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Smith EM, Huff S, Bukania R, Chiira B, Holloway C, MacLachlan M. The Kenyan assistive technology ecosystem: a network analysis. Glob Health Action 2024; 17:2302208. [PMID: 38224051 PMCID: PMC10791081 DOI: 10.1080/16549716.2024.2302208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 01/02/2024] [Indexed: 01/16/2024] Open
Abstract
BACKGROUND Assistive technology is central to the realization of the rights of persons with disabilities. However, there remains limited access to assistive technology throughout much of the world, with particularly poor access in lower- and middle-income countries. Evaluating stakeholder engagement in assistive technology networks has been used as a successful strategy to understand and address gaps in the assistive technology ecosystem. OBJECTIVE The objective of this research was to provide an overview of the Kenyan Assistive Technology Ecosystem, including available assistive products and related services, and an understanding of the nature and strength of relationships between stakeholders. METHODS In this study, we employed an online qualitative stakeholder survey (2021) with representatives of organizations involved in assistive technology in Kenya. RESULTS The assistive technology network in Kenya is distributed, with Government Ministries and Agencies and Organizations of persons with disabilities central to the network. The strength of relationships is concentrated on awareness and communication, with fewer organizations actively collaborating. Innovation training organizations are not yet well integrated into the network. CONCLUSIONS Improving access to assistive technology in Kenya will benefit from greater collaboration amongst all assistive technology stakeholders.
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Affiliation(s)
- Emma M. Smith
- Assisting Living and Learning Institute, Maynooth University, Maynooth, Ireland
| | - Stephanie Huff
- Assisting Living and Learning Institute, Maynooth University, Maynooth, Ireland
| | - Rose Bukania
- Ministry of Labour and Social Protection, Government of Kenya, Nairobi, Kenya
| | - Bernard Chiira
- Global Disability Innovation Hub, University College London, Nairobi, Kenya
| | | | - Malcolm MacLachlan
- Assisting Living and Learning Institute, Maynooth University, Maynooth, Ireland
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2
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Oldfrey BM, Morgado Ramirez DZ, Miodownik M, Wassall M, Ramstrand N, Wong MS, Danemayer J, Dickinson A, Kenney L, Nester C, Lemaire E, Gholizadeth H, Diment LE, Donovan-Hall MK, Holloway C. A scoping review of digital fabrication techniques applied to prosthetics and orthotics: Part 1 of 2-Prosthetics. Prosthet Orthot Int 2024:00006479-990000000-00243. [PMID: 38625697 DOI: 10.1097/pxr.0000000000000351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 02/01/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND Traditionally, the manufacture of prostheses is time-consuming and labor-intensive. One possible route to improving access and quality of these devices is the digitalizing of the fabrication process, which may reduce the burden of manual labor and bring the potential for automation that could help unblock access to assistive technologies globally. OBJECTIVES To identify where there are gaps in the literature that are creating barriers to decision-making on either appropriate uptake by clinical teams or on the needed next steps in research that mean these technologies can continue on a pathway to maturity. STUDY DESIGN Scoping literature review. METHODS A comprehensive search was completed in the following databases: Allied and Complementary Medicine Database, MEDLINE, Embase, Global Health Archive, CINAHL Plus, Cochrane Library, Web of Science, Association for Computing Machinery, Institute of Electrical and Electronics Engineers, and Engineering Village, resulting in 3487 articles to be screened. RESULTS After screening, 130 lower limb prosthetic articles and 117 upper limb prosthetic articles were included in this review. Multiple limitations in the literature were identified, particularly a lack of long-term, larger-scale studies; research into the training requirements for these technologies and the necessary rectification processes; and a high range of variance of production workflows and materials which makes drawing conclusions difficult. CONCLUSIONS These limitations create a barrier to adequate evidence-based decision-making for clinicians, technology developers, and wider policymakers. Increased collaboration between academia, industry, and clinical teams across more of the pathway to market for new technologies could be a route to addressing these gaps.
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Affiliation(s)
- Ben M Oldfrey
- Global Disability Innovation Hub (GDI Hub), London, UK
- Institute of Making, University College London, London, UK
- University College London Interaction Centre (UCLIC), London, UK
| | - Dafne Z Morgado Ramirez
- Global Disability Innovation Hub (GDI Hub), London, UK
- University College London Interaction Centre (UCLIC), London, UK
| | - Mark Miodownik
- Institute of Making, University College London, London, UK
| | - Matthew Wassall
- Centre for Human Movement and Rehabilitation Research, University of Salford, Salford, UK
| | - Nerrolyn Ramstrand
- Department of Rehabilitation, CHILD Research Group, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Man S Wong
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | | | - Alex Dickinson
- Faculty of Engineering & Physical Science, University of Southampton, Southampton, UK
| | - Laurence Kenney
- Centre for Human Movement and Rehabilitation Research, University of Salford, Salford, UK
| | | | - Edward Lemaire
- Faculty of Medicine, University of Ottawa, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Hossein Gholizadeth
- Faculty of Medicine, University of Ottawa, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Laura E Diment
- College of Science and Engineering, Flinders University, Adelaide, SA, Australia
| | | | - Catherine Holloway
- Global Disability Innovation Hub (GDI Hub), London, UK
- University College London Interaction Centre (UCLIC), London, UK
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Mattick K, Oldfrey B, Donovan-Hall M, Magomere G, Gakunga J, Holloway C. Experiences of lower limb prosthesis users in Kenya: a qualitative study to understand motivation to use and satisfaction with prosthetic outcomes. Disabil Rehabil 2023; 45:4478-4488. [PMID: 36495104 DOI: 10.1080/09638288.2022.2152875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 11/24/2022] [Indexed: 12/14/2022]
Abstract
PURPOSE To explore the personal and system factors that motivate and enhance outcomes for patients accessing a prosthetic service and using a lower-limb prosthesis within a low resource setting. MATERIALS AND METHODS This study employed a qualitative approach to explore the motivations and satisfaction of individuals with lower limb loss engaging with a prosthetic service in Mombasa, Kenya. In-depth interviews were conducted over Microsoft Teams with 10 lower limb prosthesis users and thematic analysis was applied. RESULTS Five key themes emerged: acceptance, self-determination, hope, clinician relationship and perception. These findings demonstrate the importance of hopeful thinking and a supportive community in overcoming physical and stigmatising challenges. The findings further highlight the value of the service provider relationship beyond just prescribing an assistive device. CONCLUSION These results have relevance in developing patient-centred services, assistive devices and personnel training that are responsive, motivating, and cognisant of the service user. This is of particular interest as assistive technology services are newly developed in low resource settings.IMPLICATIONS FOR REHABILITATIONThis research provides an understanding of lower-limb prosthesis users' satisfaction of a device and motivation for engaging with a prosthetic service within a low resource setting.The relationship the rehabilitation professional has with the service user plays a significant role in facilitating motivation during rehabilitation.Rehabilitation professionals should consider how they can foster a network of support amongst service users when planning services in remote, rural locations.Rehabilitation professionals should be aware of how hopeful thinking can be facilitated during rehabilitation to support motivation.When reviewing the success of services, or designing new service models, the service users should be consulted on what they would deem as a successful outcome.
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Affiliation(s)
- Kate Mattick
- Global Disability Innovation Hub, University College London, London, UK
| | - Ben Oldfrey
- Global Disability Innovation Hub, University College London, London, UK
- Institute of Making UCL, London, UK
| | - Maggie Donovan-Hall
- School of Health Sciences, Faculty of Environment and Life Sciences, University of Southampton, Southampton, UK
| | | | - Joseph Gakunga
- Association of the Physically Disabled of Kenya, Mombasa, Kenya
| | - Catherine Holloway
- Global Disability Innovation Hub, University College London, London, UK
- UCLIC and Computer Science, UCL, London, UK
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Bell D, Layton N, Austin V, Holloway C. Unpacking 'What Works': A Commentary of the Key Learnings for ICT from the AT2030 Program. Stud Health Technol Inform 2023; 306:281-288. [PMID: 37638926 DOI: 10.3233/shti230632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
The AT2030 programme was launched in 2018 to test 'what works' in getting assistive technology (AT) to people globally, specifically in low- and middle-income countries (LMIC), where there is often a systematic lack of provision. After four years, this paper reviews the project outcomes, focussing on published material. It provides the backdrop to the AT2030 program, contextualises current developments in global AT global and funding, and unpacks the key learnings of what works to get AT to the people that need it around the world, with a focus on ICT. The paper does this by applying Global Disability Innovation Hub's mission-led and transformative approach, concluding with contemporary actions to improve access to AT to illustrate the value of embracing complexity for AT ecosystem stakeholders, including researchers, practitioners, AT users and policymakers.
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Affiliation(s)
- Diane Bell
- Global Disability Innovation Hub, London, United Kingdom
- UCL Interaction Centre, University College London (UCL), London, United Kingdom
- University of Stellenbosch, South Africa
| | - Natasha Layton
- RAIL Research Centre, Monash University, Frankston, Australia
- Australian Rehabilitation and Assistive Technology Association, Australia
| | - Victoria Austin
- Global Disability Innovation Hub, London, United Kingdom
- UCL Interaction Centre, University College London (UCL), London, United Kingdom
- WHO Collaborating Centre, UCL, London
| | - Catherine Holloway
- Global Disability Innovation Hub, London, United Kingdom
- UCL Interaction Centre, University College London (UCL), London, United Kingdom
- WHO Collaborating Centre, UCL, London
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Barbareschi G, Teerlink W, Njuguna JG, Musungu P, Kirino MD, Holloway C. Evaluating the use of a thermoplastic socket in Kenya: A pilot study. Prosthet Orthot Int 2022; 46:532-537. [PMID: 35333813 PMCID: PMC9554758 DOI: 10.1097/pxr.0000000000000130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 01/30/2022] [Accepted: 02/15/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND Many people with amputations who live in low-resourced settings struggle to access the workshops where qualified prosthetists provide appropriate care. Novel technologies such as the thermoplastic Confidence Socket are emerging, which could help facilitate easier access to prosthetic services. OBJECTIVES The objective of this study was to evaluate the satisfaction and the performance of transtibial prosthesis featuring the Confidence Socket. STUDY DESIGN This is a longitudinal repeated-measures design study. METHODS A convenience sample of 26 participants who underwent transtibial amputation were fitted with the Confidence Socket. The performance of the socket was evaluated after a follow-up period between 1 month and 6 months using the L test of functional mobility and the amputee mobility predictor. Satisfaction with the prosthesis was measured using the Trinity Amputation and Prosthetic Experience Scales and purposefully designed 7-point Likert scales. RESULTS Ten of the 26 participants returned for follow-up. Perceived activity restriction and L test times improved significantly at follow-up, but the self-reported satisfaction with the Confidence Socket was lower at follow-up compared with that after fitting. CONCLUSIONS The Amparo Confidence Socket represents a potentially viable alternative to improve access to appropriate prosthesis in Kenya, but some aspects of users' self-reported satisfaction should be further investigated.
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Affiliation(s)
| | | | | | | | - Mary Dama Kirino
- Association for the Physically Disabled of Kenya, Mombasa, Kenya
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Holloway C, Bhot W, Yong KXX, McCarthy I, Suzuki T, Carton A, Yang B, Serougne R, Boampong D, Tyler N, Crutch SJ, Berthouze N, Cho Y. STEP-UP: Enabling Low-Cost IMU Sensors to Predict the Type of Dementia During Everyday Stair Climbing. Front Comput Sci 2022. [DOI: 10.3389/fcomp.2021.804917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Posterior Cortical Atrophy is a rare but significant form of dementia which affects people's visual ability before their memory. This is often misdiagnosed as an eyesight rather than brain sight problem. This paper aims to address the frequent, initial misdiagnosis of this disease as a vision problem through the use of an intelligent, cost-effective, wearable system, alongside diagnosis of the more typical Alzheimer's Disease. We propose low-level features constructed from the IMU data gathered from 35 participants, while they performed a stair climbing and descending task in a real-world simulated environment. We demonstrate that with these features the machine learning models predict dementia with 87.02% accuracy. Furthermore, we investigate how system parameters, such as number of sensors, affect the prediction accuracy. This lays the groundwork for a simple clinical test to enable detection of dementia which can be carried out in the wild.
