Consumer Satisfaction with Telerehabilitation Service Provision of Alternative Computer Access and Augmentative and Alternative Communication

Telerehabilitation (TR) services for assistive technology evaluation and training have the potential to reduce travel demands for consumers and assistive technology professionals while allowing evaluation in more familiar, salient environments for the consumer. Sixty-five consumers received TR services for augmentative and alternative communication or alternative computer access, and consumer satisfaction was compared with twenty-eight consumers who received exclusively in-person services. TR recipients rated their TR services at a median of 6 on a 6-point Likert scale TR satisfaction questionnaire, although individual responses did indicate room for improvement in the technology. Overall satisfaction with AT services was rated highly by both in-person (100% satisfaction) and TR (99% satisfaction) service recipients

Iterative Design and Usability Testing of the iMHere System for Managing Chronic Conditions and Disability

A novel mobile health platform, Interactive Mobile Health and Rehabilitation (iMHere), is being developed to support wellness and self-management among people with chronic disabilities. The iMHere system currently includes a smartphone app with six modules for use by persons with disabilities and a web portal for use by medical and rehabilitation professionals or other support personnel. Our initial clinical research applying use of this system provides insight into the feasibility of employing iMHere in the development of self-management skills in young adults (ages 18-40 years) with spina bifida (Dicianno, Fairman, McCue, Parmanto, Yih, et al., 2015). This article is focused on describing the iterative design of the iMHere system including usability testing of both the app modules and clinician portal. Our pilot population of persons with spina bifida fostered the creation of a system appropriate for people with a wide variety of functional abilities and needs. As a result, the system is appropriate for use by persons with various disabilities and chronic conditions, not only spina bifida. In addition, the diversity of professionals and support personnel involved in the care of persons with spina bifida (SB) also enabled the design and implementation of the iMHere system to meet the needs of an interdisciplinary team of providers who treat various conditions. The iMHere system has the potential to foster communication and collaboration among members of an interdisciplinary healthcare team, including individuals with chronic conditions and disabilities, for client-centered approach to support self-management skills.

Participatory design in the development of the wheelchair convoy system

<p>Abstract</p> <p>Background</p> <p>In long-term care environments, residents who have severe mobility deficits are typically transported by having another person push the individual in a manual wheelchair. This practice is inefficient and encourages staff to hurry to complete the process, thereby setting the stage for unsafe practices. Furthermore, the time involved in assembling multiple individuals with disabilities often deters their participation in group activities.</p> <p>Methods</p> <p>The Wheelchair Convoy System (WCS) is being developed to allow a single caregiver to move multiple individuals without removing them from their wheelchairs. The WCS will consist of a processor, and a flexible cord linking each wheelchair to the wheelchair in front of it. A Participatory Design approach – in which several iterations of design, fabrication and evaluation are used to elicit feedback from users – was used.</p> <p>Results</p> <p>An iterative cycle of development and evaluation was followed through five prototypes of the device. The third and fourth prototypes were evaluated in unmanned field trials at J. Iverson Riddle Development Center. The prototypes were used to form a convoy of three wheelchairs that successfully completed a series of navigation tasks.</p> <p>Conclusion</p> <p>A Participatory Design approach to the project allowed the design of the WCS to quickly evolve towards a viable solution. The design that emerged by the end of the fifth development cycle bore little resemblance to the initial design, but successfully met the project's design criteria. Additional development and testing is planned to further refine the system.</p

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

RESNA 2006 Proceedings Selecting an Appropriate Scan Rate: The “.65 Rule”

Investigators have discovered that the ratio between a user’s reaction time and an appropriate scan rate for that user is approximately 0.65, which we refer to as “the.65 rule. ” As part of a larger effort to develop software that automatically adapts the configuration of switch access software, data was collected comparing subject performance with a scan rate chosen using the.65 rule and a scan rate chosen by the user. Analysis of the data indicates that for many people, the.65 rule produces a scan rate that is approximately the same as the average switch press time plus two standard deviations. BACKGROUND Row-column scanning is a technique used by individuals with significant physical impairments for entering text and other data into computers and augmentative communication devices. A common implementation of row-column scanning with one switch requires three switch hits to make one selection from a two-dimensional matrix of letters, numbers, symbols, words, or phrases, as illustrated in Figure 1. The first switch hit initiates a scan through the rows of the matrix. Each row of the matrix, beginning with the first, is highlighted in turn until the second switch hit is made to select a row. Each column of the row is then highlighted in turn until the target is highlighted, when the third switch hit is made t

RESNA 2006 Proceedings Measuring Keyboard Performance for People with Disabilities

Fourteen individuals with various motor impairments performed a series of text entry exercises. Performance measures were collected which indicate overall performance (speed and error rate) and classification of errors. Such performance metrics could be useful in assessing the computer access skills of clients, and recommending software, hardware, or training interventions. BACKGROUND People with disabilities may have difficulty performing text entry tasks using a computer keyboard. The specific types of difficulty will vary depending on the person’s intrinsic abilities, the input device being used, and the task. In order to understand and remediate the difficulties faced by a particular individual, it is desirable to quantify performance and classify errors. This aids in comparing performance over time or between input devices; evaluating the success of an intervention; or communicating the client’s need for an intervention. General measures of typing performance include text entry rate and accuracy. A typical measure of text entry rate is the number of words per minute. It is more difficult to measure error rate in a consistent manner, given the variety of ways in which someone can make an error. Soukoreff and MacKenzie have proposed a measure of error rate using the mean string distance (MSD) (1). The MSD between two strings of characters is the minimu