Designing, developing and deploying assistive technologies at a scale and cost which makes them accessible to people is challenging. Traditional models of manufacturing would appear to be insufficient at helping the world's 1 billion disabled people in accessing the technologies they require. In addition, many who receive assistive technologies simply abandon them as they do not meet their needs. In this study the authors explore the changing world of design for disability. A landscape which includes the rise of the maker movement, the role of ubiquitous sensing and the changing role of the ‘user’ to one of designer and maker. The authors argue they are on the cusp of a revolution in healthcare provision, where the population will soon have the ability to manage their own care with systems in place for diagnosis, monitoring, individualised prescription and action/reaction. This will change the role of the clinician from that of diagnostician, gatekeeper and resource manager/deliverer to that of consultant informatics manager and overseer; perhaps only intervening to promote healthy behaviour, prevent crisis and react at flash moments.

This Letter presents an investigation of radio frequency identification tags integrated with sticking plasters. Conductive ink is used in the fabrication to provide good compatibility with the plaster in terms of flexibility. The tag is proposed for use as a wireless platform for long-term patient monitoring in hospital environments. A motion capture system is used to test the directions in which the tag can be read to inform a diversity study establishing the number of tags required on-body to ensure reliable reading for applications such as medical monitoring. Tag diversity performance with various body movements is also studied. It is established that four tags give all round body coverage with only 4% loss in coverage for vertically polarised tags should one of them fail.

This Letter aims to create a fuzzy logic-based assistive prevention tool for falls, based on accessible sensory technology, such as smartwatch, resulting in monitoring of the risk factors of falls caused by orthostatic hypotension (OH); a drop in systolic blood pressure (DSBP) >20 mmHg due to postural changes. Epidemiological studies have shown that OH is a high risk factor for falls and has a strong impact in quality of life (QoL) of the elderly's, especially for some cases such as Parkinsonians. Based on smartwatch data, it is explored here how statistical features of heart rate variability (HRV) can lead to DSBP prediction and estimation of the risk of fall. In this vein, a pilot study was conducted in collaboration with five Greek Parkinson's Foundation patients and ten healthy volunteers. Taking into consideration, the estimated DSBP and additional statistics of the user's medical/behavioural history, a fuzzy logic inference system was developed, to estimate the instantaneous risk of fall. The latter is fed back to the user with a mechanism chosen by him/her (i.e. vibration and/or sound), to prevent a possible fall, and also sent to the attentive carers and/or healthcare professionals for a home-based monitoring beyond the clinic. The proposed approach paves the way for effective exploitation of the contribution of smartwatch data, such as HRV, in the sustain of QoL in everyday living activities.

The purpose of this Letter was to investigate the influence of real-time verbal feedback to optimise push arc during over ground manual wheelchair propulsion. Ten healthy non-wheelchair users pushed a manual wheelchair for a distance of 25 m on level paving, initially with no feedback and then with real-time verbal feedback aimed at controlling push arc within a range of 85°–100°. The real-time feedback was provided by a physiotherapist walking behind the wheelchair, viewing real-time data on a tablet personal computer received from the Sensewheel, a lightweight instrumented wheelchair wheel. The real-time verbal feedback enabled the participants to significantly increase their push arc. This increase in push arc resulted in a non-significant reduction in push rate and a significant increase in peak force application. The intervention enabled participants to complete the task at a higher mean velocity using significantly fewer pushes. This was achieved via a significant increase in the power generated during the push phase. This Letter identifies that a lightweight instrumented wheelchair wheel such as the Sensewheel is a useful adjunct to wheelchair skills training. Targeting the optimisation of push arc resulted in beneficial changes in propulsion technique.

Spinal cord injury (SCI) typically manifests with a loss of sensorimotor control of the lower limbs. In order to overcome some of the disadvantages of chronic wheelchair use by such patients, robotic exoskeletons are an emerging technology that has the potential to transform the lives of patients. However, there are a number of points of contact between the robot and the user, which lead to interaction forces. In a recent study, the authors have shown that peak interaction forces are particularly prominent at the anterior aspect of the right leg. This study uses a similar experimental protocol with additional electromyography (EMG) analysis to examine whether such interaction forces are due to the muscular activity of the participant or the movement of the exoskeleton itself. Interestingly, the authors found that peak forces preceded peak EMG activity. This study did not find a significant correlation between EMG activity and force data, which would indicate that the interaction forces can largely be attributed to the movement of the exoskeleton itself. However, we also report significantly higher correlation coefficients in muscle/force pairs located at the anterior aspect of the right leg. In their previous research, the authors have shown peak interaction forces at the same locations, which suggests that muscular activity of the participant makes a more significant contribution to the interaction forces at these locations. The findings of this study are of significance for incomplete SCI patients, for whom EMG activity may provide an important input to an intuitive control schema.

