International Assessment of Research and Development in Technologies for Persons with Disabilities

Introduction

   This statement of work is a brief plan for conducting a comparative assessment of foreign and U.S. research and development activities relatedto technologies for persons with disabilities.  The purpose of the study will be to compare research on disability, rehabilitation, and other research on the development of technologies for independent living ongoing in the United States with that being conducted abroad.

Final Workshop

Major Objectives of Study

The objectives of the international assessment would be to:

•   Guide and justify U.S. research investments
•    Look for good ideas abroad (technology transfer)
•   Look for opportunities for cooperation and collaboration
•   Compare U.S. R&D programs and status with those abroad

Methodology

    The study would be organized on behalf of the sponsors by WTEC, which is a nonprofit research institute funded by grants from NSF and ONR.  Additional support from the NIH, DOE, NIST, NASA, and several research agencies of DOD has been made available via NSF and ONR. Panels of experts using the WTEC peer review methodology have assessed international R&D in many technologies including:  nanotechnology, tissue engineering, rapid vaccine manufacturing, simulation-based engineering and science, and many others.  Final reports are posted at http://www.wtec.org/.

    This study builds on recent WTEC international studies of R&D on brain-computer interfaces (BCI) and robotics.  The BCI study included some facets of this field, like the use of internal and external sensors of brain waves to control prosthetic limbs and computers.  It was sponsored by NSF, NIH (NINDS and NIBIB), U.S. Army TATRC, and two private foundations.  Chair Ted Berger led an eight-person expert panel to study leading research at 27 labs in Europe and Asia.  Springer has recently published a book version of the final report as a part of its WTEC international technology series (Berger 2008). 

    Another recent WTEC report covered the broad field of robotics, including some coverage of the extensive national programs for personal and service robots to assist aging populations.  The study was sponsored by NSF, NASA and NIH.  The delegation studied 50 leading labs in Europe and Asia.  The final report has just been published by the Imperial College Press (Bekey 2008). 

    A panel of U.S. experts, nominated by sponsoring agencies and recruited by WTEC, will conduct this study, using the WTEC methodology of peer reviews of research abroad, visiting the sites of the research institutions and researchers who are noted for the most advanced work in Europe and Asia.  The results will be presented in a public workshop soon after the panel returns from abroad.  An academic quality final report will serve to disseminate the results widely.

Technical Scope

    There is a wide variety of disability, rehabilitation, and other enabling research being conducted in the United States, Europe, and Asia to develop technologies for independent living.  Many such activities in the United States have been inspired by the Americans with Disabilities Act (ADA), and more recently by the New Freedom Initiative. As populations age, more people need such assistance, and there are substantial national initiatives abroad; for example, Japan and Korea have sophisticated programs in personal and service robots for seniors. Research by the U.S. Government in these areas is coordinated by the Interagency Committee on Disability Research (ICDR). 

    Among others, the active projects include technologies to support aging in place and the general issue of independent living.  Some of these projects could profit from more detailed knowledge of similar projects abroad. One problem is that commercial activity in the U.S. can best be described as a “cottage industry” where small companies build custom equipment for particular individuals, without fully exploiting opportunities to build larger markets by finding the requirements of other individuals around the world who might benefit from the same type of equipment. Thus, there are relatively few economies of scale realized in the production of devices for independent living.  Knowledge from abroad could assist in matching requirements for larger numbers of individuals, and provide ideas for making more commercial success by U.S. companies.  However, the main thrust of the study would be finding good research and development themes being conducted abroad to better inform program officers and managers in Federal agencies of the opportunities that could be pursued here.

The purpose of the proposed study will be to gather data concerning international activities in this domain, including:

•          Funding sources
•          Customer bases – requirements of the communities served
•          Goals and methodologies of research projects
•          Findings from research and development
•          Industry and market development

The results would be expected to contribute to future research planning efforts by the NSF, and the U.S. Government generally, and its partners overseas, and to enhance international technology transfer.

