Search Results (54)

Virtual reality (VR) technologies have gained increasing attention in the field of physical rehabilitation due to their potential to enhance patient engagement and provide adaptive, feedback-rich environments. In this study, we report on the development and preliminary evaluation of a VR-based rehabilitation application aimed at improving upper extremity function, including muscle strength, endurance, and joint mobility. The application delivers a structured set of interactive exercises designed to support recovery through engaging, gamified tasks with real-time performance feedback and scalable difficulty levels. A pilot usability study was conducted with a cohort of target users to assess the system’s practicality, therapeutic relevance, and user satisfaction. Qualitative data were collected to evaluate usability, effectiveness, and areas for further improvement. Preliminary results suggest that the VR application is usable, accessible, and well-received by users, with high levels of engagement reported throughout the intervention. Participants also provided constructive feedback, emphasizing the potential benefits of incorporating enhanced sensory feedback mechanisms to improve immersion and therapeutic impact. These initial findings support the viability of VR-based rehabilitation tools and provide a foundation for future clinical studies aimed at validating their efficacy in diverse patient populations. Full article

Vegetable intake among military Service Members (SMs) is well below public health guidelines, with only 12.9% meeting the Dietary Guidelines for Americans (DGAs). Low vegetable consumption negatively impacts diet quality as measured by the Healthy Eating Index (HEI), and poses risks to health and performance. Given the high physical and mental demands of military life, improving diet quality, including through increased vegetable intake, is crucial for optimizing health and readiness. Providing meal kits may help improve vegetable intake by reducing access-related barriers for SMs living or working on a military base. Furthermore, the addition of spices and herbs is a readily modifiable accompanying approach to address taste-related barriers and increase intake that has shown promise in other populations with poor diet quality. Background/Objectives: This study aimed to evaluate whether heat-and-serve meal kits with spices and herbs could increase vegetable intake and liking among active-duty SM by simultaneously targeting barriers to healthy eating and modifiable sensory factors. Methods: Conducted at Naval Support Activity Bethesda, the study randomly distributed heat-and-serve meal kits (n = 400) featuring either spiced (n = 200) or plain versions (n = 200) of four vegetables (broccoli, carrots, cauliflower, and kale). Each kit contained a quick response (QR) code for participants to upload post-consumption photos and rate vegetable liking on a nine-point Likert scale. Food photography (SmartIntake^®) was used to estimate vegetable consumption. Paired t-tests were used to determine differences between the intake of plain and spiced vegetables. Results: Intake of the heat-and-serve vegetables was very high for both the spiced and plain preparations (1.73 out of 2 cups, 87%). There was minimal difference (p = 0.87) between the consumption of spiced (1.75 cups) and plain (1.725 cups) vegetables, suggesting that both were well accepted. Overall, convenient and accessible meal options, alongside sensory-driven strategies, appear to improve some barriers to vegetable consumption in SM populations. Conclusions: Future studies should explore long-term outcomes and adaptability across different military environments, while considering additional factors, including convenience and time constraints, that influence dietary choices in the military. Full article

Heritage buildings, which symbolize the pride of a nation, were built prior to the development of current standards, including those for accessibility. As nations strive for equity, diversity, and inclusion, creating barrier-free environments, including heritage buildings, becomes imperative. This study aims to identify the “true” accessibility barriers of heritage buildings. Accordingly, a three-part study was conducted: review current standards and best practices; document and investigate the accessibility lived experiences of people with different abilities in heritage buildings; and analyze and discuss the data. The findings revealed that 19%, 17%, and 64% of reported “true” barriers per building were attributed to the conflict between accessibility and heritage preservation, accessibility standard clarity/specificity, and accessibility standard compliance, respectively. In comparison, accessibility-trained professionals attributed 16%, 39%, and 45% of their assessments to the same categories. A significant number of accessibility barriers in heritage buildings can be mitigated by applying current standards. The accessibility needs of people with cognitive/intellectual disabilities are the least addressed and understood by the standards and accessibility-trained professionals. Full article

