The increasing use of motorised mobility scooters (MMSs) has raised significant safety concerns, particularly related to user behaviour during operation. Although various advanced driving assistance systems have been incorporated into MMSs to identify potential environmental hazards, few studies have investigated the impact of user behaviour in MMS driving. This study was the first to incorporate automated behaviour monitoring into the evaluation of MMS driving using an add-on driving behaviour monitoring system (ADBMS). The ADBMS was a platform for contactless measurement that used a pre-trained convolutional neural network to estimate posture and two inertial measurement units to record steering and throttle operations. Experiments were conducted to demonstrate the usability of the ADBMS and evaluate the coordination of head movements and steering manoeuvres when driving an MMS in the outdoor environment. Cross-correlation analysis revealed that head movement consistently preceded steering operation during the driving tasks, indicating the potential of the proposed system to quantify user behaviour related to attention toward the surrounding environment. The lag time between these two parameters may serve as a novel index of driving safety. These findings could support a comprehensive understanding of users' driving behaviours and provide valuable insights into developing behavioural interventions to promote safer MMS use.

PURPOSE:This study evaluated the ability of older caregivers (aged ≥75 years) to operate a manual wheelchair across environmental barriers and examined associations with physical function. METHODS:Fifty-six women participated, including 36 older adults (aged ≥75 years) and 20 younger adults. Physical function was assessed using grip strength, mobility, balance, and locomotive syndrome (LS) stage. Wheelchair-operating ability was evaluated across level and uneven terrains-specifically through slope ascent, side-slope navigation, front-caster lifting, and wheel-recovery tasks-while participants pushed a manual wheelchair loaded with a 60-kg dummy. RESULTS:Compared with younger adults, older adults showed poorer physical function and wheelchair-operating performance across most tasks. Notably, 22.2% of older adults could not lift the front casters over a 10-cm step. Among older adults, a higher LS stage independently correlated with poorer wheelchair-operating performance during normal-speed slope ascent (β = 0.474, p = 0.002), fast slope ascent (β = 0.317, p = 0.030), and fast side-slope navigation (β = 0.579, p < 0.001). Furthermore, weaker left-hand grip strength was associated with poorer slope-ascent performance at both normal (β = -0.357, p = 0.014, adjusted R2 = 0.48) and fast speed (β = -0.413, p = 0.004, adjusted R2 = 0.53). Conversely, no physical function variables significantly predicted performance during the front-caster lifting or wheel-recovery tasks. CONCLUSION:Age-related declines in mobility and upper-limb strength may compromise wheelchair-operating safety. Targeted training, instruction, assistive technologies, and ergonomic wheelchair designs may improve safety and mobility. Barrier-free environments also remain essential for supporting community participation in ageing societies.

PURPOSE:This study aimed to clarify research and development trends in assistive technologies (ATs) designed to maintain and improve physical function during the community-living phase, using a scoping review approach. MATERIALS AND METHODS:A comprehensive search of Web of Science, PubMed, and IEEE Xplore was conducted for studies published between 2010 and 15 March 2024. A total of 1,112 records were retrieved, of which 63 studies met the inclusion criteria, focusing on ATs in community-living contexts. These studies were classified into investigations of support needs and challenges, and studies evaluating or implementing technological components. RESULTS:The majority of studies targeted individuals with physical disabilities, older adults, or those experiencing frailty. Stroke was the most frequently studied condition, followed by Parkinson's disease and spinal cord injury. Needs assessments revealed unmet requirements for mobility-related AT, home adaptations, and information technology (IT) services. The technologies that have reached the implementation stage primarily include telerehabilitation and mobile applications. ATs for walking and fall-risk assessment have advanced to implementation, whereas upper-limb functional training devices remain in the verification stage. CONCLUSIONS:This review identifies priority areas for advancing AT research and development, particularly for maintaining and improving physical functions during community living.

This study aimed to elucidate the effect of introducing an information support robot on utterance frequency and confirm the change in utterance frequency after long-term use. We presented an information support robot installed with individualized content to three older adults with cognitive impairment who live alone at home or in an assisted living residence (mean age 83.7±SD 5.4 years). Changes in the participants' utterance frequency over six months following the intervention of long-term robot use in actual living spaces were quantitatively recorded and analyzed. Two participants' total utterance frequency maintained or improved. With robot intervention, the utterance frequency to the robot was maintained for six months. When the usability and satisfaction with the robot were high, the utterance frequency increased. These results suggest that users need to be provided with personalized information that is appropriate for their individual needs to use robots effectively over the long term. Information support robots have the potential for long-term use without inflicting boredom and may encourage more frequent interactions. Long-term use of such information support robots may help older adults to continue living autonomously and independently for longer. These findings may contribute to future efforts in supporting autonomous living.