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Krishnan A, Ellenberger K, Chansavath P, Kelleher A, Matthews G, Darley D, Holloway C. Myocardial Fibrosis Occurs in Non-Hospitalised Patients With Chronic Symptoms After COVID-19. Heart Lung Circ 2022. [PMCID: PMC9345568 DOI: 10.1016/j.hlc.2022.06.267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Holloway C, Morgado Ramirez DZ, Bhatnagar T, Oldfrey B, Morjaria P, Moulic SG, Ebuenyi ID, Barbareschi G, Meeks F, Massie J, Ramos-Barajas F, McVeigh J, Keane K, Torrens G, Rao PVM, MacLachlan M, Austin V, Kattel R, Metcalf CD, Sujatha S. A review of innovation strategies and processes to improve access to AT: Looking ahead to open innovation ecosystems. Assist Technol 2021; 33:68-86. [PMID: 34951825 DOI: 10.1080/10400435.2021.1970653] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
It is essential to understand the strategies and processes which are deployed currently across the Assistive Technology (AT) space toward measuring innovation. The main aim of this paper is to identify functional innovation strategies and processes which are being or can be deployed in the AT space to increase access to AT globally. We conducted a scoping review of innovation strategies and processes in peer-reviewed literature databases and complemented this by identifying case studies demonstrating innovation strategies. The review includes WHO world region, publication year, AT type and a sector analysis against the Systems-Market for Assistive and Related Technologies Framework. We analyzed the case studies and interviews using thematic analysis. We included 91 papers out of 3,127 after review along with 72 case studies. Our results showed that product innovations were more prevalent than provision or supply innovations across papers and case studies. Case studies yielded two themes: open innovation (OI); radical and disruptive innovation. Financial instruments which encourage OI are needed and we recommend pursuing OI for AT innovation. Embedding AT within larger societal missions will be key to success governments and investors need to understand what AT is and their translational socioeconomic value.
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Affiliation(s)
- Catherine Holloway
- UCL Interaction Centre, Department of Computer Science, University College London, London, UK.,Global Disability Innovation Hub, London, UK
| | - Dafne Zuleima Morgado Ramirez
- UCL Interaction Centre, Department of Computer Science, University College London, London, UK.,Global Disability Innovation Hub, London, UK
| | - Tigmanshu Bhatnagar
- UCL Interaction Centre, Department of Computer Science, University College London, London, UK.,Global Disability Innovation Hub, London, UK
| | - Ben Oldfrey
- Global Disability Innovation Hub, London, UK.,Institute of Making, University College London, London, UK
| | - Priya Morjaria
- Global Disability Innovation Hub, London, UK.,International Centre for Eye Health (ICEH), London School of Hygiene and Tropical Medicine, London, UK
| | | | - Ikenna D Ebuenyi
- Assisting Living & Learning (All) Institute, Department of Psychology, Maynooth University, Maynooth, Ireland
| | - Giulia Barbareschi
- UCL Interaction Centre, Department of Computer Science, University College London, London, UK.,Global Disability Innovation Hub, London, UK
| | - Fiona Meeks
- Institute for Innovation and Entrepreneurship, Loughborough University London, London, UK
| | - Jessica Massie
- International Centre for Eye Health (ICEH), London School of Hygiene and Tropical Medicine, London, UK
| | - Felipe Ramos-Barajas
- UCL Interaction Centre, Department of Computer Science, University College London, London, UK.,Global Disability Innovation Hub, London, UK
| | - Joanne McVeigh
- Assisting Living & Learning (All) Institute, Department of Psychology, Maynooth University, Maynooth, Ireland
| | - Kyle Keane
- Sinha Lab, Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - George Torrens
- School of Design and Creative Arts, Loughborough University, Loughborough, UK
| | - P V M Rao
- Department of Design, IIT Delhi, New Delhi, India
| | - Malcolm MacLachlan
- Assisting Living & Learning (All) Institute, Department of Psychology, Maynooth University, Maynooth, Ireland
| | - Victoria Austin
- UCL Interaction Centre, Department of Computer Science, University College London, London, UK.,Global Disability Innovation Hub, London, UK
| | - Rainer Kattel
- Institute for Innovation and Public Purpose, University College London, London, UK
| | - Cheryl D Metcalf
- School of Health Sciences, University of Southampton, Southampton, UK
| | - Srinivasan Sujatha
- TTK Center for Rehabilitation Research and Device Development (R2d2), Department of Mechanical Engineering, Iit Madras, Chennai, India
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Paramlall M, Bakar I, Kandasamy R, Gadhvi A, Holloway C, Harding S, Tyagi H. #3105 How does self-report of mood symptoms compare with observer assessments after acquired brain injury. J Neurol Psychiatry 2021. [DOI: 10.1136/jnnp-2021-bnpa.35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
ObjectivesPost acquired brain injury (ABI) depression has been implicated in different patient outcomes such as prospective cognition, cognitive impairment, rehabilitation outcome, and quality of life. However, there have been no studies identified in the literature, investigating post ABI insight into depression across varied cognitive abilities. Here we looked at ABI patient insight into their depression across a range of cognitive abilities and compared this to an observed or an objective measure of depression.MethodsA retrospective cohort of 24 individuals with ABI (depressed and non-depressed) seen in a neuropsychiatry outpatient clinic between 2019 and 2020 completed a Patient Health Questionnaire-9 (PHQ-9), self-reported depression scale and had a Neuropsychiatry Inventory Questionnaire(NPI-Q), an observer assessment with a depression domain. The patients also underwent a formal cognitive examination using the Montreal Cognitive Assessment (MoCA).ResultsNon-depressed ABI and depressed ABI individuals with a wide range of cognitive abilities demonstrated good insight into their depression when matched to the observer rating. Chi-Square Test showed little variation between the PHQ-9 and NPI-Q Depression data sets; Wilcoxon Signed Ranks Test: Z Test -4.08, p<0.001, Effect Size 0.87 and Spearman’s rho showed positive correlation between the two data sets (Correlation Coefficient 0.527, P<0.008). Therefore, there was a statistically significant agreement between the subjective measure (PHQ-9) and the observed (objective) measure NPIQD and that there was a positive correlation between the two measurement scales for patients with ABI regardless of cognition (as measured by MoCAz score; range -6 to 2.21, mean: -1.17)ConclusionsThese findings indicate (1) self-reported measures of depression in ABI are consistent with observed (objective measures) thus can be used to assess depression in this cohort and (2) ABI patients with a wide range of cognitive abilities would appear to have good insight into their depression.
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Brown T, Beck C, Holloway C, Kerns J, Fagerstrom J, Kaurin D, Kielar K. PO-1576 A novel anthropomorphic phantom for the commissioning of MLC-based stereotactic radiosurgery. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)08027-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Zhang B, Amirian J, Eberle H, Pettré J, Holloway C, Carlson T. From HRI to CRI: Crowd Robot Interaction—Understanding the Effect of Robots on Crowd Motion. Int J Soc Robot 2021. [DOI: 10.1007/s12369-021-00812-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AbstractHow does the presence of a robot affect pedestrians and crowd dynamics, and does this influence vary across robot type? In this paper, we took the first step towards answering this question by performing a crowd-robot gate-crossing experiment. The study involved 28 participants and two distinct robot representatives: A smart wheelchair and a Pepper humanoid robot. Collected data includes: video recordings; robot and participant trajectories; and participants’ responses to post-interaction questionnaires. Quantitative analysis on the trajectories suggests the robot affects crowd dynamics in terms of trajectory regularity and interaction complexity. Qualitative results indicate that pedestrians tend to be more conservative and follow “social rules” while passing a wheelchair compared to a humanoid robot. These insights can be used to design a social navigation strategy that allows more natural interaction by considering the robot effect on the crowd dynamics.
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Oldfrey B, Tchorzewska A, Jackson R, Croysdale M, Loureiro R, Holloway C, Miodownik M. Additive manufacturing techniques for smart prosthetic liners. Med Eng Phys 2020; 87:45-55. [PMID: 33461673 DOI: 10.1016/j.medengphy.2020.11.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 10/16/2020] [Accepted: 11/11/2020] [Indexed: 10/23/2022]
Abstract
Elastomeric liners are commonly worn between the prosthetic socket and the limb. A number of improvements to the state of the art of liner technology are required to address outstanding problems. A liner that conforms to the residuum more accurately, may improve the skin health at the stump-socket interface. Previous work has shown that for effective thermal management of the socket environment, an active heat removal system is required, yet this is not available. Volume tracking of the stump could be used as a diagnostic tool for looking at the changes that occur across the day for all users, which depend on activity level, position, and the interaction forces of the prosthetic socket with the limb. We believe that it would be advantageous to embed these devices into a smart liner, which could be replaced and repaired more easily than the highly costly and labour-intensive custom-made socket. This paper presents the work to develop these capabilities in soft material technology, with: the development of a printable nanocomposite stretch sensor system; a low-cost digital method for casting bespoke prosthetic liners; a liner with an embedded stretch sensor for growth / volume tracking; a model liner with an embedded active cooling system.
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Affiliation(s)
- B Oldfrey
- Department of Mechanical Engineering, UCL, London, UK; Institute of Making, UCL, UK; Global Disability Innovation Hub, UCL, UK.
| | - A Tchorzewska
- Department of Mechanical Engineering, UCL, London, UK
| | | | - M Croysdale
- Royal National Orthopaedic Hospital, Stanmore, UK; Aspire Create, Department of Orthopaedics and Musculoskeletal Science, UCL, UK
| | - R Loureiro
- Royal National Orthopaedic Hospital, Stanmore, UK; Aspire Create, Department of Orthopaedics and Musculoskeletal Science, UCL, UK
| | - C Holloway
- Global Disability Innovation Hub, UCL, UK; UCLIC, UCL, UK
| | - M Miodownik
- Department of Mechanical Engineering, UCL, London, UK; Institute of Making, UCL, UK
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13
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Smith EM, Toro Hernandez ML, Ebuenyi ID, Syurina EV, Barbareschi G, Best KL, Danemayer J, Oldfrey B, Ibrahim N, Holloway C, MacLachlan M. Assistive Technology Use and Provision During COVID-19: Results From a Rapid Global Survey. Int J Health Policy Manag 2020; 11:747-756. [PMID: 33201656 PMCID: PMC9309903 DOI: 10.34172/ijhpm.2020.210] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 10/14/2020] [Indexed: 11/11/2022] Open
Abstract
Background: The coronavirus disease 2019 (COVID-19) pandemic has impacted all segments of society, but it has posed particular challenges for the inclusion of persons with disabilities, those with chronic illness and older people regarding their participation in daily life. These groups often benefit from assistive technology (AT) and so it is important to understand how use of AT may be affected by or may help to mitigate the impacts of COVID-19.
Objective: The objectives of this study were to explore the how AT use and provision have been affected during the initial stages of the COVID-19 pandemic, and how AT policies and systems may be made more resilient based on lessons learned during this global crisis. Methods: This study was a rapid, international online qualitative survey in the 6 United Nations (UN) languages (English, French, Spanish, Russian, Arabic, Mandarin Chinese) facilitated by extant World Health Organization (WHO) and International Disability Alliance networks. Themes and subthemes of the qualitative responses were identified using Braun and Clarke’s 6-phase analysis.
Results: Four primary themes were identified in in the data: Disruption of Services, Insufficient Emergency Preparedness, Limitations in Existing Technology, and Inadequate Policies and Systems. Subthemes were identified within each theme, including subthemes related to developing resilience in AT systems, based on learning from the pandemic.
Conclusion: COVID-19 has disrupted the delivery of AT services, primarily due to infection control measures resulting in lack of provider availability and diminished one-to-one services. This study identified a need for stronger user-centred development of funding policies and infrastructures that are more sustainable and resilient, best practices for remote service delivery, robust and accessible tools and systems, and increased capacity of clients, caregivers, and clinicians to respond to pandemic and other crisis situations.
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Affiliation(s)
- Emma M Smith
- Assisting Living and Learning Institute, Maynooth University, Maynooth, Ireland
| | | | - Ikenna D Ebuenyi
- Assisting Living and Learning Institute, Maynooth University, Maynooth, Ireland
| | - Elena V Syurina
- Athena Institute, Vrije Universiteit, Amsterdam, The Netherlands
| | | | - Krista L Best
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Universite Laval, Québec, QC, Canada
| | - Jamie Danemayer
- Global Disability Innovation Hub, University College London, London, UK
| | - Ben Oldfrey
- Global Disability Innovation Hub, University College London, London, UK
| | - Nuha Ibrahim
- Centre for Global Health, Trinity College Dublin, Dublin 2, Ireland
| | - Catherine Holloway
- University College London Interaction Centre, University College London, London, UK
| | - Malcolm MacLachlan
- Assisting Living and Learning Institute, Department of Psychology, Maynooth University, Maynooth, Ireland
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14
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Barbareschi G, Sonenblum S, Holloway C, Sprigle S. Does the setting matter? Observing wheelchair transfers across different environmental conditions. Assist Technol 2020; 34:326-333. [PMID: 32897816 DOI: 10.1080/10400435.2020.1818328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
The setting in which wheelchair transfers are performed can affect the difficulty and the risks associated with completion. This article presents results from an observational study involving 13 wheelchair users performing independent transfers across four settings. The aim is to understand how the environment affects how different types of independent transfers are performed. Descriptive analysis was performed alongside an objective assessment using the Transfer Assessment Instrument (TAI). The perceived difficulty reported after each transfer was also collected. Two participants exhibited radically different transferring techniques in different scenarios. Additionally, the transferring scenario was found to significantly affect the perceived difficulty of sitting transfers (toilet 2.17 ±.88; bed 1.47 ±.65, p =.001; car 1.63 ±.82, p =.012) and standing transfers (car 3.5 ±.71; bed 1 ± 0, p =.03; toilet 1 ± 0, p =.03), and the TAI score attributed to sitting pivot with use of a transfer board (couch 4.3 ±.88; bed 6.93 ± 1.29, p =.022; car 7.13 ± 1.32, p =.018). Overall, environmental constraints can lead to major technique changes and, more often, to different positioning of hands and feet which could impact the transfer's biomechanics.
