Introdução: Os sistemas de adequação postural ou as adaptações em cadeiras de rodas proporcionam ao seu usuário o controle postural necessário para a realização de atividades cotidianas, manutenção da independência e interação com o ambiente. Alem disso, evitam complicações respiratórias e o surgimento de deformidades nos indivíduos. A indicação do melhor sistema de adequação postural é uma das tarefas mais desafiadoras aos profissionais de saúde especializados na sua prescrição pois pode ser difícil avaliar quais componentes melhor atendem às necessidades de um indivíduo. Dessa forma, observa-se a preocupação com o desenvolvimento de evidências nessa área, e, portanto, a coleta de informações sobre prescrição de cadeiras de rodas e dos seus componentes de adequação postural são essenciais para a construção de séries históricas, avaliação de seu uso e possibilidade de novas ações e políticas nesse sentido. Objetivo: Caracterizar e quantificar as adaptações em cadeiras de rodas prescritas e dispensadas por um serviço de terapia ocupacional de hospital ortopédico especializado em relação as necessidades oriundas dos diagnósticos atendidos, dos anos 2005 a 2013. Métodos: Estudo observacional descritivo transversal e retrospectivo, realizado no serviço de terapia ocupacional do Instituto de Ortopedia e Traumatologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, a partir dos prontuários de todos os indivíduos usuários de cadeiras de rodas, atendidos pelo grupo de prescrição de cadeiras de rodas e sistemas de adequação postural do campo de estudo. Foram coletadas informações sociodemográficas (gênero e idade), diagnóstico, recebimento ou não de cadeira de rodas nova, recebimento ou não de adaptações em cadeiras de rodas e as adaptações prescritas. Resultados: Um total de 1480 prontuários de usuários foram investigados, a maioria do sexo masculino (62,1%) e a idade média da amostra foi de 24,1 anos (DP = 17,2). Destes, (30,9%) apresentava o diagnóstico de paralisia cerebral, seguido pela lesão medular (22,6%), distrofia muscular de Duchenne (13,8%), amputação decorrentes de traumas e outras patologias (8,3%) e mielomeningocele (4,2%). Dos 1480 usuários, 69,3% receberam CR novas e ainda 30,7% já possuíam CR doadas por outros serviços e/ou compradas pelo próprio paciente. Quase todas as cadeiras necessitaram de adaptações em sua estrutura (96,1%). Apenas 57 cadeiras de rodas (3,9%) não necessitaram de um SAP conjunto. A adaptação mais frequente é o cinto pélvico (96,1%), seguida do assento e encosto de base rígida (95,1% e 94,5% respectivamente). Conclusões: Nota-se que a amostra estudada necessitou de muitos itens de adequação postural junto de suas cadeiras de rodas. Apesar da grande demanda por esses recursos de tecnologia assistiva, as investigações nessa área são escassas. Diante disso, a investigação proposta por este estudo produziu importantes evidências para a prática clínica de terapeutas ocupacionais que atuam na prescrição de cadeiras de rodas e de sistemas de adequação postural para pessoas com deficiência, apresentando dados que contribuem para uma melhor indicação desses equipamentos / Introduction: The positioning system or adaptations in wheelchair provide the user with the postural control necessary for daily activities, the maintenance of independence, and interaction with the environment. In addition, they avoid respiratory complications and the appearance of deformities in individuals. Indicating the best positioning system is one of the most challenging tasks for healthcare professionals specializing in its prescription because it can be difficult to assess which components best meet the needs of an individual. Thus, we are concerned with the development of evidence in this area, and therefore the collection of information about wheelchair prescription and its components of postural adequacy are essential for the construction of historical series, evaluation of their use, and the possibility of new actions and policies in this regard. Objective: To characterize and quantify wheelchair adaptations prescribed and dispensed by an occupational therapy service of a specialized orthopedic hospital in relation to the needs arising from the diagnoses attended from 2005 to 2013. Methods: A cross-sectional and retrospective descriptive observational study performed at the Occupational Therapy Service of the Orthopedics and Traumatology Institute of the Clinics Hospital of the Medical School of the University of São Paulo using the patient records of all wheelchair users, attended by the wheelchair prescription group and positioning system of the field of study. Were collected sociodemographic information (gender and age), diagnosis, whether a new wheelchair was received, whether wheelchair adaptations were received, and the adaptations prescribed. Results: A total of 1480 patient records were investigated, the majority of which were male (62.1%); the mean age of the sample was 24.1 years (SD = 17.2). Of these, 30.9% had a diagnosis of cerebral palsy, followed by spinal cord injury (22.6%), Duchenne muscular dystrophy (13.8%), amputation due to trauma and other pathologies (8.3%). and myelomeningocele (4.2%). Of the 1480 users, 69.3% received a new wheelchair and 30.7% already had one donated by other services and / or purchased by the patient. Almost all the chairs needed adaptations in their structure (96.1%), and only 57 wheelchairs (3.9%) did not require any. The most frequent adaptation was the pelvic belt (96.1%), followed by the rigid base seat, and backrest (95.1% and 94.5%, respectively). Conclusions: It is noted that the sample studied required many positioning items for their wheelchairs. Despite the high demand for these assistive technological resources, research in this area is scarce. Therefore, the research proposed by this study has produced important evidences for the clinical practice of occupational therapists that act on the prescription of wheelchairs and systems of postural adequacy for people with disabilities, presenting data that contribute to a better indication of these equipment\'s

No description available.

