Ebook: Selected Papers from the Japanese Conference on the Advancement of Assistive and Rehabilitation Technology

The welfare-driven city is, and it must be, a city for ALL people. The quality of life (QOL) of the older adults and people with disabilities in our society depends on there being a high quality of life for everybody. Able-bodied younger people must understand that in the future they are also likely to need the welfare services that are now being provided to others – people with disabilities and older adults – because they may also one day develop a disability and – if they are lucky – they too will become older. Rehabilitation engineering and assistive technology is firmly placed to drive such a future; certainly it can contribute through collaboration with older people, those who have special needs and many other specialists: for instance physical therapists, occupational therapists, nurses, policy makers, educators and so on.

I am sure that there are people here at 23rd JCAART who joined us in Niigata in 2008 and who can contribute: together we have laid the strong foundations that will create such a welfare-driven city, providing QOL₄ALL.

We take this opportunity to thank Dr. R.A. Cooper (editor-in-chief) for providing the opportunity to publish this book and tell people in the wider world about rehabilitation engineering and assistive technology in Japan; the first super-aged society: a first in RESJA history. I am proud of our contribution from Niigata. We will contribute more in the future in this field, because we are the front runner among super-aged societies.

An international meeting to exchange wheelchair repair technology was held at the same time, contributing to extending the knowledge from the conference to technical high school students and volunteers. We would like to thank all of the authors for their contributions to the conference and to this book. Special thanks go to Dr. Diane M. Collins and also Dr. Don Parkes for proof reading the draft. Finally thank you to IOS press for their encouragement and patience.

At the final stage of this draft, we had the biggest disaster from earthquake, tsunami, and an unexpected radiological emergency in Japan. We hope this publication will encourage the people for the revival of Japan.

Hisaichi Ohnabe, Ph.D., Associate Editor (RESJA), Chair, Executive Committee of 23rd JCAART, Niigata University of Health & Welfare (University of Pittsburgh)

This is the report of the 23rd Japanese Conference on the Advancement of Assistive and Rehabilitation Technology in Niigata 2008 (The 23rd JCAART 2008) and “Flying Wheelchair International and Interactive Repair Technique Conference” which were held on 8/27-8/29 at Toki (ibis) Messe for the first time in Niigata with a theme “QOL for All” (QOL4All).

Braille, recently, has come to be written for the instructions of the elevators and the public place for blind people. However, only about 10% of people who are blind can read Braille. This paper describes a Braille reader system using a cellular phone embedded camera for people who are blind. The system extracts images of Braille dots from a photo taken by the phone camera according to Braille dot features using image-processing methods. The Braille dot features are the size and shape of areas extracted in the photo. Then, the system detects Braille cells by grouping the extracted images of dots according to the positional relation of the dots. After that, the system translates the detected Braille cells by searching a look-up table with the relationships between a Braille cell and a letter or a code, then reads aloud the translated text. In the evaluation experiment of the system, the successful translation rate was 67.5%.

In the ISO16840-1 standard, “representation” of seated posture was defined, but the procedure of “how to measure” seated posture was not. The purpose of this paper is to report our work in the development of software to measure seated posture according to the ISO16840-1 standard. We evaluated the reliability of the software by using a metal model representing human seated posture and by calculating the standard deviation of within- and between-examiner measurements. We also evaluated validity by comparing our results with a contact three-dimensional measurement device. As a result, standard deviations are almost less than 2.2 degrees. Differences between the software and the contact device were less than 4.8 degrees. In conclusion, the software is practical and suited for daily clinical use.

“Go” is a traditional game and very popular in the world. The authors have developed new “Go” play set for persons who are blind or have visual impairments using Universal design. This paper describes the outline of “Go” play set first, play set characteristics required by persons who are blind, and then the features of newly designed “Go” play set.

The use of switches is a basis for many types of daily activities of living for people with physical disabilities. A successful switch adaptation is a key determinant of Quality of Life. However, the adaptation requires that clinicians, rehabilitation engineers, and caregivers have broad knowledge and experience on, for example, positioning, motor skills, and hardware and software issues related to switches. In this paper, we present an adaptation approach based on a quantitative measure. In this approach, a three-axis acceleration sensor is attached to a body part where voluntary movement is observed. To transform the motions into corresponding switch operations, we have defined “rest,” “activation,” and “in action” states. The standard deviations of acceleration are used to classify these states with a predefined threshold. The effectiveness of our approach was examined through a case study with a child with cerebral palsy who could not use conventional switches well because of his unstable upper limb motions.

