Rehabilitation and Assistive Technology
Anitha.k,Gayathri.k,UG Degree ,Department Of BME,
GRT Institute Of Engineering And Technology
akrishnakumar693@gmail.com,gayathrijailatha2004@gamil.com
ABSTRACT
Rehabilitation is an essential part of
universal health coverage along with
promotion of good health, prevention of
disease, treatment and palliative care.
Rehabilitation helps a child, adult or
older person to be as independent as
possible in everyday activities and enables
participation in education, work,
recreation and meaningful life roles such
as taking care of family. Rehabilitation is
an important part of universal health
coverage and is a key strategy for
achieving Sustainable Development Goal
3 – “Ensure healthy lives and promote
well-being for all at all ages”. Assistive
technology (AT) is any item, piece of
equipment, software program, or product
system that is used to increase, maintain,
or improve the functional capabilities of
persons with disabilities. Assistive
technology can play an important role in
special education because many students
with disabilities need special instructional
treatment.
Key Terms
Physical therapy, healthcare, patient
safety and care, exercise physiology,
assistive demotics, physical impairments,
research trends.
I.INTRODUCTION
Rehabilitative and assistive technology refers to
tools, equipment, or products that can help people
with disabilities successfully complete activities
at school, home, work, and in the community.
Disabilities are disorders, diseases, health
conditions, or injuries that affect a person’s
physical, intellectual, or mental well-being and
functioning. Rehabilitative and assistive
technologies can help people with disabilities
function more easily in their everyday lives and
can also make it easier for a caregiver to care for
a person with disabilities. Together, these
strategies can help an individual; overcome
difficulties with thinking, seeing, hearing,
communicating, eating or moving around.
Anybody may need rehabilitation at some point
in their lives, following an injury, surgery, disease
or illness, or because their functioning has
declined with age.
Some examples of rehabilitation include:
 speech and language training to
improve a person’s communication
after a brain injury;
 physical exercise training to improve
muscle strength, voluntary
movements and balance in persons
with stroke or Parkinson disease;
 modifying an older person’s home
environment to improve their safety
 and independence at home and to
reduce their risk of falls;
 educating a person with heart disease
on how to exercise safely;
 preparing a person with an
amputation to be able to use a
prosthetic and making, fitting and
refitting the prosthesis;
 positioning and splinting techniques
to assist with skin healing, reduce
swelling, and to regain movement
after burn surgery;
 prescribing medicine to reduce
spasticity for a child with cerebral
palsy; inpatient or outpatient hospital settings,
 psychological therapies for a person outpatient physio- or occupational therapy
with emotional distress following a practices, and community settings such as an
spinal cord injury; individual’s home, a school or a workplace.
 Social skills training for persons with Some of these technologies are made
schizophrenia, autism spectrum possible through rehabilitative engineering
disorders or disorders of intellectual research, which applies engineering and
disability. scientific principles to study how people
 training a person with vision loss in with disabilities function in society. It
the use of a white cane; and includes studying barriers and designing
 working with a patient in intensive solutions so that people with disabilities can
care to improve their breathing, interact successfully in their environments.
prevent complications and speed NICHD- the National Center for Medical
their recovery after critical illness Rehabilitation Research (NCMRR), which is
charged with advancing scientific
Rehabilitation is highly person-centered, knowledge on disabilities and rehabilitation,
meaning that the interventions selected for while also providing vital support and focus
each individual are targeted to their goals for the field of medical rehabilitation to help
and preferences. Rehabilitation can be ensure the health, independence,
provided in many different places, such as productivity, and quality of life of all
people. Through the NCMRR, NICHD
supports the development and testing of
rehabilitative and assistive technologies,
with a focus on physical rehabilitation.
II.THE BENEFITS OF
REHABILITAITION AND ASSISTIVE
TECHNOLOGY
Rehabilitation can reduce the impact of a
broad range of health conditions, including
diseases (acute or chronic), illnesses or
injuries. It complements other health
interventions, such as medical and surgical
interventions, helping to facilitate recovery
and achieve the best outcome possible. In
addition, rehabilitation can help to prevent,
reduce or manage complications associated
with many health conditions, such as in the
context of spinal cord injury, stroke, or
fractures. Rehabilitation helps to minimize
or slow down the disabling effects of
chronic health conditions, such as
cardiovascular disease, cancer and diabetes
by equipping people with self-management
strategies and the assistive products they
require, or by addressing pain or other
complications. As such, it contributes to
healthy ageing.
Rehabilitation is an investment, with cost
benefits for both the individuals and society.
It can help to avoid costly hospitalization,
reduce hospital length of stay, and prevent
re-admissions. As rehabilitation also enables
individuals to engage in or return to work
and employment, or to remain independent
at home, it minimizes the need for financial
or caregiver support. Rehabilitation is an
important part of universal health coverage
and is a key strategy for achieving
Sustainable Development Goal 3 – “Ensure
healthy lives and promote well-being for all
at all ages”.
