A video-based observational methodology was used to assess the travel behaviors of 40 nursing home residents, 24 of whom were identified by nursing staff as wanderers. Travel was monitored continuously for 30 days, resulting in the recording of over 5,000 unassisted travel events. Four basic travel patterns were observed: direct travel (86.8%), lapping (11.6%), random travel (.9%), and pacing (.7%). Travel efficiency (percentage of direct travel) was significantly related to cognitive status (r = .56), with inefficient travel most prevalent in severely demented participants.

People with severe visual impairment need a means of remaining oriented to their environment as they move through it. Three wearable orientation interfaces were developed and evaluated toward this purpose: a stereophonic sonic guide (sonic "carrot"), speech output, and shoulder-tapping system. Street crossing was used as a critical test setting in which to evaluate these interfaces. The shoulder-tapping system was found most universally usable. Considering the great variety of co-morbidities within this population, the authors concluded that a combined tapping/speech interface would provide usability and flexibility to the greatest number of people under the widest range of environmental conditions.

Abstract-A walker that could help navigate and avoid collisions with obstacles could help reduce health costs and increase the quality of care and independence of thousands of people. This study evaluated the safety and performance of the Veterans Affairs Personal Adaptive Mobility Aid (VA-PAMAID). We performed engineering tests on the VA-PAMAID to determine safety factors, including stability, energy consumption, fatigue life, and sensor and control malfunctions. The VA-PAMAID traveled 10.9 km on a full charge and avoided obstacles while traveling at a speed of up to 1.2 m/s. No failures occurred during static stability, climatic, or fatigue testing. Some problems were encountered during obstacle climbing and sensor and control testing. The VA-PAMAID has good range, has adequate reaction time, and is structurally sound. Clinical trials are planned to compare the device to other low-technical adaptive mobility devices.

This study analyzed various components and compensatory strategies of balance in individuals with visual impairments. It found that people with visual impairments use different strategies to maintain balance than do sighted people, in an effort to trade efficiency for safety.A common problem associated with a visual impairment (blindness or low vision) is the use of sensory and vestibular information to establish patterns of movement and positions in space (efficient movement). Spatial concepts and the use of these concepts are required to maintain a base of support and center of gravity before one initiates a movement (Pereira, 1990). Concurrently, individuals must respond to changes in the environment by modifying and self-correcting their movement. For example, when a change in terrain or obstacles is encountered, they need to change their gait patterns to accommodate these changes.People with visual impairments place a greater demand on somatosensory and vestibular information to establish movement patterns, and their positions in space are compromised by the lack of vision or This study was supported by a grant from the Rehabilitation Research R&D Center, Atlanta VAMedical Center. minimal vision. Their orientation and mobility (O&M) depend on using sensory information other than vision to initiate changes in the center of gravity and in the base of support before they initiate a movement. Their standing balance is diminished because the loss of vision affects the vestibular system via feedback from the visual system (Maeda, Nakamuro, Otomo, Higuchi, & Motohashi, 1998). In addition, other compensatory mechanisms must provide the sensory input that is used to initiate movement and to complete the response if vision is not available or restricted. Although it appears that vision is essential for balance, especially in children, the lack of vision does not explain the movement difficulties that many individuals may encounter (Stones & Kozma, 1987).From a review of the literature, it is evident that visual impairments may affect movement in a variety of ways. For example, it is evident that major differences in movement between people who are sighted and those who are visually impaired occur

The various devices and techniques available for nonvisual travel may be evaluated in terms of the mobility coverage they provide. However, the coverage provided varies in relation to the function of the device or technique used. The long cane and the various techniques for its use are designed to provide the traveler with object, surface, and foot-placement preview. This article further refines the definition of those functions while specifying each in terms of its measurement.