Rehabilitation Engineering: Principles and Practice

Description

This book will provide an overview of the rehabilitation engineering field, including key concepts that are required to provide a solid foundation about the discipline. It will present these concepts through a mix of basic and applied knowledge from rehabilitation engineering research and practice. It's written as an introductory text in order to provide access to the field by those without previous experience or background in the field.These concepts will include those related to engineering and health that are necessary to understand the application of rehabilitation engineering to support human function. Cover Half Title Series Page Title Page Copyright Page Table of Contents Preface Editors Section I Introduction and overview Chapter 1 History of rehabilitation engineering 1.1 Chapter overview 1.1.1 History of engineering 1.1.2 Biomedical engineering 1.2 Assistive technology 1.2.1 Prosthetics 1.2.2 Technology for vision impairments 1.2.3 Technology for hearing impairments 1.2.4 Technology for mobility impairments 1.2.5 Technology for communication impairments 1.2.6 Computer technology 1.3 The beginning of modern rehabilitation engineering 1.4 Rehabilitation engineering service delivery 1.5 Rehabilitation engineering affects the complex rehabilitation technology market 1.6 Rehabilitation engineering finds a home 1.7 Summary and conclusions 1.8 Discussion questions Bibliography Chapter 2 Assistive technology 2.1 Chapter overview 2.2 Theoretical models and frameworks: Structuring assistive technology reasoning 2.2.1 Informing research and development 2.2.2 Informing practice 2.2.3 Informing education 2.3 Assistive technology: Models and frameworks 2.3.1 The HAAT model 2.3.1.1 Human Understanding the person guides AT development and selection by clarifying what the client can do and what personal skills and abilities the technology needs to augment or replace. In service delivery, consideration is given to the client’s 2.3.1.2 Activity Activity (or occupation) includes areas of self-care, instrumental activities of daily living, productivity and leisure as well as manipulation, cognition, mobility and communication that support these daily activities. Further, when unde 2.3.1.3 Context The context in which the person engages in activities is comprised of physical, social, cultural and institutional elements. Physical aspects include the built or natural environment as well as physical aspects of heat, light and sound tha 2.3.1.4 Assistive technology AT includes devices and strategies in the continuum of low to high complexity. Low technology is simple, often easy to obtain, like a mouth stick or head pointer. High technology is more complex and more difficult to obtain, s 2.3.2 The SETT framework 2.3.3 The CAT model 2.3.4 The MPT model 2.3.5 Theoretical career path 2.3.6 The HETI model 2.4 Assistive technology: The human 2.4.1 Needs and wants 2.4.2 Body structures and functions 2.4.3 Habits and roles 2.4.4 Technology acceptance 2.5 Assistive technology: The activity 2.5.1 Mobility 2.5.2 Manipulation and control of the environment 2.5.3 Communication 2.5.4 Cognition 2.6 Ethical tensions in assistive technology: Challenges and opportunities 2.6.1 Autonomy 2.6.2 Fidelity 2.6.3 Beneficence and non-maleficence 2.6.4 Justice 2.6.5 Stigma 2.7 Future vision 2.8 Discussion questions Bibliography Chapter 3 Key human anatomy and physiology principles as they relate to rehabilitation engineering 3.1 Chapter overview 3.2 Musculoskeletal system 3.2.1 Skeletal system 3.2.2 Muscular system 3.3 Integumentary system 3.4 Respiratory and cardiovascular systems 3.5 Nervous system 3.6 Future developments Bibliography Chapter 4 Psychosocial and cultural aspects of rehabilitation engineering interventions 4.1 Overview 4.1.1 Communication 4.1.2 Service delivery 4.1.3 Special groups 4.2 Defining personal factors 4.3 Importance of personal factors in the successful use of assistive technologies 4.3.1 Desire for Support 4.4 Milieu/environment factors influencing use 4.4.1 Personal attitudes 4.4.2 Personal physical context 4.4.3 Legislative/political context 4.4.4 Economic context 4.4.5 Cultural context 4.5 Culture and assistive technology: how culture impacts use and