How a Diverse Research Ecosystem Has Generated New Rehabilitation Technologies: Review of NIDILRR’s Rehabilitation Engineering Research Centers

Over 50 million United States citizens (1 in 6 people in the US) have a developmental, acquired, or degenerative disability. The average US citizen can expect to live 20% of his or her life with a disability. Rehabilitation technologies play a major role in improving the quality of life for people with a disability, yet widespread and highly challenging needs remain. Within the US, a major effort aimed at the creation and evaluation of rehabilitation technology has been the Rehabilitation Engineering Research Centers (RERCs) sponsored by the National Institute on Disability, Independent Living, and Rehabilitation Research. As envisioned at their conception by a panel of the National Academy of Science in 1970, these centers were intended to take a “total approach to rehabilitation”, combining medicine, engineering, and related science, to improve the quality of life of individuals with a disability. Here, we review the scope, achievements, and ongoing projects of an unbiased sample of 19 currently active or recently terminated RERCs. Specifically, for each center, we briefly explain the needs it targets, summarize key historical advances, identify emerging innovations, and consider future directions. Our assessment from this review is that the RERC program indeed involves a multidisciplinary approach, with 36 professional fields involved, although 70% of research and development staff are in engineering fields, 23% in clinical fields, and only 7% in basic science fields; significantly, 11% of the professional staff have a disability related to their research. We observe that the RERC program has substantially diversified the scope of its work since the 1970’s, addressing more types of disabilities using more technologies, and, in particular, often now focusing on information technologies. RERC work also now often views users as integrated into an interdependent society through technologies that both people with and without disabilities co-use (such as the internet, wireless communication, and architecture). In addition, RERC research has evolved to view users as able at improving outcomes through learning, exercise, and plasticity (rather than being static), which can be optimally timed. We provide examples of rehabilitation technology innovation produced by the RERCs that illustrate this increasingly diversifying scope and evolving perspective. We conclude by discussing growth opportunities and possible future directions of the RERC program

How 5G wireless (and concomitant technologies) will revolutionize healthcare?

The need to have equitable access to quality healthcare is enshrined in the United Nations (UN) Sustainable Development Goals (SDGs), which defines the developmental agenda of the UN for the next 15 years. In particular, the third SDG focuses on the need to “ensure healthy lives and promote well-being for all at all ages”. In this paper, we build the case that 5G wireless technology, along with concomitant emerging technologies (such as IoT, big data, artificial intelligence and machine learning), will transform global healthcare systems in the near future. Our optimism around 5G-enabled healthcare stems from a confluence of significant technical pushes that are already at play: apart from the availability of high-throughput low-latency wireless connectivity, other significant factors include the democratization of computing through cloud computing; the democratization of Artificial Intelligence (AI) and cognitive computing (e.g., IBM Watson); and the commoditization of data through crowdsourcing and digital exhaust. These technologies together can finally crack a dysfunctional healthcare system that has largely been impervious to technological innovations. We highlight the persistent deficiencies of the current healthcare system and then demonstrate how the 5G-enabled healthcare revolution can fix these deficiencies. We also highlight open technical research challenges, and potential pitfalls, that may hinder the development of such a 5G-enabled health revolution

Assessing Self-Rehabilitation Strategies for the Visually Impaired in Denmark

Self-rehabilitation technology has been developed to reduce healthcare costs and provide a convenient, reliable method for patients to recover from a physical injury. Sponsored by the Danish Association of the Blind, the following report summarizes a project exploring self-rehabilitation technologies that can accommodate blind or visually impaired patients. Potential strategies to increase awareness of such devices throughout municipalities in Denmark were evaluated as well. The data collected in this project were used to recommend that the Danish Association of the Blind advocates for further development of several rehabilitation technologies and the education of healthcare professionals about these technologies throughout Danish municipalities

Future bathroom: A study of user-centred design principles affecting usability, safety and satisfaction in bathrooms for people living with disabilities

Research and development work relating to assistive technology 2010-11 (Department of Health) Presented to Parliament pursuant to Section 22 of the Chronically Sick and Disabled Persons Act 197

