Upper limb (UL) motor impairments, common in people with disabilities, compromise independence in activities of daily living (ADLs). Assistive devices represent promising solutions for restoring or supporting these functions. However, they remain largely underutilized and underdeveloped. This systematic review provides an overview of technologies aimed at improving UL functional mobility in people with motor deficits. The search was conducted according to PRISMA guidelines, with rigorous study selection. Inclusion criteria included, among other things: original English studies on UL assistive devices used in ADLs or whose concept was adaptable to this use. Forty-five studies were included, mostly published after 2010. Nearly half involved patients with chronic post-stroke impairments, focusing on distal deficits. The most studied devices were mechatronic hand exoskeletons. Despite a plethora of prototypes, few reached the commercialization stage, limiting their actual accessibility. Although most devices are at early stages of technological maturity, their design objectives and preliminary experimental results suggest real potential for improving autonomy and quality of life, but their development remains limited. This analysis highlights the importance of user-centered development and the need to strengthen the methodological rigor of future studies to foster innovative, modular and accessible solutions.
Pressure injuries (PIs) impact individuals with limited mobility, including wheelchair users, and can lead to serious health issues. PIs occur when localized pressure and shear forces slow blood flow, create wounds, and raise infection risk. During wheelchair consultations, clinicians recommend seat cushions to users. Seat cushions are often the primary PI prevention tool for wheelchair users, but PIs remain a prevalent clinical concern. Most existing cushions alleviate pressure with inactive materials that necessitate frequent manual repositioning. A qualitative study with clinicians, an important stakeholder in the seating ecosystem, was conducted toward development of a new seat cushion design to better address PIs. Clinicians know cushion features that promote positive health outcomes, practical considerations for usefulness, and can provide insight into how cushion designs impact multiple wheelchair users' experiences. Clinician interview analysis revealed two key themes: (1) cushion selection process is influenced by clinical context and cushion attributes and (2) tradeoffs between cushion features exist when choosing among existing cushion designs. Relative importance of cushion features is also explored. Key insights into clinicians' experiences sourcing, recommending, and using wheelchair seat cushions were developed into technical design criteria which may serve as a guide for assistive technology innovators developing next-generation seat cushions.
Functional limitations related to hearing, vision, and mobility are common among older adults and may adversely affect mental health and functional independence. However, nationally representative evidence from India on assistive device use, unmet need, and related health outcomes remains limited. This study used data from Wave 1 (2017-18) of the Longitudinal Ageing Study in India (LASI), including 31,902 adults aged 60 years and above. Weighted descriptive statistics estimated assistive device use and unmet need, while survey-adjusted logistic regression models examined associations between assistive device use, severe activities of daily living (ADL) limitation (≥3 limitations), and depressive symptoms (CES-D ≥ 4). Among older adults with mobility difficulties, only 12.2% reported using mobility aids, while 87.8% reported unmet need for mobility aids. The use of vision devices was high (91.8%), with only 8.2% reporting unmet need. In contrast, hearing aid use remained very low (7.8%), with 92.2% reported unmet need. Mobility aid use was associated with higher odds of severe ADL limitation, likely reflecting reverse causation and confounding by indication. Sensitivity analyses found no significant association between mobility aid use and depressive symptoms across ADL severity groups. In contrast, the use of vision device was associated with lower odds of severe ADL limitation, highlighting the importance of equitable access to affordable assistive technologies for older adults in India.
The 1990 Americans with Disabilities Act motivated efforts to provide wheelchair users with safe and accessible transportation opportunities, primarily by adding accessibility options to public transportation vehicles. In addition, a voluntary safety standard, RESNA WC19, was created to define wheelchair crashworthiness requirements for use in ground vehicles. As the impact of these standards on wheelchair transportation safety remains relatively unknown, the present study aims to characterize the use and knowledge of WC19 wheelchairs and whether existing transportation options are meeting wheelchair users' needs per the ADA. Overall, 69 wheelchair users completed a survey on their knowledge and use of WC19 wheelchairs, as well as their transportation experiences. About half of participants (56.5%) reported prior knowledge of the WC19 standard, 62.5% use WC19 wheelchairs, and 68% of all users report being more interested in obtaining a WC19 wheelchair after survey completion. Personal vehicles (75.4%) and taxi and rideshare services (33.3%) were more commonly used than public transportation. No routinely used public transportation met user needs more than a quarter of the time. Findings demonstrate the need for further research and policy initiatives to promote WC19 use, identify further barriers to WC19 implementation, and improve public transportation to meet wheelchair user needs.