Some of the subjects to be investigated can be termed “technologies for independent living,” which is intended to encompass a wide variety of potential solutions for many issues that impede the independence of individuals in modern society.  Issues impeding independence that might be covered in the international study could include the following:

•         Limited or no vision or hearing
•         Mobility impairments
•         Motor function impairments
•         Cognitive impairments
•         Diseases of aging, which may involve some of the above

Technology and research areas that could be studied include the following:

•         Microfabrication of prosthetic and assistive devices
•         Custom manufacturing including solid freeform fabrication (SFF)
•         Applications of tissue engineering
•         Sensory and motor function rehabilitation, substitution, and control
•         Biological batteries
•         Robotics (e.g., for assistance on demand)
•         Materials (e.g., for improved mobility devices with improved strength-to-weight ratios)
•         Biosensors (e.g., for realtime in situ diagnostics)
•         Sensory translation technologies
•         Novel and “intelligent” (e.g., accessible) interfaces for computers, homes, offices, and shopping and transportation systems
•         “Intelligent home” systems
•         Applications of mobile wireless systems
•         Telemedicine and “in-home healthcare” systems
•         Educational techniques and related technologies for persons with disabilities
•         Neural-neural and neural-muscular interfaces
•         Detection of imminent failure in prostheses
•         Related issues in software, systems analysis, and control

In this initial study the focus will be on technologies for enhancing mobility and independent living.  The subtopics with tentative assignments of expert panelists were presented at the kickoff meeting as follows:

•       Overview of the Need/Disabling Conditions:  MS, CP, stroke, SCI, arthritis, amputation, orthopedic injury, TBI, balance  impairments, aging,            cognitive impairment (Aisen, Boninger)
•        Prostheses (TBD,  add authors to all chapters)
•        Exoskeletons (Reinkensmeyer)
•        Robot- and Computer-based Movement Training (Reinkensmeyer, Aisen)
•        Wheelchair technologies (Boninger)
•        Joint injury prevention and orthopedic implants (Fregly)
•        Functional electrical stimulation (Boninger)
•        Control*
•        Assistive robotics/smart homes*
•        Fall prevention technology*

One or more of the starred topics will be covered if funds permit additional panelists.

Finally, beyond the above, the study may also address the following nontechnical issues:

•        Mechanisms for enhancing international and interdisciplinary cooperation in the field
•        Opportunities for shortening the lead time for deployment of new technologies emerging from the laboratory
•        Long range research, educational, and infrastructure issues that need to be addressed to promote better progress in the field
•        Current government R&D funding levels overseas compared to the United States, to the extent data are available 

The above list of topics, including the focus on R&D for mobility, will be refined by expert panel members in consultation with the sponsors at the study kickoff meeting.

Tasks 

    WTEC, in consultation with study sponsors, shall select a panel of six (6) U.S. experts in the field (including the panel chair) who are familiar with the issues and technology elements listed above for research and who are also current in international activities in the field.  The panel chair shall have sufficient stature in this field to command respect in recruitment of panelists, and make presentations of results to his or her peers.  The chair also will have the necessary skills in leading a panel to efficiently conduct the study.  (Note: Most of the panel has been recruited: David Reikensmeyer PhD (chair), Mindy Aisen MD PhD, Michael Boninger MD, B. J. Fregley PhD.  See http://wtec.org for pix)

Task 2

    The panel shall be organized at a kickoff meeting to be held in the Washington, DC metro area.  The chair will define the scope of the study (with guidance from all of the agency sponsors) and assign each panelist a section of the final report based on his or her area of expertise within the field.  A schedule for the study will be established, including dates for the workshop and completion of the final report.  During the preliminary study, WTEC shall assist the panelists by conducting electronic literature searches to locate sites to visit and to help evaluate research leadership via bibliometrics.  Passworded and public websites will be established and maintained by WTEC during the course of the study as needed to facilitate the work of the panel. (Note: the kick off meeting was held at NSF on January 7, 2010)

