Ebook: Rehabilitation Technology

Welcome to the 1st TIDE Congress on Rehabilitation Technology Strategies for European Union. The Congress is being held in Brussels on 6 & 7 April 1993. It offers a unique opportunity to gather people from inside and outside Europe to share the results of the projects and discuss critical issues and possibilities for the future of Rehabilitation Technology in Europe, a future with an enormous market of between 60 and 80 million people concerned.

The Congress will last two days and consists of 3 parallel streams of sessions as well as an exhibition running in parallel. The subjects addressed are :

The Results from R&D Programmes.

Under these topics contributions were selected to cover the benefits for Rehabilitation Technology coming from basic and applied industrial research carried on in Community or national R&D programmes. Also considered was the impact on RT of the results of Information Technology R&D projects in areas like Microelectronics, Communications, Bioengineering, Computer Hard- and Software and suggestions for targets and development profile in RT to be explored by TIDE.

The Methodology of R&D Programmes.

Within this topic, contributions have been selected to approach the analysis of the aspects that influence the orientation of R&D and to identify specific requirements arising from the interaction between elderly or disabled persons and the various scenarios of life. Challenging areas were also considered from the point of view of their technical complexity or the innovations in general technical production processes as well as the implication of the involvement of multidisciplinary fields, human factor techniques, or complex evaluation and verification methodologies in the RT.

Market and Service Delivery.

For this topic contributions have been selected on subjects dealing with market issues such as technology transfer, information dissemination, legislation, consumer involvement, if possible based on empirical data, cases or field studies.

In the exhibition, the 20 TIDE Pilot Action projects will demonstrate their results and achievements, displaying the prototypes developed during the projects lifetime. The exhibition, which is open to the general public, also shows innovative contributions from other companies and organizations active in the RT field.

The exhibition offers an excellent opportunity to acquire comprehensive knowledge about the results obtained in all areas of the TIDE Initiative programme and it shows the contribution it makes to the economic and social life of disabled and elderly people in the Community.

I would like to thank everyone who has contributed to the Congress: the Programme Committee in charge of selecting papers; the authors and reviewers of the papers themselves; the chairmen, speakers, the project teams which set up the Exhibition demonstrations, the TIDE Office team and the TIDE Secretariat MC-Consultancy.

E. Ballabio

TIDE OFFICE

This paper summarizes the contributions made by all of the authors in Session (1) of the 1st TIDE Congress and highlights the potentialities for exploitation of research and developments in areas of technology relevant to aspects of interfaces relating to visual perception, facilitation of human communication, prosthetics and orthotics, robotics and signal processing. Means by which promising technological developments can be expedited for more widespread availability are discussed together with aspects of consumer involvement and teamwork through consortia of relevant expertise.

This paper offers an introduction to the session of the Congress concerned with “Market and Service Delivery”. It does so by reference to the experiences of the author's company, BT, of providing products and services to disabled and elderly people in the UK.

As the usage of WIMP interfaces increases, the accessibility of software to the blind and partially sighted diminishes. Research and development is underway (TIDE project VISA*) to provide universal access to these interfaces. Systems are monitored in real-time and icon and character recognition interpret the output into suitable audio or braille form. This paper describes Fast Optical Icon and Character Recognition. The fundamental requirements are analyzed. The way in which environmental and contextual information such as layout and “surrounding history” can be used to achieve the required accuracy and speed of recognition is reported.

The CAPS consortium starts from the idea that the access to the information society by a significant group of handicapped and elderly persons, who have difficulty in accessing the printed word and/or electronic information (reading impaired persons) should be guaranteed as much as possible. Within TIDE's CAPS project a system independent, ISO-standardised document architecture (the European Interchange Format based on SGML) has been developed to increase text accessibility for a large group of reading impaired persons. In this paper details will be given on all CAPS results and they will be treated within the context of other related initiatives (ICADD, Electronic libraries).

This paper deals with selected aspects of blind peoples' access to graphical user interfaces of modern computers which are addressed by the GUIB Project. A new device for two-dimensional sound output to enable users to locate the position of a screen object acoustically is described. In a prototypical application, blind people are given access to a class of computer-generated graphics using the new device in an interactive process of exploration.

