National Institute on Disability and Rehabilitation Research-Disability and Rehabilitation Research Projects and Centers Program-Disability Rehabilitation Research Projects (DRRPs) and Rehabilitation Engineering Research Centers (RERCs), 54870-54879 [E6-15548]
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54870
Federal Register / Vol. 71, No. 181 / Tuesday, September 19, 2006 / Notices
DEPARTMENT OF EDUCATION
National Institute on Disability and
Rehabilitation Research—Disability
and Rehabilitation Research Projects
and Centers Program—Disability
Rehabilitation Research Projects
(DRRPs) and Rehabilitation
Engineering Research Centers
(RERCs)
Office of Special Education and
Rehabilitative Services, Department of
Education.
ACTION: Notice of proposed priorities for
DRRPs and RERCs.
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AGENCY:
SUMMARY: The Assistant Secretary for
Special Education and Rehabilitative
Services proposes certain funding
priorities for the Disability and
Rehabilitation Research Projects and
Centers Program administered by the
National Institute on Disability and
Rehabilitation Research (NIDRR).
Specifically, this notice proposes four
priorities for DRRPs and seven priorities
for RERCs. The Assistant Secretary may
use these priorities for competitions in
fiscal year (FY) 2007 and later years. We
take this action to focus research
attention on areas of national need. We
intend these priorities to improve
rehabilitation services and outcomes for
individuals with disabilities.
DATES: We must receive your comments
on or before October 19, 2006.
ADDRESSES: Address all comments about
these proposed priorities to Donna
Nangle, U.S. Department of Education,
400 Maryland Avenue, SW., room 6030,
Potomac Center Plaza, Washington, DC
20204–2700. If you prefer to send your
comments through the Internet, use the
following address:
donna.nangle@ed.gov.
You must include the term ‘‘Proposed
Priorities for DRRPs and RERCs’’ in the
subject line of your electronic message.
FOR FURTHER INFORMATION CONTACT:
Donna Nangle or Lynn Medley.
Telephone: (202) 245–7462 (Donna
Nangle) or (202) 245–7338 (Lynn
Medley).
If you use a telecommunications
device for the deaf (TDD), you may call
the Federal Relay Service (FRS) at 1–
800–877–8339.
Individuals with disabilities may
obtain this document in an alternative
format (e.g., Braille, large print,
audiotape, or computer diskette) on
request to the contact person listed
under FOR FURTHER INFORMATION
CONTACT.
This
notice of proposed priorities is in
concert with President George W.
SUPPLEMENTARY INFORMATION:
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Bush’s New Freedom Initiative (NFI)
and NIDRR’s Final Long-Range Plan for
FY 2005–2009 (Plan). The NFI can be
accessed on the Internet at the following
site: https://www.whitehouse.gov/
infocus/newfreedom. The Plan, which
was published in the Federal Register
on February 15, 2006 (71 FR 8165), can
be accessed on the Internet at the
following site: https://www.ed.gov/
about/offices/list/osers/nidrr/
policy.html.
Through the implementation of the
NFI and the Plan, NIDRR seeks to: (1)
Improve the quality and utility of
disability and rehabilitation research;
(2) foster an exchange of expertise,
information, and training to facilitate
the advancement of knowledge and
understanding of the unique needs of
traditionally underserved populations;
(3) determine best strategies and
programs to improve rehabilitation
outcomes for underserved populations;
(4) identify research gaps; (5) identify
mechanisms of integrating research and
practice; and (6) disseminate findings.
One of the specific goals established
in the Plan is for NIDRR to publish all
of its proposed priorities, and following
public comment, final priorities,
annually, on a combined basis. Under
this approach, NIDRR’s constituents can
submit comments at one time rather
than at different times throughout the
year, and NIDRR can move toward a
fixed schedule for competitions and
more efficient grant-making operations.
This notice proposes priorities that
NIDRR intends to use for DRRP and
RERC competitions in FY 2007 and
possibly later years. However, nothing
precludes NIDRR from publishing
additional priorities, if needed.
Furthermore, NIDRR is under no
obligation to make an award for each of
these priorities. The decision to make an
award will be based on the quality of
applications received and available
funding.
For FY 2007 competitions using
priorities that already have been
established and for which publication of
a notice of proposed priority is
unnecessary (e.g., competitions for
Field-Initiated Projects, Advanced
Rehabilitation Research Training
Projects, Fellowships, and Small
Business Innovation Research Projects),
NIDRR has published or will publish
notices inviting applications. In
addition to this notice, on June 7, 2006,
NIDRR published a separate notice of
proposed priorities for a DRRP on
Vocational Rehabilitation: Transition
Services that Lead to Competitive
Employment Outcomes for TransitionAge Individuals With Blindness or
Other Visual Impairment (71 FR 32938).
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More information on these other
projects and programs that NIDRR
intends to fund in FY 2007 can be found
on the Internet at the following site:
https://www.ed.gov/fund/grant/apply/
nidrr/priority-matrix.html.
Invitation to Comment: We invite you
to submit comments regarding these
proposed priorities. To ensure that your
comments have maximum effect in
developing the notice of final priorities,
we urge you to identify clearly the
specific proposed priority or topic that
each comment addresses.
We invite you to assist us in
complying with the specific
requirements of Executive Order 12866
and its overall requirement of reducing
regulatory burden that might result from
these proposed priorities. Please let us
know of any further opportunities we
should take to reduce potential costs or
increase potential benefits while
preserving the effective and efficient
administration of the program.
