Reliability and validity of the Italian version of Quebec User Evaluation of Satisfaction with Assistive Technology 2.0 (QUEST-IT 2.0) with users of mobility assistive device

Cultural adaptation and validation in Italian of the Seated Postural Control Measure for Adults 2.0

OBJECTIVE

The aim of this study was to assess the cultural adaptation and validation in Italian of the Seated Postural Control Measure for Adults 2.0 (SPCMA 2.0).

METHODS

The original scale was translated and culturally adapted from French to Italian using the "Translation and Cultural Adaptation of Patient Reported Outcomes Measures-Principles of Good Practice" guidelines. Its internal consistency and test-retest reliability were examined. Its concurrent validity was evaluated using Pearson correlation coefficients with the Italian version of the Wheelchair use Confidence Scale and Wheelchair Skills Test 4.2.

RESULTS

Fifty-nine people were evaluated and re-evaluated after 48 h. Most of the items and subscale totals were stable in the 2 evaluations as they reported an intraclass correlation coefficient value of >0.77. The test-retest analysis of the dynamic evaluation was performed on the same patients 48 h apart. The analysis for construct validity showed statistically significant correlations with Wheelchair use Confidence Scale and Wheelchair Skills Test 4.2.

CONCLUSIONS

Seated Postural Control Measure for Adults 2.0 is one of the few tools that allow researchers to perform a quantitative and standardized posture assessment in a cost-effective and time-saving way. Furthermore, it has been demonstrated that it is an easy-to-administer scale and requires readily available tools. The limitations of this study highlighted above and the need to use quantitative and qualitative tools in clinical practice imply the need to conduct future studies.

Comprehensive evaluation methods for translating BCI into practical applications: usability, user satisfaction and usage of online BCI systems

Although brain-computer interface (BCI) is considered a revolutionary advancement in human-computer interaction and has achieved significant progress, a considerable gap remains between the current technological capabilities and their practical applications. To promote the translation of BCI into practical applications, the gold standard for online evaluation for classification algorithms of BCI has been proposed in some studies. However, few studies have proposed a more comprehensive evaluation method for the entire online BCI system, and it has not yet received sufficient attention from the BCI research and development community. Therefore, the qualitative leap from analyzing and modeling for offline BCI data to the construction of online BCI systems and optimizing their performance is elaborated, and then user-centred is emphasized, and then the comprehensive evaluation methods for translating BCI into practical applications are detailed and reviewed in the article, including the evaluation of the usability (including effectiveness and efficiency of systems), the evaluation of the user satisfaction (including BCI-related aspects, etc.), and the evaluation of the usage (including the match between the system and user, etc.) of online BCI systems. Finally, the challenges faced in the evaluation of the usability and user satisfaction of online BCI systems, the efficacy of online BCI systems, and the integration of BCI and artificial intelligence (AI) and/or virtual reality (VR) and other technologies to enhance the intelligence and user experience of the system are discussed. It is expected that the evaluation methods for online BCI systems elaborated in this review will promote the translation of BCI into practical applications.

A systematic review of the psychometric properties of Quebec user evaluation of satisfaction with assistive technology (QUEST)

PURPOSE

The aim of this systematic review was to evaluate the psychometric properties of the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST).

MATERIALS AND METHODS

Searches were conducted in August 2021 on four electronic databases: MEDLINE, CINAHL, Scopus, and Web of Science. Eligible papers included cross-sectional validation studies evaluating the psychometric properties of all QUEST versions. Cronbach's alpha, intraclass correlation coefficient, and comparison tools were reported. Study quality and risk of bias were assessed using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist.

RESULTS

Nineteen studies were included in this systematic review. Results showed that the QUEST and QUEST 2.0 were available in 10 languages, and most validation studies analysed this tool in patients using mobility devices in various clinical conditions. One article analysed the child version (QUEST 2.1) in English. The most analysed psychometric property was Cronbach's alpha for internal consistency in 14 out of 19 studies, with values ranging between 0.74 and 0.79. Overall, 17 out of 19 studies were of adequate quality, though responsiveness was never studied.

CONCLUSION

Our systematic review showed that the QUEST and its subsequent versions are reliable and valid measurement instruments to evaluate satisfaction in patients with different disabilities using various assistive technologies. This study provides useful information on the instrument's psychometric properties in different populations and cultures.

Iranian translation and psychometric of the Quebec user evaluation of satisfaction with Assistive technology (QUEST2.0) on wheelchair users

PURPOSE

QUEST2.0 is a practical tool specifically applied to assessing the satisfaction for awide array of assistive technology in a standard manner. Therefore, this study set to translate and evaluate the validity and reliability of the Iranian version of the QUEST2.0in Persian-speaking users of manual and electronic wheelchairs in Iran.