This study examines strategies to enhance transport inclusivity and passenger satisfaction for persons with disabilities in public bus systems in the Philippines. Drawing on data collected through an online questionnaire from 396 persons with disabilities who responded across various regions in the country, this study investigates eight key factors affecting satisfaction: vehicle design, diverse seating options, sensory considerations, assistance services, safety measures, subsidies/discounts, accessibility, and communication and information quality. Structural equation modeling (SEM) was used to analyze the hypothesized relationships between these variables, passenger satisfaction, and intention to reuse public transport. The SEM results revealed that accessibility (β = 0.359, p = 0.005), vehicle design (β = 0.248, p < 0.001), diverse seating options (β = 0.485, p < 0.001), safety measures (β = 0.3867, p = 0.001), and subsidies/discounts (β = 0.447, p < 0.001) significantly influenced passenger satisfaction. In turn, satisfaction had a strong positive effect on the future intention to use public transport (β = 0.760, p < 0.001). However, sensory considerations (β = 0.163, p = 0.225), assistance (β = 0.133, p = 0.519), and communication and information quality (β = 0.171, p = 0.345) were not statistically significant. The model demonstrated a good fit (chi-square/df = 4.03; SRMR = 0.078; NFI = 0.956), supporting the robustness of the proposed framework. These findings suggest that design-centered improvements and subsidies/discounts are critical to inclusive transport experiences, while overreliance on assistance may not guarantee satisfaction. This study recommends promoting autonomy through universal design, enhancing digital and physical accessibility, and increasing public awareness. These insights are intended to guide policymakers and transit authorities in creating a more inclusive, equitable, and user-driven transportation system. Full article

The concept of a digital twin (DT), rooted in mid-20th-century ideas, has recently gained significant traction even outside software simulation and engineering modeling. The recent advancements in computational power and the development of model integration methodologies have enabled the creation of virtual replicas of complex physical objects. The success of DTs in engineering has also pushed for the exploration of their use in other domains, especially where complex systems are at stake. One of these cases, which is the focus of this paper, is the modeling of cities and the way they are transformed via technologies into so-called smart cities. In these systems, the huge amount of data that are made accessible and constantly updated via sensor networks suggests that one can use DTs dedicated to the urban scenario as data-driven decision-making devices. However, the concept of a DT was not developed for socio-technical systems and requires careful analysis when applied to urban scenarios. While technologies and information systems have become integrated into city management, this has not reduced the complexity of the city. Relying only on sensory data for city modeling and management seems pretentious since detectable data (what is made accessible via sensor networks) do not seem suitable to inform on all important aspects of the city. Urban DTs hold promise, yet their development necessitates careful consideration of both opportunities and limitations. For this goal, it can be helpful to exploit an ontological analysis due to its neutral and systematic approach and to look at a city as a system of intertwined relationships across its components, such as places, agents, and knowledge. The variety of interactions that the components manifest highlights aspects of the city that the type of data we can collect today leaves unexplored. The paper presents a preliminary example of this issue by studying cases of city squares. The final part of this paper is a call to analyze DTs’ potential role in urban contexts and become aware of the intrinsic limitations of the data they rely upon. Full article

Multimodal interaction technology has become a key aspect of remote education by enriching student engagement and learning results as it utilizes the speech, gesture, and visual feedback as various sensory channels. This publication reflects on the latest breakthroughs in multimodal interaction and its usage in remote learning environments, including a multi-layered discussion that addresses various levels of learning and understanding. It showcases the main technologies, such as speech recognition, computer vision, and haptic feedback, that enable the visitors and learning portals to exchange data fluidly. In addition, we investigate the function of multimodal learning analytics in order to measure the cognitive and emotional states of students, targeting personalized feedback and refining instructional strategies. Though multimodal communication may bring a historical improvement to the mode of online education, the platform still faces many issues, such as media synchronization, higher computational demand, physical adaptability, and privacy concerns. These problems demand further research in the fields of algorithm optimization, access to technology guidance, and the ethical use of big data. This paper presents a systematic review of the application of multimodal interaction in remote education. Through the analysis of 25 selected research papers, this review explores key technologies, applications, and challenges in the field. By synthesizing existing findings, this study highlights the role of multimodal learning analytics, speech recognition, gesture-based interaction, and haptic feedback in enhancing remote learning. Full article