During and after the comment period,
you may inspect all public comments
about these proposed priorities in room
6030, 550 12th Street, SW., Potomac
Center Plaza, Washington, DC, between
the hours of 8:30 a.m. and 4 p.m.,
Eastern time, Monday through Friday of
each week except Federal holidays.
Assistance to Individuals With
Disabilities in Reviewing the
Rulemaking Record
On request, we will supply an
appropriate aid, such as a reader or
print magnifier, to an individual with a
disability who needs assistance to
review the comments or other
documents in the public rulemaking
record for these proposed priorities. If
you want to schedule an appointment
for this type of aid, please contact the
person listed under FOR FURTHER
INFORMATION CONTACT.
We will announce the final priorities
in one or more notices in the Federal
Register. We will determine the final
priorities after considering responses to
this notice and other information
available to the Department. This notice
does not preclude us from proposing or
using additional priorities, subject to
meeting applicable rulemaking
requirements.
Note: This notice does not solicit
applications. In any year in which we choose
to use these proposed priorities, we invite
applications through a notice in the Federal
Register. When inviting applications we
designate the priorities as absolute,
competitive preference, or invitational. The
effect of each type of priority follows:
Absolute priority: Under an absolute
priority, we consider only applications that
meet the priority (34 CFR 75.105(c)(3)).
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Competitive preference priority: Under a
competitive preference priority, we give
competitive preference to an application by
either (1) Awarding additional points,
depending on how well or the extent to
which the application meets the competitive
preference priority (34 CFR 75.105(c)(2)(i));
or (2) selecting an application that meets the
competitive preference priority over an
application of comparable merit that does not
meet the priority (34 CFR 75.105(c)(2)(ii)).
Invitational priority: Under an invitational
priority, we are particularly interested in
applications that meet the invitational
priority. However, we do not give an
application that meets the invitational
priority a competitive or absolute preference
over other applications (34 CFR 75.105(c)(1)).
Priorities: In this notice, we are
proposing 4 priorities for DRRPs and 7
priorities for RERCs.
For DRRPs, the proposed priorities
are:
• Priority 1—National Data and
Statistical Center for the Burn Model
Systems.
• Priority 2—Burn Model Systems
(BMS) Centers.
• Priority 3—Inclusive Emergency
Evacuation of Individuals with
Disabilities.
• Priority 4—Traumatic Brain Injury
Model Systems (TBIMS) Centers.
For RERCs, the proposed priorities
are:
• Priority 5—RERC for Spinal Cord
Injury.
• Priority 6—RERC for Recreational
Technologies and Exercise Physiology
Benefiting Individuals with Disabilities.
• Priority 7—RERC for Translating
Physiological Data into Predictions for
Functional Performance.
• Priority 8—RERC for Accessible
Medical Instrumentation.
• Priority 9—RERC for Workplace
Accommodations.
• Priority 10—RERC for
Rehabilitation Robotics and
Telemanipulation Systems.
• Priority 11—RERC for Emergency
Management Technologies.
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Disability and Rehabilitation Research
Projects (DRRP) Program
The purpose of the DRRP program is
to plan and conduct research,
demonstration projects, training, and
related activities to develop methods,
procedures, and rehabilitation
technology that maximize the full
inclusion and integration into society,
employment, independent living, family
support, and economic and social selfsufficiency of individuals with
disabilities, especially individuals with
the most severe disabilities, and to
improve the effectiveness of services
authorized under the Rehabilitation Act
of 1973, as amended. DRRPs carry out
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one or more of the following types of
activities, as specified and defined in 34
CFR 350.13 through 350.19: research,
development, demonstration, training,
dissemination, utilization, and technical
assistance.
An applicant for assistance under this
program must demonstrate in its
application how it will address, in
whole or in part, the needs of
individuals with disabilities from
minority backgrounds (34 CFR
350.40(a)). The approaches an applicant
may take to meet this requirement are
found in 34 CFR 350.40(b). In addition,
NIDRR intends to require all DRRP
applicants to meet the requirements of
the General Disability and
Rehabilitation Research Projects (DRRP)
Requirements priority that it published
in a notice of final priorities in the
Federal Register on April 28, 2006 (71
FR 25472).
Additional information on the DRRP
program can be found at: https://
www.ed.gov/rschstat/research/pubs/resprogram.html#DRRP.
Proposed Priorities
Priority 1—National Data and Statistical
Center for the Burn Model Systems
Background
It is estimated that there are more
than 1 million burn injuries in the
United States each year. Approximately
700,000 of these burn injuries are
treated in emergency departments
annually, and 54,000 are severe enough
to require hospitalization (Esselman et
al., 2006; American Burn Association,
2002).
In recent years, burn survivability has
increased dramatically. This
improvement in survival rates has
brought rehabilitation issues to the
forefront of care for burn survivors and
led to increased demands for researchbased knowledge about the post-acute
experiences and needs of burn survivors
(Esselman et al., 2006).
NIDRR created the Burn Injury
Rehabilitation Model Systems of Care
(BMS) in 1994 to provide leadership in
rehabilitation as a key component of
exemplary burn care and to advance the
research base of rehabilitation services
for burn survivors. The centers funded
under the BMS program (BMS Centers)
establish and carry out projects that
provide a coordinated system of care
including emergency care, acute care
management, comprehensive inpatient
rehabilitation, and long-term
interdisciplinary follow-up services. In
addition, the BMS program carries out
innovative projects for the delivery,
demonstration, and evaluation of
comprehensive medical, vocational, and
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other rehabilitation services to meet the
wide range of needs of individuals with
burn injury.
