No description available.

The rollator is a mobility aid commonly used to facilitate balance and mobility for individuals with cardiorespiratory, musculoskeletal, or neurological deficits. Despite its popularity, there are also reports of adverse effects related to walker use linked to increased fall risks. Studies examining the effectiveness and consequences of rollator use have employed standard laboratory-based measurement methods that rely on performing specific tasks within a short time period and under controlled conditions, potentially limiting generalization to mobility in the everyday context. An instrumented rolling walker (iWalker) was developed as an ambulatory measurement tool applicable to the assessment of balance outside of the lab or clinic for assistive device users. The iWalker autonomously collects measurements of the upper and lower limb behaviour related to balance, walker kinematics, and video of the immediate spatial environment. The design and development of the iWalker is first described, followed by two studies characterizing the involvement of the upper limbs for balance in standing and walking that served to address gaps in the literature and evaluate the utility of the upper limb measures. Overall, the upper limbs can become the primary effectors of balancing forces when lower limb capabilities are compromised. When lower limb involvement was experimentally constrained, the upper limbs became the primary effectors of balance control in healthy, young adults. In older adults, individuals demonstrating the highest upper limb usage during walking were associated with the largest reduction in frontal plane stepping parameters (i.e., step width). A third study evaluated the applicability of the iWalker to assess everyday mobility in a series of in-patients recovering from neurological injury (i.e., stroke, traumatic brain injury). Patients demonstrated significantly different upper limb balancing behaviour in everyday situations compared to in-laboratory assessments. Furthermore, the iWalker captured behaviours that may be precursors to falling, such as collisions, stumbling and lifting the assistive device. The implications of these studies on assessing the effectiveness of rollators and feasibility of using the iWalker in follow-up efforts are discussed.

This study used survey methodology to investigate the experience of acquiring assistive technology, from learning about products, to purchasing and paying for them, to evaluating how well they perform. It examined both the challenges faced and the factors that may help people acquire products. The participants were 251 adults with vision and hearing impairments, recruited from across Canada. The results revealed that the high cost of products and lack of funding for assistive technology were the main barriers faced by respondents. Intermediaries, such as community organizations and health care providers, were found to be important facilitators of access to assistive technology. Financial support to cover product costs increased respondents’ access to higher cost items. While the majority of respondents were quite or very satisfied with their products, hearing product consumers were less satisfied than vision product consumers, yet were likely to have paid more for their products.

No description available.

The rollator is a mobility aid commonly used to facilitate balance and mobility for individuals with cardiorespiratory, musculoskeletal, or neurological deficits. Despite its popularity, there are also reports of adverse effects related to walker use linked to increased fall risks. Studies examining the effectiveness and consequences of rollator use have employed standard laboratory-based measurement methods that rely on performing specific tasks within a short time period and under controlled conditions, potentially limiting generalization to mobility in the everyday context. An instrumented rolling walker (iWalker) was developed as an ambulatory measurement tool applicable to the assessment of balance outside of the lab or clinic for assistive device users. The iWalker autonomously collects measurements of the upper and lower limb behaviour related to balance, walker kinematics, and video of the immediate spatial environment. The design and development of the iWalker is first described, followed by two studies characterizing the involvement of the upper limbs for balance in standing and walking that served to address gaps in the literature and evaluate the utility of the upper limb measures. Overall, the upper limbs can become the primary effectors of balancing forces when lower limb capabilities are compromised. When lower limb involvement was experimentally constrained, the upper limbs became the primary effectors of balance control in healthy, young adults. In older adults, individuals demonstrating the highest upper limb usage during walking were associated with the largest reduction in frontal plane stepping parameters (i.e., step width). A third study evaluated the applicability of the iWalker to assess everyday mobility in a series of in-patients recovering from neurological injury (i.e., stroke, traumatic brain injury). Patients demonstrated significantly different upper limb balancing behaviour in everyday situations compared to in-laboratory assessments. Furthermore, the iWalker captured behaviours that may be precursors to falling, such as collisions, stumbling and lifting the assistive device. The implications of these studies on assessing the effectiveness of rollators and feasibility of using the iWalker in follow-up efforts are discussed.

abstract: It is well understood that many people who experience hearing loss do not realize the extent of their loss and often do not seek help. This resistance to intervention puts them at risk of social isolation, depression and even serious neurological issues such as dementia. This research explores first, the attitudes that people have toward hearing loss and how these attitudes affect the adoption of products and services that could help them. This may not seem like a design question, but it is paramount to designers who seek to improve the quality of life for this population. It is no longer enough to create beautiful, functional products. In order to make a difference in people’s lives, designers need to understand the underlying motivations that drive behavior. This informs the second question this study seeks to answer, what changes can be made to current products and services on the market in order to increase adoption. Through a series of qualitative interviews with seniors experiencing hearing loss, this study finds that the main factors in their attitudes towards hearing loss are their feelings towards aging in general, their susceptibility to stigma, and their perceptions of the cost and functionality of the hearing devices available. However, the most important factor found in this study is a lack of awareness. Awareness of their own level of hearing loss. Awareness of the risks associated with putting off intervention. And awareness of the products and services available to help. Thus, design solutions that focus on visibility of services and patient education will have the most meaningful impact on quality of life for those who suffer from hearing loss. / Dissertation/Thesis / Masters Thesis Design 2019

Wearable assistive robotics have the potential to address an unmet medical need of reducing disability in individuals with chronic hand impairments due to neurological trauma. Despite myriad prior works, few patients have seen the benefits of such devices. Following application experience with tendon-actuated soft robotic gloves and a collaborator's orthosis with novel flat-spring actuators, we identified two common assumptions regarding hand orthosis design. The first was reliance on incomplete studies of grasping forces during activities of daily living as a basis for design criteria, leading to poor optimization. The second was a neglect of increases in muscle tone following neurological trauma, rendering most devices non-applicable to a large subset of the population. To address these gaps, we measured joint torques during activities of daily living with able-bodied subjects using dexterity representative of orthosis-aided motion. Next, we measured assistive torques needed to extend the fingers of individuals with increased flexor tone following TBI. Finally, we applied this knowledge to design a cable actuated orthosis for assisting finger extension, providing a basis for future work focused on an under-represented subgroup of patients.