METHODS

The present study recruited 130 users of manual and electric wheelchairs. Psychometric properties, including; content validity and construct validity and internal consistency and test-retest reliability, were testified.

RESULTS

The content validity index of the questionnaire was 92%. The internal consistency was determined to be 0.89,0.88 and 0.74, respectively, for the whole questionnaire and dimensions of the device, and services. The test-retest reliability was 0.85, 0.80, and 0.94, respectively, for the whole questionnaire and dimensions of the device and services. Factor analysis confirmed the two-factor structure of the questionnaire. In the two-factor model, 57.75% of the total variance was explained by these two factors, of which 45.8% pertained to the first factor (device) and 11.95% to the second factor (service).

CONCLUSIONS

The results showed that QUEST2.0 had both valid and reliable for measuring satisfaction with assistive technology among wheelchair users. The assessment will also help facilitate the quality improvement processes in using assistive technology devices.

Assistive products for older adults in China: self-reported need, services, and satisfaction

Purpose: Older adults may abandon or discontinue the use of assistive products due to low levels of satisfaction. Only few studies have examined need and satisfaction related to the use of assistive products for this group in China. As such, research is needed to improve satisfaction with assistive products and related services. Method: This study used technology acceptance theory to examine the self-reported need for, and ownership of, assistive products among older adults in China, as well as to examine the association between services and satisfaction with assistive products; the underlying mechanism of this association was also assessed. The current study used the rapid assistive technology assessment (rATA) questionnaire designed by the World Health Organization (WHO) for stratified and cluster sampling. A total of 2,158 older adults living in China were interviewed. The multiple regression analysis was used to examine the independent and interactive associations between services and satisfaction. Heterogeneity and robustness tests were also undertaken.Results: The self-reported need for assistive products pertained mainly to vision, and together with ownership, the need gap has not yet been addressed. Both pre-sale (β = 0.600, p < 0.01) and follow-up services (β = 0.270, p < 0.01) were positively correlated with satisfaction, which in turn shows heterogeneity when it comes to the types of assistive products.Conclusion: Providing accessible services, especially follow-up services, will help older adults be more satisfied with their assistive products, thus ultimately ensuring the continued use of products.

STELO: A New Modular Robotic Gait Device for Acquired Brain Injury-Exploring Its Usability

In recent years, the prevalence of acquired brain injury (ABI) has been on the rise, leading to impaired gait functionality in affected individuals. Traditional gait exoskeletons are typically rigid and bilateral and lack adaptability. To address this, the STELO, a pioneering modular gait-assistive device, was developed. This device can be externally configured with joint modules to cater to the diverse impairments of each patient, aiming to enhance adaptability and efficiency. This study aims to assess the safety and usability of the initial functional modular prototype, STELO, in a sample of 14 ABI-diagnosed participants. Adverse events, device adjustment assistance and time, and gait performance were evaluated during three sessions of device use. The results revealed that STELO was safe, with no serious adverse events reported. The need for assistance and time required for device adjustment decreased progressively over the sessions. Although there was no significant improvement in walking speed observed after three sessions of using STELO, participants and therapists reported satisfactory levels of comfort and usability in questionnaires. Overall, this study demonstrates that the STELO modular device offers a safe and adaptable solution for individuals with ABI, with positive user and therapist feedback.

The Rasch Analysis Shows Poor Construct Validity and Low Reliability of the Quebec User Evaluation of Satisfaction with Assistive Technology 2.0 (QUEST 2.0) Questionnaire

This study aims to test the construct validity and reliability of the Quebec User Evaluation of Satisfaction with assistive Technology 2.0 (QUEST)-device, an eight-item questionnaire for measuring satisfaction with assistive devices. We collected 250 questionnaires from 79 patients and 32 caregivers. One QUEST was completed for each assistive device. Five assistive device types were included. QUEST was tested with the Rasch analysis (Many-Facet Rating Scale Model: persons, items, and device type). Most patients were affected by neurological disabilities, and most questionnaires were about mobility devices. All items fitted the Rasch model (InfitMS range: 0.88-1.1; OutfitMS: 0.84-1.28). However, the ceiling effect of the questionnaire was large (15/111 participants totalled the maximum score), its targeting poor (respondents mean measure: 1.90 logits), and its reliability was 0.71. The device classes had different calibrations (range: -1.18 to 1.26 logits), and item 3 functioned differently in patients and caregivers. QUEST satisfaction measures have low reliability and weak construct validity. Lacking invariance, the QUEST total score is unsuitable for comparing the satisfaction levels of users of different device types. The differential item functioning suggests that the QUEST could also be problematic for comparing satisfaction in patients and caregivers.

