Advances in Rehabilitation Technologies

Updated: Nov 8




In recent years, it is possible to identify a clear trend in the design and development of rehabilitation technologies. Initially, technologies were based more on a user-centred approach and now we can clearly see a paradigm shift from general user-centred approach to a more specific activity-centred approach.





When we talk about rehabilitation using advanced technologies, we see a transformation of flow as real world demands meet the person or the environment. Addition of these technologies can create and cultivate an optimal experience to the person in the environment. It thus improves the quality of life of the individuals, through effective support of his/her activity and environmental interaction.


Let’s speak technology and rehab! Below I have listed the top 5 types of technologies that are used in rehabilitation, dividing them according to their functional use and therapeutic benefits.



1) Technologies that aid in functional gains


The first thing that comes to mind is the use of Robotics. The development of robotic devices for healthcare has generated a fresh new wind in the field of rehabilitation. Robots can simulate a variety of computerised activities and quietly switch between them. Some robotic devices have the capability to generate arbitrary patterns of assistance and resistance as required, while some can simply assess the performances in an integrated and objective fashion using sensors.



Next in the list to aid in functional gain are the exo-skeleton devices. There are a lot of these devices available in the market, some though in the prototype stage. These devices are capable of providing partial to complete automation of functions.







2) Technologies used to achieve recovery of functions


We as occupational therapists are the masters of adding 'fun' in 'FUNctional'. As exercises and activities become repetitive and boring, technology comes to the rescue. Rehabilitation gaming systems and virtual reality use an innovative technology consisting of computer-based environments, that represent a 3-D artificial world. Some of these gaming systems even permit human computer interactions in real time.





3) Technologies that use the body’s own signals to achieve therapeutic gain


The best example of this is the biofeedback machine, using the brain computer interfaces. It directly uses brain activity signals to allow users to operate the environment with or without partial muscle activation. Another example is wearable technology. This is the most common and easily accessible one. It is available in a wide range and variety, right from smart garments with embedded sensors, to arm bands and watches, using body sensor networks.



4) Technologies that enhances impact of rehabilitation


With the ease of availability to use video calling and messages as a mode of communication, tele-rehabilitation is a definite advancement in the field of rehabilitation. Although very little evidence is available for its use in occupational therapy. We can wait for what this newer method is going to serve up for us. However, I feel it is definitely worth keeping an eye on future home programs. These would widen the scope of our services and practice, giving us the ability to reach to people in remote places and environments.


It is also important to understand that most of the above technologies work via physical interactions, but what when physical interactions are not ? For such situations we have something called as socially assistive robotics (SAR) for assisting through social interactions without physical interactions. Again, here there is very limited literature on it for its use in rehabilitation.



5) Mobile technologies


Last but not least we have mobile technologies. Smart phones, tablets and laptops have revolutionised mobile technologies and the way we communicate today. The introduction of apps (applications) have further changed the way we look at our phones. They have transformed the assistive technology market for people with disabilities. While some apps can assist function, some others can be used as rehabilitation tools for both training and retraining purpose. Not forgetting how these computer technologies have also eased the process of documentation and data storage.



Apart from mobile technologies, most of the above are expensive and not easily available to all. This makes them less accessible.

To summarise, I would say that this is just the beginning and a long way to go with rehabilitation technologies. A lot of them have their pros and cons and for the successful implementation of such technologies into clinical practice, the therapist must be able to analyse and integrate them into our conceptual frameworks.


Share your views below - and if you are using any such technologies in your practice, feel free to share your experiences.


References


  • Susan E. Fasoli, Chapter 22 - Rehabilitation Technologies to Promote Upper Limb Recovery after Stroke, Stroke rehabilitation (4th edition)2016, Pages 486-510. https://doi.org/10.1016/B978-0-323-17281-3.00022-8

  • KREBS, H. I., & VOLPE, B. T. (2013). Rehabilitation robotics. Handbook of Clinical Neurology, 110, 283–294. http://doi.org/10.1016/B978-0-444-52901-5.00023-X

  • Imam, B., Miller, W. C., Finlayson, H. C., Eng, J. J., Payne, M. W., Jarus, T., … Mitchell, I. M. (2014). A Telehealth Intervention Using Nintendo Wii Fit Balance Boards and iPads to Improve Walking in Older Adults With Lower Limb Amputation (Wii.n.Walk): Study Protocol for a Randomized Controlled Trial. JMIR Research Protocols, 3(4), e80. http://doi.org/10.2196/resprot.4031

  • Wang, M., & Reid, D. (2013). Using the Virtual Reality-Cognitive Rehabilitation Approach to Improve Contextual Processing in Children with Autism. The Scientific World Journal, 2013, 716890. http://doi.org/10.1155/2013/716890

  • Kroll, R. R., McKenzie, E. D., Boyd, J. G., Sheth, P., Howes, D., Wood, M., … for the Wearable Information Technology for hospital Inpatients (WEARIT-IN) study group. (2017). Use of wearable devices for post-discharge monitoring of ICU patients: a feasibility study. Journal of Intensive Care, 5, 64. http://doi.org/10.1186/s40560-017-0261-9

  • D. Feil-Seifer and M. J. Mataric, "Defining socially assistive robotics," 9th International Conference on Rehabilitation Robotics, 2005. ICORR 2005., Chicago, IL, 2005, pp. 465-468. doi:10.1109/ICORR.2005.1501143.

  • Criss, M. J. (2013). School-Based Telerehabilitation in Occupational Therapy: Using Telerehabilitation Technologies to Promote Improvements in Student Performance. International Journal of Telerehabilitation, 5(1), 39–46. http://doi.org/10.5195/ijt.2013.6115

  • Nix, J. and Comans, T. (2017). Home Quick – Occupational Therapy Home Visits Using mHealth, to Facilitate Discharge from Acute Admission Back to the Community. International Journal of Telerehabilitation, 9(1), 47–54. http://doi.org/10.5195/ijt.2017.6218

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