[pt] Esta pesquisa está inserida no universo dos portadores de necessidades especiais e pretende desenvolver uma nova tecnologia para projetar a estrutura de cadeira de rodas. Tal estrutura será composta por um módulo tensegrity composto de varas de bambu e cabos tensionados e adota todos os padrões antropométricos com a observância aos estudos ergonômicos e necessidades individuais de uso dos cadeirantes. Esse novo conceito de design de estrutura, por ser inédito, resulta num produto inovador e permite novas interpretações e desdobramentos. Essa pesquisa também inicia uma nova interpretação do tensegrity por sua aplicação a órteses para reabilitação que atualmente é amplamente difundido nas artes plásticas, arquitetura e no design de produto. O seu emprego pode suprir algumas necessidades como adaptação corporal favorável pela maleabilidade da estrutura que absorve os movimentos mais bruscos que possam causar incômodos, lesões e má acomodação do usuário à cadeira de rodas. / [en] This research is part of the universe of people with special needs and aims to develop a new technology to design the wheelchair frame. This structure will consist of a compound tensegrity module bamboo poles and tensioned cables and adopts all anthropometric standards with respect to ergonomic studies and individual needs of use of the wheelchair. This new concept of structure design, to be unheard of, resulting in an innovative product and allows new interpretations and developments. This research also initiates a new interpretation of tensegrity by its application to orthoses for rehabilitation that is currently widespread in art, architecture and product design. Your job can fill some needs as body adaptation favor the flexibility of the structure that absorbs the most sudden movements that may cause nuisance, injuries and poor user accommodation to the wheelchair.

Transportation-network companies such as Uber and Lyft have permeated cities around the world. While they have been lauded for introducing a new mobility option, questions of equity have been raised, including in relation to people with disabilities. Numerous lawsuits have been filed against Uber and Lyft for lack of disabled accessibility of transportation service they facilitate, with some of the lawsuit focusing on wheelchair accessibility. These have been reported in the media while work on the topic is lacking in the academic literature. This doctoral research explores wheelchair accessibility in transportation hailed through Uber and Lyft in the U.S., with a partial focus on the phenomenon in Washington, DC. The study sought to gain insight into wheelchair-accessibility matters with respect to four main stakeholders - riders, companies, drivers, and regulators and other government agencies. The purpose was a) to deepen understanding on the topic based on a holistic approach to core issues and produce evidence-based knowledge and b) to provide policy recommendations where needed. A mixed-methods approach was used to investigate the research problem. The quantitative strand surveyed 341 wheelchair users in the U.S., while the qualitative strand consisted of three sets of 16 qualitative interviews with drivers on the Uber and Lyft apps, Uber and Lyft company representatives, and representatives of relevant government agencies in Washington, DC. The study finds the following: 1) The service might be filling a transportation gap for some wheelchair users even though it is a two-tiered system that disadvantages motorized-wheelchair users. 2) The challenges surrounding wheelchair accessibility are perceived differently by the stakeholders and as a result there are differing views of how to solve them. 3) Overcoming inaccessibility challenge needs to involve changes on both Uber and Lyft and government agencies. Uber and Lyft and government agencies will find this study of interest to help them appreciate other stakeholders' perspective and use the findings to support policy decisions. / Doctor of Philosophy / Transportation-network companies connect drivers who are interested in providing a ride to riders who are looking for transportation through smartphone apps. Uber and Lyft are the most common of these companies. Both companies operate in many cities around the world. They are praised for creating a transportation alternative, but there is a concern that they may not serve everyone equally. For example, people with disabilities, especially wheelchair users have complained that they are not receiving the same service as those who do not use