Cathy Bodine

Treatment of fragile X-associated tremor ataxia syndrome (FXTAS) and related neurological problems.

Fragile X-associated tremor/ataxia syndrome (FXTAS) is a progressive neurological disorder that affects older adult carriers, predominantly males, of premutation alleles (55 to 200 CGG repeats) of the fragile X (FMR1) gene. Principal features of FXTAS are intention tremor, ataxia, parkinsonism, cognitive decline, and peripheral neuropathy; ancillary features include, autonomic dysfunction, and psychiatric symptoms of anxiety, depression, and disinhibition. Although controlled trials have not been carried out in individuals with FXTAS, there is a significant amount of anecdotal information regarding various treatment modalities. Moreover, there exists a great deal of evidence regarding the efficacy of various medications for treatment of other disorders (eg, Alzheimer disease) that have substantial phenotypic overlap with FXTAS. The current review summarizes what is currently known regarding the symptomatic treatment, or potential for treatment, of FXTAS.

Technology for improving cognitive function. A workshop sponsored by the U.S. Interagency Committee on Disability Research (ICDR): Reports from working groups

The U.S. federal Interagency Committee on Disability Research (ICDR) and its Subcommittee on Technology (IST) sponsored a state of the art workshop on “Technology for Improving Cognitive Function”, from 29 – 30 June 2006 in Washington, D.C. This paper summarizes the content of the working groups charged with providing strategic direction for the future of technology for persons with cognitive disabilities.

Technology for improving cognitive function: report on a workshop sponsored by the U.S. Interagency Committee on Disability Research.

The U.S. federal Interagency Committee on Disability Research (ICDR) and its Subcommittee on Technology (IST) sponsored a state of the art workshop on “Technology for Improving Cognitive Function,” from 29 – 30 June 2006 in Washington, D.C. This paper summarizes the content of the keynote and panel presentations.

Aging well: the use of assistive technology to enhance the lives of elders

Eighty percent of seniors have some type of functional impairment that impacts one or more activities of daily living. This paper focuses on the use of assistive technology devices to support elders with successful aging. A variety of assistive technology devices and their utilization by elders are explored.

User surveys support designing a prosthetic wrist that incorporates the Dart Thrower’s Motion

Abstract Aim: Prosthetic devices are not meeting the needs of people with upper limb amputations. Due to controlsidelimitations, prosthetic wrists cannot yet be fully articulated. This study sought to determine which wrist motions users felt were most important for completing activities of daily living. We specifically invstigated whether adding a combinationof flexion and deviation known as the Dart Throwers Motion to a prosthetic wrist would help improve functionality. Methods: Fifteen participants with a trans-radial amputation, aged 25–64 years, who use a prosthesis completed an online survey and answered interview questions to determine which types of tasks pose particular challenges. Participants were asked what kinds of improvements they would like to see in a new prosthesis. A subset of five participants were interviewed in-depth to provide further information about difficulties they face using their device. Results: The survey showed that participants had difficulty performing activities of daily living that involve a combination of wrist flexion and deviation known as the “Dart Throwers Motion”. Interview responses confirmed that users have difficulty performing these tasks, especially those that require tools. Additionally, users said that they were more interested in having flexion and deviation than rotation in a prosthetic wrist. Conclusion: This research indicates that including the Dart Throwers Motion in future designs of prosthetic wrists would improve these devices and people with upper limb amputations would be excited to see this improvement in their devices. Implications for Rehabilitation • Over one third of people with upper limb amputations do not use a prosthesis because prosthetic devices do not meet their needs.• The number of motions possible in state of the art prosthetic devices is limited by the small number of control sites available.• The Dart Thrower?s Motion is a wrist motion used for many activities of daily living but unavailable in commercial prosthetics leading many prosthetics users to have difficulty with these tasks.• Prosthetic use, and therefore quality of life, could be improved by including the Dart Thrower’s Motion in a prosthesis.

