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- Anttila, Heidi, et al.
(author)
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Quality of evidence of assistive technology interventions for people with disability : An overview of systematic reviews
- 2012
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In: Technology and Disability. - : IOS Press. - 1055-4181 .- 1878-643X. ; 24:1, s. 9-48
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Journal article (peer-reviewed)abstract
- This overview summarizes the available evidence from systematic reviews of outcomes studies on various assistive technologies (AT) for persons with disabilities. Systematic reviews published between January 2000 and April 2010 were identified by comprehensive literature searches. Study selection, data extraction and methodological quality evaluation were done by two authors independently. The quality of evidence was summarized by explicit methods. Types of disabilities, settings, and AT interventions were recorded. Outcomes were mapped according to the Taxonomy of Assistive Technology Device Outcomes. Forty-four systematic reviews were included in this overview. High-quality evidence was found in single AT (positive effects of providing AT in connection with home assessment and hearing aids, no effects of hip protectors) for limited populations (older people at home, people with hearing loss, and older people in institutional care, respectively). Low-quality or unclear evidence was found for the effectiveness of the other evaluated AT interventions. Current gaps in AT outcomes research were identified. Many frequently used devices have not been systematically reviewed. Well-designed outcomes research to inform clinical decision-making is urgently needed. The systematic review methodology seems to be feasible for summarising AT outcomes research, but methodological development for grading and for primary studies is warranted.
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- Brandt, Ase, et al.
(author)
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Towards an instrument targeting mobility-related participation: Nordic cross-national reliability
- 2008
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In: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1651-2081 .- 1650-1977. ; 40:9, s. 766-772
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Journal article (peer-reviewed)abstract
- Objective: To investigate test-retest reliability and internal consistency of a new instrument for evaluation of mobility device interventions. Material and methods: The instrument comprised 4 scales and one summed index. Two test-retest interviews involved 147 mobility device users (mean age 60 years) with a broad range of functional limitations, living at home. Results: For 2 scales and the summed index the reliability was substantial or almost perfect (K 0.71/ K-W 0.76/intraclass correlation coefficient = 0.93; confidence interval = 0.90-0.95). The reliability of one scale was moderate (K-w 0.4 1), but after reduction of grades and combination with another scale, it was substantial (K-w 0.66). The reliability of the fourth scale was moderate (K-w 0.55). The internal consistency of 3 scales varied from a 0.63 to 0.76. Conclusion: Even thou,,h the test-retest reliability of all but one of the scales of the new instrument was substantial to almost perfect, this study demonstrated that revision is required. The challenges identified were probably due to the highly complex relationship between outdoor participation while using mobility devices and accessibility to the outdoor physical environment. Thus. based on the results of this study the instrument will be revised and subsequently launched as the "Nordic mobility-related participation outcome evaluation of assistive device intervention" (NOMO instrument). More research on the concept of mobility-related participation and the psychometric qualities of the instrument is required.
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- Salminen, Anna-Liisa, et al.
(author)
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Mobility devices to promote activity and participation : a systematic review
- 2009
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In: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 41:9, s. 697-706
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To determine the effectiveness of mobility device interventions in terms of activity and participation for people with mobility limitations.DESIGN: Systematic review. Search of 7 databases during the period 1996 to 2008.METHODS: Controlled studies and non-controlled follow-up studies were included if they covered both baseline and follow-up data and focused on activity and participation. Study participants had to be aged over 18 years with mobility limitations. Mobility device interventions encompassed crutches, walking frames, rollators, manual wheelchairs and powered wheelchairs (including scooter types). Two reviewers independently selected the studies, performed the data extraction, and 4 reviewers assessed the studies’ methodological quality. Disagreements were resolved by consensus.RESULTS: Eight studies were included: one randomized controlled trial, 4 controlled studies, and 3 follow-up studies that included before and after data. Two studies dealt with the effects of powered wheelchair interventions and the other studies with various other types of mobility device. Two studies were of high, internal and external methodological quality. Interventions were found to be clinically effective in terms of activity and participation in 6 studies. The results did not, however, give a unanimous verdict on the effectiveness of mobility devices in enhancing the activity and participation of mobility impaired people.CONCLUSION: Interventions and outcome measurement methods varied between the studies; consequently, it was not possible to draw any general conclusions about the effectiveness of mobility device interventions. However, evidence was found that mobility devices improve users’ activity and participation and increase mobility. A lack of high-quality research hampers conclusions about effectiveness. More original, well-designed research is required.
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5. |
- Samuelsson, Kersti, et al.
(author)
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Effects of lower limb prosthesis on activity, participation, and quality of life : a systematic review
- 2012
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In: Prosthetics and Orthotics International. - : Informa Healthcare / SAGE Publications (UK and US). - 0309-3646 .- 1746-1553. ; 36:2, s. 145-158
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Research review (peer-reviewed)abstract
- Background: Effects presented on the use of assistive devices such as prosthesis are often based on laboratory findings (i.e. efficacy). Objectives: To summarise and evaluate findings from studies on effectiveness of lower limb prostheses for adults in real life contexts, primarily in terms of activity, participation, and quality of life (QoL) and secondarily in terms of user satisfaction, use/non-use, and/or cost-effectiveness. Study Design: Systematic review. Methods: We included controlled studies and non-controlled follow-up studies including both baseline and follow-up data. Using 14 different databases supplemented with manual searches, we searched for studies published from 1998 until June 2009. Results: Out of an initial 818 identified publications, eight met the inclusion criteria. Four studies reported on the effectiveness of a microprocessor-controlled knee (MP-knee) compared to a non-microprocessor-controlled knee (NMP-knee). Results were inconsistent except for quality of life and use/non-use, where the authors reported an improvement with the MP-knee compared to the NMP-knee. The remaining four studies included a diversity of prosthetic intervention measures and types of endpoints. Conclusions: Overall, there was an inconsistency in results and study quality. This review highlights the need for high-quality research studies that reflect the effectiveness of different prosthesis interventions in terms of users daily living and QoL.
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