Handbook of Electronic Assistive Technology

Cover
Handbook of Electronic Assistive Technology
Copyright
List of Contributors
Foreword
Preface
Acknowledgement
Glossary
1 - Basic Neurosciences With Relevance to Electronic Assistive Technology
	Introduction
	Concepts of Impairment Function and Participation
	Basic Neurosciences
	How the Central Nervous System Is Made – Neuroembryology
	Blood Supply
	Basic Structural Anatomy and Physiology
		Basic Neurophysiology
		Central Nervous System
		Motor System
	When Things Don’t Work
		Specific Conditions
			Cerebral Palsy
			Neurocutaneous Conditions
			Acquired Brain Injury
			Stroke
				Thrombotic/Embolic Strokes
				Cerebrovascular Haemorrhagic Strokes
			Tumours
			Neurometabolic Conditions/Inherited Metabolic Disorders
				Multiple Sclerosis
				Parkinsonism
				Huntington’s Disease
				Primary Dystonia
				Progressive Supranuclear Palsy
			Dementia
			Alzheimer’s
			Spinal Problems
				Spinal Muscular Atrophies
				Motor Neuron Diseases
			Peripheral Nerve Problems
			Muscle Problems
				Myopathies
				Muscular Dystrophies
				Duchenne’s Muscular Dystrophy
				Becker’s Muscular Dystrophy
	References
		Further Reading
2 - Cognitive Impairment and EAT
	Introduction
	Developmental, Acquired and Progressive Cognitive Impairment
	Specific Versus Generalised Cognitive Impairment
	Other Neuropsychological Factors
		Impaired Self-Awareness
		Motivation
		Plasticity
	Executive Functioning
	Memory
	Attention
	Implications for Technology Use
		Seeing a Benefit
		Frame of Reference and Stigma
		Lack of Personalisation
		Use of Technology for Children and Young People
		Ethical Approaches to Cognitive Support
	Conclusions
	References
3 - Functional Posture
	Introduction
	What Is Posture and Postural Control?
	The Postural Control System
		The Neural System
		What Is Muscle Tone?
		What Is a Reflex?
		The Musculoskeletal System
		The Sensory System
		Feedforward and Feedback Mechanisms
	Impairment of Postural Control
		What Is Postural Management?
	What Is a Functional Posture?
	Assessment of Postural Ability for Functional Positioning Solutions
		Gathering Your Information
		Medical Conditions Affecting Posture
		Psychological Factors Impacting Posture
		Social and Environmental Factors Affecting Posture
		Physical Assessment
			Understanding the Position of the Pelvis
			Sitting With the Pelvis in Posterior Tilt
			Sitting With the Pelvis in Anterior Pelvic Tilt
			Pelvic Obliquity
			Pelvic Rotation
			Direction of the Lower Limbs in Relation to the Pelvis
			Movement of the Lower Limbs
				Shoulder Rotation and Obliquity
				Movement and Position of the Spine
				Movement and Position of the Upper Limbs
				Position of the Head
				Weight Distribution and Loadbearing
			Assessment Out of Equipment in the Sitting Position
		Using Measurement Tools
	Case Studies
		Alan’s Case Study (Adult)
			Key Assessment Data
				Medical
			Social/Environmental/Psychological
			Physical
			Postural Management Goals
			Identified Seating Requirements
			Recommendations
		John’s Case Study (Paediatric)
			Assessment Findings
				Medical
			Social/Environmental/Psychological
			Physical
			The following postural management goals were identified for John
			Identified Seating Requirements
			Recommendations
	References
4 - Assessment and Outcomes
	What Is Assistive Technology?
