Outcomes Measurement for Rehabilitation and Assistive Technology: International Perspectives

A special issue of Technologies (ISSN 2227-7080). This special issue belongs to the section "Assistive Technologies".

Deadline for manuscript submissions: closed (31 January 2017) | Viewed by 46093

Special Issue Editor

Interdisciplinary School of Health Sciences, University of Ottawa, 25 University Private, Ottawa, ON K1N 6N5, Canada
Interests: physical rehabilitation; understanding the factors that affect the adoption and use of assistive technologies; measuring the functional and quality-of-life outcomes of assistive technologies for persons who have a disability
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The functional and psychosocial impacts of rehabilitation and assistive technologies are critical factors for their adoption and successful use by persons who have disabilities. There has been significant international research on measuring these factors, using a variety of approaches and tools. This Special Issue is intended to report the progress that has been made in advancing the widest international application of outcome measurements in this field, and the important gaps in knowledge that still remain. Articles in this Special Issue will address topics that include: the value of outcome measurement; description of frameworks, tools, and systems for measurement; and identification of unmet needs for measurement for underserved populations of technology users

Prof. Dr. Jeffrey W. Jutai
Guest Editor

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Keywords

  • assistive device
  • functional outcome
  • psychosocial outcome
  • outcome measure

Published Papers (7 papers)

