Assistive devices

辅助装置
  • 文章类型: Journal Article
    辅助技术(AT)为患有多发性硬化症(PwMS)的人提供从事日常活动的能力,然而,收购AT可能是具有挑战性的。了解有关PwMS对AT的观点和使用的当前知识状态可能会支持对AT获取过程的批判性思考。此范围审查的目的是绘制PwMS对AT使用的了解,确定知识差距,以指导未来AT匹配的研究和实践。PwMS对AT的观点和使用的定性研究的范围审查搜索了四个数据库(Medline,CINAHL,PsychNet,和工程村)。包括侧重于非机构环境的论文,解决参与者的感受/看法/经历,并且是英语。初始搜索2021年10月,更新2022年和2023年。两名审稿人进行了筛选,review,和提取,第三解决分歧。以加拿大职业绩效和敬业度模型为指导的数据提取,按生产力分类的AT使用,自我照顾,和/或休闲职业。Covidence®用于提取。调查结果被导出到电子表格中,以促进专题分析。搜索确定了22种同行评审的期刊和11种消费者出版物(n=33)。最常见的AT是移动设备。主要目的是自我保健和休闲。常见用途包括功能移动性,交通运输,个人护理,家庭管理,娱乐,和社会化。专注于AT需求的感知,调整到AT,影响因素,性能和参与度的改进,并寻求收购建议。缺乏对移动设备以外的AT的经验和使用的研究,并参与日常活动。证据为支持AT收购PwMS的未来方向和影响提供了一些见解。
    多发性硬化症患者使用一系列辅助技术,使他们能够从事休闲分类的日常生活活动,自我照顾,和生产力。人们的看法集中在他们对辅助技术的需求上,由于辅助技术而经历的调整或改变,具有影响因素的经验(资金,环境),寻求建议。目前缺乏有关多发性硬化症患者使用辅助技术的定性证据,特别是在诸如dictus带之类的设备上,凸起的厕所,步行杆,提醒系统和日历,grabber,可调节床,虚拟和语音激活助手,浴缸转移板,和家庭改造,供多发性硬化症患者使用。
    Assistive technology (AT) provides persons with Multiple Sclerosis (PwMS) ability to engage in daily activities, however acquiring AT can be challenging. Understanding current state of knowledge about perspectives and use of AT by PwMS may support critical thinking about AT acquisition process. The aim of this scoping review was to map what is known about AT use by PwMS, to identify gaps in knowledge to guide future research and practice for AT matching. A scoping review of qualitative research on perspectives and use of AT by PwMS searched four databases (Medline, CINAHL, PsychNet, and Engineering Village). Papers included focused on non-institutional settings, addressed participant\'s feelings/perceptions/experiences, and were in English. Initial search October 2021, updated 2022 and 2023. Two reviewers conducted screening, review, and extraction, with a third resolving disagreements. Data extraction guided by the Canadian Model of Occupational Performance and Engagement, categorised AT use by productivity, self-care, and/or leisure occupations. Covidence® was used for extraction. Findings were exported into a spreadsheet to facilitate thematic analysis. Search identified 22 peer-reviewed journals and 11 consumer publications (n = 33). Most common AT was mobility devices. Primary purposes were self-care and leisure. Common use included functional mobility, transportation, personal care, household management, recreation, and socialisation. Perceptions focused on AT need, adjusting to AT, influencing factors, performance and engagement improvements, and seeking acquisition advice. Lack of research on experiences and use of AT beyond mobility equipment, and for engagement of daily activities. Evidence provides some insights for future directions and implications to support AT acquisition for PwMS.
    Persons with Multiple Sclerosis use a range of assistive technologies to enable them to engage in daily life activities categorised by leisure, self-care, and productivity.Perceptions focused on their need for assistive technologies, adjusting or change experienced due to assistive technologies, experience with influential factors (funding, environment), and seeking advice.Lack of current qualitative evidence on assistive technology use by persons with Multiple Sclerosis, specifically on devices such as dictus band, raised toilet, walking poles, reminder systems and calendars, grabber, adjustable bed, virtual and voice activated assistants, tub transfer board, and home modifications for use by persons with Multiple Sclerosis.