reflects good (or bad) 4.6 Culture and stigma 4.7 The inclusive engineer 4.8 Conclusion 4.9 Future vision 4.10 Discussion questions Bibliography Chapter 5 Overview of disease, disability, and impairment 5.1 Chapter overview 5.2 Background 5.2.1 Disease and health 5.3 Disability and functioning 5.4 Impairment and participation 5.5 Barriers and facilitators 5.6 Disability, rehabilitation, and assistive technology 5.7 Future vision 5.8 Discussion questions Bibliography Chapter 6 Rehabilitation engineering across the lifespan 6.1 Chapter overview 6.2 Theories relevant to examining lifespan 6.2.1 Stage theories of human development 6.2.2 Lifespan developmental theories 6.2.3 Life course theory 6.2.4 Developmental systems theory 6.3 Development across the lifespan 6.3.1 Early development 6.3.2 Adolescent development 6.3.3 Adult development 6.3.3.1 Early adulthood A variety of physical changes are associated with early adulthood. In the period between 20 and 30 years of age, physical abilities and performance reach their greatest extent (Thies and Travers 2001). Between the ages of 18 and 25 6.3.3.2 Middle adulthood During middle adulthood, some bodily changes are notable with resultant declines in some physical abilities and comparatively stable cognitive abilities. In the musculoskeletal structures, bone and muscle mass decline, while the p 6.3.3.3 Later adulthood While many individuals are healthy and active in later adulthood, bodily changes are even more marked, and physical changes are also more apparent. Bone mass, lean body mass, and water content continue to decline (Thies and Travers 6.4 Variations in development with health-related conditions and disability 6.4.1 Early development 6.4.2 Adult and older adult development 6.5 Care approaches across the lifespan: who is the client? 6.6 Misconceptions related to working with clients across the lifespan 6.6.1 Age discrimination 6.6.2 Ableism 6.6.3 Assuming incompetence 6.6.4 Therapeutic nihilism 6.6.5 Expectations related to normative development 6.7 Future vision 6.8 Discussion questions Bibliography Section II Key topics in rehabilitation engineering Chapter 7 Policy and regulations in rehabilitation engineering 7.1 Chapter overview 7.2 Unique aspects of education and training in rehabilitation engineering 7.3 Formal education, training, and accreditation 7.3.1 Graduate attributes in international accords 7.3.2 Attributes for rehabilitation technologists, technicians, and associates 7.3.3 Competencies for independent practice 7.3.4 Credentialing in rehabilitation engineering and assistive technology competencies 7.3.5 Ongoing and continuing professional development 7.4 Regulations affecting professional practice 7.4.1 Workplace and industrial legislation and regulations 7.4.2 Industry – and service setting-specific legislation and regulations 7.4.3 Statute, corporate, and case law 7.5 Technical policies and regulations relating to technologies 7.5.1 Product and process standards 7.5.2 Medical device regulations 7.5.3 Protecting intellectual property 7.6 Future vision 7.7 Discussion questions Bibliography Chapter 8 Ethical issues in rehabilitation engineering 8.1 Chapter overview—what is ethics? 8.2 What is “rehabilitation” engineering? 8.3 The AT evaluation process 8.3.1 Implementing the HAAT model 8.3.2 The value of the client-centered intervention 8.3.3 Holistic intervention 8.3.4 The other AT team members 8.4 Your role on the AT team 8.5 The RESNA code of ethics for rehabilitation engineers 8.5.1 Hold paramount the welfare of persons served professionally 8.5.2 Practice only in their area(s) of expertise 8.5.3 Maintain the confidentiality of privileged information 8.5.4 Engage in no conduct that constitutes a conflict of interest or that adversely reflects on the association, and more broadly, on professional practice 8.5.5 Seek deserved and reasonable remuneration for services 8.5.6 Inform and educate the public on rehabilitation engineering and assistive technology and its applications 8.5.7 Comply with the laws and policies that guide professional practice 8.6 Conclusion 8.7 Case study #1 8.7.1 Ethical response 8.7.2 Ethical principles being violated 8.8 Case study #2 8.8.1 Additional questions for discussion for case study #2 Bibliography Chapter 9 