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

Effects of transit bus interior configuration on performance of wheeled mobility users during simulated boarding and disembarking

The emergence of low-floor bus designs and related regulatory standards in the U.S. have resulted in substantial improvements in public transit accessibility. However, passengers using wheeled mobility devices still experience safety concerns and inefficiencies in boarding, disembarking, and interior circulation on low-floor buses. This study investigates effects of low-floor bus interior configuration and passenger crowding on boarding and disembarking efficiency and safety. Users of manual wheelchairs (n = 18), powered wheelchairs (n = 21) and electric scooters (n = 9) simulated boarding and disembarking in three interior layout configurations at low and high passenger crowding conditions on a full-scale laboratory mock-up of a low-floor bus. Dependent measures comprised task times and critical incidents during access ramp use, fare payment, and movement to and from the doorway and wheeled mobility securement area. Individual times for unassisted boarding ranged from 15.2 to 245.3 s and for disembarking ranged from 9.1 to 164.6 s across layout and passenger crowding conditions. Nonparametric analysis of variance showed significant differences and interactions across vehicle design conditions, passenger load and mobility device type on user performance. The configuration having electronic on-board fare payment, rear-bus entrance doorways and adjacent device securement areas demonstrated greatest efficiency and safety. High passenger load adversely impacted efficiency and frequency of critical incidents during on-board circulation across all three layouts. Findings have broader implications for improving transit system efficiency and quality of service across the spectrum of transit users

Usability Evaluation of Access Ramps in Transit Buses: Preliminary Findings

The research literature on access ramps used in transit vehicles is undermined by inconsistent methodologies used across studies, thus providing an inconclusive evidence base for proposed Federal guidelines that would impose a maximum 1:6 slope for all deployment situations. The current study assessed the usability of ramp slope for mobility aid users. Four access ramp slopes were evaluated, with 27 adults representing three populations: manual wheelchair users, power wheelchair users, and people with vision impairment who use a cane or service animal. The dependent variables included five usability measures. The 1:8 and 1:12 slopes were usable and acceptable for most participants. The data indicate that the 1:4 slope is too steep for safe unassisted boarding and disembarking. Many manual wheelchair users lacked the strength needed for unassisted ascent. Power wheelchair users and people with vision impairment expressed safety concerns about descent of steeper slopes. Conclusive interpretations should be cautiously drawn because the sample size was relatively small and did not include users of scooters or ambulation aids