The BMS Centers have developed a
longitudinal database that contains
information on approximately 4,700
people injured since 1994 (BMS
Database). The BMS Database is
emerging as an important source of
information about the characteristics
and life course of individuals with burn
injury. The BMS Database can be used
to examine specific outcomes of burn
injury. NIDRR seeks to continue and
build upon this data source by funding
a National Data and Statistical Center
for the BMS (National BMS Data Center)
that will maintain the BMS Database
and improve the quality of information
that is entered into it.
The BMS Database is a collaborative
project in which all of the BMS Centers
are required to participate. The data for
the BMS Database are collected by the
BMS Centers. The directors of the BMS
Centers, including the National BMS
Data Center, in consultation with
NIDRR, determine the parameters of the
BMS Database, including the number
and type of variables to be examined,
the criteria for including BMS patients
in the database, and the frequency and
timing of data collection.
The specifications of the BMS
Database as it is currently implemented
can be obtained from the BMS Database
Coordination Center. The BMS Database
Coordination Center may be contacted
on the World Wide Web at https://bmsdcc.uchsc.edu/.
References
ABA National Burn Repository
Report, 2002. https://
www.ameriburn.org/pub/NBR.htm.
Esselman, P., Thombs, B., Fauerbach,
J., Magyar-Russell, G., & Price, M.
(2006). Burn State of the Science
Review. In Press. American Journal of
Physical Medicine and Rehabilitation.
Proposed Priority
The Assistant Secretary for Special
Education and Rehabilitative Services
proposes a priority for the establishment
of a National Data and Statistical Center
for the Burn Model Systems (National
BMS Data Center). The National BMS
Data Center must advance medical
rehabilitation by increasing the rigor
and efficiency of scientific efforts to
assess the experience of individuals
with burn injury. To meet this priority,
the National BMS Data Center’s research
and technical assistance must be
designed to contribute to the following
outcomes:
(a) Maintenance of a national
longitudinal database (BMS Database)
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for data submitted by each of the Burn
Model Systems centers (BMS Centers).
This database must provide for
confidentiality, quality control, and
data-retrieval capabilities, using costeffective and user-friendly technology.
(b) High-quality, reliable data in the
BMS Database. The National BMS Data
Center must contribute to this outcome
by providing training and technical
assistance to BMS Centers on subject
retention and data collection
procedures, data entry methods, and
appropriate use of study instruments,
and by monitoring the quality of the
data submitted by the BMS Centers.
(c) Rigorous research conducted by
BMS Centers. To help in the
achievement of this outcome, the
National BMS Data Center must make
statistical and other methodological
consultation available for research
projects that use the BMS Database, as
well as center-specific and collaborative
projects of the BMS program.
(d) Improved efficiency of the BMS
Database operations. The National BMS
Data Center must pursue strategies to
achieve this outcome, such as
collaborating with the National Data and
Statistical Center for Traumatic Brain
Injury Model Systems, the National Data
and Statistical Center for Spinal Cord
Injury Model Systems, and the Model
Systems Knowledge Translation Center.
Priority 2—Burn Model System (BMS)
Centers
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Background
The American Burn Association
(ABA) reported that about 54,000
Americans, one-third under age 20, are
hospitalized for severe burn treatment
every year. Of this number, 5,500 die
(ABA National Burn Repository Report,
2002; https://www.ameriburn.org/pub/
NBR.htm). Burn injury is a catastrophic
event that can result in significant
impairment of an individual’s physical
function. Relatively little has been
written about physical rehabilitation of
individuals following a burn injury
(Sliwa et al., 2005).
NIDRR created the Burn Injury
Rehabilitation Model Systems of Care
(BMS) in 1994 to provide leadership in
rehabilitation as a key component of
exemplary burn care and to advance the
research base of rehabilitation services
for burn survivors. The centers funded
under the BMS program (BMS Centers)
establish and carry out projects that
provide a coordinated system of care
including emergency care, acute care
management, comprehensive inpatient
rehabilitation, and long-term
interdisciplinary follow-up services. In
addition, the BMS program carries out
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innovative projects for the delivery,
demonstration, and evaluation of
comprehensive medical, vocational, and
other rehabilitation services to meet the
wide range of needs of individuals with
burn injury.
Currently, four BMS Centers conduct
research activities designed to improve
rehabilitative and pharmacological
interventions that can help optimize
levels of community participation,
employment, and overall quality of life
for individuals with burn injury. Each
center provides comprehensive
rehabilitation services to individuals
with burn injury and conducts burn
research, including clinical research and
the analysis of standardized data in
collaboration with other related
projects. The BMS Centers have
developed a longitudinal database that
contains information on over 3,046
adults and more than 1,602 children
(BMS Database). Additional information
on the BMS Database funded in 1998
can be found at https://bmsdcc.uchsc.edu).
Rehabilitation issues of concern to
NIDRR include methods of measuring
functional outcomes following burn
injury. Recently, it is reported that the
most widely used assessment of
function following injury, the functional
independence measure (FIM), may not
be sufficient to measure functional
outcomes following burn injuries (Sliwa
et al., 2005). NIDRR is also concerned
about such issues as the effectiveness of
specific rehabilitation interventions;
psychosocial adjustment following burn
injury; cognitive functioning following
burn injury; and long-term outcomes
following burn injury, including
community integration and return to
work.
