Focus on Smart Technology

Learning to Work Smarter

• By Laurie Watanabe
• Jun 01, 2021

Smart technology takes many forms. It can be a network of systems connected to the Internet that can turn up the thermostat at your command and suggest a good movie. It can be a robot vacuum that sweeps up autonomously.

In the Complex Rehab Technology (CRT) industry, more systems are being created to help people with disabilities to work smarter, not harder. These systems can adjust to changing levels of ability, or can provide insight to help a seating and mobility team make the most informed decisions possible.

Visualizer & Augmented Reality: Picture This

When Sunrise Medical launched its Nitrum ultralightweight wheelchair earlier this year, it also introduced two technologies for the evaluation process. The 3D Visualizer enables clinicians, suppliers and consumers to spec out a Nitrum online and see the effects of choices such as frame angle, rear wheels, and colors. Augmented Reality visually “places” the Nitrum in real-world settings, such as the bathroom or hallway of a consumer’s home.

Angie Kiger, M.Ed., CTRS, ATP/SMS, Clinical Strategy & Education Manager for Sunrise Medical, appreciates the ability to see what a newly spec’d Nitrum will look like.

“I know it sounds really basic to someone from the clinical side of things, but colors and how a chair looks is typically one of the top things on the priority list of the consumer,” Kiger said.

“Even if their supplier has a demo chair, they’re using maybe a two-inch color swatch. From a consumer standpoint, it’s helpful to be able to imagine the whole color or, if you have the opportunity, the colors on some of the parts of the chair. You could get different highlighted pieces, like the casters can be a different color. If you’re working with a teenager and the parent says, ‘I don’t think those two colors will look good together, is that what you really want?’ — you put them side by side, red and pink hypothetically. It may sound fun to do an apple green color, but when you look at the whole thing and you think about the clothes that you wear, maybe it’s not such a fun idea.”

When it comes to technical specs, the Visualizer can be helpful to both consumers and seating professionals. Kiger recalled meeting with several long-time wheelchair users: “All three were very, very married to their setup: ‘This is what I like, this is what I do, don’t change a thing.’

“I asked, ‘When was the last time you went to be seen by a clinician?’ [One] gentleman said, ‘I don’t want them changing things up.’ So I delved into ‘Have you had increased pain? Are you noticing that your legs are a little bit tighter?’ Maybe if we change the angle of your seat frame, you would be able to accomplish your goals a little bit better. He said, ‘I hate to admit it, but my legs are getting a little bit tighter over the years. I need to have potentially a different angle, but I don’t want to make the chair enormous.’”

Seeing how the chair would look could help. “A few degrees makes a difference, but if you could see it [via the Visualizer], then maybe it would be less abrasive,” Kiger said. “‘Oh, that’s what 5° looks like? That’s not that big a deal.’ The clinician knows that’s going to make a big deal in the feel, but the person who’s looking at the chair as a consumer is going to say ‘Okay, I can do that.’ Or ‘Nope, that’s too much, I don’t want to do that.’”

Sunrise’s new Augmented Reality takes the next step by virtually placing the Nitrum in real locations. “For me, the advantage to Augmented Reality is — it’s not going to be the exact size, but it’s pretty darn close, if you’re concerned about how bulky something is going to be, or just how it’s going to look in a normal environment,” Kiger said. “Amazon has been doing that for a while, and it helps me make decisions. It’s just an added bonus to visualize what something’s going to look like in the real world. It makes things less scary.”

The hope is that these tools will eliminate surprises upon delivery. “The therapist’s heart drops and the supplier’s heart drops when the [consumer] says, ‘Oh, that’s not what I imagined it would look like,’” Kiger said. “It’s not a consumer product where you can just say, ‘It’s okay, we’ll just exchange it.’ In ultralight wheelchairs, the aluminum has been bent specifically for the angle of that individual. It’s not easy to just swap things out. So being able to visualize and understand it is huge.”

Abilitech Assist: Promoting Dignity & Independence

Described as an orthotic with shoulder assist, the Abilitech Assist is akin to an exoskeleton for upper extremities. It assists with flexion and extension of the elbow and shoulder to facilitate a range of mobility-related activities of daily living, including self-feeding and grooming. Angie Conley, CEO of Abilitech, said of the Assist’s journey, “We have had a goal for the last five years [of] working with clinicians and potential users every week, helping to design a device that’s meaningful. It is intuitive to use. One of the things that’s important about our technology is that it is spring based, and the motors tension the springs. The patient is able to move their arms much like they would in a swimming pool because it’s gravity balanced, and their arms feel weightless.”

Conley added, “We go beyond the physical impact of helping people with activities of daily living. [The Assist facilitates] choosing when to eat and what to eat and when to drink and what to drink. We have a physical impact, we have a social-emotional impact. It’s setting their environment up so they can live more fully and engage more fully and more independently. We strive to have an economic impact, to offset those costs of needing help all the time.”

Abilitech is beginning its sales outreach by working with “centers of excellence,” including facilities specializing in muscular dystrophy, multiple sclerosis, ALS, spinal cord injury, and spinal muscular atrophy. Conley said clinicians have asked if the Assist could improve function over time by building strength: “When you enter a rehab population, which will include spinal cord injury and stroke, we believe there is an opportunity — we do need to study it. So we haven’t made any claims, because we have not studied it. Our clinicians go there right away: Within the first two minutes, they think, ‘This is great for my stroke patients. Moving with intention and repetition will facilitate the neuroplastic healing, and these people are going to get stronger.’”

While the Assist hasn’t yet been used to self propel a wheelchair, the possibilities seem robust. “We’re excited to report that we are commercially available,” Conley said. “We are listed with the FDA, so we are ready and able to help people right now. We have our own sales force that we are developing right now, and we are targeting centers of excellence that have high volume.”

As for funding, Conley said she believes reimbursement as an orthotic will be available: “We will launch with a miscellaneous code, but we can demonstrate efficacy in the very first fitting.”

This article originally appeared in the May/Jun 2021 issue of Mobility Management.