1
|
Fraudet B, Leblong E, Piette P, Nicolas B, Devigne L, Babel M, Pasteau F, Routhier F, Gallien P. SWADAPT2: benefits of a collision avoidance assistance for powered wheelchair users in driving difficulty. Disabil Rehabil Assist Technol 2024; 19:1907-1915. [PMID: 37681970 DOI: 10.1080/17483107.2023.2253339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 08/21/2023] [Indexed: 09/09/2023]
Abstract
PURPOSE In France, tens of thousands of people use a wheelchair. Driving powered wheelchairs (PWCs) present risks for users and their families. The risk of collision in PWC driver increases with severity of disability and may reduce their independence to drive. The European ADAPT project has developed a robotic assistance add-on for PWCs to prevent collisions and improve their driving performance. MATERIALS AND METHODS The aim of the SWADAPT2 study is to assess the benefit of this robotic assistance add-on arranged on a Standard Quickie Salsa M2 PWC in a population of PWC drivers with neurological disorders and driving difficulties. Eighteen (18) participants tested the system on three circuits of increasing difficulty, with and without the robotic assistance add-on. RESULTS The benefit of the robotic assistance add-on was important especially on the more difficult circuits without impacting cognitive load or driving speed. The number of collisions was significantly reduced when using robotic assistance add-on from 2.16 to 0.36 on circuit 2 (p = 0.009) and from 7.3 to 1.33 on circuit 3 (p = 0.0009). Task load demand was not increased with the assistance. CONCLUSION Finally, this system seems to be indicated to assist and improve driving safety for PWC drivers in driving difficulty. Evaluation was performed in controlled environments; therefore, further evaluation in real-world scenarios is needed to reach technology readiness.
Collapse
Affiliation(s)
| | | | | | | | - Louise Devigne
- Institut National des Sciences Appliquées de Rennes - CNRS, Rennes, France
| | - Marie Babel
- Institut National des Sciences Appliquées de Rennes - CNRS, Rennes, France
| | - François Pasteau
- Institut National des Sciences Appliquées de Rennes - CNRS, Rennes, France
| | - François Routhier
- Department of Rehabilitation, Université Laval, Québec, Canada
- Centre for interdisciplinary research in rehabilitation and social integration, Centre intégré universitaire de santé et services de sociaux de la Capitale-Nationale, Québec, Canada
| | | |
Collapse
|
2
|
Ferretti EC, Suzumura E, Rozman LM, Cooper RA, de Soárez PC. Economic evaluation of wheelchairs interventions: a systematic review. Disabil Rehabil Assist Technol 2023; 18:1163-1174. [PMID: 34753399 DOI: 10.1080/17483107.2021.1993360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 10/09/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The overall aim of this systematic review was to identify and synthesise the best available evidence on effectiveness, resource use and costs involved in wheelchair interventions of adults with mobility limitations. METHODOLOGY This systematic review was undertaken in accordance with the Centre for Reviews and Dissemination Guidelines. The protocol for this systematic review was registered with PROSPERO International Prospective Register of Systematic reviews. The following PICOS eligibility criteria were considered: (P) Population was individuals with mobility limitations that live in their community (e.g., non-institutionalized), with aged 18 or older; (I) Intervention was mobility assistive technologies (MAT), such as manual and powered wheelchairs; (C) Comparators (Not Applied); (O) Outcome, the primary outcome of interest, was established as the cost-effectiveness of wheelchair interventions. Direct and indirect costs per unit of effect were expressed in terms of clinical outcome units, quality-adjusted life years gained, utility scores, quality of life measures and incremental cost-effectiveness ratios to inform the economic outcomes. (S) Study design was considered as a health economic evaluation (i.e., including cost-effectiveness analysis, cost-utility analysis and cost benefit analysis as well as partial economic evaluations). The Consolidated Health Economic Evaluation Reporting Standards - CHEERS, checklist was used for summarising and interpreting the results of economic evaluations. RESULTS Sixteen studies were included, two were identified as full health economic evaluations and 14 were considered partial health economic evaluations. CONCLUSION Only two full health economic analyses of wheelchair interventions have been conducted and both focussed on powered wheelchair provision. There are important gaps in current knowledge regarding wheelchair health economic methods and available outcome measures, which there is a great need for further research.Implication for RehabilitationSystematic reviews of health economic evaluation studies are useful for synthesising economic evidence about health interventions and provide insight in new research development.Organisations involved in the provision of wheelchairs should apply cost-effectiveness outcome measures to help raise the standard of provision, to support evidence-based practice, and to improve resource utilisation.
Collapse
Affiliation(s)
- Eliana C Ferretti
- Departamento de Ciências do Movimento Humano, Universidade Federal de São Paulo, Santos, Brazil
| | - Erica Suzumura
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Luciana M Rozman
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Rory A Cooper
- Human Engineering Research Laboratories, University of Pittsburgh and US Department of Veterans Affairs, Pittsburgh, PA, USA
| | - Patrícia C de Soárez
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| |
Collapse
|
3
|
Joundi RA, Adekanye J, Leung AA, Ronksley P, Smith EE, Rebchuk AD, Field TS, Hill MD, Wilton SB, Bresee LC. Health State Utility Values in People With Stroke: A Systematic Review and Meta-Analysis. J Am Heart Assoc 2022; 11:e024296. [PMID: 35730598 PMCID: PMC9333363 DOI: 10.1161/jaha.121.024296] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 02/21/2022] [Indexed: 12/25/2022]
Abstract
Background Health state utility values are commonly used to provide summary measures of health-related quality of life in studies of stroke. Contemporaneous summaries are needed as a benchmark to contextualize future observational studies and inform the effectiveness of interventions aimed at improving post-stroke quality of life. Methods and Results We conducted a systematic search of the literature using Medline, EMBASE, and Web of Science from January 1995 until October 2020 using search terms for stroke, health-related quality of life, and indirect health utility metrics. We calculated pooled estimates of health utility values for EQ-5D-3L, EQ-5D-5L, AQoL, HUI2, HUI3, 15D, and SF-6D using random effects models. For the EQ-5D-3L we conducted stratified meta-analyses and meta-regression by key subgroups. We screened 14 251 abstracts and 111 studies met our inclusion criteria (sample size range 11 to 12 447). EQ-5D-3L was reported in 78% of studies (study n=87; patient n=56 976). The pooled estimate for EQ-5D-3L at ≥3 months following stroke was 0.65 (95% CI, 0.63-0.67), which was ≈20% below population norms. There was high heterogeneity (I2>90%) between studies, and estimates differed by study size, case definition of stroke, and country of study. Women, older individuals, those with hemorrhagic stroke, and patients prior to discharge had lower pooled EQ-5D-3L estimates. Conclusions Pooled estimates of health utility for stroke survivors were substantially below population averages. We provide reference values for health utility in stroke to support future clinical and economic studies and identify subgroups with lower healthy utility. Registration URL: https://www.crd.york.ac.uk/prospero/. Unique Identifier: CRD42020215942.
