TECHNOLOGY-BASED REHAB [ back to Recovering from a Brain injury ]

PORTABLE ELECTRONIC DEVICES
One of the more simple and less costly modalities of rehabilitation is training in the use of portable electronic devices. PEDs are sometimes referred to as "cognitive orthotic devices," which refers to the role they can play in compensating for a person's deficits in such functions as memory, place orientation, time orientation and so forth. Examples range in sophistication from the car finder, pager, beeping watch and cell phone to the pocket PDA such as the Palm Pilot and portable mini-computers like the PSION.

A pager, a beeping watch or a cell phone can all be used to prompt a person to remember to do something at the appointed time, like take a medication, go to the doctor or check in with a loved one. The latest generation of cell phones can receive or send e-mails or log onto the internet, and can be used to download maps to help find your way to an appointment. Palm Pilots and equivalent devices made by Sony and Mindspring will hold and allow easy access to a wealth of important data, such as emergency medical and non-medical contacts; daily, weekly or monthly schedule of activities and appointments; and the names, addresses and phone numbers of family members, friends, health insurance claims people, health care professionals, legal professionals, pharmacies, TBI support group members, etc. The PSION does similar things but is easier to use because of the keyboard. Another useful device is the portable, handheld tape recorder - either old fashioned or digital. It can be used to help you recall practical things like the floor and stall number of your parking spot in a big, impersonal parking garage. It can also make an easily accessible record of advice from your doctor, psychologist or lawyer.

During the 1990s a series of more sophisticated cognitive orthotic devices was marketed. NeuroPage allows caregivers to send schedules of reminder messages into a service center that can get relayed at appropriate times to the client's pager. The Jogger is a PED that assists with scheduling and organization, displays information, provides behavioral prompts, tracks actions of the client and permits 2 way communication with a service center. The Jogger requires active involvement of the client's therapist.

PEAT (Planning and Execution Assistant Trainer) custom scripts sequences of common everyday tasks and maintains a performance log record of user cues and responses. It is supposed to adjust schedules automatically when scheduled tasks get interrupted, delayed or canceled. ISAAC provides information and prompts organized in contextual fashion and displayed with graphics. Healthy Connections provides extensive health care/case management scheduling and dispatch. Essential Steps is a software program to be used on a home PC for assistance with communication, banking, check writing and appointment scheduling. It uses simple visual graphics that register topics like Time, Phone Log, Tools, Money or Work.

MOVEMENT ENHANCING DEVICES
Brain injury can leave people with restricted movement due to muscle weakness, muscle spasticity, balance disorders, gait disorders and other reasons. The primitive wheelchairs of yesterday have given way to a new generation of remarkable machines.

Bounder Wheelchairs are durable, can hold 1,000 pounds and travel up to 12 mph (www.wheelchairs.com) The All-Terrain Wheelchair can traverse curbs, steps, beaches and parks (www.cis.upenn.edu) Some have been designed for active and fun participation in sports (www.sportaid.com) Some can comfortably tilt or recline to allow napping (www.bestwheelchairs.com) Research to improve and increase the availability of wheelchairs is going on all the time. Ralf Hotchkiss, a disabled engineer at San Francisco State University, has created Whirlwind Wheelchair International to join wheelchair developers in poor, developing countries to make tougher, faster and cheaper wheelchairs. On 1/4/03 Dr. Ross (VP of Clinical Rehabilitation Services for UPMC Health System) announced that the University of Pittsburgh had won two grants totaling $4,000,000 to develop computerized electric wheelchairs. Some of these will be designed to compensate for minimal hand strength, erratic hand movements or other impairments consequent to brain injury that now limit wheelchair use. Another will be linked with a virtual reality and robotics strategy to help people relearn movement.

Not everyone who needs a wheelchair can afford one. Such persons should contact Wheelchairs for Humanity at 12750 Raymer Street #4 North Hollywood, CA 91605 (818) 766-8000 URL www.wheelsforhumanity.org