Assistive technology in the rehabilitation of patients with high spinal cord lesions

The functional requirements for daily living at home are the same for a ventilator dependent quadriplegic person as they are for anyone, whether less severely disabled or able bodied. In persons with high spinal cord lesions, the necessary presence of a carer near to hand should not deter the use of assistive technology to increase independence. Maximised independence is desirable to free the carer from minute by minute tasks such as turning pages, switching lights, TV etc. This not only frees the carer for other tasks, making the caring task more bearable (and thus easier to recruit carers) but also vastly improves the morale of the disabled person. Some assistive devices, especially those concerned with mobility and transfer can avoid the need for multiple carers at times such as toiletting and going on car journeys. Whichever devices are required by the quadriplegic person, they all clearly need to be worked by a common, carefully selected input interface device matched to his or her preferences and physical abilities for switching. It is vital to ensure a technical integration of the four generic areas of device functionality: those of mobility (wheelchairs, cars), manipulation (page-turners, robotic arms), communication (keyboard emulators, voice processors, artificial speech) and control of the environment. In most countries this integration is poorly addressed owing to the different agencies involved in the provision of devices relating to each of these generic areas--despite the technology being available today.(ABSTRACT TRUNCATED AT 250 WORDS)