Block-based programming environments like Scratch have become widely adopted in Computer Science Education, but the mouse-based drag-and-drop interface can challenge users with disabilities. While prior work has provided solutions supporting children with visual impairment, these solutions tend to focus on making content perceivable and do not address the physical interaction barriers faced by users with motor disabilities. To bridge this gap, we introduce MeowCrophone, an approach that uses voice control to allow editing code in Scratch. MeowCrophone supports clicking elements, placing blocks, and navigating the workspace via a multi-modal voice user interface that uses numerical overlays and label reading to bypass physical input entirely. As imperfect speech recognition is common in classrooms and for children with dysarthria, MeowCrophone employs a multi-stage matching pipeline using regular expressions, phonetic matching, and a custom grammar. Evaluation shows that while free speech recognition systems achieved a baseline success rate of only 46.4%, MeowCrophone's pipeline improved results to 82.8% overall, with simple commands reaching 96.9% accuracy. This demonstrates that robust voice control can make Scratch accessible to users for whom visual aids are insufficient.
Objectives: Artificial intelligence (AI) can potentially improve the effectiveness, accuracy, and quality of nursing practice by reducing workload and freeing nurses to concentrate on complex decision-making and direct patient care. This study aimed to assess nurses’ attitudes toward and knowledge of AI technology.
Methods: This descriptive, cross-sectional study was conducted from September 25, 2024, to April 1, 2025. A convenience sample of 354 nurses was selected from different hospital departments, including surgical wards, medical, intensive care unit, emergency, dialysis, and maternal and child units. The three sections of the questionnaire were the nurses’ sociodemographic variables (SDVs), the AI knowledge questionnaire, and the attitudes toward AI scale. Data were evaluated using both descriptive (percentages and frequencies) and inferential (Cronbach’s α, Kruskal-Wallis H test, Mann-Whitney U analysis, and Pearson correlation coefficient) statistics.
Results: According to the study’s findings, 57.6% of the participants were female, and 94.4% had not received training courses regarding AI. (85.6 %) of nurses had moderate knowledge and (83.3%) had positive attitudes toward AI. A correlation was observed between nurses’ attitudes and knowledge and their knowledge and certain characteristics (age, educational background, department or unit, training program) at P≤0.05.
Discussion: According to the statistical results, most nurses have a moderate degree of understanding, and their attitudes towards AI are positive.
Medicine, Vocational rehabilitation. Employment of people with disabilities
Mohamed M. Ahmed, Azza A. Al Areefy, Abdulrahman A. Alsayegh
Due to their cognitive and physical impairments, children with autism spectrum disorder (ASD) have detrimental effects on their daily activities. The goals of physical therapy (PT) treatment plans are to lessen impairments to body structure and function, support milestones, and encourage developmental sequence. Neurodevelopmental treatment (NDT) is a sensory–motor approach used by physical therapists/occupational therapists to children and adult function and manage movement disorders due to neurological impairment. No studies until now have focused on the role of the NDT approach of PT on children with ASD. So, the purpose of this study was to investigate the effect of NDT PT approach on the gross motor development and cognition of children with ASD. Forty children with ASD were randomly distributed into two groups: group A (intervention group) for PT, and group B (control group). They were evaluated using gross motor functional measure (GMFM)-66 to measure gross motor skills and Stanford-Binet Intelligence Scales fifth edition (SB5) to measure the intelligence quotient and cognitive variables before and after intervention. Intervention continued for 3 months for children with ASD in the Jazan region, Kingdom of Saudi Arabia. Group A had significant improvements for both gross motor function ( P = 0.001) and cognition ( P = 0.001), and group B showed no significant change for both gross motor ( P = 0.69) and cognition ( P = 0.21) while between-groups comparison showed significant improvement in group A for cognition ( P = 0.003) and gross motor function ( P = 0.003). It was concluded that gross motor development on GMFM-66 and cognitive functions of children with ASD on SB5 significantly improved after a structured individualized NDT PT program for 3 months of daily sessions for 1 h at school age for non-obese children with ASD.
