Writing Good-Quality Assistive Technology Assessment Reports.

Objective: To provide recommendations for the successful implementation of Assistive Technology (AT) in cognitive rehabilitation by investigating the attitudes towards AT of professionals, individuals with acquired brain injury (ABI) and their caregivers in two exploratory studies.Method: A total of 147 professionals in cognitive rehabilitation filled out a web-based survey. Fifteen patients with ABI and 14 caregivers were interviewed.Results: Most professionals were willing to use AT in the future, although only 27% used AT currently in a treatment setting. Professionals with AT experience were more positive than those without about the potential of AT and their own ability to use it in their treatment programmes. Most patients and caregivers were positive about using AT in the future, still, only a minority currently used AT. Refusal to reimburse AT devices by health insurance companies appeared an important barrier for a more widespread use.Conclusions: Although enthusiasm about AT was evident in both studies, a lack of progress in the implementation of AT was noted. This could be improved by promoting knowledge and hands-on experience of professionals who work in rehabilitation centres. More evidence on the efficacy of AT is required to improve coverage of AT devices by insurance companies.

Purpose Assistive Technologies encompass a wide array of products, services, healthcare standards, and the systems that support them. Product/market fit is necessary for a technology to be transferred successfully. Current tools lack variables that are key to technology transfer, and current trainings do not have a validated tool to assess the effectiveness of a training, increasing innovators’ readiness for technology transfer. The goal was to develop a tool to evaluate the readiness of a technology by incorporating other models and focusing beyond just commercialization. Materials and Methods The development involved five stages: 1. Review of current tools used in technology transfer in academic, government, and industry settings; 2. Development of the draft version of the tool with internal review; 3. Alpha version review and refinement, 4. Content validation of the tool’s beta version; 5. Assessment of the readiness tool for reliability and preparedness for wide-use dissemination. Results The tool was revised and validated to 6 subscales and 25 items. The assistive technology subscale was removed from the final version to eliminate repetitive questions and taking into consideration that the tool could be used across technologies. Conclusions We developed a flexible assessment tool that looked beyond just commercial success and considered the problem being solved, implications on or input from stakeholders, and sustainability of a technology. The resulting product, the Technology Translation Readiness Assessment Tool (TTRAT)TM, has the potential to be used to evaluate a broad range of technologies and assess the success of training programs. IMPLICATIONS FOR REHABILIATION Quality of life can be substantially impacted when an assistive technology does not meet the needs of an end-user. Thus, effective Assistive Technology Tech Transfer (ATTT) is needed. The use of the TTRAT may help to inform NIDILRR and other funding agencies that invest in rehabilitation technology development on the overall readiness of a technology, but also the impact of the funding on technology readiness. The TTRAT may help to educate novice rehabilitation technology innovators on appropriate considerations for not only technology readiness, but also general translation best practices like assembling a diverse team with appropriate skillsets, understanding of the market and its size, and sustainability strategies.

This paper reports the findings of a study that developed a standardized method to track individual assistive technology (AT) interventions for any user, able to generate reports needed in clinical practice, measure the outcome and detect possible critical issues requiring adjustment. Individual AT interventions were carried out with 120 participants, and the process was tracked by means of a purposely-developed template including five sections: (1) contact data, (2) Assessment Report, (3) Verification Report, (4) Follow-up Report, and (5) statistical data. The outcome of the interventions was measured for 34 participants by means of three instruments (KWAZO, IPPA and QUEST). KWAZO proved useful to capture the user’s perception about the quality of the process. IPPA proved useful to describe the perceived effectiveness of the assistive solution provided; negative IPPA scores are clear alerts that the user needs to be contacted again to check what happened and - if possible - undertake corrective interventions; near-to-zero (<1) IPPA scores also suggest to check whether the assistive solution has proved ineffective or brought about positive effects in relation to some problems and negative effects in relation to others. Likewise, possible low QUEST scores (<3) alert that the related products had critical problems and corrective actions may be required, in order to increase the assistive solution effectiveness.