The Emerging Role of Robotics in Personal Health Care: Bringing Smart Health Care Home

Affordable, accessible health care is in short supply in the U.S., due to the rapidly aging population; robotics can provide a solution to this problem. This project developed user requirements for a personal health care robot. From interviews with robotics professionals and focus groups with caregivers and the elderly, the team gained an understanding of potential users’ desired functionalities and acceptance of robots. The team developed a taxonomy to characterize robots’ interaction with users. The requirements generated by the studies were used in conjunction with this taxonomy to recommend a robot for use in personal health care. An in-home monitoring system was found to have the greatest potential to benefit the health care industry and the target demographic

Creative Haptic Interface Design for the Aging Population

Audiovisual human-computer-interfaces still make up the majority of content to the public; however, haptic interfaces offer unique advantage over the dominant information infrastructure, particularly for users with a disability or diminishing cognitive and physical skills like the elderly. The tactile sense allows users to integrate new, unobstructive channels for digital information into their sensorium, one that is less likely to be overwhelmed compared to vision and audition. Haptics research focus on the development of hardware, improving resolution, modality, and fidelity of the actuators. Despite the technological limitations, haptic interfaces are shown to reinforce physical skill acquisition, therapy, and communication. This chapter will present key characteristics intuitive tactile interfaces should capture for elderly end-users; sample projects will showcase unique applications and designs that identify the limitations of the UI

Ambient Assisted Living: Scoping Review of Artificial Intelligence Models, Domains, Technology, and Concerns

Background: Ambient assisted living (AAL) is a common name for various artificial intelligence (AI)—infused applications and platforms that support their users in need in multiple activities, from health to daily living. These systems use different approaches to learn about their users and make automated decisions, known as AI models, for personalizing their services and increasing outcomes. Given the numerous systems developed and deployed for people with different needs, health conditions, and dispositions toward the technology, it is critical to obtain clear and comprehensive insights concerning AI models used, along with their domains, technology, and concerns, to identify promising directions for future work. Objective: This study aimed to provide a scoping review of the literature on AI models in AAL. In particular, we analyzed specific AI models used in AАL systems, the target domains of the models, the technology using the models, and the major concerns from the end-user perspective. Our goal was to consolidate research on this topic and inform end users, health care professionals and providers, researchers, and practitioners in developing, deploying, and evaluating future intelligent AAL systems. Methods: This study was conducted as a scoping review to identify, analyze, and extract the relevant literature. It used a natural language processing toolkit to retrieve the article corpus for an efficient and comprehensive automated literature search. Relevant articles were then extracted from the corpus and analyzed manually. This review included 5 digital libraries: IEEE, PubMed, Springer, Elsevier, and MDPI. Results: We included a total of 108 articles. The annual distribution of relevant articles showed a growing trend for all categories from January 2010 to July 2022. The AI models mainly used unsupervised and semisupervised approaches. The leading models are deep learning, natural language processing, instance-based learning, and clustering. Activity assistance and recognition were the most common target domains of the models. Ambient sensing, mobile technology, and robotic devices mainly implemented the models. Older adults were the primary beneficiaries, followed by patients and frail persons of various ages. Availability was a top beneficiary concern. Conclusions: This study presents the analytical evidence of AI models in AAL and their domains, technologies, beneficiaries, and concerns. Future research on intelligent AAL should involve health care professionals and caregivers as designers and users, comply with health-related regulations, improve transparency and privacy, integrate with health care technological infrastructure, explain their decisions to the users, and establish evaluation metrics and design guidelines. Trial Registration: PROSPERO (International Prospective Register of Systematic Reviews) CRD42022347590; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022347590This work was part of and supported by GoodBrother, COST Action 19121—Network on Privacy-Aware Audio- and Video-Based Applications for Active and Assisted Living