Background/Objectives: Children with special healthcare needs (SHCNs) face various physical, developmental, sensory, behavioral, or cognitive challenges affecting oral health and highlighting the need for specialized and more accessible oral and dental care. Mobile health (m-health) applications have emerged as a promising solution to bridge oral health education gaps and improve dental care access. This narrative review aimed to examine the available dental m-health applications designed for children with cognitive and physical impairments, exploring the perspectives of children, parents/caregivers, and dentists regarding their use and potential contribution to oral health. Based on these insights, a concept for a tailored dental m-health app is proposed, considering the interactions between children, caregivers, and dentists to support oral care. Methods: A literature search was conducted using MEDLINE/PubMed, Scopus, and Web of Science to identify studies on the use of m-health apps in pediatric dentistry for SHCN children. Results: Six studies were included in this review. M-health applications helped manage anxiety, behavioral issues, and compliance in children and were generally well received by parents and caregivers, thus improving oral hygiene practices and regular dental visits, and having the potential to reduce oral health disparities in children with cognitive and physical impairments and their families. However, current apps designed for children are limited and may not fully accommodate the diverse sensory needs of these SHCN children. Conclusions: The development of a tailored dental m-health app that adapts to the individual characteristics of SHCN children could enhance oral health awareness and support better compliance among children, parents/caregivers, and dentists. Full article

The integration of artificial intelligence (AI) with additive manufacturing (AM) is driving breakthroughs in personalized rehabilitation and physical therapy solutions, enabling precise customization to individual patient needs. This article presents the current state of knowledge and perspectives of using personalized solutions for rehabilitation and physiotherapy thanks to the introduction of AI to AM. Advanced AI algorithms analyze patient-specific data such as body scans, movement patterns, and medical history to design customized assistive devices, orthoses, and prosthetics. This synergy enables the rapid prototyping and production of highly optimized solutions, improving comfort, functionality, and therapeutic outcomes. Machine learning (ML) models further streamline the process by anticipating biomechanical needs and adapting designs based on feedback, providing iterative refinement. Cutting-edge techniques leverage generative design and topology optimization to create lightweight yet durable structures that are ideally suited to the patient’s anatomy and rehabilitation goals .AI-based AM also facilitates the production of multi-material devices that combine flexibility, strength, and sensory capabilities, enabling improved monitoring and support during physical therapy. New perspectives include integrating smart sensors with printed devices, enabling real-time data collection and feedback loops for adaptive therapy. Additionally, these solutions are becoming increasingly accessible as AM technology lowers costs and improves, democratizing personalized healthcare. Future advances could lead to the widespread use of digital twins for the real-time simulation and customization of rehabilitation devices before production. AI-based virtual reality (VR) and augmented reality (AR) tools are also expected to combine with AM to provide immersive, patient-specific training environments along with physical aids. Collaborative platforms based on federated learning can enable healthcare providers and researchers to securely share AI insights, accelerating innovation. However, challenges such as regulatory approval, data security, and ensuring equity in access to these technologies must be addressed to fully realize their potential. One of the major gaps is the lack of large, diverse datasets to train AI models, which limits their ability to design solutions that span different demographics and conditions. Integration of AI–AM systems into personalized rehabilitation and physical therapy should focus on improving data collection and processing techniques. Full article

