Collective making: Co-designing 3D printed assistive technologies with occupational therapists, designers, and end-users.

In this study, we conducted four participatory workshops to facilitate co-designing 12 writing assistive technology (AT) interventions with occupational therapists, industrial designers, and an end-user with physical impairments. We observed participants' activities during the workshops and held a post-workshop follow-up reflection session where we invited the OTs and the end-user to share their experience about the co-design activities and co-created devices. The study findings revealed characteristics of the clinical-technical-individual co-design contributions that are conducive to the collective making of usable and useful AT prototypes.

The TechSAge Minimum Battery: A multidimensional and holistic assessment of individuals aging with long-term disabilities.

Background: People with disabilities acquired in early to mid-life are living longer, contributing to growing numbers of older adults who are aging with disability, an understudied population likely to be underserved.

Objectives: This paper demonstrates the usefulness of the TechSAge Minimum Battery as a holistic assessment of health for people aging with disabilities.

Methods: Survey data of socio-demographic and health characteristics were collected from 176 older adults with long-term vision, hearing, and/or mobility disabilities.

Closing the Capacity-Ability Gap: Using Technology to Support Aging With Disability.

There is a critical need to develop supports for older adults who have a wide range of abilities, including those aging with long-term impairments. Without appropriate support, many individuals will be functioning below optimal levels and will face participation barriers. Technology holds great promise to provide individualized support for a wide range of abilities and for a variety of domains.

Needs Assessment-mHealth Applications for People Aging with Multiple Sclerosis.

Multiple sclerosis (MS) is a complex inflammatory disorder of the central nervous system. It is characterized by a large number and variety of symptoms, with cognitive changes and mobility limitations being the most significant ones related to disability. A majority of individuals diagnosed with MS experience a major decline in their abilities due to the progression of MS after 5 years post-diagnosis.

Effects of bilateral swing-away grab bars on the biomechanics of stand-to-sit and sit-to-stand toilet transfers.

Purpose: Kinetic characteristics of transfers to and from a toilet performed using bilateral grab bars are not fully quantified to inform grab bar design and configuration. The purpose of this study was to (1) determine effects of bilateral swing-away grab bars on peaks of ankle, knee and hip joint moments during grab bar assisted stand-to-sit and sit-to-stand transfers; and (2) determine effects of three different heights and widths of swing-away grab bars on the same kinetic characteristics.

Methods: Healthy subjects (N = 11, age 25-58 years) performed stand-to-sit and sit-to-stand transfers with and without grab bars.

How a diverse research ecosystem has generated new rehabilitation technologies: Review of NIDILRR's Rehabilitation Engineering Research Centers.

Over 50 million United States citizens (1 in 6 people in the US) have a developmental, acquired, or degenerative disability. The average US citizen can expect to live 20% of his or her life with a disability. Rehabilitation technologies play a major role in improving the quality of life for people with a disability, yet widespread and highly challenging needs remain.

Beyond ADA Accessibility Requirements: Meeting Seniors' Needs for Toilet Transfers.

Purpose: To identify the optimal spatial and dimensional requirements of grab bars that support independent and assisted transfers by older adults and their care providers.

Background: Although research has demonstrated that toilet grab bars based on the Americans with Disabilities Act (ADA) Accessibility Standards do not meet the needs of older adults, the specific dimensional requirements for alternative configurations are unknown.

Methods: A two-phased study with older adults and care providers in residential facilities was conducted to determine the optimal requirements for grab bars.

Development and validation of a remote home safety protocol.

Aim: Environmental assessments and subsequent modifications conducted by healthcare professionals can enhance home safety and promote independent living. However, travel time, expense and the availability of qualified professionals can limit the broad application of this intervention. Remote technology has the potential to increase access to home safety evaluations.

A randomized controlled trial on Stroke telerehabilitation: The effects on falls self-efficacy and satisfaction with care.

We determined the effect of a multifaceted stroke telerehabilitation (STeleR) intervention on falls-related self-efficacy and satisfaction with care. We conducted a prospective, randomized, multisite, single-blinded trial in 52 veterans from three Veterans Affairs Medical Centers. Participants who experienced a stroke in the past 24 months were randomized to the STeleR intervention or usual care.

Personalized technology to support older adults with and without cognitive impairment living at home.

Although persons with dementia (PWD) and their family caregivers need in-home support for common neuropsychiatric symptoms (NPS), few if any assistive technologies are available to help manage NPS. This implementation study tested the feasibility and adoption of a touch screen technology, the Companion, which delivers psychosocial, nondrug interventions to PWD in their home to address individual NPS and needs. Interventions were personalized and delivered in home for a minimum of 3 weeks.

A model of job activity description for workplace accommodation assessment.

Workplace accommodations to enable employees with disabilities to perform essential job tasks are an important strategy ways for increasing the presence of people with disabilities in the labor market. However, assessments, which are crucial to identifying necessary accommodations, are typically conducted using a variety of methods that lack consistent procedures and comprehensiveness of information. This can lead to the rediscovery of the same solutions over and over, inability to replicate assessments and a failure to effectively meet all of an individual's accommodation needs.

An investigation of noncompliant toilet room designs for assisted toileting.

Objective: By comparing an Americans with Disabilities Act Accessibility Guidelines (ADAAG) compliant design with alternative designs, this pilot study resulted in recommendations for designing patient bathrooms to facilitate assisted toileting.

Background: The ADA Accessibility Guidelines were developed primarily to address the needs of disabled populations, such as returning Vietnam veterans, with sufficient upper body strength to transfer independently directly from a wheelchair to the toilet. However, the majority of older persons with disabilities (90%) stand to transfer to the toilet, rather than laterally moving from the wheelchair to the toilet.