State of the art of audio- and video based solutions for AAL

Working Group 3. Audio- and Video-based AAL ApplicationsIt is a matter of fact that Europe is facing more and more crucial challenges regarding health and social care due to the demographic change and the current economic context. The recent COVID-19 pandemic has stressed this situation even further, thus highlighting the need for taking action. Active and Assisted Living (AAL) technologies come as a viable approach to help facing these challenges, thanks to the high potential they have in enabling remote care and support. Broadly speaking, AAL can be referred to as the use of innovative and advanced Information and Communication Technologies to create supportive, inclusive and empowering applications and environments that enable older, impaired or frail people to live independently and stay active longer in society. AAL capitalizes on the growing pervasiveness and effectiveness of sensing and computing facilities to supply the persons in need with smart assistance, by responding to their necessities of autonomy, independence, comfort, security and safety. The application scenarios addressed by AAL are complex, due to the inherent heterogeneity of the end-user population, their living arrangements, and their physical conditions or impairment. Despite aiming at diverse goals, AAL systems should share some common characteristics. They are designed to provide support in daily life in an invisible, unobtrusive and user-friendly manner. Moreover, they are conceived to be intelligent, to be able to learn and adapt to the requirements and requests of the assisted people, and to synchronise with their specific needs. Nevertheless, to ensure the uptake of AAL in society, potential users must be willing to use AAL applications and to integrate them in their daily environments and lives. In this respect, video- and audio-based AAL applications have several advantages, in terms of unobtrusiveness and information richness. Indeed, cameras and microphones are far less obtrusive with respect to the hindrance other wearable sensors may cause to one’s activities. In addition, a single camera placed in a room can record most of the activities performed in the room, thus replacing many other non-visual sensors. Currently, video-based applications are effective in recognising and monitoring the activities, the movements, and the overall conditions of the assisted individuals as well as to assess their vital parameters (e.g., heart rate, respiratory rate). Similarly, audio sensors have the potential to become one of the most important modalities for interaction with AAL systems, as they can have a large range of sensing, do not require physical presence at a particular location and are physically intangible. Moreover, relevant information about individuals’ activities and health status can derive from processing audio signals (e.g., speech recordings). Nevertheless, as the other side of the coin, cameras and microphones are often perceived as the most intrusive technologies from the viewpoint of the privacy of the monitored individuals. This is due to the richness of the information these technologies convey and the intimate setting where they may be deployed. Solutions able to ensure privacy preservation by context and by design, as well as to ensure high legal and ethical standards are in high demand. After the review of the current state of play and the discussion in GoodBrother, we may claim that the first solutions in this direction are starting to appear in the literature. A multidisciplinary 4 debate among experts and stakeholders is paving the way towards AAL ensuring ergonomics, usability, acceptance and privacy preservation. The DIANA, PAAL, and VisuAAL projects are examples of this fresh approach. This report provides the reader with a review of the most recent advances in audio- and video-based monitoring technologies for AAL. It has been drafted as a collective effort of WG3 to supply an introduction to AAL, its evolution over time and its main functional and technological underpinnings. In this respect, the report contributes to the field with the outline of a new generation of ethical-aware AAL technologies and a proposal for a novel comprehensive taxonomy of AAL systems and applications. Moreover, the report allows non-technical readers to gather an overview of the main components of an AAL system and how these function and interact with the end-users. The report illustrates the state of the art of the most successful AAL applications and functions based on audio and video data, namely (i) lifelogging and self-monitoring, (ii) remote monitoring of vital signs, (iii) emotional state recognition, (iv) food intake monitoring, activity and behaviour recognition, (v) activity and personal assistance, (vi) gesture recognition, (vii) fall detection and prevention, (viii) mobility assessment and frailty recognition, and (ix) cognitive and motor rehabilitation. For these application scenarios, the report illustrates the state of play in terms of scientific advances, available products and research project. The open challenges are also highlighted. The report ends with an overview of the challenges, the hindrances and the opportunities posed by the uptake in real world settings of AAL technologies. In this respect, the report illustrates the current procedural and technological approaches to cope with acceptability, usability and trust in the AAL technology, by surveying strategies and approaches to co-design, to privacy preservation in video and audio data, to transparency and explainability in data processing, and to data transmission and communication. User acceptance and ethical considerations are also debated. Finally, the potentials coming from the silver economy are overviewed.publishedVersio