People with higher brain dysfunction show executive impairments, attention deficits, and/or memory disorders. Monitoring and analyzing their activities during day-care rehabilitation is important to understand their individual needs. However, monitoring and analyzing these activities are cumbersome for clinicians. As a result, the rehabilitation is usually designed by the experiences of the clinicians and their interpretations of objective neuropsychological tests typically performed months earlier. For this reason, we developed a day-care rehabilitation support system. One of the real rehabilitation activities, a card game, has been implemented within the framework of this system. This system can record the user's interactions, such as mouse clicking and movements, and to analyze the results, for example, the number of correct and incorrect operations and the distance moved by the mouse can be determined. The system can be used to visualize these data via the following views: months, hours in a day, number of repetitions, and in a single game. The results of our case study conducted over several months suggest that quantitative observations using this system can be useful to understand individual characteristics.

This paper describes the standardization of the evaluation scale to measure psychosocial impacts of assistive products. J-PIADS (Japanese Psychosocial Impact of Assistive Devices Scale) was formulated with translation of an English version of the PIADS developed by Jutai et al. This scale is composed of 26 items: competence subscale, adaptability subscale and self-esteem subscale. The test-retest investigation and the internal consistency tests that were conducted on the users of eye glasses, contact lenses, wheelchairs and prostheses proves the scale to be reliable enough. Setting the obvious base line was effective on the good reliability. In addition, the inspections that were conducted on the users of eye glasses, contact lenses and dysphemia reducing products support validation of the J-PIADS.

Mounting-operation-free vertical (pole)-type grab bar is fixed between floor and ceiling and is currently being sold in Japan. This type of assistive device is essential to help persons with disabilities or who are aging to rise from a chair or toilet. In this research study, we measured the load applied to the grab bar by rising elderly participants to develop standards for vertical grab bars.

In this study, we investigated the wheelchairs used for older people who live in aged-care nursing home to clarify the current problems with using wheelchairs in this setting. We measured the fit between the sizes of the wheelchair and the physical dimensions of the older people. We conducted a research of 61 participants who had used wheelchairs on a daily basis and could not move around without them. We measured the wheelchair sizes and the physical dimensions of the participants by the Wheelchair Measure Set, and compared measured data with the recommended value stipulated by the special interest group (SIG) of a rehabilitation engineering society of Japan. The main purpose of using wheelchairs were to move around (98%), sitting (93%), and eating (90%). The mean daily usage of wheelchair was 9.9 ± 4.0 hours, and maximal score was 16 hours. Over 80% of the participants had used wheelchairs that were provided by the aged-care nursing home. Most of the wheelchairs were lacking in adjustable functions, and additionally about half of the wheelchairs did not have enough air or had flat tires. In terms of the fit between the wheelchair sizes and physical dimensions of the older people, most of the wheelchairs were much bigger than the recommended sizes. Therefore, older people who live in aged-care nursing home spent much of their day in poorly fitting wheelchairs that were provided by the facility.

In this paper, new support functions of a power wheelchair are proposed. These functions restrict joystick input, and restricted input is released in a systematic process according to the progress of user's proficiency. Three kinds of restricted modes were used: “one-shot forward mode” where the wheelchair moves forward at a given time regardless of the input direction of the joystick; “one-shot all-round mode” where the wheelchair moves as directed by joystick input at a given time; “quantity limited one-shot mode” where the wheelchair stops immediately as soon as the joystick is pressed fully. We conducted a trial of adaptations of the wheelchair at a school for children with physical or developmental disabilities. During the trial, teachers used the wheelchair with creative ideas according to the characteristics and needs of each student. The results indicate that the wheelchair may be used as a mobility support system or an educational material (or play equipment) to promote sensory integration through movements.

A user of a power wheelchair usually utilizes a joystick as an input device. However, when one cannot manipulate a joystick due to some kind of physical disability, an input device of the simple switch type replaces the joystick. The switching device is, in general, more inconvenient to use than the joystick, (e.g., when completing turnabout actions). Specifically, it causes one crucial problem when crossing a slope, where the user has to operate the switch more frequently so that the wheelchair continues to go straight. Therefore, a series of operations of the switch may put a strain on the user. This research aims to reduce the user's strain of operations on a slope, and proposes a support system which assists a user for driving a power wheelchair to go straight ahead on a slope by using a simple switching operation. Through the experiments with a prototype system, the effectiveness and the applicability of the proposed system have been confirmed.

The flying wheelchair project was started in the Tochigi Technical Senior High School in 1990 and has since spread to other technical senior high schools. The aim of the project is to provide upgraded wheelchairs to Asian countries, for use by students. This paper describes the overview of International Voluntary Activity by Japan and Korea since 1990 and the future activities' prospect on this matter.