Task 3            

    It has been proven in previous R&D assessments that visits to foreign laboratories greatly improve the amount, accuracy, and timeliness of the information available to the panelists.  Thus, WTEC shall organize a fact-finding trip for the panel to visit centers of excellence in research on the subject technologies at selected sites abroad.  WTEC has found that professional advance work for these trips is highly beneficial, thus advance work will be performed by proven WTEC consultants. The study will benefit from existing networks of colleagues in other countries that officials of ICDR member agencies have developed.   This budget assumes that the panel will travel to Western Europe (probably including the UK, Finland, France, Germany, and the Netherlands) or to Asia (Japan, South Korea, and China).    Optionally the scope could be expanded to cover both regions or other selected countries.

Task 4

      With the assistance of NSF field offices, the contractor shall organize local workshops in Tokyo, Beijing and Paris (as these cities are visited by the WTEC delegation) to more efficiently gather information from local researchers.  As it has done many times before, WTEC will identify a local host scientist to chair the workshop and coordinate invitations to participants.  Approximately 15 local participants would be invited to present their research activities and findings. For reciprocity, the WTEC panelists would make a similar presentation on their work in the U.S.  WTEC will capture electronic versions of all presentations and make them available as a workshop report on its Web site and on CDs.

    The contractor shall organize a final workshop in the Washington, DC area for the presentation of the overall results.  Approximately 60 key participants from government and the private sector would be expected to attend a one-day presentation and discussion of the results.  Each panelist will make a 30-minute presentation with visual aids of his or her findings, and the chair will provide an overall summary.  WTEC will print 100 copies of a workshop proceedings in time for the workshop meeting.  This public workshop will be preceded by a one-day private meeting of sponsors and panelists.

Task 6

    Panelists will draft a complete final report with illustrations and citations.  Site reports will be included as an appendix.  WTEC will edit the report into academic quality and will convert the complete final written report into Adobe Acrobat (pdf) formats and make it available on the WTEC Web server and on CD-ROM. 

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Schedule, Milestones, & Deliverables

The schedule for the study will be determined at the kickoff meeting by mutual agreement of the sponsors, WTEC staff, and panel members.  However, a typical schedule and associated deliverables are shown below.  The term “or” means the latter of two events.  The schedule presented below is a plan for finishing the study in 12 months, although 18 months is allowed to provide time for dissemination activities that may extend for some months after the report is complete.

a.         kickoff meeting -- approximately one month after project initiation (API) (delivery of draft scope of panel work and panelist data)

b.         foreign site visits completed -- approximately five months API

c.         draft site reports from the site visits - approximately six months API or within six weeks after the last site visits

d.         workshop -- approximately seven months API or within two months after the last site visits (hard copies of presentation material delivered and posted on Web shortly thereafter)

e.         draft analytical report -- approximately ten months API or three months after the workshop

f.                    final report -- approximately twelve months API or two months after the draft report is sent to the site visit hosts for review (printed report, 100 copies total, simultaneously placed in pdf format on a CD and the WTEC public website -- the primary means of dissemination). 

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For more information:

Duane Shelton, WTEC, 717-659-7714, shelton@wtec.org

Ben Benokraitis, WTEC, 410-467-9832, vbenokraitis@scienceus.org

Selected References:

1. www.nsf.gov/eng/cbet/aiche/25_5342_research_aid_persons_disabilities.ppt

2. Berger, T. et al., Brain-Computer Interfaces: An International Assessment of Research and Development Trends, Dordrecht: Springer, 2008.