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Affiliation(s)
| | - Sharon Sonenblum
- Rehabilitation Engineering and Applied Research, Georgia Institute of Technology, Atlanta, Georgia, USA
| | | | - Stephen Sprigle
- Rehabilitation Engineering and Applied Research, Georgia Institute of Technology, Atlanta, Georgia, USA
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Ebuenyi ID, Smith EM, Holloway C, Jensen R, D'Arino L, MacLachlan M. COVID-19 as social disability: the opportunity of social empathy for empowerment. BMJ Glob Health 2020; 5:e003039. [PMID: 32830130 PMCID: PMC7445099 DOI: 10.1136/bmjgh-2020-003039] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 07/10/2020] [Accepted: 07/23/2020] [Indexed: 02/05/2023] Open
Affiliation(s)
- Ikenna D Ebuenyi
- Assisting Living & Learning (ALL) Institute, Department of Psychology, Maynooth University, Maynooth, Ireland
| | - Emma M Smith
- Assisting Living & Learning (ALL) Institute, Department of Psychology, Maynooth University, Maynooth, Ireland
| | - Catherine Holloway
- Interaction Centre and Global Disability Innovation Hub, University College London, London, United Kingdom
| | - Rune Jensen
- World Federation of the DeafBlind (WFDB), Oslo, Norway
| | - Lucía D'Arino
- World Federation of the DeafBlind (WFDB), Oslo, Norway
| | - Malcolm MacLachlan
- Assisting Living & Learning (ALL) Institute, Department of Psychology, Maynooth University, Maynooth, Ireland
- Olomouc University Social Health Institute (OUSHI), Palacký University, Olomouc, Czech Republic
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Herrera RR, Holloway C, Morgado Ramirez DZ, Zhang B, Cho Y. Breathing Biofeedback Relaxation Intervention for Wheelchair Users in City Navigation. Annu Int Conf IEEE Eng Med Biol Soc 2020; 2020:4575-4578. [PMID: 33019012 DOI: 10.1109/embc44109.2020.9176144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Manual wheelchair users experience numerous invisible barriers while navigating cities, often reporting how stressful journeys are. This stress affects a wheelchair user's quality of life. To alleviate such psychological burden, we propose a novel intervention strategy with a respiratory biofeedback interface which is designed to help users feel relaxed in urban navigation. We conducted a study in a real-world setting to explore its potential to provide real-time psychological support. From qualitative and quantitative analysis, we report on the strengths and weaknesses of the approach.
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Joshi S, Herrera RR, Springett DN, Weedon BD, Ramirez DZM, Holloway C, Dawes H, Ayaz H. Neuroergonomic Assessment of Wheelchair Control Using Mobile fNIRS. IEEE Trans Neural Syst Rehabil Eng 2020; 28:1488-1496. [PMID: 32386159 PMCID: PMC7598937 DOI: 10.1109/tnsre.2020.2992382] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
For over two centuries, the wheelchair has been one of the most common assistive devices for individuals with locomotor impairments without many modifications. Wheelchair control is a complex motor task that increases both the physical and cognitive workload. New wheelchair interfaces, including Power Assisted devices, can further augment users by reducing the required physical effort, however little is known on the mental effort implications. In this study, we adopted a neuroergonomic approach utilizing mobile and wireless functional near infrared spectroscopy (fNIRS) based brain monitoring of physically active participants. 48 volunteers (30 novice and 18 experienced) self-propelled on a wheelchair with and without a PowerAssist interface in both simple and complex realistic environments. Results indicated that as expected, the complex more difficult environment led to lower task performance complemented by higher prefrontal cortex activity compared to the simple environment. The use of the PowerAssist feature had significantly lower brain activation compared to traditional manual control only for novices. Expertise led to a lower brain activation pattern within the middle frontal gyrus, complemented by performance metrics that involve lower cognitive workload. Results here confirm the potential of the Neuroergonomic approach and that direct neural activity measures can complement and enhance task performance metrics. We conclude that the cognitive workload benefits of PowerAssist are more directed to new users and difficult settings. The approach demonstrated here can be utilized in future studies to enable greater personalization and understanding of mobility interfaces within real-world dynamic environments.
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Situ Y, Subbiah R, Brew B, Holloway C. 243 Pilot Study of the Samsung S-patch for Cardiac Monitoring. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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19
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Anthony C, Imran M, Pouliopoulos J, Emmanuel S, Iliff J, Ross J, Moffat K, Mccrohon J, Holloway C, Kotlyar E, Muthiah K, Keogh A, Hayward C, Macdonald P, Jabbour A. 004 Cardiovascular Magnetic Resonance for Rejection Surveillance After Cardiac Transplantation. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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20
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de Bruyns A, Li H, MacNeil A, Simmons C, Clarkson P, Goddard K, Munk PL, Hart JJ, Holloway C, Truong P, Feng X. Evolving Practice Patterns Over Two Decades (1993-2013) in the Management of Desmoid-type Fibromatosis in British Columbia. Clin Oncol (R Coll Radiol) 2019; 32:e102-e110. [PMID: 31685376 DOI: 10.1016/j.clon.2019.10.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 09/19/2019] [Accepted: 10/04/2019] [Indexed: 01/24/2023]
Abstract
AIMS Due to the rarity and varied natural history of desmoid-type fibromatosis, evidence-based treatment standards for this disease remain lacking. This study evaluated outcomes in patients with desmoid-type fibromatosis managed at a Canadian institution over two decades. MATERIALS AND METHODS Records of 227 patients with desmoid-type fibromatosis referred from 1990 to 2013 were retrospectively reviewed to investigate management strategies including active surveillance, surgery, radiation therapy, cryoablation, and systemic therapy, including tamoxifen and chemotherapy. RESULTS Thirty-two per cent of cases were men, median age 40 years, median tumour size 5.4 cm. Initial treatments were surgery (79%), tamoxifen (13%), radiation therapy (5.0%), chemotherapy (1.8%) and cryoablation (1.2%). Active surveillance was used upfront in 26% of cases, most after 2005. At a median follow-up of 77 months, one patient died of disease, 13 died of unrelated causes and the remainder were alive with no evidence of disease (56%), stable/responding disease (33%) or progressive disease (4%). The recurrence rate was 25% after upfront surgery. Response rates and disease control rates were 40% and 76% for active surveillance; 68% and 96% for radiation therapy; 31% and 67% for tamoxifen; and 53% and 80% for chemotherapy. On univariable analysis, factors associated with a higher recurrence after initial surgery were young age (P = 0.012), male gender (P = 0.012) and extremity location (P = 0.005). On multivariable analysis, only young age was significantly associated with recurrence risk (P = 0.010). CONCLUSIONS Active surveillance was associated with spontaneous regression and long-term disease control consistent with other studies. Primary radiation therapy appeared to provide a similar response and disease control compared with systemic treatments and may be a viable option for patients who are not candidates for surgery or active surveillance.
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Affiliation(s)
- A de Bruyns
- Faculty of Medicine, Island Medical Program, University of British Columbia, Victoria, British Columbia, Canada
| | - H Li
- Department of Mathematics and Statistics, University of Calgary, Calgary, Alberta, Canada
| | - A MacNeil
- Department of Surgery, Vancouver General Hospital, University of British Columbia, British Columbia Cancer Agency - Vancouver Center, Vancouver, British Columbia, Canada
| | - C Simmons
- Department of Medical Oncology, University of British Columbia, British Columbia Cancer Agency - Vancouver Center, Vancouver, British Columbia, Canada
| | - P Clarkson
- Department of Surgery, Vancouver General Hospital, University of British Columbia, British Columbia Cancer Agency - Vancouver Center, Vancouver, British Columbia, Canada
| | - K Goddard
- Department of Radiation Oncology, University of British Columbia, British Columbia Cancer Agency - Vancouver Center, Vancouver, British Columbia, Canada
| | - P L Munk
- Department of Medical Imaging, Vancouver General Hospital, University of British Columbia, British Columbia Cancer Agency - Vancouver Center, Vancouver, British Columbia, Canada
| | - J J Hart
- Department of Medical Oncology, University of British Columbia, British Columbia Cancer Agency - Vancouver Center, Vancouver, British Columbia, Canada
| | - C Holloway
- Department of Radiation Oncology, University of British Columbia, British Columbia Cancer Agency - Vancouver Center, Vancouver, British Columbia, Canada
| | - P Truong
- Department of Radiation Oncology, University of British Columbia, British Columbia Cancer Agency - Vancouver Center, Vancouver, British Columbia, Canada
| | - X Feng
- Department of Medical Oncology, University of British Columbia, British Columbia Cancer Agency - Vancouver Center, Vancouver, British Columbia, Canada.
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McCarthy I, Suzuki T, Holloway C, Poole T, Frost C, Carton A, Tyler N, Crutch S, Yong K. Detection and localisation of hesitant steps in people with Alzheimer's disease navigating routes of varying complexity. Healthc Technol Lett 2019; 6:42-47. [PMID: 31119037 PMCID: PMC6498402 DOI: 10.1049/htl.2018.5034] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 12/19/2018] [Accepted: 01/03/2019] [Indexed: 12/11/2022] Open
Abstract
People with Alzheimer's disease (AD) have characteristic problems navigating everyday environments. While patients may exhibit abnormal gait parameters, adaptive gait irregularities when navigating environments are little explored or understood. The aim of this study was to assess adaptive locomotor responses of AD subjects in a complex environment requiring spatial navigation. A controlled environment of three corridors was set up: straight (I), U-shaped (U) and dog-leg (S). Participants were asked to walk along corridors as part of a counterbalanced repeated-measures design. Three groups were studied: 11 people with posterior cortical atrophy (PCA), 10 with typical Alzheimer's disease (tAD) and 13 controls. Spatio-temporal gait parameters and position within the corridors were monitored with shoe-mounted inertial measurement units (IMUs). Hesitant steps were identified from statistical analysis of the distribution of step time data. Walking paths were generated from position data calculated by double integration of IMU acceleration. People with PCA and tAD had similar gait characteristics, having shorter steps and longer step times than controls. Hesitant steps tended to be clustered within certain regions of the walking paths. IMUs enabled identification of key gait characteristics in this clinical population (step time, length and step hesitancy) and environmental conditions (route complexity) modifying their expression.
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Affiliation(s)
- Ian McCarthy
- Pedestrian Accessibility and Movement Environment Laboratory, Department of Civil Environmental and Geomatic Engineering, University College London, London N19 5UN, UK
| | - Tatsuto Suzuki
- Pedestrian Accessibility and Movement Environment Laboratory, Department of Civil Environmental and Geomatic Engineering, University College London, London N19 5UN, UK
| | - Catherine Holloway
- UCL Interaction Centre, Department of Computer Science, University College London, London, UK
| | - Teresa Poole
- Department of Medical Statistics, Faculty of Epidemiology and Public Health, London School of Hygiene & Tropical Medicine, London, UK.,Dementia Research Centre, Institute of Neurology, University College London, London, UK
| | - Chris Frost
- Department of Medical Statistics, Faculty of Epidemiology and Public Health, London School of Hygiene & Tropical Medicine, London, UK.,Dementia Research Centre, Institute of Neurology, University College London, London, UK
| | - Amelia Carton
- Dementia Research Centre, Institute of Neurology, University College London, London, UK
| | - Nick Tyler
- Pedestrian Accessibility and Movement Environment Laboratory, Department of Civil Environmental and Geomatic Engineering, University College London, London N19 5UN, UK
| | - Sebastian Crutch
- Dementia Research Centre, Institute of Neurology, University College London, London, UK
| | - Keir Yong
- Dementia Research Centre, Institute of Neurology, University College London, London, UK
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Abstract
Purpose: Transferring to and from the wheelchair is among the most important routine tasks for many wheelchair users. Transfers are also greatly affected by many personal and external factors. The purpose of this study is to investigate personal experiences, needs and concerns of wheelchair users in relation to wheelchair transfers performed in their everyday lives.Methods: A series of focus groups and interviews were carried out with 11 wheelchair users and 4 occupational therapists. Data were analysed using a hybrid deductive and inductive approach of thematic analysis.Results: The seven themes identified emphasize the importance and complexity of wheelchair transfers. Transfers were described as gateways to independence that grant access to life opportunities, and community participation. Nonetheless, transferring skills are difficult to acquire and the concept of correct technique, although really important, is often poorly defined. Wheelchair transfers can be further complicated by the characteristics of the individual, the presence of upper limb pain, fear of falling or the characteristics of the environment. Despite the importance of transfer training to improve safety and reduce the risk of overload injuries, only a few people receive dedicated advice from health professionals. Currently available assistive technologies were perceived as only partially successful in providing support to wheelchair users during the execution of transfers, especially when environmental constraints make the transfer more challenging.Conclusion: Due to their multifactorial nature, creating effective solutions to improve any aspect of wheelchair transfers will require a collaborative effort from users, clinicians, designers and other professionals.Implications for rehabilitationThe ability to transfer independently is extremely important for many wheelchair users and can affect not only their personal and social lives, but also the way they perceive themselves and are perceived by others.The use of a correct transferring technique plays an important role in reducing the effort required to complete a transfer and decreases the risk factors for both falls and upper limb injury development. Unfortunately, few wheelchair users have access to in-person training to develop transferring skills. The remaining people rely on a combination of peer observation, personal research and simple trial and error to figure out the movement strategies that better suit their needs.Currently available assistive technologies are perceived by wheelchair users as only partially successful in providing support during the execution of transfers. Transfer boards and other devices are often described as only useful for basic transfers and for individuals with reduced, but still sufficient, upper limb function.