In 2005, NIDRR conducted a review of
its current BMS program. It is NIDRR’s
intent that, through funding of BMS
Centers under the following proposed
priority, the BMS program will serve as
a platform for multi-site research that
contributes to the formulation of
practice guidelines to improve
rehabilitation outcomes for individuals
with burn injury.
References
ABA National Burn Repository
Report, 2002. https://
www.ameriburn.org/pub/NBR.htm.
Sliwa, J. A., Heinemann, A., Semik, P.
(2005). Inpatient Rehabilitation
Following Burn Injury: Patient
Demographics and Functional
Outcomes. Archives of Physical
Medicine and Rehabilitation, 86: 1920–
1923.
Raymond, I., Ancoli-Israel, S.,
Choiniere, M. (2004). Sleep
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Disturbances, Pain, and Analgesia in
Adults Hospitalization for Burn Injuries.
Sleep Medicine, 5(6): 551–559.
Proposed Priority
The Assistant Secretary for Special
Education and Rehabilitative Services
proposes a priority for the funding of
Burn Model Systems (BMS) centers
(BMS Center) under the Disability and
Rehabilitation Research Projects (DRRP)
Program to conduct research that
contributes to evidence-based
rehabilitation interventions and clinical
as well as practice guidelines that
improve the lives of individuals with
burn injury. Each BMS Center must—
(a) Contribute to continued
assessment of long-term outcomes of
burn injury by enrolling at least 30
subjects per year into the national
longitudinal database for BMS data
maintained by the National Data and
Statistical Center for the BMS, following
established protocols for the collection
of enrollment and follow-up data on
subjects;
(b) Contribute to improved outcomes
for individuals with burn injury by
proposing one collaborative research
module project and participating in at
least one collaborative research module
project, which may range from pilot
research to more extensive studies; and
(c) Contribute to improved long-term
outcomes of individuals with burn
injury by conducting no more than two
site-specific research projects to test
innovative approaches that contribute to
rehabilitation interventions and
evaluating burn injury outcomes in
accordance with the focus areas
identified in NIDRR’s Final Long-Range
Plan for FY 2005–2009 (Plan).
Applicants who propose more than two
site-specific projects will be
disqualified.
In carrying out these activities, each
BMS Center may select from the
following research domains related to
specific areas of the Plan: Health and
function, employment, participation
and community living, and technology
for access and function.
In addition, each BMS Center must—
(1) Provide a multidisciplinary system
of rehabilitation care specifically
designed to meet the needs of
individuals with burn injury. The
system must encompass a continuum of
care, including emergency medical
services, acute care services, acute
medical rehabilitation services, and
post-acute services; and
(2) Coordinate with the NIDRRfunded Model Systems Knowledge
Translation Center to provide scientific
results and information for
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dissemination to clinical and consumer
audiences.
Priority 3—Inclusive Emergency
Evacuation of Individuals With
Disabilities
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Background
Executive Order 13347, Individuals
with Disabilities in Emergency
Preparedness, directs the Federal
Government to protect the safety and
security of individuals with disabilities
in disasters. Legal requirements related
to nondiscrimination, architectural and
communications access, technology,
transportation, and other areas, such as
those contained in the Americans with
Disabilities Act of 1990, as amended, 42
U.S.C. 12101 et seq. (ADA) and relevant
court decisions, apply in emergency
situations as well.
Incorporating disability
considerations into emergency
evacuation, planning, preparation, and
other activities is critical. Currently,
there is insufficient evidence on
demonstrating the most effective ways
to ensure the safety of individuals with
disabilities during emergency situations.
For example, many individuals with
disabilities rely on elevators, accessible
transportation, and accessible
communications, all of which can be
compromised during disasters or other
emergency situations (Executive Order
13347, Annual Report, 2005).
Additional research is needed on
approaches to evacuation that include
the evacuation of individuals with
disabilities (e.g., physical, sensory,
mental impairments).
A study by the National Council on
Disability states that, while there is a
wealth of anecdotal reports by the
disability community about their
experiences in disaster situations, there
is scarce research related to people with
disabilities in disaster planning,
mitigation, preparedness, response, and
recovery. This study also reports that: ‘‘a
common theme emerging after 9/11 is
there are virtually no empirical data on
the safe and efficient evacuation of
persons with disabilities in emergency
planning’’ (National Council on
Disability, 2005). Increased knowledge
about devices, systems, plans,
standards, and the incorporation of
disability considerations into
mainstream emergency management
initiatives are needed in order to build
system capacity and improve outcomes
for individuals with disabilities in
emergencies.
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References
Americans with Disabilities Act of
1990, as amended, 42 U.S.C. 12101 et
seq.
National Council on Disability, Saving
Lives: Including People with Disabilities
in Emergency Planning. April 2005.
Available at: https://www.ncd.gov.
U.S. Department of Homeland
Security, Individuals with Disabilities
in Emergency Preparedness: Executive
Order 13347, Annual Report. July 2005.
Available at: https://www.dhs.gov/
disabilitypreparednessicc.
