Designing Inclusion: Using 3D Printing to Maximize Adapted Physical Education Participation

Assistive technology is critical to maximize the functional skills of the person with a physical disability at home, work, and school. As assistive devices become increasingly complex and expensive and more options are available, the need for an assistive technology specialist is enhanced. Recent regulations and advances in technology are affecting the type, quality, and comprehensiveness of assistive technology service provision and need for assistive technology specialists. The occupational therapist's role as an assistive technology specialist is illustrated in an example of an assistive technology program within a special education setting.

Empirical research and data are necessary for policy, planning and provision of services for persons with disabilities. Research data may be available but still not used by researchers and policy makers. The aim of this study is to explore existing empirical research and sources of data on Assistive Technology (AT) in Malawi in order to facilitate the development of an AT policy and Assistive Product List (APL). A two-stage process using a scoping review methodology was adopted to identify (1) empirical research on AT in Malawi and (2) sources of existing data on AT in Malawi. Following a narrative synthesis, 12 heterogenous studies that reported on the use, availability, sources and knowledge about AT in Malawi were identified. Identified studies suggest that there is high unmet need for AT and services in Malawi. Five major sources of data on disability and AT were Identified. Only 2 out of the 12 studies had used existing sources of data. The high unmet need for AT and services in Malawi have substantial implications for persons with disabilities. Developing mechanisms that will improve the use of existing data on AT in all countries is pivotal for the efficient and effective development of AT ecosystems.

Assistive technology usage, unmet needs and barriers to access: a sub-population-based study in India.

Three-dimensional (3D) printing now allows rehabilitation professionals to design and manufacture assistive technologies in a few hours. However, there is limited guidance for researchers and clinicians for implementing 3D printing assistive technology interventions and measuring their outcomes. The goal of this study was to develop a standardized 3D printing assistive technology intervention and a research methodology, using pillboxes as an example. Fourteen pillbox users engaged in a study comparing their use of an off-the-shelf pillbox to a customized 3D printed pillbox. Study outcomes were evaluated on feasibility (recruitment capability, study procedures and outcome measures, acceptability of the study procedures, the research team’s ability to manage and implement the study, and the participant’s preliminary response to intervention). Participant outcomes were measured on satisfaction with the device and medication adherence. Fourteen participants completed the study and received customized 3D printed pillboxes. The study design performed well on all aspects of feasibility except the research team’s ability to manage and implement the study, as they experienced several technical issues. Notably, the participants reported improved device satisfaction and medication adherence with the 3D printed device with large effect sizes. The 3D printed assistive technology intervention is a replicable process that supports professionals in printing their own assistive technologies. Recommendations are made to further enhance feasibility of 3D printing assistive technology studies. Future research is warranted.IMPLICATIONS FOR REHABILITATION3D printing is an increasingly feasible approach allowing for the design and manufacture of customized assistive technologyEvaluation for assistive technology that will be 3D printed should include information about the person’s activities, routines, skills, abilities, and preferences. Evaluation of outcomes should include satisfaction with the device and a functional measure.3D printed assistive technology interventions should include the collaboration between the assistive technology professional and client. It should also include device training.Future 3D printing research studies should report pragmatic data including printing device, time to print, and number of errors.

Purpose. To determine whether service delivery system factors, including having a quality medical home, access to therapeutic services, or enrolment in early intervention/special education services, are associated with meeting children's needs for assistive technology (AT).Method. Data were analysed for children 0–17 years of age participating in the 2001 US National Survey of Children with Special Health Care Needs who required AT services (N = 18,372) and a subgroup of children needing assistive devices typically provided by rehabilitation professionals (N = 4429). AT needs included vision or hearing aids or care, communication or mobility devices, or other medical equipment. Unmet need was defined as not receiving all needed services. Estimates were generated of the per cent of children needing and having unmet needs for services. Associations between the medical home, therapy and education variables and having an unmet need for AT were assessed using logistic regression.Results. An estimated 49% of children with special health care needs require AT services. Twelve per cent require AT services typically provided by rehabilitation professionals. Of the latter group, 14% had unmet needs. The likelihood of having unmet AT needs was greater for children lacking a quality medical home (a.O.R. = 3.27 [95% C.I. = 2.29–4.66]) and/or those not receiving needed therapy services (a.O.R. = 3.52 [95% C.I. = 2.25–5.48]) than for children whose medical home and therapy service expectations were met. Enrolment in early intervention/special education was not associated with having unmet needs for AT.Conclusions. Promoting quality care within a complex service delivery system is critical to meeting the AT needs of children and their families. Changes in the structure and processes of care, including facilitating access to a quality medical home and needed therapy services would likely increase access to needed AT.