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Abstract
OBJECTIVES Theoretical and untested interactions between antiretrovirals and direct-acting oral anticoagulants have limited the use of this new class of anticoagulant in people with HIV infection. This case series, the first of its kind, reports on the successful concurrent use of the direct-acting oral anticoagulant dabigatran and antiretroviral therapy. METHODS This series involved 14 patients requiring anticoagulation for management of atrial fibrillation, who were either unable or unwilling to take warfarin, and who were receiving concurrent treatment for HIV infection. Participants were treated with dabigatran with dose monitoring to establish the safety and efficacy of concurrent use with antiretrovirals. All were commenced on 110 mg twice daily, increased to 150 mg twice daily if the trough level was < 69.3 ng/mL. RESULTS In the 14 patients treated with dabigatran and antiretrovirals, there were no thromboembolic or bleeding complications. Dabigatran treatment was discontinued in one patient because of undetectable dabigatran levels despite dose escalation. Dabigatran levels fell within the fivefold variance seen in the Randomized Evaluation of Long-Term Anticoagulation Therapy (RE-LY) study at a dose of either 110 or 150 mg twice daily. CONCLUSIONS This case series represents the largest published population to date successfully receiving antiretroviral and direct-acting oral anticoagulant therapy. Given the significant health care burden faced by people living with HIV, the availability of safe anticoagulant therapy without the requirement for monitoring is an important option in this patient population.
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Affiliation(s)
- J Perram
- Royal Prince Alfred and Concord Hospitals, Sydney, NSW, Australia
| | - E O'Dwyer
- St Vincent's Hospital, Sydney, NSW, Australia
| | - C Holloway
- St Vincent's Hospital, Sydney, NSW, Australia
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Abstract
BACKGROUND: Thermal discomfort among lower-limb prosthesis wearers is prevalent with social and medical consequences. OBJECTIVES: This study aimed to verify the feasibility of out-of-laboratory thermal comfort studies. STUDY DESIGN: Repeated measures pilot study. METHODS: Thermistors were placed on participants' residual limbs during two experimental phases. In phase 1, mean limb temperature was calculated over a controlled 55-min rest-exercise-rest protocol. In phase 2, participants conducted activities of their choosing wherever they wanted away from the lab, while limb temperature data were collected. Descriptive statistics and statistical differences between phases are presented. RESULTS: Five male amputees participated with an average age ±standard deviation of 30 ± 9 years. In phase 1, mean limb temperature change ranged between 1.6°C and 3.7°C. In phase 2, mean limb temperature change ranged between 1.8°C and 5.1°C. Limb temperature was significantly higher in out-of-lab studies (+1.9°C, p = 0.043) compared to in-lab studies. CONCLUSION: Independent multiple-hour temperature studies are shown to be feasible. Results also indicate that out-of-lab residual limb temperature can be significantly higher than in-lab temperatures. CLINICAL RELEVANCE Thermal discomfort and sweating may lead to skin conditions and reduce quality of life among prosthesis wearers. Out-of-lab, long-term temperature studies are needed to comprehensively characterize thermal discomfort to create preventive solutions.
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Affiliation(s)
| | - Atsushi Takashima
- 2 Research Institute, National Rehabilitation Center for Persons with Disabilities, Tokorozawa, Japan
| | - Toru Ogata
- 2 Research Institute, National Rehabilitation Center for Persons with Disabilities, Tokorozawa, Japan
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Conte S, Jones K, Molan N, Holloway C. Direct Oral Anticoagulants for Left Ventricular Thrombus. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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26
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Situ Y, Lin L, Namasivayam M, Watson B, Emmanuel S, Jabbour A, McCrohon J, Holloway C. The Utility of Cardiovascular Magnetic Resonance in the Assessment of Patients before Pacemaker Implantation. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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McLean K, Glasbey J, Borakati A, Brooks T, Chang H, Choi S, Goodson R, Nielsen M, Pronin S, Salloum N, Sewart E, Vanniasegaram D, Drake T, Gillies M, Harrison E, Chapman S, Khatri C, Kong C, Claireaux H, Bath M, Mohan M, McNamee L, Kelly M, Mitchell H, Fitzgerald J, Bhangu A, Nepogodiev D, Antoniou I, Dean R, Davies N, Trecarten S, Henderson I, Holmes C, Wylie J, Shuttleworth R, Jindal A, Hughes F, Gouda P, Fleck R, Hanrahan M, Karunakaran P, Chen J, Sykes M, Sethi R, Suresh S, Patel P, Patel M, Varma R, Mushtaq J, Gundogan B, Bolton W, Khan T, Burke J, Morley R, Favero N, Adams R, Thirumal V, Kennedy E, Ong K, Tan Y, Gabriel J, Bakhsh A, Low J, Yener A, Paraoan V, Preece R, Tilston T, Cumber E, Dean S, Ross T, McCance E, Amin H, Satterthwaite L, Clement K, Gratton R, Mills E, Chiu S, Hung G, Rafiq N, Hayes J, Robertson K, Dynes K, Huang H, Assadullah S, Duncumb J, Moon R, Poo S, Mehta J, Joshi K, Callan R, Norris J, Chilvers N, Keevil H, Jull P, Mallick S, Elf D, Carr L, Player C, Barton E, Martin A, Ratu S, Roberts E, Phan P, Dyal A, Rogers J, Henson A, Reid N, Burke D, Culleton G, Lynne S, Mansoor S, Brennan C, Blessed R, Holloway C, Hill A, Goldsmith T, Mackin S, Kim S, Woin E, Brent G, Coffin J, Ziff O, Momoh Z, Debenham R, Ahmed M, Yong C, Wan J, Copley H, Raut P, Chaudhry F, Nixon G, Dorman C, Tan R, Kanabar S, Canning N, Dolaghan M, Bell N, McMenamin M, Chhabra A, Duke K, Turner L, Patel T, Chew L, Mirza M, Lunawat S, Oremule B, Ward N, Khan M, Tan E, Maclennan D, McGregor R, Chisholm E, Griffin E, Bell L, Hughes B, Davies J, Haq H, Ahmed H, Ungcharoen N, Whacha C, Thethi R, Markham R, Lee A, Batt E, Bullock N, Francescon C, Davies J, Shafiq N, Zhao J, Vivekanantham S, Barai I, Allen J, Marshall D, McIntyre C, Wilson H, Ashton A, Lek C, Behar N, Davis-Hall M, Seneviratne N, Esteve L, Sirakaya M, Ali S, Pope S, Ahn J, Craig-McQuaide A, Gatfield W, Leong S, Demetri A, Kerr A, Rees C, Loveday J, Liu S, Wijesekera M, Maru D, Attalla M, Smith N, Brown D, Sritharan P, Shah A, Charavanamuttu V, Heppenstall-Harris G, Ng K, Raghvani T, Rajan N, Hulley K, Moody N, Williams M, Cotton A, Sharifpour M, Lwin K, Bright M, Chitnis A, Abdelhadi M, Semana A, Morgan F, Reid R, Dickson J, Anderson L, McMullan R, Ahern N, Asmadi A, Anderson L, Boon Xuan JL, Crozier L, McAleer S, Lees D, Adebayo A, Das M, Amphlett A, Al-Robeye A, Valli A, Khangura J, Winarski A, Ali A, Woodward H, Gouldthrope C, Turner M, Sasapu K, Tonkins M, Wild J, Robinson M, Hardie J, Heminway R, Narramore R, Ramjeeawon N, Hibberd A, Winslow F, Ho W, Chong B, Lim K, Ho S, Crewdson J, Singagireson S, Kalra N, Koumpa F, Jhala H, Soon W, Karia M, Rasiah M, Xylas D, Gilbert H, Sundar-Singh M, Wills J, Akhtar S, Patel S, Hu L, Brathwaite-Shirley C, Nayee H, Amin O, Rangan T, Turner E, McCrann C, Shepherd R, Patel N, Prest-Smith J, Auyoung E, Murtaza A, Coates A, Prys-Jones O, King M, Gaffney S, Dewdney C, Nehikhare I, Lavery J, Bassett J, Davies K, Ahmad K, Collins A, Acres M, Egerton C, Cheng K, Chen X, Chan N, Sheldon A, Khan S, Empey J, Ingram E, Malik A, Johnstone M, Goodier R, Shah J, Giles J, Sanders J, McLure S, Pal S, Rangedara A, Baker A, Asbjoernsen C, Girling C, Gray L, Gauntlett L, Joyner C, Qureshi S, Mogan Y, Ng J, Kumar A, Park J, Tan D, Choo K, Raman K, Buakuma P, Xiao C, Govinden S, Thompson O, Charalambos M, Brown E, Karsan R, Dogra T, Bullman L, Dawson P, Frank A, Abid H, Tung L, Qureshi U, Tahmina A, Matthews B, Harris R, O'Connor A, Mazan K, Iqbal S, Stanger S, Thompson J, Sullivan J, Uppal E, MacAskill A, Bamgbose F, Neophytou C, Carroll A, Rookes C, Datta U, Dhutia A, Rashid S, Ahmed N, Lo T, Bhanderi S, Blore C, Ahmed S, Shaheen H, Abburu S, Majid S, Abbas Z, Talukdar S, Burney L, Patel J, Al-Obaedi O, Roberts A, Mahboob S, Singh B, Sheth S, Karia P, Prabhudesai A, Kow K, Koysombat K, Wang S, Morrison P, Maheswaran Y, Keane P, Copley P, Brewster O, Xu G, Harries P, Wall C, Al-Mousawi A, Bonsu S, Cunha P, Ward T, Paul J, Nadanakumaran K, Tayeh S, Holyoak H, Remedios J, Theodoropoulou K, Luhishi A, Jacob L, Long F, Atayi A, Sarwar S, Parker O, Harvey J, Ross H, Rampal R, Thomas G, Vanmali P, McGowan C, Stein J, Robertson V, Carthew L, Teng V, Fong J, Street A, Thakker C, O'Reilly D, Bravo M, Pizzolato A, Khokhar H, Ryan M, Cheskes L, Carr R, Salih A, Bassiony S, Yuen R, Chrastek D, Rosen O'Sullivan H, Amajuoyi A, Wang A, Sitta O, Wye J, Qamar M, Major C, Kaushal A, Morgan C, Petrarca M, Allot R, Verma K, Dutt S, Chilima C, Peroos S, Kosasih S, Chin H, Ashken L, Pearse R, O'Loughlin R, Menon A, Singh K, Norton J, Sagar R, Jathanna N, Rothwell L, Watson N, Harding F, Dube P, Khalid H, Punjabi N, Sagmeister M, Gill P, Shahid S, Hudson-Phillips S, George D, Ashwood J, Lewis T, Dhar M, Sangal P, Rhema I, Kotecha D, Afzal Z, Syeed J, Prakash E, Jalota P, Herron J, Kimani L, Delport A, Shukla A, Agarwal V, Parthiban S, Thakur H, Cymes W, Rinkoff S, Turnbull J, Hayat