PURPOSE:To clarify the issues in providing assistive products for cognitive function (APCs) to older adults with dementia or cognitive impairment based on healthcare professionals' perceptions in Japan. METHODS:Fifteen healthcare professionals providing assistive products to older adults with dementia participated in semi-structured online interviews (mean age 44.6 ± 6.5 years, 11 women, 4 men). Data were analyzed using qualitative thematic analysis. RESULTS:The following four categories were identified as issues in the introduction, assessment, and use of assistive products for cognitive impairment: (1) lack of acceptance of assistive products by older adults with dementia and their ability to operate these products; (2) lack of cognitive assistive products available to older adults; (3) gaps in awareness of APC between professionals and caregivers; and (4) insufficient follow-up systems. Opinions were also extracted to create an environment in which it was easier for older adults with dementia to use electronic devices and information and communication technology (ICT). CONCLUSIONS:To effectively utilize the assistive products needed by older adults with dementia or cognitive impairment, caregivers' understanding of assistive products and the continued involvement of professionals are essential so that the functions of assistive products match the characteristics of the users. To facilitate these efforts, it is necessary to establish a framework for providing assistive products for dementia-related cognitive function.

An asymmetric windswept posture is often seen in children with severe cerebral palsy (CP). However, it is still unclear how long children with CP remain in the windswept posture in daily life. Thus, we developed a triple-accelerometer system for detecting windswept posture. The aim of this study was to assess the validity of a system for classifying various body postures and movements. We assessed the accuracy of our system in nine healthy young adults (age range, 21-23 years). The participants wore acceleration monitors on the sternum and both thighs, then spent 3 min each in eight different positions and three physical activities. Once accuracy was confirmed, we assessed the posture and movements for 24 h in six healthy young adults (age range, 21-23 years) in their home environments. The body postures and activities were correctly detected: the agreement across the subjects were 100% compatible with the subjects' activity logs at least 68% of the time, and at least 96% of the time for recumbent positions. We concluded that the proposed monitoring system is a reliable and valid approach for assessing windswept hip posture in a free-living setting.

BACKGROUND:The purpose of this study was to reveal inter- and intra-rater reliability of the detailed evaluation of cognitive function by assistive robot for older adults. METHODS:We investigated the inter-rater and test-retest reliability. Neurobehavioral Cognitive Status Examination was conducted twice for each participant using an assistive robot and the examiner respectively (Experiment 1). The order of these two tests was randomly selected and the interval between them was 1 week. In Experiment 2, we investigated the test-retest reliability of the first robot test and this additional robot test was conducted approximately 6 weeks after Experiment 1. RESULTS:Fifty-one (13 men and 38 women, mean age: 80.5 ± 5.6 years) participants went through Experiment 1 and 29 of those (eight men and 21 women, mean age: 80.4 ± 4.8 years) completed Experiment 2. In Experiment 1, the interclass coefficient (ICC) in orientation was in the high range and its Cronbach's α was 0.919, rated as excellent internal consistency. On the other hand, other items did not show positive results. In Experiment 2, the ICCs in orientation, attention, and repetition were in the adequate range, while other items showed marginal or low range. CONCLUSIONS:Orientation was supposed to be utilised for figuring out initial symptoms of dementia. In the future, as robot functions become more high-tech, a partner robot might be able to measure the symptoms and severity of dementia.

There is a growing concern regarding the driving safety of Motorized Mobility Scooters (MMSs) for the elderly and mobility-impaired individuals. Although various research has made progress in sensor-based driving assistance systems to identify environmental hazards, few studies focus on investigating the impact of user behavior on MMS driving. In this paper, a driving status logging (DSL) system is developed to measure the user’s behavior while driving. A cross-correlation analysis is implemented to quantify the temporal relationship between the head movement and steering operation in the driving of MMSs. The preliminary results suggest that the head movement can be used as an appropriate index to predict the intended steering operation in the driving of MMSs. Moreover, the quantified head-steering lag time provides the possibility to identify the hazardous driving pattern of MMS users.Clinical Relevance— The investigation of user behavior has the potential to improve the safety of MMSs. In this study, the user behavior in the driving of MMSs was quantitatively measured using the developed DSL system. Consequently, the temporal relationship between head movement and steering operation was first quantified in MMS-related research. These outcomes provide valuable insights into developing behavioral interventions to address the user’s risky behavior patterns, thereby promoting the driving safety of MMSs.

