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

Perceptions of Older Adults on the Use of an Interactive Video Game in Promoting Health and Well-Being

Background: This study explored the perceptions of older adults on the use of a custom built interactive video game (IVG) in promoting health and well-being among the older adult population. Method: This qualitative study used a phenomenological approach and enrolled 10 older adults over the age of 65 years in a client-centered, custom-built interactive video game program. This program was designed to promote activity tolerance, balance, range of motion, cognitive skills, and enjoyment through physical activity. The participants completed up to 12 Coin Catcher IVG sessions over a 4-week period. A postprogram, semi-structured, and audio-recorded interview explored their perceptions and experiences of the IVG. Results: The participant interview transcripts were individually coded, categorized, and then collapsed into broader themes. The three themes emerged as: I was thinking all the time, it is a good workout, and I thought it was fun. Conclusion: The custom built IVG is perceived by the older adult population to be engaging and meaningful while promoting physical performance

Journal of Accessibility and Design for All

This volume 2, number 1 of the Journal of Accessibility and Design for All comprises a selection of papers presented at the IV International Congress on Design, Research Networks, and Technology for all held in Madrid, June, 27 - 29, 2011. This congress is promoted by the ONCE Foundation for cooperation and social inclusion of persons with disabilities and intends to monitor the progress of assistive technologies for people with disabilities. Therefore, papers here presented cover different areas related to learning, health, communication and social life, which are also in line with the philosophy of the journal and complement some of the five research areas of this journal.Peer Reviewe

New techniques for neuro-rehabilitation: Transcranial Electric Stimulation and Virtual Reality

Recovery of motor and cognitive performances after a neurological illness remains a significant challenge for rehabilitation specialists. The traditional rehabilitative interventions are usually delivered using a multidisciplinary approach, whose results are not always satisfactory. These limitations in functional recovery have led researchers to consider alternative approaches. The hypothesis of providing new therapeutic possibilities in the different patients treated is, as a rehabilitator, very rewarding and represents a challenge for the future. The application of simple and low-cost techniques, defined by the literature as "unconventional" or “novel”, can provide new ideas not only in the field of research but above all of application in clinical reality.A suitable approach to improve the rehabilitation outcome is to utilize these novel rehabilitation techniques that act as a substitute or an addition to the traditional ones. In this context, some recent approaches have been proposed that might increase the effectiveness of a traditional treatment. Among them, two techniques have been demonstrated to be very promising, namely non-invasive brain stimulation (NIBS) and Virtual Reality (VR).In light of the foregoing, my thesis has been divided into two main lines of research, namely: a) the study of the effects of transcranial direct current stimulation (tDCS) in different neurological conditions; b) the application of VR (used alone or combined with tDCS) in the treatment of some neurocognitive disorders. A semi-immersive VR tool (ReMOVES system) has been used as a user-friendly platform providing activities based on exergames

A Service Robot for Navigation Assistance and Physical Rehabilitation of Seniors

The population of the advanced countries is ageing, with the direct consequence that an increasing number of people will have to live with sensitive, cognitive and physical disabilities. People with impaired physical ability are not confident to move alone, especially in crowded environment and for long journeys, highly reducing the quality of their life. We propose a new generation of robotic walking assistants whose mechanical and electronic components are conceived to optimize the collaboration between the robot and its users. We will apply these general ideas to investigate the interaction between older adults and a robotic walker, named FriWalk, exploiting it either as a navigational or as a rehabilitation aid. For the use of the FriWalk as a navigation assistance, the system guides the user securing high levels of safety, a perfect compliance with the social rules and non-intrusive interaction between human and machine. To this purpose, we developed several guidance systems ranging from completely passive strategies to active solutions exploiting either the rear or the front motors mounted on the robot. The common strategy at the basis of all the algorithms is that the responsibility of the locomotion belongs always to the user, both to increase the mobility of elder users and to enhance their perception of control over the robot. This way the robot intervenes only whenever it is strictly necessary not to mitigate the user safety. Moreover, the robotic walker has been endowed with a tablet and graphical user interface (GUI) which provides the user with the visual indications about the path to follow. Since the FriWalk was developed to suit the needs of users with different deficits, we conducted extensive human-robot interaction (HRI) experiments with elders, complemented with direct interviews of the participants. As concerns the use of the FriWalk as a rehabilitation aid, force sensing to estimate the torques applied by the user and change the user perceived inertia can be exploited by doctors to let the user feel the device heavier or lighter. Moreover, thanks to a new generation of sensors, the device can be exploited in a clinical context to track the performance of the users' rehabilitation exercises, in order to assist nurses and doctors during the hospitalization of older adults