Purpose In the context of rehabilitation, research shows a close connection between patients’ physical activity, care culture, and the built environment. As these three impact on patients’ rehabilitation process, we aim to understand what affects physical activity in a particular rehabilitation centre. Materials and methods We combine insights from literature with a qualitative study informed by quantitative data. Semi-structured and walking interviews with 16 patients were informed by output from activity trackers. Two focus-group interviews with respectively four nurses and two therapists provided extra perspectives. Results We found that patients interpret physical activity rather narrowly, equating it with therapy. Yet, the data of the activity trackers show that daily activities are often as active as therapy, as confirmed by nurses and therapists. Motivation to be physically active was found in setting clear goals, social interaction, allowing choice and control to achieve a sense of normality, and the built environment. How patients act in and interact with the built environment are closely related to how staff approaches and communicates care. Conclusions The focus on what affects – defines, hampers, or supports – physical activity in a rehabilitation centre allowed developing a better understanding of how care culture and the built environment interrelate. Implications for rehabilitation How physical activity is perceived by patients reflects the goals they like to achieve through rehabilitation. The built environment is a third factor in the relation between care culture and patients’ physical activity. Fully supporting patients to be physically active with respect to their personality and capabilities requires differentiating between patients both in how they are approached (patient- or person-centred) and in how they are spatially facilitated.

Designed to Deter: Community Barriers to Physical Activity for People with Visual or Motor Impairments

Background Assistive Technology (AT) helps individuals with multiple sclerosis (MS) to overcome limitations and enhance their social engagement by providing support in areas that would otherwise be difficult or unachievable. Objective The aim of this study is to determine the level of AT usage among individuals with MS and to address various questions related to the sociological implications of (non)use of AT devices, (un)awareness, and logistical barriers that prevent the full utilization of AT devices in the daily activities. Method 121 participants with previously diagnosed MS (26 AT users, 95 non-users), aged 18–65, were surveyed using a modified The Rapid Assistive Technology Assessment tool (rATA) covering: demographics, needs, supply, financing, satisfaction, and recommendations. Results Totally 21.5% of MS individuals used AT, dominantly mobility devices. Insecurity prevents desirable usage of AT devices. Affordability is a factor relevant for the device ownership. Both MS individuals and society lacked sufficient AT informedness. Conclusion Based on the results and current guidelines, it’s essential to improve policies, supplying, AT device enhancements, and education to fully utilize AT’s potential in people with MS.

AIthough much is known about how people make the decisions in the abstract, as well as in specific fields such as medicine, this knowledge has not yet been applied to the assistive technology (AT) assessment process. This article is an attempt to identify lessons that therapists can apply to their own practice based on what is known about how people make decisions. This article also identifies strategies that clinicians can use to help clients, caregivers, and third-party payers make better decisions. Finally, this article suggests how technology might further improve the decision making process. It should be noted that we are directly familiar with the assessment process for computer access, augmentative communication, electronic aids to daily living, and wheeled mobility, but the same principles of decision science are likely to apply to other disciplines within AT in which a clinician (or team of clinicians) works with a client, the client's caregivers, durable medical equipment (DME) vendors, and third-party payers to identify the most appropriate AT for the client (e.g., orthotics and prosthetics).

While assistive technology is often suggested as a way to increase, maintain, or improve functional ability for individuals with disabilities within physical activity (PA) settings, cost and availability of such items are often noted as barriers. In recent years, 3D printing has become available to the general public through the adoption of 3D printers in schools, libraries, and universities. Through individual design and rapid prototyping, 3D printing can support physical educators in accommodating student need for assistive technology through a multitude of modification possibilities. This article will highlight the capacity for 3D printed assistive technology within educational settings, and will illustrate how teachers, APE specialists, and other related service personnel can utilize this technology to support student success in PE and PA settings. This article will also assist practitioners with locating, uploading, and utilizing existing collections of 3D assistive technology models from open-source websites, such as Thingiverse.

which unique insights can be gained from the investigations of the physiology of the growing child? Are there pragmatic outcomes to research in children's exercise science that bear specific utility to this age group or to their future life? What importance do exercise responses in youth bear to our