As urban environments pose significant challenges to people of all ages and abilities, ensuring equal accessibility is essential for achieving social inclusion in cities. Authors claim that universal design, initially developed to assist people with disabilities, can also benefit older adults. Despite common assumptions, there is limited evidence to support this claim. This study examines whether the urban mobility needs of people with disabilities (physical, sensory, and cognitive) align with those of older adults, both with regular physiological ageing or age-related diseases. Using an integrative review methodology, this study synthesized 56 references on urban mobility measures and 121 references on the specific urban requirements and mobility profiles for both groups and subgroups. The findings reveal significant overlaps in the mobility requirements of people with disabilities and older adults, particularly regarding inclusive features such as barrier-free crossings, intermediate seating, noise reduction, and improved wayfinding. These measures benefit both groups, with universal design strategies supporting the mobility of people with disabilities while also addressing the needs of the ageing population, which is rapidly increasing. The findings offer valuable insights for urban planners, policymakers, and designers to create inclusive, accessible, and high-quality urban spaces that support people of all ages and abilities. Full article

Dementia’s escalating incidence, coupled with its economic burden, highlights the need for architectural designs and forms that benefit people living with dementia. This research explores strategies and design principles that focus on establishing supportive spaces for the prolonged autonomy, well-being, and safety of dementia patients. Contemporary research emphasizes the implementation of effective navigational techniques, via visual cues, familiar landmarks, and simplified layouts. For greater navigational signage, the intentional use of contrasting colors, textures, and lighting are recommended to demarcate functional areas within a structure. Incorporating familiar objects in personalized areas enhances treatment outcomes, e.g., reminiscence therapy leverages familiar objects, environmental cues, scents, sounds, and tactile features to trigger and retain memory. Integrating safety precautions such as slip-resistant flooring, handrails, and accessible bathrooms helps mitigate falls for the cognitively impaired. From a therapeutic perspective, this study draws attention towards incorporating gardens and outdoor spaces, which offers sensory stimulation, encourages physical activity, and fosters social engagement. Additionally, the integration of scents, sounds, and tactile features enriches the sensory experience for individuals with dementia. Through comprehensive consideration of design elements, this research highlights how intentionally crafted, dementia-friendly environments can convert spaces into empowering therapeutic settings tailored to address the unique need of this vulnerable group. This architectural approach acts as a valuable complement to the medical and therapeutic interventions in the treatment and care of people living with dementia and their families. Full article

Background: Smart home technologies (SHTs) hold promise for supporting older adults by enabling early detection and intervention in mental health challenges such as depression, anxiety, and cognitive decline. However, adoption remains limited due to usability, accessibility, and privacy concerns. Methods: This narrative review examined the literature from 2010 to early 2024 related to SHTs and their impact on older adults’ mental health. In total, 34 relevant studies met the inclusion criteria, and also, a standardized quality assessment tool was used to evaluate the methodological soundness of the included studies. Results: Findings reveal that interface complexity, cognitive overload, high costs, and privacy concerns are significant barriers to adoption. Accessibility challenges, including physical and sensory impairments, further reduce engagement and inclusivity. Key facilitators for user acceptance include user-centric design, personalization, participatory co-development, and cultural adaptations. SHTs incorporating AI-driven features, such as behavioral monitoring, medication reminders, and social engagement tools, demonstrate significant potential for early mental health interventions. Based on these findings, we propose a holistic framework integrating technical innovation with human-centered design to address these challenges and optimize SHTs for mental healthcare. Conclusions: Tailored systems that prioritize usability, accessibility, ethical data management, and user feedback can empower older adults to maintain autonomy, support aging in place, and enhance their quality of life with dignity. Full article

Background: The COVID-19 pandemic brought many challenges for all and especially for people with a visual impairment. As a result, many healthcare services had to close or be reduced, and new rules and regulations were implemented. These rules, regulations and testing procedures were challenging for many people with a visual impairment. Methods: Focus groups were conducted with sensory support workers at a regional sensory meeting in Northern Ireland. A set of semi-structured questions were asked about how services were conducted, the challenges faced by people with a visual impairment and any specific cases which showed its impact. Two researchers transcribed and analysed the focus group data. Results: The analysis resulted in four themes, namely “as a result”; healthcare; rules, regulation and testing; and mental and physical health. Some of the biggest issues mentioned were access to healthcare, COVID testing, online working, online schools, one-way systems, social distancing and the impact on mental and physical health. Conclusions: As expected, COVID-19 impacted people with a visual impairment. This study shows some of the barriers faced by people with a visual impairment, especially with regards to the rules and regulations. People with a visual impairment also found it difficult to access the necessary healthcare and support, or they were too fearful to seek it out. This paper provides an insight into the barriers faced by people with a visual impairment and how we may support them in the future. Full article

