Human-activity-centered measurement system:challenges from laboratory to the real environment in assistive gait wearable robotics

Assistive gait wearable robots (AGWR) have shown a great advancement in developing intelligent devices to assist human in their activities of daily living (ADLs). The rapid technological advancement in sensory technology, actuators, materials and computational intelligence has sped up this development process towards more practical and smart AGWR. However, most assistive gait wearable robots are still confined to be controlled, assessed indoor and within laboratory environments, limiting any potential to provide a real assistance and rehabilitation required to humans in the real environments. The gait assessment parameters play an important role not only in evaluating the patient progress and assistive device performance but also in controlling smart self-adaptable AGWR in real-time. The self-adaptable wearable robots must interactively conform to the changing environments and between users to provide optimal functionality and comfort. This paper discusses the performance parameters, such as comfortability, safety, adaptability, and energy consumption, which are required for the development of an intelligent AGWR for outdoor environments. The challenges to measuring the parameters using current systems for data collection and analysis using vision capture and wearable sensors are presented and discussed

What matters to older people with assisted living needs? A phenomenological analysis of the use and non-use of telehealth and telecare

Telehealth and telecare research has been dominated by efficacy trials. The field lacks a sophisticated theorisation of [a] what matters to older people with assisted living needs; [b] how illness affects people's capacity to use technologies; and [c] the materiality of assistive technologies. We sought to develop a phenomenologically and socio-materially informed theoretical model of assistive technology use. Forty people aged 60–98 (recruited via NHS, social care and third sector) were visited at home several times in 2011–13. Using ethnographic methods, we built a detailed picture of participants' lives, illness experiences and use (or non-use) of technologies. Data were analysed phenomenologically, drawing on the work of Heidegger, and contextualised using a structuration approach with reference to Bourdieu's notions of habitus and field. We found that participants' needs were diverse and unique. Each had multiple, mutually reinforcing impairments (e.g. tremor and visual loss and stiff hands) that were steadily worsening, culturally framed and bound up with the prospect of decline and death. They managed these conditions subjectively and experientially, appropriating or adapting technologies so as to enhance their capacity to sense and act on their world. Installed assistive technologies met few participants' needs; some devices had been abandoned and a few deliberately disabled. Successful technology arrangements were often characterised by ‘bricolage’ (pragmatic customisation, combining new with legacy devices) by the participant or someone who knew and cared about them. With few exceptions, the current generation of so-called ‘assisted living technologies’ does not assist people to live with illness. To overcome this irony, technology providers need to move beyond the goal of representing technology users informationally (e.g. as biometric data) to providing flexible components from which individuals and their carers can ‘think with things’ to improve the situated, lived experience of multi-morbidity. A radical revision of assistive technology design policy may be needed

Unpowered Assistive Knee Brace for Sit-to-Stand Transition

Individuals experiencing diminished leg strength often encounter difficulty performing the transition from a sitting to a standing position. An adult will complete an average of sixty transitions per day, making it one of the most physically demanding tasks performed in day-to-day life. The elderly population of the USA increased by 7% in fifty years, and thus the number of persons lacking the ability to successfully complete the Sit to Stand Transition (STST) has also been increasing. This project designed a portable mechanism that can be mounted on an individual’s leg to provide an assistive knee extension moment during the STST. The final design is a spring-driven ratchet and cam system that stores the potential energy expended during sitting for usage during the STST

Assessment of Power Wheelchair User Satisfaction Using Seat Elevators

The purpose of this study was to assess the difference in satisfaction of using seat elevators (SE) on power wheelchairs among individuals with disabilities through retrospective analysis of two clinical quality assurance databases that included time 1 (T1) and time 2 (T2) Functional Mobility Assessment (FMA) scores. The FMA is a validated self-report questionnaire that measures a person’s satisfaction in performing Mobility Related Activities of Daily Living (MRADL) across 10 items (Kumar, 2013). The databases collectively held 731 cases while 123 cases met the inclusion criteria of using a power wheelchair equipped with a SE at either T1, T2, or both. Three aspects of the FMA were assessed; #5 (reach), #6 (transfer), and total score. Cases were assigned to one of the three following groups; power wheelchair (PWC) users using a device with a SE at T1 but using a new device without a SE at T2 (SE – NSE, n = 14); PWC users using a device with a SE at T1 and using a device with a SE at T2 (SE – SE, n = 42); and PWC users using a device without a SE at T1 but using a device with a SE at T2 (NSE – SE, n = 67). The three aspects of the FMA were analyzed within the three groups of PWC users. For the SE-NSE group, there was a significant decrease for FMA item #5 (reach) (p = .03). There were no significant changes for FMA item #6 (transfer) (p = .48) and total score (p = .57). For the SE-SE group, there were significant improvements in FMA items #5 (reach) (p < .01), #6 (transfer) (p < .01), and total score (p < .01). For the NSE-SE group, there were significant improvements for FMA items #5 (reach) (p < .01), #6 (transfer) (p < .01), and total score (p < .01). In summary, the study indicates a SE can increase satisfaction of PWC users. The lack of a statistically significant difference in FMA item #6 and FMA total for the SE – NSE group was likely due to a small sample in that subgroup

A probabilistic approach to learn activities of daily living of a mobility aid device user