	The Growing Need for Assistive Technology
	Assessment and Provision of AT
	Assessment Models
	The Assessment Team
	Referral Forms
	Assessment Time
	Physical Skills
	Sensory Skills
	Follow-Ups and Reviews
	Outcome Measures for Assistive Technology
		International Classification and Function
		Individually Prioritised Problem Assessment
		Psychological Impact of Assistive Devices Scale
		Quebec User Evaluation of Satisfaction With Assistive Technology
		Therapy Outcome Measures System
		Functional Independence Measure11
		Goal Attainment Scaling12
	References
		Further Reading
5 - Alternative Access Technologies
	Introduction
		Device
		Control Site
		Control Interface
		Selection Set
			Items
			Item Size
			Selection Set Dimensions
			Item Spacing
			Item Representation
			Fixed or Dynamic Selection Set
		Direct and Indirect Selection
			Scanning
			Coded Access
		Seating and Positioning
	Keyboards
		Keyboard Connections
		Keyboard Accessibility Options
			Jack’s Case Study
		Sticks and Pointers
			Barrie’s Case Study
		Keyguards
		Compact Keyboards
		High Contrast Keyboards and Stickers
		Large Key Keyboards
			Mary’s Case Study
		Ergonomic Keyboards
			Alice’s Case Study
	Touchscreens
		Touchscreen Accessibility Options
		Styli
		Alternative Access to Touchscreen Devices
	Pointing Devices
		Pointing Device Connections
		Pointing Device Accessibility Options
		MouseKeys – Controlling the Mouse With the Keyboard
		Clicking the Mouse Button
			Ross’s Case Study
		Dwell Select
		Dragging
		Double Clicking
		Keyboard Shortcuts and Macros
		Trackballs
			Jennifer’s Case Study
		Joysticks
			Malcolm’s Case Study
			Nick’s Case Study
		Trackpads
			Chloe’s Case Study
			Trackpad Settings
		Pen Tablets
		Ergonomic Mice
		Head-Controlled Pointing Devices
		Mouse Pointer Control With Switches
			Direct Mouse Control With Multiple Switches
			Scanning Mouse Control With One or Two Switches
		Mouse Pointer Control With Speech
			Digital Assistants
			Speech Recognition
	Eye-Gaze Access
		Eye-Gaze Technology
		Assistive Technology Eye-Gaze Systems
		Eye-Gaze Software
		Applications of Eye-Gaze Systems
			Communication
			Computer Access
			Exploration and Early Learning
			Assessment
		Selection Set Design for Eye-gaze
		Michael’s Case Study
		Malcolm’s Case Study
	Switch Access
		Stephen Hawking’s Case Study
		Switch Control Sites
		Mechanical Switches
		Switch Comfort
		Sip-Puff (Pneumatic) Switch
		Proximity Switches
		Switch Interfaces
		Scanning Access
			Simple Scan
			Group Scan
			Directed Scan
		Highlighter Movement Control
		Switch Actions
		Error Handling
		Switch Settings
		Rate Enhancement and Speed of Access
	Speech Recognition
		Personal ‘Digital Assistants’
		Dictation
		Computer Control
		Alternative and Augmentative Communication
		Microphones
	Brain–Computer Interface
	Key Points
	References
6 - Environmental Control
	Introduction
	Environmental Control Systems
		Definition of Environmental Controls (EC)
		Reasons for EC Provision
			Environmental Control Functions
			Violet’s Case Study
				Background
				Violet’s Goals and Expectations
				ECS Intervention
				Follow-Up
		Outline of an EC System
			User Interface
			EC Controller Unit
				Control Transmission Signals
				Feedback Signals, Processing and Modulation
				Controlled Appliances
				Mounting and Stands for EC Controller and Accessories
		Controller Mode of Operation of Selection Process
			Single Switch Scanning Access
				Scan Patterns
			Single Switch With Temporal Control
			Two Switch – User Advanced Scanning
			Multiple-Switch Input
			Multidirectional – Proportional Input
			Speech Recognition Input
		Historical Development of EC Equipment
			First-Generation Systems: 1960s
			Second Generation Systems – ‘Hardwired Fixed Installation Systems’ in the Home: 1980s
			Third Generation – Remote Transmission, Portable Controller Systems: 1990s
			Fourth Generation – Computer-Based EC Controllers: 2010 Onward
			Fifth Generation Utilising the ‘Internet of Things’
	Alternative Access to Computer Technologies
		Text Entry Methods
		Cursor Control Methods
			Computer-Based Operating System Adjustments
			Tablet-Based Operating System Adjustments
		Alternative Access for Computer Gaming
	Assessment for EC Provision
		Assessment Domains for EC Provision
		Means of access or interface to the user
			Equipment Specification to Meet the Control Needs of the Individual
			Operational Aspects and Management of Risk With EC Provision
		Evidence Base for Effectiveness of EC Provision
			Qualitative Indicators
	Summary
	References
		Further Reading
7 - Alternative and Augmentative Communication
	Introduction
	A History of AAC
	Prevalence of Need
	Defining and Classifying AAC Systems
	Components of an AAC System
		Input Methods
		Selection Sets and Language Processors
		Output Methods
	Assessment
		Body Functions and Structure
		Activity and Participation
		Environmental Factors
		Personal Factors
	Communicative Competence
		Linguistic Competence
		Operational Competence
		Social Competence
		Strategic Competence
		Communication Partners and Communicative Competence
		Communicative Competence – Moving Forward
	Evidence-Based Practice in AAC
		Patient Values and Preferences
		Clinical Experience
		Best Research Evidence
		Practice-Based Evidence
	AAC Service Delivery in the United Kingdom
		England
		Scotland
		Wales
		Northern Ireland
	Conclusion
		Nikhil’s Case Study (Paediatric)
			Background
			Assessment and Outcome
		Martin’s Case Study (Adult)
			Background
			Assessment
			Martin’s Goals
			Options Considered
			Outcome
			Low-Tech
	References
8 - Assisted Living
	Definition of Assisted Living
	Smart Homes
	The Technology
		ISO OSI Model of Data Transmission
		KNX
		LonWorks
		BACnet
		Powerline Technologies
		X10
		CEBus
		HomePlug
		Radio Frequency
		Z-Wave
		Zigbee
		EnOcean
		Bluetooth
		Thread
		Internet Protocol
		OSGi
	Smart Homes in the United Kingdom
		INTEGER
		The AID House
		The York Smart Flat
		Wigton Smart Home
		CUSTODIAN
		Cambus Smart Cottage
		Bath Institute of Medical Engineering
		John Grooms Housing Association
		The Cedar Foundation
		Hereward College
		Manchester Methodist Housing Association
		Millennium Homes Project
		iCue
	Automation
		Flexibility in Control Layout
		Adaptability of Design
		Selectivity
	Safety Monitoring
	Active Support of Lifestyle
	Lifestyle Monitoring
	Carer Support
	The Use of Telecare and Telehealth in Assisted Living
		Telecare
		Telehealth
		Telehealth and Telecare in Europe
	The Internet of Health
	Concluding Remarks
	References
9 - Powered Mobility
	Introduction
		Indoor or Outdoor?