wheelchair. In the US, there are numerous lawsuits have been filed against Uber and Lyft for lack of disabled accessibility. Some of the lawsuit focus on wheelchair accessibility. These issues are reported in the media mostly. This doctoral research looks at wheelchair accessibility in transportation hailed through Uber and Lyft in the U.S., with a partial focus on the phenomenon in Washington, DC. The study sought to gain insight into wheelchair-accessibility matters with respect to four main stakeholders - riders, companies, drivers, and regulators and other government agencies. The purpose was a) to deepen understanding on the topic based on a holistic approach to core issues and produce evidence-based knowledge and b) to provide policy recommendations where needed. A survey and a set of interviews were used to investigate the research problem. The study finds the following: 1) The service might be filling a transportation gap for some wheelchair users even though it is a two-tiered system that disadvantages motorized-wheelchair users. 2) The challenges surrounding wheelchair accessibility are perceived differently by the stakeholders and as a result there are differing views of how to solve them. 3) Overcoming inaccessibility challenge needs to involve changes on both Uber and Lyft and government agencies. Uber and Lyft and government agencies will find this study of interest to help them appreciate other stakeholders' perspective and use the findings to support policy decisions.

Sedan 2021 regleras medicintekniska produkter inom EU av förordningen MDR (EU 2017/745). Det primära syftet med regelverket är att säkerställa ändamålsenliga produkter med hög säkerhet. Det nya regelverket ställer högre krav på företag som tillverkar medicintekniska produkter samt andra aktörer inom den medicintekniska industrin. De mer omfattande kraven innebär att det blir mer utmanande att uppfylla samtliga kriterier som krävs för att kunna lansera medicintekniska produkter på unionsmarknaden. Detta examensarbete har undersökt hur företag som tillverkar specifika medicintekniska produkter som rullstolar och personlyftar upplever förutsättningarna för att nå marknaden. För att undersöka tidigare studier kring ämnet har en litteraturstudie genomförts och sedan utformades intervjufrågor med hjälp av samtliga handledare. Frågorna besvarades av företag som tillverkar rullstolar eller personlyftar. Som komplement till de semistrukturerade intervjuerna har upphandlingar undersökts med syfte att kartlägga vilka standarder som refereras till som skall-krav vid inköp av rullstolar och personlyftar. Resultatet visar att de ökade kraven påverkar större medicintekniska företag, men att mindre företag påverkas i högre utsträckning enligt intervjuobjekten. Dessutom noteras att standarder nämns mindre frekvent i upphandlingar än vad de intervjuade personerna hävdar. Slutligen anser intervjuobjekten att det är värdefullt att följa standarder vid utveckling och marknadsföring av personlyftar och rullstolar. / Since 2021, the Medical Device Regulation (MDR) has regulated medical devices within the EU (EU2017/745). The regulation’s primary purpose is to ensure fit-for-purpose products with high safety standards. The new regulatory framework imposes strict requirements on companies manufacturing medical devices and other actors within the medical device industry. The more extensive requirements make meeting all the criteria necessary for launching medical devices on the European Union market more challenging. This thesis has examined how companies that manufacture medical devices, especially wheelchairs and patient lifts, perceive the conditions for reaching the market. A literature review was conducted to examine previous studies on the subject. Then, interview questions were formulated with the assistance of supervisors to participate by companies manufacturing wheelchairs or patient lifts. Procurements were examined to complement the semi-structured interviews and map out which standards are mandatory requirements in procuring wheelchairs and patient lifts. The results indicate that the increased requirements affect larger medical device companies, but the interviewees say smaller companies are more affected.  Additionally, standards are mentioned less frequently in procurements than what the interviewed individuals claim. Finally, the semi-structured interviews revealed that the interviewees consider it valuable to adhere to standards in developing and marketing wheelchairs and patient lifts.

No description available.