Rehabilitation engineering in the assistive technology industry 9.1 Chapter overview 9.2 The role of rehabilitation engineering in the AT industry 9.3 AT classification systems 9.3.1 Formal classification systems 9.3.2 Informal classification systems 9.3.2.1 United States All AT devices are intended to address functional limitations by providing interventions for the person, the task or the environment. Consequently, human functions are, so far, the most successful organizing constructs for AT product 9.3.2.2 European Union The European Union applied the structure found within the International Standards Organization (ISO) to create the first alpha-numeric classification system for AT devices consisting of a hierarchical structure of classes, subclasse 9.4 Obstacles preventing a clear definition of the AT industry 9.4.1 Primary obstacle to AT industry definition 9.4.2 Secondary obstacles to clearly define the AT industry 9.5 Provisional profile for the AT industry 9.5.1 A sample of AT companies 9.5.2 AT industry factors and dynamics 9.5.3 Barriers to entry 9.5.4 Crucial information gaps in the AT industry 9.6 Future of the AT industry 9.6.1 AT industry performance as an indicator of future trends 9.6.2 AT industry life cycle path 9.6.3 AT industry globalization efforts 9.7 Discussion questions Bibliography Chapter 10 Understanding the end user 10.1 Chapter overview 10.2 Introduction 10.2.1 The evolution of user-centered models of technology design 10.3 Methods for understanding the user 10.4 Connecting with the user 10.5 Case studies 10.5.1 Case study 1: user-directed implementation of adapted controls for driving (written by Johnny Kelley) 10.5.2 Case study 2: involving end users in research to design and develop novel assistive technologies for home use 10.6 Ethical considerations 10.7 Conclusions 10.8 Future vision 10.9 Discussion questions Bibliography Chapter 11 Rehabilitation engineering in less resourced settings 11.1 Chapter overview 11.2 History 11.3 Context 11.4 Availability of materials in LRS 11.4.1 Wood 11.4.2 Metals 11.4.3 Rubber 11.4.4 Foams and fabrics 11.4.5 Plastics 11.5 Availability of tools in LRS 11.5.1 Hand tools 11.5.2 Power tools 11.6 Product development for LRS 11.7 Product testing in LRS 11.7.1 Testing principles 11.7.2 Qualifying tests 11.7.2.1 R&D tests Introduction: When a new wheelchair is designed, an existing design is modified, or new components are designed or modified it is important to perform tests prior to launching the product. Testing will help ensure the product is safe an 11.8 Extended user trials 11.9 The user experience 11.10 Organizations engaged in LRS 11.11 Sustainability 11.12 Working in LRS 11.13 Ethics 11.14 The future of RE and provision of AT in LRS 11.15 Discussion questions Bibliography Section III Rehabilitation engineering and areas of application Chapter 12 Rehabilitation engineering seating and mobility 12.1 Chapter overview 12.2 Introduction 12.3 Assistive technology service delivery 12.4 Transportation for wheelchair users 12.5 Basic seating principles 12.5.1 Manual wheelchairs 12.5.2 Powered wheelchairs 12.5.3 Control system 12.6 Robotic and connected wheelchairs and seating 12.6.1 Robotic-powered wheelchairs 12.6.2 Assistive robotic manipulators 12.7 Basic wheelchair design principles 12.7.1 User needs and characteristics 12.7.2 Manual wheelchairs 12.7.3 Powered wheelchairs 12.7.4 Drive wheel configurations 12.7.5 Seating system 12.8 Wheelchair maintenance 12.9 Key concepts 12.10 Custom wheelchair accessories through digital fabrication 12.11 Discussion questions Bibliography Chapter 13 Universal design and the built environment 13.1 Chapter overview 13.2 The need for universal design 13.3 Evolution of universal design 13.4 Who benefits from universal design? 