RehabWire Volume 1 Number 5, June 1999

The fifth edition of RehabWire looks into the future of rehabilitation. In this issue of RehabWire we’re examining rehabilitation in the communication age: telerehabilitation, telemedicine, video- and teleconferencing all bring rehab and disability services to the most rural areas.

NIDRR Projects: Research in the New Millenium.

Rehabilitation Research and Training Center on Secondary Conditions of Spinal Cord Injury: Promoting General Health, Well-Being, and Community Integration Through Home-Based, Self-Directed Care, University of Alabama/Birmingham (H133B980016) led by Amie B. Jackson, MD.
Abstract: This RRTC conducts coordinated, integrated, and advanced research in the prevention and treatment of secondary conditions of Spinal Cord Injury (SCI). The eight interrelated projects include: (1) determine the effectiveness of cranberry pills to prevent and treat urinary tract infections (UTIs); (2) evaluate interventions used to prevent and treat UTIs in people with SCI using the University of Alabama/Birmingham SCI Urologic Database; (3) study the relationship of beverage consumption and water hardness to the risk of urinary tract stones; (4) address pain following SCI by evaluating SCI pain classification systems, studying the effectiveness of gabapentine and methadone in relieving certain types of pain, and developing a method to target those at risk; (5) determine the duration of immune response to pneumococcal vaccine and the need for revaccination; (6) evaluate a screening tool to identify people with SCI at high risk for sleep apnea, and evaluate treatments to improve their health and quality of life; (7) study the use of telemedicine to reduce depression and secondary conditions among people with SCI and their caregivers through problem solving interventions; and (8) evaluate and adapt a nationally recognized weight-loss project for a population of people with SCI. A collaborative project with another Center evaluates a computer-based risk assessment and feedback tool for assessing secondary conditions. This RRTC provides training on research methodology and information based on research activities to people with disabilities, their families, service providers, and rehabilitation professionals. Information is disseminated through print media (information sheets and newsletters), electronically (through the Internet and a fax information service), and through technical assistance.
Find out more at: http://www.spinalcord.uab.edu

computer in shadowTelerehabilitation to Support Assistive Technology, Shepherd Center, Inc. (H133G990133) led by Michael L. Jones, PhD.
Abstract: This project explores the application of telerehabilitation to support assistive technology (AT) and assistive technology services, implementing three activities that involve development and testing of new methods and devices. The first project examines telerehabilitation to provide training in the use of augmentative communication systems to individuals with significant physical and speech disabilities. The second project explores the use of telecommunications technology by seating and mobility specialists to provide follow-up consultation and verify set-up and use of new wheelchairs. If successful, this approach permits follow-up with consumers who cannot return to the clinic for a follow-up clinic visit. The third project investigates the use of videoconferencing technology to complete accessibility assessments in remote locations. Most individuals who experience mobility impairments require modifications or the addition of adaptive devices in their homes. Individuals with gradual loss of functioning over time (e.g., as a result of aging) can also benefit from environmental adaptations that support independence. However, the expertise needed to evaluate accessibility problems and prescribe appropriate solutions is not widely available.

Rehabilitation Engineering Research Center on Telerehabilitation, Catholic University of America (H133E980025) led by Jack Winters, PhD.
Abstract: This project experiments with various models of telerehabilitation for strategic populations, engages in development activities that exploit promising technologies, and focuses on all aspects of the human-technology interface in a broad range of activities that benefit people with disabilities. Structured to include national resources with a strong focus on outreach and dissemination activities and a broad-based set of research activities, the Center focuses on: (1) Tele-homecare: telesupport for stroke caregivers; (2) Telecoaching: enhancing job options; (3) Telemonitoring: passive sensing of functional performance and health parameters at home using unobtrusive instrumentation; (4) Teleassessment: remote evaluation of skin health and decubiti for people with SCI at rural hospitals and clinics using innovative technologies; (5) Telerehab Consumer Toolkit: outreach and development activities and products; (6) Home Telerehab: interactive systems for remote delivery of therapy, assessment, teaching and demonstration at home; (7) Telecounseling and Teleevaluation: remote psychological counseling and neuropsychological evaluation at rural clinics and homes; (8) Behavioral Virtual Reality: investigation and training of social and attending behaviors using virtual environment technology; (9) Teleplay: therapeutic play, including embedded teleassessment for children with disabilities; (10) Integrating Telerehabilitation in Today's Health Care Marketplace. The Center also establishes National Resources activities: (1) Homecare and Telerehabilitation Technology Center; (2) Homecare and Telerehab Education/Training Center; (3) Virtual Library and Dissemination Center; (4) Standards, Codes and Electronic Patient Records (EPR); (5) Telerehab Policy Information Center. The Center comprises three institutions: The Catholic University of America (CUA), the National Rehabilitation Hospital (NRH); and the Sister Kenny Institute (SKI).

