Disability Rehabilitation Rehabilitation and Technology

Many countries in the world have a significant number of people in a disability. Four million people in Australia (18.5%) have a disability[1]. In USA, 18.4 % or 54.4 million people are in some level disability and 12 % are in a severe disability[2]. Over 10 million disabled people exits in Britain[3].

World Health Organisation (WHO) : a great number of different functional limitations occurring in any population in any country of the world. People may be disabled by physical, intellectual or sensory impairment, medical conditions or mental illness. Such impairments, conditions or illnesses may be permanent or transitory in nature[4]. Based on SDAC, disability is defined as any limitation, restriction or impairment which restricts everyday activities and has lasted or is likely to last for at least six months[1].

In the result of SDAC, the incidence of disability was classified into two groups
a disability caused by mental or

behavioural disorders and a disability caused by physical conditions.

Over 15 % of Australians had physical disability and the rest, about 3.4 % of them got mental disability[1]

Diseases Diseases of the musculoskeletal system and connective tissue Diseases of the ear and mastoid process Diseases of the nervous system Injury, poisoning and other external causes Diseases of the respiratory system Endocrine, nutritional and metabolic disorders

Percentage 6.8 1.4 1.3 1.2 0.9 0.6

Diseases of the eye and adnexa

Cancer, lymphomas and leukaemia Diseases of the digestive system Congenital and perinatal disorders Other physical condition*

0.4
0.3 0.3 0.2 0.9

*Infectious and parasitic diseases; diseases of the blood and blood-forming organs; skin conditions; genito-urinary system diseases; symptoms

WHO : a process aimed at enabling persons with disabilities to reach and maintain their optimal physical, sensory, intellectual, psychiatric and/or social functional levels, thus providing them with the tools to change their lives towards a higher level of independence. Rehabilitation may include measures to provide and/or restore functions, or compensate for the loss or absence of a function or for a functional limitation.[4]. Rehabilitation aims to return the patients physical, sensory, intellectual and mental capabilities that were lost because of injury, illness, and disease, and to help the patient to compensate for weakness that cannot be treated medically [5].

Therapeutic modalities. The goal of therapeutic modalities is to treat and resolve the effects of pain, spasm and edema[5]. Therapeutic exercises main goal to recover the patient condition so that they can be normally involved in daily activities as others[5]. Therapeutic exercises are activities intended to enable the patient to remediate or prevent impairments, to enhance function, to reduce risk, to optimize overall health, and to enhance fitness and well-being[9].

The use of laser for wound healing[6], Fractional photothermolysis for Xanthelasma[7] Personalized peptide vaccines for cancer therapy[8].

Patient with Neurological condition

Combination Functional electrical stimulation

(FES) and a standard physiotherapy home exercise program for multiple sclerosis[10], loading exercises (e.g., stepping, brisk walking, repeated sit-to-stand) on hip for stroke patient [11], a weight-bearing exercise on foot ulceration, a lower-extremity exercise and walking intervention on balance for diabetic peripheral neuropathy people[12], combination between standard rehabilitation and technology to avoid boring in children with cerebral Palsy [13]

The musculoskeletal conditions

therapy for patient with osteoarthritis of

the hip[14], patient with neck pain[15], low back pain[16], and rehabilitation for lower limb disability [17] and upper limb disability [18].

The cardiopulmonary Condition

therapy for patient with heart failure[19],

hypertension[20],asthma [21], chronic obstructive pulmonary disease[22], and cervical spinal cord injury[23]

Why does a rehabilitation need technology? Because The rehabilitation will not be effective without technology. Why is it not effective? Without technology, the rehabilitation is time consuming, costly, and boring

Time consuming A patient have to go to rehabilitation centre for performing observations and it needs many visitations. By technology, observations can be done at home saving time Costly Repetition observation and visitation can be costly. Boring because of monotonous exercises. By technology, the exercise is more interactive than before

Egyptian stelae and Roman mosaics have shown that technology has been used in rehabilitation since antiquity, especially by people who had undergone amputations and people who had had polio Paintings by Brueghel the Elder show the use of a number of simple technologies in the 16th century by people with disabling conditions. Wars and conflicts have been primary stimuli for technological innovations in the rehabilitation of people with disabling injuries

The armor makers of the medieval era were skilled at making functionally effective artificial hands and leg prostheses of metal and were probably early forerunners of todays prosthetists and orthotists. In Goethes play The Iron Hand, the noble German knight Gtz von Berlichingen remarks that his iron hand had served him better in the fight than ever did the original of flesh. The Napoleonic wars fostered some technical innovations in rehabilitation

The enormous number of amputations resulting from the U.S. Civil War more or less created the prosthetics industry in the United St World War I set the stage for the modern rehabilitation movement. Of particular note were the advances made in Germany during and following that war[25]