		Further Variations
		Models of Provision
	Assessment
	Control Systems
		Outline Operation
		Joysticks
		Programming
		Outputs
		Maintenance and Reliability
	Powered Wheelchair Selection
		Introduction
		Seat to Ground Height
		Drive-Only Powered Chair
		Method of Driving Access
		What Powered Functions Will Be Required?
		Tilt-In-Space and Recline Functions
		Powered Elevating Leg Rest/s
		Powered Seat Height Adjustment
		Standing Function
		Drive Wheel Options
			Rear Wheel Drive
			Mid-Wheel Drive
			Front Wheel Drive
		Comparison of Wheel Layouts With Respect to Space Requirements for Turns
		Further Considerations With the Home Environment
		Specific Points for Use in an Educational Setting
		Workplace Considerations
		Psychological Adjustment to Using a Powered Wheelchair
	Summary
	References
10 - Assistive Technology Integration and Accessibility
	Overview
	Introduction
	History and Research into Integration
		Foundations of Electronic Assistive Technology and Integrated Systems
		Computer Accessibility
		Web Accessibility
		Standalone Integration
		Communication Aid and Environmental Control Software
		Wheelchair Controls
		Development in Access Methods
		Tablet Technology for Assistive Technology
		Looking Ahead
		Reasons for Integration
			Chris’s Case Study
	Factors to Consider When Recommending Integration
		Individual Considerations
			Input Ability
			Cognitive Load
		Environmental Considerations
		Integrator Considerations
			Failure Mode
			Mode Switching
			Wheelchair Systems
	Models of Integration
		Dedicated Integrator Unit or Device-Switching Model
		Primary/Secondary Pass-Through Model
		Wheelchair as Base Model
			James’s Case Study
		Assistive Technology Software-Mediated Model
			Pauline’s Case Study
		Operating System Model
			John’s Case Study
	Conclusions
	References
11 - Robotics
	Background
	A Brief History of Robotics
	Emergence of Assistive Robots
	Application of Robotics in Rehabilitation
		Robots for Physical Therapy and Movement Assistance
			Upper Limb Robotic Rehabilitation Systems
				MIT-MANUS
				Mirror Image Motion Enabler
				GENTLE/s System
				REHAROB Therapeutic System
				Bi-Manu-Track (Reha-Stim, Berlin, Germany)
				ARMin
			Lower Limb Robotic Rehabilitation Systems
				Fixed/Stationary Systems
					Lokomat (Hocoma, Volketswil, Switzerland)The Lokomat (Fig. 11-5)5 is one of the more well-researched stationary robotic systems ...
					The Lower Extremity Powered ExoSkeleton (LOPES) was developed at the University of Twente to assist stroke patients in walking r...
					The GaitTrainer (Reha Stim, Berlin, Germany)The GaitTrainer (Fig. 11-6)6 is a footplate-based end-effector-based device designed...
				Overground Walking Systems/Mobile Exoskeletons
					ReWalk was the first FDA-approved exoskeleton in 2014 to be used as a personal device at home and in the community. It is approv...
					REX (Rex Bionics, New Zealand)7REX (Fig. 11-7)8 is an exoskeleton with actuators at the knee, hip and ankle joints. It enables t...
					Hybrid Assistive Limb9The Hybrid Assistive Limb (HAL) is a bilateral lower limb exoskeleton that has been developed for both per...
					Ekso Exoskeleton10Ekso is a wearable lower extremity robotic exoskeleton designed for the assistance and rehabilitation of patie...
					Indego11Indego (also known as the Vanderbilt exoskeleton) is a powered lower limb exoskeleton designed to enable people with SCI...
					ATLAS Exoskeleton12The ATLAS (Fig. 11-8) is a wearable exoskeleton designed to provide walking capabilities for children affecte...
					HEI Exoskeleton15Researchers at the HEI-YNCREA School of Advanced Engineering Studies have produced a noncommercial rehabilitati...
		Socially Assistive Robots
		Robots for Supporting Activities of Daily Living (ADL)
	Design Considerations for Robotic Exoskeletons
	Roboethics
	Future of Robotics
	References
Index
	A
	B
	C
	D
	E
	F
	G
	H
	I
	J
	K
	L
	M
	N
	O
	P
	Q
	R
	S
	T
	U
	V
	W
	X
	Y
	Z
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