Play is vital to the wellbeing of children, but playgrounds can be inaccessible to children with disabilities and limit their physical and social participation. This study evaluated the accessibility/inclusivity of twenty-five free-entry playgrounds in two Australian states and investigated whether location, construction age, and regional socioeconomic status affected accessibility/inclusivity. The New South Wales Government’s Everyone Can Play: Playspace Evaluation Checklist was used as the assessment tool with a maximum score of 156 points. Playground scores ranged from 29% to 96% of available points. The average score for destination playgrounds was significantly higher (78.0% ± 16.6%) than that for neighborhood playgrounds (54.5% ± 20.7%). Modern playgrounds generally scored higher than older playgrounds. Regional socioeconomic status did not correlate with playground score. The audit tool inadequately addresses the needs of children with disability, allocating just 24 points (15.4%) to features they need and mostly considering mobility impairment. More inclusive audit tools that capture the needs of a wide range of impairment should be developed. Main areas for improving playground accessibility include wayfinding, layout, signage (including braille, auditory, and pictorial information), and sensory and cognitive play opportunities. These findings are useful for stakeholders involved in the design, provision, and maintenance of community playgrounds. Full article

The case of Hellen Keller presents a great example of what a learner who is deafblind can achieve if provided with the appropriate educational accommodation in terms of content, environment, learning approach, instructional strategies, and teaching methodologies. However, access to education is not the reality for most learners who are deafblind due to their unique educational needs, owing to their dual sensory impairment. There has been an assertion that learners who are deafblind may not thrive in inclusive educational spaces, but there is a paucity of research to support or dispute this assertion. This scoping review explored what is documented in the literature on the barriers and facilitators to inclusive education for learners who are deafblind. A scoping review methodology using Arksey and O’Malley’s framework was employed. A search was conducted using six databases, including Science Direct, PubMed, Scopus Medline, ProQuest and gray literature, to identify publications focusing on the barriers and facilitators to inclusive education for learners who are deafblind. The findings from the scoping review suggest that the factors that influence the inclusion of learners who are deafblind in inclusive educational settings include the availability of educational settings; accessibility to the physical and social environment, and assistive devices; acceptability by peers and educators and the preparedness of educators; and the adaptability of classroom strategies. For learners who are deafblind to thrive in inclusive educational settings, transformational attitudes and intentional and specific strategies from multiple stakeholders are necessary. Therefore, the educational system, schools, peers and communities should be deliberate in putting in place specialized support and resources to accommodate the diverse needs of learners who are deafblind in all phases of their schooling life. Full article

Continuous changes in society and the need for sustainable development demand updates in designing better built environments to respond to the variety of user needs. Notwithstanding the growing interest of research and the introduction of guidelines and standards on inclusion, diversity, equity, and accessibility, there are still several limitations in effectively and efficiently embedding such principles for the design of buildings and neighborhoods. Previous research demonstrated the critical need for innovative tools and methods to support professionals in designing responsive, inclusive spaces for an extended range of users. This article reports the results of a pilot study using the new IDEA Audit Tool for assessing how inclusion, diversity, equity, and accessibility are perceived by building occupants in a specific facility. The analysis of significant data provided by this study shows the challenges and highlights the benefits of the tool, including fostering an evidence-based decision-making process, speeding up the prioritization of critical design improvements, demonstrated through a six-month trial with a London-based inclusive design firm. The research-driven outcomes showcase the huge potential that the tool offers to improve the company strategy while evolving towards more inclusive, accessible spaces that foster diversity and equity, and has the potential to be replicated in several fields of action to raise awareness and improve the application of IDEA principles in all phases of the design process. Full article