Assistive technology enables students with
disabilities to compensate for certain
impairments. This specialized technology
promotes independence and decreases the
need for other support. Assistive technology
also benefits employers, teachers, family
members, and everyone who interacts with
people who use the technology. As assistive
technologies become more commonplace,
people without disabilities are benefiting
from them. For example, people for whom
English is a second language are taking
advantage of screen readers. Older
individuals are using screen enlargers and
magnifiers.
III.LEVELS OF PREVENTION OF
DISEASE
Any health care that attempt to halt a
person’s slide down the slope of the health
status scale is term as preventive health care
and any attempt to push it up towards the
peak i.e. optimum is term as therapeutic
health care. This total spectrum is classified
into three levels of prevention by the world
health organization.
1. Primary prevention
It explains as measures taken prior to the
onset of any disease, eg immunization
against childhood infections or chlorination
of drinking water. It is designed to promote
general health and to improve the quality of
life.
2. Secondary prevention
It is explained as a measure taken to arrest
the development of a disease while it is still
in an early asymptomatic stage of the
disease. It involves early diagnosis and
immediate treatment.
3. Tertiary prevention
It is explained as a measure taken to
minimize the consequence of a disease or
injury once it has become clinically
manifested.
IV.Definition of impairment, Disability
and Handicap
Impairment- Any loss or abnormality of
psychological or anatomical structure or
function
e.g. loss of finger, loss of pinna of the ear.
Not all impairment leads to disability.
Disability:- Any restriction or lack of ability
to perform an activity in the manner or
within
the range considered normal for a human
being resulting from an impairment e.g.
difficult in
walking after lower limb amputation.
Handicap:- A disadvantage for a given
individual in his or her social context
resulting from
an impairment or a disability that limits or
prevents the fulfilment of a role that is
normal for
that individual.
Impairment is a manifestation of a problem
at the tissue or organ level, disability at the
level
of the individual, while handicap in the
translation of the problem at the societal
level.
Types of disability
a. primary disability
b. Secondary disability
Disabilities that are direct consequence of a
disease or condition are called primary
disability.
E.g. Paraplegia following spinal cord injury,
inability to walk following hip fracture are
example of primary injury.
On the other hand, disabilities that did not
exist at the onset of the primary disability
but
develop subsequently are called secondary
disabilities. Secondary disabilities are
indirectly
related to the disease or condition that is
responsible for the primary disability.
Examples are
joint contracture in poliomyelitis,
subluxation of shoulder joint in hemiplegia.
V.WHAT ARE SOME TYPES OF
ASSISTIVE DEVICES AND HOW ARE
THEY USED?
Some examples of assistive technologies
are:
 Mobility aids, such as wheelchairs,
scooters, walkers, canes, crutches,
prosthetic devices, and orthotic
devices.
 Hearing aids to help people hear or
hear more clearly.
 Cognitive aids, including computer
or electrical assistive devices, to help
people with memory, attention, or
other challenges in their thinking
skills.
 Computer software and hardware,
such as voice recognition programs,
screen readers, and screen
enlargement applications, to help
people with mobility and sensory
impairments use computers and
mobile devices.
 Tools such as automatic page
turners, book holders, and adapted
pencil grips to help learners with
disabilities participate in educational
activities
 Closed captioning to allow people
with hearing problems to watch
movies, television programs, and
other digital media.
 Physical modifications in the built
environment, including ramps, grab
bars, and wider doorways to enable
access to buildings, businesses, and
workplaces.
 Lightweight, high-performance
mobility devices that enable persons
with disabilities to play sports and be
physically active.
 Adaptive switches and utensils to
allow those with limited motor skills
 to eat, play games, and accomplish
other activities.
 Devices and features of devices to
help perform tasks such as cooking,
dressing, and grooming; specialized
handles and grips, devices that
extend reach, and lights on
telephones and doorbells are a few
examples.
VI.MEDICAL AND PARAMEDICAL
TEAM
i. Physiatrist:- Also known as physical
medicine. The physiatrist is the leader of the
rehabilitation team. The functions of the
physiatrist are
a. clinical assessment of the patient
b. functional diagnosis
c. evaluation of disability.
Physical therapist:-the physical therapist
assists the patient in movement restoration.