Proposed Priority
The Assistant Secretary for Special
Education and Rehabilitative Services
proposes a priority for a Disability
Rehabilitation Research Project (DRRP)
on Inclusive Emergency Evacuation of
Individuals with Disabilities to conduct
research that contributes to the
development of evidence-based
emergency evacuation procedures to
improve outcomes for individuals with
disabilities. Under this priority, the
DRRP must be designed to contribute to
the following outcomes:
(a) Increased evidence-based
knowledge about the inclusive
evacuation of individuals with
disabilities from one or more of the
following areas: buildings,
transportation systems, and geographic
locations (e.g., cities and States). The
DRRP must contribute to this outcome
by—(1) Synthesizing the current
evidence base in one or more of the
following areas: disability-related
evacuation devices, plans, exercises,
protocols, models, systems, networks,
and standards; (2) identifying, for the
areas identified in (a)(1) of this priority,
the components and specifications
needed for reliable, usable, accessible,
safe, and effective evacuation of
individuals with disabilities; and (3)
assessing the degree to which the areas
selected in (a)(1) of this priority
contains the components or
specifications identified in (a)(2) of this
priority.
(b) Increased implementation of
disability-related evacuation solutions
within existing emergency management
initiatives. The DRRP must contribute to
this outcome by—(1) Examining barriers
and facilitators to effective
implementation of disability-related
evacuation solutions within existing
emergency management initiatives
(including but not limited to
communication between key
stakeholders and attitudinal barriers);
and (2) working with the emergency
management community to propose
solutions to the barriers identified in
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accordance with paragraph (b)(1) of this
priority.
In addition to the above outcomes,
applicants must:
• Define, in their applications, the
parameters and units of analysis for
their proposed activities. Applications
must include a description of each of
the following: (1) Type of evacuation
(i.e., evacuation from buildings,
transportation systems, geographic
locations such as cities or States); (2)
target population (e.g., with physical,
sensory, mental impairments); and (3)
type of response (e.g., devices, plans,
exercises, protocols, models, systems,
networks, or standards).
• Demonstrate in their applications
how they plan to implement a
sustained, meaningful, and integrated
collaboration throughout the project
with key stakeholders, including but not
limited to the following: (1) Disability
and aging advocates, organizations,
disability subject matter experts, and
qualified individuals with disabilities;
(2) fire engineers, homeland security
and preparedness personnel, and other
mainstream emergency management
professionals and associations; (3)
industry, standard-setting organizations,
and other relevant stakeholders
involved in standards development; (4)
researchers (including researchers
working on projects funded by NIDRR,
other government agencies, and
researchers in the private sector); and
(5) relevant Federal agencies, including
but not limited to those participating in
the Interagency Coordinating Council on
Emergency Preparedness and
Individuals with Disabilities.
Priority 4—Traumatic Brain Injury
Model Systems (TBIMS) Centers
Background
The Centers for Disease Control and
Prevention (CDC) report that at least 1.4
million people sustain a traumatic brain
injury (TBI) in the United States each
year (Langlois, Rutland-Brown, &
Thomas, 2004). Of these, approximately
50,000 die, 235,000 are hospitalized,
and 1.1 million are treated and released
from emergency departments. These
estimates do not include those
individuals who sustained a TBI and
did not seek medical care or were seen
only in private doctors’ offices. The
three leading causes of TBI are motor
vehicle/traffic collisions, falls and
assaults.
Disabilities resulting from TBI depend
on several factors such as the severity
and location of the injury, length of
impaired consciousness, age and general
health of the patient, and the intensity
of rehabilitation services (Cifu, Kreutzer,
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Kolakowsky-Hayner, Marwtiz &
Englander, 2003; Dikmen, Machamer,
Powell & Temkin, 2003; Sarajuuri,
Kaipio, Koskinen, Niemela, Servo &
Vilkki, 2005). Common disabilities
resulting from TBI include problems
with cognition, sensory processing,
communication, and behavioral or
mental health; and some TBI survivors
develop long-term medical
complications (National Institute of
Neurological Disorders and Stroke,
2002). CDC reports that each year an
estimated 80,000 to 90,000 Americans
sustain TBI resulting in permanent
disability. At least 5.3 million
Americans have a long-term or lifelong
need for help to perform activities of
daily living as a result of TBI (Thurman,
Alverson, Dunn, Guerrero, & Sniezek,
1999).
The Traumatic Brain Injury Model
Systems (TBIMS) program was created
by NIDRR in 1987 to demonstrate the
benefits of a coordinated system of
neurotrauma and rehabilitation care and
to conduct innovative research on all
aspects of care for those who sustain
TBI. NIDRR currently funds 16 TBIMS
centers throughout the United States.
These centers provide comprehensive
systems of brain injury care to
individuals who sustain TBI and
conduct TBI research, including clinical
research and the analysis of
standardized data in collaboration with
other related projects. The mission of
the TBIMS is to improve the lives of
persons who experience TBI, and of
their families and communities by
creating and disseminating new
knowledge about the natural course of
TBI and rehabilitation treatment and
outcomes following TBI.
For purposes of the TBIMS, TBI is
defined as damage to brain tissue
caused by an external mechanical force
as evidenced by loss of consciousness or
post-traumatic amnesia due to brain
trauma or by objective neurological
findings that can be reasonably
attributed to TBI on physical
examination or mental status
examination. Both penetrating and nonpenetrating wounds that fit this criteria
are included, but, primary anoxic
encephalopathy is not.
Each TBIMS center funded under this
program should be designed to offer a
multidisciplinary system for providing
rehabilitation services specifically
designed to meet the special needs of
individuals with TBI. These services
span the continuum of treatment from
acute care through community re-entry.