Collapse
Affiliation(s)
- Raed A. Joundi
- Department of Clinical NeurosciencesUniversity of CalgaryAlbertaCanada
- Division of NeurologyHamilton Health SciencesMcMaster University & Population Health Research InstituteHamiltonOntarioCanada
| | | | | | | | | | | | - Thalia S. Field
- University of British ColumbiaVancouverBritish ColumbiaCanada
| | | | | | - Lauren C. Bresee
- Department of Community Health SciencesUniversity of CalgaryAlbertaCanada
| |
Collapse
|
4
|
Atigossou O, Honado AS, Routhier F, Flamand VH. Psychometric properties of the Psychosocial Impact of Assistive Devices Scale (PIADS): A systematic review. Assist Technol 2021:1-9. [PMID: 34813722 DOI: 10.1080/10400435.2021.2010149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND The Psychosocial Impact of Assistive Devices Scale (PIADS) is commonly used to assess the psychosocial effects of an assistive device. Given its growing use, an appraisal of the evidence regarding its psychometric properties is required. PURPOSE To conduct a systematic review using validated critical appraisal scales to analyze both the quality and content of the evidence on the psychometric properties of the PIADS. METHODS PubMed/Medline, Embase and CINAHL were systematically searched for identification of studies. Two independent reviewers appraised the retrieved studies using MacDermid and COSMIN-RoB checklists, and extracted data regarding the psychometric measurements reported. RESULTS MacDermid scores showed that 8 out of 11 studies were at least of good methodological quality. COSMIN-RoB scores ranged from inadequate to very good. Except criterion and construct validity, which have presented a moderate level of evidence, the other psychometric properties assessed have demonstrated a high level of evidence. Cross-cultural validity, measurement error and responsiveness have not been studied. CONCLUSION Few studies have yet evaluated the psychometric properties of the PIADS. However, the quality of the evidence that they provide is mostly adequate. Therefore, this review supports the use of the PIADS which has overall good psychometric properties.
Collapse
Affiliation(s)
- Olg Atigossou
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada.,Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec City, QC, Canada
| | - A S Honado
- Service de Rééducation, Centre Hospitalier Universitaire Départemental de l'Ouémé et du Plateau (CHUD-OP), Porto-Novo, Bénin
| | - F Routhier
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada.,Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec City, QC, Canada
| | - V H Flamand
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada.,Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec City, QC, Canada
| |
Collapse
|
5
|
Borgestig M, Al Khatib I, Masayko S, Hemmingsson H. The Impact of Eye-gaze Controlled Computer on Communication and Functional Independence in Children and Young People with Complex Needs - A Multicenter Intervention Study. Dev Neurorehabil 2021; 24:511-524. [PMID: 33872136 DOI: 10.1080/17518423.2021.1903603] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Children and young people with complex needs (severe motor impairments and without speech) have few opportunities to use alternative devices for communication. Eye-gaze controlled computers (EGCCs) might provide individuals with complex needs increased opportunities for communication and participation in society. OBJECTIVE To investigate the impact of EGCCs on communication, functional independence and participation in activities in children and young people with complex needs. METHODS A multicenter intervention study during seven months, measuring outcomes with or without EGCC at four time points, was conducted in Sweden, Dubai, and in USA. Seventeen participants (aged 3-26 years, diagnosis e.g. cerebral palsy, Rett syndrome) were provided with EGCC and services from an Assistive Technology center to implement EGCC in school and/or at home. RESULTS Participants significantly increased their expressive communication skills and functional independence with EGCC compared to baseline. All but one (16 of 17) increased their activity repertoire and computer use with EGCC. With EGCC, participation in computer activities averaged 4.1 performed activities (e.g. communication, play), with a duration of 70 minutes/day and a frequency of 76% of days. DISCUSSION The study strengthened the research evidence that EGCC can be an effective intervention in daily life for children and young people with complex needs. Communication and independence, common goals of intervention, were shown to be relevant EGCC outcomes.
Collapse
Affiliation(s)
- Maria Borgestig
- Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Isphana Al Khatib
- Al Noor Training Centre for Persons with Disabilities, Dubai, United Arab Emirates
| | - Sandra Masayko
- Assistive Technology Department, Easterseals Southeastern Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Helena Hemmingsson
- Department of Special Education, Stockholm University, Stockholm, Sweden.,Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| |
Collapse
|
6
|
Impact of a Hybrid Assisted Wheelchair Propulsion System on Motion Kinematics during Climbing up a Slope. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10031025] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Overcoming terrain obstacles presents a major problem for people with disabilities or with limited mobility who are dependent on wheelchairs. An engineering solution designed to facilitate the use of wheelchairs are assisted-propulsion systems. The objective of the research described in this article is to analyze the impact of the hybrid manual–electric wheelchair propulsion system on the kinematics of the anthropotechnical system when climbing hills. The tests were carried out on a wheelchair ramp with an incline of 4°, using a prototype wheelchair with a hybrid manual–electric propulsion system in accordance with the patent application P.427855. The test subjects were three people whose task was to propel the wheelchair in two assistance modes supporting manual propulsion. The first mode is hill-climbing assistance, while the second one is assistance with propulsion torque in the propulsive phase. During the tests, several kinematic parameters of the wheelchair were monitored. An in-depth analysis was performed for the amplitude of speed during a hill climb and the number of propulsive cycles performed on a hill. The tests performed showed that when propelling the wheelchair only using the hand rims, the subject needed an average of 13 ± 1 pushes on the uphill slope, and their speed amplitude was 1.8 km/h with an average speed of 1.73 km/h. The climbing assistance mode reduced the speed amplitude to 0.76 km/h. The torque-assisted mode in the propulsive phase reduced the number of cycles required to climb the hill from 13 to 6, while in the climbing assistance mode the number of cycles required to climb the hill was reduced from 12 to 10 cycles. The tests were carried out at various values of assistance and assistance amplification coefficient, and the most optimally selected parameters of this coefficient are presented in the results. The tests proved that electric propulsion assistance has a beneficial and significant impact on the kinematics of manual wheelchair propulsion when compared to a classic manual propulsion system when overcoming hills. In addition, assistance and assistance amplification coefficient were proved to be correlated with operating conditions and the user’s individual characteristics.