Based on Fungsionality Rehabilitaton Technology for Monitoring Pervasive assistive technology Rehabilitation Technology for coaching Assistive Robot

Monitor Rehabilitation Outcomes in Stroke Survivors Using Wearable Technology[26] Using pedometer for monitoring walking activity [27] Developing multi sensor monitoring device for arm rehabilitation[28] Monitoring technology in assistive living [29] Information system with enhanced sensor for COPD rehabilitation [30]

Coaching using smartphone for cardiac rehabilitation [31] Role of technology in assistive living [32] Providing a cushion for wireless healthcare application development[33] Tele-health care for stroke rehabilitation [34] Game for stroke rehabilitation [35] Music in hand rehabilitation [36] Pervasive system in Healthcare [37]

Effectiveness of motor learning coaching in children with celebal palsy using microsoft exel. [38] Coaching using smartphone for cardiac rehabilitation [31] Weightlifting Performance Measurements Using Low Cost Accelerometers With Applications to Real Time Coaching and Rehabilitation[39]

1. Ewing, I., Disability, Ageing And Carers, Australia: Summary Of Findings, 2009, A.B.o. Statistics, Editor 2010, Australian Bureau of Statistics: Canberra. p. 40. 2. Brault, M.W., Americans With Disabilities: 2005, 2008, U.S. CENSUS BUREAU. 3. Farmer, M. and F. Macleod, Involving Disabled People in Social Research : Guidance by the Office for Disability Issues, 2011, The Office for Disability Issues UK. p. 7. 4. WHO, The UN Standard Rules on the Equalization of Opportunities for Persons with Disabilities. II. Main Report, 2001. WHO/DAR/01.2: p. 290. 5. Akdoan, E. and M.A. Adli, The design and control of a therapeutic exercise robot for lower limb rehabilitation: Physiotherabot. Mechatronics, 2011. 21(3): p. 509-522. 6. Hawkins, D., N. Houreld, and H. Abrahamse, Low Level Laser Therapy (LLLT) as an Effective Therapeutic Modality for Delayed Wound Healing. Annals of the New York Academy of Sciences, 2005. 1056(1): p. 486-493. 7. Katz, T.M., L.H. Goldberg, and P.M. Friedman, Fractional Photothermolysis: A New Therapeutic Modality for Xanthelasma. Arch Dermatol, 2009. 145(10): p. 1091-1094. 8. Itoh, K. and A. Yamada, Personalized peptide vaccines: A new therapeutic modality for cancer. Cancer Science, 2006. 97(10): p. 970-976. 9. Hall, C.M. and L.T. Brody, Therapeutic Exercise: Moving Toward Function. Second ed2004, London: Lippincott Williams & Wilkins. 10. Barrett, C.L., et al., A randomized trial to investigate the effects of functional electrical stimulation and therapeutic exercise on walking performance for people with multiple sclerosis. Multiple Sclerosis (13524585), 2009. 15(4): p. 493-504

11. Lau, R. and M. Pang, An assessment of the osteogenic index of therapeutic exercises for stroke patients: relationship to severity of leg motor impairment. Osteoporosis International, 2009. 20(6): p. 979-987. 12. Kruse, R.L., J.W. LeMaster, and R.W. Madsen, Fall and Balance Outcomes After an Intervention to Promote Leg Strength, Balance, and Walking in People With Diabetic Peripheral Neuropathy: "Feet First" Randomized Controlled Trial. Physical Therapy, 2010. 90(11): p. 1568-1579. 13. Dunne, A., et al. Upper extremity rehabilitation of children with cerebral palsy using accelerometer feedback on a multitouch display. in Engineering in Medicine and Biology Society (EMBC), 2010 Annual International Conference of the IEEE. 2010. 14. Fernandes, L., et al., Development of a therapeutic exercise program for patients with osteoarthritis of the hip. Physical Therapy, 2010. 90(4): p. 592-601. 15. Jull, G.A., et al., The effect of therapeutic exercise on activation of the deep cervical flexor muscles in people with chronic neck pain. Manual Therapy, 2009. 14(6): p. 696-701. 16. Waller, B., J. Lambeck, and D. Daly, Therapeutic aquatic exercise in the treatment of low back pain: a systematic review. Clinical Rehabilitation, 2009. 23(1): p. 3-14. 17. Scarfe, A.C., et al., A New Progression Scale for Common Lower-Limb Rehabilitation Tasks. The Journal of Strength & Conditioning Research, 2011. 25(3): p. 612. 18. de Arajo, R.C., et al., Reliability of electromyographic amplitude values of the upper limb muscles during closed kinetic chain exercises with stable and unstable surfaces. Journal of Electromyography and Kinesiology, 2009. 19(4): p. 685-694. 19. Flynn, K.E., et al., Effects of exercise training on health status in patients with chronic heart failure. JAMA: the journal of the American Medical Association, 2009. 301(14): p. 1451. 20. Fowler, R., et al., Australian perspective regarding recommendations for physical activity and exercise rehabilitation in pulmonary arterial hypertension. Journal of Multidisciplinary Healthcare, 2011. 4: p. 451.