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Research

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237 KiB  
Article
Measurement of Assistive Technology Outcomes Associated with Computer-Based Writing Interventions for Children and Youth with Disabilities
by Stephen E. Ryan and Mary-Beth Sophianopoulos
Technologies 2017, 5(2), 19; https://doi.org/10.3390/technologies5020019 - 22 Apr 2017
Cited by 3 | Viewed by 5693
Abstract
Young people who have chronic disabilities use computer technologies and receive rehabilitation services to overcome functional limitations associated with writing activities. However, the functional impact of these specialized assistive technologies on the everyday lives of children is not clearly understood; in part due [...] Read more.
Young people who have chronic disabilities use computer technologies and receive rehabilitation services to overcome functional limitations associated with writing activities. However, the functional impact of these specialized assistive technologies on the everyday lives of children is not clearly understood; in part due to the lack of targeted outcome measures. This article describes the development and evaluation of the Family Impact of Assistive Technology Scale for Writing Interventions (FIATS-WI). The FIATS-WI is a multi-dimensional, parent-report questionnaire designed to measure child functioning and outcomes associated with computer-based writing interventions for children and youth aged 5–18 years. Participants included parents of children with writing-related disabilities who completed the questionnaire at home during one of two study phases. In the first phase, 121 eligible parents, out of 364 invited, completed a single administration of the questionnaire. In the second phase, 28 out of 33 eligible parents completed the FIATS-WI twice to assess its stability. Item and subscale correlations informed an item reduction plan, and Cronbach’s alpha and intraclass correlation coefficients provided acceptable estimates for internal consistency and test–retest reliability, respectively. Correlations between FIATS-WI scores and scores from a standardized home participation measure tested its convergent validity. The study provides emerging evidence for the FIATS-WI as a sound measure of computer-based writing technology outcomes for children and youth with disabilities. Full article
452 KiB  
Article
Capturing the True Value of Assistive Technologies to Consumers in Routine Outcome Measurement
by Desleigh De Jonge and Wendy Stevens
Technologies 2016, 4(4), 35; https://doi.org/10.3390/technologies4040035 - 14 Oct 2016
Cited by 2 | Viewed by 4610
Abstract
(1) Background: Recent reforms in Australia, providing people with disability and older people with choice and control over allocated funding, have altered consumer expectations and transformed the landscape of assistive technology (AT) service provision. The purpose of this study is to report on [...] Read more.
(1) Background: Recent reforms in Australia, providing people with disability and older people with choice and control over allocated funding, have altered consumer expectations and transformed the landscape of assistive technology (AT) service provision. The purpose of this study is to report on the routine AT outcomes of people who accessed an AT consultation service and examine how well these capture the impact of AT on their lives; (2) Methods: This study, which uses mixed methods for concurrent triangulation of the data, reports on the outcomes for 127 people who acquired a range of assistive technology in 2015 and examines the adequacy of an existing service outcome framework in capturing the true value of these technologies to AT users. Outcome data was routinely collected by a community service 2–4 months following an AT consultation. A telephone or face-to-face interview gathered demographic information as well as AT outcomes, using two standardized tools, the Individualized Prioritised Problem Assessment (IPPA) and the EATS 6D. Qualitative comments relating to the impact of the AT on the person’s life were also documented; (3) Results: The acquired AT generally met or exceeded expectations of the person using the AT and the attending health professional. Overall, people experienced decreased difficulty and increased feelings of autonomy, with most of the reported improvements identified in mobility and usual activities; (4) Conclusion: Routine outcome data provide some evidence of the value of AT in addressing concerns as identified by clients. Qualitative data, which captured the impact of AT on people’s lives, suggest that the empowering and transformative aspects of AT are not currently being captured by existing measures. Full article
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1315 KiB  
Article
The Provision of Powered Mobility Devices in Italy: Linking Process with Outcomes
by Lorenzo Desideri, Devis Trioschi, Roberta Agusto, Martina Bizzarri, Gianantonio Spagnolin, Sabrina Cantelli, Caterina Paolini, Massimiliano Malavasi and Claudio Bitelli
Technologies 2016, 4(3), 31; https://doi.org/10.3390/technologies4030031 - 09 Sep 2016
Cited by 3 | Viewed by 6965
Abstract
The present paper reports on a series of studies conducted at the Regional Center for Assistive Technology (Centro Regionale Ausili, CRA) in Bologna, Italy. Our purpose was to identify a set of internationally validated instruments and a training circuit with a view to [...] Read more.
The present paper reports on a series of studies conducted at the Regional Center for Assistive Technology (Centro Regionale Ausili, CRA) in Bologna, Italy. Our purpose was to identify a set of internationally validated instruments and a training circuit with a view to developing a structured and validated Powered Mobility Device (PMD) assessment and training program. To develop the program, three studies were conducted in order to identify: validated measures for assessing the user’s driving skills and training needs for using a PMD (Study 1); measures for evaluating the outcomes of the PMD (Study 2); and, the elements necessary for building a circuit for conducting PMD training (Study 3). In studies 1 and 2, the Wheelchair Skill Test 4.2 Power Wheelchair (WST) and the Wheelchair Outcome Measure (WhOM) were selected and pilot tested using QUEST 2.0. These studies represent an important step in the development and definition of a PMD assessment and training program to be implemented in routine clinical activities in a regional center for assistive technology in Italy. The measures, the circuit and the program will be further tested in future for validity and reliability in order to assess their efficacy in helping professionals to select the most adequate PMD for users, to conduct specific PMD training, and to evaluate PMD outcomes. Full article
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212 KiB  
Article
Ready for eHealth. Older Swedes’ Perceptions of eHealth Services: Using the PIADS Scale as a Predictor for Readiness
by Sarianne Wiklund Axelsson and Anita Melander Wikman
Technologies 2016, 4(3), 29; https://doi.org/10.3390/technologies4030029 - 07 Sep 2016
Cited by 8 | Viewed by 4375
Abstract
Introduction: Relevant determinants of adoption of eHealth are needed in order to understand future usage. Aim: To investigate the anticipated psychosocial impact of present and future eHealth services and discuss how psychosocial factors can impact the readiness for eHealth services among older Swedes [...] Read more.
Introduction: Relevant determinants of adoption of eHealth are needed in order to understand future usage. Aim: To investigate the anticipated psychosocial impact of present and future eHealth services and discuss how psychosocial factors can impact the readiness for eHealth services among older Swedes and reflect upon instruments for measuring eHealth acceptance. Method: The Psychosocial Impact of Assistive Device Scale (PIADS) measured the psychosocial impact of eHealth services as illustrated in pictures of a set of events of eHealth services that may reasonably occur in the present and the future. The PIADS scale and the scenarios were administered via a randomly selected sample from the Swedish population aged 55–105. Results and Discussion: Older Swedes have, from a psychosocial perspective, positive expectations regarding eHealth services. The PIADS scale could be a useful supplement to acceptance measurements in the context of eHealth. Using animated illustrations to depict eHealth services, together with the PIADS scale, can generate findings that are generalizable across technologies. The dimensions adaptability, competence and self-esteem could be relevant determinants of adoption of eHealth. Full article
219 KiB  
Article
Psychosocial Impact of Assistive Technologies for Mobility and Their Implications for Active Ageing
by Anabela Correia Martins, João Pinheiro, Beatriz Farias and Jeffrey Jutai
Technologies 2016, 4(3), 28; https://doi.org/10.3390/technologies4030028 - 02 Sep 2016
Cited by 15 | Viewed by 8246
Abstract
Purpose: Active ageing is defined as the process of optimizing opportunities for physical, social and mental health to enable older people to actively take part in society without discrimination and to enjoy independence and good quality of life. The World Health Organization assumed [...] Read more.
Purpose: Active ageing is defined as the process of optimizing opportunities for physical, social and mental health to enable older people to actively take part in society without discrimination and to enjoy independence and good quality of life. The World Health Organization assumed this to be a process for increasing and maintaining an individual’s participation in activities to enhance his/her quality of life. In this survey, the authors addressed the following question: is assistive technology (AT) for mobility contributing to enhancement of lifelong capacity and performance? Method: From June 2015 until February 2016, 96 community dwelling adults, AT users for mobility (powered wheelchairs, manual wheelchairs, lower limb prostheses, walkers, crutches and canes), aged 45–97, mean 67.02 ± 14.24 years old, 56.3% female, were interviewed using the Psychosocial Impact of Assistive Devices Scale (P-PIADS), the Activities and Participation Profile related to Mobility (APPM) and demographics, clinical and questions about AT use and training. Results and Discussion: The participants’ profiles revealed moderate limitation and restrictions in participation, measured by the APPM (2.03). Most participants displayed a positive impact from AT; average scores obtained from the P-PIADS subscales were: Self-esteem 0.62, Competency 1.11 and Adaptability 1.10. The P-PIADS total was 0.96, with the powered wheelchair users scoring the highest (1.53) and the walker users scoring the lowest (0.73). All subscales and the P-PIADS total were positively correlated with the activities and participation profile. There was no relation between age and the psychosocial impact of AT or activities and participation profile. These results encourage the authors to follow up with these participants for a lifelong intervention. To accomplish that aim, currently, the protocol is implemented at the AT prescribing centers in Coimbra, Portugal in order to assess the impact of AT on participation in society, one of the domains of the Active Ageing Index, a new analytical tool to help policy makers in developing policies for active and healthy ageing. Full article
216 KiB  
Article
Assistive Technology Needs and Measurement of the Psychosocial Impact of Assistive Technologies for Independent Living of Older Hispanics: Lessons Learned
by Elsa M. Orellano-Colón, Jeffrey Jutai, Angélica Santiago, Víctor Torres, Keyla Benítez and Mayra Torres
Technologies 2016, 4(3), 21; https://doi.org/10.3390/technologies4030021 - 21 Jul 2016
Cited by 8 | Viewed by 5299
Abstract
(1) Knowledge about the assistive technology (AT) needs and psychosocial impact of AT in different populations is needed because the adoption, retention, or abandonment of AT may be influenced by the psychosocial impact that AT has on its users. The aims of this [...] Read more.
(1) Knowledge about the assistive technology (AT) needs and psychosocial impact of AT in different populations is needed because the adoption, retention, or abandonment of AT may be influenced by the psychosocial impact that AT has on its users. The aims of this study were to: (a) identify the AT needs of a sample of Hispanic older adults with functional limitations; (b) describe the psychosocial impact of these technologies on the sample’s quality of life; and (c) describe the methodological challenges in using the Puerto Rican version of the Psychosocial Impact of Assistive Device Scale (PR-PIADS) with a Hispanic sample; (2) Methods: This study used a cross-sectional design conducted with a sample of 60 participants. Data was collected using the Assistive Technology Card Assessment Questionnaire (ATCAQ) and the PR-PIADS. Data analyses included descriptive statistics and bivariate analysis; (3) Results: The sample’s most frequently reported needs for AT devices were in the areas of cooking, home tasks, and home safety activities. The sample reported a positive impact of AT use in their quality of life. Several methodological challenges of the PIADS were identified; (4) Conclusions: The sample has unmet needs for using AT devices to overcome difficulties in daily living activities. Full article
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Review

