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

Empowering and assisting natural human mobility: The simbiosis walker

This paper presents the complete development of the Simbiosis Smart Walker. The device is equipped with a set of sensor subsystems to acquire user-machine interaction forces and the temporal evolution of user's feet during gait. The authors present an adaptive filtering technique used for the identification and separation of different components found on the human-machine interaction forces. This technique allowed isolating the components related with the navigational commands and developing a Fuzzy logic controller to guide the device. The Smart Walker was clinically validated at the Spinal Cord Injury Hospital of Toledo - Spain, presenting great acceptability by spinal chord injury patients and clinical staf

The effectiveness of interventions targeting physical activity and/or sedentary behaviour in people with Multiple Sclerosis: a systematic review

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A Universalist strategy for the design of Assistive Technology

Assistive Technologies are specialized products aiming to partly compensate for the loss of autonomy experienced by disabled people. Because they address special needs in a highly-segmented market, they are often considered as niche products. To improve their design and make them tend to Universality, we propose the EMFASIS framework (Extended Modularity, Functional Accessibility, and Social Integration Strategy). We first elaborate on how this strategy conciliates niche and Universalist views, which may appear conflicting at first sight. We then present three examples illustrating its application for designing Assistive Technologies: the design of an overbed table, an upper-limb powered orthose and a powered wheelchair. We conclude on the expected outcomes of our strategy for the social integration and participation of disabled people

Medical device technologies: Who is the user?

A myriad of medical devices deployed by many users play an essential role in healthcare, and they, and their users, need to be defined, classified and coded effectively. This study provides definitions of terms frequently employed to describe the users of medical device technologies (MDT) as well as a classification of such users. Devices are widely used, developed and assessed by many others than clinicians. Thus, users of medical devices need to be classified in various relevant ways, such as primary and secondary users; user groups such as healthcare professionals, patients, carers, persons with disabilities, those with special needs, as well as professionals allied with healthcare. Proper definition and classification of MDT users is particularly important for integrating the users’ perspectives in the process of MDT development and assessment, as well as in relation to the regulatory, health and safety, and insurance perspectives concerning MDT

INTELIGENTNY WÓZEK INWALIDZKI Z NAPĘDEM ELEKTRYCZNYM: PROBLEMY I WYZWANIA W PODEJŚCIU PRODUKTOWYM

This paper focuses on intelligent assistant for power wheelchair (PW) usage in home conditions. Especially in the context of PW intelligent assistant as a consumer product. The main problematic aspects and challenges of smart PW in real application are noted. The approach to formation of system requirements and their classification is offered. The research results proposed and implemented in the ongoing Mobilis project for smart PW. Further prospects of research and development are noted. Also, it is stated that the implementation of smart PW technology opens possibilities to effective integration with new control methods (including brain-computer interfaces).Niniejszy artykuł koncentruje się na omówieniu problemów i wyzwań dotyczących nowego produktu, jakim jest Smart Power Wheelchair (SPW), czyli inteligentny asystent używany w elektrycznych wózkach inwalidzkich w warunkach domowych. Zwrócono szczególnie uwagę na ukazanie SPW jako nowego produktu konsumenckiego na rynku dóbr. Przedstawione zostały główne problematyczne aspekty i wyzwania dla SPW, które mogą pojawić się w warunkach rzeczywistych. Artykuł zawiera również propozycje dotyczące tworzenia wymagań systemowych oraz ich klasyfikacji. W kolejnej części artykułu przedstawiono wyniki badań, zrealizowanych w ramach projektu Mobilis, dzięki którym wdrożono szereg zmian w produkcie. Ponadto autorzy zapewniają o planowanych dalszych badaniach nad rozwojem produktu. Należy zwrócić uwagę, że wprowadzenie technologii SPW otwiera możliwości efektywnej integracji z nowymi metodami komunikacji (w tym z interfejsami mózg-komputer, z ang. brain-computer interfaces – BCI), z których szczególną korzyść będą miały osoby z niepełnosprawnością ruchową

Suggested approach for establishing a rehabilitation engineering information service for the state of California

An ever expanding body of rehabilitation engineering technology is developing in this country, but it rarely reaches the people for whom it is intended. The increasing concern of state and federal departments of rehabilitation for this technology lag was the stimulus for a series of problem-solving workshops held in California during 1977. As a result of the workshops, the recommendation emerged that the California Department of Rehabilitation take the lead in the development of a coordinated delivery system that would eventually serve the entire state and be a model for similar systems across the nation