M, Darr S, Khan U, Lim J, Higgins A, Lakshmipathy G, Forte B, Canning E, Jaitley A, Lamont J, Toner E, Ghaffar A, McDowell M, Salmon D, O'Carroll O, Khan A, Kelly M, Clesham K, Palmer C, Lyons R, Bell A, Chin R, Waldron R, Trimble A, Cox S, Ashfaq U, Campbell J, Holliday R, McCabe G, Morris F, Priestland R, Vernon O, Ledsam A, Vaughan R, Lim D, Bakewell Z, Hughes R, Koshy R, Jackson H, Narayan P, Cardwell A, Jubainville C, Arif T, Elliott L, Gupta V, Bhaskaran G, Odeleye A, Ahmed F, Shah R, Pickard J, Suleman Y, North A, McClymont L, Hussain N, Ibrahim I, Ng G, Wong V, Lim A, Harris L, Tharmachandirar T, Mittapalli D, Patel V, Lakhani M, Bazeer H, Narwani V, Sandhu K, Wingfield L, Gentry S, Adjei H, Bhatti M, Braganza L, Barnes J, Mistry S, Chillarge G, Stokes S, Cleere J, Wadanamby S, Bucko A, Meek J, Boxall N, Heywood E, Wiltshire J, Toh C, Ward A, Shurovi B, Horth D, Patel B, Ali B, Spencer T, Axelson T, Kretzmer L, Chhina C, Anandarajah C, Fautz T, Horst C, Thevathasan A, Ng J, Hirst F, Brewer C, Logan A, Lockey J, Forrest P, Keelty N, Wood A, Springford L, Avery P, Schulz T, Bemand T, Howells L, Collier H, Khajuria A, Tharakan R, Parsons S, Buchan A, McGalliard R, Mason J, Cundy O, Li N, Redgrave N, Watson R, Pezas T, Dennis Y, Segall E, Hameed M, Lynch A, Chamberlain M, Peck F, Neo Y, Russell G, Elseedawy M, Lee S, Foster N, Soo Y, Puan L, Dennis R, Goradia H, Qureshi A, Osman S, Reeves T, Dinsmore L, Marsden M, Lu Q, Pitts-Tucker T, Dunn C, Walford R, Heathcote E, Martin R, Pericleous A, Brzyska K, Reid K, Williams M, Wetherall N, McAleer E, Thomas D, Kiff R, Milne S, Holmes M, Bartlett J, Lucas de Carvalho J, Bloomfield T, Tongo F, Bremner R, Yong N, Atraszkiewicz B, Mehdi A, Tahir M, Sherliker G, Tear A, Pandey A, Broyd A, Omer H, Raphael M, Chaudhry W, Shahidi S, Jawad A, Gill C, Fisher IH, Adeleja I, Clark I, Aidoo-Micah G, Stather P, Salam G, Glover T, Deas G, Sim N, Obute R, Wynell-Mayow W, Sait M, Mitha N, de Bernier G, Siddiqui M, Shaunak R, Wali A, Cuthbert G, Bhudia R, Webb E, Shah S, Ansari N, Perera M, Kelly N, McAllister R, Stanley G, Keane C, Shatkar V, Maxwell-Armstrong C, Henderson L, Maple N, Manson R, Adams R, Semple E, Mills M, Daoub A, Marsh A, Ramnarine A, Hartley J, Malaj M, Jewell P, Whatling E, Hitchen N, Chen M, Goh B, Fern J, Rogers S, Derbyshire L, Robertson D, Abuhussein N, Deekonda P, Abid A, Harrison P, Aildasani L, Turley H, Sherif M, Pandey G, Filby J, Johnston A, Burke E, Mohamud M, Gohil K, Tsui A, Singh R, Lim S, O'Sullivan K, McKelvey L, O'Neill S, Roberts H, Brown F, Cao Y, Buckle R, Liew Y, Sii S, Ventre C, Graham C, Filipescu T, Yousif A, Dawar R, Wright A, Peters M, Varley R, Owczarek S, Hartley S, Khattak M, Iqbal A, Ali M, Durrani B, Narang Y, Bethell G, Horne L, Pinto R, Nicholls K, Kisyov I, Torrance H, English W, Lakhani S, Ashraf S, Venn M, Elangovan V, Kazmi Z, Brecher J, Sukumar S, Mastan A, Mortimer A, Parker J, Boyle J, Elkawafi M, Beckett J, Mohite A, Narain A, Mazumdar E, Sreh A, Hague A, Weinberg D, Fletcher L, Steel M, Shufflebotham H, Masood M, Sinha Y, Jenvey C, Kitt H, Slade R, Craig A, Deall C, Reakes T, Chervenkoff J, Strange E, O'Bryan M, Murkin C, Joshi D, Bergara T, Naqib S, Wylam D, Scotcher S, Hewitt C, Stoddart M, Kerai A, Trist A, Cole S, Knight C, Stevens S, Cooper G, Ingham R, Dobson J, O'Kane A, Moradzadeh J, Duffy A, Henderson C, Ashraf S, McLaughin C, Hoskins T, Reehal R, Bookless L, McLean R, Stone E, Wright E, Abdikadir H, Roberts C, Spence O, Srikantharajah M, Ruiz E, Matthews J, Gardner E, Hester E, Naran P, Simpson R, Minhas M, Cornish E, Semnani S, Rojoa D, Radotra A, Eraifej J, Eparh K, Smith D, Mistry B, Hickling S, Din W, Liu C, Mithrakumar P, Mirdavoudi V, Rashid M, Mcgenity C, Hussain O, Kadicheeni M, Gardner H, Anim-Addo N, Pearce J, Aslanyan A, Ntala C, Sorah T, Parkin J, Alizadeh M, White A, Edozie F, Johnston J, Kahar A, Navayogaarajah V, Patel B, Carter D, Khonsari P, Burgess A, Kong C, Ponweera A, Cody A, Tan Y, Ng A, Croall A, Allan C, Ng S, Raghuvir V, Telfer R, Greenhalgh A, McKerr C, Edison M, Patel B, Dear K, Hardy M, Williams P, Hassan S, Sajjad U, O'Neill E, Lopes S, Healy L, Jamal N, Tan S, Lazenby D, Husnoo S, Beecroft S, Sarvanandan T, Weston C, Bassam N, Rabinthiran S, Hayat U, Ng L, Varma D, Sukkari M, Mian A, Omar A, Kim J, Sellathurai J, Mahmood J, O'Connell C, Bose R, Heneghan H, Lalor P, Matheson J, Doherty C, Cullen C, Cooper D, Angelov S, Drislane C, Smith A, Kreibich A, Palkhi E, Durr A, Lotfallah A, Gold D, Mckean E, Dhanji A, Anilkumar A, Thacoor A, Siddiqui Z, Lim S, Piquet A, Anderson S, McCormack D, Gulati J, Ibrahim A, Murray S, Walsh S, McGrath A, Ziprin P, Chua E, Lou C, Bloomer J, Paine H, Osei-Kuffour D, White C, Szczap A, Gokani S, Patel K, Malys M, Reed A, Torlot G, Cumber E, Charania A, Ahmad S, Varma N, Cheema H, Austreng L, Petra H, Chaudhary M, Zegeye M, Cheung F, Coffey D, Heer R, Singh S, Seager E, Cumming S, Suresh R, Verma S, Ptacek I, Gwozdz A, Yang T, Khetarpal A, Shumon S, Fung T, Leung W, Kwang P, Chew L, Loke W, Curran A, Chan C, McGarrigle C, Mohan K, Cullen S, Wong E, Toale C, Collins D, Keane N, Traynor B, Shanahan D, Yan A, Jafree D, Topham C, Mitrasinovic S, Omara S, Bingham G, Lykoudis P, Miranda B, Whitehurst K, Kumaran G, Devabalan Y, Aziz H, Shoa M, Dindyal S, Yates J, Bernstein I, Rattan G, Coulson R, Stezaker S, Isaac A, Salem M, McBride A, McFarlane H, Yow L, MacDonald J, Bartlett R, Turaga S, White U, Liew W, Yim N, Ang A, Simpson A, McAuley D, Craig E, Murphy L, Shepherd P, Kee J, Abdulmajid A, Chung A, Warwick H, Livesey A, Holton P, Theodoreson M, Jenkin S, Turner J, Entwisle J, Marchal S, O'Connor S, Blege H, Aithie J, Sabine L, Stewart G, Jackson S, Kishore A, Lankage C, Acquaah F, Joyce H, McKevitt K, Coffey C, Fawaz A, Dolbec K, O'Sullivan D, Geraghty J, Lim E, Bolton L, FitzPatrick D, Robinson C, Ramtoola T, Collinson S, Grundy L, McEnhill P, Harbhajan Singh G, Loughran D, Golding D, Keeling R, Williams R, Whitham R, Yoganathan S, Nachiappan R, Egan R, Owasil R, Kwan M, He A, Goh R, Bhome R, Wilson H, Teoh P, Raji K, Jayakody N, Matthams J, Chong J, Luk C, Greig R, Trail M, Charalambous G, Rocke A, Gardiner N, Bulley F, Warren N, Brennan E, Fergurson P, Wilson R, Whittingham H, Brown E, Khanijau R, Gandhi K, Morris S, Boulton A, Chandan N, Barthorpe A, Maamari R, Sandhu S, McCann M, Higgs L, Balian V, Reeder C, Diaper C, Sale T, Ali H, Archer C, Clarke A, Heskin J, Hurst P, Farmer J, O'Flynn L, Doan L, Shuker B, Stott G, Vithanage N, Hoban K, Nesargikar P, Kennedy H, Grossart C, Tan E, Roy C, Sim P, Leslie K, Sim D, Abul M, Cody N, Tay A, Woon E, Sng S, Mah J, Robson J, Shakweh E, Wing V, Mills H, Li M, Barrow T, Balaji S, Jordan H, Phillips C, Naveed H, Hirani S, Tai A, Ratnakumaran R, Sahathevan A, Shafi A, Seedat M, Weaver R, Batho A, Punj R, Selvachandran H, Bhatt N, Botchey S, Khonat Z, Brennan K, Morrison C, Devlin E, Linton A, Galloway E, McGarvie S, Ramsay N, McRobbie H, Whewell H, Dean W, Nelaj S, Eragat M, Mishra A, Kane T, Zuhair M, Wells M, Wilkinson D, Woodcock N, Sun E, Aziz N, Ghaffar MKA. Critical care usage after major gastrointestinal and liver surgery: a prospective, multicentre observational study. Br J Anaesth 2019; 122:42-50. [PMID: 30579405 DOI: 10.1016/j.bja.2018.07.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 07/19/2018] [Accepted: 07/23/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Patient selection for critical care admission must balance patient safety with optimal resource allocation. This study aimed to determine the relationship between critical care admission, and postoperative mortality after abdominal surgery. METHODS This prespecified secondary analysis of a multicentre, prospective, observational study included consecutive patients enrolled in the DISCOVER study from UK and Republic of Ireland undergoing major gastrointestinal and liver surgery between October and December 2014. The primary outcome was 30-day mortality. Multivariate logistic regression was used to explore associations between critical care admission (planned and unplanned) and mortality, and inter-centre variation in critical care admission after emergency laparotomy. RESULTS Of 4529 patients included, 37.8% (n=1713) underwent planned critical care admissions from theatre. Some 3.1% (n=86/2816) admitted to ward-level care subsequently underwent unplanned critical care admission. Overall 30-day mortality was 2.9% (n=133/4519), and the risk-adjusted association between 30-day mortality and critical care admission was higher in unplanned [odds ratio (OR): 8.65, 95% confidence interval (CI): 3.51-19.97) than planned admissions (OR: 2.32, 95% CI: 1.43-3.85). Some 26.7% of patients (n=1210/4529) underwent emergency laparotomies. After adjustment, 49.3% (95% CI: 46.8-51.9%, P<0.001) were predicted to have planned critical care admissions, with 7% (n=10/145) of centres outside the 95% CI. CONCLUSIONS After risk adjustment, no 30-day survival benefit was identified for either planned or unplanned postoperative admissions to critical care within this cohort. This likely represents appropriate admission of the highest-risk patients. Planned admissions in selected, intermediate-risk patients may present a strategy to mitigate the risk of unplanned admission. Substantial inter-centre variation exists in planned critical care admissions after emergency laparotomies.