Parkinson's disease (PD) is a neurodegenerative disorder characterized by motor symptoms as well as cognitive impairments that require attention in rehabilitation. In recent years, various assistive technologies have been used to enhance the quality of life and support daily activities in individuals with PD. However, their impact on cognitive function remains unclear. This review examines randomized controlled trials published in English between 2018 and 2024, identified through searches in PubMed, PEDro, and Scopus. Trials were selected according to predefined inclusion and exclusion criteria and assessed using the PEDro Quality Assessment, with statistical results of the included trials interpreted by the researchers. Seven trials met the inclusion criteria, with interventions ranging from 15 to 24 sessions involving technologies such as smartphone and computer applications, treadmills, exoskeletons, robotic walking, and virtual reality. Cognitive function was evaluated using validated scales, and findings suggest that assistive technologies positively influence memory, attention, executive function, and mood, alongside improvements in motor function and quality of life. While the results highlight potential benefits, further research is needed to identify the most effective assistive technologies for cognitive function and optimize their application in PD rehabilitation.
Sign language relies on hand gestures, facial expressions, and body postures. Vision-based systems are crucial for recognizing these gestures to convert sign language into text or speech. Tamil Sign Language Recognition (TSLR) remains underdeveloped, with limited studies on Tamil vowels and consonants. Many Tamil words can be represented with one hand, but no benchmark dataset exists for Tamil Sign Language. To address this, we constructed a dataset with 56 classes, including vowels, consonants, and Tamil Single-Hand Alphabets (TSHA), incorporating variations in scale, background, pose, resolution, and lighting. We propose Tamil Sign Language - You Only Look Once-small (TSL-YOLOv8s), an enhanced YOLOv8s model integrating Space to Depth - Convolution, Batch Normalization, and Sigmoid Activation (SPD-CBS) with Dynamic Head (DyHead) to improve recognition accuracy without increasing computational cost. The proposed model achieves 94% accuracy, outperforming state-of-the-art methods and demonstrating its effectiveness in real-world applications.
Fatigue induces adverse short- and long-term health risks in wheelchair users. This study aimed to develop a machine learning approach to predict fatigue onset during wheelchair incremental exercise via surface electromyography (sEMG). sEMG from eight upper-limb muscles and oxygen uptake data were collected from nine wheelchair users (3 females, 6 males) performing incremental wheelchair propulsion on an ergometer. Ventilatory threshold (VT) derived from oxygen uptake was defined as the fatigue onset label, with sEMG signals as predictive features. A dynamic weighted attention long short-term memory (DWA-LSTM) model was built to distinguish non-fatigued and fatigue-transition propulsion cycles and identify critical muscle contributors. The model achieved an average classification accuracy of 94.82% using eight-muscle sEMG intensity. Notably, single-channel pectoralis major sEMG still yielded 89% accuracy. These findings indicate wearable fatigue monitoring systems may rely on single-muscle EMG to detect propulsion-related fatigue onset.
Mobile devices enable individuals to efficiently and effectively complete instrumental activities of daily living (IADLs), and independence in IADLs is associated with a positive quality of life (QOL). While there may be barriers to adults with acquired communication disorders learning to use these tools, research supports their capability to do so successfully given proper support. Speech-language pathologists (SLPs) are qualified to deliver mobile device instruction given their unique skill sets in working with individuals with cognitive-linguistic, behavioral, sensory, and physical barriers. We present three case studies of individuals with acquired communication disorders after their participation in a specialty graduate student clinic focused on individualized mobile device training. Client records were examined retrospectively to investigate the impact of such training on independence in IADLs and QOL. The results of this endeavor resulted in positive outcomes in IADL completion and QOL across all participants. SLPs and related professionals are urged to incorporate mobile device instruction into their treatments when addressing client goals.