Thesis (MScPhysio)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Background: Access to wheelchairs is considered a basic human right. Wheelchairs enhance function, improve independence, and enables persons with disabilities to successfully live in the community. An inappropriate wheelchair may however limit function rather than promote it. Achieving an ideal match between user and technology, however is challenging. A recent audit in the Eastern Cape revealed that standard folding frame type wheelchairs were predominantly being issued and waiting list for wheelchairs is long. The need for investigation into prescription practice, from the perspective of both prescribing therapists as well as wheelchair users, was identified. Aims: To describe wheelchair prescription practice in the public sector of the Eastern Cape; and to determine whether the wheelchairs being issued address the psychosocial needs of users. Study design: A descriptive mixed-method cross-sectional study design was used. Quantitative and qualitative data from questionnaires and functional wheelchair skills tests of wheelchair users (Phase 1) and from semi-structured interviews with prescribing therapists (Phase 2) was used to describe prescription practice and investigate the psychosocial needs of wheelchair users. Methods: A small sample of convenienve according to home address was obtained that included 30 users (15 from a rural; 15 from a semi-rural setting). The Psychosocial Impact of Assistive Devices Scale (PIADS) questionnaire, Functioning Everyday with a wheelchair (FEW/FMA) scale and a self-compiled wheelchair specifications checklist (WSC) were used to determine user functionality and level of satisfaction with the wheelchair. Purposive sampling was done to identify the therapists that had prescribed the wheelchairs for the participants in the first phase of the study. A semi- structured interview was used to determine prescription practice including perceived barriers of wheelchair prescription with ten prescribing therapists. Data analysis: Qualitative data was analysed deductively and frequency of responses tabulated. Quantitative data was summarised as means and standard deviations and subgroup analysis comparisons were done using the Chi-square test and relationships between variables investigated using Pearson/ Spearman correlation or ANOVA. A p < 0.05 was deemed significant. Results: Eighty three % of wheelchairs issued were urban wheelchairs. These are generally perceived by users as sufficient to address their psychosocial needs regarding mobility and transport, however, seem to fail users in terms of accessibility and independence within their rural/ semi- rural environment. According to the WSC scores, peri-urban wheelchairs were found to be more appropriate for the users than urban wheelchairs (p < 0.01). No significant relationships were found between wheelchair fit, use of a cushion, occurrence of pressure sores and self-perceived psychosocial needs in this sample. The users experienced most difficulty with outdoor mobility (57% needed full assistance) and transport (63% needed full assistance) within their current wheelchairs. Ten prescribing therapists participated in the study. Most valued appropriate seating, are knowledgeable regarding prescription practice, but reported several barriers to this practice including budget restraints (90%), time to delivery (100%) and lack of training (40%). The need for more appropriate wheelchair designs to suit multi- level manoeuvrability of persons in rural/ semi-rural environments was also reported (60%). Conclusion: The results of this study show that wheelchair prescription in the Western Region of the Eastern Cape (WRoEC) has various challenges. Although the wheelchair users were mostly satisfied with their wheelchairs, this study identified areas for improvement in the users’ functioning, postural support and biomechanics within their wheelchairs, especially as it relates to their home environment. There is scope for improvement of wheelchair delivery to persons in the WRoEC – from on-going training of therapists and clients to more appropriate wheelchair designs for persons in rural settings. Further research in this