Collapse
|
7
|
Psychosocial Impact of Powered Wheelchair, Users’ Satisfaction and Their Relation to Social Participation. TECHNOLOGIES 2019. [DOI: 10.3390/technologies7040073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Several studies showed positive effects of assistive technologies on psychosocial impact and participation of adults with mobility impairments. The purpose of this study was to assess the psychosocial and participation impact of powered wheelchairs. Participants were thirty persons with disabilities who use powered wheelchairs with diverse medical conditions. The Quebec User Evaluation of Satisfaction with Assistive Technology, the Psychosocial Impact of Assistive Devices Scale and the Activities and Participation Profile Related to Mobility were used, in addition to demographic, clinical and wheelchair related questions. The participants were satisfied with both the assistive technology and related services, with the lowest satisfaction scores belonging to those who had been using their wheelchairs for a longer period of time. We noticed significant restrictions in participation mostly among persons with longer wheelchair utilization. The most satisfied were the ones with better performance in terms of social participation. Psychosocial scores showed a positive impact with higher adaptability among persons who transitioned from a manual compared to those who already had a powered wheelchair. There was a positive psychosocial impact and therefore an increase in quality of life of its users.
Collapse
|
8
|
Zander V, Johansson-Pajala RM, Gustafsson C. Methods to evaluate perspectives of safety, independence, activity, and participation in older persons using welfare technology. A systematic review. Disabil Rehabil Assist Technol 2019; 15:373-393. [PMID: 30786779 DOI: 10.1080/17483107.2019.1574919] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Purpose: To conduct a systematic review of existing methods to evaluate the individual aspects of welfare technology from the perspectives of independence, safety, activity, and participation. Furthermore, the study aimed to describe outcomes that have been the focus of previous research to evaluate individual aspects of welfare technology in older persons living in ordinary housing. Materials and methods: A systematic literature review in PubMed, CINAHL Plus, PsycINFO, Scopus, and Web of Science. Studies selected were those that explored the use of assistive and welfare technology devices from older persons' perspectives, and which considered the concepts of independence, safety, activity and participation, and quality of life. Results: A broad spectrum of instruments was applied in the studies. For independence, three questionnaires were used in the identified studies. For safety, one instrument was used in two versions. To study activity and participation as well as quality of life, several scales were used. Additionally, several studies included qualitative approaches for evaluation, such as interviews, or posed one or more questions regarding the effects of welfare technology. Conclusions: The integration of digital assistive and welfare technology should be based on the needs of older persons, and those needs must be assessed using reliable and relevant instruments. The heterogeneity of the target group, i.e., older persons, together with the fact that assessments must give consideration to identifying goals, obstacles, and risks as well as users' preferences, implies a person-centred approach.Implications for rehabilitationThe integration of digital assistive and welfare technology should be based on older persons' needs, and those needs must be assessed using reliable and relevant instruments.The heterogeneity of the target group, i.e. older persons, together with the fact that assessments must give consideration to identifying goals, obstacles and risks as well as users' preferences, implies a person-centred approach.The ideal would be one coherent model that explores the use of digital assistive and welfare technology from the individual, economic as well as organisational dimensions. This would cover the different needs and expectations of various stakeholders, including economic and organisational, but also the needs of the older person.
Collapse
Affiliation(s)
- V Zander
- School of Health, Care, and Social Welfare, Mälardalen University, Eskilstuna, Sweden
| | - R-M Johansson-Pajala
- School of Health, Care, and Social Welfare, Mälardalen University, Eskilstuna, Sweden
| | - C Gustafsson
- School of Health, Care, and Social Welfare, Mälardalen University, Eskilstuna, Sweden
| |
Collapse
|
9
|
Linking the Psychosocial Impact of Assistive Devices Scale (PIADS) to the International Classification of Functioning, Disability, and Health. Qual Life Res 2018; 27:3217-3227. [PMID: 30132254 DOI: 10.1007/s11136-018-1973-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2018] [Indexed: 02/07/2023]
Abstract
PURPOSE Assistive technologies are widely implemented in clinical and research settings. Despite their dissemination, the psychosocial impact of their adoption still deserves further consideration. The aim of the present study is to determine the degree of compatibility between the Psychosocial Impact of Assistive Devices Scale (PIADS) and the International Classification of Functioning, Disability, and Health (ICF). METHODS Six health professionals (two neurologists, one neuro-rehabilitation technician, two psychologists, one university professor of rehabilitation) created a technical board to discuss upon the PIADS-ICF linking. The standardized linking methodology was applied, and a Delphi technique was used to examine consensus. RESULTS Five Delphi sessions were required to reach 100% of consensus and to finalize the procedure. Of the 26 PIADS' items, 23 were linked to an ICF category: 9 items were endorsed at the 3rd ICF level, and 14 items at the 2nd ICF level. Two items were classified as "not defined" and 1 item as "not covered". CONCLUSION The study highlighted the conceptual connection between the PIADS and the ICF framework and set a bio-psychosocial standpoint by which accounting the role of assistive devices in rehabilitation settings.
Collapse
|
10
|
Kirby RL, Rushton PW, Routhier F, Demers L, Titus L, Miller-Polgar J, Smith C, McAllister M, Theriault C, Matheson K, Parker K, Sawatzky B, Labbé D, Miller WC. Extent to Which Caregivers Enhance the Wheelchair Skills Capacity and Confidence of Power Wheelchair Users: A Cross-Sectional Study. Arch Phys Med Rehabil 2018; 99:1295-1302.e9. [PMID: 29305847 DOI: 10.1016/j.apmr.2017.11.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Accepted: 11/17/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To test the hypothesis that caregivers enhance the wheelchair skills capacity and confidence of the power wheelchair users to whom they provide assistance, and to describe the nature of that assistance. DESIGN Multicenter cross-sectional study. SETTING Rehabilitation centers and communities. PARTICIPANTS Participants (N=152) included caregivers (n=76) and wheelchair users (n=76). INTERVENTIONS None. MAIN OUTCOME MEASURES Version 4.3 of the Wheelchair Skills Test (WST) and the Wheelchair Skills Test-Questionnaire (WST-Q). For each of the 30 individual skills, we recorded data about the wheelchair user alone and in combination (blended) with the caregiver. RESULTS The mean total WST capacity scores ± SD for the wheelchair users alone and blended were 78.1%±9.3% and 92.4%±6.1%, respectively, with a mean difference of 14.3%±8.7% (P<.0001). The mean WST-Q capacity scores ± SD were 77.0%±10.6% and 93.2%±6.4%, respectively, with a mean difference of 16.3%±9.8% (P<.0001). The mean WST-Q confidence scores ± SD were 75.5%±12.7% and 92.8%±6.8%, respectively, with a mean difference of 17.5%±11.7% (P<.0001). The mean differences corresponded to relative improvements of 18.3%, 21.0%, and 22.9%, respectively. The nature and benefits of the caregivers' assistance could be summarized in 7 themes (eg, caregiver provides verbal support [cueing, coaching, reporting about the environment]). CONCLUSIONS Caregivers significantly enhance the wheelchair skills capacity and confidence of the power wheelchair users to whom they provide assistance, and they do so in a variety of ways. These findings have significance for wheelchair skills assessment and training.