Research on the role of Assistive Technology (AT) in supporting students with Visual Impairments (VIs) in higher education has increased in recent years, though the field remains underexplored. This review analyzes AT interventions aimed at enhancing academic skills and promoting inclusion among students with VI in higher education. A systematic search of Scopus, ERIC, PubMed, and Google Scholar databases (2013-2025) identified 1,239 studies, of which seven met the inclusion criteria. Descriptive analysis of these studies revealed that AT interventions improved accessibility and participation in academic life. However, barriers persist, including limited access to accessible digital media, inadequate financial and institutional resources, and insufficient incentives for students. The findings align with previous research, confirming that AT facilitates inclusion and accessibility but is hindered by systemic challenges such as lack of funding, insufficient teacher training, and accessibility gaps. This review highlights the need for greater institutional support, investment in resources, and further research to advance the equitable integration of AT in higher education.
Thermoplastic ankle-foot orthotics (AFOs) effectively manage foot drop but are time-intensive to fabricate, while 3D printing offers a faster, customizable alternative with promising early results. However, broader adoption requires further clinical evidence on biomechanical efficacy and user satisfaction, particularly for novel 3D-printed AFOs. This study compared the biomechanical effects of a 3D-printed ankle-foot orthosis (3D-AFO) with a standard thermoplastic AFO (S-AFO) during walking in individuals with unilateral foot drop and evaluated user satisfaction. Nine participants were assessed while walking barefoot, with S-AFO and 3D-AFO conditions. Gait was analyzed using a three-dimensional optical motion-capture system, and satisfaction was measured using the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST 2.0). The 3D-AFO significantly increased walking speed (0.62 v.s. 0.42 m/s barefoot; p = 0.040) and improved satisfaction regarding device dimensions (p = 0.014) and comfort (p = 0.020). SPM analysis showed both AFOs improved ankle kinematic symmetry during initial and terminal swing phases, with no significant differences at the hip or knee. Overall, the 3D-AFO improves patient satisfaction, walking speed, and ankle kinematics compared to barefoot walking. These results demonstrate that 3D-AFOs are a clinically viable and effective alternative to traditionally made S-AFOs for individuals with unilateral foot drop.
Children with hearing impairments often demonstrate delayed literacy development compared to their typically developing peers. While educational toys serve as crucial intervention tools for children's literacy development, existing designs fail to adequately address the learning needs of children with hearing impairments. Currently, there is a lack of systematic methods to identify and prioritize their specific requirements. To address this gap, the study proceeded in three stages. First, need-related data were collected from direct users and relevant adult stakeholders through interviews and analyzed with the Kawakita Jiro model (KJ method). As a result, the study identified 36 user needs. In the second stage, these 36 user needs were categorized according to the Kano model into five types. Finally, the Analytic Hierarchy Process (AHP) was employed to prioritize the relative importance of each requirement type. The highest-priority requirements within the main Kano categories were Child-proof Sizing (#1) for must-be requirements, Large-Grip Design (#5) for one-dimensional requirements, and Trans-sensory Equality (#31) for attractive requirements. These findings suggest a layered design logic for educational puzzle toys. Safety functions as a baseline condition, while usability supports manipulation and literacy-oriented play. Trans-sensory Equality further provides a more specific direction for non-stigmatizing inclusive design.
Caregiver burden affects the caregiver, care process, and outcome of the recipient. Therefore, the factors that influence the psychosocial caregiver burden must be examined. We conducted a mixed-methods study to evaluate the effect of mobile hoist on the burden of caregivers of individuals with severe disabilities and older adults with impaired mobility. Thirty caregivers used a mobile hoist for 7 days. Care burden, burnout, and self-esteem were measured using the Rapid Entire Body Assessment, Job Strain Index, Rapid Upper Limb Assessment, and time per caregiving session scores. Caregivers' experiences were collected through interviews. Data were analyzed using descriptive statistics. The use of mobile hoist reduced the care burden scores and increased the time per caregiving session. The following themes were identified: caregiver burden relief, burden of using mobile hoist, and increased confidence in caregiving. Mobile hoist reduced the psychosocial and physical burden of the caregivers.