TBIMS centers engage in initiatives and
new approaches and maintain close
working relationships with other
governmental and non profit
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institutions and organizations to
coordinate scientific efforts, encourage
joint planning, and promote the
interchange of data and reports among
TBI researchers. As part of these
cooperative efforts, TBIMS centers
participate in collaborative research
module projects, which range from pilot
research to more extensive studies.
A committee consisting of the
individual TBIMS project program
directors has, since its inception, guided
the TBIMS program. This group meets
bi-annually in Washington, DC, and, in
consultation with NIDRR, develops and
oversees the policies of the TBIMS.
NIDRR intends for the work of this
group to continue.
Since 1989, the TBIMS centers have
collected and contributed information
on common data elements for a
centralized TBIMS database, which is
maintained through a NIDRR-funded
grant for a National Data and Statistical
Center for the TBIMS. (Additional
information on the TBIMS database can
be found at https://tbindc.org). The TBI
National Data and Statistical Center for
the TBIMS coordinates data collection,
manages the TBIMS database, and
provides statistical support to the model
systems projects. To date, TBIMS
centers have contributed 5,756 cases to
the TBIMS database, with follow up
data extending to 15 years post injury.
References
Cifu, D.X., Kreutzer, J.S., KolakowskyHayner, S.A., Marwitz, J.H., &
Englander, J. (2003). The Relationship
Between Therapy Intensity and
Rehabilitative Outcomes after Traumatic
Brain Injury: A Multicenter Analysis.
Archives of Physical Medicine and
Rehabilitation, 84(10): 1441–8.
Dikmen, S.S., Machamer, J.E., Powell,
J.M., & Temkin, N.R. (2003). Outcome 3
to 5 Years After Moderate to Severe
Traumatic Brain Injury. Archives of
Physical Medicine and Rehabilitation,
84(10): 1449–57.
Langlois, J.A., Rutland-Brown, W., &
Thomas, K.E. (2004). Traumatic Brain
Injury in the United States: Emergency
Department Visits, Hospitalizations, and
Deaths. Atlanta, GA: Centers for Disease
Control and Prevention, National Center
for Injury Prevention and Control.
National Institute of Neurological
Disorders and Stroke (NINDS). (2002,
February). Traumatic Brain Injury: Hope
Through Research. Bethesda, MD:
National Institute of Health. NIH
Publication No. 02–2478. Retrieved
February 2, 2006, from the NINDS Web
site: https://www.ninds.nih.gov/
disorders/tbi/detail_tbi.htm.
Sarajuuri, J.M., Kaipio, M.L.,
Koskinen, S.K., Niemela, M.R., Servo,
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A.R., & Vilkki, J.S. (2005). Outcome of
a Comprehensive Neurorehabilitation
Program for Patients with Traumatic
Brain Injury. Archives of Physical
Medicine and Rehabilitation, 86(12):
2296–302.
Thurman, D.J., Alverson, C.A., Dunn,
K.A., Guerrero, J., & Sniezek, J.E. (1999).
Traumatic Brain Injury in the United
States: A Public Health Perspective.
Journal of Head Trauma Rehabilitation,
14(6): 602–615.
Proposed Priority
The Assistant Secretary for Special
Education and Rehabilitative Services
proposes a priority for Traumatic Brain
Injury Model Systems (TBIMS) centers
under the Disability and Rehabilitation
Research Projects (DRRP) program to
conduct research that contributes to
evidence-based rehabilitation
interventions which improve the lives
of individuals with traumatic brain
injury (TBI). Each TBIMS center must
contribute to the following outcomes:
(a) Continued assessment of long-term
outcomes of TBI by enrolling at least 35
subjects per year into the longitudinal
portion of the TBIMS database
maintained by the National Data and
Statistical Center for the TBIMS,
following established protocols for the
collection of enrollment and follow-up
data on subjects.
(b) Improved outcomes for
individuals with TBI by proposing one
collaborative research module project
and participating in at least one
collaborative research module project,
which may range from pilot research to
more extensive studies (At the
beginning of the funding cycle, the
TBIMS directors, in conjunction with
NIDRR, will select specific modules for
implementation from the approved
applications).
(c) Improved long-term outcomes of
individuals with TBI by conducting no
more than two site-specific research
projects to test innovative approaches
that contribute to rehabilitation
interventions and evaluating TBI
outcomes in accordance with the focus
areas identified in NIDRR’s Long-Range
Plan for FY 2005–2009. Applicants who
propose more than two site-specific
projects will be disqualified.
In carrying out each of these research
activities, each TBIMS Center may
select from the following research
domains related to specific areas of the
Plan: Health and Function,
Employment, Participation and
Community Living, and Technology for
Access and Function.
In addition, each TBIMS Center
must—
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(1) Provide a multidisciplinary system
of rehabilitation care specifically
designed to meet the needs of
individuals with TBI. The system must
encompass a continuum of care,
including emergency medical services,
acute care services, acute medical
rehabilitation services, and post-acute
services; and
(2) Coordinate with the NIDRRfunded Model Systems Knowledge
Translation Center to provide scientific
results and information for
dissemination to clinical and consumer
audiences.