Internet discussion lists are excellent sources of information, community, and support. Search the NARIC Knowledgebase for disability and rehabilitation related lists and information on how to subscribe.

New Research: Selections from REHABDATA

Johnson, L., Moxon, E. (1998). In Whose Service? Technology, Care And Disabled People: The Case For A Disability Politics Perspective. Disability & Society, 13(2), 241-258. Accession Number: J35164.
Abstract: Article discussing the disability movement perspective on new technology-based services for people with disabilities. The article focuses on a European Union (EU) telematics project providing teleshopping, telecare (2-way video access to a social worker), an information package for people with disabilities, and a videophone facility linking participants. The authors review responses to new technologies in recent literature of the disability movement in Britain, and contrast these disability movement perspectives to the interests of businesses, technologists, and service providers, which until now have determined the character of technology-based services. They express concern that new technologies may serve as a substitute for access, confining rather than empowering people with disabilities.

Man in wheelchair. Hagglund, K. J., Clay, D. L., Acuff, M. (1998). Community Reintegration For Persons With Spinal Cord Injury Living In Rural America. Topics in Spinal Cord Injury Rehabilitation, 4(2), 28-40. Missouri Model Spinal Cord Injury System, University of Missouri/Columbia, Department of Physical Medicine and Rehabilitation. Accession Number: J35663
Abstract: Article discussing barriers to successful community integration of persons with spinal cord injury (SCI) living in rural areas. Barriers discussed include: transportation; physical and architectural inaccessibility; and health care delivery barriers. Also discusses programs to improve community reintegration for people with SCI, including Telehealth, area health education centers, the Office of Rural Health Policy, the AgrAbility project, and independent living centers in rural areas.

Burns, R. B., Crislip, D., Daviou, P., Temkin, A., Vesmarovich, S., Furbish, C., Jones, M. L. (1998). Using Telerehabilitation To Support Assistive Technology. Assistive Technology, 10(2), 126-133. Shepherd Center, Crawford Research Institute. Accession Number: J36224.
Abstract: Article describing the experiences of a rehabilitation hospital in providing telerehabilitation, that is, support for home use of assistive technology delivered through telecommunications. Four case studies are presented to illustrate how telerehabilitation may be used in connection with seating evaluation, evaluation of home accessibility, setup of computer access systems, and training in the use of augmentative communications devices.

Conner, K. (1999). Technology Through Television. (2), 72-75. Accession Number: J36339.
Abstract: Article describing a program at the University of Texas Medical Branch (UTMB) that provides special pediatric services to remote areas of Texas through teleconferencing. The interdisciplinary services include advice concerning medical devices, therapy, and specialized medical care.

Shaw, D. K. (1999). Telemedicine And Cardiopulmonary Rehabilitation: Where Do We Stand? Journal of Cardiopulmonary Rehabilitation, 19(1), 59-61. Accession Number: J36353.
Abstract: Article providing an overview of telemedicine and exploring its possible impact on cardiopulmonary rehabilitation programs. The article outlines past developments, describes some current programs, and speculates on future trends.

Defining Disability: Updating the REHABDATA Thesaurus

The REHABDATA Thesaurus is a key instrument in indexing the materials in the NARIC collection. The Thesaurus is a constantly evolving document which is modified and updated on a regular basis. Each month we look at a term, how it’s defined, and how it’s used in indexing rehabilitation and disability literature.

Welcome to the Communication Age! As rehabilitation moves into the next century, telecommunication tools will help rehabilitation professionals bridge distance and circumstance to reach underserved people.

Telecommunications
Scope Notes: Includes teleconferencing, satellites, telefacsimile transmission
Broad Term: Communication
Related Terms: Audiovisual materials; Computers; Devices; Electronics; Internet; Radio; TDD; Telephones; Television

A row of books.