Collapse
Affiliation(s)
- R Lee Kirby
- Department of Medicine, Dalhousie University, Halifax, NS, Canada.
| | - Paula W Rushton
- School of Rehabilitation, University of Montreal, Montréal, QC, Canada
| | - Francois Routhier
- Department of Rehabilitation, Laval University Quebec City, QC, Canada
| | - Louise Demers
- School of Rehabilitation, University of Montreal, Montréal, QC, Canada
| | - Laura Titus
- School of Occupational Therapy, University of Western Ontario, London, ON, Canada
| | - Jan Miller-Polgar
- School of Occupational Therapy, University of Western Ontario, London, ON, Canada
| | - Cher Smith
- Department of Occupational Therapy, Nova Scotia Health Authority, Halifax, NS, Canada
| | - Mike McAllister
- Faculty of Computer Science, Dalhousie University, Halifax, NS, Canada
| | - Chris Theriault
- Department of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Kara Matheson
- Department of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Kim Parker
- Assistive Technology Program, Nova Scotia Health Authority, Halifax, NS, Canada
| | - Bonita Sawatzky
- Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada
| | - Delphine Labbé
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
| | - William C Miller
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
| |
Collapse
|
11
|
Bray N, Noyes J, Harris N, Edwards RT. Defining health-related quality of life for young wheelchair users: A qualitative health economics study. PLoS One 2017; 12:e0179269. [PMID: 28617820 PMCID: PMC5472290 DOI: 10.1371/journal.pone.0179269] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 05/27/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Wheelchairs for children with impaired mobility provide health, developmental and psychosocial benefits, however there is limited understanding of how mobility aids affect the health-related quality of life of children with impaired mobility. Preference-based health-related quality of life outcome measures are used to calculate quality-adjusted life years; an important concept in health economics. The aim of this research was to understand how young wheelchair users and their parents define health-related quality of life in relation to mobility impairment and wheelchair use. METHODS The sampling frame was children with impaired mobility (≤18 years) who use a wheelchair and their parents. Data were collected through semi-structured face-to-face interviews conducted in participants' homes. Qualitative framework analysis was used to analyse the interview transcripts. An a priori thematic coding framework was developed. Emerging codes were grouped into categories, and refined into analytical themes. The data were used to build an understanding of how children with impaired mobility define health-related quality of life in relation to mobility impairment, and to assess the applicability of two standard measures of health-related quality of life. RESULTS Eleven children with impaired mobility and 24 parents were interviewed across 27 interviews. Participants defined mobility-related quality of life through three distinct but interrelated concepts: 1) participation and positive experiences; 2) self-worth and feeling fulfilled; 3) health and functioning. A good degree of consensus was found between child and parent responses, although there was some evidence to suggest a shift in perception of mobility-related quality of life with child age. CONCLUSIONS Young wheelchair users define health-related quality of life in a distinct way as a result of their mobility impairment and adaptation use. Generic, preference-based measures of health-related quality of life lack sensitivity in this population. Development of a mobility-related quality of life outcome measure for children is recommended.
Collapse
Affiliation(s)
- Nathan Bray
- Centre for Health Economics and Medicines Evaluation, Bangor University, Bangor, Gwynedd, United Kingdom
- * E-mail:
| | - Jane Noyes
- School of Social Sciences, Bangor University, Bangor, Gwynedd, United Kingdom
| | - Nigel Harris
- DesignAbility, Bath Institute of Medical Engineering, Bath, Somerset, United Kingdom
| | - Rhiannon Tudor Edwards
- Centre for Health Economics and Medicines Evaluation, Bangor University, Bangor, Gwynedd, United Kingdom
| |
Collapse
|
12
|
Boland P, Levack W, Perry M, Graham F. Equipment provision after stroke: A scoping review of the use of personal care and mobility aids in rehabilitation. Br J Occup Ther 2016. [DOI: 10.1177/0308022616664910] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction The aim of this scoping review was to examine and synthesise literature on adaptive equipment use for personal care and mobility after stroke. Method We searched databases including Medline, EMBASE, AMED, CINAHL and Scopus to February 2016. Two authors independently screened 789 titles, identifying 28 studies for inclusion in the review. Results Findings were grouped into four themes: (1) stroke-specific impairments and consequences for equipment use and training; (2) meaning of equipment for people with stroke; (3) cost of equipment after stroke; and (4) conflicts between equipment provision and models of stroke rehabilitation. Conclusion The wide range of impairments after stroke increases complexity of how people use equipment. Nonetheless, training needs and the relationship between social context, identity and equipment use are increasingly better understood,. The findings highlight a tension between practice that seeks to re-train function by ‘normal’ movement without equipment and restoration of function by using compensation strategies involving use of equipment. However, there is no evidence that compensation strategies impede recovery of physical abilities. High-quality evidence about costs of equipment after stroke, which could inform policy decisions, is urgently needed.
Collapse
Affiliation(s)
- Pauline Boland
- Lecturer, MSc Occupational Therapy Programme, Clinical Therapies, University of Limerick, Republic of Ireland
- Senior Lecturer, Rehabilitation, Teaching and Research Unit, University of Otago, New Zealand
| | - William Levack
- Senior Lecturer, Rehabilitation, Teaching and Research Unit, University of Otago, New Zealand
| | - Meredith Perry
- Lecturer, Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Wellington, New Zealand
| | - Fiona Graham
- Senior Lecturer, Rehabilitation, Teaching and Research Unit, University of Otago, New Zealand
| |
Collapse
|
13
|
Ready for eHealth. Older Swedes’ Perceptions of eHealth Services: Using the PIADS Scale as a Predictor for Readiness. TECHNOLOGIES 2016. [DOI: 10.3390/technologies4030029] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
14
|
Winstein CJ, Stein J, Arena R, Bates B, Cherney LR, Cramer SC, Deruyter F, Eng JJ, Fisher B, Harvey RL, Lang CE, MacKay-Lyons M, Ottenbacher KJ, Pugh S, Reeves MJ, Richards LG, Stiers W, Zorowitz RD. Guidelines for Adult Stroke Rehabilitation and Recovery: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke 2016; 47:e98-e169. [PMID: 27145936 DOI: 10.1161/str.0000000000000098] [Citation(s) in RCA: 1538] [Impact Index Per Article: 192.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE The aim of this guideline is to provide a synopsis of best clinical practices in the rehabilitative care of adults recovering from stroke. METHODS Writing group members were nominated by the committee chair on the basis of their previous work in relevant topic areas and were approved by the American Heart Association (AHA) Stroke Council's Scientific Statement Oversight Committee and the AHA's Manuscript Oversight Committee. The panel reviewed relevant articles on adults using computerized searches of the medical literature through 2014. The evidence is organized within the context of the AHA framework and is classified according to the joint AHA/American College of Cardiology and supplementary AHA methods of classifying the level of certainty and the class and level of evidence. The document underwent extensive AHA internal and external peer review, Stroke Council Leadership review, and Scientific Statements Oversight Committee review before consideration and approval by the AHA Science Advisory and Coordinating Committee. RESULTS Stroke rehabilitation requires a sustained and coordinated effort from a large team, including the patient and his or her goals, family and friends, other caregivers (eg, personal care attendants), physicians, nurses, physical and occupational therapists, speech-language pathologists, recreation therapists, psychologists, nutritionists, social workers, and others. Communication and coordination among these team members are paramount in maximizing the effectiveness and efficiency of rehabilitation and underlie this entire guideline. Without communication and coordination, isolated efforts to rehabilitate the stroke survivor are unlikely to achieve their full potential. CONCLUSIONS As systems of care evolve in response to healthcare reform efforts, postacute care and rehabilitation are often considered a costly area of care to be trimmed but without recognition of their clinical impact and ability to reduce the risk of downstream medical morbidity resulting from immobility, depression, loss of autonomy, and reduced functional independence. The provision of comprehensive rehabilitation programs with adequate resources, dose, and duration is an essential aspect of stroke care and should be a priority in these redesign efforts. (Stroke.2016;47:e98-e169. DOI: 10.1161/STR.0000000000000098.).