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Rehabilitation Engineering Research
Centers Program General Requirements
of Rehabilitation Engineering Research
Centers (RERCs)
RERCs carry out research or
demonstration activities in support of
the Rehabilitation Act of 1973, as
amended, by—
• Developing and disseminating
innovative methods of applying
advanced technology, scientific
achievement, and psychological and
social knowledge to: (a) Solve
rehabilitation problems and remove
environmental barriers; and (b) study
and evaluate new or emerging
technologies, products, or environments
and their effectiveness and benefits; or
• Demonstrating and disseminating:
(a) Innovative models for the delivery of
cost-effective rehabilitation technology
services to rural and urban areas; and (b)
other scientific research to assist in
meeting the employment and
independent living needs of individuals
with severe disabilities; and
• Facilitating service delivery systems
change through: (a) The development,
evaluation, and dissemination of
consumer-responsive and individual
and family-centered innovative models
for the delivery to both rural and urban
areas of innovative cost-effective
rehabilitation technology services; and
(b) other scientific research to assist in
meeting the employment and
independence needs of individuals with
severe disabilities.
Each RERC must be operated by or in
collaboration with one or more
institutions of higher education or one
or more nonprofit organizations.
Each RERC must provide training
opportunities, in conjunction with
institutions of higher education and
nonprofit organizations, to assist
individuals, including individuals with
disabilities, to become rehabilitation
technology researchers and
practitioners.
Additional information on the RERC
program can be found at: https://
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www.ed.gov/rschstat/research/pubs/
index.html.
Priorities 5, 6, 7, 8, 9, 10, and 11—
Rehabilitation Engineering Research
Centers (RERCs) for Spinal Cord Injury
(Priority 5), Recreational Technologies
and Exercise Physiology Benefiting
Individuals With Disabilities (Priority 6),
Translating Physiological Data Into
Predictions for Functional Performance
(Priority 7), Accessible Medical
Instrumentation (Priority 8), Workplace
Accommodations (Priority 9),
Rehabilitation Robotics and
Telemanipulation Systems (Priority 10),
and Emergency Management
Technologies (Priority 11)
Background
Individuals with disabilities regularly
use products developed through
rehabilitation and biomedical research
to achieve and maintain maximum
physical function, live independently,
study and learn, and attain gainful
employment. The range of engineering
research encompasses not only assistive
technology but also technology at the
systems level (e.g., the built
environment, information and
communication technologies, and
transportation) and technology that
interfaces between individuals and
systems and is basic to community
integration.
The NIDRR RERC program has been a
major force in the development of
technology to enhance independent
function for individuals with
disabilities. The RERCs are recognized
as national centers of excellence in their
respective areas and collectively
represent the largest federally supported
program responsible for advancing
rehabilitation engineering research. For
example, the RERC program was an
early pioneer in the development of
augmentative communication and has
been at the forefront of prosthetics and
orthotics research for both children and
adults. RERCs have played a major role
in the development of voluntary
standards that the medical equipment
and technology industries use when
developing wheelchairs, wheelchair
restraint systems, information
technologies, and the World Wide Web.
RERCs also have been a driving force in
the development of universal design
principles that can be applied to the
built environment, information
technology, and consumer products.
Advancements in basic biomedical
science and technology have resulted in
new opportunities to further enhance
the lives of individuals with disabilities.
Specifically, recent advances in
biomaterials research, composite
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technologies, information and
telecommunication technologies,
nanotechnologies, micro electro
mechanical systems (MEMS), sensor
technologies, and the neurosciences
provide a wealth of opportunities for
individuals with disabilities and could
be incorporated into research focused
on disability and rehabilitation.
Through the following proposed
priorities, NIDRR intends to fund RERCs
that advance rehabilitation engineering
in the following research areas: Spinal
Cord Injury, Recreational Technologies
and Exercise Physiology Benefiting
People with Disabilities, Translating
Physiological Data into Predictions for
Functional Performance, Accessible
Medical Instrumentation, Workplace
Accommodations, Rehabilitation
Robotics and Telemanipulation
Systems, and Emergency Management
Technologies.
Priority 5—RERC for Spinal Cord Injury
It is estimated that the number of
Americans living with traumatic spinal
cord injury (SCI) ranges from 222,000 to
285,000, with an incidence of
approximately 11,000 new cases each
year (Spinal Cord Injury: Facts and
Figures at a Glance, 2004).
Technology plays a pivotal role in the
lives of individuals with SCI, starting
with the onset of injury and continuing
into the individual’s reintegration into
community life (Cooper, 2004). The
development of cutting-edge devices
and the application of existing
technologies such as integrated control
systems, robotics, and neuroprosthetics
can help individuals with SCI perform
activities of daily living and work, and
participate in their communities. These
devices can enhance the mobility and
function of users with SCI, which in
turn, aids in the preservation of their
overall health. Enhanced mobility,
function and overall health are vital to
the independence and quality of life of
individuals with SCI. Accordingly,
NIDRR seeks to fund an RERC that
focuses on improving the quality of life
of individuals with SCI and promotes
health, rehabilitation, independence,
and community participation.
References
Spinal Cord Injury: Facts and Figures
at a Glance. (2004). Retrieved February
13, 2006 from the National Data and
Statistical Center for Spinal Cord Injury
Model Systems Web site: https://
www.spinalcord.uab.edu.
Cooper, R.A. (2004). Bioengineering
and Spinal Cord Injury: A Perspective
on the State of the Science. The Journal
of Spinal Cord Medicine; 27: 351–364.
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Priority 6—RERC for Recreational
Technologies and Exercise Physiology
Benefiting Individuals With Disabilities
Individuals with disabilities are
generally less likely to be physically
active than their non-disabled peers.