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  • 文章类型: Journal Article
    外骨骼是可以帮助增加或改善机动性的技术,灵巧,和力量。它们可以用作辅助设备,为了恢复失去的负担,或康复。虽然机械外骨骼是被动的,并且依靠身体的力量进行运动,动力外骨骼是主动机械系统,可以帮助或增强用户的能力,包括强度和性能。他们还提供了扩大或增强超出简单医疗支持的范围,具有未来超人力量和力量的潜力。虽然这些技术提供了有希望的临床机会,包括那些想要恢复步行能力的人,他们也带来了道德问题,例如关于数据隐私和可访问性。此外,该技术的物理特征可以在精神上证明,物理上,经济上的要求,并且可以部署在用户选择和自主权受到限制的上下文中。在这篇文章中,我们讨论这些问题,并提出一些相关的伦理问题,并非所有这些都能轻易回答。我们涉及医疗和治疗用途,对于工业和工作场所设置,特别是在军事背景下,鉴于这些是可能需要甚至强加这种技术的背景。我们认为,对此类技术的合理乐观需要通过足够的道德评估来确定和解决研究障碍,发展,和使用。除了管理对用户健康和福祉的任何影响和期望,对自主权的潜在影响和胁迫的风险,我们必须考虑记录或使用什么样的数据,以及这些技术可能加剧现有不平等或危害的风险。
    Exoskeletons are technologies that can help to increase or improve mobility, dexterity, and strength. They can be used as assistive devices, to restore lost affordances, or for rehabilitation. While mechanical exoskeletons are passive and rely on the body\'s power for movement, powered exoskeletons are active mechanical systems that can assist or enhance a user\'s capacity, including in strength and performance. They also offer scope to augment or enhance beyond simple medical support, with potential in the future for superhuman power and strength. While these technologies present promising clinical opportunities, including for those who want to regain walking capacity, they also bring ethical questions, such as about data privacy and accessibility. In addition, the physical features of the technology can prove mentally, physically, and financially demanding, and may be deployed in contexts where user choice and autonomy is constrained. In this article, we discuss these issues, and raise some pertinent ethical questions, not all of which can be easily answered. We touch upon medical and therapeutic uses, for industrial and workplace settings, and in military contexts specially, given these are contexts where such technology may be required or even imposed. We argue that reasonable optimism for such technologies needs to be tempered by sufficient ethical assessment to identify and address barriers to research, development, and use. As well as managing any impacts and expectations for the health and wellbeing of users, the potential impact on autonomy and the risk of coercion, we have to consider what kind of data may be recorded or used, and the risk that these technologies could exacerbate existing inequalities or harms.
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  • 文章类型: Journal Article
    目的:癌症幸存者经常经历行动不便,对他们参与日常活动的能力产生负面影响。在癌症护理的连续性中与患者一起工作的医疗保健提供者在识别和解决行动不便方面发挥着至关重要的作用。本文的目的是介绍在管理癌症和癌症治疗相关的行动不便方面有价值的常见辅助设备。
    方法:同行评审的科学出版物和专家意见。
    结果:本文重点介绍了在各种癌症护理环境中常用的辅助设备,并描述了它们如何解决癌症幸存者面临的不同损伤。在培训临床工作人员时,所提供的信息可能会作为一种资源(例如,肿瘤学护理人员)在所有设置中提供设备。这些信息也有助于患者和护理人员了解与癌症和治疗相关的潜在功能障碍,以及有助于提高患者功能能力和减轻护理人员负担的辅助设备。
    结论:必须让不同的团队成员参与进来,以确定和选择最适合患者功能需求和身体能力的辅助设备,并对他们进行设备使用培训,以便他们能够安全地执行日常工作。
    结论:肿瘤科护士是最早发现癌症患者活动障碍的提供者之一。这篇文章将有助于增加他们对常见辅助设备的知识,这些辅助设备对于解决与癌症和治疗相关的各种行动不便有价值。通过额外的器械配置培训,肿瘤科护士将更有能力与康复合作,以识别潜在的行动不便,启动设备配置,并鼓励他们的病人使用治疗服务。最终,这可以减少与活动障碍有关的伤害,并改善患者的功能独立性和整体生活质量。
    OBJECTIVE: Cancer survivors often experience mobility impairments that negatively impact their ability to engage in everyday activities. Healthcare providers working with patients in the continuum of cancer care play essential roles in identifying and addressing mobility impairments. The objective of this article is to present common assistive devices valuable in managing cancer and cancer treatment-related mobility impairments.