The human brain is capable of an extraordinary degree of plasticity (self-organization), enabling learning, and leaving open the possibility for motor recovery. Therefore, neural rehabilitation for people who have had cerebral vascular accidents is effective. Using apparatus that applies robotic and virtual reality technologies makes new training methods and exercises in rehabilitation possible. We introduce the development of EMUL, Robotherapist and PLEMO using ER fluid for upper limb rehabilitation.

The purpose of this study was to characterize the teacher's eye gaze and corresponding focus of attention, in the context of children writing characters. The subjects included seven teachers (teacher group: T-group) and seven controls (non-teacher group: NT-group). Using an eye-tracking apparatus and the attached software, we measured the subjects' eye gaze area and gazing time as they viewed 10 serial photographs of a boy writing characters. We also obtained subjective reports from both groups concerning their eye gaze area and comments related to writing guidance. We found that though both groups paid attention to almost the same areas, they differed in gazing time (fixation length), time to first fixation, and subjective reports. When watching a boy's whole body, T-group participants looked to the boy's face earlier than to his hand. They also looked earlier at the facial area than NT-group participants did. In the subjective reports, total numbers of comments about writing guidance did not differ between groups, but when limited to the entries describing praise, the counts (numbers) were greater in the teachers' group. Based on these results, we discuss characteristics of the teachers' eye gaze and questions of interest that remain.

In order to develop assistive technologies for an advanced inhomemedical care system, the Japanese government has established several projects. The project “Acceleration of a Social Returns on Research Achievements” is a five-year project that began in 2008. The aim is to accelerate society's realization of returns on research funding by integrating some of the technologies that are expected to reach their implementation stage in the near future and promoting integrated experimental studies as well as ‘institutional’ reforms. A second project to create “Innovative Technology” started in 2009. To launch this project, an “Innovative Technology Promotion Fund” was established for the specific promotion of “Innovative Technology” that will enable prompt, mobile investments to be made in research and development, regardless of the government ministry responsible. This fund is hoped to strengthen the connection to the private sector, and build a system using all our national resources. The third project, “Super Special Consortia” System, was established to support the development of cutting-edge medical care, using pharmaceutical consults in its earliest stages, efficient research fund management and structural reforms. The five research areas were identified, such as iPS cell application, regenerative medicine, innovative medical instruments, innovative biotechnology-based drugs and other important medicines, and 24 research projects were selected to be promoted by the Super Special Consortia System.

Independent mobility is an important element for children's development and beneficial in helping them acquire physical and intellectual activities. Unfortunately, existing interface devices for powered wheelchairs are inaccessible to individuals with muscular impairment of their upper/lower limbs or who have involuntary movements of their extremities. This research aims to develop an autonomous mobility device, which adapts the self-learning system to personal characteristic movements. This device incorporates a light sensor to reduce the physical burden and uses a learning algorithm, such as a neural network system. In this paper, we describe the measurement of the user's movement, the establishment of a neural network system, which discriminates the target movement, and the overall system evaluation.

This paper proposes a design of seat mechanism for multi-posture-controllable wheelchair to change seating posture into standing, reclining, tilting and elevation. The seat is designed based on a link mechanism including linear actuator and kinematics analysis. To control the multi-postures, we designed a Proportional–Integral–Derivative (PID)-based position and speed controller. In addition a motion planner is introduced to generate an available new posture. Simulation results showed that the designed seat mechanism and its motion planner are effective in developing the multi-postures-controllable wheelchair.

In order to develop and make widely available assistive devices for persons with severe physical disabilities, understanding their needs is crucial. However previous surveys limited to interviews and questionnaires might not reflect their needs properly or fully. Here we report the results of 24-hour monitoring of daily activities and assisted activities for 3 persons with severe physical disabilities to better understand their actual needs of assistive technology objectively. The results showed that two of the participants with severer disabilities spent more time to keep their health levels than persons without disabilities and needed more assists to gather information and to communicate. Gathering information and communicating with telephones, televisions and computers were most of these two participants' social activities. One of them desired for assistive technology to help them more than others keep privacy in these activities. The other participant used a communication aid and mostly satisfied with the status quo, even with the severest handicap of the three. The results suggests that, in spite of the use of public support and availability of certain assistive devices, the demands for developing and distributing new assistive devices still exists in terms of better support, of ADL, of easier maintenance of health, and of more independence in gathering information and communication, for persons with severe physical disabilities.