Vocational rehabilitation. Employment of people with disabilities
For children with disabilities, participation in group physical activities can promote inclusion and a sense of belonging, enhance physical functioning, and improve mental health. Yet, there are very few youth sports programs that offer adaptive programs for children with disabilities. Why do some youth sports programs offer these special programs? The purpose of this qualitative study was to understand the experiences and challenges of select youth gymnastics and dance programs in the eastern part of the U.S. that offer adaptive programs for children with disabilities. Nine program directors individually participated in zoom interviews between 45 and 60 min. Results revealed the background of program directors (limited disability experience), why they started their programs (parent requests/personal experiences), challenges faced when creating and sustaining their program (recruitment of participants), advertising the program and recruiting participants (mostly word of mouth), and recruiting and training coaches (within the gym).
Vocational rehabilitation. Employment of people with disabilities
Background: Diabetes mellitus is a chronic metabolic disorder characterized by impaired glucose regulation. Exercise is a key non-pharmacological strategy to improve insulin sensitivity and metabolic control. Emerging evidence indicates that the timing of exercise, especially in the afternoon, may optimize glycemic outcomes.
Objective: To analyze the effect of exercise timing on glycemic markers in individuals with metabolic diseases like diabetes.
Methodology: For this review, two authors performed literature searches in numerous databases. For quality assessment Modified Downs and Black Checklist has been used. After a comprehensive analysis, seven studies met the inclusion criteria.
Results: Afternoon timing results had favorable outcomes, showing a decline in their glucose parameters. Unlike morning timing also showed considerable results in a decrease of glycemic factors. Studies reported statistically significant findings in favor of afternoon exercise. For example, Savikj et al. (2018) reported reduced blood glucose levels based on CGM in the afternoon group (6.1 ± 0.4 mmol/l) compared to the morning group (6.6 ± 0.4 mmol/l; p < 0.05). Mancilla et al. (2020) showed a decline in fasting plasma glucose in the afternoon group (−0.3 ± 1.0 mmol/l) versus an increase in the morning group (+0.5 ± 0.8 mmol/l), with a significant intergroup difference (p = 0.02). VO₂ max improvements were significant in both groups with p-values of 0.003 (morning) and 0.001 (afternoon). Additionally, Gomez et al. (2015) found that hypoglycemic events were significantly lower following morning exercise sessions compared to afternoon (p < 0.001).
Conclusion: Afternoon timing plays a pivotal role in reducing the glycemic parameters. Future research endeavors should focus on incorporating larger sample sizes, and more randomized control trials should be conducted on the female population
Keywords: Circadian Rhythm; Diabetes; Exercise Timing; Muscle Clocks; Morning Exercise; Afternoon Exercise
Vocational rehabilitation. Employment of people with disabilities, Therapeutics. Psychotherapy
Yfat Ben Refael, Patrice L. Weiss, Yael Shidlovsky Press
et al.
In today’s job market, effective social communication is crucial for employment success. We investigated “Cog ‘n’ Role”, a novel video modeling (VM) intervention that integrates video self-modeling (VSM) and social problem-solving therapy (SPST) to enhance socio-vocational skills in individuals with intellectual and developmental disabilities (IDDs). The intervention is delivered via “PowerMod”, an application featuring ready-to-use VM scenarios and enhanced accessibility options; our aim was to examine (a) the app’s social validity and (b) the effectiveness of the intervention in improving job-related social skills. Thirty-four adults with IDD used “PowerMod” to view video clips of common workplace scenarios and rated their experiences through questionnaires. Subsequently, seventeen adults who have social difficulties at work participated in four weekly therapy sessions featuring the “Cog ‘n’ Role” intervention via the PowerMod app. Socio-vocational skills were measured through questionnaires filled out by their counselors; participants found the adapted video clips to be significantly more comprehensible and relevant compared to non-adapted video clips. Additionally, the intervention group showed significant improvements in socio-vocational behaviors and a significant transition to jobs that required higher levels of independence. These findings provide preliminary evidence for the impact of this innovative intervention in enhancing socio-vocational skills among individuals with mild to moderate IDD.