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McGrath-Cadell L, Hesselson S, Iismaa S, Mishra K, Wong C, Fatkin D, Dunwoodie S, Harvey R, Holloway C, Muller D, Giannoulatou E, Graham R. Familial Clustering of Spontaneous Coronary Artery Dissection. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Barbareschi G, Holloway C, Bianchi-Berthouze N, Sonenblum S, Sprigle S. Use of a Low-Cost, Chest-Mounted Accelerometer to Evaluate Transfer Skills of Wheelchair Users During Everyday Activities: Observational Study. JMIR Rehabil Assist Technol 2018; 5:e11748. [PMID: 30573447 PMCID: PMC6320409 DOI: 10.2196/11748] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 09/25/2018] [Accepted: 09/25/2018] [Indexed: 01/19/2023] Open
Abstract
Background Transfers are an important skill for many wheelchair users (WU). However, they have also been related to the risk of falling or developing upper limb injuries. Transfer abilities are usually evaluated in clinical settings or biomechanics laboratories, and these methods of assessment are poorly suited to evaluation in real and unconstrained world settings where transfers take place. Objective The objective of this paper is to test the feasibility of a system based on a wearable low-cost sensor to monitor transfer skills in real-world settings. Methods We collected data from 9 WU wearing triaxial accelerometer on their chest while performing transfers to and from car seats and home furniture. We then extracted significant features from accelerometer data based on biomechanical considerations and previous relevant literature and used machine learning algorithms to evaluate the performance of wheelchair transfers and detect their occurrence from a continuous time series of data. Results Results show a good predictive accuracy of support vector machine classifiers when determining the use of head-hip relationship (75.9%) and smoothness of landing (79.6%) when the starting and ending of the transfer are known. Automatic transfer detection reaches performances that are similar to state of the art in this context (multinomial logistic regression accuracy 87.8%). However, we achieve these results using only a single sensor and collecting data in a more ecological manner. Conclusions The use of a single chest-placed accelerometer shows good predictive accuracy for algorithms applied independently to both transfer evaluation and monitoring. This points to the opportunity for designing ubiquitous-technology based personalized skill development interventions for WU. However, monitoring transfers still require the use of external inputs or extra sensors to identify the start and end of the transfer, which is needed to perform an accurate evaluation.
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Affiliation(s)
| | | | | | - Sharon Sonenblum
- Rehabilitation Engineering and Applied Research Laboratory, Georgia Institute of Technology, Atlanta, GA, United States
| | - Stephen Sprigle
- Rehabilitation Engineering and Applied Research Laboratory, Georgia Institute of Technology, Atlanta, GA, United States
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Kaurin D, Eagle A, Hart A, Holloway C, Courlas G, Stevens P, Gopan O, Schoen A. Profile- and output-determined Prp output corrections for a Varian TrueBeam and Elekta Versa HD. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1381] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Mahmod M, Hundertmark M, Stoll V, Raman B, Ariga R, Dass S, Holloway C, Karamitsos T, Rodgers C, Rider O, Neubauer S. P1808Patients with heart failure with mid-range and reduced left ventricular ejection fraction show similar derangement of cardiac energy and lipid metabolism. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- M Mahmod
- University of Oxford Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, Oxford, United Kingdom
| | - M Hundertmark
- University of Oxford Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, Oxford, United Kingdom
| | - V Stoll
- University of Oxford Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, Oxford, United Kingdom
| | - B Raman
- University of Oxford Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, Oxford, United Kingdom
| | - R Ariga
- University of Oxford Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, Oxford, United Kingdom
| | - S Dass
- University of Oxford Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, Oxford, United Kingdom
| | - C Holloway
- University of Oxford Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, Oxford, United Kingdom
| | - T Karamitsos
- University of Oxford Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, Oxford, United Kingdom
| | - C Rodgers
- University of Oxford Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, Oxford, United Kingdom
| | - O Rider
- University of Oxford Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, Oxford, United Kingdom
| | - S Neubauer
- University of Oxford Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, Oxford, United Kingdom
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Abstract
BACKGROUND AND AIM Thermal discomfort often affects prosthesis wearers and could be addressed by increasing liner thermal conductivity. This note explores a liner made from thermally conductive silicone and two additional alternative liner designs. TECHNIQUE Thermally conductive silicone was used to create a conductive liner and a hybrid liner. Additionally, one with open elements was made. These were compared with a plain silicone liner and a no liner scenario. Scaled down liner prototypes were used due to the high-cost of the thermally conductive silicone. Temperature decay profiles were collected by attaching thermistors to a heated liner phantom and used to evaluate scenarios. DISCUSSION No scenario performed much better than the plain silicone liner. Implementation of passive solutions may be easier, but alternative liner materials are unlikely to affect dissipation enough to address thermal discomfort. Based on this work, future research efforts may be better spent developing active thermal discomfort solutions. Clinical relevance Thermal discomfort can increase the probability of skin damage, reduce prosthesis satisfaction and, ultimately, the quality of life. The prosthesis-wearing experience could be improved if thermal discomfort can be addressed by technological improvements.
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Barbareschi G, Cheng TJ, Holloway C. Effect of technique and transfer board use on the performance of wheelchair transfers. Healthc Technol Lett 2018; 5:76-80. [PMID: 29750117 PMCID: PMC5933366 DOI: 10.1049/htl.2017.0075] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 10/04/2017] [Indexed: 11/23/2022] Open
Abstract
Transferring to and from the wheelchair seat is a necessary skill for many wheelchair users who wish to be independent of their everyday life. The performance of wheelchair transfers has been associated with the risk of falling and developing upper limb injuries. Both present a risk to the independence of the individual. Previous studies on wheelchair transfers have focused mainly on the analysis of sitting transfers performed by individuals with spinal cord injury, which only represent a small portion of the wider wheelchair users’ population. The purpose of this study is to investigate the effect of different transferring techniques (sitting, standing) and transfer board use on the ground reaction forces under the hands during transfer performance and transfer quality measured using the transfer assessment instrument (TAI). Sitting transfers displayed generally higher peak and mean reaction forces underneath both leading and trailing hands compared with the other techniques, but the difference was only significant between sitting and standing transfers. Standing transfers had significantly lower TAI scores compared with sitting transfer, potentially indicating a decreased level of safety associated with their performance. Transfer boards were only partially effective in reducing the weight born by the upper limbs and they caused only a minor reduction in the overall TAI score in comparison to sitting transfers.
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Affiliation(s)
- Giulia Barbareschi
- University College London Interaction Centre, University College London, London WC1E 6EA, UK
| | - Tsu-Jui Cheng
- Centre for Health Sciences Research, University of Salford, Salford M6 6PU, UK
| | - Catherine Holloway
- University College London Interaction Centre, University College London, London WC1E 6EA, UK
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Yong KXX, McCarthy ID, Poole T, Suzuki T, Yang B, Carton AM, Holloway C, Papadosifos N, Boampong D, Langham J, Slattery CF, Paterson RW, Foulkes AJM, Schott JM, Frost C, Tyler N, Crutch SJ. Navigational cue effects in Alzheimer's disease and posterior cortical atrophy. Ann Clin Transl Neurol 2018; 5:697-709. [PMID: 29928653 PMCID: PMC5989777 DOI: 10.1002/acn3.566] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 03/01/2018] [Accepted: 03/19/2018] [Indexed: 12/18/2022] Open
Abstract
Objective Deficits in spatial navigation are characteristic and disabling features of typical Alzheimer's disease (tAD) and posterior cortical atrophy (PCA). Visual cues have been proposed to mitigate such deficits; however, there is currently little empirical evidence for their use. Methods The effect of visual cues on visually guided navigation was assessed within a simplified real-world setting in individuals with tAD (n = 10), PCA (n = 8), and healthy controls (n = 12). In a repeated-measures design comprising 36 trials, participants walked to a visible target destination (an open door within a built environment), with or without the presence of an obstacle. Contrast and motion-based cues were evaluated; both aimed to facilitate performance by applying perceptual changes to target destinations without carrying explicit information. The primary outcome was completion time; secondary outcomes were measures of fixation position and walking path directness during consecutive task phases, determined using mobile eyetracking and motion capture methods. Results Results illustrate marked deficits in patients' navigational ability, with patient groups taking an estimated two to three times longer to reach target destinations than controls and exhibiting tortuous walking paths. There were no significant differences between tAD and PCA task performance. Overall, patients took less time to reach target destinations under cue conditions (contrast-cue: 11.8%; 95% CI: [2.5, 20.3]) and were more likely initially to fixate on targets. Interpretation The study evaluated navigation to destinations within a real-world environment. There is evidence that introducing perceptual changes to the environment may improve patients' navigational ability.
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Affiliation(s)
- Keir X X Yong
- Dementia Research Centre Department of Neurodegeneration UCL Institute of Neurology University College London London United Kingdom
| | - Ian D McCarthy
- Pedestrian Accessibility and Movement Environment Laboratory Department of Civil, Environmental and Geomatic Engineering Faculty of Engineering Science University College London London United Kingdom
| | - Teresa Poole
- Dementia Research Centre Department of Neurodegeneration UCL Institute of Neurology University College London London United Kingdom.,Department of Medical Statistics Faculty of Epidemiology and Population Health London School of Hygiene and Tropical Medicine London United Kingdom
| | - Tatsuto Suzuki
- Pedestrian Accessibility and Movement Environment Laboratory Department of Civil, Environmental and Geomatic Engineering Faculty of Engineering Science University College London London United Kingdom
| | - Biao Yang
- Pedestrian Accessibility and Movement Environment Laboratory Department of Civil, Environmental and Geomatic Engineering Faculty of Engineering Science University College London London United Kingdom.,School of Architecture and Urban Planning Harbin Institute of Technology Shenzhen Graduate School Shenzhen China
| | - Amelia M Carton
- Dementia Research Centre Department of Neurodegeneration UCL Institute of Neurology University College London London United Kingdom.,Oxford Health NHS Foundation Trust Oxford United Kingdom
| | - Catherine Holloway
- Pedestrian Accessibility and Movement Environment Laboratory Department of Civil, Environmental and Geomatic Engineering Faculty of Engineering Science University College London London United Kingdom.,Department of Computer Science Faculty of Engineering Science University College London London United Kingdom
| | - Nikolaos Papadosifos
- Pedestrian Accessibility and Movement Environment Laboratory Department of Civil, Environmental and Geomatic Engineering Faculty of Engineering Science University College London London United Kingdom
| | - Derrick Boampong
- Pedestrian Accessibility and Movement Environment Laboratory Department of Civil, Environmental and Geomatic Engineering Faculty of Engineering Science University College London London United Kingdom
| | - Julia Langham
- Department of Medical Statistics Faculty of Epidemiology and Population Health London School of Hygiene and Tropical Medicine London United Kingdom
| | - Catherine F Slattery
- Dementia Research Centre Department of Neurodegeneration UCL Institute of Neurology University College London London United Kingdom
| | - Ross W Paterson
- Dementia Research Centre Department of Neurodegeneration UCL Institute of Neurology University College London London United Kingdom
| | - Alexander J M Foulkes
- Dementia Research Centre Department of Neurodegeneration UCL Institute of Neurology University College London London United Kingdom
| | - Jonathan M Schott
- Dementia Research Centre Department of Neurodegeneration UCL Institute of Neurology University College London London United Kingdom
| | - Chris Frost
- Dementia Research Centre Department of Neurodegeneration UCL Institute of Neurology University College London London United Kingdom.,Department of Medical Statistics Faculty of Epidemiology and Population Health London School of Hygiene and Tropical Medicine London United Kingdom
| | - Nick Tyler
- Pedestrian Accessibility and Movement Environment Laboratory Department of Civil, Environmental and Geomatic Engineering Faculty of Engineering Science University College London London United Kingdom
| | - Sebastian J Crutch
- Dementia Research Centre Department of Neurodegeneration UCL Institute of Neurology University College London London United Kingdom
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Abstract
Purpose: Being able to transfer in and out of their wheelchair is an important task for wheelchair users that can be affected by a variety of different factors. The aim of this study was to investigate the interplay between personal characteristics, wheelchair users' transferring technique and the other factors that can affect the performance of wheelchair transfers. Method: A cross-sectional survey study was designed to recruit wheelchair users, aged 18 or older, performing sitting-pivot or standing-pivot wheelchair transfers, independently or with assistance. Results: Forty-two usable surveys were returned. Transferring technique is usually determined by the individual's impairment. In turn, transferring technique will greatly affect the perceived difficulty of different types of wheelchair transfers and, the number of transfers that people will perform in a day. The presence of upper limb pain increased the difficulty reported for certain types of transfers while the use of assistive technologies appears to be only partially successful in facilitating the performance of wheelchair transfers. Conclusion: This study highlights the complexity of the factors included in the performance of wheelchair transfers. Findings from this survey can be utilized to broaden the boundaries of future research. Implications for rehabilitation Transferring technique is usually determined by the individual?s impairment. In turn, transferring technique will greatly affect the perceived difficulty of different types of wheelchair transfers and, the number of transfers that people will perform in a day. The performance of wheelchair transfers exacerbate the painful symptomatology of the person, regardless of their medical condition or transferring technique. The presence of pain increases the reported difficulty of wheelchair trasnfers. Use of assistive technologies during transfers is linked to the increased body weight of the person, while the choice of the type of assistive technology seems to be dependent of the transferring technique used by the person. Overall, available ATs are only moderately effective in enabling people to perform wheelchair transfer and they can be cause of frustration for the users due to their high cost and limited functionality.