Collapse
|
15
|
Kirby RL, Miller WC, Routhier F, Demers L, Mihailidis A, Polgar JM, Rushton PW, Titus L, Smith C, McAllister M, Theriault C, Thompson K, Sawatzky B. Effectiveness of a Wheelchair Skills Training Program for Powered Wheelchair Users: A Randomized Controlled Trial. Arch Phys Med Rehabil 2015; 96:2017-26.e3. [PMID: 26232684 PMCID: PMC4674291 DOI: 10.1016/j.apmr.2015.07.009] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Revised: 07/16/2015] [Accepted: 07/17/2015] [Indexed: 11/18/2022]
Abstract
OBJECTIVES To test the hypothesis that powered wheelchair users who receive the Wheelchair Skills Training Program (WSTP) improve their wheelchair skills in comparison with a control group that receives standard care, and secondarily to assess goal achievement, satisfaction with training, retention, injury rate, confidence with wheelchair use, and participation. DESIGN Randomized controlled trial. SETTING Rehabilitation centers and communities. PARTICIPANTS Powered wheelchair users (N=116). INTERVENTION Five 30-minute WSTP training sessions. MAIN OUTCOME MEASURES Assessments were done at baseline (t1), posttraining (t2), and 3 months posttraining (t3) using the Wheelchair Skills Test Questionnaire (WST-Q version 4.1), Goal Attainment Score (GAS), Satisfaction Questionnaire, injury rate, Wheelchair Use Confidence Scale for Power Wheelchair Users (WheelCon), and Life Space Assessment (LSA). RESULTS There was no significant t2-t1 difference between the groups for WST-Q capacity scores (P=.600), but the difference for WST-Q performance scores was significant (P=.016) with a relative (t2/t1 × 100%) improvement of the median score for the intervention group of 10.8%. The mean GAS ± SD for the intervention group after training was 92.8%±11.4%, and satisfaction with training was high. The WST-Q gain was not retained at t3. There was no clinically significant difference between the groups in injury rate and no statistically significant differences in WheelCon or LSA scores at t3. CONCLUSIONS Powered wheelchair users who receive formal wheelchair skills training demonstrate modest, transient posttraining improvements in their WST-Q performance scores, have substantial improvements on individualized goals, and are positive about training.
Collapse
Affiliation(s)
- R Lee Kirby
- Department of Medicine, Division of Physical Medicine and Rehabilitation, Dalhousie University, Halifax, Nova Scotia, Canada.
| | - William C Miller
- Department of Occupational Science and Occupational Therapy, University of British Columbia; Vancouver, British Columbia, Canada
| | - Francois Routhier
- Department of Rehabilitation, Laval University, Québec City, Quebec, Canada; Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City Rehabilitation Institute, Québec City, Quebec, Canada
| | - Louise Demers
- School of Rehabilitation, University of Montreal, Montréal, Quebec, Canada; Research Center, University of Montreal Institute of Geriatrics, Montréal, Quebec, Canada
| | - Alex Mihailidis
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Jan Miller Polgar
- School of Occupational Therapy, Western University, London, Ontario, Canada
| | - Paula W Rushton
- School of Rehabilitation, University of Montreal, Montréal, Quebec, Canada; University Hospital Centre Sainte-Justine Research Center, Montréal, Quebec, Canada
| | - Laura Titus
- School of Occupational Therapy, Western University, London, Ontario, Canada
| | - Cher Smith
- Department of Occupational Therapy, Capital District Health Authority, Halifax, Nova Scotia, Canada
| | - Mike McAllister
- Faculty of Computer Science, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Chris Theriault
- Research Methods Unit, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Kara Thompson
- Research Methods Unit, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Bonita Sawatzky
- Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada
| |
Collapse
|
16
|
Mortenson WB, Demers L, Rushton PW, Auger C, Routhier F, Miller WC. Exploratory Validation of a Multidimensional Power Wheelchair Outcomes Toolkit. Arch Phys Med Rehabil 2015; 96:2184-93. [PMID: 26403685 DOI: 10.1016/j.apmr.2015.08.430] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 08/27/2015] [Accepted: 08/28/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To evaluate the relation among the measures in a power wheelchair outcomes toolkit. DESIGN We performed path analysis of cross-sectional data from self-report questionnaires and 1 objective measure. SETTING Six sites. PARTICIPANTS A convenience sample of power wheelchair users (N=128). Most (n=69; 53.9%) participants were women. Multiple sclerosis and spinal cord injury/disease were the most common diagnoses. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES The power wheelchair version of the Wheelchair Skills Test version 4.1 was used to carry out an objective evaluation of capacity to perform 32 wheelchair skills. The Late-Life Disability Index measured frequency of participation in 16 life activities. The Life-Space Assessment measured independence, extent, and frequency of mobility. The Assistive Technology Outcomes Profile for Mobility was used to assess perceived difficulty performing activity and participation using assistive technology. The Wheelchair Use Confidence Scale for powered wheelchair users captured users' self-efficacy with wheelchair use. RESULTS Wheelchair confidence was independently associated with less difficulty with activity (β=.028, P=.002) and participation (β=.225, P<.001), increased life space (β=.095, P<.003), and greater wheelchair skills (β=.30, P<.001). Less perceived difficulty with activity was independently associated with increased frequency of participation (β=.55, P<.001). Life-space mobility was independently associated with increased frequency of participation (β=.167, P<.001). Less difficulty with participation was independently associated with greater life-space mobility (β=.59, P<.001) and greater frequency of participation (β=.13, P<.001). CONCLUSIONS This study provides empirical support for the measures included as part of the power wheelchair outcomes toolkit. They appear to provide complementary information on a variety of constructs related to power wheelchair use.