Individuals who suffer from amyotrophic lateral sclerosis (ALS) have a loss of motor control and possibly the loss of speech. A brain-computer interface (BCI) provides a means for communication through nonmuscular control. Visual BCIs have shown the highest potential when compared to other modalities; nonetheless, visual attention concepts are largely ignored during the development of BCI paradigms. Additionally, individual performance differences and personal preference are not considered in paradigm development. The traditional method to discover the best paradigm for the individual user is trial and error. Visual attention research and personal preference provide the building blocks and guidelines to develop a successful paradigm. This study is an examination of a BCI-based visual attention assessment in an ALS sample. This assessment takes into account the individual’s visual attention characteristics, performance, and personal preference to select a paradigm. The resulting paradigm is optimized to the individual and then tested online against the traditional row-column paradigm. The optimal paradigm had superior performance and preference scores over row-column. These results show that the BCI needs to be calibrated to individual differences in order to obtain the best paradigm for an end user.

The current study evaluates the effectiveness of a Brain-Computer Interface (BCI) system that operates by detecting a P300 elicited by one of four randomly presented stimuli (i.e., YES, NO, PASS, END). Two groups of participants were tested. The first group included three ALS patients that varied in degree of disability, but all retained the ability to communicate; the second group included three Non-ALS controls. Each participant participated in ten experimental sessions during a period of approximately 6 weeks. Sessions were conducted either at the participant's home or in the lab. During each run the participant's task was to attend to one stimulus and disregard the other three. Stimuli were presented auditorily, visually, or in both modes. Additionally, on each run, the experimenter would either tell the participant which stimulus to focus on, or ask the participant a question and the participant would focus on the correct "YES/NO" answer to the question. Overall, for each participant, the ERPs elicited by the target stimuli could be discriminated from the non-target stimuli; however, less variability was observed in the Non-ALS group. Comparing across sessions, the within session variability was lower than across session variability. In addition, waveform morphology varied as a function of the presentation mode, but not in a similar pattern for each participant. Offline and simulated online classification algorithms conducted using step-wise discriminant analysis produced results suggesting the potential for online classification performance at levels acceptable for communication. Future investigations will begin to focus on testing online classification performance with real-time feedback, and continuing to examine stimulus properties to determine how to maximize P300 amplitude for individual users.

Ældre udgør en stigende del af befolkningen. En del ældre får funktionsnedsættelser, både på grund af de naturlige aldersforandringer og på grund af kroniske sygdomme, der ofte forstærkes med alderen. Derved øges antallet af mennesker, der får behov for hjælpemidler. Formålet med undersøgelsen var, at kortlægge forbruget af hjælpemidler hos den ældre del af befolkningen i en dansk kommune, med henblik på at undersøge om der var forskel i antal og typer af hjælpemidler hos de yngste og de ældste af befolkningen over 65 år. Data blev indsamlet via registre i kommunen og blev inddelt i aldersgrupper fra 65 – 99 år. Undersøgelsen omfattede i alt 736 personers hjælpemiddeldata. Data blev analyseret og resultatet viste, som forventet, at behovet for hjælpemidler stiger med alderen, men at forbruget ikke stiger lige meget for alle typer af hjælpemidler. Behovet for specielt ganghjælpemidler, bade-/toilethjælpemidler og inkontinenshjælpemidler stiger markant mere end andre typer af hjælpemidler. Endvidere viste undersøgelsen, at der bruges flere personlige hjælpemidler end genbrugshjælpemidler blandt de ”unge” gamle, og at det omvendte gælder for de ”gamle” ældre. Resultatet kan bruges til at forudsige den økonomiske udgift på hjælpemiddelområdet i de kommende år, samt til at give en indikation af, hvor der kan sættes ind med træningstilbud for at opnå et bedre funktionsniveau i hverdagen og dermed mindre forbrug af hjælpemidler. / The elderly in the population are increasing. Some old people get disabilyties caused by natural changes due to age and by cronical diseases, which will often increase with increasing age. Thus the number of people, who needs assistive devices, are also increasing. The purpose of the study was to investigate the consumption of assistive devices by the elderly in a Danish municipality, to see if there was any difference in the number and type of assistive devices in the younger and older part of the population passed the age of 65 years. Data were collected via files in the municipality and was then divided in groups according to age between 65-99 years of age. The investigation included all data of assistive devices from 736 persons. The data were analysed and the result showed as expected that the need of assistive devices increases with age but that the consumption does not increase equally for all types of assistive devices. The need for especially assistive devices concerning walking, bathing and problems with incontinens was increasing much more than other types of assistive devices. Furthermore the investigation showed that the younger part of the target group used more of personal assistive devices than of recycled assistive devices. The facts are reversed when concerning the oldest part of the target group. The result may be used to predict the economically expense on the field of assistive devices in the years to come, and to indicate where rehabilitation could be offered in order to get a higher level of function in daily life and thereby less use of assistive devices. / <p>ISBN 978-91-85721-05-4</p>