Occupational therapy focuses on complex dynamic relationships between people, occupations and environments. For clients with spinal cord injuries (SCI), a way of improving the connection between these three aspects is by providing assistive technology (AT). A fundamental issue identified by consumers regarding AT provision was abandonment, which is caused by a mismatch between aspects of the person, the assistive product, and characteristics of the environment. One solution is engaging collaboratively with clients and recognizing individual needs, thereby allowing therapists to meet clients’ occupational expectations and provide clients with increased functional independence. During this capstone project, barriers to AT provision were identified through an extensive review of the literature, an online survey sent to 82 therapists, and a 90-hour residency with AT specialists. Respondents reported a need for further education on AT, that confidence with high-tech AT was lower than with low-tech AT, and a need for a simplified AT resource tool. This resulted in creation of an educational resource AT tool, in website format, called the Assistive Technology Prescription Tool for Occupational therapists (ATPT-OT). The ATPT-OT is a tool designed to enhance occupational therapists’ ability to identify and recommend AT for individuals with SCI during the prescription process.

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Of the 795,000 people that suffer a stroke in the United States every year, 65% experience hemiparesis. Foot drop is a common gait pathology in people with lower-limb paresis and is often caused by neuropathy of the peroneal nerve that innervates the muscles responsible for ankle dorsiflexion. Foot drop can impede toe clearance and increase the risk of falling, the leading cause of injury among adults ≥65 years. Lower-limb robotic exoskeletons have been used for gait training and can aid with walking, but current devices on the market can be heavy, expensive, and constrained to in-clinic use. Soft wearable robotic devices offer a lightweight and cost-effective alternative to traditional lower-limb exoskeletons. In particular, soft pneumatic systems have the potential to provide a high power-to-weight ratio making them ideal for a wearable application. The soft pneumatic exosuit consists of a footplate to collect air, storage to temporarily house the collected air, and two pneumatic actuators to provide an assistive torque around the wearer’s ankle joint while walking. EMG and IMU sensors were integrated to control the opening and closing of solenoid valves so that assistive torques could be applied to the ankle joint at optimal moments during the gait cycle. Preliminary validation of the soft pneumatic exosuit on a healthy participant demonstrated that the system could successfully deliver the air required to contract the actuators when the EMG sensors detected an increase in muscle activity. These results demonstrate that the current soft pneumatic exosuit appears to be a promising alternative to current rehabilitation exoskeletons on the market while remaining portable and low-cost. / 2025-05-24T00:00:00Z

Introduction: Handcycling is an excellent exercise for people with spinal cord injuries. However, some users experience barriers to transferring to the handcycle. The most common barriers are the height difference between the handcycle and sitting surface and dependence on others. Purpose: This thesis aims to develop an assistive technology to help users independently transfer in and out of a handcycle. Methods: The framework for the thesis is the double-diamond, guiding the designing of the products concepts. Users, professionals, and manufacturers were interviewed regarding the facilitators and barriers while transferring in and out of the handcycle and the product needs to help prevent the barriers. A content analysis was performed to find the facilitators and barriers, and a need analysis was performed to find the needs for the product. The needs were translated into target specifications to have measurable characteristics. Benchmarking was performed, and the products were evaluated in regard to the target specifications. The market segment, personas, mood board, and design brief served to inspire and inform the specifications for the product. Brainstorming and sketching were performed to generate four concepts. The participants evaluated these concepts, and the top-ranked concept was further developed. A computer-aided model was created and rendered to better illustrate the product. A guide on how to use the product was developed based on TAI 4.0, which also was used to find limitations in the transfer technique of the new product. An evaluation regarding the target specifications was also performed. Result: The final product concept allows height transfer and can be used independently. It fulfills seven out of the seventeen target specifications in the current state. However, six target specifications cannot be defined yet as they should be developed further in other iterations. Conclusion: A lifting device concept for transferring was developed. It would still need further iterations to keep improving the product before it would be able to be released for users.

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.