Collapse
Affiliation(s)
- W Ben Mortenson
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada; International Collaboration on Repair Discoveries, University of British Columbia Faculty of Medicine and Vancouver Coastal Health Research Institute, Vancouver, BC, Canada; Rehabilitation Research Program, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada.
| | - Louise Demers
- School of Rehabilitation, Université de Montréal, Montreal, QC, Canada; Research Center of the Institut universitaire de gériatrie de Montréal, School of Rehabilitation, Université de Montréal, Montreal, QC, Canada
| | - Paula W Rushton
- School of Rehabilitation, Université de Montréal, Montreal, QC, Canada; Marie Enfant Rehabilitation Center, Sainte-Justine University Hospital Research Center, Montréal, PQ, Canada
| | - Claudine Auger
- School of Rehabilitation, Université de Montréal, Montreal, QC, Canada; Center for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montréal, PQ, Canada
| | - Francois Routhier
- Department of Rehabilitation, Laval University, Quebec City, PQ, Canada; Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City Rehabilitation Institute, Quebec City, PQ, Canada
| | - William C Miller
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada; International Collaboration on Repair Discoveries, University of British Columbia Faculty of Medicine and Vancouver Coastal Health Research Institute, Vancouver, BC, Canada; Rehabilitation Research Program, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
| |
Collapse
|
17
|
Shankar S, Mortenson WB, Wallace J. Taking Control: An Exploratory Study of the Use of Tilt-in-Space Wheelchairs in Residential Care. Am J Occup Ther 2015; 69:6902290040. [PMID: 26122688 DOI: 10.5014/ajot.2014.013565] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Tilt-in-space (TIS) wheelchairs are common in residential care, but little empirical evidence exists regarding how they are used by residents and staff in these settings. As part of a larger study exploring the use of wheeled mobility in these facilities, we conducted a substudy to examine how TIS wheelchairs are used in practice and to explore the experiences of the residents who use them. We conducted a series of three participant observations and interviews with 6 residents or their family members and interviewed 10 staff. Our analysis identified taking control as the main overarching theme, subsuming two subthemes: promoting comfort and mobilizing to participate. Findings suggest that power TIS wheelchairs enable user control, whereas manual TIS wheelchairs promote staff control. These findings illustrate how TIS wheelchairs may enable or inhibit occupational engagement and suggest that vigilance is necessary to prevent their use as a restraint.
Collapse
Affiliation(s)
- Sneha Shankar
- Sneha Shankar, MSc, MOT, is Doctoral Student and Occupational Therapist, Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver;
| | - W Ben Mortenson
- W. Ben Mortenson, MSc, PhD, is Assistant Professor, Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver; Principal Investigator, International Collaboration on Repair Discoveries, University of British Columbia/Vancouver Coastal Health Research Institute, Vancouver; and Principal Investigator, G.F. Strong Rehabilitation Research Program, Vancouver Coastal Health Research Institute, British Columbia
| | - Justin Wallace
- Justin Wallace, MOT, is Manager, Yukon Government, Health and Social Services, Continuing Care Division, Extended Care Branch, Whitehorse, Yukon
| |
Collapse
|
18
|
Pettersson I, Hagberg L, Fredriksson C, Hermansson LN. The effect of powered scooters on activity, participation and quality of life in elderly users. Disabil Rehabil Assist Technol 2015; 11:558-63. [DOI: 10.3109/17483107.2015.1027301] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Ingvor Pettersson
- School of Health and Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden and
| | - Lars Hagberg
- School of Health and Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden and
| | - Carin Fredriksson
- School of Health and Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden and
| | - Liselotte N Hermansson
- School of Health and Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden and
- Department of Prosthetics and Orthotics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| |
Collapse
|
19
|
|
20
|
Pettersson C, Iwarsson S, Brandt A, Norin L, Månsson Lexell E. Men's and women's perspectives on using a powered mobility device: benefits and societal challenges. Scand J Occup Ther 2014; 21:438-46. [PMID: 24784724 DOI: 10.3109/11038128.2014.905634] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To describe how men and women experience their use of powered wheelchairs (PW) and powered scooters (PS) in everyday occupations, in the home and in society at large. METHODS A qualitative research approach with focus-group methodology was used. Four focus groups were created, with men and women as well as PW and PS users in different groups. Applying a descriptive approach, data were analysed according to the principles described by Krueger. FINDINGS Three categories emerged and revealed that even though use of PW and PS increased independence and enabled everyday occupations, participants struggled to be independent powered mobility device (PMD) users. They experienced many accessibility problems in dwellings and in society, described similarly by users of PW and PS. Men and women experienced their use of (PMD) differently, especially in relation to the service delivery process. CONCLUSIONS The study contributes with new knowledge on accessibility for PW and PS users and related service delivery processes, stating that gender differences regarding provision and training must be taken into account. Occupational therapists can contribute to an enhanced understanding of PMD users' challenges in person-environment-occupation transactions in the home and society, and thereby promote occupational justice for PMD users.
Collapse
|
21
|
Exploring powered wheelchair users and their caregivers' perspectives on potential intelligent power wheelchair use: a qualitative study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:2244-61. [PMID: 24566051 PMCID: PMC3945596 DOI: 10.3390/ijerph110202244] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Revised: 01/30/2014] [Accepted: 02/10/2014] [Indexed: 11/17/2022]
Abstract
Power wheelchairs (PWCs) can have a positive impact on user well-being, self-esteem, pain, activity and participation. Newly developed intelligent power wheelchairs (IPWs), allowing autonomous or collaboratively-controlled navigation, could enhance mobility of individuals not able to use, or having difficulty using, standard PWCs. The objective of this study was to explore the perspectives of PWC users (PWUs) and their caregivers regarding if and how IPWs could impact on current challenges faced by PWUs, as well as inform current development of IPWs. A qualitative exploratory study using individual interviews was conducted with PWUs (n = 12) and caregivers (n = 4). A semi-structured interview guide and video were used to facilitate informed discussion regarding IPWs. Thematic analysis revealed three main themes: (1) “challenging situations that may be overcome by an IPW” described how the IPW features of obstacle avoidance, path following, and target following could alleviate PWUs’ identified mobility difficulties; (2) “cautious optimism concerning IPW use revealed participants” addresses concerns regarding using an IPW as well as technological suggestions; (3) “defining the potential IPW user” revealed characteristics of PWUs that would benefit from IPW use. Findings indicate how IPW use may help overcome PWC difficulties and confirm the importance of user input in the ongoing development of IPWs.
