conducted to determine the efficacy of a bed assistive device in a patient population. The objective was to compare self-perceived recovery measures and usage of pain medication between patients in the control (n = 8; age, 34.0 ± 6.3years) and device (n = 7; 40.7 ± 12.4) groups. A total of fifteen female participants undergoing either abdominal hysterectomy (n = 6) or Cesarean-section (n = 9) procedures were recruited for the study. Both groups completed a total of twelve questionnaires over a five-week recovery period. Responses to self-perceived recovery measures were significantly different. In general, the device group reported higher levels of energy, less pain interference, lower perceived pain, less reliance on pain medication and returned to activities of daily living faster than the control group. The results from the study provide clinicians or other practitioners information on the benefits of bed assistive devices for patients during postoperative recovery. Age and surgery differences should be considered when suggesting bed movement patterns with assistive intervention. / Master of Science

This work deals with a new approach of designing ortho-prosthetic devices in terms of mechanical solution and innovative design. The work was addressed to a specific patient with congenital malformation of upper limbs called phocomelia. A custom-made compensatory aid was made on basis of personal consultations and meetings on specialized workplace; however the aid was built in a way and from parts for other kind of disability. As it turned out, the use of this equipment is associated with many complications, and therefore as a result, this solution proved as unsatisfactory. Nevertheless, thanks to this compensation aid it was possible to specify the problems, to reveal important patterns and highlight the needs for development of entirely new and unique aid designed for patients with phocomelia disability. The work is based on these findings and knowledge acquired from bibliographic search in the field of orthotics, prosthetics, assistive devices and prosthetic equipment. A complete redesign was done with the aim to eliminate all detected problems. The presented result is a unique tool for people with specific congenital disability of upper limbs, with working label 4TE.

The purpose of this thesis is to explore the subject of industrial exoskeleton in accord-ance to the applicability of the technology preventing musculoskeletal disorders within the automotive industry. The modern technology of exoskeletons has a limited field of research and knowledge and is in need to be studied to provide organisations with proper findings for understanding the applicability of the technology. In the auto-motive industry musculoskeletal disorders (MSDs) is one of the most common disor-ders among employees and industries work constantly to decrease and prevent MSDs within their work environments. By conducting literature reviews, the status of exo-skeleton research and development concluded that academic research mostly focuses on technological development of exoskeletons, and not laboratory and/or field testing of currently available industrial exoskeletons. However, through database and website searches, twenty-four available industrial exoskeletons were identified which could be applicable within the automotive industry. Through literature and a case illustration, a number of potential causes for MSDs within the automotive industry were identified and a framework was developed in order to match appropriate available industrial ex-oskeleton to be used in potentially preventing common MSDs. The discussion of the thesis highlights the benefits and challenges of implementing an industrial exoskele-ton within an industry. Proper research on the currently available industrial exoskele-tons is lacking and creates questions of reliability for the technology. However, devel-opment of industrial exoskeletons have shown to focus on prevention of the most common causes of MSDs within industries in their design and development, making the applicability of industrial exoskeletons highly possible.