field is recommended. / AFRIKAANSE OPSOMMING: Agtergrond: Toegang tot rolstoele word as ‘n basiese mensereg geag. Rolstoele dra by tot verbeterde funksionaliteit, groter onafhanklikheid, en bemagtig mense met gestremdhede om suksesvol in die gemeenskap te lewe. Nietemin, ‘n onvanpaste rolstoel mag funksie beperk eerder as om dit te bevorder. Om die ideale pas tussen rolstoel gebruiker en tegnologie te vind is uitdagend.’n Onlangse oudit in die Oos- Kaap het getoon dat standaard vou-raam tipe rolstoele oorwegend uitgereik word, en dat die waglys vir rolstoele lank is. Die gaping vir verdere ondersoek rakende voorskrif praktyk, vanaf beide die perspektief van die terapeute wat voorskryf asook rolstoel gebruikers, is geidentifiseer. Doel: Om rolstoel voorskrif praktryk in die publieke sektor van die Oos- Kaap te beskryf; en om vas te stel of die rolstoele wat uitgereik word die psigososiale behoeftes van gebruikers addresseer. Studie Ontwerp: ‘n Beskrywende gemengde metode deursnee studie ontwerp is gebruik. Kwantitatiewe en kwalitatiewe data van vraelyste en funksionele rolstoelvaardigheids toetse van rosltoel gebruikers (Fase 1) en van semi- gestruktureerde onderhoude met voorskrywende terapeute (Fase 2) is gebruik om voorskrif praktyk te beskryf en om die psigososiale behoeftes van gebruikers te ondersoek. Metodes: Dertig rolstoel gebruikers (15 van ‘n landelike; 15 van ‘n gedeeltelik- landelike opset) het deelgeneem in die studie. Die PIADS vraelys, “Functioning Everyday with a Wheelchair” (FMA/ FEW) skaal en ‘n self-opgestelde rolstoel spesifikasie kontrolelys (WSC) is gebruik om gebruiker funksionaliteit en tevredenheid met die rolstoel vas te stel. ‘n Semi- gestruktureerde onderhoud is gebruik om rolstoel voorskrifpraktyk insluitend persepsies van beperkinge tot die voorskrifte van rolstoele vas te stel onder tien terapeute. Dataverwerking: Kwalitatiewe data is deduktief geanaliseer en getal response is getabuleer. Kwantitatiewe data is opgesom as gemiddeldes en standaardafwykings en subgroep analise vergelyking is gedoen deur middel van die Chi- square toets. Verhoudings tussen veranderlikes is ondersoek deur middel van die Pearson/ Spearman korrelasie/ ANOVA. P < 0.05 is as statisties beduidend aanskou. Resultate: Drie-en-tagtig % van die uitgereikte rolstoele was landelike rolstoele. Hierdie stoele word oor die algemeen deur gebruikers ervaar as genoegsaam om hulle psigososiale behoeftes rakende vervoer en mobilitiet te bevredig, maar skiet nietemin tekort as dit kom by toeganklikheid en onafhanklikheid binne hulle landelike-/ semi- landelike omgewing. Volgens die WSC resultate, is die semi- landelike rolstoele meer toepaslik vir die gebruikers as die stedelike rolstoele. Geen merkwaardige verhoudings is gevind tussen rolstoel pas, gebruik van kussing, druksere en persepsie van psigososiale behoeftes nie. Die gebruikers het die meeste gesukkel met buitemuurse mobiliteit (57% het volle bystand benodig) en vervoer (63% het volle bystand benodig) in hulle huidige rolstoele. Tien terapeute het aan semi-gestruktureerde onderhoude deelgeneem. Daar is bevind dat hulle korrekte “seating” waardevol ag, kundig is rakende voorskrif praktyk, maar het talle beperkinge geidentifiseer in die praktyk insluitend: begrotings beperkings (90%), tyd tot aflewering (100%) en tekort aan opleiding in dié veld (40%). Die behoefte aan meer toepaslike rolstoel ontwerpe om multi- dimensionele beweeglikheid van persone in landelike/ semi- landelike omgewings te verseker, is ook vasgestel (60%). Gevolgtrekking: Die resultate van hierdie studie toon dat die voorskryf van rolstoele in die Westelike streek van die Oos- Kaap (WSvOK) vele uitdagings het. Alhoewel die rolstoel gebruikers grotendeels tevrede was met hulle rolstoele, het hierdie studie areas vir verbetering geidentifiseer in die gebruikers se funksionaliteit, posturale ondersteuning en biomeganika in hulle rolstoele, veral soos dit van toepassing is op hulle tuis omgewing. Daar is ruimte vir verbetering vir rolstoel lewering aan persone in die WSvOK; vanaf deurlopende opleiding vir terapeute en gebruikers, tot meer toepaslike rolstoel ontwerpe vir persone in landelike gebiede. Verdere navorsing in dié veld word aanbeveel.