Collapse
|
22
|
Abstract
Introduction: Every aspect of the wheelchair and seating provision process has an impact on overall outcomes for service users. This critical appraisal sought to identify outcome measures suitable for evaluation of wheelchair and seating provision, considering activity, participation, and impact of the service delivery on quality of life. Method: Outcome measures were identified using databases: Medline, CINHAL, PsychInfo, and Google Scholar. An evaluation was conducted to establish those that were particularly useful and a critical appraisal was completed. Findings: Five outcome measures identified as relevant for critical appraisal included: Wheelchair Outcome Measure; Functioning Every day in a Wheelchair; Goal Attainment Scale; Psychosocial Impact of Assistive Devices Scales; and the Quebec User Evaluation of Satisfaction with Assistive Technology. The strengths and limitations of each were identified. Conclusion: No single outcome measure captures all necessary information; trade-offs are inevitable. When choosing an outcome measure, the specific goals of the service evaluation and the resources available need to be considered within context. Critical appraisal of five outcome measures deemed appropriate for the evaluation highlighted some areas for consideration to inform decision making. A move towards sustainability indicators is suggested to monitor, measure, and respond to the provision processes and outcomes required to meet this primary need.
Collapse
Affiliation(s)
- Siobhan Kenny
- Occupational Therapist, Peamount Healthcare, Newcastle, Co. Dublin, Ireland
| | | |
Collapse
|
23
|
The Anticipated Positive Psychosocial Impact of Present Web-Based E-Health Services and Future Mobile Health Applications: An Investigation among Older Swedes. Int J Telemed Appl 2013; 2013:509198. [PMID: 24368912 PMCID: PMC3866775 DOI: 10.1155/2013/509198] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Revised: 09/30/2013] [Accepted: 10/21/2013] [Indexed: 11/24/2022] Open
Abstract
This study investigates the anticipated psychosocial impact of present web-based e-health services and future mobile health applications among older Swedes. Random sample's of Swedish citizens aged 55 years old and older were given a survey containing two different e-health scenarios which respondents rated according to their anticipated psychosocial impact by means of the PIADS instrument. Results consistently demonstrated the positive anticipation of psychosocial impacts for both scenarios. The future mobile health applications scored more positively than the present web-based e-health services. An increase in age correlated positively to lower impact scores. These findings indicate that from a psychosocial perspective, web-based e-health services and mobile health applications are likely to positively impact quality of life. This knowledge can be helpful when tailoring and implementing e-health services that are directed to older people.
Collapse
|
24
|
Goil A, Derry M, Argall BD. Using machine learning to blend human and robot controls for assisted wheelchair navigation. IEEE Int Conf Rehabil Robot 2013; 2013:6650454. [PMID: 24187271 DOI: 10.1109/icorr.2013.6650454] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
This work presents an algorithm for collaborative control of an assistive semi-autonomous wheelchair. Our approach is based on a statistical machine learning technique to learn task variability from demonstration examples. The algorithm has been developed in the context of shared-control powered wheelchairs that provide assistance to individuals with impairments that affect their control in challenging driving scenarios, like doorway navigation. We validate our algorithm within a simulation environment, and find that with relatively few demonstrations, our approach allows for safe traversal of the doorway while maintaining a high level of user control.
Collapse
|
25
|
Smith DW, Davies EW, Wissinger E, Huelin R, Matza LS, Chung K. A systematic literature review of cardiovascular event utilities. Expert Rev Pharmacoecon Outcomes Res 2013; 13:767-90. [PMID: 24175732 DOI: 10.1586/14737167.2013.841545] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Cardiovascular disease (CVD) results in half of the non-communicable disease-related deaths worldwide. Rising treatment costs have increased the need for cost-utility models designed to compare the value of new and existing therapies. Cost-utility models require utilities, values representing the strength of preferences for various health states. This systematic literature review aimed to identify and evaluate utilities reported for stroke, myocardial infarction (MI) and angina. In total, 83 unique studies were identified that reported utilities for these events. Approximately two-thirds reported utility values for stroke, and most used the EuroQoL five dimension to derive utilities. Utility values were lower in patients who experienced cardiovascular (CV) events than in patients who did not. The utility estimates for each condition varied greatly, likely due to differences in assessment methodologies and patient populations. This variability must be considered when choosing values for cost-utility models. Comparisons among reported utilities are further complicated by inconsistent CV event definitions.
Collapse
Affiliation(s)
- Donald W Smith
- Evidera, 430 Bedford St. Suite 300 Lexington, MA 02420, USA
| | | | | | | | | | | |
Collapse
|
26
|
Guyot M, Kokosy A, Lenne B, Malapel L, Donzé C. Attentes et besoins technologiques des utilisateurs de fauteuil roulant électrique. Ann Phys Rehabil Med 2013. [DOI: 10.1016/j.rehab.2013.07.169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
27
|
Évaluation de la satisfaction des usagers après une première acquisition de fauteuil roulant électrique. Ann Phys Rehabil Med 2013. [DOI: 10.1016/j.rehab.2013.07.367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
28
|
Malapel-Empis H, Saragoni A, Guyot M, Donze C. Evaluation of user's satisfaction after their first acquisition of an electric-powered wheelchair. Ann Phys Rehabil Med 2013. [DOI: 10.1016/j.rehab.2013.07.374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
29
|
Technological needs and expectations of powered wheelchairs users. Ann Phys Rehabil Med 2013. [DOI: 10.1016/j.rehab.2013.07.176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
30
|
Borgestig M, Falkmer T, Hemmingsson H. Improving computer usage for students with physical disabilities through a collaborative approach: a pilot study. Scand J Occup Ther 2013; 20:463-70. [PMID: 24041227 DOI: 10.3109/11038128.2013.837506] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the effect of an assistive technology (AT) intervention to improve the use of available computers as assistive technology in educational tasks for students with physical disabilities during an ongoing school year. METHODS Fifteen students (aged 12-18) with physical disabilities, included in mainstream classrooms in Sweden, and their teachers took part in the intervention. Pre-, post-, and follow-up data were collected with Goal Attainment Scaling (GAS), a computer usage diary, and with the Psychosocial Impact of Assistive Devices Scale (PIADS). Teachers' opinions of goal setting were collected at follow-up. RESULTS The intervention improved the goal-related computer usage in educational tasks and teachers reported they would use goal setting again when appropriate. At baseline, students reported a positive impact from computer usage with no differences over time regarding the PIADS subscales independence, adaptability, or self-esteem. DISCUSSION The AT intervention showed a positive effect on computer usage as AT in mainstream schools. Some additional support to teachers is recommended as not all students improved in all goal-related computer usage. A clinical implication is that students' computer usage can be improved and collaboratively established computer-based strategies can be carried out by teachers in mainstream schools.
