Fall prevention intervention technologies: A conceptual framework and survey of the state of the art

In recent years, an ever increasing range of technology-based applications have been developed with the goal of assisting in the delivery of more effective and efficient fall prevention interventions. Whilst there have been a number of studies that have surveyed technologies for a particular sub-domain of fall prevention, there is no existing research which surveys the full spectrum of falls prevention interventions and characterises the range of technologies that have augmented this landscape. This study presents a conceptual framework and survey of the state of the art of technology-based fall prevention systems which is derived from a systematic template analysis of studies presented in contemporary research literature. The framework proposes four broad categories of fall prevention intervention system: Pre-fall prevention; Post-fall prevention; Fall injury prevention; Cross-fall prevention. Other categories include, Application type, Technology deployment platform, Information sources, Deployment environment, User interface type, and Collaborative function. After presenting the conceptual framework, a detailed survey of the state of the art is presented as a function of the proposed framework. A number of research challenges emerge as a result of surveying the research literature, which include a need for: new systems that focus on overcoming extrinsic falls risk factors; systems that support the environmental risk assessment process; systems that enable patients and practitioners to develop more collaborative relationships and engage in shared decision making during falls risk assessment and prevention activities. In response to these challenges, recommendations and future research directions are proposed to overcome each respective challenge.The Royal Society, grant Ref: RG13082

Augmented Reality in Physical Therapy: Systematic Review and Meta-analysis

Background: Augmented reality (AR) is a rapidly expanding technology; it comprises the generation of new images from digital information in the real physical environment of a person, which simulates an environment where the artificial and real are mixed. The use of AR in physiotherapy has shown benefits in certain areas of patient health. However, these benefits have not been studied as a whole. Objective: This study aims to ascertain the current scientific evidence on AR therapy as a complement to physiotherapy and to determine the areas in which it has been used the most and which variables and methods have been most effective. Methods: A systematic review registered in PROSPERO (International Prospective Register of Systematic Reviews) was conducted following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta - Analyses) recommendations. The search was conducted from July to August 2021 in the PubMed, PEDro, Web of Science, Scopus, and Cochrane Library scientific databases using the keywords augmented reality, physiotherapy, physical therapy, exercise therapy, rehabilitation, physical medicine, fitness, and occupational therapy. The methodological quality was evaluated using the PEDro scale and the Scottish Intercollegiate Guidelines Network scale to determine the degree of recommendation The Cochrane Collaboration tool was used to evaluate the risk of bias. Results: In total, 11 articles were included in the systematic review. Of the 11 articles, 4 (36%) contributed information to the meta-analysis. Overall, 64% (7/11) obtained a good level of evidence, and most had a B degree of recommendation of evidence. A total of 308 participants were analyzed. Favorable results were found for the Berg Balance Scale (standardized mean change 0.473, 95% CI -0.0877 to 1.0338; z=1.65; P=.10) and the Timed Up and Go test (standardized mean change -1.211, 95% CI -3.2005 to 0.7768; z=1.194; P=.23). Conclusions: AR, in combination with conventional therapy, has been used for the treatment of balance and fall prevention in geriatrics, lower and upper limb functionality in stroke, pain in phantom pain syndrome, and turning in place in patients with Parkinson disease with freezing of gait. AR is effective for the improvement of balance; however, given the small size of the samples and the high heterogeneity of the studies, the results were not conclusive. Future studies using larger sample sizes and with greater homogeneity in terms of the devices used and the frequency and intensity of the interventions are needed

I-BaR: Integrated Balance Rehabilitation Framework

Neurological diseases are observed in approximately one billion people worldwide. A further increase is foreseen at the global level as a result of population growth and aging. Individuals with neurological disorders often experience cognitive, motor, sensory, and lower extremity dysfunctions. Thus, the possibility of falling and balance problems arise due to the postural control deficiencies that occur as a result of the deterioration in the integration of multi-sensory information. We propose a novel rehabilitation framework, Integrated Balance Rehabilitation (I-BaR), to improve the effectiveness of the rehabilitation with objective assessment, individualized therapy, convenience with different disability levels and adoption of an assist-as-needed paradigm and, with an integrated rehabilitation process as a whole, i.e., ankle-foot preparation, balance, and stepping phases, respectively. Integrated Balance Rehabilitation allows patients to improve their balance ability by providing multi-modal feedback: visual via utilization of Virtual Reality; vestibular via anteroposterior and mediolateral perturbations with the robotic platform; proprioceptive via haptic feedback.Comment: 37 pages, 2 figures, journal pape