PURPOSE:This study aimed to investigate the provision and need for assistive products for older adults with cognitive impairment among rehabilitation therapists, identify any unmet needs, and analyze current issues in providing such products. METHODS:We conducted a questionnaire survey with rehabilitation therapists involved in selecting and providing assistive products for cognitive function in older adults with cognitive impairments. Questionnaires comprising ten items about the experience and need for cognitive assistive products were sent to 300 facilities for older adults in Japan between January and February 2021. One hundred thirty-five responses were received. RESULTS:The mean age of the participants was 39.5 ± SD7.1. There were 70 females, 64 males, and one unanswered questionnaire. In total, 72 (53.3%) of the 135 therapists had introduced or provided assistive products to their patients. The most frequently provided products were for safety and security; some were provided to support memory and orientation. 86% of therapists did not use the insurance system to provide them. The survey showed that most participants with experience providing assistive products needed information on the available resources. CONCLUSIONS:Although the need for assistive products for cognition is increasing, they are not sufficiently supplied in caring for older adults with cognitive impairment. Their availability differed depending on the assistive product type. It is necessary to have an effective social insurance system and access to up-to-date information to provide appropriate assistive products.

Every research participant has their own personality characteristics. For example, older adults assisted by socially assistive robots (SAR) may have their own unique characteristics and may not be representative of the general population of older adults. In this research, we compared the average personality characteristics of participants in a workshop on robotics recruited directly through posting with those of older Japanese adults to examine participant selection bias and group representativeness for future study of SARs. After a one-week recruitment period, the workshop was attended by 20 older participants (nine males and 11 females) aged between 62 and 86 years. Extroversion among workshop participants was 4.38, 0.40 higher than the average for older adults in Japan. The workshop participants' openness was 4.55, 1.09 higher than the average for the Japanese elderly. Thus, the results indicate a slight selection bias in the personal characteristics of the participants depending on the recruitment method when compared to the Japan national average for older adults. In addition, only one of 20 participants was below the cutoff on the LSNS-6 score and considered to have a tendency toward social isolation. The development and introduction of socially assistive robots is often being considered to support people in social isolation in their daily lives; however, the results of this study showed that it is difficult to recruit people who tend to be socially isolated when gathering research participants by methods such as posting. Therefore, the effectiveness of the method of recruiting participants should be carefully verified in research regarding socially assistive robots.

PURPOSE:This study proposes a concept for emotion recognition systems for children with profound intellectual and multiple disabilities (PIMD) based on artificial intelligence (AI) using physiological and motion signals. METHODS:First, the heartbeat interval (R-R interval, RRI) of a child with PIMD was measured, and the correlation between the RRI and emotion was briefly tested in a preliminary experiment. Then, a concept based on AI for emotion recognition systems for children with PIMD was created using physiological and motion signals, and an emotion recognition system based on the proposed concept was developed using a random forest classifier taking as inputs the RRI, eye gaze, and other data acquired using low physical burden sensors. Subsequently, the developed emotion recognition system was evaluated, validating the proposed concept. Finally, we proposed a validated concept for emotion recognition systems. RESULTS:A correlation was found between the RRI and emotion. The emotion recognition system was created based on the proposed concept and tested. According to the results, the recognition rate of "negative" and "not negative" of 70.4% ± 6.1% (Mean ± S.D.) of the developed emotion recognition system was higher than 48.5% ± 5.0% of an unfamiliar person used as a control. CONCLUSION:The results indicate that the proposed concept for emotion recognition systems is useful for communicating with children with PIMD.