Vocational rehabilitation. Employment of people with disabilities
Effective rehabilitation assessment is essential for monitoring patient progress, particularly in home-based settings. Existing systems often face challenges such as data imbalance and difficulty detecting subtle movement errors. This paper introduces Error-Guided Pose Augmentation (EGPA), a method that generates synthetic skeleton data by simulating clinically relevant movement mistakes. Unlike standard augmentation techniques, EGPA targets biomechanical errors observed in rehabilitation. Combined with an attention-based graph convolutional network, EGPA improves performance across multiple evaluation metrics. Experiments demonstrate reductions in mean absolute error of up to 27.6 percent and gains in error classification accuracy of 45.8 percent. Attention visualizations show that the model learns to focus on clinically significant joints and movement phases, enhancing both accuracy and interpretability. EGPA offers a promising approach for improving automated movement quality assessment in both clinical and home-based rehabilitation contexts.
This paper presents a novel rehabilitation robot designed to address the challenges of passive range of motion (PROM) exercises for frozen shoulder patients by integrating advanced scapulohumeral rhythm stabilization. Frozen shoulder is characterized by limited glenohumeral motion and disrupted scapulohumeral rhythm, with therapist-assisted interventions being highly effective for restoring normal shoulder function. While existing robotic solutions replicate natural shoulder biomechanics, they lack the ability to stabilize compensatory movements, such as shoulder shrugging, which are critical for effective rehabilitation. Our proposed device features a 6 degrees of freedom (DoF) mechanism, including 5 DoF for shoulder motion and an innovative 1 DoF Joint press for scapular stabilization. The robot employs a personalized two-phase operation: recording normal shoulder movement patterns from the unaffected side and applying them to guide the affected side. Experimental results demonstrated the robot's ability to replicate recorded motion patterns with high precision, with root mean square error (RMSE) values consistently below 1 degree. In simulated frozen shoulder conditions, the robot effectively suppressed scapular elevation, delaying the onset of compensatory movements and guiding the affected shoulder to move more closely in alignment with normal shoulder motion, particularly during arm elevation movements such as abduction and flexion. These findings confirm the robot's potential as a rehabilitation tool capable of automating PROM exercises while correcting compensatory movements. The system provides a foundation for advanced, personalized rehabilitation for patients with frozen shoulders.
Santiago Berrezueta-Guzman, WenChun Chen, Stefan Wagner
Virtual Reality (VR) offers promising avenues for innovative therapeutic interventions in populations with intellectual disabilities (ID). This paper presents the design, development, and evaluation of Space Exodus, a novel VR-based role-playing game specifically tailored for children with ID. By integrating immersive gameplay with therapeutic task design, Space Exodus aims to enhance concentration, cognitive processing, and fine motor skills through structured hand-eye coordination exercises. A six-week pre-test/post-test study was conducted with 16 children in Ecuador, using standardized assessments, the Toulouse-Pieron Cancellation Test, and the Moss Attention Rating Scale complemented by detailed observational metrics. Quantitative results indicate statistically significant improvements in concentration scores, with test scores increasing from 65.2 to 80.3 and 55.4 to 68.7, respectively (p < 0.01). Qualitative observations revealed reduced task attempts, enhanced user confidence, and increased active participation. The inclusion of a VR assistant provided consistent guidance that further boosted engagement. These findings demonstrate the potential of immersive, game-based learning environments as practical therapeutic tools, laying a robust foundation for developing inclusive and adaptive rehabilitation strategies for children with ID.
Chelsea E Brehmer, Hannah Fry, Malachy Bishop
et al.
