ObjectiveThe aim of this study was to provide a systematic review of studies that investigated the effectiveness of robot-assisted therapy on ankle motor and function recovery from musculoskeletal or neurologic ankle injuries.MethodsThirteen electronic databases of articles published from January, 1980 to June, 2012 were searched using keywords ‘ankle*’, ‘robot*’, ‘rehabilitat*’ or ‘treat*’ and a free search in Google Scholar based on effects of ankle rehabilitation robots was also conducted. References listed in relevant publications were further screened. Eventually, twenty-nine articles were selected for review and they focused on effects of robot-assisted ankle rehabilitation.ResultsTwenty-nine studies met the inclusion criteria and a total of 164 patients and 24 healthy subjects participated in these trials. Ankle performance and gait function were the main outcome measures used to assess the therapeutic effects of robot-assisted ankle rehabilitation. The protocols and therapy treatments were varied, which made comparison among different studies difficult or impossible. Few comparative trials were conducted among different devices or control strategies. Moreover, the majority of study designs met levels of evidence that were no higher than American Academy for Cerebral Palsy (CP) and Developmental Medicine (AACPDM) level IV. Only one study used a Randomized Control Trial (RCT) approach with the evidence level being II.ConclusionAll the selected studies showed improvements in terms of ankle performance or gait function after a period of robot-assisted ankle rehabilitation training. The most effective robot-assisted intervention cannot be determined due to the lack of universal evaluation criteria for various devices and control strategies. Future research into the effects of robot-assisted ankle rehabilitation should be carried out based on universal evaluation criteria, which could determine the most effective method of intervention. It is also essential to conduct trials to analyse the differences among different devices or control strategies.

The results from this case study highlight the infancy of BCIs as a form of assistive technology for people with cerebral palsy. Existing commercial BCIs are not designed according to the needs of end-users. Implications for Rehabilitation Mood, fatigue, physical illness and motivation influence the usability of a brain-computer interface. Commercial brain-computer interfaces are not designed for practical assistive technology use for people with cerebral palsy. Practical brain-computer interface assistive technologies may need to be flexible to suit individual needs.

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AIM The purpose of this study was to systematically review published evidence on the development, use, and effectiveness of devices and technologies that enable or enhance self-directed computer access by individuals with cerebral palsy (CP).METHODS Nine electronic databases were searched using keywords 'computer', 'software', 'spastic', 'athetoid', and 'cerebral palsy'; the reference lists of articles thus identified were also searched. Thirty articles were selected for review, with 23 reports of development and usability testing of devices and seven evaluations of algorithms to increase computer recognition of input and cursor movements.RESULTS Twenty-four studies had fewer than 10 participants with CP, with a wide age range of 5 to 77 years. Computer task performance was usually tested, but only three groups sought participant feedback on ease and comfort of use. International standards exist to evaluate effectiveness of non-keyboard devices, but only one group undertook this testing. None of the study designs were higher than American Academy for Cerebral Palsy and Developmental Medicine level IV.INTERPRETATION Access solutions for individuals with CP are in the early stages of development.Future work should include assessment of end-user comfort, effort, and performance as well as design features. Engaging users and therapists when designing and evaluating technologies to enhance computer access may increase acceptance and improve performance.

The goal of the study was to examine the accuracy and precision of control of adaptive locomotion using haptic information in normally sighted humans before and after practice. Obstacle avoidance paradigm was used to study adaptive locomotion; individuals were required to approach and step over different sizes of obstacles placed in the travel path under three sensory conditions: full vision (FV); restricted lower visual field (RLVF) using blinders on custom glass frames; and no vision (NV) using haptic information only. In the NV condition, individuals were a given an appropriate-sized cane to guide their locomotion. Footfall patterns were recorded using the GAITRite system, and lead and trail limb trajectories were monitored using the OPTOTRAK system, which tracked infrared diodes placed on the toes and the cane. Approach step lengths were reduced for the haptic condition: this slowed the forward progression and allowed greater time for haptic exploration, which ranged from 2.5 to 4 s and consisted of horizontal cane movements (to detect the width and relative location of the obstacle) and vertical cane movements (to detect the height of the obstacle). Based on feed-forward and on-line sensory (under both vision and haptic conditions) information about location of the obstacle relative to the individual, variability of foot placement reduced as the individual came closer to the obstacle, as has been shown in the literature. The only difference was that the reduction in variability of foot placement under haptic condition occurred in the last step compared with earlier under vision. Considering that the obstacle is detected only when the cane comes in contact, as opposed to vision condition when it is visible earlier, this difference is understandable. Variability and magnitude of lead and trail limb elevation for the haptic condition was higher than the RLVF and FV conditions. In contrast, only the magnitude of lead and trail limb elevation was higher in the RLVF condition when compared with the FV condition. This suggests that it is the inability of the haptic sense to provide accurate information about obstacle characteristics compared with the visual system, and not simple caution that lead to higher limb elevation. In the haptic and RLVF condition when vision was unavailable for on-line monitoring of lead limb elevation, kinesthetic information from lead limb elevation was used to fine-tune trail limb elevation. Both the control of approach phase and limb elevation findings held up even after sufficient practice to learn haptic guidance of adaptive locomotion in the second experiment. These results provide a clear picture of the efficacy of the haptic sensory system to guide locomotion in a cluttered environment.

The results are similar to other literature, suggesting new innovations and changes are in dire need, to improve assistive technology experiences for all stakeholders. Implications for Research Service providers for assistive technology desire more effective training and support of existing and emerging technologies. Although the set procedure for acquiring assistive technology in New Zealand is comprehensive, incorporating multiple perspectives, it is difficult to follow through in practice. More innovative procedures are needed. The movement of Universal Design is significantly improving the perception of individuals with disabilities, and has enabled greater social inclusion. More assistive technology developers need to ensure that they incorporate these principles in their design process.

The purpose of this study is to systematically review published evidence regarding the development, use, and effectiveness of assistive devices and technol ogies that enable internet access for individuals who are deafblind. Eight electronic research databases (CINAHL, Embase, Engineering Village MEDLINE, PsycINFO, PubMed, Cochrane Library, and Web of Science) and three clinical trials registries (ISRCTN Registry, WHO ICTRP, and ClinicalTrials.gov) were searched. Seven articles met the inclusion criteria for this systematic review. The assistive technologies described were in the preliminary stages of development, with only three of the technologies having undergone any testing. The effectiveness of all seven assistive technologies was quantified in this review based on the proposed impacts of internet access on the domains of the World Health Organization's International Classification of Functioning, Disability and Health framework. Internet access technologies for individuals with deafblindness are in the early stages of development and are targeted toward specific functions of the internet. It is imperative that future device development and evaluation seek input from persons who are deafblind. There is also a need to address the gap between academic research, which seeks to develop assistive technology to access the internet and the translation into real-world use of this technology.

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