    METHODS: Peer-reviewed scientific publications and expert opinions.
    RESULTS: This article highlights assistive devices commonly used in various settings of cancer care and describes how they address different impairments faced by cancer survivors. The information presented can potentially serve as a resource when training clinical staff (eg, oncology nursing staff) on device provision across all settings. The information can also be useful for patients and caregivers to learn about potential functional impairments linked to cancer and treatments and assistive devices that can be useful to improve patients\' functional capacity and reduce caregiver burden.
    CONCLUSIONS: It is essential to involve different team members to identify and select the most appropriate assistive devices that match the patient\'s functional needs and physical capacity and to train them in device use so they can safely carry out their daily routine.
    CONCLUSIONS: Oncology nurses are one of the first providers to identify mobility impairments in cancer patients. This article will help increase their knowledge in common assistive devices valuable for addressing various mobility impairments associated with cancer and treatments. With additional training on device provision, oncology nurses will be more empowered to collaborate with rehabilitation to identify potential mobility impairments, initiate device provision, and encourage their patients to work with therapy services. Ultimately this could reduce injuries linked to mobility impairments and improve the patient\'s functional independence and overall quality of life.
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  • 文章类型: Journal Article
    处于粗大运动功能分类系统(GMFCS)IV-V级的儿童无法保持对齐的站立姿势或在没有支撑的情况下采取步骤。直立定位和移动设备对这些孩子及其家庭具有心理社会意义,加强视觉的使用,通信,功能和情感幸福。支架和支持的踏步装置有助于生物力学加载的机会,可能有助于建立和维持肌肉和骨骼的完整性,它们促进身体发育。然而,家庭通常需要为年幼的孩子在这两种设备之间进行选择。本研究旨在通过两个当代理论框架的镜头来综合支持站立和步进设备的使用和益处的证据,以支持临床推理和实施。儿童发展的F字(功能,家庭,健身,有趣,朋友,未来)和相互依存-人类活动辅助技术(iHAAT)模型相结合,以说明儿童之间的复杂互动,家庭,看护者,与GMFCSIV级和V级儿童一起实施站立和踏步装置时的同伴和情境因素。支持的站立和踏步装置提供互补的好处,两者都可能需要在9-15个月开始。我们建议它们都包括在时间,以及其他适合年龄的定位和移动设备,促进非门诊脑瘫儿童更公平的发展机会。
    Children functioning at Gross Motor Function Classification System (GMFCS) levels IV-V cannot maintain an aligned standing position or take steps without support. Upright positioning and mobility devices have psycho-social significance for these children and their families, enhancing use of vision, communication, functioning and emotional well-being. Standers and supported stepping devices facilitate opportunities for biomechanical loading, potentially helping to build and maintain muscle and bone integrity, and they promote physical development. However, families are often required to choose between these two devices for their young child. This study aims to synthesize evidence for use and benefits of both supported standing and stepping devices through the lens of two contemporary theoretical frameworks to support clinical reasoning and implementation. The F-words for childhood development (functioning, family, fitness, fun, friends, future) and the interdependence-Human Activity Assistive Technology (iHAAT) models were combined to illustrate the complex interactions between the child, family, caregivers, peers and contextual factors when implementing standing and stepping devices with children at GMFCS levels IV and V. Supported standing and stepping devices provide complementary benefits, and both may be necessary starting at 9-15 months. We propose they both be included ON-Time, along with other age-appropriate positioning and mobility devices, to promote more equitable developmental opportunities for children with non-ambulant cerebral palsy.
