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

A study of applications of microcomputer technology in special education in western Massachusetts schools.

The purpose of this study is to survey microcomputer applications in special education in Western Massachusetts Schools and, in particular, to assess the extent to which special education is moving beyond drill and practice software with special needs students. Data were collected from 185 special education teachers by a questionnaire and follow-up interviews from eleven special education teachers in Western Massachusetts. Results showed that computers and software are generally integrated in special education teachers\u27 curricula. They used the microcomputer as a compensatory tool to sharpen students\u27 mathematics skills, language arts and reading comprehension. Some special education teachers also used computers for language assessment, speech training, eye-hand coordination and communication. Apple computers were the most popular brand used in this study. Adaptive devices such as firmware cards, switches, and speech synthesizers were used to help special needs students access computers. Computer-assisted instruction, word processing and games were the most popular software used. Students worked on computers generally alone, or in a small group, or in combination; the amount of supervision required depended upon students\u27 functioning level and physical limitations. Most special education teachers did not teach and computer language; only a few teachers explored Logo or BASIC with their students. Special education teachers realized that the computer is a good tool to motivate students and to increase self-esteem and attention; they received some inservice training on computer uses, but complained that it was not enough to help their students. Factors making it difficult for special education teachers to use computers were: lack of appropriate software, teachers being behind the trend, not enough class time to use computers, and perceptions of computers as dehumanizing. The study concludes with recommendations for increasing special education teachers\u27 computer training via input from hardware and software experts, and for requiring special education teachers to take introductory computer courses such as Logo, BASIC programming, authoring language systems and software evaluation. Also, it recommends that school administrations give financial and technical support for such training in order to use microcomputers and related devices more effectively

Rehabilitation for Multiple Sclerosis, in Adults (II); Management and Impact on Impairment, Functioning, and Quality of Life: An Overview

Multiple sclerosis (MS) often leads to different levels of severity and progression of impairment and disability and to dissimilar levels of limitation in activities and participation in different social domains, with varying impacts on quality of life (QoL) among people with MS (PwMS). Results have shown that, for PwMS, prioritizing goal setting may enhance adherence to treatment. Interdisciplinary rehabilitation may prolong the functional status level of PwMS, may result in transient improvement in the aspects of impairment features, may increase their participation in activities, and may improve their QoL, even when disease progression is not modified. Single rehabilitation packages of comprehensive care have proven beneficial, such as physiotherapy, which enhances aerobic capacity, strength, pain, mood, mobility, and QoL. Occupational therapy can help reduce the impact of impairment on QoL, especially fatigue. Neuropsychological interventions, such as learning and memory remediation, psychological intervention for depressive disorders, and acquistion of coping skills and self-management techniques help PwMS to adjust to disease and disability. Speech therapy can improve intelligibility of communication. Learning swallowing techniques can help prevent material from entering the airway. Clean intermittent self-catheterization can help prevent urinary tract infections. Power wheelchairs enhance occupational performance and energy conservation. Further vocational rehabilitation settings and research are required for more appropriate interventions due to high unemployment rates among PwMS. Comprehensive care for PwMS should include planning for future independent living and long-term care needs.Martinez-Assucena, A.; Marnetoft, S.; Roig Rovira, T.; Hernandez-San-Miguel, J.; Bernabeu, M.; Martinell-Gispert-Sauch, M. (2010). Rehabilitation for Multiple Sclerosis, in Adults (II); Management and Impact on Impairment, Functioning, and Quality of Life: An Overview. 22(1-4):179-239. doi:10.1615/CritRevPhysRehabilMed.v22.i1-4.100179239221-