© 2014 IEEE. The problem of inferring human behaviour is naturally complex: people interact with the environment and each other in many different ways, and dealing with the often incomplete and uncertain sensed data by which the actions are perceived only compounds the difficulty of the problem. In this paper, we propose a framework whereby these elaborate behaviours can be naturally simplified by decomposing them into smaller activities, whose temporal dependencies can be more efficiently represented via probabilistic hierarchical learning models. In this regard, patterns of a number of activities typically carried out by users of an ambulatory aid device have been identified with the aid of a Hierarchical Hidden Markov Model (HHMM) framework. By decomposing the complex behaviours into multiple layers of abstraction the approach is shown capable of modelling and learning these tightly coupled human-machine interactions. The inference accuracy of the proposed model is proven to compare favourably against more traditional discriminative models, as well as other compatible generative strategies to provide a complete picture that highlights the benefits of the proposed approach, and opens the door to more intelligent assistance with a robotic mobility aid

Functional impairment in patients with myotonic dystrophy type 1 can be assessed by an ataxia rating scale (SARA)

Myotonic dystrophy type 1 (DM1) is not characterised by ataxia per se; however, DM1 and ataxia patients show similar disturbances in movement coordination often experiencing walking and balance difficulties, although caused by different underlying pathologies. This study aims to investigate the use of a scale previously described for the assessment and rating of ataxia (SARA) with the hypothesis that it could have utility in DM1 patients as a measure of disease severity and risk of falling. Data from 54 DM1 patients were pulled from the PHENO-DM1 natural history study for analysis. Mean SARA score in the DM1 population was 5.45 relative to the maximum score of eight. A flooring effect (score 0) was observed in mild cases within the sample. Inter-rater and test–retest reliability was high with intraclass coefficients (ICC) of 0.983 and 1.00, respectively. Internal consistency was acceptable as indicated by a Cronbach’s alpha of 0.761. Component analysis revealed two principle components. SARA correlated with: (1) all measures of muscle function tested, including quantitative muscle testing of ankle dorsiflexion (r = −0.584*), the 6 min walk test (r = −0.739*), 10 m walk test (r = 0.741*), and the nine hole peg test (r = 0.602*) and (2) measures of disease severity/burden, such as MIRS (r = 0.718*), MDHI (r = 0.483*), and DM1-Activ (r = −0.749*) (*p &lt; 0.001). The SARA score was predicted by an interaction between modal CTG repeat length and age at sampling (r = 0.678, p = 0.003). A score of eight or above predicted the use of a walking aid with a sensitivity of 100% and a specificity of 85.7%. We suggest that further research is warranted to ascertain whether SARA or components of SARA are useful outcome measures for clinical trials in DM1. As a tool, it can be used for gathering information about disease severity/burden and helping to identify patients in need of a walking aid, and can potentially be applied in both research and healthcare settings

ROAD: Domestic Assistant and Rehabilitation Robot

This study introduces the concept design and analysis of a robotic system for the assistance and rehabilitation of disabled people. Based on the statistical data of the most common types of disabilities in Spain and other industrialized countries, the different tasks that the device must be able to perform have been determined. In this study, different robots for rehabilitation and assistance previously introduced have been reviewed. This survey is focused on those robots that assist with gait, balance and standing up. The structure of the ROAD robot presents various advantages over these robots, we discuss some of them. The performance of the proposed architecture is analyzed when it performs the sit to stand activity

Motivation: An Occupational Therapists Guide for Motivating Young Male Clients with Spinal Cord Injuries

According to the Center for Disease Control and Prevention (2010), males account for approximately 80% of those who endure a spinal cord injury (SCI). Most newly diagnosed clients with spinal cord injuries are between the ages of 15-35 years (50%-70%) (CDC, 2010). Occupational therapists often work with clients who have sustained a SCI. It is in the best interest of the profession and our clients to address the psychosocial impact motivation can have on clients\u27 recovery. According to authors of research, a major problem to participation in treatment with clients who had a spinal cord injury was a lack of motivation (Chan et aI., 2000; Craig et ai., 2009; Kennedy, Evans, & Sandhu, 2009; Lohne & Severinsson, 2004). Due to clients\u27 possible decrease in occupational participation following a SCI, motivation may be a barrier to recovery. There is limited research in occupational therapy regarding the use of motivation for clients with SCI as an intervention tool. In one study, Wahman, Biguet, and Levi (2006) indicated that motivation is a key factor in increasing client participation in activities. By engaging in activities clients are either improving or maintaining health and preventing secondary conditions. The purpose of this project was to develop a guide to address motivation in young male clients following spinal cord injury (SCI). Historically, there has been little research that addressed motivation in relationship to engagement in occupations following SCI. For the purposes of this project, the authors examined the role motivation has in recovery of SCI for young male adults and developed an occupational therapy guide to address client motivation. A comprehensive literature review was conducted to explore the physical and psychological effects of clients who sustained a SCI. Furthermore, the authors conducted a theoretical review and explored literature that addressed the role of motivation in clients who sustained a SCI. Currently, there is limited research and programs available that specifically addresses motivation in clients engaging in SCI rehabilitation. Therefore, an occupational therapy guide was developed for occupational therapists working with young male clients who sustained a SCI. This guide was developed using the theoretical concepts of the Model of Human Occupation (MOHO) and Occupational Adaptation (OA). The guide will direct clinicians to use motivational concepts as intervention strategies. This will give occupational therapists a resource to utilize when motivation is a ban-ier to client participation in meaningful occupations. By motivating a client with SCI, his participation in meaningful occupations increases. In return, young male clients with SCI have an improved quality of life. The development of this guide follows the occupational therapy process: assessment, intervention, and outcome measures. Previous evidence from authors of research indicated the benefits of addressing motivation. In return, a clinician\u27s guide for occupational therapists to address motivation in SCI recovery will increase clients\u27 participation in activities to increase overall quality of life