Collapse
Affiliation(s)
- Maria Borgestig
- Department of Social and Welfare Studies, Linköping University , Linköping, Sweden
| | | | | |
Collapse
|
31
|
Abstract
PURPOSE The aim of this study was to explore the psychosocial impact of standing devices as experienced by users. METHOD This is the second part of a comprehensive survey in five counties in Sweden where all the subjects with standing devices were invited to participate. The impact of standing devices on functional independence, quality of life and wellbeing was assessed using a questionnaire, Psychosocial Impact of Assistive Devices Scale (PIADS). RESULTS The psychosocial impact of the standing devices was perceived as positive. The highest PIADS scores in relation to age were found in the oldest group, aged 65 years and older. The ability to walk and independence in ambulation resulted in higher scores than the use of a wheelchair and/or dependence on others. Those who stood often awarded higher scores in the PIADS questionnaire compared to those who used the device less frequently. When standing was integrated in various activities, its psychosocial impact received high scores. CONCLUSION The psychosocial impact of standing devices was generally experienced positively. The main results indicated that standing in a standing device had a value and we as professionals should ask the users about the intended purpose of their standing in order to prescribe the optimal device. IMPLICATIONS FOR REHABILITATION Standing in standing devices has positive psychosocial impact for the user. As professionals we should broaden our view of the use of standing devices, i.e. to see the standing device as an aid that not only treats the body's structures or improves the user's abilities in activities, but also provides a psychosocial impact on the user's daily life, and to find meaningful goals for the user from a psychosocial perspective.
Collapse
Affiliation(s)
- Birgitta Nordström
- Department of Research and Development, Norrbotten County Council , Luleå , Sweden and
| | | | | | | |
Collapse
|
32
|
Löfqvist C, Pettersson C, Iwarsson S, Brandt A. Mobility and mobility-related participation outcomes of powered wheelchair and scooter interventions after 4-months and 1-year use. Disabil Rehabil Assist Technol 2011; 7:211-8. [DOI: 10.3109/17483107.2011.619224] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
33
|
Rudolf KD, Kus S, Chung KC, Johnston M, LeBlanc M, Cieza A. Development of the International Classification of Functioning, Disability and Health core sets for hand conditions--results of the World Health Organization International Consensus process. Disabil Rehabil 2011; 34:681-93. [PMID: 21978202 DOI: 10.3109/09638288.2011.613514] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
PURPOSE A formal decision-making and consensus process was applied to develop the first version of the International Classification on Functioning, Disability and Health (ICF) Core Sets for Hand Conditions. METHOD To convene an international panel to develop the ICF Core Sets for Hand Conditions (HC), preparatory studies were conducted, which included an expert survey, a systematic literature review, a qualitative study and an empirical data collection process involving persons with hand conditions. A consensus conference was convened in Switzerland in May 2009 that was attended by 23 healthcare professionals, who treat hand conditions, representing 22 countries. RESULTS The preparatory studies identified a set of 743 ICF categories at the second, third or fourth hierarchical level. Altogether, 117 chapter-, second-, or third-level categories were included in the comprehensive ICF Core Set for HC. The brief ICF Core Set for HC included a total of 23 chapter- and second-level categories. CONCLUSIONS A formal consensus process integrating evidence and expert opinion based on the ICF led to the formal adoption of the ICF Core Sets for Hand Conditions. The next phase of this ICF project is to conduct a formal validation process to establish its applicability in clinical settings.
Collapse
Affiliation(s)
- Klaus-Dieter Rudolf
- Department of Hand Surgery, Plastic- and Microsurgery, Burns Unit, BG Trauma Hospital Hamburg, Germany
| | | | | | | | | | | |
Collapse
|
34
|
Sorrento GU, Archambault PS, Routhier F, Dessureault D, Boissy P. Assessment of joystick control during the performance of powered wheelchair driving tasks. J Neuroeng Rehabil 2011; 8:31. [PMID: 21609435 PMCID: PMC3127827 DOI: 10.1186/1743-0003-8-31] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2010] [Accepted: 05/24/2011] [Indexed: 11/30/2022] Open
Abstract
Background Powered wheelchairs are essential for many individuals who have mobility impairments. Nevertheless, if operated improperly, the powered wheelchair poses dangers to both the user and to those in its vicinity. Thus, operating a powered wheelchair with some degree of proficiency is important for safety, and measuring driving skills becomes an important issue to address. The objective of this study was to explore the discriminate validity of outcome measures of driving skills based on joystick control strategies and performance recorded using a data logging system. Methods We compared joystick control strategies and performance during standardized driving tasks between a group of 10 expert and 13 novice powered wheelchair users. Driving tasks were drawn from the Wheelchair Skills Test (v. 4.1). Data from the joystick controller were collected on a data logging system. Joystick control strategies and performance outcome measures included the mean number of joystick movements, time required to complete tasks, as well as variability of joystick direction. Results In simpler tasks, the expert group's driving skills were comparable to those of the novice group. Yet, in more difficult and spatially confined tasks, the expert group required fewer joystick movements for task completion. In some cases, experts also completed tasks in approximately half the time with respect to the novice group. Conclusions The analysis of joystick control made it possible to discriminate between novice and expert powered wheelchair users in a variety of driving tasks. These results imply that in spatially confined areas, a greater powered wheelchair driving skill level is required to complete tasks efficiently. Based on these findings, it would appear that the use of joystick signal analysis constitutes an objective tool for the measurement of powered wheelchair driving skills. This tool may be useful for the clinical assessment and training of powered wheelchair skills.
Collapse
Affiliation(s)
- Gianluca U Sorrento
- School of Physical & Occupational Therapy, McGill University, Montréal, Canada.
| | | | | | | | | |
Collapse
|
35
|
Rates and Predictors of Manual and Powered Wheelchair Use for Persons With Stroke: A Retrospective Study in a Canadian Rehabilitation Center. Arch Phys Med Rehabil 2010; 91:639-43. [DOI: 10.1016/j.apmr.2009.11.025] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2009] [Revised: 11/20/2009] [Accepted: 11/23/2009] [Indexed: 11/20/2022]
|
36
|
Mountain AD, Kirby RL, Eskes GA, Smith C, Duncan H, MacLeod DA, Thompson K. Ability of People With Stroke to Learn Powered Wheelchair Skills: A Pilot Study. Arch Phys Med Rehabil 2010; 91:596-601. [DOI: 10.1016/j.apmr.2009.12.011] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2009] [Revised: 12/04/2009] [Accepted: 12/10/2009] [Indexed: 11/28/2022]
|