Background Physical and psychosocial contexts of employment and the quality of the work environments impact both physical and mental health, particularly among individuals with disabilities. Objective Given the relationship between health and employment and the need to understand the relationship between quality of work and COVID-19 acquisition risk, this project focused on studying the impacts of job quality following the emergence of the COVID-19 virus. Method GLM logistic regression to explore odds ratios of employment quality factors on our dependent variable, contracting COVID-19. Results The overall model was significant, indicating selection of predictor and control variables have an impact on COVID-19 risk (χ 2 (11) = 59.53, p < .001, N = 2325). Age and race were significant individual predictors. Finally, among the employment quality variables, only one comparison was significant. Individuals with some but not all markers of employment quality, compared to individuals who were unemployed, were 1.3 times more likely to contract COVID-19 (OR = 1.3, p = 0.03). Conclusion Employment, in light of COVID-19, is full of complexity and nuances. Even more so is the relationship between COVID-19, health, and employment for PWDs. The significant findings from the current study have important implications for the incorporation of employment, and specifically quality employment, as a predictor of physical health among PWDs.
Background: Infant carrying, which involves holding an infant in arms or using a baby carrier, enables a newborn to remain physically close to their mother. However, the physical demands of caring for a newborn can make nursing mothers more prone to developing musculoskeletal disorders (MSDs).
Objective: To determine the association between infant carrying methods, duration, and trunk position among nursing mothers of Lahore.
Methodology: A descriptive cross-sectional study was conducted using a non-probability convenience sampling technique. The study included 176 female participants of childbearing age (18-35 years) with a body mass index (18.5-24.9 kg/m²) and infants aged 0-2 years. Data was collected from six immunization centers and four postnatal clinics in Lahore. A standardized questionnaire, consisting of three sections, was used. Section A focused on socio-demographic and infant-maternal characteristics, while sections B and C addressed various infant carrying methods (ICMs) and related musculoskeletal injuries. The test-retest reliability coefficients of this questionnaire were 0.80 and 0.79, respectively. Statistical analysis was performed using SPSS version 26.
Results: Out of 176 participants, 31.3% (n=55) commonly carry their infants in their arms, primarily adopting a forward trunk lean position (35.2%, n=62). Additionally, 76.1% (n=134) carry their infants for 1 to 6 hours daily. Musculoskeletal pain was predominantly reported in the upper limbs (65.4%, n=115) and upper back (68.2%, n=120). A significant association (p<0.05) was found between the infant carrying methods, trunk position, and time spent carrying an infant.
Conclusion: A greater number of participants used in-arms ICM for 1-6 hours daily, and reported forward lean trunk position, as well as upper limbs and upper back pain, suggesting an association between ICM duration and musculoskeletal discomfort.
Keywords: Body Mass Index, Caregivers, Infant, Musculoskeletal Pain
Vocational rehabilitation. Employment of people with disabilities, Therapeutics. Psychotherapy
The integration of brain-computer interfaces (BCIs) into the realm of smart wheelchair (SW) technology signifies a notable leap forward in enhancing the mobility and autonomy of individuals with physical disabilities. BCIs are a technology that enables direct communication between the brain and external devices. While BCIs systems offer remarkable opportunities for enhancing human-computer interaction and providing mobility solutions for individuals with disabilities, they also raise significant concerns regarding security, safety, and privacy that have not been thoroughly addressed by researchers on a large scale. Our research aims to enhance wheelchair control for individuals with physical disabilities by leveraging electroencephalography (EEG) signals for BCIs. We introduce a non-invasive BCI system that utilizes a neuro-signal acquisition headset to capture EEG signals. These signals are obtained from specific brain activities that individuals have been trained to produce, allowing for precise control of the wheelchair. EEG-based BCIs are instrumental in capturing the brain's electrical activity and translating these signals into actionable commands. The primary objective of our study is to demonstrate the system's capability to interpret EEG signals and decode specific thought patterns or mental commands issued by the user. By doing so, it aims to convert these into accurate control commands for the wheelchair. This process includes the recognition of navigational intentions, such as moving forward, backward, or executing turns, specifically tailored for wheelchair operation. Through this innovative approach, we aim to create a seamless interface between the user's cognitive intentions and the wheelchair's movements, enhancing autonomy and mobility for individuals with physical disabilities.