La perte de vision périphérique (vision tubulaire) a pour conséquence de nombreux déficits qui réduisent fortement l'autonomie des personnes qui en sont atteintes et par conséquent leur qualité de vie. Nombre de ces déficits témoignent d'une cognition spatiale dégradée mettant en jeu des relations étroites entre vision périphérique et représentations spatiales. Le double objectif de ce travail de thèse consiste à mieux comprendre la nature de ces relations et, sur la base de ces connaissances, contribuer à l'émergence de dispositifs d'assistance plus adaptés et performants, capables de suppléer l'absence de vision périphérique. Dans un premier temps, je me suis intéressé au rôle de la vision périphérique dans la construction de représentations spatiales égocentrées. J'ai d'abord collaboré à une expérience de psychophysique impliquant la détection en vision périphérique de cibles visuelles situées soit droit-devant, soit excentrées par rapport à l'axe du corps. En mesurant les temps de réaction nous avons pu démontrer que les sujets humains répondaient plus rapidement aux cibles présentées droit-devant qu'aux cibles excentrées. J'ai pris en charge une deuxième étude complémentaire portant sur le lien entre ce traitement sensoriel privilégié du droit-devant en vision périphérique et la dynamique des saccades oculaires de recentrage. En comparant les dynamiques de pro-saccades et d'anti-saccades de recentrage ou d' " excentrage ", j'ai pu mettre en évidence que la supériorité dynamique des saccades de recentrage guidées par la vision périphérique reposait à la fois sur des facteurs sensoriels et oculomoteurs. Ces travaux révèlent l'intégration précoce de signaux visuels et oculomoteurs en vision périphérique, pouvant servir à localiser les éléments visuels par rapport à soi et à privilégier le traitement des éléments situés dans l'axe droit-devant. Dans un deuxième temps, mes travaux ont abordé l'influence de la vision périphérique dans les représentations spatiales allocentrées. Pour étudier l'implication de la vision périphérique dans le codage allocentré, j'ai réalisé une expérience impliquant une tâche de pointage vers des cibles visuelles en vision centrale, accompagnées ou non d'indices visuels à différentes distances en vision périphérique. Les résultats obtenus montrent que des indices visuels capturés par la vision périphérique peuvent effectivement contribuer au codage allocentré d'une cible fixée, et ce même lorsque ces indices périphériques doivent être extraits de scène visuelles complexes en moins de 200 ms. Dans une étude complémentaire, j'ai montré que l'utilisation de ces indices allocentrés situés en périphérie avait un véritable rôle fonctionnel, accélérant les recherches visuelles. Ainsi, ces travaux révèlent une implication fonctionnelle forte de la vision périphérique dans l'extraction des relations spatiales entre éléments présents dans l'environnement visuel. J'ai voulu, durant la dernière partie de ma thèse, initier le développement d'un dispositif d'assistance dont la finalité est de suppléer les fonctions spatiales, égocentrées et allocentrées, de la vision périphérique. Comme preuve de concept, mon travail a consisté à concevoir et développer un dispositif tactile placé sur le poignet et capable de communiquer la position spatiale d'objets d'intérêt pour en simplifier leurs recherches visuelles. Les résultats obtenus chez des sujets sains avec un champ visuel artificiellement réduit (10°) montrent que l'interface tactile permet d'accélérer par trois la vitesse de recherche visuelle. Des résultats similaires ont été observés chez une personne atteinte de glaucome (champ visuel de 10x15°). Ma thèse pluridisciplinaire permet d'apporter un nouvel éclairage sur l'implication de la vision périphérique dans la construction de représentations spatiales, et elle propose de nouvelles pistes pour le développement de dispositifs d'assistance adaptés aux personnes atteintes de vision tubulaire. / The loss of peripheral vision (tunnel vision) leads to numerous deficits, reducing both independence and quality of life. These deficits reflect spatial cognition impairments, and highlight the close relationship between peripheral vision and spatial representations. This thesis has two main objectives: reaching a better understanding of the nature of these relationships, and using the acquired knowledge in order to propose adaptive, performant and innovative assistive devices able to overcome the peripheral loss. At first, I address the role of peripheral vision in egocentric space coding. I collaborated in a psychophysics experiment, involving detection of visual objects placed in peripheral vision. The visual objects formed similar images on the retina and differed only with respect to their egocentric location: either straight-ahead or eccentric with respect to the head/body midline. We found that straight-ahead objects elicit consistently shorter behavioral responses than eccentric objects. I took in charge a second study evaluating the link between the privileged sensory processing of the straight ahead direction and the dynamic of ocular saccades. Comparison between centripetal and centrifugal pro-saccades and anti-saccades revealed that the superior dynamic of centripetal saccades comes from both sensory and oculomotor factors. These works reveal the early integration of both visual and oculomotor signals in peripheral vision, leading to egocentric representations in which the straight ahead direction is highlighted. Secondly, I investigated the influence of peripheral vision in extracting allocentric spatial representations. In order to assess the role of peripheral vision in allocentric coding, I performed a memory-based pointing task toward previously gazed targets, which were briefly superimposed with visual cues placed at different eccentricities. The results showed that visual cues in peripheral (>10°) vision can contribute to the allocentric coding of a fixated target. A complementary experiment showed that these peripheral allocentric cues play a functional role, notably by facilitating visual searches. These works highlight the importance of peripheral vision in extracting functional spatial relationships between distant elements of the visual environment. Finally, I wanted to promote the development of new assistive devices, able to substitute both egocentric and allocentric spatial functions of the peripheral vision. As a proof of concept, I designed and evaluated a tactile interface mounted on wrist, communicating the spatial location of specific objects and facilitating visual search. Results showed that healthy subjects with artificial tunnel vision (10°) were able to increase by three visual search speeds thank to this tactile interface. Similar results were obtained on a glaucoma subject (field of view 10x15°). My multidisciplinary thesis highlights new roles of peripheral vision in spatial representations and proposes an innovative solution to develop assistive device for tunnel vision.

