Rehabilitative and assistive technology have been part of NICHD’s portfolio since its founding. Initially, efforts focused on ways to assist those with intellectual and developmental disabilities (IDDs), such as cerebral palsy and Down syndrome, in completing activities and navigating their environments. Later, when the National Center for Medical Rehabilitation Research (NCMRR) was established within NICHD, it provided a focal point for research aimed at improving and restoring function of people with disabilities from many types of causes, including injury and illness. Today, NCMRR provides NIH-wide coordination of rehabilitation-related activities, including conducting and supporting activities in rehabilitative and assistive technologies.
NICHD’s research portfolio on rehabilitative and assistive technology includes a variety of interdisciplinary research priorities:
- Improving functional mobility of individuals with disabilities
- Promoting behavioral adaptation to functional losses
- Assessing the efficacy and outcomes of medical rehabilitation therapies and practices
- Developing improved assistive technology
- Understanding whole body system responses to physical impairments and functional changes
- Developing more precise methods of measuring impairments, disabilities, and societal and functional limitations
- Training research scientists in the field of rehabilitation
Much of this activity is coordinated and supported through NICHD’s NCMRR. The center recently led the development of an NIH-wide research plan on rehabilitation. You can read the plan at https://www.nichd.nih.gov/sites/default/files/publications/pubs/Documents/NIH_ResearchPlan_Rehabilitation.pdf (PDF 443 KB).
Institute Activities and Advances
NCMRR is the primary NICHD funding source for research on rehabilitative and assistive technology. NCMRR supports the development and application of devices to improve the human-environment interface and to restore or enhance an individual’s capacity to function in his or her environment. This type of applied research and rehabilitation technology includes, but is not limited to, prosthetics, wheelchairs, biomechanical modeling, and other devices that aim to enhance mobility, communication, cognition, and environmental control. Researchers interested in learning more about NCMRR support for this type of research should visit https://www.nichd.nih.gov/about/org/ncmrr/foas.
Other extramural components, including the Intellectual and Developmental Disabilities Branch and the Pregnancy and Perinatology Branch, also support projects that could be considered habilitative and assistive technology.
Visit https://www.nichd.nih.gov/grants-contracts/FOAs-notices/active-FOAs?org_term=HNT8 to see current funding opportunities.
Advances that have resulted from NICHD funding exemplify the range of the institute’s interests within rehabilitative and assistive technology. Examples are listed below.
- Researchers are using mild electrical currents to affect the brain’s own electrical impulses in ways that may one day help rehabilitate its function. A preliminary study of 20 children and youth with cerebral palsy found that applying an electrical current to the part of the brain unaffected by the condition was safe and resulted in a small but significant increase in hand function for those retaining neural connections between the injured and non-injured sides of the brain. The research may allow researchers to distinguish children who may benefit from the treatment from those who will not. Read the news release.
- NICHD has supported development of two technologies that assist in rehabilitation from disabilities, injuries, or stroke. The first is an upper-arm prosthetic interface that strengthens and improves analysis of electric signals in remaining muscles, giving amputees greater control of prosthetic limbs. The second is a software system that helps people with neurological impairments with daily tasks. It uses sensor technology to track upper arm movements, which then are simulated and repeated on a screen by an avatar. Read the news release.
- Researchers are developing innovative robots that work cooperatively with people. A four-legged robot enhances mobility for the elderly to help them remain physically active. The robot can carry a load and walk alongside a user and remove environmental obstacles. A hand-worn assistive device uses computer vision and natural feedback mechanisms to help visually impaired users grasp objects and better navigate their environments. A third robot is a social companion that promotes children’s curiosity and belief that dedication and hard work can improve basic abilities. Read the news release.
- Treadmills can help children with physical disabilities master walking. Researchers supported by NICHD investigated whether children have better motor learning when they receive body-weight-supported treadmill training with limb facilitation, a passive strategy, or with added resistance while the leg swings during walking. Children who had added resistance saw greater gains in walking speed and distance than did children who had supported treadmill training, a finding that could have implications for their care. (PMID 28576629)
- Spinal cord injury resulting in paralysis leads to reduction of muscles’ ability to use oxygen, which may be associated with the development of chronic diseases. Researchers tested a device that spurs muscle contraction by sending electrical impulses to nerves to see if it could help improve muscles’ ability to use oxygen. They found that when patients with spinal cord injuries used the device at home, they had a 119% improvement, on average, in muscles’ capacity to use oxygen. Spurring muscle contraction did not improve muscle composition or blood metabolic and lipid profiles. (PMID 27576602)
- No national data provide information on limb loss in the United States, so NICHD and the Department of Defense are establishing a Limb Loss and Preservation Registry. It will include data about the medical conditions that cause limb loss, clinical efforts to prevent it, related surgical procedures, prosthetic use and fitting, rehabilitation, and outcomes.
Other Activities and Advances
The Medical Rehabilitation Research Resource Network, funded through NCMRR with additional support from the National Institute of Biomedical Imaging and Bioengineering and the National Institute of Neurological Disorders and Stroke, builds research infrastructure in medical rehabilitation by providing investigators with access to expertise, courses and workshops, technologies, and other collaborative opportunities from allied disciplines such as neuroscience, engineering, applied behavior, and the social sciences. The network is made up of six resource centers around the country.
NCMRR’s Rehabilitation Research Career Development Program provides mentoring and career development support to rehabilitation researchers in several fields: physiatrists, physical and occupational therapists and allied health professionals, clinicians involved in neurological rehabilitation, and bioengineers. The program currently involves four sites around the country.
In addition, much of NICHD’s small business-related research involves rehabilitative and assistive technology. For more information, visit our Small Business Programs website.