Game controllers for persons with progressive muscular dystrophy have recently been developed. This controller is for the users who cannot press the command buttons on the standard video game controllers. When the user selects the command from the virtual controller on the personal computer by using the mouse, the controller operates the video game controller for the user. This controller consists of the user interface software which works on the PC as a virtual game controller and a signal control unit which emulates pressing buttons of the video game controller electrically. The game controller we developed is now in use and we have received positive feedback

This paper describes a series of trials based on mathematical information engineering that were designed to enable assistive technologies to help with the travel and mobility of the visually impaired. In order for technology to be of assistance to travel, two different concepts are necessary, i.e., to assist travel performance and to assist travel planning. In the former case, we developed a GPS-based “travel assist” system (TAS) so that an adaptive fuzzy inference neural network could be employed to stabilize positional guidance. In many cities and towns in Japan it is often the case that an area of buildings surrounding a particular street rather than the street itself assumes the identity of a recognized landmark. Therefore, GPS measurements acquired by a pedestrian walking on such a street are likely to randomly output landmarks on both sides of the street. The adaptive fuzzy inference neural network enabled the TAS to guide the user to just the landmark that was required by the pedestrian. In the latter case, we developed an AHP-based “plan assist” system (PAS), whereby the system assists in the self-determination of the route selection. These concepts are of special importance to visually impaired persons, even those with guide helpers, because such self-determination might enhance their efficacy when traveling, and, as a result, might add to the self-sufficiency of the visually impaired.

Some patients with rheumatism cannot use ordinary working chairs, because an ordinary chair cannot accommodate the height requirements for safe and comfortable sitting/standing actions or stability during these actions. We have developed a new functional working chair that assists with standing and sitting for patients with rheumatism, like cooking for instance, allowing them to be supported or take breaks with out experiencing pain. The concept model was first developed in 2003, and then modified and tested to determine the optimum sitting posture for comfort as well as functional performance for patients with rheumatism. These test results were applied to the first prototype. The evaluation of the prototype showed that a patient with rheumatism could sit in the chair securely without pain. By adjusting the cooking and dining tables heights, the person could also cook or eat sitting in this working chair. Now we have developed a second prototype that is commercially available. We review the functions of the newly developed working chair, and the results of the usability assessment by the patients with rheumatism in this paper.

Persons with disabilities from cervical level spinal cord injuries have difficulty with activities of daily living, such as turning switches ON or OFF and driving powered wheelchair. A variety of operation devices have been developed for people with such serious disabilities: voice or breath control, head motion control and eye movement control systems etc. for example. Each has its own merits and disadvantages respectively, but a need still exists to develop other types of device interfaces. Tongue movement control is also an option and is one of solutions applied to several assistive devices for persons with disabilities. In this study, we have tried to develop a mouthpiece-type remote controller for those with serious disabilities. This remote controller has passive Radio Frequency Identification transponders, with no batteries required.

In order to develop the mouthpiece remote controller, we need to know the basic characteristics of the RFID and what type of Radio Frequency Identification should be applied to this mouthpiece remote controller. Therefore, we investigated the basic characteristics of the RFID transponders, including 134.2 kHz and 13.56 MHz type. The Maximum Communication Range was measured under three environmental conditions of the atmosphere, water and meat. Every RFID transponders of 134.2 kHz and 13.56 MHz type has enough MCR under each condition. Then we developed a trial mouthpiece type remote controller using 13.56MHz transponders. This trial remote controller was also evaluated with the same tests. The results indicated that this trial controller has performed satisfactorily and may be applied safely to the mouthpiece-type remote controller for people with serious disabilities.

To make sure that the trial controller was able to control a powered wheelchair, we first tried to operate a remote-controlled model car. TR3-MD001E was used as the RFID identifier system. NI 9263 and cRIO 9014 were used to control the model car. With this system, we succeeded in operating the model car by pushing the switches on the mouthpiece remote controller with the tongue. It was suggested that possibility of this system can be applied to new assistive devices for people with serious disabilities.

The development of assistive products requires the involvement of experiments involving human participants. While the informed consent process and Institutional Review Boards (IRB) are essential concepts protecting human rights in any medical, rehabilitation engineering and assistive technology research, they have not been fully established in these areas in Japan. The Japanese Society for Wellbeing Science and Assistive Technology has recognized the importance of this issue and has initiated an effort to establish a review board on behalf of individual research institutes to ensure protection of human participants in research studies.

Persons with dementia are likely to experience a decline in self-esteem because of the awareness of the gradual loss of cognitive functions. We have developed a device for enhancing highly positive self-perceptions (self-enhancement) of people with dementia, by assisting them to remember successful experiences. Seventy-eight Japanese adult participants recalled the experience that provides their strongest feelings of self-worth, and rated the characteristics of the experience to specify experiences that should be recorded and reviewed by the devise for promoting self-enhancement. The proportion of self-esteem memories focused on interpersonal themes was equal to the proportion of memories focused on achievement themes. Memories with direct reciprocity themes provided a stronger the sense of self than memories that involved both achievement and interpersonal themes together. This result indicated that recalling memories of direct reciprocity could enhance not only self-esteem, but also the sense of self-identity, which is weak in people with dementia.