13.5 Universal design and housing 13.6 Universal design and public accommodations 13.7 Universal design and streetscapes 13.8 Universal design and public transportation 13.9 Universal design and products 13.10 The future 13.11 Discussion questions Bibliography Chapter 14 Wireless technologies 14.1 Chapter overview 14.2 Evolution of mobile phone use by people with disabilities: 1990s–present 14.2.1 Deaf consumers 14.2.2 Hearing aid users 14.2.3 Blind and low vision consumers 14.2.4 Consumers with complex communications needs 14.2.5 Consumers with mobility and dexterity limitations 14.3 Legislation and regulation 14.4 Wireless device ownership and activities 14.5 Internet of Things: Smart homes and wearable technology 14.6 Future vision – “you are the product”: Mass data intelligence, pervasive systems 14.7 Discussion questions Bibliography Chapter 15 Transportation access 15.1 Chapter overview 15.2 Pedestrian travel 15.2.1 Accessible routes 15.2.2 Wayfinding and navigation 15.2.3 Bicycles and non-roadway vehicles 15.3 Automobiles 15.3.1 Ingress/egress 15.3.2 Securement 15.3.3 Vehicle control 15.3.4 Driver-vehicle interaction 15.4 Mass transportation 15.4.1 Pre-trip 15.4.2 Wayfinding and navigation 15.4.3 Ingress/egress 15.4.4 On-board circulation 15.4.5 Human service 15.5 Future vision 15.5.1 Connected vehicles and pedestrians 15.5.2 Autonomous vehicles 15.5.3 Guardian angel systems 15.6 Opportunities for rehabilitation engineers in transportation 15.7 Discussion questions Bibliography Chapter 16 Rehabilitation robotics 16.1 Chapter overview 16.2 Need/motivation and definitions 16.2.1 Target populations 16.2.1.1 Stroke A stroke or a cerebrovascular accident occurs when blood flow to the cerebral vasculature is blocked or cut off, resulting in a failure to supply oxygen to brain cells. This causes brain cells to die due to oxygen deprivation. A stroke may 16.2.1.2 Traumatic brain injury A traumatic brain injury (TBI) is typically caused by a bump, blow, jolt, or other head injuries that cause damage to the brain. Half of TBIs are caused by motor vehicle accidents, with other causes being falls and military 16.2.1.3 Spinal cord injury A spinal cord injury (SCI) impacts the vertebral column disrupting the signals between the body and the brain. The annual global incidence of SCI ranges from 13.1 to 163.4 per million new cases each year. The most common causes 16.2.1.4 Parkinson’s disease Parkinson’s disease is a movement disorder that occurs when the brain nerve cells do not produce enough of a chemical called dopamine (Abbruzzese et al. 2016). It is estimated that about ten million people worldwide have Parki 16.2.1.5 Multiple sclerosis Multiple sclerosis (MS) is a disorder of the nervous system that impacts the brain and the spinal cord by damaging the myelin sheath that surrounds and protects the nerve cells. This damage slows down or blocks messages between 16.2.1.6 Cerebral palsy Cerebral palsy is a group of neurological disorders that appear in infancy or early childhood that affect body movement and muscle coordination caused by damage to the brain. According to the Centers for Disease Control and Prevent 16.2.1.7 Elders The population of older adults is growing around the world. There were 962 million individuals aged 60 and older in 2017 and this number is expected to increase to 2.1 billion by 2050, especially due to the aging of the baby boomer generat 16.3 Therapy robots 16.3.1 Lower limb therapy robots 16.3.2 Upper limb therapy robots 16.3.3 Simpler and more affordable therapy robots 16.4 Assistive robots 16.5 Clinical considerations 16.6 Robot design considerations 16.7 Future directions 16.8 Discussion questions Bibliography Chapter 17 Universal interfaces and information technology 17.1 Chapter overview 17.1.1 We will all experience disabilities – if we live long enough 17.2 Spectrum of user interface needs 17.3 Strategies for addressing user needs 17.3.1 General approaches 17.3.2 Pluggable user interfaces 17.3.3 Working together, blending together 17.3.4 Specific strategies to address needs 17.4 Priorities in implementation 17.4.1 First dimension for prioritization: Accessibility/usability 17.4.2 The second dimension affecting prioritization: Independence vs. co-dependence 17.4.3 The third dimension affecting prioritization: Efficiency and urgency requirement 17.4.4 A pseudo-priority dimension: Ease of implementation 17.4.5 Cognitive constraints: A unique dimension 17.4.6 Setting priorities 17.5 Discussion questions Bibliography Chapter 18 AAC in the 21st century: The outcome of technology: Advancements and amended societal attitudes 18.1 Chapter overview 18.1.1 Social history 18.2 Research 18.2.1 AAC access research: Efficiency and production rates 18.2.2 Access 18.2.3 Interaction in time