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688 KiB  
Review
Measuring Outcomes for Children with Cerebral Palsy Who Use Gait Trainers
by Roslyn Livingstone and Ginny Paleg
Technologies 2016, 4(3), 22; https://doi.org/10.3390/technologies4030022 - 01 Aug 2016
Cited by 12 | Viewed by 10166
Abstract
Gait trainers are walking devices that provide additional trunk and pelvic support. The primary population of children using gait trainers includes children with cerebral palsy (CP) functioning at Gross Motor Function Classification System (GMFCS) levels IV and V. A recent systematic review found [...] Read more.
Gait trainers are walking devices that provide additional trunk and pelvic support. The primary population of children using gait trainers includes children with cerebral palsy (CP) functioning at Gross Motor Function Classification System (GMFCS) levels IV and V. A recent systematic review found that evidence supporting the effectiveness of gait trainer interventions for children was primarily descriptive and insufficient to draw firm conclusions. A major limitation identified was the lack of valid, sensitive and reliable tools for measuring change in body structure and function, activity and participation outcomes. Twelve different clinical tools were identified in the systematic review and in this paper we review and discuss the evidence supporting their reliability, validity and clinical utility for use with children using gait trainers. We also describe seven additional clinical measurement tools that may be useful with this intervention and population. The Pediatric Evaluation of Disability Inventory (PEDI) rated highest across all areas at this time. Individualized outcome measures, such as the Canadian Occupational Performance Measure (COPM) and Goal Attainment Scaling and measuring user satisfaction with tools, such as the Quebec User Evaluation of Satisfaction with assistive Technology, show potential for gait trainer outcomes research. Spatiotemporal measures appear to be less useful than functional measures with this intervention and population. All tools would benefit from further development for use with children with CP functioning at GMFCS levels IV and V. Full article
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