To realize a society in which older adults can live independently in their homes and familiar environments for as long as possible, their lives can be supported by providing appropriate technology. In this case, a new intervention for older people using socially assistive robots (SARs) is proposed; however, previous research has demonstrated that individual differences exist in the use and response to SAR interventions, and it has also been reported that SARs are not used by users in some cases. Therefore, in this study, we developed a self-disclosure function to promote continuous interaction with robots, using a Japanese corpus and self-disclosure items. In this study, we defined the specific requirements and functions of self-disclosure in SARs and developed ten non-arbitrary speech scripts from the field of social psychology using a Japanese corpus and self-disclosure items. To evaluate the effect of self-disclosure in SARs, an SAR was introduced to each household for 20 days, with the consent of seven community-dwelling older adults. Based on the recorded voice interaction data, we analyzed how the number, total time, and quality of verbal interactions changed with the SAR's self-disclosure. Furthermore, we conducted group interviews with the participants and received positive comments regarding the robot's self-disclosure. Some participants considered the specific personality of the SAR by accumulating its behavioral characteristics. As a consequence, these results indicate that the robot's self-disclosure feature is effective in significantly increasing the quantity and quality of verbal interactions with older adults.

支援機器は,国際生活機能分類(ICF)では環境因子に位置づけられ,生活機能の維持,向上に重要な役割を果たす.また,支援機器と,心身機能・身体構造および活動・参加との関係は機器の性格により異なるため,その点について,歩行支援機器を例として解説した.ICFの活用例として,心身機能・身体構造にて利用者の特徴を表し,活動・参加によって機器の利用場面を表すことで,支援機器のマッピングを行った事例を示した.このような対応表をもとに,支援機器の選定・導入に役立てるガイドの概要についても紹介した.急速に進展するデータ社会の流れの中で,さらなるICFの活用も広がる可能性もある.

Objective/background: Agitation is a common behaviour of Alzheimer's Disease (AD). Although healing robots have previously been used for alleviating agitation for people with dementia in hospitals and other healthcare facilities, its effects remain unclear whether an information-support robot capable of disseminating information with user needs may have similar effects when it is applied in community dwellings. This study was to investigate the effects of information-support robots for reducing agitation in older people with AD residing alone in community-dwellings. Methods One participant with AD who lived alone in a community-dwelling was recruited. Participant's frequencies, durations, and time courses of four patterns of agitation at home at baseline and during intervention were analysed. In this study, agitation was defined as: (a) restlessness going to the corridor (RLtoC), (b) restlessness going to the toilet (RLtoT), (c) restlessness going to the entrance (RLtoE), and (d) restlessness going to multiple places (RLtoMP). In the intervention phase, the information-support robot disseminated daily schedule or date information to the participant. Results RLtoC and RLtoMP were significantly reduced in frequency during the intervention. The durations of each episode of RLtoT and RLtoMP in the intervention were slightly reduced than those at the baseline. There were no differences in time courses of episodes of RLtoC and RLtoMP after the intervention. Conclusion This case study showed that information-support robot was useful to alleviate agitation of an older adult with AD living alone in a community-dwelling. Further study is warranted.

Aims The purposes of this study were to reveal the effectiveness of an electric calendar, showing the date and schedule automatically for older people, and to prove the characteristics of appropriate users. Material and Methods The participants were 27 older adults with or without dementia (9 men and 18 women, mean age: 81.56.9years, range: 72-94years). The study design was a cross-over randomized controlled trial, with 15 participants (55.6%) allocated to the first group to use the electric calendar, and 12 participants (44.4%) to the second intervention group. The outcome measures are daily behaviors and cognitive function assessed by the Mini-Mental State Examination and Neurobehavioral Cognitive Status Examination. Results Participants showed significant increase in total Mini-Mental State Examination score (p=0.020, a paired t-test) after intervention period, whereas there was no significant difference after no intervention. Daily activities related healthcare were improved. The participants with positive outcomes showed higher motivations, and around 18 points in Mini-Mental State Examination. Most healthy older adults mentioned that electric calendars were useful, but unnecessary. Conclusion and Significance Using the electric calendar was effective in improving global cognitive function and daily activities. The target users are older people, who (1) might have mild dementia, (2) have difficulties in daily activities, (3) can be supported by caregivers, and (4) have positive motivation to new technologies. IMPLICATIONS FOR REHABILITATION An electric calendar is effective on grovel cognitive function, and activities of daily living related to healthcare in older adults, as well as reality orientation therapy. The electric calendar can be useful for older people with mild dementia or mild cognitive impairment, having difficulties activities of daily living, supported by caregivers at regular intervals.