The first study to compare walking ability, balance and perceived daily functioning of two microprocessor stance-and-swing-phase-controlled knee-ankle-foot orthoses (SSCKAFOs) and a stance-control KAFO (SCKAFO). A 67-year-old man with knee instability due to the late effects of polio, currently using a NEURO TRONIC SCKAFO received two newly fabricated microprocessor-controlled SSCKAFOs: the NEURO HiTRONIC and C-Brace. Measurements taken after 10-weeks of using each SSCKAFO were compared to the SCKAFO baseline measurements. Outcomes included walking speed, walking energy cost, stair and hill descend, balance performance, balance confidence and perceived daily functioning. Compared to the NEURO TRONIC, both SSCKAFOs improved walking speed (NEURO HiTRONIC: +12.5%, C-Brace: +20.2%), walking energy cost (NEURO HiTRONIC: -11.4%, C-Brace: -12.4%), balance confidence (NEURO HiTRONIC: +11, C-Brace: +24 on the Activities Balance Confidence scale) and perceived daily functioning (NEURO HiTRONIC: +10, C-Brace: +14 on the Orthotics and Prosthetics User Survey-Lower Extremity Functional Status. Stair and hill descend improved exclusively with the C-Brace (both +2). Microprocessor-controlled SSCKAFOs showed improved functioning compared to a SCKAFO in a polio survivor with knee instability. Notably, the C-Brace SSCKAFO provided greater and additional benefits compared to the NEURO HiTRONIC SSCKAFO, highlighting its potential to further enhance daily life functioning.
This single-subject study evaluated the immediate, mid-term (with AFO after six weeks), and therapeutic (without AFO after six weeks) effects of an ankle-foot orthosis (AFO) with a Klenzak joint and lateral cuff on gait in women with medial knee osteoarthritis (KOA). Five participants were analyzed using a 3D motion analysis system and force plate. Kinetic variables included the external knee adduction moment (EKAM), external knee flexion moment (EKFM), center of pressure (COP) displacement, and spatiotemporal parameters (cadence, stride length, speed). Descriptive statistics and individual effect sizes were used. Immediately, the AFO caused a lateral COP shift (high effect sizes in 4/5 participants) and reduced the first peak EKAM in three participants. After six weeks, mean EKAM and EKFM increased, showing variable individual responses. Therapeutically, the first peak EKAM decreased again in three participants. Most participants showed improvements in spatiotemporal parameters across evaluations. The most consistent biomechanical benefits were found in participants with neutral foot posture. These findings suggest that the AFO may offer immediate and therapeutic benefits for knee loading and gait in some individuals with KOA. However, mid-term reduction in effectiveness indicates the possible need for orthosis readjustment.
Pain is a significant global burden impacting healthcare resources and patients. Assistive technology can help ease the burden, but the available literature regarding specific skills and competencies required by healthcare professionals to effectively support patients with pain is very heterogeneous. This scoping review explored and mapped the skills and competencies needed by healthcare professionals to utilize the assistive technologies, mobile applications, monitoring, telemedicine/telehealth, and augmented/virtual reality in pain management. The search strategy involved multiple databases and manual searching of reference lists, focusing on publications from 2018 to 2026. All publications underwent independent screening and data extraction by two members of the review team. The screening, selection, and data extraction process was carried out using Covidence. The review includes 76 publications providing insight into the skills and competencies of healthcare professionals in using technologies and supporting the needs of patients with pain. The information identified on skills and competencies included understanding potential adverse effects, technical proficiency, effective communication, and the ability to integrate assistive technologies into standard procedures and routines. To support people with pain, focus should be on personalizing the use of assistive technologies to meet individual patient needs, addressing usability concerns, and ensuring patient safety and engagement.
