Background Assistive technology (AT) is a way to enhance the performance of daily activities in people with disabilities and help them live more independently. However, an important problem in providing AT lies in the effectiveness of information management. Local policymakers and health service providers have become aware of this problem and their perspectives are the key to solving it. Methods This study explored the types of AT provided for people with disabilities in the community and the perspectives on information management of local policymakers and health service providers. A survey checklist and semistructured in-depth interview were the instruments of this study. The key informants in this study included administrators, nurses, and physical therapists from four community areas in Chiang Mai, Thailand. Results The medical records showed that the types of AT provided were mostly second-hand (57.24%) and borrowed devices (57.73%). All of them were low-tech devices (crutch, cane, walker, wheelchair, and adaptive tricycle). In addition, the results indicated three perspective aspects related to information management: (1) problems in the database recording system, (2) different policies and processes of information management, and (3) improvement of the AT provision system. Conclusion The perspectives of local policymakers and health service providers indicated related problems, impacts of policies, and ways to improve the AT provision system by applying information technology.

BackgroundCognitive dysfunction caused by brain injury often prevents a patient from achieving a healthy and high quality of life. By now, each cognitive function is assessed precisely by neuropsychological tests. However, it is also important to provide an overall assessment of the patients’ ability in their everyday life. We have developed a Virtual Shopping Test (VST) using virtual reality technology. The objective of this study was to clarify 1) the significance of VST by comparing VST with other conventional tests, 2) the applicability of VST to brain-damaged patients, and 3) the performance of VST in relation to age differences.MethodsThe participants included 10 patients with brain damage, 10 age-matched healthy subjects for controls, 10 old healthy subjects, and 10 young healthy subjects. VST and neuropsychological tests/questionnaires about attention, memory and executive function were conducted on the patients, while VST and the Mini-Mental State Examination (MMSE) were conducted on the controls and healthy subjects. Within the VST, the participants were asked to buy four items in the virtual shopping mall quickly in a rational way. The score for evaluation included the number of items bought correctly, the number of times to refer to hints, the number of movements between shops, and the total time spent to complete the shopping.ResultsSome variables on VST correlated with the scores of conventional assessment about attention and everyday memory. The mean number of times referring to hints and the mean number of movements were significantly larger for the patients with brain damage, and the mean total time was significantly longer for the patients than for the controls. In addition, the mean total time was significantly longer for the old than for the young.ConclusionsThe results suggest that VST is able to evaluate the ability of attention and everyday memory in patients with brain damage. The time of VST is increased by age.

We developed a virtual reality test to assess the cognitive function of Japanese people in near-daily-life environment, namely, a virtual shopping test (VST). In this test, participants were asked to execute shopping tasks using touch panel operations in a "virtual shopping mall." We examined differences in VST performances among healthy participants of different ages and correlations between VST and screening tests, such as the Mini-Mental State Examination (MMSE) and Everyday Memory Checklist (EMC). We included 285 healthy participants between 20 and 86 years of age in seven age groups. Therefore, each VST index tended to decrease with advancing age; differences among age groups were significant. Most VST indices had a significantly negative correlation with MMSE and significantly positive correlation with EMC. VST may be useful for assessing general cognitive decline; effects of age must be considered for proper interpretation of the VST scores.

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We developed a Virtual Shopping Test with three different task levels for assessment of daily cognitive function using virtual reality technology. The objective of present study was to investigate the difference on task performance, brain activation and subjective assessment in relation to the difficulty levels of the tasks. Subjects were asked to buy specific 2 items in Task 1, 4 items in Task 2, and 6 items in Task 3 at a virtual mall. The tasks and questionnaires were conducted on 10 convalescent brain-damaged patients and 6 healthy young adults. Hemodynamic changes in the prefrontal cortex (PFC) during activation due to the tasks were examined using functional near-infrared spectroscopy. As the result, the mean total time was significantly longer for the patients than for healthy subjects. PFC showed a greater response for related Task 2 than Task 1 in shopping and moving phase in patient group. The patients evaluated Tasks 1 and 2 are more difficult and bring more psychological load than healthy adults subjectively. That is, although the healthy adults did not show large difference in their task performances as well as PFC responses, they can evaluate the differences between three task levels, subjectively, while which could not be * Corresponding author.S. Okahashi et al. 248for the patients means that patients could not distinguish the difference of the tasks, subjectively. The results suggest that 4-item shopping task might be enough difficulty level that causes brain activation for the brain-damaged patients.

Fine motor dysfunction and cognitive impairments commonly develop after stroke, which greatly impact the daily lives of patients. In current occupational therapy, hand dexterity and cognitive functions are evaluated individually (e.g., by manipulation of small objects with ngers, or a paper-and-pencil test), which is insuf cient for therapists to grasp the total ability of combined dexterity and cognition in everyday situations. Additionally, the traditional methods require a tester to measure the completion time manually and tend to be monotonous for patients. These problems would be solved using technology. This study aimed to develop a new electric pegboard (e-Peg) prototype and to investigate preliminary utility in healthy adults. The system judges the peg insertion accuracy based on magnetism and records the time course and scores, which are linked to human object manipulation ability. The e-Peg executes three types of tasks: a basic color matching task (BT), a color comparison task using a pattern sheet (CT), and a visual memory task (MT), with one/two-color sample patterns. Six older and nine younger healthy adults performed the e-Peg tasks, functional tests, and responded to questionnaires. As a result, the number of correct answers in a bicolor symmetrical MT were signi cantly greater in the younger group than in the older group. The older group required a signi cantly longer completion time for BT and CT than the younger group. Signi cant correlations were found between one-color BT/ CT and dexterity tests, between bicolor BT/CT and dexterity/cognitive tests, and between a bicolor MT and a cognitive test. Questionnaire results revealed that participants regarded BT/CT as easy/interesting tasks, whereas MT was considered a dif cult/challenging task. In conclusion, our e-Peg is potentially a useful rehabilitation device that facilitates many tasks related to hand manipulation and attention/executive functions, and a valuable tool for personalized therapy.

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Aim: To clarify the characteristics of desktop dual tasks that cause dorsolateral prefrontal cortex (DLPFC) activation. Methods: Subjects (29 young adults and 22 middle-aged adults) performed three different combinations of dual tasks composed of a pencil and paper task (copying numbers or calculation) and a hand-shape changing task (in response to visual hints or self judgment). We measured brain activation using near-infrared spectroscopy. Results: Right DLPFC activation was significantly higher for the simplest dual task than the complex dual task with the younger group, whereas there was no significant difference between tasks with the middle-aged group. Task performance was higher in the younger group than the middle-aged group, whereas there was no difference in brain activation between the two age groups. Conclusion: A dual task including two of each task performed automatically could be used for training frontal lobe functions, and the difficulty level should be adjusted depending on age.