Personalized Brain-Computer Interface and Its Applications

Brain-computer interfaces (BCIs) are a new technology that subverts traditional human-computer interaction, where the control signal source comes directly from the user's brain. When a general BCI is used for practical applications, it is difficult for it to meet the needs of different individuals because of the differences among individual users in physiological and mental states, sensations, perceptions, imageries, cognitive thinking activities, and brain structures and functions. For this reason, it is necessary to customize personalized BCIs for specific users. So far, few studies have elaborated on the key scientific and technical issues involved in personalized BCIs. In this study, we will focus on personalized BCIs, give the definition of personalized BCIs, and detail their design, development, evaluation methods and applications. Finally, the challenges and future directions of personalized BCIs are discussed. It is expected that this study will provide some useful ideas for innovative studies and practical applications of personalized BCIs.

Cross-Cultural Validation of Quebec User Satisfaction with Assistive Technology 2.0 for Spanish Population (QUEST-2.0 ES)

Background: Assistive technologies (ATs) are resources to promote the independence and participation of people with a disability. The use of standardized tools, based on outcome measures, is essential for guaranteeing high-quality rates. The Quebec User Evaluation of Satisfaction with AT–2.0 (QUEST) is a scale to assess the satisfaction of people using any AT. Objectives: To translate and culturally validate the QUEST–2.0 for the Spanish population (QUEST 2.0-ES). Methods: A validation cross-design and descriptive study. The test–retest reliability, validity, and internal consistency of QUEST 2.0-ES were studied. It was divided into two phases: Sample 1 was formed by 26 persons; in sample 2, 30 persons participated. The conditions included neurological conditions, amputations, rare diseases, and deafness. Results: Thirty-five men and 21 women participated in total. The majority of AT used were those for mobility. QUEST 2.0-ES analysis showed internal consistency values between the test (α = 0.87) and retest versions (α = 0.89). The internal consistency was high for AT (test, α = 0.83; retest, α = 0.87) and Service (test, α = 0.80; retest, α = 0.80). The temporal reliability (1–2 weeks) for test–retest was 0.88. Conclusion: QUEST 2.0-ES showed good psychometric properties in terms of validity and test–retest reliability, and it is a good tool to assess the user’s satisfaction with ATs and services.

Psychometric evaluation of the Arabic version of the Quebec user evaluation of satisfaction with assistive technology (A-QUEST 2.0) in prosthesis users

BACKGROUND

The evaluation of patient satisfaction and perceptions plays a vital role in determining the quality of prosthesis users' devices and the competency of healthcare services.

AIM

To evaluate the psychometric properties of the Arabic Quebec User Evaluation of Satisfaction with Assistive Technology (A-QUEST 2.0) with prosthetics users.

DESIGN

A methodological study.

SETTING

Saudi Arabia, Turkey.

POPULATION

A convenience sample of outpatient prosthesis users (N.=183).

METHODS

The A-QUEST 2.0 includes two subscales respectively evaluating the user's satisfaction with the device and the services provided. The data for each subscale were investigated using Rasch analysis to evaluate the item fit, reliability indices, item difficulty, local item dependency, and differential item functioning (DIF).

RESULTS

Both subscales met the Rasch criteria for the functioning of rating scale categories. All items showed an acceptable fit to the Rasch model. The person separation indices for the Device and Services subscales were 2.21 (Cronbach's α=0.90) and 1.72 (Cronbach's α=0.85), respectively. Therefore, the two subscales are sensitive enough to distinguish between at least three different levels of satisfaction. The unidimensionality of each subscale was confirmed, and none of the items displayed differential item functioning across age, gender, location of amputation, country, and duration of use.

CONCLUSIONS

Overall, the findings indicate the psychometric evaluation of A-QUEST 2.0 is effective with prosthesis users across different clinical contexts and cultures. Thus, the A-QUEST 2.0 allows for a comprehensive understanding of users' perceptions of prosthesis characteristics, particularly among subjects with lower limb amputations caused by traumatic injuries.

CLINICAL REHABILITATION IMPACT

Our paper provides clinicians dealing with Arabic patients a validated outcome measure for satisfaction with prosthesis. Besides providing information in the development of new products and service delivery. Further studies are necessary to improve the measure's metric quality in different contexts and for different prosthesis devices.

Seated postural control measure: Italian translation and validation in children with cerebral palsy

BACKGROUND

Seating interventions are part of the postural management program recommended for children with Cerebral Palsy (CP) who are nonambulatory or have difficulty in walking. The lack of validated outcome measures for assessing seating interventions limits access to obtain valid and comparable data internationally.