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  • 文章类型: Journal Article
    神经系统疾病是一组异质性的中枢或外周神经疾病,其主要症状包括行走和平衡受损。神经系统疾病的主要干预措施之一是使用辅助设备,有必要考虑这些设备对用户的社会心理影响。在神经系统疾病患者中评估了波斯语版本的辅助设备心理社会影响量表(PIADS)的心理测量特性。根据IQULA将量表翻译成波斯语后,票面和内容效度进行了测定。通过与矫形器和假肢用户调查(OPUS)的关系来检查该量表的差异有效性。使用内部一致性和重测方法在两周内对50名患有神经系统疾病且使用辅助设备至少六个月的患者进行了评估,评估了该工具的可靠性。确认了PIADS的面形和内容有效性。所有分量表的ICC均高于0.78,这表明相关性良好。然而,该量表与OPUS量表的差异有效性未得到证实.波斯语版本的PIADS是伊朗神经系统疾病患者的有效且可靠的措施。
    Neurological disorders are a heterogeneous group of central or peripheral nervous disorders of which the main symptoms include impaired walking and balance. One of the main interventions for neurological disorders is the use of assistive devices, and it is necessary to consider the psychosocial effects of these devices on users. The psychometric properties of the Persian version of the Psychosocial Impact of Assistive Devices Scale (PIADS) were evaluated in patients with neurological disorders. After translating the scale into Persian based on IQULA, face and content validity were determined. The divergent validity of the scale was examined through its relationship with the Orthotics and Prosthetics Users\' Survey (OPUS). Reliability of the tool was evaluated using an internal consistency and test-retest method over two weeks with 50 patients with neurological disorders and a history of using assistive devices for at least six months. The face and content validity of the PIADS was confirmed. The ICC for all subscales was higher than 0.78, which indicates a good correlation. However, the divergent validity of the scale with the OPUS scale was not confirmed. The Persian version of PIADS is a valid and reliable measure for patients with neurological disorders in Iran.
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  • 文章类型: Editorial
    暂无摘要。
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  • 文章类型: Journal Article
    拐杖的使用是在下肢肌肉骨骼损伤恢复期间帮助人们的常见方法。根据患者的需要,有几种不同的拐杖行走方式。拐杖步态或拐杖步态模式的结构根据辅助和脚放置之间的延迟而变化,并发接触点的数量,和偏侧性。在康复过程中,规定的模式可能会根据受伤情况而有所不同,治疗和个人的状况。临床医生可以改善诊断,评估,培训,通过监测和分析步态模式进行治疗。这项研究旨在使用从仪器拐杖获得的空间和时间参数来评估和表征四种拐杖行走模式。为此,27名健康用户在多次试验中进行了四种不同的步态模式。每个试验都使用集成到拐杖中的便携式系统进行记录,测量力,position,和加速度。根据数据角度,开发了一种算法来将试验分成步态周期并确定步态阶段.下一步是确定描述每个步态模式的最合适的度量。使用了几个指标来分析收集的数据,包括武力,加速度,angle,和跨步时间。在27名参与者中,拐杖步态模式之间存在显着差异。通过使用这些空间和时间参数,在使用拐杖监测辅助步态方面获得了有希望的结果。此外,结果证明了使用器械拐杖作为临床工具的可能性.
    The use of crutches is a common method of assisting people during recovery from musculoskeletal injuries in the lower limbs. There are several different ways to walk with crutches depending on the patient\'s needs. The structure of crutch gaits or crutch gait patterns varies based on the delay between the aid and foot placement, the number of concurrent points of contact, and laterality. In a rehabilitation process, the prescribed pattern may differ according to the injury, the treatment and the individual\'s condition. Clinicians may improve diagnosis, assessment, training, and treatment by monitoring and analyzing gait patterns. This study aimed to assess and characterize four crutch walking patterns using spatial and temporal parameters obtained from the instrumented crutches. For this purpose, 27 healthy users performed four different gait patterns over multiple trials. Each trial was recorded using a portable system integrated into the crutches, which measured force, position, and acceleration. Based on the data angle, an algorithm was developed to segment the trials into gait cycles and identify gait phases. The next step was to determine the most appropriate metrics to describe each gait pattern. Several metrics were used to analyze the collected data, including force, acceleration, angle, and stride time. Among 27 participants, significant differences were found between crutch gait patterns. Through the use of these spatial and temporal parameters, promising results were obtained for monitoring assisted gait with crutches. Furthermore, the results demonstrated the possibility of using instrumented crutches as a clinical tool.