21. Razavi, M., P. Nazarali, and P. Hanachi, The effect of an exercise programme and consumption of vitamin D on performance and respiratory indicators in patients with asthma. Sport Sciences for Health, 2011. 6(2): p. 89-92. 22. Maltais, F., et al., Effects of home-based pulmonary rehabilitation in patients with chronic obstructive pulmonary disease: a randomized trial. Annals Of Internal Medicine, 2008. 149(12): p. 869-878. 23. Tawashy, A.E., et al., Aerobic Exercise During Early Rehabilitation for Cervical Spinal Cord Injury. Physical Therapy, 2010. 90(3): p. 427-437. 24. Brandt, ., et al., Activity and participation, quality of life and user satisfaction outcomes of environmental control systems and smart home technology: a systematic review. Disability & Rehabilitation: Assistive Technology, 2010(00): p. 1-18. 25. Utz, S.W., Enabling America: Assessing the Role of Rehabilitation Science and Engineering. Family & Community Health, 1999. 22(2): p. 97. 26. Patel, S., et al., A Novel Approach to Monitor Rehabilitation Outcomes in Stroke Survivors Using Wearable Technology. Proceedings of the IEEE, 2010. 98(3): p. 450-461. 27. Dallas, M., et al., Using pedometers to monitor walking activity in outcome assessment for pulmonary rehabilitation. Chronic Respiratory Disease, 2009. 6(4): p. 217. 28. Ambar, R., M. Ahmad, and M. Abdul Jamil, Design and Development of a Multi-sensor Monitoring Device for Arm Rehabilitation. International Journal of Integrated Engineering, 2011. 3(2). 29. Alwan, M., et al. Psychosocial impact of monitoring technology in assisted living: A pilot study. 2006. IEEE. 30. Helmer, A., et al. A sensor-enhanced health information system to support automatically controlled exercise training of COPD patients. in Pervasive Computing Technologies for Healthcare (PervasiveHealth), 2010 4th International Conference on-NO PERMISSIONS. 2010.

31. Chen, X., C. Ho, and E. Lim. An interactive cardiac tele rehabilitation program using a mobile device. 2008. IEEE. 32. Ballegaard, S.A., J. Bunde-Pedersen, and J.E. Bardram. Where to, Roberta?: reflecting on the role of technology in assisted living. 2006. ACM. 33. Yu, H., et al., Providing a cushion for wireless healthcare application development. Potentials, IEEE, 2010. 29(1): p. 19-23. 34. Postolache, G., et al. Rehabilitative TeleHealthCare for post-stroke outcome assessment. in Pervasive Computing Technologies for Healthcare (PervasiveHealth), 2011 5th International Conference on. 2011. 35. Di Loreto, I., G. Abdelkader, and N. Hocine. Mixed reality serious games for post-stroke rehabilitation. in Pervasive Computing Technologies for Healthcare (PervasiveHealth), 2011 5th International Conference on. 2011. 36. Markow, T., et al. Mobile Music Touch: Vibration stimulus in hand rehabilitation. in Pervasive Computing Technologies for Healthcare (PervasiveHealth), 2010 4th International Conference on-NO PERMISSIONS. 2010. 37. Kameas, A. and I. Calemis, Pervasive Systems in Health CareHandbook of Ambient Intelligence and Smart Environments, H. Nakashima, H. Aghajan, and J.C. Augusto, Editors. 2010, Springer US. p. 315-346. 38. Bar-Haim, S., et al., Effectiveness of motor learning coaching in children with cerebral palsy: a randomized controlled trial. Clinical Rehabilitation, 2010. 24(11): p. 1009. 39. Tangonan, G.L., et al., Weightlifting Performance Measurements Using Low Cost Accelerometers With Applications to Real Time Coaching and Rehabilitation. Hong Kong Physiotherapy Journal, 2010. 28(1): p. 24-25. 40. Daponte, P., et al. Electronic measurements in rehabilitation. in Medical Measurements and Applications Proceedings (MeMeA), 2011 IEEE International Workshop on. 2011. 41. Krebs, H.I. and N. Hogan, Therapeutic Robotics: A Technology Push. Proceedings of the IEEE, 2006. 94(9): p. 1727-1738.