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Affiliation(s)
- Giulia Barbareschi
- a University College London Interaction Centre , University College London , London , UK
| | - Catherine Holloway
- a University College London Interaction Centre , University College London , London , UK
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Lin L, Namasivayam M, Muller D, Holloway C. Advanced Imaging Using Cardiac Magnetic Resonance Imaging and Three-Dimensional Echocardiography of Tendyne Valve Implantation. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Brotherhood E, Ball P, Camic PM, Evans C, Fox N, Murphy C, Walsh F, West J, Windle G, Billiald S, Firth N, Harding E, Harrison C, Holloway C, Howard S, McKee-Jackson R, Jones E, Junghaus J, Martin H, Nolan K, Rollins B, Shapiro L, Shapiro L, Twigg J, van Leeuwen J, Walton J, Warren J, Wray S, Yong K, Zeilig H, Crutch S. Preparatory planning framework for Created Out of Mind: Shaping perceptions of dementia through art and science. Wellcome Open Res 2017; 2:108. [PMID: 29387805 PMCID: PMC5710169 DOI: 10.12688/wellcomeopenres.12773.1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2017] [Indexed: 12/28/2022] Open
Abstract
Created Out of Mind is an interdisciplinary project, comprised of individuals from arts, social sciences, music, biomedical sciences, humanities and operational disciplines. Collaboratively we are working to shape perceptions of dementias through the arts and sciences, from a position within the Wellcome Collection. The Collection is a public building, above objects and archives, with a porous relationship between research, museum artefacts, and the public. This pre-planning framework will act as an introduction to Created Out of Mind. The framework explains the rationale and aims of the project, outlines our focus for the project, and explores a number of challenges we have encountered by virtue of working in this way.
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Affiliation(s)
- Emilie Brotherhood
- Dementia Research Centre, Institute of Neurology, University College London, London, UK.,Created Out of Mind, The Hub, Wellcome Collection, London, UK
| | - Philip Ball
- Created Out of Mind, The Hub, Wellcome Collection, London, UK.,Science Writer, London, UK
| | - Paul M Camic
- Created Out of Mind, The Hub, Wellcome Collection, London, UK.,Salomons Centre for Applied Psychology, Canterbury Christ Church University, Tunbridge Wells, Kent, UK
| | - Caroline Evans
- Created Out of Mind, The Hub, Wellcome Collection, London, UK.,Tryce Ltd., London, UK
| | - Nick Fox
- Dementia Research Centre, Institute of Neurology, University College London, London, UK.,Created Out of Mind, The Hub, Wellcome Collection, London, UK
| | - Charlie Murphy
- Created Out of Mind, The Hub, Wellcome Collection, London, UK.,Visual Artist, London, UK
| | - Fergus Walsh
- Created Out of Mind, The Hub, Wellcome Collection, London, UK.,British Broadcasting Corporation, Portland Place, London, UK
| | - Julian West
- Created Out of Mind, The Hub, Wellcome Collection, London, UK.,Royal Academy of Music, Marylebone, London, UK
| | - Gill Windle
- Created Out of Mind, The Hub, Wellcome Collection, London, UK.,Dementia Services Development Centre (DSDC), DSDC Wales, Bangor University, Bangor, UK
| | - Sarah Billiald
- Created Out of Mind, The Hub, Wellcome Collection, London, UK.,Collaborate, Clarence Centre for Enterprise & Innovation, St George's Circus, London, UK
| | - Nicholas Firth
- Created Out of Mind, The Hub, Wellcome Collection, London, UK.,Department of Computer Science, Faculty of Engineering Science, University College London, London, UK
| | - Emma Harding
- Dementia Research Centre, Institute of Neurology, University College London, London, UK.,Created Out of Mind, The Hub, Wellcome Collection, London, UK
| | - Charles Harrison
- Created Out of Mind, The Hub, Wellcome Collection, London, UK.,Visual Artist, London, UK
| | - Catherine Holloway
- Created Out of Mind, The Hub, Wellcome Collection, London, UK.,Department of Computer Science, Faculty of Engineering Science, University College London, London, UK
| | - Susanna Howard
- Created Out of Mind, The Hub, Wellcome Collection, London, UK.,Living Words, The Workshop, Folkestone, Kent, UK
| | - Roberta McKee-Jackson
- Created Out of Mind, The Hub, Wellcome Collection, London, UK.,Rare Dementia Support, London, UK
| | - Esther Jones
- Created Out of Mind, The Hub, Wellcome Collection, London, UK.,National Youth Choirs Great Britain, The Rivergreen Centre, Durham, UK
| | - Janette Junghaus
- Dementia Research Centre, Institute of Neurology, University College London, London, UK.,Created Out of Mind, The Hub, Wellcome Collection, London, UK
| | - Harriet Martin
- Created Out of Mind, The Hub, Wellcome Collection, London, UK.,Wellcome, Euston Road, London, UK
| | - Kailey Nolan
- Dementia Research Centre, Institute of Neurology, University College London, London, UK.,Created Out of Mind, The Hub, Wellcome Collection, London, UK
| | - Bridie Rollins
- Created Out of Mind, The Hub, Wellcome Collection, London, UK.,Wellcome, Euston Road, London, UK
| | - Lillian Shapiro
- Created Out of Mind, The Hub, Wellcome Collection, London, UK.,Rare Dementia Support, London, UK
| | - Lionel Shapiro
- Created Out of Mind, The Hub, Wellcome Collection, London, UK.,Rare Dementia Support, London, UK
| | - Jane Twigg
- Created Out of Mind, The Hub, Wellcome Collection, London, UK.,Rare Dementia Support, London, UK
| | - Janneke van Leeuwen
- Dementia Research Centre, Institute of Neurology, University College London, London, UK.,Created Out of Mind, The Hub, Wellcome Collection, London, UK
| | - Jill Walton
- Dementia Research Centre, Institute of Neurology, University College London, London, UK.,Created Out of Mind, The Hub, Wellcome Collection, London, UK
| | - Jason Warren
- Dementia Research Centre, Institute of Neurology, University College London, London, UK.,Created Out of Mind, The Hub, Wellcome Collection, London, UK
| | - Selina Wray
- Created Out of Mind, The Hub, Wellcome Collection, London, UK.,Department of Molecular Neuroscience, University College London, London, UK
| | - Keir Yong
- Dementia Research Centre, Institute of Neurology, University College London, London, UK.,Created Out of Mind, The Hub, Wellcome Collection, London, UK
| | - Hannah Zeilig
- Created Out of Mind, The Hub, Wellcome Collection, London, UK.,London College of Fashion, University of the Arts London, Marylebone, London, UK
| | - Sebastian Crutch
- Dementia Research Centre, Institute of Neurology, University College London, London, UK.,Created Out of Mind, The Hub, Wellcome Collection, London, UK
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Ko J, Gelowitz G, Tinker A, Holloway C, Kumar A. Impact of the adjuvant management and risk factors on survival in FIGO stage 3 endometrial cancer patients. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx372.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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39
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McCarthy I, Suzuki A, Suzuki T, Tyler N, Holloway C, Boampong D, Papadosifos NN, Carton AM, Ocal D, Yong K, Crutch SJ. [TD‐P‐022]: USE OF WEARABLE MOTION SENSORS TO ASSESS THE BEHAVIOUR OF ALZHEIMER'S PATIENTS IN SIMULATED DOMESTIC ENVIRONMENTS. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.06.2618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Ian McCarthy
- University College London, Engineering SciencesLondonUnited Kingdom
| | - Ayako Suzuki
- University College London, Engineering SciencesLondonUnited Kingdom
| | - Tatsuto Suzuki
- University College London, Engineering SciencesLondonUnited Kingdom
| | - Nick Tyler
- University College London, Engineering SciencesLondonUnited Kingdom
| | | | - Derrick Boampong
- University College London, Engineering SciencesLondonUnited Kingdom
| | | | - Amelia M. Carton
- Dementia Research CentreInstitute of Neurology, University College LondonLondonUnited Kingdom
| | - Dilek Ocal
- University College London, Institute of NeurologyLondonUnited Kingdom
| | - Keir Yong
- Dementia Research CentreInstitute of Neurology, University College LondonLondonUnited Kingdom
| | - Sebastian J. Crutch
- Dementia Research CentreInstitute of Neurology, University College LondonLondonUnited Kingdom
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40
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Holloway C, Heravi B, Barbareschi G, Nicholson S, Hailes S. Street rehab: Linking accessibility and rehabilitation. Annu Int Conf IEEE Eng Med Biol Soc 2017; 2016:3167-3170. [PMID: 28268980 DOI: 10.1109/embc.2016.7591401] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
As part of the Accessible Routes from Crowdsourced Cloud Services project (ARCCS) we conducted a series of experiments using the ARCCS sensor to identify push style of wheelchair users. The aim of ARCCS is to make use of a set of well-calibrated sensors to establish a processing chain that then provides ground truth of known accuracy about location, the nature of the environment, and physiological effort. In this paper we focus on two classification problems 1) The push style employed by people as they push themselves and 2) Whether the person is being pushed by an attendant or pushing themselves (independent of push style). Solving the first enables us to develop a level of granularity to pushing classification which transcends rehabilitation and accessibility. The first problem was solved using a wrist-mounted ARCCS sensor, and the second using a wheel-mounted ARCCS sensor. Push styles were classified between semi-circular and arc styles in both indoor and outdoor environments with a high-decrees of precision and recall (>95%). The ARCCS sensor also proved capable of discerning attendant from self-propulsion with near perfect accuracy and recall, without the need for a body-worn sensor.
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41
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Symonds A, Barbareschi G, Taylor S, Holloway C. A systematic review: the influence of real time feedback on wheelchair propulsion biomechanics. Disabil Rehabil Assist Technol 2017; 13:47-53. [PMID: 28102100 DOI: 10.1080/17483107.2016.1278472] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Clinical guidelines recommend that, in order to minimize upper limb injury risk, wheelchair users adopt a semi-circular pattern with a slow cadence and a large push arc. OBJECTIVES To examine whether real time feedback can be used to influence manual wheelchair propulsion biomechanics. REVIEW METHODS Clinical trials and case series comparing the use of real time feedback against no feedback were included. A general review was performed and methodological quality assessed by two independent practitioners using the Downs and Black checklist. The review was completed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guidelines. RESULTS Six papers met the inclusion criteria. Selected studies involved 123 participants and analysed the effect of visual and, in one case, haptic feedback. Across the studies it was shown that participants were able to achieve significant changes in propulsion biomechanics, when provided with real time feedback. However, the effect of targeting a single propulsion variable might lead to unwanted alterations in other parameters. Methodological assessment identified weaknesses in external validity. CONCLUSIONS Visual feedback could be used to consistently increase push arc and decrease push rate, and may be the best focus for feedback training. Further investigation is required to assess such intervention during outdoor propulsion. Implications for Rehabilitation Upper limb pain and injuries are common secondary disorders that negatively affect wheelchair users' physical activity and quality of life. Clinical guidelines suggest that manual wheelchair users should aim to propel with a semi-circular pattern with low a push rate and large push arc in the range in order to minimise upper limbs' loading. Real time visual and haptic feedback are effective tools for improving propulsion biomechanics in both complete novices and experienced manual wheelchair users.
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Affiliation(s)
- Andrew Symonds
- a University College London Aspire Centre for Rehabilitation and Assistive Technology , London , UK
| | - Giulia Barbareschi
- b University College London, University College London Interaction Centre , London , UK
| | - Stephen Taylor
- c University College London Institute of Orthopaedics and Musculoskeletal Science, Royal National Orthopaedic Hospital Stanmore , Brockley Hill , Stanmore , UK
| | - Catherine Holloway
- b University College London, University College London Interaction Centre , London , UK
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42
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Savage P, Holloway C, Lindsay G, Shubrook K, Jones C, Fung M, Schaff K, Anderson H, Nystedt K, Rauw J. Cancer referral and treatment activity 2010-2015: a population-based study from Vancouver Island. ACTA ACUST UNITED AC 2017; 23:e626-e629. [PMID: 28050153 DOI: 10.3747/co.23.3306] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The years since 2005 have seen major changes in cancer treatment and significant increases in the number of anticancer drugs available. However, there are relatively few published data to reflect how those changes are affecting the activity and workload of oncology services. To explore the effects of those changes, we reviewed the population-based cancer treatment activity on Vancouver Island for the period 2010-2015. METHODS Information about new patient referrals, radiation courses, new chemotherapy cycles commenced, total intravenous (IV) chemotherapy treatment visits, and pharmacy activity for oral anticancer drug prescriptions was obtained from BC Cancer Agency databases. RESULTS During the 5-year study period, the Vancouver Island population increased by 2.8% and the number of new referrals to the BC Cancer Agency increased by 17.7%. The overall number of radiation courses increased by 6.1%. In contrast, IV chemotherapy activity increased by 52.1% for new courses commenced and by 62% for total IV chemotherapy attendances. Oral anticancer drug prescriptions rose by 22.9% during the 5-year period. CONCLUSIONS Our study documents substantial recent increases in cancer therapy activity in terms of patient referrals and particularly IV chemotherapy and oral anticancer therapy. The data reported here could be of value in planning for future care provision.