3. Bekey, G. et al., Robotics: State of the Art and Future Challenges, London: Imperial College Press, 2008.

4. National Institute on Disability and Rehabilitation Research (NIDRR)  http://www.ed.gov/about/offices/list/osers/nidrr/index.html

5. National Center for Dissemination of Disability Research http://www.ncddr.org

6. National Rehabilitation Information Center (NARIC) http://www.naric.com/

7. Journal of Rehabilitation Research and Development – mostly U.S. Papers, sponsored by VA, 103 papers in 2007.

8. International Journal of Rehabilitation Research – mostly non-U.S. Papers, 123 of 177 in 2007.

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Panelists  

	David Reinkensmeyer, Ph.D, (Chair), University of California, Irvine David Reinkensmeyer received the B.S. degree in electrical engineering from the Massachusetts Institute of Technology, Cambridge in 1988, and the M.S. and Ph.D. degrees in electrical engineering from the University of California, Berkeley in 1991 and1993, with dissertation work on human control of hand movements and robotic devices for movement therapy after stroke. He was a postdoctoral fellow then research assistant professor in the Sensory Motor Performance Program, Rehabilitation Institute of Chicago and Department of Physical Medicine and Rehabilitation, Northwestern University Medical School from 1994 – 1998. He joined the Department of Mechanical and Aerospace of Engineering and the Center for Biomedical Engineering at the University of California, Irvine in 1998.
	Paolo Bonato Ph.D, Harvard Medical School Paolo Bonato received the M.S. degree in Electrical Engineering from Politecnico di Torino, Torino, Italy (1989), and the Ph.D. degree in Biomedical Engineering from Università di Roma “La Sapienza”, Roma, Italy (1995). He serves as Director of the Motion Analysis Laboratory at Spaulding Rehabilitation Hospital, Boston, MA, he is Assistant Professor in the Department of Physical Medicine and Rehabilitation, Harvard Medical School, and he is member of the Affiliated Faculty of the Harvard-MIT Division of Health Sciences and Technology. Dr. Bonato is IEEE Senior Member, IEEE EMBS AdCom elected member, and past president of Kinesiology. He served as Chair of the IEEE EMBS Technical Committee on Wearable Biomedical Sensors and Systems. He founded and Editor-in-Chief of Journal on Neuroengineering and Rehabilitation. Dr. Bonato has co-authored more than 40 research papers and 150 conference proceedings. His research work is focused on wearable technology and its applications in physical medicine and rehabilitation. He has developed intelligent signal processing tools and artificial intelligence methods for the analysis of data recorded using wearable sensors with application to numerous clinical conditions such as chronic obstructive pulmonary disease, epilepsy, stroke, and Parkinson’s disease.
	Michael Boninger, M.D., University of Pittsburgh Michael Boninger is professor and Chair of the Department of Physical Medicine and Rehabilitation and Associate Dean for Medical Student Research in the School of Medicine. Since November 2007, Dr. Boninger has directed the UMPC Rehabilitation Institute, which combines medical care and research to help individuals regain independence and enhance their quality of life. Dr. Boninger also directs University of Pittsburgh’s Model Center on Spinal Cord Injury and serves as medical director of the Human Engineering Research Laboratories, a joint venture of the University of Pittsburgh Medical Center, the University of Pittsburgh, and the VA Pittsburgh Healthcare System. Dr. Boninger holds five U.S. patents and is recognized for his research on spinal cord injury, assistive technology, and overuse injuries, particularly those associated with manual wheelchair propulsion. Dr. Boninger has authored more than 150 peer-reviewed journal publications, 20 book chapters, and nearly 200 refereed conference papers. Dr. Boninger graduated from Ohio State University with both a medical doctorate and a degree in mechanical engineering.
	Leighton Chan, M.D., National Institutes of Health, Clinical Center Leighton Chan received his B.A. degree from Dartmouth College, Hanover, New Hampshire with a major in political science. He graduated from the UCLA School of Medicine in 1990. Chan then completed postgraduate training in Physical Medicine and Rehabilitation at the University of Washington. During his training he also obtained a Master of Science degree in rehabilitation science. Subsequently, he completed a Robert Wood Johnson Clinical Scholar Fellowship, earned a master of public health degree at the University of Washington School of Public Health and was a Congressional Fellow for the Honorable Jim McDermott (Washington). From 1994 to 2006, Dr. Chan was on the faculty of the University of Washington’s Department of Rehabilitation Medicine. From 2002 to 2006, he was associate professor. He is board certified in physical medicine and rehabilitation and in electrodiagnostic medicine. His research interests include health services research, quality of care given to Medicare beneficiaries, and Medicare payment policy issues. He has published more than 70 peer reviewed articles and numerous book chapters. In 2007, he was elected to the Institute of Medicine