This systematic review aims to examine the use and effectiveness of virtual reality (VR)-based interventions in improving the functional skills of individuals with different types of muscular dystrophies (MD). A comprehensive search of keywords related to VR, MD, and functional skills was conducted across various databases. Screening of titles and abstracts resulted in 35 studies being evaluated through full-text review, with 10 studies ultimately included in the review. The quality of the included studies was assessed using the Mixed-Methods Appraisal Tool (MMAT). The review highlights various VR methods and interventions for assisting patients with different types of MD. While evidence is limited, existing literature suggests that the use of VR in rehabilitation can enhance functional independence, motor skills, and patient motivation. Overall, VR shows promise as a valuable tool for improving recovery in individuals with MD. Further research and development of VR-based interventions tailored to the specific needs of persons affected by MD are warranted to fully harness its benefits in improving functional outcomes for this patient population.
Children with disabilities in low-resource environments (LREs) face major barriers to education, participation, and well-being. Assistive technologies like prostheses can help, but current solutions often fail to meet child-specific needs, particularly in LREs. This study engages pediatric prosthesis users in Cambodia to identify their unique user needs. This study used a novel interactive interview with card games and functional mobility assessment. While the card games and mobility assessment provided quantitative data, the interview responses were analyzed using thematic analysis. Six themes emerged from the analysis, demonstrating children remarkable understanding of both benefits and limitations of their prostheses. They appreciated the independence and cosmetic appearance, but pointed to limited mobility, heavy components, and discomfort as major issues. These priorities were echoed in the card games, where anatomically looking prostheses were the most preferred style, and culturally important activities such as walking fast, sitting cross-legged and kneeling were ranked highest. Children clearly expressed what it is important for them and identified key areas for improvement in current prostheses to improve their social inclusion. Future prosthetic research and development must adopt a user-centered, culturally sensitive approach that actively involves children, ensuring prosthetic solutions meet their physical, emotional, and social needs.
In-wheel suspension systems for manual wheelchairs offer a potential remedy for dissipating whole body vibrations; however, some users feel that they impede their propulsion efficiency. The purpose of this study was to compare Loopwheel Urban, a type of in-wheel suspension wheel to a carbon fiber wheel (Spinergy CLX) and standard spoked wheel to elucidate their comparative effects on rolling resistance force and axle deformation. Component-level drum-based testing revealed that the average rolling resistance force of the Loopwheels was 118% and 44% higher on linoleum and carpet surfaces than the standard wheels, respectively, and approximately 160% higher on carpet than the Spinergy CLX. Loopwheels demonstrated greater deformation (70 mm average across all loading conditions) compared to both standard and CLX wheels under static loading conditions. The increased rolling resistance force and deformation may help explain the perception among manual wheelchair users that Loopwheels impede their propulsion efficiency, despite their smoother ride and reduction of vibrations and shocks.
This integrative review examines how culturally embedded conceptualizations of rapport influence assistive technology implementation in elder care across diverse global contexts. Through systematic analysis of 76 studies spanning seven major cultural regions, the review reveals that rapport operates as a fundamental mediator of technological acceptance, manifesting through distinct cultural constructs: filial piety frameworks (xiao, hyo, amae) in East Asia; seva and Saṅgha in South Asia; karam in Arab/Muslim societies; Ubuntu in Sub-Saharan Africa; whānau and Two-Eyed Seeing in Indigenous contexts; familismo and personalismo in Latin America/Hispanic societies; and autonomy-based trust in Western societies. Cross-cultural analysis using Hofstede's framework reveals systematic patterns: high power distance cultures embed AT within hierarchical obligations, collectivist societies require technologies to support extended networks, and uncertainty avoidance influences openness to unfamiliar devices. The review demonstrates that AT implementation outcomes vary significantly based on cultural rapport conceptualizations, with technologies achieving higher adoption when aligned with existing relational frameworks rather than attempting to replace traditional care values. These findings challenge universal technology acceptance models and suggest the need for culturally specific implementation strategies that honor diverse rapport conceptualizations while addressing practical care needs in aging populations worldwide.