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Affiliation(s)
- P Savage
- BC Cancer Agency, Vancouver Island, Victoria, BC
| | - C Holloway
- BC Cancer Agency, Vancouver Island, Victoria, BC
| | - G Lindsay
- BC Cancer Agency, Vancouver Island, Victoria, BC
| | - K Shubrook
- BC Cancer Agency, Vancouver Island, Victoria, BC
| | - C Jones
- Division of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, U.K
| | - M Fung
- BC Cancer Agency, Vancouver Island, Victoria, BC
| | - K Schaff
- BC Cancer Agency, Vancouver Island, Victoria, BC
| | - H Anderson
- BC Cancer Agency, Vancouver Island, Victoria, BC
| | - K Nystedt
- BC Cancer Agency, Vancouver Island, Victoria, BC
| | - J Rauw
- BC Cancer Agency, Vancouver Island, Victoria, BC
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43
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Cheng TJ, Kenney L, Amor JD, Thies SB, Costamagna E, James C, Holloway C. Characterisation of rollator use using inertial sensors. Healthc Technol Lett 2016; 3:303-309. [PMID: 28008367 PMCID: PMC5168841 DOI: 10.1049/htl.2016.0061] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 09/13/2016] [Accepted: 09/19/2016] [Indexed: 11/19/2022] Open
Abstract
The use of walking aids is prevalent among older people and people with mobility impairment. Rollators are designed to support outdoor mobility and require the user to negotiate curbs and slopes in the urban environment. Despite the prevalence of rollators, analysis of their use outside of controlled environments has received relatively little attention. This Letter reports on an initial study to characterise rollator movement. An inertial measurement unit (IMU) was used to measure the motion of the rollator and analytical approaches were developed to extract features characterising the rollator movement, properties of the surface and push events. The analytics were tested in two situations: first, a healthy participant used a rollator in a laboratory using a motion capture system to obtain ground truth. Second, the IMU was used to measure the movement of a rollator being used by a user with multiple sclerosis on a flat surface, cross-slope, up and down slopes and up and down a step. The results showed that surface inclination and distance travelled measured by the IMU have close approximation to the results from ground truth; therefore, demonstrating the potential for IMU-derived metrics to characterise rollator movement and user's pushing style in the outdoor environment.
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Affiliation(s)
- Tsu-Jui Cheng
- Centre for Health Sciences Research , University of Salford , Salford M6 6PU , UK
| | - Laurence Kenney
- Centre for Health Sciences Research , University of Salford , Salford M6 6PU , UK
| | - James David Amor
- Warwick Engineering in Biomedicine, School of Engineering , University of Warwick , Coventry CV4 7AL , UK
| | | | - Eleonora Costamagna
- Centre for Health Sciences Research , University of Salford , Salford M6 6PU , UK
| | - Christopher James
- Warwick Engineering in Biomedicine, School of Engineering , University of Warwick , Coventry CV4 7AL , UK
| | - Catherine Holloway
- Department of Computer Science , University College London , Gower Street, London WC1E 6BT , UK
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Holloway C, Dawes H. Disrupting the world of Disability: The Next Generation of Assistive Technologies and Rehabilitation Practices. Healthc Technol Lett 2016; 3:254-256. [PMID: 28008360 DOI: 10.1049/htl.2016.0087] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 10/31/2016] [Indexed: 11/19/2022] Open
Abstract
Designing, developing and deploying assistive technologies at a scale and cost which makes them accessible to people is challenging. Traditional models of manufacturing would appear to be insufficient at helping the world's 1 billion disabled people in accessing the technologies they require. In addition, many who receive assistive technologies simply abandon them as they do not meet their needs. In this study the authors explore the changing world of design for disability. A landscape which includes the rise of the maker movement, the role of ubiquitous sensing and the changing role of the 'user' to one of designer and maker. The authors argue they are on the cusp of a revolution in healthcare provision, where the population will soon have the ability to manage their own care with systems in place for diagnosis, monitoring, individualised prescription and action/reaction. This will change the role of the clinician from that of diagnostician, gatekeeper and resource manager/deliverer to that of consultant informatics manager and overseer; perhaps only intervening to promote healthy behaviour, prevent crisis and react at flash moments.
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Affiliation(s)
| | - Helen Dawes
- Elizabeth Casson Trust Chair, Movement Science Group , Oxford Institute of Nursing and Allied Health Research (OxINAHR) , UK
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45
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Symonds A, Taylor SJ, Holloway C. Sensewheel: an adjunct to wheelchair skills training. Healthc Technol Lett 2016; 3:269-272. [PMID: 28008362 PMCID: PMC5168756 DOI: 10.1049/htl.2016.0056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 09/07/2016] [Indexed: 11/20/2022] Open
Abstract
The purpose of this Letter was to investigate the influence of real-time verbal feedback to optimise push arc during over ground manual wheelchair propulsion. Ten healthy non-wheelchair users pushed a manual wheelchair for a distance of 25 m on level paving, initially with no feedback and then with real-time verbal feedback aimed at controlling push arc within a range of 85°-100°. The real-time feedback was provided by a physiotherapist walking behind the wheelchair, viewing real-time data on a tablet personal computer received from the Sensewheel, a lightweight instrumented wheelchair wheel. The real-time verbal feedback enabled the participants to significantly increase their push arc. This increase in push arc resulted in a non-significant reduction in push rate and a significant increase in peak force application. The intervention enabled participants to complete the task at a higher mean velocity using significantly fewer pushes. This was achieved via a significant increase in the power generated during the push phase. This Letter identifies that a lightweight instrumented wheelchair wheel such as the Sensewheel is a useful adjunct to wheelchair skills training. Targeting the optimisation of push arc resulted in beneficial changes in propulsion technique.
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Affiliation(s)
- Andrew Symonds
- Centre for Rehabilitation Engineering and Assistive Technology, University College London, London HA7 4LP, UK
| | - Stephen J.G. Taylor
- Centre for Rehabilitation Engineering and Assistive Technology, University College London, London HA7 4LP, UK
| | - Catherine Holloway
- University College London Interaction Centre, University College London, London WC1E 6EA, UK
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46
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Symonds A, Holloway C, Suzuki T, Smitham P, Gall A, Taylor SJ. Identifying key experience-related differences in over-ground manual wheelchair propulsion biomechanics. J Rehabil Assist Technol Eng 2016; 3:2055668316678362. [PMID: 31186918 PMCID: PMC6453058 DOI: 10.1177/2055668316678362] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objectives The purpose of this study was to investigate technique differences between expert and novice manual wheelchair users during over-ground wheelchair propulsion. Method Seven experts (spinal cord injury level between T5 and L1) and six novices (non-wheelchair users) pushed a manual wheelchair over level ground, a 2.5% cross slope and up a 6.5% incline (7.2 m length) and 12% incline (1.5 m length). Push rim kinetics, trunk and shoulder kinematics and muscle activity level were measured. Results During the level and cross slope tasks, the experts completed the tasks with fewer pushes by applying a similar push rim moment over a greater push arc, demonstrating lower muscle activity. During the incline tasks, the experts required fewer pushes and maintained a greater average velocity, generating greater power by applying a similar push rim moment over a greater push arc with greater angular velocity, demonstrating greater trunk flexion and higher shoulder muscle activity. Conclusions This study identifies experience-related differences during over-ground manual wheelchair propulsion. These differences are particularly evident during incline propulsion, with the experts generating significantly greater power to maintain a higher velocity.
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Affiliation(s)
- Andrew Symonds
- Aspire Centre for Rehabilitation Engineering and Assistive Technology, University College London, United Kingdom
| | | | - Tatsuto Suzuki
- Department of Civil, Environmental and Geomatic Engineering, University College London, United Kingdom
| | - Peter Smitham
- Aspire Centre for Rehabilitation Engineering and Assistive Technology, University College London, United Kingdom
| | - Angela Gall
- London Spinal Cord Injury Centre, Royal National Orthopaedic Hospital NHS Trust, United Kingdom
| | - Stephen Jg Taylor
- Aspire Centre for Rehabilitation Engineering and Assistive Technology, University College London, United Kingdom
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Ezeh C, Holloway C, Carlson T. MoRe-T2 (mobility research trajectory tracker): validation and application. J Rehabil Assist Technol Eng 2016; 3:2055668316670552. [PMID: 31186912 PMCID: PMC6453034 DOI: 10.1177/2055668316670552] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Accepted: 08/22/2016] [Indexed: 11/19/2022] Open
Abstract
It is important to assess the suitability of mobility aids before prescribing
them to patients. This assessment is often subjectively completed by a therapist
and it often includes a variety of basic practical tests. An objective
assessment of a patient's capability, which captures not only speed of task
completion and success, but also accuracy and risk of manoeuvres, would be both
a fairer and safer approach. Yet until now such an assessment would have been
cost-prohibitive, especially in low resource settings. We pave the way towards
this end goal, by describing, validating and demonstrating a low-cost computer
vision based system called MoRe-T2 (mobility research trajectory tracker). The
open-source MoRe-T2 system uses low-cost off-the-shelf webcams to track the pose
of fiducial markers, which are simply printed onto regular office paper. In this
article, we build upon previous work and benchmark the accuracy of MoRe-T2
against an industry standard motion capture system. In particular, we show that
MoRe-T2 achieves accuracy comparable to CODA motion tracking system. We go on to
demonstrate a use case of MoRe-T2 in assessing wheelchair manoeuvrability over a
relatively large area. The results show that MoRe-T2 is scalable at a much lower
cost than typical industry-standard motion trackers. Therefore, MoRe-T2 can be
used to develop more objective and reliable assessments of mobility aids,
especially in low-resource settings.
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Affiliation(s)
- Chinemelu Ezeh
- Aspire Centre for Rehabilitation Engineering and Assistive Technology, University College London, UK
| | - Catherine Holloway
- Aspire Centre for Rehabilitation Engineering and Assistive Technology, University College London, UK
| | - Tom Carlson
- Aspire Centre for Rehabilitation Engineering and Assistive Technology, University College London, UK
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48
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Barbareschi G, Richards R, Thornton M, Carlson T, Holloway C. Statically vs dynamically balanced gait: Analysis of a robotic exoskeleton compared with a human. Annu Int Conf IEEE Eng Med Biol Soc 2016; 2015:6728-31. [PMID: 26737837 DOI: 10.1109/embc.2015.7319937] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
In recent years exoskeletons able to replicate human gait have begun to attract growing popularity for both assistive and rehabilitative purposes. Although wearable robots often need the use of external support in order to maintain stability, the REX exoskeleton by REX Bionics is able to self-balance through the whole cycle. However this statically balanced gait presents important differences with the dynamically balanced gait of human subjects. This paper will examine kinematic and kinetic differences between the gait analysis performed on a subject wearing the REX exoskeleton and human gait analysis data as presented in literature. We will also provide an insight on the impact that these differences can have for both rehabilitative and assistive applications.
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49
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Imran M, Wang L, McCrohon J, Holloway C, Otton J, Yu C, Hunag J, Grover R, Moffat K, Ross J, Kotlyar E, Keogh A, Hayward C, Macdonald P, Jabbour A. Multiparametric Tissue Mapping in the Diagnosis and Management of Cardiac Transplant Rejection: A Prospective, Histologically-Validated Study. Heart Lung Circ 2016. [DOI: 10.1016/j.hlc.2016.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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50
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James CJ, Amor JD, Holloway C, Kenney L. AART-BC: a sensor system for monitoring Assistive Technology use beyond the clinic. Annu Int Conf IEEE Eng Med Biol Soc 2016; 2016:3151-3154. [PMID: 28268976 DOI: 10.1109/embc.2016.7591397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
A wide range of assistive and rehabilitative technologies (ART) are available to assist with mobility and upper limb function. However, anecdotal evidence suggests many of the devices prescribed, or purchased, are either poorly used, or rejected entirely. This situation is costly, both for the healthcare provider and the user, and may be leading to secondary consequences, such as falls and/or social isolation. This paper reports on the development and initial feasibility testing of a system for monitoring when and how assistive devices are used outside of the clinic setting, and feeding this information to the device user themselves and/or prescribing clinician (where appropriate). Illustrative data from multiple time-synchronized device and body worn sensors are presented on a wheelchair user and a user of a "rollator" walking frame, moving along a walkway. Observation of the sensor data in both cases showed characteristic signatures corresponding to individual "pushes". In parallel with this work, other project partners are exploring clinician and patient data requirements, as well we sensor set acceptability The initial results highlight the potential for the approach and demonstrate the need for further work to reduce and optimize the sensor set.
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