This work deals with a new approach of designing ortho-prosthetic devices in terms of mechanical solution and innovative design. The work was addressed to a specific patient with congenital malformation of upper limbs called phocomelia. A custom-made compensatory aid was made on basis of personal consultations and meetings on specialized workplace; however the aid was built in a way and from parts for other kind of disability. As it turned out, the use of this equipment is associated with many complications, and therefore as a result, this solution proved as unsatisfactory. Nevertheless, thanks to this compensation aid it was possible to specify the problems, to reveal important patterns and highlight the needs for development of entirely new and unique aid designed for patients with phocomelia disability. The work is based on these findings and knowledge acquired from bibliographic search in the field of orthotics, prosthetics, assistive devices and prosthetic equipment. A complete redesign was done with the aim to eliminate all detected problems. The presented result is a unique tool for people with specific congenital disability of upper limbs, with working label 4TE.

Wearable robotics and exoskeletons have been explored for their efficacy in physical rehabilitation and for assistance in daily activities for people with motor disorders. The overall objective of this thesis is to design a powered soft exoskeleton for people with dropfoot and excessive inversion, commonly after a stroke, and to optimize the control parameters for each individual while considering different dimensions. This compilation thesis is based on two papers that focus on the design and verification of the ankle joint exoskeleton prototype, and control parameters optimization using human-in-the-loop optimization, respectively. In the first paper, we presented the design of the powered soft ankle exoskeleton, mainly consisting of the actuation system, Bowden cables, and textile components, to assist two degrees of freedom (DoF), dorsiflexion and eversion, simultaneously.A proof-of-concept study was performed to verify the functionality of the exoskeleton in two aspects: assisting/controlling two DoFs simultaneously and compensating for the resistance during ankle plantarflexion. Our results suggested that two-DoF assistance can be delivered with the structure, and the proposed force-free controller can counteract the inherent resistance in the system. In the second paper, a multi-objective-based human-in-the-loop optimization method was proposed, aiming at optimizing gait quality in different aspects simultaneously.In this case study, the multi-objective optimization method, Non-dominated Sorting Genetic Algorithm II, was implemented in the human-in-the-loop optimization. Four generations, comprising ten sets of control parameters in each generation, were tested on one non-disabled subject wearing the exoskeleton described in paper I. The results indicated that this novel method can identify the control laws that optimize both gait quality metrics. In the set of solutions, control laws with different focuses can be selected for different purposes or individual uses. / Bärbara robotar och exoskelett har utforskats för deras effektivitet inom fysisk rehabilitering och som stöd i dagliga aktiviteter för personer med motoriska störningar. Det övergripande målet med denna avhandling är att designa en kraftdriven mjuk exoskelett för personer med fallfot och överdriven inversion, vanligt efter en stroke, och att optimera kontrollparametrarna för varje individ med hänsyn till olika dimensioner. Denna sammanställda avhandling bygger på två artiklar som fokuserar på design och verifiering av prototypen för fotledsexoskelett samt optimering av kontrollparametrar med mänsklig medverkan. I den första artikeln presenterade vi designen av det kraftdrivna mjuka fotledsexoskelettet, som huvudsakligen består av aktiveringssystem, Bowden-kablar och textilkomponenter, för att assistera i två grader av frihet (DoF), dorsiflexion och eversion, samtidigt. En konceptbevisstudie genomfördes för att verifiera funktionen hos exoskelettet avseende två aspekter: assistera/styra två DoFs samtidigt och kompensera för motståndet under plantarflektion i fotleden. Våra resultat antydde att två-DoF-assistans kan levereras med strukturen och att den föreslagna kraftfria styrenheten kan motverka det inneboende motståndet i systemet. I den andra artikeln föreslogs en mänsklig medverkande optimeringsmetod baserad på flera mål, med syfte att optimera gångkvaliteten i olika aspekter samtidigt. I denna fallstudie implementerades den flerobjektiva optimeringsmetoden Non-dominated Sorting Genetic Algorithm II i den mänskliga medverkansoptimeringen. Fyra generationer, med tio uppsättningar av kontrollparametrar i varje generation, testades på en icke-funktionshindrad försöksperson som bar det exoskelett som beskrivs i den första artikeln. Resultaten indikerade att denna nya metod kan identifiera styrregler som optimerar både gångkvalitetsmått. I uppsättningen lösningar kan styrregler med olika fokus väljas för olika ändamål eller individuella användningsområden. / <p>QC 231115</p>

