Future bathroom: A study of user-centred design principles affecting usability, safety and satisfaction in bathrooms for people living with disabilities

Research and development work relating to assistive technology 2010-11 (Department of Health) Presented to Parliament pursuant to Section 22 of the Chronically Sick and Disabled Persons Act 197

How a Diverse Research Ecosystem Has Generated New Rehabilitation Technologies: Review of NIDILRR’s Rehabilitation Engineering Research Centers

Over 50 million United States citizens (1 in 6 people in the US) have a developmental, acquired, or degenerative disability. The average US citizen can expect to live 20% of his or her life with a disability. Rehabilitation technologies play a major role in improving the quality of life for people with a disability, yet widespread and highly challenging needs remain. Within the US, a major effort aimed at the creation and evaluation of rehabilitation technology has been the Rehabilitation Engineering Research Centers (RERCs) sponsored by the National Institute on Disability, Independent Living, and Rehabilitation Research. As envisioned at their conception by a panel of the National Academy of Science in 1970, these centers were intended to take a “total approach to rehabilitation”, combining medicine, engineering, and related science, to improve the quality of life of individuals with a disability. Here, we review the scope, achievements, and ongoing projects of an unbiased sample of 19 currently active or recently terminated RERCs. Specifically, for each center, we briefly explain the needs it targets, summarize key historical advances, identify emerging innovations, and consider future directions. Our assessment from this review is that the RERC program indeed involves a multidisciplinary approach, with 36 professional fields involved, although 70% of research and development staff are in engineering fields, 23% in clinical fields, and only 7% in basic science fields; significantly, 11% of the professional staff have a disability related to their research. We observe that the RERC program has substantially diversified the scope of its work since the 1970’s, addressing more types of disabilities using more technologies, and, in particular, often now focusing on information technologies. RERC work also now often views users as integrated into an interdependent society through technologies that both people with and without disabilities co-use (such as the internet, wireless communication, and architecture). In addition, RERC research has evolved to view users as able at improving outcomes through learning, exercise, and plasticity (rather than being static), which can be optimally timed. We provide examples of rehabilitation technology innovation produced by the RERCs that illustrate this increasingly diversifying scope and evolving perspective. We conclude by discussing growth opportunities and possible future directions of the RERC program

A Novel Design of a Cable-driven Active Leg Exoskeleton (C-ALEX) and Gait Training with Human Subjects

Exoskeletons for gait training commonly use a rigid-linked "skeleton" which makes them heavy and bulky. Cable-driven exoskeletons eliminate the rigid-linked skeleton structure, therefore creating a lighter and more transparent design. Current cable-driven leg exoskeletons are limited to gait assistance use. This thesis presented the Cable-driven Active Leg Exoskeleton (C-ALEX) designed for gait retraining and rehabilitation. Benefited from the cable-driven design, C-ALEX has minimal weight and inertia (4.7 kg) and allows all the degrees-of-freedom (DoF) of the leg of the user. C-ALEX uses an assist-as-needed (AAN) controller to train the user to walk in a new gait pattern. A preliminary design of C-ALEX was first presented, and an experiment was done with this preliminary design to study the effectiveness of the AAN controller. The result on six healthy subjects showed that the subjects were able to follow a new gait pattern significantly more accurately with the help of the AAN controller. After this experiment, C-ALEX was redesigned to improve its functionality. The improved design of C-ALEX is lighter, has more DoFs and larger range-of-motion. The controller of the improved design improved the continuity of the generated cable tensions and added the function to estimate the phase of the gait of the user in real-time. With the improved design of C-ALEX, an experiment was performed to study the effect of the weight and inertia of an exoskeleton on the gait of the user. C-ALEX was used to simulate exoskeletons with different levels of weight and inertia by adding extra mass and change the weight compensation level. The result on ten subjects showed that adding extra mass increased step length and reduced knee flexion. Compensating the weight of the mass partially restored the knee flexion but not the step length, implying that the inertia of the mass is responsible for the change. This study showed the distinctive effect of weight and inertia on gait and demonstrated the benefit of a lightweight exoskeleton. C-ALEX was designed for gait training and rehabilitation, and its training effectiveness was studied in nine healthy subjects and a stroke patient. The healthy subjects trained with C-ALEX to walk in a new gait pattern with 30% increase in step height for 40 min. After the training, the subjects were able to closely repeat the trained gait pattern without C-ALEX, and the step height of the subjects increased significantly. A stroke patient also tested C-ALEX for 40 minutes and showed short-term improvements in step length, step height, and knee flexion after training. The result showed the effectiveness of C-ALEX in gait training and its potential to be used in stroke rehabilitation

Robot-assisted gait self-training: assessing the level achieved

This paper presents the technological status of robot-assisted gait self-training under real clinical environment conditions. A successful rehabilitation after surgery in hip endoprosthetics comprises self-training of the lessons taught by physiotherapists. While doing this, immediate feedback to the patient about deviations from the expected physiological gait pattern during training is important. Hence, the Socially Assistive Robot (SAR) developed for this type of training employs task-specific, user-centered navigation and autonomous, real-time gait feature classification techniques to enrich the self-training through companionship and timely corrective feedback. The evaluation of the system took place during user tests in a hospital from the point of view of technical benchmarking, considering the therapists’ and patients’ point of view with regard to training motivation and from the point of view of initial findings on medical efficacy as a prerequisite from an economic perspective. In this paper, the following research questions were primarily considered: Does the level of technology achieved enable autonomous use in everyday clinical practice? Has the gait pattern of patients who used additional robot-assisted gait self-training for several days been changed or improved compared to patients without this training? How does the use of a SAR-based self-training robot affect the motivation of the patients

Overcoming barriers and increasing independence: service robots for elderly and disabled people

This paper discusses the potential for service robots to overcome barriers and increase independence of elderly and disabled people. It includes a brief overview of the existing uses of service robots by disabled and elderly people and advances in technology which will make new uses possible and provides suggestions for some of these new applications. The paper also considers the design and other conditions to be met for user acceptance. It also discusses the complementarity of assistive service robots and personal assistance and considers the types of applications and users for which service robots are and are not suitable

Patterns of use: how older adults with progressed dementia interact with a robot

Older adults represent a new user group of robots that are deployed in their private homes or in care facilities. In the presented study tangible aspects of older adults' interaction with an autonomous robot were focused. The robot was deployed as a companion in physical therapy for older adults with progressed dementia. Interaction was possible via a mounted touch screen. The menu was structured in a single layer and icons were big and with strong contrast. Employing a detailed observation protocol, interaction frequencies and contexts were assessed. Thereby, it was found that most of the interaction was encouraged by the therapists and that two out of 12 older adults with progressed dementia showed self-inducted interactions

Robotics Technology in Mental Health Care

This chapter discusses the existing and future use of robotics and intelligent sensing technology in mental health care. While the use of this technology is nascent in mental health care, it represents a potentially useful tool in the practitioner's toolbox. The goal of this chapter is to provide a brief overview of the field, discuss the recent use of robotics technology in mental health care practice, explore some of the design issues and ethical issues of using robots in this space, and finally to explore the potential of emerging technology