In a world where in-person context transitions more into remote and hybrid concepts, we should consider new concepts of interaction in health and rehabilitation and what advantages and disadvantages they bring. One of the rising topics is mixed reality, where we can use the advantages of immersive 3D, 360-degree environments. Meanwhile, physical activity is further decreasing and with it negative effects increase through sedentary behaviour or wrong and untrained movements. In this position paper, we discuss these new risks and potential benefits of mixed reality technology when used for rehabilitation and fitness. We conclude with suggesting better feedback and guidance for physical movement and tasks at home. Improving feedback and guidance for participants could be achieved through using new technologies like virtual reality and motion tracking.
Physical movement therapy is a crucial method of rehabilitation aimed at reinstating mobility among patients facing motor dysfunction due to neurological conditions or accidents. Such therapy is usually featured as patient-specific, repetitive, and labor-intensive. The conventional method, where therapists collaborate with patients to conduct repetitive physical training, proves strenuous due to these characteristics. The concept of robot-assisted rehabilitation, assisting therapists with robotic systems, has gained substantial popularity. However, building such systems presents challenges, such as diverse task demands, uncertainties in dynamic models, and safety issues. To address these concerns, in this paper, we proposed a bilateral teleoperation system for rehabilitation. The control scheme of the system is designed as an integrated framework of impedance control and disturbance observer where the former can ensure compliant human-robot interaction without the need for force sensors while the latter can compensate for dynamic uncertainties when only a roughly identified dynamic model is available. Furthermore, the scheme allows free switching between tracking tasks and physical human-robot interaction (pHRI). The presented system can execute a wide array of pre-defined trajectories with varying patterns, adaptable to diverse needs. Moreover, the system can capture therapists' demonstrations, replaying them as many times as necessary. The effectiveness of the teleoperation system is experimentally evaluated and demonstrated.
Mamoona Tasleem Afzal, Saad Tariq, Muhammad Shakir Khan
et al.
Background: Cerebral palsy (CP) affects the mobility and functional strength of children which leads to a decline in the quality of life of children. Functional strength training may considered objective-oriented to achieve some specific activity level and improve the overall performance of children. Objective: To determine the effects of additional functional strength training on mobility in Children with Hemiplegic Cerebral Palsy (HCP). Method: A single-blind randomized control trial (NCT05878756) was conducted on (n=40) children with hemiplegic cerebral palsy (HCP) at the National Institute of Rehabilitation Science, Islamabad. Children who can follow commands, not using assistive devices, and are not being treated in any other rehabilitation services were included. Children aged 4-12 years were recruited through a non-probability convenient sampling technique and a total of n=40 participants were randomly divided into Group A (n=20) which received conventional therapy along with functional strength training for 4 weeks, while Group B (n=20) only received conventional physical therapy. Both groups received intervention for 4weeks. The tools, Gross Motor Function Measure (GMFM) used for the severity of mobility and, five times sit to stand (FTSST) to assess functional lower extremity strength, transitional movement balance, and fall risk in older adults, were used at baseline and post-treatment assessment. Results: Both groups had improvements in strength and mobility but there was significant improvement in strength and mobility in Group A after 4th week (p≤ 0.05). However, no significant increase in the dimension of lying and kneeling was observed. Comparison between both groups (pre and post-treatment) for dimensions of walking, running, and jumping in both groups showed significant improvement (p=0.045). According to the result of GMFM scoring, a significant improvement in the interventional group (A) as compared to Group B (p=0.003). So, there is a considerable increase in GMFM score for Group A than Group B group. Conclusion: It is concluded that additional functional therapy has a better outcome as compared to conventional therapy on mobility and strength of children with CP. Keywords Cerebral palsy; functional strength training; mobility; Gross Motor Function Measure; Gross Motor Function Classification System
Vocational rehabilitation. Employment of people with disabilities
Vuthea Chheang, Rakshith Lokesh, Amit Chaudhari
et al.