INTRODUÇÃO: O modelo \'prática baseada em evidência na tecnologia assistiva\', possui como objetivo agregar os objetivos dos clientes integrando a experiência dos profissionais às melhores evidências disponíveis da pesquisa sistemática para a escolha do produto. Para o campo da tecnologia assistiva (TA), isso implica uma ênfase na pesquisa de resultados que discute sobre as contribuições dos dispositivos e os serviços relacionados à vida diária dos usuários. No Brasil, existe uma falta de modelos que articulem o uso da TA, diminuindo o abandono dos dispositivos. Com os modelos e os instrumentos de medida, é possível obter dados, comparar os resultados entre populações distintas, adquirir medidas de resultado confiáveis e válidas, de forma econômica e eficaz, e transformar medidas subjetivas em dados objetivos, que podem ser quantificados e analisados. Isso possibilita que se verifiquem os impactos nos processos de intervenção em saúde e se comparem os produtos com menos recursos financeiros. OBJETIVO: Este estudo tem dois objetivos distintos, mas que se entrelaçam ao dar suporte à sua justificativa e que aqui são chamados de Fase A e Fase B. O primeiro, consiste em identificar através da realização de uma revisão sistemática da literatura os diferentes questionários utilizados para selecionar itens de TA. O segundo, realizar o processo de adaptação transcultural do quadro de estruturação para a modelagem conceitual de resultados de dispositivos de TA (QEMCRDTA) para ser utilizado no Brasil. MÉTODO: Para selecionar e escolher o modelo utilizado nesta pesquisa, visando alcançar os objetivos descritos, foram efetuados dois estudos, divididos aqui em fase A e B. Na Fase A, procedeu-se a uma revisão sistemática da literatura nacional e internacional, com o objetivo de identificar os diferentes questionários utilizados para selecionar itens de TA, descrever e avaliar os procedimentos adotados para fazer a adaptação transcultural, com as características e os domínios temáticos de cada artigo, avaliar o processo de adaptação cultural adotado e descrever as propriedades psicométricas encontradas nos trabalhos. A Fase B compreendeu as etapas de: 1) tradução/síntese das traduções; 2) retrotradução (back translation); 3) Análise pelo comitê de especialistas; 4) Teste da versão pré-final conforme diretrizes internacionais. CONCLUSÕES: Os resultados da fase A mostraram que dentre os 560 artigos encontrados, Apenas 05 pesquisas foram incluídas na síntese qualitativa atendendo os critérios de inclusão. O QUEST pode ser considerado o instrumento mais traduzido e adaptado para outras culturas. Os achados da Fase B, expõem um alto índice da validade do conteúdo certificando a qualidade dos itens que representam o conceito mensurado. Todos os itens que passaram pelo processo de adaptação transcultural foram classificados como de fácil entendimento e nenhum item foi acrescentado ou retirado do Quadro de Estruturação para a Modelagem Conceitual de Resultados de Dispositivos de TA (QEMCRDTA) / INTRODUCTION: The model is based on assistive technology, whose main objective is to choose the professionals for the best results of the systematic research to choose the product. For the TA field, this implies an emphasis on researching results on applications and services related to users\' daily life. In Brazil, there is a lack of models that address the use of assistive technology, reducing the abandonment of devices. With models and measuring instruments, it is possible to obtain data, to compare results between distinctions, to obtain expected and variable measures of results, on a temporary and efficient basis, and to carry out the application of objective data, which can be quantified and analyzed. This enables the results of health and health process studies to be compared with other financial resources. PURPOSE: This study has two distinct objectives, but they are intertwined with support for its justification and are called Phase A and Phase B. The first is to identify through the systematic review of the literature the different questionnaires used to select Assistive Technology items. The second was the process of cross-cultural adaptation of the framework for a conceptual modeling of assistive technology resources for use in Brazil. METHOD: To obtain the number of sequential actions, the index was corrected in two years, divided into two years, divided into stages A and B. In Phase A, a systematic review of the national and international literature was carried out, with the Abstract Keywords of different questions for users to change such as trends, the as described and assessor of the evaluation of adaptive studies to discover the cross-cultural characteristics, and the psychiatric strategies processes to adaptability in the works. Phase B comprised the steps of: 1) translation / synthesis of translations; 2) back translation (reverse translation); 3) Analysis by the committee of experts; 4) Testing the pre-final relationship according to international guidelines. CONCLUSIONS: the results of the phase A change that are among the 560 articles found, only 05 were inserted in the qualitative synthesis in proposing inclusion. QUEST can be considered the most translated and adapted instrument for other cultures. The findings of Phase B, expose a high index of content validity, certifying the quality of the items that represent the concept measured. All cases that received the cross-cultural adaptation process were classified as easy to understand and no item was included or removed from the Structuring Framework for a Conceptual Modeling of Assistive Technology Devices Results