Technology and dementia: the future is now

Background: Technology has multiple potential applications to dementia from diagnosis and assessment to care delivery and supporting ageing in place. Objectives: To summarise key areas of technology development in dementia and identify future directions and implications. Method: Members of the US Alzheimer’s Association Technology Professional Interest Area involved in delivering the annual pre-conference summarised existing knowledge on current and future technology developments in dementia. Results: The main domains of technology development are as follows: (i) diagnosis, assessment and monitoring, (ii) maintenance of functioning, (iii) leisure and activity, (iv) caregiving and management. Conclusions: The pace of technology development requires urgent policy, funding and practice change, away from a narrow medical approach, to a holistic model that facilitates future risk reduction and pre- vention strategies, enables earlier detection and supports implementation at scale for a meaningful and fulfilling life with dementia

Investigating Immersive Augmented Reality as a Rehabilitation Tool for Parkinson disease

Physical rehabilitation programs are often prescribed in an effort to maintain range of motion, and to adapt strategies for managing the debilitating symptoms of Parkinson disease (PD) in everyday life. An emerging trend to overcome the limitations of traditional rehabilitation is the use of virtual reality technologies. IThe goal of the present study was to determine the feasibility of augmented reality technology (IAR) in a rehabilitative setting. Three IAR environments were designed and a corresponding task was completed in each one. Not surprisingly, the control group generally performed better than the PD group on the tasks. All participants typically performed better in the real-world than the IAR environment. Additionally both the PD and control groups’ performances improved with repeated visits. The system was well-tolerated and important lessons are highlighted about future implementation of this rehabilitation approach (e.g., the need for a familiarization period to the system)

Nebraska Biomechanics Core Facilty 2008 Annual Report, Issue 7

April 2008 - March 2009 This issue features Announcements, Featured News, Nonlinear Workshop, Projects, Collaborations, Visitors, Awards, Publications, and Support.https://digitalcommons.unomaha.edu/nbcfnewsletter/1006/thumbnail.jp

Walking adaptability therapy after stroke: study protocol for a randomized controlled trial

Background: Walking in everyday life requires the ability to adapt walking to the environment. This adaptability is often impaired after stroke, and this might contribute to the increased fall risk after stroke. To improve safe community ambulation, walking adaptability training might be beneficial after stroke. This study is designed to compare the effects of two interventions for improving walking speed and walking adaptability: treadmill-based C-Mill therapy (therapy with augmented reality) and the overground FALLS program (a conventional therapy program). We hypothesize that C-Mill therapy will result in better outcomes than the FALLS program, owing to its expected greater amount of walking practice.Methods: This is a single-center parallel group randomized controlled trial with pre-intervention, post-intervention, retention, and follow-up tests. Forty persons after stroke (≥3 months) with deficits in walking or balance will be included. Participants will be randomly allocated to either C-Mill therapy or the overground FALLS program for 5 weeks. Both interventions will incorporate practice of walking adaptability and will be matched in terms of frequency, duration, and therapist attention. Walking speed, as determined by the 10 Meter Walking Test, will bethe primary outcome measure. Secondary outcome measures will pertain to walking adaptability (10 Meter Walking Test with context or cognitive dual-task and Interactive Walkway assessments). Furthermore, commonly used clinicalmeasures to determine walking ability (Timed Up-and-Go test), walking independence (Functional Ambulation Category), balance (Berg Balance Scale), and balance confidence (Activities-specific Balance Confidence scale) will be used, as well as a complementary set of walking-related assessments. The amount of walking practice (the number of steps taken per session) will be registered using the treadmill’s inbuilt step counter (C-Mill therapy) and video recordings (FALLS program). This process measure will be compared between the two interventions.Discussion: This study will assess the effects of treadmill-based C-Mill therapy compared with the overground FALLS program and thereby the relative importance of the amount of walking practice as a key aspect of effective intervention programs directed at improving walking speed and walking adaptability after stroke.Trial registration: Netherlands Trial Register NTR4030. Registered on 11 June 2013, amendment filed on 17 June 2016.Keywords: Exercise, Rehabilitation, Stroke, Therapy, Walking adaptability, Walking spee