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

Elderly travel frequencies and transport mode choices in Greater Rotterdam, the Netherlands

Demographic ageing is a key societal challenge in Europe as well as in many other western and non-western societies. A crucial dimension concerns elderly daily mobility patterns. While still partaking fewer and shorter trips than younger generations, today’s elderly have been found increasingly (auto)mobile. Although the elderly benefit from the independence, freedom of movement, and social inclusion, concerns may rise regarding the environmental and accessibility impacts of this induced mobility. The present study adds to the expanding literature on elderly mobility, an integrated analysis of the effects of socio-demographic, health, trip, spatial and weather attributes on elderly mobility. Utilizing travel diary data for Greater Rotterdam, The Netherlands, trip frequencies and transport mode choices of the elderly are analysed by means of zero-inflated negative binomial models as well as multinomial logit regression models, and contrasted to the non-elderly subpopulation to explore (dis)similarities. While the results show common determinants, the models also highlight important differences in the magnitude of the estimated coefficients and factors only influencing transport patterns for the elderly. Embedded in the context of an aging population, the empirical findings assist policy-makers and planners in several respects: For transportation plans and programs it is critical to recognize mobility needs of the elderly. As the seniors are becoming increasingly automobile, the results call for strategies to encourage older people to use more physically active and environmentally friendly transport modes such as public transport, walking and cycling