INTRODUÇÃO: O modelo \'prática baseada em evidência na tecnologia assistiva\', possui como objetivo agregar os objetivos dos clientes integrando a experiência dos profissionais às melhores evidências disponíveis da pesquisa sistemática para a escolha do produto. Para o campo da tecnologia assistiva (TA), isso implica uma ênfase na pesquisa de resultados que discute sobre as contribuições dos dispositivos e os serviços relacionados à vida diária dos usuários. No Brasil, existe uma falta de modelos que articulem o uso da TA, diminuindo o abandono dos dispositivos. Com os modelos e os instrumentos de medida, é possível obter dados, comparar os resultados entre populações distintas, adquirir medidas de resultado confiáveis e válidas, de forma econômica e eficaz, e transformar medidas subjetivas em dados objetivos, que podem ser quantificados e analisados. Isso possibilita que se verifiquem os impactos nos processos de intervenção em saúde e se comparem os produtos com menos recursos financeiros. OBJETIVO: Este estudo tem dois objetivos distintos, mas que se entrelaçam ao dar suporte à sua justificativa e que aqui são chamados de Fase A e Fase B. O primeiro, consiste em identificar através da realização de uma revisão sistemática da literatura os diferentes questionários utilizados para selecionar itens de TA. O segundo, realizar o processo de adaptação transcultural do quadro de estruturação para a modelagem conceitual de resultados de dispositivos de TA (QEMCRDTA) para ser utilizado no Brasil. MÉTODO: Para selecionar e escolher o modelo utilizado nesta pesquisa, visando alcançar os objetivos descritos, foram efetuados dois estudos, divididos aqui em fase A e B. Na Fase A, procedeu-se a uma revisão sistemática da literatura nacional e internacional, com o objetivo de identificar os diferentes questionários utilizados para selecionar itens de TA, descrever e avaliar os procedimentos adotados para fazer a adaptação transcultural, com as características e os domínios temáticos de cada artigo, avaliar o processo de adaptação cultural adotado e descrever as propriedades psicométricas encontradas nos trabalhos. A Fase B compreendeu as etapas de: 1) tradução/síntese das traduções; 2) retrotradução (back translation); 3) Análise pelo comitê de especialistas; 4) Teste da versão pré-final conforme diretrizes internacionais. CONCLUSÕES: Os resultados da fase A mostraram que dentre os 560 artigos encontrados, Apenas 05 pesquisas foram incluídas na síntese qualitativa atendendo os critérios de inclusão. O QUEST pode ser considerado o instrumento mais traduzido e adaptado para outras culturas. Os achados da Fase B, expõem um alto índice da validade do conteúdo certificando a qualidade dos itens que representam o conceito mensurado. Todos os itens que passaram pelo processo de adaptação transcultural foram classificados como de fácil entendimento e nenhum item foi acrescentado ou retirado do Quadro de Estruturação para a Modelagem Conceitual de Resultados de Dispositivos de TA (QEMCRDTA) / INTRODUCTION: The model is based on assistive technology, whose main objective is to choose the professionals for the best results of the systematic research to choose the product. For the TA field, this implies an emphasis on researching results on applications and services related to users\' daily life. In Brazil, there is a lack of models that address the use of assistive technology, reducing the abandonment of devices. With models and measuring instruments, it is possible to obtain data, to compare results between distinctions, to obtain expected and variable measures of results, on a temporary and efficient basis, and to carry out the application of objective data, which can be quantified and analyzed. This enables the results of health and health process studies to be compared with other financial resources. PURPOSE: This study has two distinct objectives, but they are intertwined with support for its justification and are called Phase A and Phase B. The first is to identify through the systematic review of the literature the different questionnaires used to select Assistive Technology items. The second was the process of cross-cultural adaptation of the framework for a conceptual modeling of assistive technology resources for use in Brazil. METHOD: To obtain the number of sequential actions, the index was corrected in two years, divided into two years, divided into stages A and B. In Phase A, a systematic review of the national and international literature was carried out, with the Abstract Keywords of different questions for users to change such as trends, the as described and assessor of the evaluation of adaptive studies to discover the cross-cultural