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The ability to perform activities of daily living and mobility-related activities of daily living are substantial indicators of one's ability to live at home and to participate in one's community. Technologies to assist with mobility and manipulation are among the most important tools that clinicians can provide to people with disabilities to promote independence and community participation. For people with severe disabilities involving both the upper and lower extremities, there are few systems that provide practical and coordinated assistance with mobility and manipulation tasks. The personal mobility and manipulation appliance (PerMMA) was created in response to goals set forth by a team of clinicians and people with disabilities.