ASSISTIVE DEVICES
Definition:
“Any Device that is designed, made, or adapted to assist a person perform a particular task is known as Assistive Device”.
Ø Assistive devices for Mobility / Ambulation
§ Canes
§ Crutches
§ Walkers
Ø Assistive devices for Activities of Daily Living (ADL) and Self-Care
§ Plate Guards
§ Spoons With Built Up Handles
§ Elastic Shoelaces
§ Doorknobs With Rubber Levers
Ø Assistive devices for Hearing, Vision, and Safety
§ Hearing Aids
§ Magnifying Glasses
§ Hand Railings for Stairs
Assistive devices for mobility / ambulation can be referred to as ambulatory aids. Ambulatory aids (eg, canes, crutches, walkers) are used to provide an extension of the upper extremities to help transmit body weight and provide support for the patient.
The type of ambulatory aid needed depends on how much balance and weight-bearing assistance is needed. Generally, the more disabled the individual is, the greater the complexity required in the walking device.
A walker supplies the most support, and a standard cane provides the least.
USES OF ASSISTIVE DEVICES INCLUDE THE FOLLOWING:
Ø Redistribute and unload a weight-bearing lower limb
Ø Improve balance
Ø Reduce lower limb pain
Ø Provide sensory feedback
Adequate upper limb strength, coordination, and hand function are required for the proper use of ambulatory aids.
Assistive devices for ADL, as well as for self-care and leisure activities, range from simple objects for daily use (eg, plate guards, spoons with built-up handles, elastic shoelaces, doorknobs with rubber levers) to complex electronic devices, such as voice-activated environmental control systems.
Batavia and Hammer identified 4 key Evaluation and Selection Criteria for long-term users of assistive devices:
Effectiveness - The extent to which the function of the device improves one's living situation, functional capability, or independence
Affordability - The extent to which the purchase, maintenance, or repair of the device causes financial difficulty
Operability - The extent to which the device is easy to operate and adequately responds to demands
Dependability - The extent to which the device operates with repeatable and predictable levels of accuracy under conditions of reasonable use
ASSISTIVE DEVICES AND THEIR USE FOR IMPAIRMENTS
Impairments and the associated assistive devices that aid in ambulation and mobility are as follows:
v Mildly impaired balance/stability - Single-point cane
v Unilateral lower limb pain/mild weakness - Single-point cane; hold with unaffected side
v Moderate impaired balance/stability - Quad cane (narrow or wide base)
v Moderate-to-severe unilateral weakness/hemiplegia - Walk cane/hemiwalker
v Bilateral lower extremity weakness/paralysis - Bilateral crutches or walker (pickup or front-wheeled)
v Severely impaired stability - Walker (pickup or front-wheeled)
v Impaired wrist or hand function - Platform forearm walker
v Difficulty climbing stairs - Stair-climbing walker
v Impaired bed mobility - Bed rails (half or full); hospital bed (manual or electrically controlled)
v Difficulty with transfer - Transfer (sliding) board
v Difficulty getting up from chair - Seat-lift chair or uplift seat assist
IMPAIRMENTS AND ASSOCIATED ASSISTIVE DEVICES THAT AID IN ADL
LIMITED HAND FUNCTION AND FINE MOTOR CONTROL
Eating - Built-up utensils, universal cuff with utensil hold
Dressing - Button hook, zipper hook, Velcro closure, sock aid, long shoe horn, elastic shoe laces
Bathing - Wash mitts, long-handled sponge
Grooming - Built-up combs or brushes, electric toothbrush, electric razor with custom handle
Loss in 1 hand of eating-related functions - Plate guard, rocker knife
Impaired coordination, tremor - Weighted utensils
Impaired range of motion (ROM) of shoulder, proximal weakness - Reacher
Impaired mobility for bathing - Tub transfer bench, hand-held shower, grab bars on tub or shower; shower chair
IMPAIRMENTS AND ASSOCIATED ASSISTIVE DEVICES
v Difficulty holding pen to write - Built-up pen or pencil
v Difficulty typing - Typing stick
v Reading difficulty caused by impaired vision - Magnifying glasses, talking clock or watch
v Difficulty dialing and using phone - Push-button dialing or 1-touch dialing with speaker phone; voice-activated phone
v Difficulty calling for help - Simple buzzers or other signaling devices operated by switches that require minimal pressure; medical alert system, such as Life Alert.
IMPAIRMENTS DUE TO COMPLETE LOSS OF ALL 4 LIMBS OR LIMB MOTOR FUNCTION
Brain-computer interface (BCI) devices or motor neuroprosthetic devices are systems that allow individuals to translate in real time the electrical activity of the brain into overt device control such that it reflects the user’s intentions. In essence, these constructs can decode the electrophysiologic signals representing motor intent. They do not rely on muscular activity and can therefore provide communication and control for those who are severely paralyzed due to injury or disease.
Current BCIs differ in how the neural activity of the brain is recorded, how subjects (human or animal) are trained to produce a specific electroencephalographic response, how the signals are translated into device commands, and which application is provided to the user. Patients with any of a variety of conditions, such as locked-in syndrome, spinal cord injury, stroke, limb loss, or a neuromuscular disorder, may benefit from the implantation of these BCIs, which augment the ability of a patient to communicate and interact with his/her environment.