BACKGROUND

The Philippine General Hospital (PGH) is a tertiary government hospital that serves as the national referral center for Filipinos from across the country. In partnership with Latter-Day Saint Charities (LDSC), PGH has been serving patients in need of mobility devices, such as wheelchairs, through in-person services from screening to assessment, measurement, assembly, fitting, and mobility training. Given the patients’ barriers to in-person follow-up consultations, regular healthcare provision has been challenging. The use of telerehabilitation, a form of telemedicine, has emerged as a practical and innovative solution, but it needs further evaluation.

The study aimed to determine the wheelchair recipients’ perceived barriers to in-person and virtual follow-up consultations.

This cross-sectional study involved a purposive sample of 413 patients who received a wheelchair from the LDSC through PGH. An original survey was prepared to determine patients’ perceived barriers to actual in-person and potential virtual follow-up consultations. Consent was obtained prior to data collection. After the pretest and pilot testing were conducted, the final version of the survey was administered either electronically or through individual phone interviews. Descriptive statistics was used to analyze and present the data.

A total of 113 wheelchair recipients participated, with an average of 42.9 years of age. The majority resided outside Metro Manila (53.1%), and 86.7% were within the income bracket of less than PhP 9,520 per month. The majority received a standard type of wheelchair (85.8%). The top 3 reasons hindering compliance to in-person consultation follow-ups were accessibility issues (82.3%), costs of travel (79.6%), and distance to hospital/wheelchair assessor (71.7%). With respect to potential virtual follow-ups, 72% expressed willingness to experience telemedicine/telerehabilitation in the future, despite having neither prior awareness (50.4%) nor experience (74.3%) of it. The majority had access to mobile phones (98.2%), and 67% had stable internet access.

The main barriers to in-person follow-ups were related to accessibility, costs, and travel. Telehealth or telerehabilitation in particular, despite patients’ interest and willingness to try it, still has yet to be optimized in our country. Internet connectivity can still be improved, as well as our stakeholders’ level of telehealth awareness. Future efforts to improve and sustain the uptake of telehealth solutions are recommended, as well as studies comparing the cost-effectiveness of in-person versus virtual consultations especially among persons with lived experiences of disability.

Occupational Therapy (OT) can help enhance human performance and well-being through assistive technology (AT). This entails guiding clients through the AT selection and acquisition process down to helping them integrate these tools’ use as supports to their day-to-day living. Unfortunately, the AT prescription and acquisition process can be tedious, costly, complicated, and uncoordinated in some countries such as the Philippines. AT service delivery is an undeveloped area of practice among Filipino occupational therapists due to the lack of local evidence-based research, practice models, and practical knowledge of the process. Moreover, access to AT is affected by economic factors and by some Filipinos’ negative attitudes towards assistive devices as being a validation of one’s incapacitation. The SAKLAY is a service delivery framework that was created to offer a practical and systematic guide to Filipino occupational therapists who render AT services for persons with disabilities (PWD) that takes into account the client’s needs, resources, abilities, and contexts.
Occupational Therapy ; Assistive Technology ; Philippines

Brain-computer interface (BCI) can establish a direct communications pathway between the human brain and the external devices, which is independent of peripheral nerves and muscles. Compared with invasive BCI, non-invasive BCI has the advantages of low cost, low risk, and ease of operation. In recent years, using non-invasive BCI technology to control devices has gradually evolved into a new type of human-computer interaction manner. Moreover, the control strategy for BCI is an essential component of this manner. First, this study introduced how the brain control techniques were developed and classified. Second, the basic characteristics of direct and shared control strategies were thoroughly explained. And then the benefits and drawbacks of these two strategies were compared and further analyzed. Finally, the development direction and application prospects for non-invasive brain control strategies were suggested.
Humans ; Electroencephalography ; Brain-Computer Interfaces ; Communication Aids for Disabled ; User-Computer Interface ; Brain/physiology*