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  • 文章类型: Journal Article
    在公共场所使用这些设施时,硬壳马桶座可能会危害安全性,并阻碍有压力伤害(PI)风险的个人的参与,酒店,或家人/朋友洗手间。此外,人们经常添加“洗衣服”来增加额外的衬垫,以提高舒适度,并降低因轮椅表面上的压力或剪切而产生PI的风险。这项研究调查了便携式垫的使用情况,最初设计用于厕所,但适应各种地方和环境,同时检查垫的可用性。
    横截面描述性调查设计。
    住院护理,门诊护理,和社区设置。
    45个人面临PI风险。
    参与者将这些垫子的使用范围扩展到厕所之外,在其他环境中使用它们作为轮椅扶手和腿托垫。来自定制问卷的反馈表明归因于垫的高水平的有用性(8.5/10)和易用性(9.1/10)。在这些特征中,最受欢迎的三个是易用性,舒适/缓冲,和功能。参与者表示希望使用各种尺寸和颜色,以实现多种用途,并建议使用一个口袋来存放小物品。
    面临PI风险的个人不仅需要在硬壳马桶座圈上进行缓冲,但也为额外的填充,保护和加强轮椅的使用。康复专业人员可以在教育和培训客户和护理人员以了解PI预防方面发挥关键作用。使他们能够在适当的情况下有效地利用垫子,从而提高他们在社会参与过程中坐在轮椅上的舒适度。
    UNASSIGNED: Hard-shell toilet seats may compromise safety and hinder the participation of individuals at risk for pressure injuries (PIs) when using these facilities away from home in public, hotel, or family/friend restrooms. Moreover, people often add \"wash-cloths\" for additional padding for comfort, and to reduce the risk of PIs due to pressure or shearing on their wheelchairs surfaces. This study investigated the utilization of portable pads, initially designed for toilet use but adaptable to various places and contexts, while examining pad usability.
    UNASSIGNED: A cross-sectional descriptive survey design.
    UNASSIGNED: Inpatient care, outpatient care, and community setting.
    UNASSIGNED: 45 individuals at risk of PIs.
    UNASSIGNED: Participants extended the use of these pads beyond toilets, employing them as wheelchair armrest and leg rest pads in other settings. Feedback from a customized questionnaire indicated high levels of usefulness (8.5/10) and ease of use (9.1/10) attributed to the pads. Among the features, the top three favored were ease of use, comfort/cushioning, and function. Participants expressed a desire for a variety of sizes and colors to enable versatile usage and suggested incorporating a pocket for storing small items.
    UNASSIGNED: Individuals at risk of PIs require cushioning not only on hard-shell toilet seats, but also for additional padding, protection and enhancing the use of wheelchairs. Rehabilitation professionals can play a crucial role in educating and training both clients and caregivers to understand PI prevention, enabling them to effectively leverage the pads in appropriate situations, thereby enhancing their comfort in their wheelchairs during social engagement.