The purpose of this study was to reveal comprehensible instructions from an assistive robot for older adults, across cognitive levels and characteristics. Participants included 19 older adults with or without cognitive impairment. We administered cognitive tests assessing all major domains (e.g., memory and attention). Participants were required to listen to robot instructions carefully, and perform three activities of daily living (e.g., taking medicine) with three different types of instructions. In instruction pattern 1 (IP1), the robot informed seniors of the task in one sentence, while in instruction patterns 2 and 3 (IP2 and IP3), the steps of each activity were split into two and three sentences, respectively. Participants with lower cognitive level showed lower task performance with IP1, whereas almost all participants completed tasks with IP2 and IP3. Cognitive domains such as working memory significantly affected task performances. Participants with lower attention made mistakes in taking their medicine. The results imply that step-by-step instructions should be used for older people with lower levels of cognitive function, especially working memory, and repeated instructions may be required for lower attention. Types of instruction should be selected depending on cognitive characteristics.

Selection of assistive technology devices (ATDs), which are imperative for persons with disabilities to improve their quality of life, requires collaboration of users and multidisciplinary professionals. However, it is still unknown how to design and implement an adequate collaborative work flow and a professional team. Under Japanese governmental ATD provision system, based on the application by clients, ATDs are mainly selected through collaborative processes with the clients and health professionals in public organizations, rehabilitation counseling centers (RCCs). By employing qualitative study methods in this study, we investigated the ATD selection process in which health professionals in RCCs collaboratively assess clients with physical disabilities so as to support them in selecting the adequate ATDs. To identify the perspectives required for ATD selection completely, the assessment processes were recorded and analyzed with a pseudo setting in two RCCs. Content analysis of the conversations between the client and professionals revealed the characteristics of the information exchanged in the assessment processes. A total of 760 assessment items were identified, thus indicating a broad array of interest. Despite the richness of information collected for the assessment, half of the assessment items did not have corresponding items in the documents that were employed during the prescription process. Thematic analysis of the interviews that followed revealed the common values and collaborative processes in ATD selection, which were shared and elaborated among the staff in daily social interactions. To facilitate implementation of ATD provision in various areas with few resources, it may be effective to convert this tacit-to-tacit knowledge sharing into a more explicit sharing by promoting analyses of good practices.

Information support robots (ISRs) have the potential to assist older people living alone to have an independent life. However, the effects of ISRs on the daily activity, especially the sleep patterns, of older people have not been clarified; moreover, it is unclear whether the effects of ISRs depend on the levels of cognitive function. To investigate these effects, we introduced an ISR into the actual living environment and then quantified induced changes according to the levels of cognitive function. Older people who maintained their cognitive function demonstrated the following behavioral changes after using the ISR: faster wake-up times, reduced sleep duration, and increased amount of activity in the daytime (p < 0.05, r = 0.77; p < 0.05, r = 0.89, and p < 0.1, r = 0.70, respectively). The results suggest that the ISR is beneficial in supporting the independence of older people living alone since living alone is associated with disturbed sleep patterns and low physical activity. The impact of the ISR on daily activity was more remarkable in the subjects with high cognitive function than in those with low cognitive function. These findings suggest that cognitive function is useful information in the ISR adaptation process. The present study has more solid external validity than that of a controlled environment study since it was done in a personal residential space.

Purpose: This paper describes international actions to collaborate in the assistive technology (AT) arena and provides an update of programmes supporting AT globally. Methods: The World Health Organisation (WHO) identifies the severe global uneven distribution of resources, expertise and extensive unmet need for AT, as well the optimistic substantial capability for innovations and developments in appropriate and sustainable AT design, development and delivery. Systems thinking and market shaping are identified as means to address these challenges and leverage the ingenuity and expertise of AT stakeholders. Results: This paper is a 'call to action', showcasing emerging AT networks as exemplars of a distributed, but integrated mechanism for addressing AT needs globally, and describing the Global Alliance of Assistive Technology Organisations (GAATO) as a vehicle to facilitate this global networking. Conclusion: Partners in this Global Alliance aim to advance the field of assistive technology by promoting shared research, policy advocacy, educating people and organisations within and outside the field, teaching, training and knowledge transfer by pulling together broad-based membership organisations.Implications for RehabilitationCollegial, cross discipline and multi-stakeholder collaborations support assistive technology research and practice.Knowledge exchange within and across countries and regions is mutually beneficial.Self-organising assistive technology communities are emerging and supported by global movements such as WHO GATE and GAATO.