with technology 18.2.4 Integrating research findings into practice: Responsibilities of the rehabilitation engineer 18.3 Synthetic speech 18.3.1 Speech synthesis and personal identity 18.3.2 Voice banking 18.4 Alternative access technologies for AAC 18.4.1 Access defined 18.4.2 Assessment of alternative access technologies 18.4.3 Exploring alternative access technologies 18.4.3.1 Direct access methods Traditional input devices should first be considered such as mice, trackpads, trackballs, and joysticks controlled by a hand, foot, or mouth. External input devices can connect to computers, mobile devices, and SGDs through 18.4.3.2 Indirect access methods Adaptive switches allow a person to activate assistive technology devices in their environment. A switch acts as an interface between the user and a computer, toy, environmental control unit, or other device. The individua 18.4.4 Switch skill progression 18.4.5 The future of alternative access technologies 18.5 Low- and mid-technology options 18.5.1 Benefits and limitations of low-tech and mid-tech AAC 18.6 High-technology communication options 18.6.1 Types of high-tech AAC 18.6.2 Display options 18.6.3 Physical access options 18.7 Service delivery 18.7.1 Participation and feature matching models 18.7.1.1 Participation model Currently, two complementary models of assessment and service delivery are considered to be best practice. They are the participation model and the feature matching model. The participation model focuses on providing the indiv 18.7.1.2 Feature matching model Imagine a room filled with the latest and most effective low-, mid-, and high-tech devices along with a growing collection of peripherals such as symbol sets, switches, mounting hardware, and so on. This assembly of product 18.7.2 Changes to service delivery models in the last decade 18.8 Conclusion 18.9 Discussion questions References Chapter 19 Cognitive technologies 19.1 Chapter overview 19.2 Introduction: Background 19.2.1 Cognitive disability statistics 19.2.2 Cognitive disability 19.2.3 Overview of design and development considerations 19.3 Mobile technologies 19.3.1 Activities of daily living 19.3.2 Workplace 19.3.3 Training/therapy 19.4 Computer-driven software 19.4.1 Activities of daily living 19.4.2 Training/therapy 19.4.3 Education 19.5 Virtual reality 19.5.1 Training/therapy 19.6 Social assistive robots 19.6.1 Activities of daily living 19.6.2 Training/therapy 19.6.3 Assessment 19.7 Smart home technology 19.7.1 Activities of daily living 19.8 Future vision 19.9 Discussion questions Bibliography Chapter 20 Technology for sensory impairments (vision and hearing) 20.1 Chapter overview 20.2 Introduction: Historical overview 20.3 The visually impaired population: User characteristics and needs 20.4 Impact of emerging visual prostheses and new medical treatments 20.5 Vision measures and assessment 20.6 Technology for reading, writing, and note taking 20.6.1 Audio recordings 20.6.2 Braille reading and writing technology 20.6.3 Optical low vision aids 20.6.4 “CCTV” magnifiers 20.6.5 Pocket electronic magnifiers 20.6.6 Head-mounted electronic devices 20.6.7 Large print production 20.6.8 Low vision writing aids 20.6.9 Lighting 20.7 Access to graphical and pictorial information 20.7.1 Textual image description 20.7.2 Tactile and audio-tactile graphics 20.7.3 Active tactile displays 20.7.4 Computer graphics access 20.8 Access to computers and the internet 20.8.1 Screen readers 20.8.2 Speech output 20.8.3 Braille output 20.8.4 Screen magnification software 20.8.5 Internet access 20.8.6 Access to video information 20.9 Access to communications and portable computing devices 20.9.1 Landline phones 20.9.2 Smartphones 20.9.3 Smartphone apps 20.10 Access to appliances, displays, and daily living activities 20.10.1 Appliances with mechanical controls 20.10.2 Access to appliances with digital displays and controls 20.10.3 Talking appliances 20.10.4 “Connected” appliances 20.10.5 Lighting 20.11 Jobsite, career, and STEM technology 20.11.1 Technologies for traditional professions 20.11.2 Technology for STEM careers and pastimes 20.12 Technology for independent travel 20.12.1 Canes and guide dogs 20.12.2 Obstacle detectors and environmental sensors 20.12.3 Accessible GPS 20.12.4 Accessible signage 