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  • 文章类型: Journal Article
    手功能在我们生活的各个方面都很重要。在广泛的神经肌肉疾病中,遗传性共济失调,运动神经元疾病,多发性神经病,和肌病——人们会经历手部力量的损失,tone,运动,灵巧,接头范围,和感觉。这种变化会对日常活动的功能和独立性产生不利影响,减少参与和生活质量。已知涉及手的神经肌肉疾病(pwNMD)患者应定期评估临床和使用损害的变化。性能,函数,和患者报告的结果测量(视情况而定)。建议采用以患者为中心的管理方法,临床医生与个人合作,他们的护理人员和跨专业团队创造个性化的解决方案,可以克服障碍,参与和最好地满足受神经肌肉疾病影响的个人的目标。管理策略应该是多方面的,可能包括锻炼,矫形器,辅助设备,技术解决方案,环境或任务适应,药物,和/或手术。运动建议和矫形器应个性化,并根据疾病进展而发展,损伤,和功能限制。虽然药物和手术对特定临床情况的作用很小,有大量的辅助和技术解决方案来协助日常生活的基本和工具活动,工作/教育,以及手部功能降低的pwNMD的休闲。此外,临床医生应倡导在工作/学校为减少手功能提供适当的便利,以及制定和遵守支持无障碍和包容的立法。
    Hand function is important in every aspect of our lives. Across a wide range of neuromuscular disorders-inherited ataxias, motor neuron diseases, polyneuropathies, and myopathies-people can experience losses in hand strength, tone, movement, dexterity, joint range, and sensation. Such changes can adversely affect function and independence in daily activities, reducing participation and quality of life. People with neuromuscular disorders (pwNMD) known to involve the hand should be assessed at regular intervals for changes both clinically and using impairment, performance, function, and patient-reported outcome measures as appropriate. A patient-centered approach to management is recommended, with clinicians partnering with the individual, their caregivers and the interprofessional teams to create personalized solutions that can overcome barriers to participation and best meet the goals of individuals affected by neuromuscular disorders. Management strategies should be multifaceted, and may include exercise, orthoses, assistive devices, technological solutions, environmental or task adaptations, medications, and/or surgery. Exercise recommendations and orthoses should be individualized and evolve based on disease progression, impairments, and functional limitations. While medications and surgery have a small role for specific clinical situations, there is a plethora of assistive and technological solutions to assist with basic and instrumental activities of daily living, work/education, and leisure for pwNMD with reduced hand function. In addition, clinicians should advocate for appropriate accommodations for reduced hand function at work/school, and the development of and adherence to legislation supporting accessibility and inclusion.
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  • 文章类型: Journal Article
    辅助接口实现了人与机器人之间的协作交互。与传统的刚性设备相比,具有可调机械性能的适形织物已成为引人注目的替代品。然而,现有的由流体或热刺激驱动的辅助织物难以适应复杂的身体轮廓,并且受到诸如驱动后的大体积和缓慢响应速率等挑战的阻碍。为了克服这些限制,我们从结合了硬相和软相的生物保护性生物中汲取灵感,并提出了主动辅助织物,该织物由与柔性致动纤维互连的建筑刚性瓷砖组成。通过将目标身体形状可编程地镶嵌到建筑瓷砖中,并通过致动纤维控制它们的相互作用,我们的活性织物可以快速(在几秒钟内)在柔软的顺应性配置和刚性状态之间转变,以适应身体(>350倍刚度变化,负载能力重量比>50),同时在致动后最小化装置体积。我们展示了我们的活性织物的多功能性,作为用于震颤抑制和提升辅助的机械护甲。我们还展示了其作为防弹衣缓解冲击的潜力。电热致动器被集成用于具有方便的折叠能力的智能致动。我们的工作为设计具有形状适应性和可控刚度的可定制活性织物提供了一个实用的框架,这些活性织物在可穿戴式运动服中具有广泛的应用,触觉设备,和医疗康复系统。本文受版权保护。保留所有权利。
    Assistive interfaces enable collaborative interactions between humans and robots. In contrast to traditional rigid devices, conformable fabrics with tunable mechanical properties have emerged as compelling alternatives. However, existing assistive fabrics actuated by fluidic or thermal stimuli struggle to adapt to complex body contours and are hindered by challenges such as large volumes after actuation and slow response rates. To overcome these limitations, inspiration is drawn from biological protective organisms combining hard and soft phases, and active assistive fabrics consisting of architectured rigid tiles interconnected with flexible actuated fibers are proposed. Through programmable tessellation of target body shapes into architectured tiles and controlling their interactions by the actuated fibers, the active fabrics can rapidly transition between soft compliant configurations and rigid states conformable to the body (>350 times stiffness change) while minimizing the device volume after actuation. The versatility of these active fabrics is demonstrated as exosuits for tremor suppression and lifting assistance, as body armors for impact mitigation, and integration with electrothermal actuators for smart actuation with convenient folding capabilities. This work offers a practical framework for designing customizable active fabrics with shape adaptivity and controllable stiffness, suitable for applications in wearable exosuits, haptic devices, and medical rehabilitation systems.
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