Jusqu’à 93% des musiciens sont affectés par des troubles musculo-squelettiques liés à la pratique instrumentale, dont particulièrement les violonistes qui combinent les facteurs de risque principaux : une posture asymétrique et contraignante, le maintien d’une charge (le violon et le membre supérieur gauche) dans une position quasi-statique, la répétition de mouvements à haute vitesse et la pression des doigts (sur le manche de l’instrument), tous entrainant l’accumulation de fatigue musculaire. Il est crucial d’aménager leur environnement de travail afin de réduire l’accumulation de la fatigue. Les dispositifs d’assistance au mouvement sont utilisés dans le milieu industriel pour réduire les activations musculaires et potentiellement ralentir le développement de la fatigue musculaire. La modification de la dynamique de l’environnement des violonistes via l’application d’une force antigravitationnelle nécessaire au maintien du membre supérieur gauche et de l’instrument pourrait cependant perturber leurs mouvements et affecter leur performance musicale. L’objectif de ce projet de maîtrise est donc d’évaluer l’adaptation motrice à un dispositif d’assistance au mouvement en comparant (O1) la cinématique et (O2) l’électromyographie des membres supérieurs et du cou ainsi que (O3) la performance musicale avec et sans assistance. Quinze violonistes issus d’orchestres professionnels et de programmes de cycles supérieurs en interprétation musicale ont été recrutés. Les participants ont été équipés de 61 marqueurs réfléchissants et de 11 capteurs électromyographiques pour enregistrer leurs mouvements et activations musculaires. Afin de quantifier l’adaptation motrice, les violonistes ont répété une séquence musicale de 13 secondes sans (contrôle), avec (adaptation), et sans (post-adaptation) assistance par un dispositif passif (Kinova O110, Boisbriand, QC, Canada) exerçant une force antigravitationnelle au niveau du coude gauche. Les conditions ont été répétées une semaine plus tard pour évaluer la réadaptation. Neuf à douze mois plus tard, les participants ont écouté des enregistrements audio de leur performance avec et sans assistance et ont évalué leur performance musicale en aveugle. Des modèles linéaires mixtes ont été utilisés afin de comparer la cinématique, l’électromyographie et la performance musicale des conditions avec et sans assistance. L’augmentation de l’erreur angulaire de tous les degrés de liberté du membre supérieur gauche suggère que l’utilisation d’un dispositif d’assistance au mouvement a perturbé la cinématique des violonistes. L’adaptation très sélective de la cinématique articulaire observée au cours de la condition d’adaptation était probablement due à l’absence d’erreur de prédiction de la performance musicale nécessaire pour guider l’adaptation motrice. En effet, la comparaison de la performance musicale avec et sans dispositif n’a montré aucune différence significative, indiquant que les violonistes experts peuvent maintenir un haut niveau de performance malgré la modification de leur patron moteur. En outre, la similarité des angles articulaires et des activations musculaires entre les conditions avec et sans dispositif est restée forte. Enfin, la réduction des activations du deltoïde médian et du trapèze supérieur gauches avec l’assistance est prometteuse quant à l’utilisation des dispositifs pour limiter l’accumulation de fatigue musculaire et réduire la prévalence des troubles musculo-squelettiques liés à la pratique du violon. / Up to 93% of musicians are affected by playing-related musculoskeletal disorders, and particularly violinists who combine the major factors leading to these disorders: an asymmetrical and constrained posture, quasi-static weight (violin and left upper-limb) holding, quick repetitive movements, and finger pressure (onto the instrument’s neck), all leading to muscle fatigue accumulation. It is crucial to adjust violinists’ working environments to prevent muscle fatigue accumulation. Dynamic