Development and evaluation of the environment and communication assessment toolkit with speech-language pathologists.

Communication dysfunction that results from dementia can be exacerbated by environmental barriers such as inadequate lighting, noisy conditions, poor or absent environmental cues, and visual clutter. Speech-language pathologists (SLPs) should address these environmental barriers as part of a comprehensive treatment plan for clients with dementia. The Environment and Communication Assessment Toolkit for Dementia Care (ECAT) was evaluated by SLPs to determine: (1) changes in awareness of environmental factors prior to and after training; (2) impact of the ECAT on practice as measured by changes in the number of environmental modifications recommended and made prior to and after training; (3) utility of the information as measured by the helpfulness, amount of new information, and usefulness of the ECAT; and (4) usability of the ECAT materials based on ease of use.

New technology-based functional assessment tools should avoid the weaknesses and proliferation of manual functional assessments.

Background: Formal functional assessment tools for use with older adults have been in widespread use since the 1960s. Instruments have been designed to assess a wide range of different aspects of a person's everyday life. This article seeks to document the evolution of the tools used in such a way as to inform the development of the field.

Effects of telerehabilitation on physical function and disability for stroke patients: a randomized, controlled trial.

Background And Purpose: To determine the effect of a multifaceted stroke telerehabilitation (STeleR) intervention on physical function, and secondarily on disability, in veterans poststroke.

Methods: We conducted a prospective, randomized, multisite, single-blinded trial in 52 veterans with stroke from 3 Veterans Affairs medical centers. Veterans with a stroke in the preceding 24 months were randomized to the STeleR intervention or usual care.

Home and Community Environmental Features, Activity Performance, and Community Participation among Older Adults with Functional Limitations.

This paper describes relationships among home and community environmental features, activity performance in the home, and community participation potential to support aging in place. A subset of data on older adults with functional limitations (N = 122), sixty three (63) with mobility and 59 with other limitations, were utilized in this study from a larger project's subject pool. Results showed significant and positive correlations between environmental barriers, activity dependence and difficulty at home, and less community participation in the mobility limitation group.

Study protocol: home-based telehealth stroke care: a randomized trial for veterans.

Background: Stroke is one of the most disabling and costly impairments of adulthood in the United States. Stroke patients clearly benefit from intensive inpatient care, but due to the high cost, there is considerable interest in implementing interventions to reduce hospital lengths of stay. Early discharge rehabilitation programs require coordinated, well-organized home-based rehabilitation, yet lack of sufficient information about the home setting impedes successful rehabilitation.

Implementing telerehabilitation research for stroke rehabilitation with community dwelling veterans: lessons learned.

Telerehabilitation (TR) is the use of telehealth technologies to provide distant support, rehabilitation services, and information exchange between people with disabilities and their clinical providers. This article discusses the barriers experienced when implementing a TR multi-site randomized controlled trial for stroke patients in their homes, and the lessons learned. The barriers are divided into two sections: those specific to TR and those pertinent to the conduct of tele-research.

A retrospective analysis of recommendations for workplace accommodations for persons with mobility and sensory limitations.

Many studies of workplace accommodations have primarily focused on a particular disability or functional limitation. The need exists for a broad-based study of the types and frequency of accommodations recommended for a variety of functional limitations, including multiple limitations. The researchers conducted a retrospective analysis of 266 persons who received vocational rehabilitation assessment to determine the frequency and types of recommended workplace accommodations.

Environmental barriers and supports to the health, function, and participation of people with developmental and intellectual disabilities: report from the State of the Science in Aging with Developmental Disabilities Conference.

Background: This article summarizes the proceedings of the Environmental Barriers and Supports to Health, Function and Participation Work Group that was part of the "State of the Science in Aging with Developmental Disabilities: Charting Lifespan Trajectories and Supportive Environments for Healthy Living" symposium. The aim was to provide a research and policy agenda targeting the assessment and evaluation of environmental factors influencing the health, function, and participation of people with developmental and intellectual disabilities (I/DD).

Methods: Key environmental areas addressed were (1) the built environment including homes and communities; (2) assistive and information technology design and use; (3) social environment factors and interventions; and (4) environmental access and participation policies, legislation, and system change implications.

Wheelchair use by veterans newly prescribed a manual wheelchair.

Objective: To describe the characteristics of the wheelchairs, the users, and their wheelchair use among persons newly prescribed a manual wheelchair.

Design: Cohort study.

Setting: Veterans Affairs teaching hospital.

Development of an evidence-based conceptual framework for workplace assessment.

One solution to the underutilization of workplace accommodations is to use teleconferencing technology to conduct remote assessments, effectively expanding the geographical area that experienced rehabilitation specialists can cover. However, such an effort requires a highly structured and comprehensive assessment protocol. This paper reports on the analysis of 53 existing assessments to develop a conceptual framework for assessment and the use of that framework to evaluate the applicability of 10 work-related assessment protocols for remote tele-assessment.

The effects of in-home rehabilitation on task self-efficacy in mobility-impaired adults: A randomized clinical trial.

Objectives: To examine the effect on mobility self-efficacy of a multifactorial, individualized, occupational/physical therapy (OT/PT) intervention delivered via teletechnology or in-home visits.

Design: Randomized, clinical trial.

Setting: One Department of Veterans Affairs and one private rehabilitation hospital.

Development of a teletechnology protocol for in-home rehabilitation.

Our ability to provide in-home rehabilitation is limited by distance and available personnel. We may be able to meet some rehabilitation needs with videoconferencing technology. This article describes the feasibility of teletechnology for delivering multifactorial, in-home rehabilitation interventions to community-dwelling adults recently prescribed a mobility aid.