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

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

Background: Prosthesis and orthosis are assistive devices used for different forms of cases. Lower limb prostheses and orthoses are very crucial to improve patient’s ability to walking, increased level of activity and participation to enhance their quality of life. However, there is limited knowledge of workplace variables that either satisfy or dissatisfy the prosthesis and orthosis users in the regional state, Ethiopia. Therefore, this study aimed to assess the satisfaction and associated factors among lower limb prosthesis and orthosis users in Amhara National Regional State Rehabilitation Center, Ethiopia. Methods: Institution based cross-sectional study was conducted from April 01 to May 30, 2019, at Amhara National Regional State Rehabilitation Center among lower limb prosthesis and orthosis users. Data were collected using a structured interviewer-administered questionnaire by the standardized assessment tool; Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST 2.0). The study included a total of 207 participants. Binary logistic regression analysis was performed. In the multivariable logistic regression analysis, p value < 0.05 and adjusted odds ratio (AOR) with 95% confidence interval (CI) were used to identify the associated factors. Results: The study revealed that 56.5% (95% CI: 49.9-63.3) of lower limb prosthesis and orthosis users were satisfied. Experiencing pain (AOR: 5.56, 95%CI: 2.68-11.52), living in the rural area (AOR: 3.52, 95%CI: 1.51-8.21), use of prosthesis and orthosis devices on an average less than 9 hours (AOR=0.30, 95% CI 0.11-0.80) and 9-12 hours in a day (AOR: 0.16, 95% CI: 0.07-0.38) were factors significantly associated with satisfaction. Conclusion: The magnitude of lower limb prosthesis and orthosis users’ satisfaction was found to be relatively low. Therefore, healthcare providers and managers of the rehabilitation center need to emphasize on status of the client’s device throughout patient care in the management of clients’ pain and use of devices on an average hour per day.

Findings of the 2005 AAOMS Research Summit

The Council on Health Care Technology of the Institute of Medicine, National Academy of Sciences, has published the Medical Technology Assessment Directory. The 712 page directory is an extensive compilation and description of activities in the field.The publication is designed to help crystallize the subject matter of medical technology assessment and to identify and serve the emerging network of individuals, organizations, and institutions that generate and use technology assessments. The directory provides access to assessment people, programs, and resources to keep users up to date on developments in the field. It should be useful for reviewing available assessments of a particular technology before beginning an assessment project or making a decision on coverage, reimbursement, acquisition, medical practice, or standard setting.The directory includes profiles of 68 assessment programs and a total of approximately 3,200 bibliographic citations of their assessment reports. These programs are located in public and private sector organizations, including professional, scientific, and industry associations, biomedical research institutions, educational institutions, government advisory bodies, regulatory agencies, third party payers, policy institutes, and for-profit corporations.

To determine the concordance between patients with multiple sclerosis and their clinical team members on the identification of goals for an inpatient rehabilitation stay. Prospective cohort study of patients admitted for rehabilitation in an adult inpatient neurospinal unit at a Rehabilitation Centre in Ottawa, Canada. Twenty-seven patients (11 men and 16 women, mean age of 45.3 yrs) with either a laboratory or a clinically supported diagnosis of multiple sclerosis. Patients rated 55 goals from a preexisting list, indicating the importance of each goal to be addressed during the inpatient stay. The goals fell into five broad domains of health/medical issues, daily activities, mobility, community life, and personal well-being. Patients also identified their five most important individual goals. In a separate session, the clinical team also rated the 55 goals in relation to each patient and identified an independent list of the five most important rehabilitation goals. Main outcome measures included concordance between patient and team ratings in the identification of goals, ratings of the likelihood of success of achieving each goal, and ratings of the amount of change required to realize a minimal clinically important difference. The patients and the team agreed on an average of 1.7 of the patient's five top-rated goals. Compared with the team, patients gave higher importance ratings to goals within the health/medical, mobility, and daily activities domains. They also considered that a greater average improvement would be required to achieve a meaningful benefit, and they gave higher ratings of the likelihood of success in achieving their selected goals. Patients with multiple sclerosis and clinical team members do not necessarily agree on specific goals for a rehabilitation stay. Patients may also have greater expectations than clinicians with respect to the amount of improvement and the likelihood of achieving their goals.