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

Vulnerable Users’ Perceptions of Transport Technologies

As the global population continues to grow, age and urbanize, it is vital to provide accessible transport so that neither ageing nor disability constitute barriers to social inclusion. While technology can enhance urban access, there is a need to study the ways by which transport technologies - real-time information, pedestrian navigation, surveillance, and road pricing - could be more effectively adopted by users. The reason for this is that some people, and particularly vulnerable populations, are still likely to reluctantly use (or even avoid using) technologies perceived as 'unknown' and 'complicated'. Based on evidence from British and Swedish case studies on older people's perceptions of the aforementioned transport technologies, as well as on a Swedish case study of visually impaired people's perceptions, this article makes the case that technology is only one tool in a complex socio-technical system, and one which brings challenges. The authors also suggest that although vulnerable populations are not homogeneous when expressing attitudes towards transport technologies, their assessment criteria tend to be 'pro-social' as they usually consider that the societal benefits outweigh the personal benefits. Emphasising aspects linked to the technologies' pro-social potential or relevance to the individual user could increase acceptance

Exergames for motor rehabilitation in older adults: an umbrella review

Background: Exergames have been used as an innovative motor rehabilitation method with the main aim of improving motivation and exercise. As research interest in exergaming for rehabilitation is rapidly growing, a review of existing systematic reviews is important to synthesize the available evidence and provide recommendations. Objectives: In this article, we systematically synthesized the information from reviews that have examined the effects if exergames on different body movement parameters in older adults with and without specific pathologies. Method: Searches were conducted in Web of Science, Scopus, PsycARTICLES, PsycINFO, Psychology and Behavioural Sciences Collection, PubMed, SciELO, B-On and Google Scholar, articulating different terms and Boolean operators. Systematic reviews, meta-analysis and literature reviews published until May 2017 that investigated exergame interventions on physical outcomes, such as balance, gait, limb movements, muscle strength, in healthy and non-healthy older adults. Results: Based on prior reviews, exergaming, as a standalone intervention, has a positive effect on balance, gait, muscle strength, upper limb function, and dexterity. When compared to traditional physiotherapy, exergaming has at least similar effects on these outcomes. Many of the investigated studies indicated low methodological quality for the evaluation of the effects of exergames on different outcomes related to motor rehabilitation. Conclusions: Exergames could be used as a complement to traditional forms of motor rehabilitation, but future individual studies and reviews should follow more rigorous methodological standards in order to improve the quality of the evidence and provide guidelines for the use of exergames in motor rehabilitation.info:eu-repo/semantics/acceptedVersio

Design and Evaluation of a Virtual Reality Game to Improve Physical and Cognitive Acuity

Physical and mental health are both integral to healthy living and ageing, and a causal-cum-symbiotic relationship has been observed between the two. Physical and cognitive activities such as exercise and board games are known to promote healthy ageing. In this regard, highly engaging lightboard games are known to improve hand-eye coordination, reflexes, and motor skills for individuals. Immersivity of virtual reality games can transform mundane and repetitive exercise routines into stimulating experiences, and they can be utilized by users to improve physical and cognitive performance from the comfort of their homes. In this study, we adopt design science framework to design, develop and evaluate a VR BATAK lightboard game to improve physical reaction, hand-eye coordination, visual memory and cognitive processing. Based on the findings from evaluation over three phases, we propose three design principles related to accessibility, sensory cueing and cognitive loading, as theoretical and practical contributions of this study

UPPERCARE: a community aware environment for post-surgical musculoskeletal recovery of elderly patients

Trabalho apresentado na Conferência Internacional realizada em Wellington, Nova Zelândia, de 26-28 de abril de 2017Disability from musculoskeletal diseases and comorbidities may lead to the worsening of social and economic well-being through a multitude of paths. Moreover since in European Union (EU) Member States it is projected that those aged 65 and over will become a much larger share (rising from 17% to 30% of the population), and those aged 80 and over (rising from 5% to 12%) will almost become as numerous as the young population in 2060, there is a great potential for Information and Communication Technologies (ICT) solutions for addressing the present and future living arrangements in older people. The UPPERCARE system is meant to affect positively both the intergenerational and partners care since it contributes to decrease usability barriers and promote collaborative environments for informal and self-care. UPPERCARE is a new approach for integrated care supported by ICT systems and services, focusing on post-operative rehabilitation of musculoskeletal pathologies, having as a case study the knee post-operative scenarios of prosthetic care. This paper presents the UPPERCARE system, that provides an integrated care solution, supported ICT, for empowering self-care and adherence to rehabilitation plans through natural interfaces, gamification and cross-modal paths for community care collaboration. The system addresses current barriers from technological, clinical, social and organisational perspectives in a multidisciplinary environment. Special attention is given to the patients’ needs and behaviours entailing the participation of a wide care community, including clinical and non-clinical people, associations, institutions and authorities) through an user driven interaction within the system.This work was supported by Project ”NanoSTIMA: Macroto-Nano Human Sensing: Towards Integrated Multimodal Health Monitoring and Analytics/NORTE-01-0145-FEDER- 000016” financed by the North Portugal Regional Operational Programme (NORTE 2020), under the PORTUGAL 2020 Partnership Agreement, and through the European Regional Development Fund (ERDF).info:eu-repo/semantics/publishedVersio