Stroke patients often experience upper limb impairments that restrict their mobility and daily activities. Physical therapy (PT) is the most effective method to improve impairments, but low patient adherence and participation in PT exercises pose significant challenges. To overcome these barriers, a combination of virtual reality (VR) and robotics in PT is promising. However, few systems effectively integrate VR with robotics, especially for upper limb rehabilitation. This work introduces a new virtual rehabilitation solution that combines VR with robotics and a wearable sensor to analyze elbow joint movements. The framework also enhances the capabilities of a traditional robotic device (KinArm) used for motor dysfunction assessment and rehabilitation. A pilot user study (n = 16) was conducted to evaluate the effectiveness and usability of the proposed VR framework. We used a two-way repeated measures experimental design where participants performed two tasks (Circle and Diamond) with two conditions (VR and VR KinArm). We observed no significant differences in the main effect of conditions for task completion time. However, there were significant differences in both the normalized number of mistakes and recorded elbow joint angles (captured as resistance change values from the wearable sleeve sensor) between the Circle and Diamond tasks. Additionally, we report the system usability, task load, and presence in the proposed VR framework. This system demonstrates the potential advantages of an immersive, multi-sensory approach and provides future avenues for research in developing more cost-effective, tailored, and personalized upper limb solutions for home therapy applications.
This paper examines the long-term gender-specific impacts of parental health shocks on adult children's employment in China. We build up an inter-temporal cooperative framework to analyze household work decisions in response to parental health deterioration. Then employing an event-study approach, we establish a causal link between parental health shocks and a notable decline in female employment rates. Male employment, however, remains largely unaffected. This negative impact shows no abatement up to eight years that are observable by the sample. These findings indicate the consequence of "growing old before getting rich" for developing countries.
Yuanxiang Ma, Andreas Polydorides, Jitesh Joshi
et al.
Chronic Obstructive Pulmonary Disease (COPD) can be fatal and is challenging to live with due to its severe symptoms. Pulmonary rehabilitation (PR) is one of the managements means to maintain COPD in a stable status. However, implementation of PR in the UK has been challenging due to the environmental and personal barriers faced by patients, which hinder their uptake, adherence, and completion of the programmes. Moreover, increased exercise capacity following PR does not always translate into physical activity (PA) and unfortunately, can lead back to exercise capacity seen prior to PR. Current alternative solutions using telerehabilitation methods have limitations on addressing these accessibility problems, and no clear conclusion can be drawn on the efficacy of telerehabilitation in enhancing the sustainability of PR outcomes via promoting PA in patients' everyday life. In this work, the authors propose a novel design of sensor-based assistive product with the aim of facilitating PR and promoting PA maintenance in a home-based setting. Prototypes of different levels of fidelity are presented, followed by an evaluation plan for future research directions.
The Fifty-eighth World Health Assembly, having considered the report on disability, provides for “the need to invest in health and rehabilitation services necessary to ensure equality of opportunity and a good quality of life for people with disabilities.” The Convention on the Rights of the Child and the Law on Education of the Russian Federation include the possibility of obtaining education, vocational guidance and vocational training for persons with disabilities. Objective is to assess the medical and social problems of adaptation of children with intellectual disabilities in educational institutions, vocational guidance for choosing the appropriate profession, training and employment. Review of current data on the problems of education and health care of children with mental retardation, their professional orientation, vocational training. Assessment of the modern regulatory framework for teaching children and adolescents with disabilities. The search for information was carried out using the eLibrary information portals.RU, PUBMED, Web of Science and Scopus. It is shown that there are problems of attracting adolescents with mental retardation in the management of vocational education, where the number of students remains minimal. New regulatory documents are presented, which define the conditions and training loads for persons with disabilities in educational institutions. The necessity of improving the quality of medical, psychological and pedagogical support of students with disabilities with the involvement of doctors of the appropriate profile has been established. The development of the material and technical base for the upbringing, training and rehabilitation of children with mental retardation is shown. The problems with the readiness of teachers to work with children with disabilities in the implementation of the State program “Accessible Environment” are noted. The “Concept of the development of education of children with disabilities”, developed by teachers-defectologists, is considered. The modern regulatory framework for vocational training and employment of persons with disabilities is presented. Conclusion. The results of the review are aimed at identifying problems with professional orientation and training of adolescents with mental retardation. They can be useful for specialists dealing with such children and adolescents.