20.12.5 Travel with low vision 20.12.6 Tactile, audio-tactile, and large print maps 20.13 Recreational technology 20.13.1 Physical recreation 20.13.2 Indoor recreational activities 20.13.3 Music 20.13.4 Television and movies 20.13.5 Low vision aids 20.14 General purpose remote assistance technology 20.15 Hearing loss: Prevalence and types of loss 20.15.1 Causes of hearing loss 20.15.2 Types of hearing loss 20.16 Evolution of the hearing aid 20.16.1 The pre-electronic era 20.16.2 The electronic era 20.16.3 The digital era 20.17 The hearing aid as a personal communication aid 20.18 Future vision Bibliography Chapter 21 Prosthetic and orthotic devices 21.1 Chapter overview 21.2 Prosthetic devices 21.2.1 History of limb prostheses 21.2.2 Amputation levels and etiology 21.2.3 Rehabilitation and prosthetic design for lower extremity amputees 21.2.3.1 Rehabilitation A successful functional outcome for a patient with limb loss requires the cooperation and communication of the rehabilitation team. This collaborative effort may begin before amputation. For example, the amputation surgeon (e.g., 21.2.3.2 Prosthetic prescription Reimbursement criteria for prosthetic devices via both federal and private insurance in the United States typically adhere to Medicare policies and guidelines. These guidelines are based on functional level definitions tha 21.2.3.3 Prosthetic components and design Various prosthetic components are available, from many manufacturers, to meet the different functional needs of the individual. New components are frequently introduced to address unmet needs, reduce prosthesis ma 21.2.3.4 Sports/running prostheses Other technologies include activity-specific prostheses such as “running blades” (Figure 21.8), swim legs, modified feet for rock climbing, and rotators to facilitate golfing and dancing. The running feet incorporate car 21.2.3.5 Prosthetic fit, volume adjustment, and alignment While the fit and comfort of the prosthetic socket are critical to prosthesis use, the stability and function of the prosthesis are also dependent on the alignment of the various prosthetic compone 21.2.3.6 Functional outcomes In addition to the qualitative assessment of socket fit and static/dynamic prosthetic alignment, quantitative evaluation of functional outcomes is imperative in demonstrating the medical necessity for the prescribed prosthesis 21.2.3.7 Emerging technologies in lower extremity prosthetic devices and amputation surgery Emerging technologies include recent advances in prosthetic power and control. Until recently, all lower limb prostheses were passive, relying on the remnant muscu 21.2.4 Upper extremity amputation, rehabilitation, and prosthetic devices 21.2.4.1 Rehabilitation In contrast to lower limb amputees for whom physical therapy is critical for successful prosthetic outcomes, both physical and occupational therapy are important for upper extremity amputees. Many activities of daily living require 21.2.4.2 Prosthetic prescription There is a wide variety of prosthetic components available to address the functional needs of upper extremity amputees at the various amputation levels. As the most common upper extremity amputation levels are at the trans 21.2.4.3 Prosthetic components Similar to lower limb prostheses, upper limb prostheses vary based on amputation level, proximal joint mobility, functional needs, desired reliability, comfort, cosmesis, and cost constraints. These factors influence the sel 21.2.4.4 Emerging technology in upper extremity prosthetic devices and amputation surgery Recent advances in upper extremity componentry include externally powered prosthetic hands that incorporate independent finger movement and variable grasp patterns, 21.3 Orthotic devices 21.3.1 History of orthotics 21.3.2 Types of orthoses 21.3.3 Lower limb orthoses 21.3.4 Upper limb orthoses 21.3.5 Spinal orthoses 21.3.6 Orthotic design and treatment objectives 21.3.7 Medical conditions benefiting from orthotic intervention 21.3.8 Orthotic prescription and fitting 21.3.8.1 Prefabricated versus custom orthoses Orthoses may be classified as prefabricated or “off-the-shelf” (OTS), custom-fitted, and custom-fabricated. Prefabricated orthoses are available in a variety of sizes and require minimal adjustments to