21the Wheelchair Project Case Study: Leveraging Collaborative Efforts and Partnerships to Provide Assitive Devices for People Affected by Disability in Thailand and Southeast Asia

Many people affected by disability require assistive devices, particularly mobility aids, in order to live independently and fully integrate into their communities. Throughout the world, numerous methods have been implemented in facilitating the provision of these devices to people affected by disabilities. This case study intends use the Rajanagarindra Institute of Child Development Wheelchair Project, located in Chiang Mai, Thailand, to evaluate the viability and efficacy of mobility-provision programs which adapt wheelchairs and other assistive devices not originally intended for the end user. Programs which must “retro-adapt” equipment, like the Wheelchair Project, rely heavily on medical and mechanical expertise to identify the recipients’ needs and safely modify the device accordingly. By examining the distribution statistics from the Wheelchair Project over its 20 years of operation and the needs of the disability community reported by the National Statistics Office of Thailand alongside a cost-benefit analysis of the declared value provided versus operational cost, this case-study systematically details the scope and financial viability of this approach. While not without constraints, this model succeeds in effectively capitalizing on available resources (both in regard to physical equipment as well as professional expertise) to meet the needs of those affected by disabilities in Thailand and Southeast Asia. Although still limited in size and reach, the Wheelchair Project demonstrably shows its viability and the potential this approach presents given the right circumstances.

An Effectiveness and Cost-Estimation Model for Deploying Assistive Technology Solutions in Elderly Care

Background Deployment of modern assistive technologies is one of the major trends contained in the strategies of developed countries. However, the use of technology in households is not yet a common practice. The aim of this paper is present a model for assessment of selected smart device solutions in elderly care and the evaluation of overall care costs. The model provides the optimal set of devices for different target groups in terms of financial savings. Methods The model uses demographic projections taken from Eurostat for EU countries and the disability incidence from the annual report of the Ministry of Labour and Social Affairs of the Czech Republic as an input. The model was implemented in the software Stella Professional dedicated to system dynamics modelling including a web interface and is accessible online. Results In relation to the combination of five assistive devices for the elderly, the optimal solution, the cost savings are 37.8% or182 billion CZK), cumulatively in the simulated time period 2021-2060. Out of the five available assistive devices, up to three - UpWalker, Jaco robotic arm and Poseidon - were employed by the model for different target groups. Conclusion According to the performed analysis the assistive technologies proved a significant potential to maintain the quality of life of elderly and lessen the burden on public budgets. With respect to the ongoing demographic transition, the need to employ smart device solutions should further increase and their price could decline with increasing scale of production and overall advancement in technology.

Mesh Network of eHealth Intelligent Agents for Visually Impaired and Blind People

Smart assistive devices for blind and visually impaired (B&VI) people are of high interest today since wearable IoT hardware became available for a wide range of users. In the first project, the Raspberry Pi 3 B board measures a distance to the nearest obstacle via ultrasonic sensor HC-SR04 and recognizes human faces by Pi camera, OpenCV library, and Adam Geitgey module. Objects are found by Bluetooth devices of classes 1-3 and iBeacons. Intelligent eHealth agents cooperate with one another in a smart city mesh network via MQTT and BLE protocols. In the second project, B&VIs are supported to play golf. Golf flagsticks have sound marking devices with a buzzer, NodeMcu Lua ESP8266 ESP-12 WiFi board, and WiFi remote control. In the third project, an assistive device supports the orientation of B&VIs by measuring the distance to obstacles via Arduino Uno and HC-SR04. The distance is pronounced through headphones. In the fourth project, the soft-/hardware complex uses Raspberry Pi 3 B and Bytereal iBeacon fingerprinting to uniquely identify the B&VI location at industrial facilities.

Rehabilitation Interventions for Gait Problems in Patients With Diabetic Peripheral Neuropathy: A Scoping Review

Background and Objectives: Gait and balance disturbances are challenging conditions in patients with Diabetic Peripheral Neuropathy (DPN). The overall literary consensus is that rehabilitation interventions are effective in improving gait performance in this patient group. This review sought to highlight and assess the literature and provide a scoping review on the current knowledge gaps in the rehabilitation interventions for the gait problems of patients with DPN. Methods: An electronic databases search was done between 2001 and May 2020. Besides, a hand-search method was used for grey literature. Two experts reviewed the results and screened them based on the subject’s diagnosis with DPN and gait problems. Results: Of 87 studies obtained, nine met the inclusion criteria. The frequent components of the rehabilitation interventions included exercise therapy, dual-task intervention, and the use of assistive devices. The outcomes utilized most frequently included changes in balance and stability, muscle strength, proprioception, function, and gait parameters. Conclusion: Evidence was formed as a scoping review to guide rehabilitation for DPN patients with gait problems. Rigorous comparative studies with clearly defined interventions are needed.

Tailoring assistive smart glasses according to pathologies of visually impaired individuals: an exploratory investigation on social needs and difficulties experienced by visually impaired individuals

Recent advances in the field of assistive devices technology represent a great opportunity for improving the quality of life of people with moderate to severe visual impairment. However, it is still unclear what are the precise daily difficulties, needs and expectations of the smart glasses technology for visually impaired individuals. To this aim, we conducted a survey based on three questionnaires to provide qualitative and quantitative insights on those questions across five groups suffering from various visual pathologies ($$N=50$$ N = 50 ). The results clearly showed the importance of developing tailored solutions to fulfill the heterogeneous daily difficulties and needs identified across pathologies. Overall, groups shared similar expectations regarding the assistive smart glasses functionalities in order to improve social interactions.

Postural Asymmetries and Assistive Devices Used by Adults With Cerebral Palsy in Lying, Sitting, and Standing

Purpose: To describe the use of assistive devices and postural asymmetries in lying, sitting and standing positions in adults with cerebral palsy, and to analyze postural asymmetries and any associations with their ability to maintain or change position and time in these positions.Methods: A cross-sectional study based on data from the Swedish Cerebral Palsy follow-up program of 1,547 adults aged 16–76 years, at Gross Motor Function Classification System (GMFCS) levels I (n = 330), II (n = 323), III (n = 235), IV (n = 298), and V (n = 361). Assistive devices such as wheelchairs, seating systems, adjustable beds, standing equipment and time in each position were reported. The Posture and Postural Ability Scale was used to identify asymmetries and rate the ability to maintain or change position. Binary logistic regression models were used to estimate odds ratios (OR) for postural asymmetries in supine, sitting and standing.Results: Assistive devices were used by 63% in sitting (range 5–100% GMFCS levels I–V), 42% in lying (4–92% levels I-V), and 32% in standing (2–70% levels II–V). Wheelchairs were used as seating systems by 57%. Most adults had postural asymmetries in supine (75%; range 35–100% levels I–V), sitting (81%; 50–99% levels I–V) and standing (88%; 65–100% levels I–V). Men were more likely than women to have postural asymmetries, and the likelihood of postural asymmetries increased with age, GMFCS levels and inability to change position. Inability to maintain position increased the probability of postural asymmetries in all positions from OR 2.6 in standing to OR 8.2 in lying and OR 13.1 in sitting.Conclusions: Almost twice as many adults used assistive devices in sitting than in lying or standing. Two thirds of the adults who used standing devices used it for <1 h per day, indicating that they might spend the remaining 23 out of 24 h per day either sitting or lying. Asymmetric postures were frequent across all ages and were highly associated with inability to change or maintain position.