Assistive technology (AT) is a term for assistive, adaptive, and rehabilitative devices for people with disabilities and the elderly. People with disabilities often have difficulty performing activities of daily living (ADLs) independently, or even with assistance. ADLs are self-care activities that include toileting, mobility (ambulation), eating, bathing, dressing, grooming, and personal device care. Assistive technology can ameliorate the effects of disabilities that limit the ability to perform ADLs. Adaptive equipment promotes greater independence and creates new opportunities by enabling people to perform tasks they were formerly unable to accomplish, or had great difficulty accomplishing, by providing enhancements to, or changing methods of interacting with, the technology needed to accomplish such tasks to allow for future success. For example, wheelchairs provide independent mobility for those who cannot walk, while assistive eating devices can enable people who cannot feed themselves to do so. Due to assistive technology, people with disabilities have an opportunity of a more positive and easygoing lifestyle, with an increase in "social participation", "security and control", and a greater chance to "reduce institutional costs without significantly increasing household expenses." In schools, assistive technology can be critical in allowing students with disabilities to access the general education curriculum. Students who experience challenges writing or keyboarding, for example, can use voice recognition software instead. Assistive technologies assist people who are recovering from strokes and people who have sustained injuries that affect their daily tasks.
A recent study from India led by Edmond Fernandes et al. from Edward & Cynthia Institute of Public Health which was published in WHO SEARO Journal informed that geriatric care policies which address functional difficulties among older people ought to be mainstreamed, resolve out-of-pocket spending for assistive technologies, and look at government schemes for social protection.
Adaptive technology Adaptive technology and assistive technology are different. Assistive technology is something that is used to help people with disabilities, while adaptive technology covers items that are specifically designed for disabled people and would seldom be used by a non-disabled person. In other words, assistive technology is any object or system that helps people with disabilities, while adaptive technology is specifically designed for disabled people. Consequently, adaptive technology is a subset of assistive technology. Adaptive technology often refers specifically to electronic and information technology access.
Adaptive equipment are devices that are used to assist bathing, dressing, grooming, toileting, and feeding are self-care activities that are including in the spectrum of activities of daily living (ADLs). Jennifer McLaughlin Maly a P.T./ D.P.T. in her article located in the journal Exceptional Parent gives a more complete definition of adaptive equipment:
A growing market for adaptive equipment is in the use of mobility vans. In this case, adaptive equipment, also known as assistive technology, can help a person with a disability operate a motor vehicle when otherwise they would not be able to.
Occupational therapy and assistive technology Occupational Therapy (OT) utilizes everyday occupations as a therapeutic tool for enhancing or enabling participation in healthy occupations to promote health and well-being (AOTA, 2020). Occupations include activities of daily living (ADLs), instrumental activities of daily living (IADLs), health management, rest and sleep, education, work, play, leisure, and social participation (AOTA, 2020). "As occupational therapy professionals, we are uniquely trained to advocate for client-centered care that reduces barriers to participation in meaningful occupations and promotes overall well-being" (Clark, Iqbal & Myers, 2022)
OT practitioners (OTP) utilize assistive technologies (AT) to modify environments and promote access and fit to facilitate independence. For example, voice activated smart home technology allows an individual to control devices such as light switches, thermostat, oven, blinds, and music from their location. OTP evaluate client's strengths and abilities and connects with desired tasks. OTP help empower the client to match specific goals to AT tools. The theoretical approaches or frameworks OTPs frequently use to guide a client's AT choices may include: 1) The HAAT model by Cook, Polgar & Encarnaçāo (2015) 2) The interdependence - Human Activity Assistive Technology Model (I-HAAT) by Lee, et al. (2020); 3) The SETT Framework by Zabala (2005); or 4) The Unified Theory of Acceptance and Use of Technology (UTAUT 2) by Venkatesh, Thong & Xu (2012). Also, OTPs may seek advanced training through the Rehabilitation Engineering and Assistive Technology Society of North America (RESNA) organization to receive their Assistive Technology Professional (ATP) Certification and/or Seating and Mobility Specialist (SMS) Certification. Additional trainings and certifications may specialize in a focus area such as the Certified Assistive Technology Instructional Specialist for Individuals with Visual Impairments (CATIS™) (ACVREP, 2024).
Mobility impairments
There are several types of assistive devices. Wheelchairs
A manual or motorized wheelchair is a chair with attached wheels that allow a person who cannot walk, due to illness, injury, or disability, to move around. Wheelchairs are devices that can be manually propelled or electrically propelled, and that include a seating system and are designed to be a substitute for the normal mobility that most people have. Wheelchairs and other mobility devices allow people to perform mobility-related activities of daily living which include feeding, toileting, dressing, grooming, and bathing. The devices come in a number of variations where they can be propelled either by hand or by motors where the occupant uses electrical controls to manage motors and seating control actuators through a joystick, sip-and-puff control, head switches or other input devices.Francisco Sandoval, et al. "Wheelchair Collaborative Control For Disabled Users Navigating Indoors." Artificial Intelligence in Medicine 52.3 (2011): 177–191. Academic Search Complete. Web. 9 April 2013 Often there are handles behind the seat for someone else to do the pushing or input devices for caregivers. Wheelchairs are used by people for whom walking is difficult or impossible due to illness, injury, or disability. Ambulatory wheelchair users may also use other devices, such as walkers.
