Psychosocial impact of mobility assistive technology on people with neurological conditions

Translation and validation of the Persian version of "The Psychosocial Impact of Assistive Devices Scale" in patients with neurological disorders

Neurological disorders are a heterogeneous group of central or peripheral nervous disorders of which the main symptoms include impaired walking and balance. One of the main interventions for neurological disorders is the use of assistive devices, and it is necessary to consider the psychosocial effects of these devices on users. The psychometric properties of the Persian version of the Psychosocial Impact of Assistive Devices Scale (PIADS) were evaluated in patients with neurological disorders. After translating the scale into Persian based on IQULA, face and content validity were determined. The divergent validity of the scale was examined through its relationship with the Orthotics and Prosthetics Users' Survey (OPUS). Reliability of the tool was evaluated using an internal consistency and test-retest method over two weeks with 50 patients with neurological disorders and a history of using assistive devices for at least six months. The face and content validity of the PIADS was confirmed. The ICC for all subscales was higher than 0.78, which indicates a good correlation. However, the divergent validity of the scale with the OPUS scale was not confirmed. The Persian version of PIADS is a valid and reliable measure for patients with neurological disorders in Iran.

Assistive technologies, educational engagement and psychosocial outcomes among students with disabilities in higher education

PURPOSE

Increasing numbers of students with disabilities are accessing higher education each year, yet little is known about their assistive technology (AT) needs and its influence on relevant outcomes. The aim of this study was to examine met/unmet AT needs on educational engagement, academic self-efficacy and well-being and the impact of AT use in the areas of competence, adaptability and self-esteem for students with disabilities in higher education in Ireland.

METHODS

One hundred and eleven students with disabilities completed a cross-sectional online survey comprising the College Learning Effectiveness Inventory, the Student Course Engagement Questionnaire, the Self-Efficacy for Learning Form Abridged, the Psychosocial Impact of Assistive Devices Scale, and the Warwick-Edinburgh Mental Well-Being Scale.

RESULTS

AT use was found to have a positive psychosocial impact in the areas of competence, adaptability and self-esteem. Those whose AT needs were fully met scored significantly higher on academic self-efficacy, well-being, and on 4 of the 10 educational engagement subscales compared to those who had unmet AT needs. Met/unmet AT needs were not predictive of educational engagement.

CONCLUSION

These findings highlight the importance of AT from both educational engagement and psychosocial perspectives for students with a wide variety of disability diagnoses. The wide-reaching benefits of AT must be considered by governmental departments when making funding allocations to disability services within higher education institutions. Implications for rehabilitationStudents with disabilities can face many additional challenges within the higher education environment.Findings from this research show that access to appropriate assistive technology can support students' educational engagement, increase well-being and academic self-efficacy and have a positive impact in the areas of competence, adaptability and self-esteem.Disability and Assistive Technology Officers in higher education should be cognizant of both the educational and psychological benefits of assistive technology across diverse students with various disability diagnoses.Policy makers should consider the wide-reaching benefits of assistive technology when making funding allocations to higher education institutions.

Trekking Poles to Aid Multiple Sclerosis Walking Impairment: An Exploratory Comparison of the Effects of Assistive Devices on Psychosocial Impact and Walking

Background

Walking dysfunction is reported by two-thirds of persons with multiple sclerosis (MS). Assistive devices are frequently recommended to improve walking; however, it is uncommon to consider their psychosocial impact, although many users abandon their assistive devices. The psychosocial impact, walking, balance, and fatigue associated with three assistive devices were compared to guide clinical decision making.

Methods

Twenty-five persons with MS (median Expanded Disability Status Scale score, 4.0; range, 2.5-6.0) who reported walking difficulty were trained in the use of three assistive devices-a single-point cane (SPC), a four-point cane (FPC), and a trekking pole (TP)-at 1- to 2-week intervals, then used the assistive device for their usual activities. Outcome measures included the Psychosocial Impact of Assistive Devices Scale (PIADS), the 6-Minute Walk Test (6MWT), walking speed, cadence, stride length, stride time, the 12-item Multiple Sclerosis Walking Scale (MSWS-12), the Activities-specific Balance Confidence (ABC) scale, the 5-item Modified Fatigue Impact Scale (MFIS-5), and a visual analogue scale of fatigue (VAS-F).

Results

The SPC and TP were more positive in the PIADS adaptability, competence, and self-esteem subscales. The SPC and TP resulted in higher 6MWT, walking speed, cadence, stride length, stride time, and MSWS-12 scores compared with the FPC. No differences were found in ABC scale, MFIS-5, or VAS-F scores.

Conclusions

Participants reported more positive psychosocial impact, and walked faster and with higher quality, with the SPC and TP than with the FPC. Clinicians should consider suggesting an SPC or TP to patients who may benefit from assistive device use and for whom psychosocial impact is an important consideration.

Psychometric Properties of the Spanish Version of Psychosocial Impact of Assistive Devices Scale in a Large Sample of People With Neuromuscular, Neurological, or Hearing Disabilities

Assistive technology (AT) is any device, software, or equipment designed for and used by individuals with disabilities to engage in everyday activities and achieve independence. However, the usefulness of those technology-based or supported treatments is a complex issue that has led to the development of various conceptual models for assistive technology outcomes research and practice as well as different assessment tools that help to explore the effect of technology on people's lives. One of those instruments is the Psychosocial Impact of Assistive Device Scale (PIADS), a 26-item questionnaire that measures the psychosocial impact of interventions, using assistive devices in three quality-of-life domains: competence, adaptability, and self-esteem. PIADS scale has been translated and adapted to several languages, and it has been successfully used to measure AT outcomes in different disability profiles to predict abandonment or even as a relevant determinant of future adoption of eHealth. Quinteiro (2010) adapted PIADS to Spanish for the first time, although no studies have yet been published to systematically study its psychometric properties. Therefore, the purpose of this study was to evaluate measurement properties of the Spanish version of PIADS scale by means of a dataset obtained from its application to a large sample (n = 417) of people with neuromuscular, neurological, or hearing disabilities that used different assistive devices. The results will provide valuable indicators about the measurement quality of the Spanish PIADS scale and will help to promote the use of reliable and valid AT outcome assessment tools for research and clinical purposes.

A Pilot Study of the Psychosocial Impact of Low-Cost Assistive Technology for Sexual Functioning in People with Acquired Brain Injury

People with acquired brain injury (ABI) face limitations when performing activities of daily living, including sexuality. Despite the common use among this group of assistive technology to compensate for or neutralize the limitations deriving from their condition, there is very little literature on outcome measures in assistive technology for sexual functioning. The aim of this study was to explore the psychosocial impact of the use of low-cost assistive technology in people with ABI. The sample was made up of 18 users: 15 men and 3 women diagnosed with ABI. The PLISSIT model was used, as well as the Psychosocial Impact of Assistive Device Scale-PIADS as an assessment tool. Three types of low-cost assistive technology were developed: seat cushions, bed equipment, and back supports. All three types of AT obtained positive scores on the PIADS total scale and its three subscales: competence, adaptability, and self-esteem. Although the results of this study are positive, more research into outcome measures for products to improve sexual functioning in people with ABI is required.