characteristics, and the psychiatric strategies processes to adaptability in the works. Phase B comprised the steps of: 1) translation / synthesis of translations; 2) back translation (reverse translation); 3) Analysis by the committee of experts; 4) Testing the pre-final relationship according to international guidelines. CONCLUSIONS: the results of the phase A change that are among the 560 articles found, only 05 were inserted in the qualitative synthesis in proposing inclusion. QUEST can be considered the most translated and adapted instrument for other cultures. The findings of Phase B, expose a high index of content validity, certifying the quality of the items that represent the concept measured. All cases that received the cross-cultural adaptation process were classified as easy to understand and no item was included or removed from the Structuring Framework for a Conceptual Modeling of Assistive Technology Devices Results

Orientador: Franco Giuseppe Dedini / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Engenharia Mecanica / Made available in DSpace on 2018-08-10T20:07:38Z (GMT). No. of bitstreams: 1 Madeira_PauloHenriquedeAraujo_M.pdf: 5298392 bytes, checksum: 05f68847570423d7d13072c10b061a19 (MD5) Previous issue date: 2008 / Resumo: Há uma parcela da população que, por possuir severas limitações físicas e motoras, é inapta a utilizar cadeiras de rodas convencionais, manuais ou elétricas, bem como dispositivos de interface que não consideram as suas características particulares. Deste modo, este trabalho possui foco no desenvolvimento de interfaces e sistemas de navegação para cadeiras de rodas, provendo soluções para a inclusão deste grupo de usuários. Para isto, a revisão bibliográfica envolve três aspectos: as interfaces para usuários, os sistemas de navegação e a integração entre ambos. Primeiramente localiza-se a interface como parte da relação entre usuário e tarefa, para posteriormente restringir-se a interfaces para portadores de severas limitações físicas. Reconhecendo que determinados tipos de limitações de usuários demandam sistemas de navegação, estes são descritos na forma de exemplos de implementações. A revisão bibliográfica conclui com a descrição de métodos para a integração entre interface, navegação e controle da cadeira de rodas. Com base nesta pesquisa bibliográfica, desenvolveu-se um protocolo de integração e três tipos interfaces: controle de voz, filtragem do sinal de joystick para usuários com dificuldade em posicionar a mão, e controle por contrações musculares. A interface de reconhecimento de voz permitiu obter dois protótipos: um primeiro que utiliza um software comercial e um segundo em microcontrolador. A interface de filtragem do sinal do joystick foi prototipada virtualmente, demonstrando a resposta deste filtro a diferentes distúrbios. A interface que utiliza controle por contrações musculares foi implementada em protótipo funcional, por meio de um microcontrolador, e modularizada por meio do protocolo de integração desenvolvido. Este protocolo de integração foi testado em um kit de motorização com os módulos joystick, interface por contrações musculares e sonar, permitindo alternar, remover e inserir módulos sem a necessidade de reprogramação / Abstract: There is a part of population, with physical impairment, that cannot use conventional manual or powered wheelchair and kinds of interface with do not consider they own characteristics. To solve this problem, this work does a bibliographic review on wheelchair interfaces and navigation support, alloying development on solutions for inclusion of this users group. The bibliographic review embraces three aspects: interfaces and users, navigation support systems, and integration between navigation and interfaces. The first chapter, interfaces and users, localizes the interface as an medium between user and task, allowing to be more focused on next chapter: interfaces for wheelchair uses with severe impairment level. Recognizing about in some kind¿s of user impairment levels an adequate interface is not enough, navigation support systems are described. The bibliographic review concludes with a description about integration methods for interfaces, navigation support and wheelchair control. Based on this bibliographic review, an integration protocol and three interfaces have developed: voice control, joystick filtering for users with difficult on hand positioning, and muscular contraction control. The voice recognition interface allows creating two prototypes: one with commercial software, and a second using embedded microcontroller on wheelchair. The joystick filtering interface was virtually prototyped allowing response tests for different noisy sources. The muscular contraction interface has implemented as functional prototyping, by a microcontroller, and modularized by the developed modularization protocol. This protocol has tested in a wheelchair motorization kit with joystick, muscular contraction interface and auxiliary sonar modules, allowing inserting or removing then without any reprogramming needs / Mestrado / Mecanica dos Sólidos e Projeto Mecanico / Mestre em Engenharia Mecânica