His
task includes the following
Muscle strength evaluation and
quantification
b. Exercise to maintain and increase joint
range of motion.
c. Evaluate and train sitting and standing
balance.
d. Exercise to increase strength, endurance
and coordination for other specific muscle
groups
or the entire body.
iii. Occupational Therapist: The WHO
defines occupational therapy as “the art and
science
of directing man’s participation in selected
activities to restore, reinforce and enhance
function or performance or decrease
disability and thus to promote healing. The
occupational therapist is involved in
evaluating and training the patient in self-
care activities
such as dressing, eating, bathing and
personal hygiene to maximize
independence.
iv. Prosthetist-Orthotist:- The prosthetist-
orthotist is responsible for the design,
fabrication
and fitting of the orthosis(brace) and
prosthesis(artificial limb)
v. Recreational therapist:- The recreation
therapist uses recreational activity to
improve
social and emotional behaviour and promote
the growth and development of the patient.
vi. Rehabilitation nurse:- The rehabilitation
nurse maintains the health of the bed ridden
patient and helps to reach short and long
term goal. She takes care of nursing needs
during
hospitalization and in the rehabilitation
ward. In some case she makes house visits
and look
after the self-care activities of the patien
VII.DELIVERY OF REHABILITATION
The delivery of rehabilitation is done
through the following approach
1. Institute based rehabilitation (IBR)
2. Homes
3. Day care centre
4. Outpatient clinics
5.Camps and CBR
VIII.Rehabilitation Principles
There are seven principles of rehabilitation;
principles are the foundation upon which
rehabilitation is based. This mnemonic may
help you remember the principles of
rehabilitation: ATC IS IT.
Avoid aggravation
Timing
Compliance
Individualization
Specific sequencing
Intensity
Total patient
A: Avoid aggravation. It is important not to
aggravate the injury during the rehabilitation
process. Therapeutic exercise, if administered
incorrectly or without good judgment, has the
potential to exacerbate the injury, that is, make
it worse. The primary concern of the
therapeutic exercise program is to advance the
injured individual gradually and steadily and
to keep setbacks to a minimum.
T: Timing. The therapeutic exercise portion of
the rehabilitation program should begin as
soon as possible—that is, as soon as it can
occur without causing aggravation. The sooner
patients can begin the exercise portion of the
rehabilitation program, the sooner they can
return to full activity. Following injury, rest is
sometimes necessary, but too much rest can
actually be detrimental to recovery.
C: Compliance. Without a compliant patient,
the rehabilitation program will not be
successful. To ensure compliance, it is
important to inform the patient of the content
of the program and the expected course of
rehabilitation. Patients are more compliant
when they are better aware of the program
they will be following, the work they will
have to do, and the components of the
rehabilitation process.
I: Individualization. Each person responds
differently to an injury and to the subsequent
rehabilitation program. Expecting a patient to
progress in the same way as the last patient
you had with a similar injury will be
frustrating for both you and the patient. It is
first necessary to recognize that each person is
different. It is also important to realize that
even though an injury may seem the same in
type and severity as another, undetectable
differences can change an individual's
response to it. Individual physiological and
chemical differences profoundly affect a
patient's specific responses to an injury.
S: Specific sequencing. A therapeutic exercise
program should follow a specific sequence of
events. This specific sequence is determined
by the body's physiological healing response
and is briefly addressed in the next section of
this chapter.
I: Intensity. The intensity level of the
therapeutic exercise program must challenge
the patient and the injured area but at the same
time must not cause aggravation. Knowing
when to increase intensity without overtaxing
the injury requires observation of the patient's
response and consideration of the healing
process.
T: Total patient. You must consider the total
patient in the rehabilitation process. It is
important for the unaffected areas of the body
to stay finely tuned. This means keeping the
cardiovascular system at a preinjury level and
maintaining range of motion, strength,
coordination, and muscle endurance of the
uninjured limbs and joints. The whole body
must be the focus of the rehabilitation
program, not just the injured area. Remember
that the total patient must be ready for return
to normal activity or competition; providing
the patient with a program to keep the
uninvolved areas in peak condition, rather
than just rehabilitating the injured area, will
help you better prepare the patient physically
and psychologically for when the injured area
is completely rehabilitated.
IX.CONCLUSION:
Effective rehabilitation is a person-centred
process, with treatment tailored to the
individual patient's needs and, importantly,
personalized monitoring of changes
associated with intervention, with further
changes in goals and actions if
needed.Assistive technology has from time
to time benefited the people living with
different types of disabilities. Health and
social care facilities have come a long way
to use the assistive technologies to help
people with disability to live an independent
life.
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29.[BOOK] Assistive
technology assessment
handbook
S Federici, M Scherer - 2012 -
books.google.com
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bibliographical references and index. ISBN
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Taylor & Francis Diagnostics, Rehabilitation,
… and Assistive Technologies
Advancing rehabilitation and assistive tech R Garg, N Driscoll, S Shankar, T
nology (AT) … Person- Hullfish… - Small …, 2023 - Wiley Online
centred rehabilitation is Library
provided across disabilities and … , led by High‐density surface electromyography
the Global Cooperation (HDsEMG) allows noninvasive muscle
on Assistive Technology (GATE) [… monitoring
and disease diagnosis. Clinical translation of
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