	Rachel Cowan, Ph.D, University of Miami Rachel Cowan is a post-doctoral fellow in the laboratory of Dr. Mark Nash at The Miami Project to Cure Paralysis, received the Fritz Krauth Memorial Fellowship for her new grant funded by the Paralyzed Veterans of America (PVA) Research Foundation 2010 grant cycle. Dr. Cowan’s grant is titled “Barriers & Participation after SCI: Relationship with Fitness & Mobility”. It is known that manual wheelchair users commonly report poor fitness and the physical environment as barriers to achieving their desired level of participation in the community.  Dr. Cowan hypothesizes that a person’s fitness and wheelchair self-propulsion ability are related to their participation, view of the environment as a barrier, and choices to avoid environmental barriers (such as curbs or ramps).  In addition to her scientific expertise, she has extensive personal knowledge about this topic because she has a spinal cord injury herself; she utilizes a manual wheelchair for mobility and balances participation and environmental barriers on a daily basis. Her long-term research goal is to facilitate participation by improving fitness and/or self-propulsion capacity, thereby enabling persons with SCI to independently navigate environmental features which were previously unconquerable.
	B.J. Fregly, Ph.D, University of Florida B.J. Fregly is the director of the Computational Biomechanics Lab at the University of Florida. The research focus of the lab is on clinical problems related to knee osteoarthritis. Existing projects involve: 1) computational simulation of knee osteoarthritis development, 2) computational design of a rehabilitation treatment for knee osteoarthritis, and 3) computational estimation of knee muscle and contact forces during walking using novel surrogate modeling techniques. An overarching theme for these projects is patient-specific musculoskeletal modeling, where dynamic models calibrated to patient imaging and movement data are used to design optimal treatments. Dr. Fregly has published over 100 papers involving musculoskeletal modeling, simulation, and optimization with an emphasis on analysis of the human knee joint. Before joining the University of Florida, Dr. Fregly completed a post-doctoral fellowship in biomechanics at the University of Lyon in France. He also worked in industry as a software developer for Parametric Technology Corporation. Dr. Fregly earned a B.S. degree in Mechanical Engineering from Princeton University and M.S. and Ph.D. degrees in the same field from Stanford University.
	Mary M. Rodgers, PT, Ph.D, University of Maryland School of Medicine Mary Rodgers is the George R. Hepburn Dynasplint Professor and Chair, Department of Physical Therapy and Rehabilitation Science (PTRS), University of Maryland School of Medicine. Her major research interest is in rehabilitation biomechanics and overuse injury prevention.  Over the past two decades, Dr. Rodgers has performed extensive clinical investigation in individuals who use manual wheelchairs that has been supported by grants from the NIH-NCMRR and the Veterans Administration.  As Director of the Pilot Exploratory Studies Core and co-PI of the Research Career Development Core, Dr. Rodgers is heavily involved in the mentorship, educational and dissemination efforts of the University of Maryland Claude D. Pepper Older Americans Independence Center. Dr. Rodgers’ track-record of productive patient-oriented research includes 32 publications in high quality journals, and the mentoring of three post-doctoral fellows, 7 PhD students and four MS students in rehabilitation biomechanics.   She has also published four book chapters and co-authored a book.  She has published extensively on topics related to gait biomechanics and neuromuscular performance in elderly and neurologically impaired individuals. She is internationally recognized in the field of Biomechanics, and serves this community in a number of leadership roles, including serving as President of the International Society of Biomechanics, being on the editorial board of several journals, reviewing articles and sitting on study sections.