BACKGROUND: This study described and analysed the features of powered mobility device (PMD)-related injuries and compared elderly and younger adult injuries.METHODS: Data from Korea Emergency Department-based Injury In-depth Surveillance (EDIIS) database involving eight emergency departments in 2011–2016 were analysed. The inclusion criteria were injuries sustained during the use of PMDs. The variables were compared between adults aged ≥ 65 years and younger adults. Primary and secondary outcomes were severe trauma and poor clinical course accordingly. The logistic regression analysis was used to identify risk factors for study outcomes.RESULTS: A total of 231 adults were enrolled, of whom 150 were ≥ 65 years of age. The total number of PMD-related injuries and the proportion of elderly injured patients increased annually, and most injuries occurred on the roadway and did not involve crash opponents. By multivariate analysis, patients aged ≥ 65 years had a higher injury severity score (adjusted odds ratio [AOR], 2.78; 95% confidence interval [CI], 1.50–5.40) and had a higher incidence of intensive care unit admissions, surgery, and death (AOR, 2.42; 95% CI, 1.16–5.28).CONCLUSION: Given the higher number and severity of injuries sustained among elderly adults ≥ 65 years of age shown in this study, we recommend that safety educations, such as the use of protective equipment and the safe driving on the roadway, are considered for PMD users ≥ 65 years of age.
Adult ; Aged ; Emergencies ; Emergency Service, Hospital ; Epidemiology ; Humans ; Incidence ; Injury Severity Score ; Intensive Care Units ; Korea ; Logistic Models ; Multivariate Analysis ; Odds Ratio ; Risk Factors ; Wheelchairs

BACKGROUND: There have been some concerns related to manual handling of large items in industry. Manual handling operations of large sheet metal may expose workers to risks related to efficiency as well as occupational safety and health. Large sheet metals are difficult to move and burdensome to lift/transfer, and handling the sharp sheet edges may result in contact stress and/or cut injuries on the workers. METHODS: Through observation, interview, and immersive simulation activities, a few problems related to current handling of sheet metals were identified. A sheet metal trolley-lifter was then designed and fabricated to address these issues. A pilot study on the use of the developed trolley-lifter for handling sheet metals was conducted to compare between the new and traditional handling methods. RESULTS: The pilot study of the trolley-lifter showed promising results in terms of improving the cycle time, manpower utilization, and working postures compared with the traditional handling method. CONCLUSION: The trolley-lifter offers an alternative solution to automation and a mechanized assistive device by providing a simple mechanism to assist the handling of sheet metals effectively and safely.
Automation ; Human Engineering ; Metals ; Methods ; Occupational Health ; Pilot Projects ; Posture ; Self-Help Devices

BACKGROUND/AIMS: Endoscopic assistive devices have been developed to reduce the complexity and improve the safety of surgeries involving the use of endoscopes. We developed an assistive robotic arm for endoscopic submucosal dissection (ESD) and evaluated its efficiency and safety in this in vitro pilot study. METHODS: ESD was performed using an auxiliary transluminal endoscopic robot. An in vitro test bed replicating the intra-abdominal environment and pig stomachs were used for the experiment. Participants were divided into skilled operators and unskilled operators. Each group performed ESD 10 times by using both conventional and robot-assisted methods. The perforation incidence, operation time, and resected mucous membrane size were measured. RESULTS: For the conventional method, significant differences were noted between skilled and unskilled operators regarding operation time (11.3 minutes vs 26.7 minutes) and perforation incidence (0/10 vs 6/10). Unskilled operators showed a large decrease in the perforation incidence with the robot-assisted method (conventional method vs robot-assisted method, 6/10 vs 1/10). However, the operation time did not differ between the conventional and robot-assisted methods. On the other hand, skilled operators did not show differences in the operation time and perforation incidence between the conventional and robot-assisted methods. Among both skilled and unskilled operators, the operation time decreased with the robot-assisted method as the experiment proceeded. CONCLUSIONS: The surgical safety of unskilled operators greatly improved with robotic assistance. Thus, our assistive robotic arm was beneficial for ESD. Our findings suggest that endoscopic assistive robots have positive effects on surgical safety.
Arm ; Endoscopes ; Endoscopy ; Hand ; In Vitro Techniques ; Incidence ; Methods ; Mucous Membrane ; Pilot Projects ; Self-Help Devices ; Stomach ; Surgery, Computer-Assisted

OBJECTIVES: The purpose of this study was to assess the ergonomic risk factors in beekeeping, and to evaluate the effectiveness of assistive device hive lift. METHODS: This study included 30 subjects of beekeeper in Pocheon, Korea. We assessed the ergonomic risk of main task in beekeeping with NLE, OWAS and evaluate the effectiveness of hive lift. We also surveyed prevalence of musculoskeletal symptoms among the subjects based on the Korea Working Condition Survey. RESULTS: Moving to different floral origin, internal inspection of beehives, feeding syrup is the most burdensome to musculoskeletal system (NLE LI value=2~3. OWAS action category=4). The prevalence of musculoskeletal symptoms (lower and upper extremities) among the subjects was over 80 %. The introduction of assistive devices in the three hazardous tasks has dramatically reduced the risk by removing manual lifting hives (OWAS action category<1). CONCLUSIONS: Beekeeping is a heavy workload on the musculoskeletal system because it has a lot of manual lifting task. As a result of applying the hive lift, the burden could be reduced.
Beekeeping ; Korea ; Lifting ; Musculoskeletal System ; Prevalence ; Risk Assessment ; Risk Factors ; Self-Help Devices ; Urticaria

