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

Critical Importance of Standardized Nomenclature and Classification in Venous Surgery and Interventional Treatments

In this chapter the authors explain the need for standardization of nomenclature and classification of deep venous disease in patients selected for venous surgery and/or (minimally invasive) interventional treatment. For both acute deep vein obstruction (deep vein thrombosis) and chronic deep vein obstruction (deep vein stenosis or occlusion), the concept behind treatment selection and classification of disease is explained and illustrated with figures.keywordsinferior vena cavavaricose veiniliac veinvenous diseasevenous insufficiencythese keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves

Vascular Studies for Nonvascular Surgeons

A patient’s therapeutic plan is guided by a combination of their medical history, vascular test results, and physical examination. Diagnostic tests play an essential role in the detection of vascular disease from both a venous and arterial standpoint. The sooner vascular disease can be identified in an individual, the sooner both physicians and patients can work toward integrating therapies that will prevent or mitigate ulcer formation. Knowledge regarding the proper indications and interpretations of the various vascular studies is critical to the successful management of each patient