Assistive tech for arms: perspectives and propositions by Yara Perterko

Literature suggests that mobility devices include both lower limb as well as the upper limb
mobility (Cowan et al 2012: Zallio & Ohashi 2022), this makes it harder to distinguish statistics
in the development of both areas. While assistive devices for lower limb mobility are well
known and established, the same can not be said for upper limb technologies. This is also
evident in the Global indicators of assistive technology use amongst occupational therapists
– report of WFOT (2019), where assistive devices for upper limbs are notably absent from the
categories of described products within the past 12 months. This gap raises the question:
why is there a disparity, and what can be done to change this?

Given the broad nature of the field, I will focus on orthotic devices in combination with
electronic components and adaptive equipment. There are several factors making assistive
devices for the upper limb especially difficult to customise to the individual’s needs.
Components that mainly influence the use of devices are the size, the weight, the
accessibility and also their ability to be used independently by the client (Hays et al 20230,
Kabir et al 2023).

This insight was reinforced during my Master’s Degree in Health Assisting Engineering at FH
Campus Wien, where interdisciplinary teams assessed multiple assistive devices and direct
client interactions. The main objective of the program was that therapists and other medical
personnel would understand the thought processes and abilities of the technicians better
and that technicians would learn more about clients’ needs and different disabilities and
challenges.

One key finding was that the weight of many devices, primarily due to the battery, was too
high for users to benefit from them. For example, we assessed gloves designed to support
grip strength but could not recommend them because their weight might have caused pain
in other parts of the arm. Another issue was that intended users often could not operate the
devices independently due to small buttons, strong Velcro without gripping points, or push
buttons that were too difficult to press.

Collaboration between therapists and technicians was crucial in identifying these areas for
improvement. Technicians were often unaware of the issues, while therapists lacked the
technical knowledge to implement necessary changes. Therapists were more advanced in
client interviews and engagement than the technicians and also had a better understanding
of the technical aspects of the products than the clients themselves. Therefore, having
therapists as the link between clients and technicians was essential.

And this is where one of the keys lies for future developments in the field. There needs to be
interprofessional collaboration to make sure that the devices actually benefit the target
population (Hays et al 2023: Wei Qi Koh et al 2024).

The World Health Organization (WHO) has recently highlighted the importance of developing
more inclusive and effective assistive technologies. Their guidelines recommend increased
research and evidence-based practices (EBP) to guide developers and therapists.
Emphasising on how user-centred design and iterative testing with real users can significantly
enhance the efficacy and adoption of upper limb assistive devices (WHO, 2022). Therapists
need to be involved in the development process to serve as the crucial link between the
client or end-user and the technicians, ensuring that the needs of the users are adequately
addressed.