How a diverse research ecosystem has generated new rehabilitation technologies: Review of NIDILRR's Rehabilitation Engineering Research Centers

Over 50 million United States citizens (1 in 6 people in the US) have a developmental, acquired, or degenerative disability. The average US citizen can expect to live 20% of his or her life with a disability. Rehabilitation technologies play a major role in improving the quality of life for people with a disability, yet widespread and highly challenging needs remain. Within the US, a major effort aimed at the creation and evaluation of rehabilitation technology has been the Rehabilitation Engineering Research Centers (RERCs) sponsored by the National Institute on Disability, Independent Living, and Rehabilitation Research. As envisioned at their conception by a panel of the National Academy of Science in 1970, these centers were intended to take a “total approach to rehabilitation”, combining medicine, engineering, and related science, to improve the quality of life of individuals with a disability. Here, we review the scope, achievements, and ongoing projects of an unbiased sample of 19 currently active or recently terminated RERCs. Specifically, for each center, we briefly explain the needs it targets, summarize key historical advances, identify emerging innovations, and consider future directions. Our assessment from this review is that the RERC program indeed involves a multidisciplinary approach, with 36 professional fields involved, although 70% of research and development staff are in engineering fields, 23% in clinical fields, and only 7% in basic science fields; significantly, 11% of the professional staff have a disability related to their research. We observe that the RERC program has substantially diversified the scope of its work since the 1970’s, addressing more types of disabilities using more technologies, and, in particular, often now focusing on information technologies. RERC work also now often views users as integrated into an interdependent society through technologies that both people with and without disabilities co-use (such as the internet, wireless communication, and architecture). In addition, RERC research has evolved to view users as able at improving outcomes through learning, exercise, and plasticity (rather than being static), which can be optimally timed. We provide examples of rehabilitation technology innovation produced by the RERCs that illustrate this increasingly diversifying scope and evolving perspective. We conclude by discussing growth opportunities and possible future directions of the RERC program.

A UHF RFID positioning system for use in warehouse navigation by employees with cognitive disability

Abstract Unemployment among the almost 5 million working-age adults with cognitive disabilities in the USA is a costly problem in both tax dollars and quality of life. Job coaching is an effective tool to overcome this, but the cost of job coaching services sums with every new employee or change of employment roles. There is a need for a cost-effective, automated alternative to job coaching that incurs a one-time cost and can be reused for multiple employees or roles. An effective automated job coach must be aware of its location and the location of destinations within the job site. This project presents a design and prototype of a cart-mounted indoor positioning and navigation system with necessary original software using Ultra High Frequency Radio Frequency Identification (UHF RFID). The system presented in this project for use within a warehouse setting is one component of an automated job coach to assist in the job of order filler. The system demonstrated accuracy to within 0.3 m under the correct conditions with strong potential to serve as the basis for an effective indoor navigation system to assist warehouse workers with disabilities. Implications for rehabilitation An automated job coach could improve employability of and job retention for people with cognitive disabilities. An indoor navigation system using ultra high frequency radio frequency identification was proposed with an average positioning accuracy of 0.3 m. The proposed system, in combination with a non-linear context-aware prompting system, could be used as an automated job coach for warehouse order fillers with cognitive disabilities.

The Rehabilitation Engineering Research Center for the Advancement of Cognitive Technologies

Barring few exceptions, allied health professionals, engineers, manufacturers of assistive technologies (ATs), and consumer product manufacturers have developed few technologies for individuals with cognitive impairments (CIs). In 2004, the National Institute on Disability Rehabilitation Research (NIDRR) recognized the need to support research in this emergent field. They funded the first Rehabilitation Engineering Research Center for the Advancement of Cognitive Technologies (RERC-ACT). The RERC-ACT has since designed and evaluated existing and emerging technologies through rigorous research, improving upon existing AT devices, and creating new technologies for individuals with CIs. The RERC-ACT has contributed to the development and testing of AT products that assist persons with CIs to actively engage in tasks of daily living at home, school, work, and in the community. This article highlights the RERC-ACT’s engineering development and research projects and discusses how current research may impact the quality of life for an aging population.