Complex Rehab Technologies – Research in the Future of Mobility

This week is Complex Rehabilitation Technology Awareness Week, organized by the National Coalition for Assistive and Rehabilitation Technology (NCART). Complex rehabilitation technology, or CRT, may be an unfamiliar term to some, but most people have seen or interacted with some type of CRT: a manual or powered wheelchair is just one example.

According to NCART, CRT products are “medically necessary, individually configured devices that require evaluation, configuration, fitting, adjustment, or programming” by a team of rehabilitation professionals such as physicians and nurses, occupational and physical therapists, assistive technologists, and engineers. CRT products are designed to meet the specific and unique medical, physical, and functional needs of individuals with disabilities. They can include manual and powered wheelchair systems, seating and positioning systems, standing devices, and much more.

NIDILRR-funded research in CRT covers the engineering, prescription, and policy issues around getting people with disabilities the technology they need to live and move around independently in the community. Here’s a quick look at some of the projects currently working in this area.

Wheeled Mobility

• University of Pittsburgh Model Center on Spinal Cord Injury includes a project, Increasing Access to Wheelchair Skills Training (SKILL), that focuses on addressing barriers to wheelchair skills training by determining the effectiveness of remote training for both clinicians and wheelchair users.
• Assessing the Mechanical Efficiency of Manual Wheelchairs Using Robotic Propulsion aims to improve the state of the knowledge about the work required to propel manual wheelchairs by studying the propulsion cost of manual wheelchairs during over-ground maneuvers using a wheelchair-propelling robot.

Seating and Positioning

• Project Pluto: A Smart Wheelchair Cushion for the Reduction of Pressure Injuries is developing a new wheelchair cushion cover that increases comfort, decreases moisture, improves weight distribution to help prevent and treat pressure injuries for individuals with disabilities who are wheelchair users.

Robotics

• Foundational Ingredients of Robotic Gait Training for People with Spinal Cord Injury During Inpatient Therapy (FIRST) aims to improve the health and function of people with incomplete spinal cord injury (SCI) by conducting innovative, systematic, and highly focused research examining robotic gait training (RGT) during inpatient rehabilitation.
• Rehabilitation Interventions Based on Accurate Assessments with Combined Home-Hospital Rehabilitation champions innovative technologies/approaches for assessment-based rehabilitation with combined hospital-home rehabilitation that will improve therapeutic outcomes among individuals with neurologic disorders and older adults with disabilities.

Multiple Mobility Areas

• Technologies to Evaluate and Advance Mobility and Manipulation (TEAMM) Rehabilitation Engineering Research Center develops technologies to evaluate and advance mobility and manipulation for people with movement disabilities.
• Collaborative Machines Enhancing Therapies (COMET) focuses on advancing technologies that work in partnership with patients and clinicians to enhance gait and dexterity outcomes for individuals with stroke and spinal cord injury (SCI) and other people with disabilities in a real-life rehabilitation setting.
• Rehabilitation Engineering Research Center on Patient-Centered, Home-Based Technologies to Assess and Treat Motor Impairment in Individuals with Neurologic Injury promotes rehabilitation engineering-based devices, strategies, techniques, and interventions that can facilitate activity and mobility following neurologic injuries, specifically home-based technologies for treating motor impairments.

Policy and Practice

• The Next-Generation Public Charging Infrastructure and Cyber-Information Network for Enhanced Inclusion and Independent Living of Power Mobility Device Users pilots a public charging infrastructure and cyber-information system to support the outdoor use of power mobility devices (PMDs), to improve the mobility and inclusion of their owners.
• Rehabilitation Engineering Research Center on Physical Access and Transportation aims to advance accessibility and universal design (UD) across built environments (i.e., commercial buildings, community infrastructure, housing) and along the travel chain, through an integrated research, development, and deployment program.
• Assessment and Investigation of New Coverage Policies for Complex Rehabilitation Technology (CRT) Within a Contemporary Accountable Care Environment investigates a new health coverage policy for custom manual and power wheelchairs (aka: Complex Rehabilitation Technology or CRT) for people with disabilities to improve their ability to live and participate in their communities.
• Improving Health and Function Through Use of Performance Standards in Wheelchair Selection investigates performance-based selection as a rehabilitation strategy that uses results from standards testing to inform the process of selecting appropriate wheelchair products for people with mobility disabilities, matching appropriate and quality products to meet user needs.

These are just some of the current projects currently working in CRT and related areas. You can explore more current and completed projects in CRT in the NIDILRR Program Database, along with their publications indexed in the REHABDATA database.