Rehabilitation Engineering

Development and Scope

Limb prosthetics is a subspecialty of rehabilitation engineering. It is concerned with the replacement of arms, hands, and legs with artificial components. Since antiquity, specialists have provided artificial replacements for lost limbs, particularly limbs lost in the conflicts of wars. After World War II, persons with limb loss often reentered society successfully, and high-quality artificial limbs coming out of federally sponsored research and development programs in prosthetics at that time contributed to this success. Consequently, in the late 1960s, the generalizing concept of rehabilitation engineering evolved, based on the thought that if engineers could work creatively with rehabilitation physicians and clinicians to improve limb prosthesis outcomes, they probably would also be able, through engineering techniques and scientific principles, to assist with the rehabilitation process for many other disabling conditions. Thus, the generalized field of rehabilitation engineering was launched.

In the late 1960s, one of the original objectives for the new field of rehabilitation engineering, as proposed by James B. Reswick, was “to improve the quality of life of the physically handicapped through a total approach to rehabilitation, combining medicine, engineering, and related science.” Today, this field is viewed much more broadly, placing many chronically disabling conditions under the possible purview of engineering approaches. Physical disabilities such as limb loss are only one aspect of this field that now also includes communication disabilities, sensory disabilities, cognitive disabilities, and the many disabling conditions resulting from spinal cord injuries, head injuries, strokes, blindness and visual impairments, hearing impairments and deafness, neuromuscular diseases, musculoskeletal conditions, arthritis, orthopedic disabilities (bone and joint), cerebral palsy, pulmonary insufficiencies, cardiac deficits, disabling conditions from birth, disabilities of aging, disfigurement, and numerous other traumas, conditions, and diseases.

Technology Serves the Process

Rehabilitation engineering is connected with treatments and therapies (e.g., robotic-aided therapy). It is associated with the avoidance of secondary disabling conditions and with comfort and alleviation of pain (e.g., witness the significant role engineering played in the orthopedic success of total joint replacements). This field also has to do with access to medical and rehabilitation services, tele-rehabilitation, and a wide scope of health care and possible cures that may result from genetics and stem cell medicine.

Personal Aids

The possibilities and prospects of rehabilitation engineering are as broad as life itself, which makes them innumerable. There are walking aids, functional electrical stimulation of muscles, manipulation aids, and wheeled mobility (e.g., powered chairs such as the unique iBOT Mobility System). Issues to be addressed include proper seating and positioning in wheelchairs and elsewhere, and management of pressure on body tissues. There are memory aids, and self-care aids (e.g., for handling one's medical prescriptions), speaking aids, reading aids, writing aids, hearing aids, visual aids, eating aids, teeth hygiene, toiletry aids, bladder and bowel management, recreational aids, temperature and lighting controls, telephone controls, control of entertainment equipment, assistance for caregivers, and attention in general to as many aspects of independent living as are feasible and reasonable. Modern computerbased technologies and wireless communication systems are making many of the aids listed available and easily customized to individual needs.

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