Blind or visually impaired persons as well as persons suffering from severe motoric impairments face various problems when it comes to independent travelling. This paper will shortly review the state-of-the-art technical solutions and show what future improvements could be achieved by using up-to-date technology like GPS (Global Positioning System), optical 3D scene analysis or digitally stored maps. The paper is also a call for European R&D cooperation to make these new technologies available to disabled users as soon as possible.

The project SYMBOL has been developed within the framework of the European Community program in support of technological initiatives for handicapped and elderly persons. It is positioned at the intersection of two areas : development of new technologies and application of pedagogic innovations for the purposes of rehabilitation.

In March 1991 a new interdisciplinary research project was launched at the Technical University of Berlin (TUB). The aim is to design a computer animation program showing realistic movements of an abstracted speaker's face. For this purpose, video tapes with prototypic speakers have been recorded and analyzed. The investigations lead to the fundamental correlation between phonetic sequences of given German text and corresponding visual movements of the articulation organs. The animation program is designed to be a training aid for lipreading for hearing-impaired people and is based on an open vocabulary. First performance evaluations at a hard-of-hearing school show that after a short-term crash-course the recognition of long single words increased by approx. 15% for a natural speaker. Involved in this project are the Departments of Electronics and Linguistics of the TUB as well as the Department of Special Education (in the field of Rehabilitation) of the Humboldt-University, Berlin. The project is based on various preliminary studies of the participating departments.

Multi-Talk II, a voice output communication aid (VOCA) is currently being evaluated by five adults who are physically disabled and users of augmentative and alternative communication (AAC) systems. This paper presents findings from three subjects and describes their communicative interactions with their regular communication system and Multi-Talk II. For one subject, communication rate increased with Multi-Talk II but there were more communication breakdowns, whereas for the other two subjects rate of communication increased with Multi-Talk II and there were no breakdowns.

This paper presents research on the development of a software architecture for users with special needs. One of the aims is to gain experience with modular and versatile communication aids and access systems. A software architecture has been specified that incorporates some of the requirements of technical aids for disabled users. To be able to evaluate its feasibility empirically, an interactive design tool based on this architecture has been developed. It includes an Interface Builder, a Configuration Editor and a Vocabulary Editor. Existing software is integrated by way of a communication protocol that implements an abstract application. Trained therapists have already used the tool successfully to construct new applications from existing software components.

Gait restoration in paraplegics by means of electrical stimulation of paralysed muscles (FES) in combination with orthoses (hybrid systems) is being investigated at the Centre for Rehabilitation Technology (University of Twente and the Roessingh Rehabilitation Centre). The research is well embedded in concerted European efforts in this field. Research activities include electrical stimulation of paralysed muscles, orthosis design, automatic control systems, gait analysis, biomechanical modelling, and clinical application.

This paper presents the results of the MECCS project run under the pilot phase of the TIDE programme. The objective of the project was to produce a prototype of a home control and communications system for wheelchair users. The paper gives brief descriptions of the system designed by the project, the problems encountered, and the conclusions reached.

Physically handicapped children can derive exceptional benefits from computer applications. A careful evaluation of such applications is called for, however, to thwart unjustified hopes or claims. This paper describes the development and evaluation of a computer based environment, refered to as the ‘information prosthetic’. It consists of pointing devices and a computer program. In a large scale pre-test post-test design, the information prosthetic was evaluated on its effects on attention and cognitive- and emotional development of physically handicapped children aged four to eight. The experimental group worked five months, twice a week, during 20 minutes with the computer. Teacher questionnaires confirmed previous research that immediate effects may be considerable. In contrast however, an analysis of variance (ANOVA) showed long term treatment effects to be negligible.

Integrated Control Systems allow disabled and elderly people access to multiple functions from a single input device (for example a joystick with a switch). Multiple handicapped users are thereby able to switch efficiently between wheelchair control, manipulator control, control of their environment, computer access and communication without help. The control of integrated systems is a safe and easy to use possibility with the general purpose interface M3S.

