After reading this chapter, the reader will be able to:
Discuss the latest advancements in adaptive technology for mobility
Discuss the use of adaptive technology for performing activities of daily living
Discuss assessment of the individual and the individual's need for assistive technology
Understand how to select the appropriate assistive device based on the assessment of the individual and the individual's needs
Describe available adaptive technology for recreational activities
Technology now gives increased independence to many individuals with spinal cord injury (SCI) in their homes, at work, and in recreational activities. The purpose of this chapter is to assist the clinician by briefly reviewing the traditional assistive technology devices available and then highlighting some of the newer devices, with an emphasis on the process of device selection and their practical use.
Assistive technology is defined by the 1988 Technology Related Assistance for Individuals with Disabilities Act as "any item, piece of equipment, or product system, whether acquired commercially off the shelf, modified, or customized, that is used to increase, maintain, or improve functional capabilities of individuals with disabilities."1 The assistive technology field is expanding, with countless devices in a market that generate $2.87 billion in U.S. sales.2 How do we sort through them and match the right device to the individual?
Relying on the literature for an answer regarding a specific device's clinical efficacy will be ineffective, as rarely will there be mention of the product being considered. Some products do have published studies to inform the clinician, while other studies focus on categories of devices rather than specific products. One such survey of civilians and veterans found that the most frequently owned devices fall into categories of (1) manual or powered mobility and independent living, (2) prosthetics and orthotics, (3) assistive computer technology, and (4) augmentative and alternative communication devices (AACD).1 Several of these device categories will be covered in this chapter, with a focus on newer devices and technologies. Included is a discussion of devices identified as being most important to employment, including powered environmental control devices and ambulatory support devices.1
Members of a rehabilitation team strive to help individuals with SCI overcome the functional loss that occurs with injury to the spinal cord. Assistive devices play a key role in the lives of these individuals as they provide a bridge to maximum independence. Prior to the injury, the individual functions automatically and spontaneously to satisfy desires and daily needs, from activities as physically simple as turning in bed to those as complex as walking. After a SCI, activities once taken for granted are now seemingly out of reach. However, with the deliberate introduction of assistive devices, many lost functions may be regained.
The importance of conducting a thorough assessment of the individual's needs and priorities cannot be overemphasized. Before recommending a particular device, the ...