The use of Technology is fast evolving and becoming increasingly common place within our lives. The average household now has access to a wide range of gadgets including laptops, smart phones, e-readers, games consoles and tablets to go online. The Scottish Household Survey (2011) found that 73% of households reported having home Internet access. This continues a well-established trend of year-on-year increases.
Rehabilitation in TBI and Spinal Injury has always embraced technological advances. However, with easier access to the internet, improving accessibility and reducing costs, assistive technology is being increasingly recommended within rehab practice to enhance quality of life and independence. (1,5,8) Some devices are highly specialised and can be costly, such as bespoke communication aids, monitoring devices / sensors and newly emerging technology of mind-machine interface or brain computer interface (BCI). BCI is at the cutting edge of technology enhancing rehabilitation but everyday gadgets can introduce challenges, providing opportunity to explore new avenues and change rehabilitation practice. (4)
At CMS we are exploring the use of smart phones and tablets to enhance the rehabilitation process for our clients. This includes providing personalised training sessions for clients, carers and family in how to incorporate their phones and tablets within their rehabilitation programmes. Traditional compensatory aids such as the paper diary, whiteboards, alarms and To Do Lists can now easily be incorporated within these devices through the use apps. There are apps for a wide range of rehab needs and the market is constantly evolving to provide us with more options in this area. We have also begun trialling software programmes designed to facilitate the rehabilitation process such as brain training exercises.
Positive outcomes include clients reporting that using smart devices and apps feels “normal” as they are used by their peers. This is especially so for younger adults and children who are already familiar with these devices. Case managers report clients are using their smart phones / tablets for prompting e.g. to recall appointments or check shopping lists as well as a platform for engaging in rehab activities. We have also found that the design of many smart phones and tablets involves simple repetitive steps which make the user interface relatively intuitive and an easy skill to learn.
Like all rehab strategies, the use of gadgets to enhance function and skill has its limitations and therefore may not be appropriate for all. It is easy to become over reliant on an aid, some people report being overwhelmed when faced with a shiny new gadget, the instructions can seem impossible to follow and most importantly what do we do when our gadget is lost or broken? Despite this we are keen to explore the use of gadgets and apps further having identified it as an area that can be beneficial for our clients and their outcomes.
Evidence in the literature re use of smart technology.
1. Culley, C & Evans, J (2010) SMS text messaging as a means of increasing recall of therapy goals in brain injury rehabilitation: A single-blind within-subjects trial Neuropsychological Rehabilitation, 20:1, 103-119
2. Hart, T., Buchhofer, R. & Vaccaro, M. (2004) Portable Electronic Devices as Memory and Organizational Aids After Traumatic Brain Injury: A Consumer Survey Study Journal of Head Trauma rehabilitation VOL 19 5ZZ) PP 351 – 365
3. Ptak, R., Van der Linden, M. & Schnider, A. (2010) Cognitive rehabilitation of episodic memory disorders: from theory to practice frontiers in human neuroscience vol 4 article 57 pp 1 – 11
4. Serruya, M.D. & Kahana M.J. (2008) Techniques and devices to restore cognition. Behavioural Brain Research. Vol 192 (149-165)
5. Svoboda, E. & Richards, B. (2009) Compensating for anterograde amnesia: A new training method that capitalizes on emerging smartphone technologies Journal of the International Neuropsychological Society vol 15 pp 629 – 638
6. Teasdale, T., Emslie, H., Quik, K., Evans, J., Fish, J. & Wilson, B. (2009) Alleviation of carer strain during the use of the NeuroPage device by people with acquired brain injury Journal of Neurology, Neurosurgery and Psychiatry vol 80 pp 781 – 783
7. Thornton, K., and Carmody, D., (2008). Efficacy of traumatic brain injury rehabilitation: Interventions of QEEG-guided biofeedback, computers, strategies and medications. Vol, 33, pg 101-124.
8. Wallace, T. & Bradshaw, A. (2011) Technologies and Strategies for people with communication problems following brain injury or stroke NeuroRehabilitation vol 28 pp 199-209
9. Wilson, B., Evans, J., Emslie, H., & Bartram, C. (2001). Comparison of pocket-computer memory aids for people with brain injury. Brain Injury, 15, 787-800.
Image courtesy of Mervi Eskelinen aka Tasselflower, Creative Commons