Technological change imposes special training needs on the elderly. We introduce a concept for flexible, self-directed learning in the workplace. Standard workstations without additional multimedia-hardware running CAD-software in a Unix-environment with the X-Window system are basis for our development. In this way the people with training needs can access the trainig-modules in their actual environment, out of real-world problem situations which they encounter. This will enhance their capabilities and provide guidance especially to those elderly workers in the construction-office without prior computer knowledge.

The contribution describes the opportunities for providing support to elderly persons in their homes using videotelephony. Such services were tested in Frankfurt am Main as part of the Project, “Application Pilot for People with Special Needs (APPSN)” in the CEC RACE Programme.

Videotelephony offers opportunities to provide services to the home, encouraging and supporting an independent way of life and thereby reducing elderly people's need to recourse to institutional care. It is shown that services which can be provided using videotelephony in a local care scheme can potentially help maintain social competence, motivating and enabling continued participation in social activities, thereby helping to prevent decline into dependence. Other opportunities to provide help centre on informing the elderly about activities and events, providing refresher exercises between regular therapy sessions, and general assistance in coping with problems of everyday living.

Data from logging files were used to analyse the usage levels of the new services. An overview of frequency, duration and patterns of calls is given. Besides these automatically generated data, information was gathered in several surveys with participants and staff of the pilot project. The surveys were carried out as part of the evaluation of the videotelephony-based support services.

It can be shown that the implementation of a videotelephony-based social support service has a potential to assist professional carers in their difficult tasks and a potential to improve the quality of life of the elderly with special needs.

This paper presents an open control architecture for a smart omni-directional wheelchair allowing a flexible configuration of user required functionality, which is essential for an individual adaptation to the special needs of severely physically disabled and mentally handicapped people. The demand for a large functionality with high flexibility, leads to a modular structured control system, composed of different smart units. Each unit is provided with local intelligence to yield a high independence from other modules as well as to get an open control system.

The application of mechatronics principles to artificial hands has lagged a long way behind other areas of medical technology. Current provision uses simple open loop grippers that require concentration to be controlled successfully, and can only perform a limited range of tasks. By adding sensors and a microprocessor it is possible to control a more complex and functional hand with simpler instructions.

Tou is a robotic arm conceived to provide tetraplegic people with some autonomy in their daily life. The main characteristic of Tou is to be intrinsically safe due to its soft structure. This, together with the fact that the user's orders are imprecise, implies the need to develop special control algorithms. Tou is not aimed to substitute an human assistant but to avoid the need of continuous dependance on others of the severely disabled in tasks such as picking up light objects, scratching or to turn the pages of a book.

This paper presents recent developments in end-effector design for a robotised workstation for disabled people. The workstation is intended for use at computerised office work places and the robot tasks will primarily be within the area of paper and book handling including page turning. Additional tasks, such as loading diskettes and serving refreshments are included as well. During initial tests the end-effcetors have shown excellent results with respect to expected functionality and reliability. Future developments will be concentrated on integrating more sensors to the end-effectors and the robot controller in order to produce more autonomous and flexible robot tasks in a less structured environment.

Many profoundly hearing impaired listeners experience not only an increase in auditory threshold but also a severe loss in hearing differences among sounds at any level above their threshold. We studied audio-visual perception of natural speech versus synthesized speech based on voice fundamental frequency and on one or two vowel formants. Intelligibility scores of four profoundly hearing impaired subjects showed an interdependency between the type of speech processing scheme and the type of residual hearing. This project was performed within the project ‘STRIDE’ of the TIDE program.

The paper gives an overview of a research project submitted to the CEC Human Capital & Mobility programme. The aim of the project is to initiate research to improve communication for the communication impaired using a single hardware and software platform. The project will build on current state-of-the-art techniques in multi-lingual “normal” speech recognition, processing and synthesis but will use clinical assessment and analysis to fundamentally re-appraise speech processing parameters. Novel techniques will be brought to the graphical interfacing for visual communication, which will start from the use of symbolic language systems. If successful, the speech recognition and speech synthesis work will have benefits for general applications as well as for speakers with disability.