Background: Assistive technology (AT) can support autistic adults in navigating employment-related challenges. However, limited research has explored autistic adults’ actual needs and experiences with AT in the workplace. Existing studies often overlook how well current AT solutions align with the real-world demands autistic adults face across the employment process. To address this gap, this study conducted a needs assessment to explore autistic adults’ perceived AT and AT service needs across employment stages, identify satisfaction and discontinuation patterns, and examine barriers and facilitators to effective use. Methods: A total of 501 autistic adults were recruited through an online crowdsourcing platform, Prolific. Participants completed a needs assessment that included Likert-scale items and open-ended questions. Quantitative data were analyzed using descriptive statistics and weighted needs scoring procedures. Thematic analysis was applied to qualitative responses regarding satisfaction, discontinuation, and general reflections on AT use. Results: Job retention received the highest total weighted needs score, followed closely by skill development and job performance. Participants reported lower perceived needs for AT in the job development and placement domain. Qualitative findings revealed that AT was described as essential for daily functioning and independence, but barriers such as limited access, inadequate training, and social stigma affected use. Participants also emphasized the need for more person-centered and context-specific AT services. Conclusions: AT has the potential to significantly enhance employment outcomes for autistic adults. However, current services often lack personalization and alignment with real-world needs. Findings support the development of more inclusive, tailored, and accessible AT solutions across all employment stages.

Physical Education, Exercise, Fitness and Sports: Early PM&R Leaders Build a Strong Foundation

Functional limitations become more prevalent as populations age, emphasising an increasingly urgent need for assistive technology (AT). Critical to meeting this need trajectory is understanding AT access in older ages. Yet few publications examine this from a longitudinal perspective.This review aims to identify and collate what data exist globally, seeking all population-based cohorts and repeated cross-sectional surveys through the Maelstrom Research Catalogue (searched May 10, 2022) and the Disability Data Report (published 2022), respectively. Datasets incorporating functional limitations modules and question(s) dedicated to AT, with a wave of data collection since 2009, were included.Of 81 cohorts and 202 surveys identified, 47 and 62 meet inclusion criteria, respectively. Over 40% of cohorts were drawn from high-income countries which have already experienced significant population ageing. Cohorts often exclude participants based on pre-existing support needs. For surveys, Africa is the most represented region (40%). Globally, 73% of waves were conducted since 2016. ’Use’ is the most collected AT access indicator (69% of cohorts and 85% of surveys). Glasses (78%) and hearing aids (77%) are the most represented AT. While gaps in data coverage and representation are significant, collating existing datasets highlights current opportunities for analyses and methods for improving data collection across the sector.

Despite the large body of literature and advocacy for evidence-based behavior management practices when working with children, explicit steps and strategies for implementing such practices are less common. This may be a barrier for practitioners working with children with disabilities and unique behavioral needs within physical education and other physical activity settings. This article introduces response interruption and redirection within physical education and physical activity settings and provides practical steps and strategies for how teachers and other practitioners can redirect a variety of off-task behaviors.