Newer advancements in wheelchair design enable wheelchairs to climb stairs, go off-road or propel using segway technology or additional add-ons like handbikes or power assists.
Transfer devices
Patient transfer devices generally allow patients with impaired mobility to be moved by caregivers between beds, wheelchairs, commodes, toilets, chairs, stretchers, shower benches, automobiles, swimming pools, and other patient support systems (i.e., radiology, surgical, or examining tables).
The most common devices are transfer benches, stretcher or convertible chairs (for lateral, supine transfer), sit-to-stand lifts (for moving patients from one seated position to another i.e., from wheelchairs to commodes), air bearing inflatable mattresses (for supine transfer i.e., transfer from a gurney to an operating room table), gait belts (or transfer belt) and a slider board (or transfer board), usually used for transfer from a bed to a wheelchair or from a bed to an operating table. Highly dependent patients who cannot assist their caregiver in moving them often require a patient lift (a floor or ceiling-suspended sling lift) which though invented in 1955 and in common use since the early 1960s is still considered the state-of-the-art transfer device by OSHA and the American Nursing Association.
Walkers A walker or walking frame is a tool for people with disabilities who need additional support to maintain balance or stability while walking. It consists of a frame that is about waist high, approximately twelve inches deep and slightly wider than the user. Walkers are also available in other sizes, such as for children, or for heavy people. Modern walkers are height-adjustable. The front two legs of the walker may or may not have wheels attached depending on the strength and abilities of the person using it. It is also common to see caster wheels or glides on the back legs of a walker with wheels on the front.C. Barrué. Personalization and Shared Autonomy in Assistive Technologies. Ph. Thesis. Universitat Politècnica de Catalunya. 2012 A walker with three or four wheels is often referred to as a Rollator.
Treadmills Bodyweight-supported treadmill training (BWSTT) is used to enhance walking ability of people with neurological injury. These machines are therapist-assisted devices that are used in the clinical setting, but is limited by the personnel and labor requirements placed on physical therapists.Hornby, T. George, David H. Zemon, and Donielle Campbell. "Robotic-Assisted, Body-Weight–Supported Treadmill Training in Individuals Following Motor Incomplete Spinal Cord Injury." Physical Therapy 85, no. 1 (January 2005): 52–66. Academic Search Complete, EBSCOhost (accessed 9 April 2013) The BWSTT device, and many others like it, assist physical therapists by providing task-specific practice of walking in people following neurological injury.
Prosthesis A prosthesis, prosthetic, or prosthetic limb is a device that replaces a missing body part caused from either an illness, accident, or a birth defect. It is part of the field of biomechatronics, the science of using mechanical devices with human muscular, musculoskeletal, and nervous systems to assist or enhance motor control lost by trauma, disease, or defect. Prostheses are typically used to replace parts lost by injury (traumatic) or missing from birth (congenital) or to supplement defective body parts. Inside the body, artificial heart valves are in common use with artificial hearts and lungs seeing less common use but under active technology development. Other medical devices and aids that can be considered prosthetics include hearing aids, artificial eyes, palatal obturator, gastric bands, and dentures.
Prostheses are specifically not orthoses, although given certain circumstances, a prosthesis might end up performing some or all of the same functionary benefits as an orthosis. Orthotic devices, or orthoses, are devices used to align, brace, or correct deformities. Orthoses also help to improve the movement of one's joints, spine, or limbs. Prostheses are technically the complete finished item. For instance, a C-Leg knee alone is not a prosthesis, but only a prosthetic component. The complete prosthesis would consist of the attachment system to the residual limb – usually a "socket", and all the attachment hardware components all the way down to and including the terminal device. Despite the technical difference, the terms are often used interchangeably.
An Occupational Therapist's role in prosthetics includes therapy, training, and evaluations. Prosthetic training includes orientation to prosthetic components and terminology, donning and doffing, wearing schedule, and how to care for the residual limb and the prosthesis.
Exoskeletons A powered exoskeleton is a wearable mobile machine that is powered by a system of electric motors, pneumatics, levers, hydraulics, or a combination of technologies that allow for limb movement with increased strength and endurance. Its design aims to provide back support, sense the user's motion, and send a signal to the motors that manage the gears. The exoskeleton supports the shoulder, waist, and thigh, and assists movement for lifting and holding heavy items, while lowering back stress.