A brain-computer interface (BCI) speller provides non-muscular communication via detection of EEG features. In a non-disabled population, a Checkerboard (CB) stimulus presentation has been shown to improve BCI performance over the standard Row/Column (RC) paradigm. Another improvement is a gray-to-color (CL) paradigm that presents perceptually-salient targets defined by nine unique colors. The current study examines the RC, CB, and CL paradigms in an amyotrophic lateral sclerosis (ALS) population (N = 7). Pilot data suggest improved performance of CB and CL over RC. The results suggest matrices including CB and CL provide more efficient communication and higher user satisfaction in an ALS population.

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I investigated the presence, utility, and emergence of tacit knowledge in 9 study participants who used assistive-augmentative technology. I conducted phenomenologic interviews, audio-taping, and transcribed the interview with the written consent of the participants. Sixteen highly trained experts critiqued the final product of the interviews and answered a 25-question survey instrument. Non-parametric statistical processes were chosen to conduct inferential hypotheses testing. Wilcoxon - Mann Whitney U tests and Kruskal - Wallis One-Way ANOVA (alpha level of 0.05) were used for questions 1-10, and a 2 x R (R = 3 or 4) contingency table and Fisher's Exact Chi-Square were used for questions 11- 25. The responses to survey questions showed no statistically significant differences or interaction for the variables gender, expertise, and service (p < 0.0017). Qualitative analysis found discernable heuristics and ideation that was indicative of the presence of implicitly learned tacit knowledge in study participants; the utility of tacit knowledge emerged during direct observation or when participant's engaged in analogy, storytelling, and metaphor. The participants in this study used introspeculation, a learning style framed by reflection and introspection on the validity of one's own knowledge and the value of what is learned from life experience and in the classroom. The introspeculative examined the presence and utility of tacit knowledge in decision-making, and questioned the veracity of sources and resources that guide them on the path of life. The study suggested that tacit knowledge not only informs the practice of therapists and technology users but may assist classroom teachers facing student involvement in individual education plans (IEPs), Individuals with Disabilities Education Act (IDEA), or section 504 of the Americans with Disabilities Act (ADA).

The purpose of this study was to compare postsecondary institutions in North Carolina including state universities, private colleges and universities, and community colleges in regard to the number of students with disabilities, assistive technology availability, funding ratios for assistive technology, frequency of professional development training, legislative understanding, and other support factors for students with disabilities. This comparison was accomplished through quantitative and case summarization and analysis research methodologies. Data were collected through case summarizations and the administration of surveys sent to 110 coordinators of students with disabilities services at the 15 state universities, 37 private colleges and universities, and 58 community colleges within North Carolina. The response rate was 65.5% (N =72). Findings suggest there were no significant differences among coordinators' perceptions of legislative issues, student responsibility, institutional responsibility, consideration of context in which accommodations are used, and the impact of accommodations on other faculty and students and the institution. However, there were significant differences between the three types of institutions regarding assistive technology, funding for assistive technology, and services available to students who have disabilities. The findings also included that students who self-report disabilities attend private colleges and universities at a greater percentage than attend state universities or community colleges in North Carolina.

Autism spectrum disorder (ASD) affects about 1.5 million individuals in the US alone. The consequences of ASD affect families, caregivers, and social structures. This thesis adds to a growing group of people performing research on mitigating the effects of autism through robotics. Children with ASD tend to interact with robots more easily than with other humans. The goal of robotic therapy is not to help children interact with robots, but to generalize the behavior to humans. An articulated spine is a key to human emotional expression through shaping, weight shifting, and flow. Despite this importance, this feature is all but lacking in robots. The primary contribution of this work is a novel 3-link planar spine with compliant, partial-gravity-compensating springs, capable of reproducing simple emotion-conveying poses for use in robot-based therapy for children with ASD. The design was based on the movements of expression experts using motion tracking markers. This information was used to optimize the number of links in the spine and their corresponding lengths. It is the goal of this research to make robotic therapy more effective for the children, raising the potential for life-changing results.