assistive support (DAS) is used in industrial settings to reduce muscle activations and thus potentially slow down fatigue development. Modifying violinists’ environmental dynamics by introducing the anti-gravitational force needed to support their left upper-limbs and instruments may perturb their movements and impair musical performance. The objective of this Masters’ project is thus to investigate motor adaptation to DAS by comparing upper-limb and neck (O1) kinematics, (O2) electromyography, and (O3) musical performance with and without DAS. Fifteen violinists were recruited from professional orchestras and graduate programs in music performance. Participants were equipped with 61 reflective markers and 11 electromyography electrodes to record kinematics and muscle activity, respectively. To quantify motor adaptation, violinists played a looped 13-second excerpt without (control), with (adaptation), and without (washout) DAS provided by a passive device (Kinova O110, Boisbriand, QC, Canada) applying an anti-gravitational force at the left elbow. All conditions were repeated one week later to test for potential savings. Nine to twelve months later, participants listened to their own audio recordings playing with and without DAS and blindly assessed their performances. Linear mixed models were used to compare DAS and no-DAS conditions’ kinematic, electromyography and musical performance data. The increase in angular error for all left degrees of freedom suggests that DAS perturbed violinists’ kinematics. The highly selective kinematic adaptation observed during the adaptation condition might have been due to the absence of auditory feedback prediction errors needed to drive motor adaptation. Indeed, musical performance with and without DAS showed no significant difference, indicating that expert violinists can maintain a high level of performance despite changes in motor output. Additionally, similarity of joint angles and muscle activities between DAS and no-DAS conditions remained strong. Finally, reduced activations of left medial deltoid and superior trapezius in assisted conditions make DAS a promising tool to limit violinists’ muscle fatigue accumulation and prevent playing-related musculoskeletal disorders.

Thesis (M.Ed. (Community and Continuing Education)) -- University of Limpopo, 2022 / This study is an exploration of the educational needs and assets of the visual impaired undergraduate students at a Rural-Based University in South Africa. The research question addressed is What are the educational needs and assets of the visual impaired Undergraduate students at a Rural-Based University in South Africa. The study is underpinned within the interpretivist paradigm. A qualitative research approach was adopted, utilising a case study design. Data was collected through document analysis, semi-structured interviews and observations. Analytic induction in which themes, patterns and categories emerged from the data was deemed appropriate. The study sample was composed of the Director of Reakgona Disability Centre, four the visual impaired undergraduate students from the three faculties of the University of Limpopo (Humanities, Management and Law, and Science and Agriculture), as well as four academic staff members teaching the sampled students. The total study sample comprised nine participants. The study has revealed the existence of a highly inflexible curriculum, lack of assistive devices, poor teaching and assessment strategies, untrained academic staff, poor support from the majority of academic staff members, poor support from a few of the peers with normal sight, difficulties during transition from secondary school to university, and limited library services that led to the marginalisation of the visual impaired undergraduate students. The study also found that the visual impaired undergraduate students possess the following educational assets: the availability of Reakgona Disability Centre, support from the majority of peers with normal sight, support from a few academic staff members, availability of associations and institutions that offer financial assistance to the visual impaired students, and the health clinic that provides health care. Based on the findings of the research some conclusions were drawn. Several recommendations are made to address the educational needs and assets of the visual impaired undergraduate students at a Rural-Based University in South Africa. Suggestions for future research are made to close the gap that exists in research on the education of students with visual impairments