OBJECTIVE

To translate the Seated Postural Control Measure (SPCM) into Italian and assess reliability and validity of the translated measure in a population of children with CP.

STUDY DESIGN

Cross-sectional and repeated measures study.

METHODS

The original version of the SPCM was translated and culturally adapted by a multidisciplinary team according to international guidelines. Internal consistency was examined with Cronbach's alpha. Both inter- and intrarater reliabilities were estimated using intraclass correlation coefficients with 95% confidence intervals. Intrarater reliability was estimated over a 1-week period. Convergent construct validity was investigated by comparing SPCM values with the Level of Sitting Scale, the Gross Motor Function Classification System, and the Manual Ability Classification System using Pearson's correlation coefficients.

RESULTS

The Italian version of the SPCM (IT-SPCM) was evaluated on 72 children with CP aged 4-18 years. Cronbach's alpha was 0.83, 0.95, and 0.93 for IT-SPCM alignment subscale, IT-SPCM functioning subscale, and total score, respectively. Reliability for IT-SPCM total score was high for both inter- and intrarater reliabilities (0.95 and 0.93). The IT-SPCM total score was moderately correlated with the Level of Sitting Scale (0.37), Gross Motor Function Classification System (-0.41), and Manual Ability Classification System (-0.56).

CONCLUSION

Preliminary evidence supports the reliability and validity of using IT-SPCM with a population of children with CP.

Athletes with disability' satisfaction with sport wheelchairs: an Italian cross sectional study

PURPOSE

Physical activity is essential for health and well-being. People with physical disability often experience barriers in performing sports due to the lack of appropriate assistive technologies. The present research aimed to investigate athletes with disability satisfaction when using sports wheelchairs and to explore clinometric properties of the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST).

MATERIALS AND METHODS

One hundred and twenty-eight athletes were involved in the present study. Data on sport discipline and wheelchair provision were collected with qualitative approach. Internal consistency and reliability of QUEST were respectively analyzed with Cronbach's Alpha and Intraclass Correlation Coefficient. Validity was investigated with the correlation of the Wheelchair Use Confidence Scale for Manual users.

RESULTS

Results revealed good internal consistency (.858) and moderate inter-rater reliability for service subscale (.664) and for the total score (.675), while for device subscale (.802) reliability was high. Validity revealed moderate correlation (.300) with a p < 0.05. Qualitative analysis highlighted economic barriers as primary social determinant who affect participation in sport activities.

CONCLUSIONS

The present study confirms preliminary evidence of the QUEST for athletes with disability. The research group also recommends an international effort to promote a comprehensive evaluation of sports wheelchair involving rehabilitation professionals, sport technicians and people with disability.Implications for rehabilitationEconomic factors linked to the purchase of a wheelchair seem being the main barrier for practising sportThe Quebec User Evaluation of Satisfaction with Assistive Technology is a useful tool to measure athletes' satisfaction using a wheelchairRehabilitation professionals and sport technicians should collaborate together with people with disability in determining how choose appropriate sport wheelchairs.

Quality of life, concern of falling and satisfaction of the sit-ski aid in sit-skiers with spinal cord injury: observational study

STUDY DESIGN

Observational study.

OBJECTIVE

To describe (1) user satisfaction, (2) the Quality of Life (QoL) and (3) fear of falling in individuals with tetraplegia or paraplegia who used a mono-ski for sit-skiing.

SETTING

Spinal units and Sport associations.

METHODS

An observational study of people with spinal cord injury (SCI) who used a sit-ski. Participants were recruited in various SCI rehabilitation centers and sport associations. Participants completed three assessment tools: the Quebec User Evaluation of Satisfaction with assistive Technology (QUEST 2.0); the World Health Organization Quality of Life (WHOQoL-BREF); the Spinal Cord Injury Fall Concern Scale (SCI-FCS). Results were evaluated with chi-squared test and Kolmogorov-Smirnov's test and the significance was set for p values < 0.05.

RESULTS

Fifteen participants were included. Results showed positive and statistically significant values for all the items of the SCI-FCS related to fear of falling, and for most of the items of the WHOQoL-BREF related to QoL and the QUEST 2.0 related to satisfaction with the device.

CONCLUSIONS

This study highlights that sit skiing is correlated with high levels of satisfaction with the mono-ski, increases in QoL, and low levels of fear of falling. In adding these findings to the existent literature, it can be stated with more certainty that sit-skiing is a sport that can be recommended in rehabilitation and sports therapy programs.