fit an 21.3.9 Orthotic design 21.3.10 Functional outcomes 21.4 Future vision 21.5 Discussion questions Bibliography Chapter 22 Neural engineering 22.1 Chapter overview 22.2 Functional electrical stimulation 22.2.1 Introduction to functional electrical stimulation 22.2.2 Drop foot stimulator 22.2.3 FES for standing 22.2.4 FES for walking 22.2.5 Spinal cord stimulation 22.2.6 FES for upper limb function 22.3 Electrical neuromodulation 22.3.1 Restoring bladder function 22.3.2 Neuroprostheses for urinary incontinence 22.3.3 Neuroprosthesis for bladder voiding 22.4 Concluding remarks 22.5 Discussion questions Bibliography Section IV Outcomes and assessments Chapter 23 Assessment approaches in rehabilitation engineering 23.1 Chapter overview 23.2 The rehabilitation engineering assessment methodology 23.3 Models and instruments contribute to a systematic approach of the assessment process 23.4 Best practices and commonalities 23.4.1 Individual centered 23.4.2 Family/support system inclusion 23.4.3 Goal setting 23.4.4 Consideration of environment and task 23.4.5 Transdisciplinary 23.4.6 Consideration of culture 23.5 Following best practices in lieu of REP environment or referral source constraints 23.6 Conducting a high-quality assistive technology assessment 23.6.1 Recognition of need 23.6.2 Collect information 23.6.3 Assess abilities 23.6.4 Develop specifications 23.6.4.1 Determination of access method Next, determine an access method. An access method is how the individual is going to interface with the technology. There are two components, one is input and one is feedback. How does the person know that their inp 23.6.4.2 Development and prioritization of a feature list After possible access methods are determined, the next step is the development of a feature list (also called a specification list or characteristic list). This helps the REP and transdisciplinary 23.6.5 Determine/trial possible solutions 23.6.6 Select preferred solution 23.6.7 Communicate solution and implementation plan 23.7 Continuing service delivery process – implementation and training 23.8 Quality assurance and outcome measurement in the assessment process 23.9 Future vision 23.10 Discussion questions Bibliography Chapter 24 Product usability testing and outcomes: What works? for whom? and why? 24.1 Chapter overview 24.2 Background and problem 24.2.1 Literature on usability testing 24.2.2 Usability standards 24.2.3 Products, interfaces and usability 24.3 Purpose of usability testing 24.3.1 Providing information to make informed decisions 24.3.1.1 Informing design Designers are not generally representative of the range of users who will use the products they design and, even when they understand the needs of some users, users often use products or expect them to function in the ways that d 24.3.1.2 Informing production Usability is a market separator. As a result, testing is used to enhance sales and get user buy-in for changes and updates. In addition, data that can be used to remedy usability problems prior to release can increase profita 24.3.1.3 Informing service provision Service providers, including rehabilitation specialists, clinicians, usability specialists, sales representatives, product support staff, third party payers and consumer organizations, among others, are responsible wit 24.3.1.4 Informing consumption/use Consumers, such as corporate buyers who purchase products for others, and actual users are most likely to know their own needs and abilities. As a result, usability information that will enable users to make their own de 24.3.2 Generating information to make informed decisions 24.3.2.1 Formative evaluation Formative evaluation is a process that provides feedback to improve product usability during the design process. In practice, formative testing is a find-and-fix approach (Redish and others 2002) focused on problem diagnosis 24.3.2.2 Summative evaluation Summative evaluation is intended to establish the usability of a complete product rather than its specific characteristics. It can be used to inform each of the four types of decisions described above, although it is most use 24.3.2.3 Formative vs summative evaluation Formative testing can be a quick-and-dirty process to quickly identify what works at the level of the