Alma’s Technology: Therapy and Rehabilitation Technologies

Messages from Majd | April 17, 2013

CAST’s new video, , follows 83-year-old Alma Jones on her journey from home to hospital, to a rehabilitation center, and back home. In this fourth installment of our 12-part series on “Alma’s Technology,” CAST Executive Director Majd Alwan explores technologies that can help older adults prevent physical decline or regain functional abilities after a stroke.

My name is Alma Jones. I have my aches and pains for sure but I never thought I’d live on my own in my 80s."

Most older adults prefer to live on their own in the place they call home. But sometimes, living alone may increase the likelihood that physical functional decline occurs without anyone noticing. As a result, caregivers who only see the older adult occasionally could miss the opportunity to intervene early with therapeutic activities and assistive devices.

Injuries like falls, illnesses like stroke, Parkinson’s disease, arthritis and the like can lead to loss of functional ability and mobility impairment. Mobility impairments are not only limited to the ability to walk, however. They also include limitations or inability to use one or more extremities, or a lack of strength to walk, grasp or lift objects. Mobility impairment can also result from congenital disorders.

Functional decline and mobility impairment could keep the older adult from taking part in physical activity that could, in turn, prevent further decline.

Alma Jones doesn’t worry about this. The 83-year-old great-grandmother is the central character in CAST’s new video, called High-Tech Aging: Improving Lives Today. The video shows how a variety of technology solutions are helping Alma stay connected with her caregivers so they will know if she is declining or needs assistance. It also shows Alma taking part in critical exercise programs from the comfort of her own home.

This is the 4th installment of our 12-part series on the technologies that appear in our video. In this installment, I’ll be exploring technologies that can help older adults regain functional abilities after a stroke. These technologies can also help prevent physical decline by keeping older adults physically active and connected to resources that can help them stay vibrant and active.

Functional Decline, Mobility Impairments and Loss of Independence

Many older adults experience limitations in their ability to perform activities of daily living (ADL) and instrumental activities of daily living (IADL), according a recent Report to Congress on aging services technologies written by CAST and NORC at the University of Chicago.

In 2007, for example, 25% of independently living Medicare recipients reported difficulty with one or more ADL. This proportion rose to 46% among older adults in community housing with services and 83% among those in long-term care settings.

Physical decline can cause emotional trauma for older adults and can add to their isolation. But it also carries a financial cost. Consider that, in 2006:

  • An estimated $146 billion was spent on functional limitations among community-dwelling residents.
  • $236 billion was spent on those in need of IADL and ADL assistance.
  • $268 billion was spent on assistance for other functional deficits. 

The Role of Technology in Addressing Functional Decline and Mobility Impairments

A variety of technologies can help older adults and their caregivers assess and prevent physical decline and address mobility issues. Those technologies fall in these categories:

  • Wearable monitoring devices: These devices incorporate sensors, like accelerometers, that monitor activity to assess whether an individual has motion, gait or balance issues or needs rehabilitative interventions to improve strength and mobility. These technologies can also be used to measure progress and improvements in range of motion and functional abilities in response to therapy and other interventions. Other wearable monitoring devices promote wellness-oriented behaviors, like exercise and weight loss, by cueing the person to be active and tracking activity levels.
  • Virtual reality therapy and exercising: A number of commercial products combine physical activity, visual stimulation and sometimes entertainment to make therapy exercising more enjoyable and sustainable. This broad array of technologies can accelerate the process of restoring and maintaining function. Sophisticated virtual reality rehabilitation technologies, like the ones used in Walter Reed Medical Center, fit into this category. So do adaptive technologies used in occupational therapy. Commercial gaming systems like the Nintendo Wii and Microsoft Kinect also promote physical activity and exercise.
  • Rehabilitation and assistive robots: These technologies include robotic arms, like the rehabilitation robots used by the Veteran’s Administration Health Systems, which accelerate recovery by providing guided and measured physical assistance during the rehabilitation sessions. Engineers in Israel and Japan have developed robotic suits that assist individuals with mobility impairment. These wearable suits typically attach to limbs. They enhance the user’s strength and compensate for muscle weakness by using electrodes to detect the nerve activation signal and control motors. The latter group of robots can also be used as assistive mobility devices. 
  • Smart walkers and wheelchairs: Wheel-based odometers and embedded force sensors in the handles of “smart walkers” can passively monitor stride time, step and stride length, and walking speed. An autonomous, voice-activated wheelchair, now in development, determines its location by using sensors to create a virtual map of the environment. In addition, researchers are now developing robotic walkers that provide navigation functions to help users avoid obstacles. 

Selection Tips

The selection of professional rehabilitation and therapy technologies is a function of:

  • The sophistication of rehabilitation and therapy services offered by the provider.
  • The population served.
  • The specific conditions members of that population are experiencing. 

Providers should ensure that their therapists are aware of the latest developments in rehabilitation and therapy technologies so that they consider those technologies when looking for rehabilitation and therapy options.

Therapists should look for visually stimulating, entertaining and engaging technologies. These technologies will speed recovery, be highly sustainable and result in better outcomes.

For More Information

I recommend watching the full-version of the Alma video, and I would encourage you to check the mobility aids section of CAST’s report on the State of Technology in Aging Services to find out relevant information and technologies.