This Letter presents a capacitive-based sensor system for fingertip contact applications. It is capable of simultaneously measuring normal (pressure) and tangential (shear) stresses at the interface between a fingertip and external objects. This could be potentially exploitable for applications in the fields of upper limb prosthetics, robotics, hand rehabilitation and so on. The system was calibrated and its performance was tested using a test machine. To do so, specific test protocols reproducing typical stress profiles in fingertip contact interactions were designed. Results show the system's capability to measure the applied pressure and stresses, respectively, with high linearity between the measured and applied stresses. Subsequently, as a case study, a ‘press-drag-lift’ based fingertip contact test was conducted by using a finger of a healthy subject. This was to provide an initial evaluation for real-life applications. The case study results indicate that both interface pressure and shear were indeed measured simultaneously, which aligns well with the designed finger test protocols. The potential applications for the sensor system and corresponding future works are also discussed.

This study aimed at developing a prototype of portable FES rehabilitation system for relearning gait pattern of healthy subjects, which can measure gait information during walking applying electrical stimulation for foot drop correction or providing timing information. A gait event detection method using an inertial sensor attached on the foot was determined based on gait of healthy subjects from simultaneous measurements with pressure sensors. From the result of comparing the detected gait event timings with EMG signal of the tibialis anterior muscle during walking of healthy subjects, the toe off and the foot flat timings detected by the inertial sensor were suggested to be useful to determine the stimulation timing for the foot drop correction. The gait event detection method was implemented in a prototype of portable FES rehabilitation system consisting of an 8-inch tablet-type device, 2 inertial sensors and an electrical stimulator. The portable system was examined with hemiplegic subjects under the conditions of FES foot drop correction and inducing voluntary effort to develop ankle dorsiflexion at the timing given by electrical stimulation with small stimulation intensity. The system was considered to be useful for gait rehabilitation of hemiplegia using FES foot drop correction or inducing voluntary effort.

Blood leakages and blood loss are both serious complications during dialysis therapies. According to dialysis survey reports, these events are life-threatening issues for nephrology nurses, medical staff, and patients. When venous needle dislodgement occurs, it takes only <2.5 min of reaction time for blood loss in an adult patient, resulting in mortality. As an early-warning design, a wireless assistive technology using an integrated flexible sensor and virtual alarm unit was developed to detect blood leakage during dialysis therapies. The flexible sensor was designed using a screen print technique with printing electronic circuits on a plastic substrate. A self-organising algorithm was used to design a virtual alarm unit, consisting of a virtual direct current grid and a virtual alarm driver. In other words, this warning device was employed to identify the blood leakage levels via wireless fidelity wireless network in cloud computing. The feasibility was verified, and commercialisation designs can also be implemented in an embedded system.

Smart mobile and wearable technology offers exciting opportunities to support people with dementia (PwD). Its ubiquity and popularity could even benefit user adoption – a great challenge for assistive technology (AT) for PwD that calls for user-centred design (UCD) methods. This study describes a user-centred approach to developing and testing AT based on off-the-shelf pervasive technologies. A prototype is created by combining a smartphone, smartwatch and various applications to offer six support features. This is tested among five end-users (PwD) and their caregivers. Controlled usability testing was followed by field testing in a real-world context. Data is gathered from video recordings, interaction logs, system usability scale questionnaires, logbooks, application usage logs and interviews structured on the unified theory of acceptance and use of technology model. The data is analysed to evaluate usability, usefulness and user acceptance. Results show some promise for user adoption, but highlight challenges to be overcome, emphasising personalisation and familiarity as key considerations. The complete findings regarding usability issues, usefulness of support features and four identified adoption profiles are used to provide a set of recommendations for practitioners and further research. These contribute toward UCD practices for improved smart, pervasive AT for dementia.

The use of walking aids is prevalent among older people and people with mobility impairment. Rollators are designed to support outdoor mobility and require the user to negotiate curbs and slopes in the urban environment. Despite the prevalence of rollators, analysis of their use outside of controlled environments has received relatively little attention. This Letter reports on an initial study to characterise rollator movement. An inertial measurement unit (IMU) was used to measure the motion of the rollator and analytical approaches were developed to extract features characterising the rollator movement, properties of the surface and push events. The analytics were tested in two situations: first, a healthy participant used a rollator in a laboratory using a motion capture system to obtain ground truth. Second, the IMU was used to measure the movement of a rollator being used by a user with multiple sclerosis on a flat surface, cross-slope, up and down slopes and up and down a step. The results showed that surface inclination and distance travelled measured by the IMU have close approximation to the results from ground truth; therefore, demonstrating the potential for IMU-derived metrics to characterise rollator movement and user's pushing style in the outdoor environment.