PURPOSE: This study examined the injury and rehabilitation of athletes with disabilities in racket sports projects (i.e., badminton, table tennis, and wheelchair tennis). In addition, the characteristics of each project and the differences among those projects are discussed. METHODS: Business team athletes with disabilities in racket sport were enrolled as subjects (i.e., 19 badminton athletes, 19 table tennis athletes, and 19 wheelchair tennis athletes). The real conditions of the injury, injury severity, injury site, symptoms, and rehabilitation methods after injury were analyzed. RESULTS: No significant differences were observed among the actual condition, injury severity, symptoms and the methods of rehabilitation on racket sport for athletes (i.e., badminton, table tennis, and wheelchair tennis athletes) with disability. The differences were focused mainly on the injury sites due to the characteristics of the different projects, and specific technical actions. CONCLUSION: This study examined the real condition of the injury, injury severity, injury site, symptoms and rehabilitation methods after the injury on the rackets (i.e., badminton, table tennis, and wheelchair tennis) athletes with disabilities. The data can be used to eliminate the incidence of injury and minimize the injury severity for racket athletes with disabilities. In addition, it can also be used for the disabled, who like racket projects, as the fundamental material to prevent injury and assist in recovery.
Athletes ; Commerce ; Disabled Persons ; Humans ; Incidence ; Racquet Sports ; Rehabilitation ; Tennis ; Wheelchairs

PURPOSE: The purpose of this study was to identify the risk factors for falls in tertiary hospital inpatients and to suggest data for developing a nursing intervention program for preventing falls.METHODS: Data were collected between January 1, 2017, to December 31, 2017. Kaplan-Meier estimation was used to measure the survival rate, and the log-rank test was used for the differences between the fall group and the non-fall group. The Cox proportional hazards model was used to identify the risk factors for falls.RESULTS: The incidence rate of falls for the inpatients was 1.2 cases per 1,000 days of hospitalization. The risk factors for falls were more likely to be found among those who were aged ≥81, had not undergone surgery, had poor joint motion, had unsteady gait, needed help or supervision, used assistive devices, had comorbidity, and took at least two drugs.CONCLUSION: For the inpatients, the risk factors for falls included age, surgery, comorbidity, medication that could change mobility, joint motion, and use of patient care equipment. It is necessary to give special attention to inpatients who have any of these risk factors and to develop a falls risk assessment tool.
Accidental Falls ; Comorbidity ; Gait Disorders, Neurologic ; Hospitalization ; Humans ; Incidence ; Inpatients ; Joints ; Nursing ; Organization and Administration ; Patient Care ; Proportional Hazards Models ; Risk Assessment ; Risk Factors ; Self-Help Devices ; Survival Analysis ; Survival Rate ; Tertiary Care Centers

BACKGROUND: The aim of this study was to investigate the current state of the assistive devices and appliances provision system for cerebral palsy patients registered with brain disability. METHODS: From 2003 to 2013, we analyzed the records of cerebral palsy patients who had assistive devices and appliances provisioned at least once in their lives based on National Health Information Database. Patients with cerebral palsy were divided into three groups: infants and toddlers, school age and adolescence, and adults. RESULTS: Data on short leg plastic orthoses, ankle joint orthoses, and wheelchair were mainly analyzed. The types of ankle joint orthoses divided into three categories: limited, 90° limited, and Klenzac. Limited ankle joint orthoses was most frequently supported of the three in all age groups. Powered wheelchair and scooter were most supported to adult patients. When the re-supply duration was evaluated, the duration was suitable to the duration on guideline of regulation of re-supplement according to the related laws in adult patients but not in infants/toddlers and school age/adolescence as the actual re-supplement duration was much shorter than the reference value. CONCLUSION: This study confirmed the pattern of assistive devices and appliances supply differed depending on the age of cerebral palsy patients.
Adolescent ; Adult ; Ankle Joint ; Brain ; Cerebral Palsy ; Foot Orthoses ; Humans ; Infant ; Jurisprudence ; Korea ; Leg ; Orthotic Devices ; Plastics ; Reference Values ; Self-Help Devices ; Wheelchairs