Chapter 2 - 3D printing and nanotechnology

استفاده از فناوریهای نوین نمونه سازی در بازسازی بخش های مفقود سفالینه های باستان شناسی

PurposeSkin cancer is the most common tumor in the population. There are different therapeutic modalities. Brachytherapy is one of the techniques used, in which it is necessary to build customized moulds for some patients. Currently, these moulds are made by hand using rudimentary techniques. We present a new procedure based on 3D printing and the analysis of the clinical workflow.Material and methodsMoulds can be made either by hand or by automated 3D printing. For making moulds by hand, a patient’s alginate negative is created and, from that, the gypsum cast and customized moulds are made by hand from the patient’s negative template. The new process is based on 3D printing. The first step is to take a 3D scan of the surface of the patient and then, 3D modelling software is used to obtain an accurate anatomical reconstruction of the treatment area. We present the clinical workflow using 3D scanning and printing technology, comparing its costs with the usual custom handmade mould protocol.ResultsThe time spent for the new process is 6.25 hours, in contrast to the time spent for the conventional process, which is 9.5 hours. We found a 34% reduction in time required to create a mould for brachytherapy treatment. The labor cost of the conventional process is 211.5 vs. 152.5 hours, so the reduction is 59 hours. There is also a 49.5% reduction in the financial costs, mostly due to lack of need of a computed tomography (CT) scan of the gypsum and the mould. 3D scanning and printing offers financial benefits and reduces the clinical workload.ConclusionsAs the present project demonstrates, through the application of 3D printing technologies, the costs and time spent during the process in the clinical workload in brachytherapy treatment are reduced. Overall, 3D printing is a promising technique for brachytherapy that might be well received in the community.

3D Printing, sometimes referred to as additive manufacturing, has made the concept of personalized medicine a reality. The primary objective of 3D and 4D printing is to produce intricate, customized pharmaceuticals at a reasonable cost. With improvements in materials, resolution, and speed, 3D printing technology is quickly developing. It includes faster construction, cost efficiency through reduced waste, design flexibility for complex structures, and sustainability through optimized material usage. An extensive literature survey was done on 3D and 4D printing of pharmaceuticals using PubMed, Elsevier, ScienceDirect, and Springer. The results were then filtered based on the titles, abstracts, and accessibility of the complete texts. The search engine Google Scholar was accessed for literature data mining. From the data mining, it was found that from the year 2009 to 2024 the number of research publications surged more than 200 times on the current topic. Even though 3-D and 4-D printing technologies have advanced significantly in a short amount of time, the most often used ones are still stereolithography, nozzle-based deposition, inkjet, and selective laser sintering. Their use has been modified for the production of nanoparticles, polypills, tablets, and implants, etc. Pharma's aspirations for tailored medications are being revolutionized by 3D printing, but cost, flexibility, and bioequivalence still need to be investigated. The present review offers a thorough analysis of various 3D and 4D printing methods and emphasizes the major advantages and disadvantages and major key challenges of 3D and 4D printing related to pharmaceuticals. Compared to 3D Printing, 4D printing offers better quality, efficacy, and functionality.

Three-dimensional(3D) printing, a key technique of rapid prototyping (RP), is developing rapidly all over the world. As 3D printing has a significant advantage of personalized manufacturing, it has exerted a profound effect on medicine. The high demand for personalized manufacturing in the field of orthosis provides an excellent opportunity for widespread use of 3D printing technique. This review briefly introduces the principles and characteristics of different forming methods of 3D printing, the types and characteristics of 3D printing materials widely used at present, and classification and clinical application of orthoses. We also summarize the domestic and international research on and manufacture of orthoses using 3D printing techniques, and discuss current problems and future development of 3D printing techniques in orthosis. Key words: Orthopedic fixation devices; Rehabilitation; Review; 3D Printing; Additive manufacturing

The aim of this study is to explore the use and perceived unfilled need for assistive technology (AT) for everyday life in three age-groups during the ageing process. Data on use and perceived unfilled need for AT from three age-groups were used; the very old age-group; 81-90, n=314, the oldest old age-group; 85-94, n=154 and younger agegroup, 67-71. The results show that the proportion of users highly increased between the youngest age-group and the very old age-group. An increase of use was also seen between the very old and oldest old age-groups, however not so prominent. In most respects the perceived unfilled need followed the same pattern. The result of this study can contribute to increased effectiveness of the supply of AT.