product and interface features, for whom and why. As a result, it identifies the broadest range of potential u 24.4 What works, for whom and why 24.4.1 Models for understanding what works, for whom and why 24.4.2 Methods for understanding what works, for whom and why 24.4.2.1 Usability expert reviews Expert reviews are formative evaluations that occur early in the design process (i.e., at the conceptual stage) to provide feedback that will either guide or refine initial design concepts. Expert reviews are useful in pr 24.4.2.2 Focus group reviews (subject matter experts or users) Group discussions are used to provide formative evaluation of one or more prototype designs at the middle stages of the design process. It is typically effective in comparing several initial d 24.4.2.3 User testing Testing with actual product users is the most effective method of conducting both formative and summative evaluations. The former is most often implemented in a controlled laboratory setting to inform the design process. Although lab 24.5 What works: quantifying usability outcomes (dependent variables) 24.5.1 Outcome measure domains 24.5.1.1 Types of outcome domains There are two types of outcome domains – those that identify key outcomes directly and those that do so indirectly. The former, as represented by the ISO and Nielsen’s HCI domain models, directly identify performance and 24.5.2 Direct outcome measures of user interaction 24.5.2.1 Usability outcomes for mechanical and consumer products (ISO 202082-2:2013) This standard classifies usability based on ISO 9241-11, which defines usability as product effectiveness, efficiency and satisfaction. This definition has remained intac 24.5.2.2 Usability outcomes for quality in use and product quality (ISO/IEC 25010:2011) ISO/IEC 25010:2011 (2011) sets requirements for software and computer systems, although the standard recognizes that many of the characteristics are also relevant to w 24.5.2.3 HCI outcomes (Nielsen 2012) Jakob Nielsen has long proposed a system for HCI that categorizes usability by five domains: learnability, efficiency, memorability, errors and satisfaction. In many ways these domains are a hybrid of the two ISO model 24.5.3 Indirect outcome measures of product performance 24.5.3.1 Usability dimensions for consumer electronic products (Kim and Han 2008) In an effort to develop an overall usability index for consumer electronic products, Kim and Han (2008) developed a comprehensive list of the usability outcomes that would b 24.5.3.2 Usability scale for assistive technology (Arthanat and others 2007) To evaluate the usability of AT devices the usability scale for AT (USAT) was conceptualized as a function of the individual’s participation in activities with the AT device, the 24.5.3.3 Principles of universal design (Connell and others 1997) A decade before either Kim and Han’s usability dimensions or the iPhone, a group of experts representing a range of design disciplines developed the seven principles of universal design (UD 24.5.4 Performance and preference 24.5.4.1 Subjective outcomes Although subjective response outcomes are identified in all four of the other frameworks, including ISO’s domain of appropriateness recognizability, Nielsen’s satisfaction, Kim and Han’s effectiveness and USAT’s suitability an 24.5.4.2 Accessibility The UD principles are silent on the issue of accessibility for good reason. The first principle of equitable use includes a guideline that promotes the same means of use for all users, regardless of ability. Since this applies to al 24.5.4.3 Breadth By virtue of their being design guidelines, the three indirectly derived outcome domain frameworks are more comprehensive compared to the domains in the two direct frameworks, with the UD principles being the most robust. Among those doma 24.6 For whom: matching people to products 24.6.1 Accessibility vs usability 24.6.2 Identifying participants for usability testing 24.6.3 Selecting the number of participants 24.7 Why: identifying design measures (independent variables) 24.7.1 Design features 24.7.2 Design characteristics 24.8 A case study of what works, for whom and why 24.8.1 What works 24.8.2 For whom 24.8.3 Why 24.9 Chapter summary 24.10 Discussion questions Bibliography Index