However, regular physical activity,
sports participation, and active
recreation are important contributors to
the prevention of disease, promotion of
health, and maintenance of functional
independence for all individuals,
including individuals with disabilities.
Several studies have demonstrated that
many persons with a variety of
disabilities benefit from increased levels
of physical activity, as evidenced by
alterations in various components of
their physical fitness (Ada, Dean, Hall,
Bampton, Crompton, 2003; Hicks,
Martin, Ditor, Latimer, Craven,
Bugaresti, McCartney, 2003; Husted,
Pham, Hekking, Niederman, 1999;
Romberg, Virtanen, Ruutiainen, Aunola,
Karppi, Vaara, Surakka, Pohjolainen,
Seppanen, 2004).
Accessible recreation requires more
than ramps or automatic door openers at
buildings containing recreational space.
In a recreational facility, equipment and
programs themselves contribute to an
environment that promotes equal access
or creates a barrier to pursuing
recreational goals. Recreational
equipment needs obvious and easy
adjustability, variable range of motion,
adequate surrounding space, and
transferability (North Carolina Office on
Disability and Health (2001)).
Furthermore, recreational spaces are in
need of accessible points of entry and
accessible surfacing (North Carolina
Office on Disability and Health (2001)).
Although modifications to
recreational equipment have been made,
such as swing away seats to allow use
from a wheelchair or the addition of
Braille instructions, these modifications
are not universal and recreational
equipment remains a primary barrier to
physical activity participation (Rimmer,
J.H., Riley, B., Wang, E., Rauworth, A.
(2005)). Existing recreational
technologies are in need of new features
to increase access to and participation
in recreational environments by
individuals with disabilities. In
addition, newly improved and novel
recreational technologies need to be
researched and tested to demonstrate
the degree to which they can increase
access to and participation in
recreational environments by
individuals with disabilities.
Accordingly, NIDRR seeks to fund an
RERC that facilitates equitable access to,
and safe use of, recreational equipment,
facilities, and programs, and will reduce
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debilitating secondary conditions
associated with disability and sedentary
lifestyle.
References
Ada, L., Dean, C.M., Hall, J.M.,
Bampton, J., Crompton, S. (2003). A
Treadmill and Overground Walking
Program Improves Walking in Persons
Residing in the Community After
Stroke: A Placebo-Controlled,
Randomized Trial. Archives of Physical
Medicine and Rehabilitation, Oct.;
84(10): 1486–91.
Hicks, A.L., Martin, K.A., Ditor, D.S.,
Latimer, A.E., Craven, C., Bugaresti, J.,
McCartney, N. (2003). Long-term
Exercise Training in Persons with
Spinal Cord Injury: Effects on Strength,
Arm Ergometry Performance and
Psychological Well-Being. Spinal Cord,
Jan.; 41(1): 34–43.
Husted, C., Pham, L., Hekking, A.,
Niederman, R. (1999). Improving
Quality of Life for People with Chronic
Conditions: The Example of T’ai Chi
and Multiple Sclerosis. Alternative
Therapies in Health Medicine, Sep.;
5(5): 70–4.
Romberg, A., Virtanen, A.,
Ruutiainen, J., Aunola, S., Karppi, S.L.,
Vaara, M., Surakka, J., Pohjolainen, T.,
Seppanen, A. (2004). Effects of a 6Month Exercise Program on Patients
with Multiple Sclerosis: A Randomized
Study. Neurology, Dec. 14; 63(11):
2034–8.
North Carolina Office on Disability
and Health (2001). Removing Barriers to
Health Clubs and Fitness Facilities.
Chapel Hill, NC: Frank Porter Graham
Child Development Center.
Rimmer, J.H., Riley, B., Wang, E.,
Rauworth, A. (2005). Accessibility of
Health Clubs for People with Mobility
Disabilities and Visual Impairments.
American Journal of Public Health,
Nov.; 95(11): 2022–8.
Priority 7—RERC for Translating
Physiological Data Into Predictions for
Functional Performance
The fields of biomedical and
rehabilitation engineering have
produced and applied a wide variety of
instruments and devices to measure the
physiological capacity of the human
body. Many of these measurement tools,
which examine parameters such as
range of motion, force, gait, and
electrophysiological features, have been
applied by physiatrists and other allied
professionals in research or practice in
physical medicine and rehabilitation
(Hesse, et al., 2002; Koontz, et al., 2005;
Wimalartna, et al., 2002).
To realize the potential for these
physiological measures to shape clinical
practices and services, biomedical
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engineers and rehabilitation clinicians
must develop methods for translating
physiological measures into predictions
for functional performance. One
example would be translating the results
of a strength measure into a prognosis
for the capacity to carry out a particular
activity of daily living (ADL). NIDRR,
therefore, seeks to fund an RERC that
develops and evaluates models and
methods to determine the relationship
between physiological measures and the
capacity to perform basic tasks among
individuals with disabilities.
References
Hesse, S., Schmidt, H., Werner, C.,
Bardeleben, A. (2002). Upper and Lower
Extremity Robotic Devices for
Rehabilitation and for Studying Motor
Control. Current Opinion in Neurology,
Dec.; 16(6): 705–10.
Koontz, A.M., Cooper, R.A., Boninger,
M.L., Yang, Y., Impink, B.G., van der
Woude, L.H. (2005). A Kinetic Analysis
of Manual Wheelchair Propulsion
During Start-Up on Select Indoor and
Outdoor Surfaces. Journal of
Rehabilitation Research and
Development, Jul.–Aug.; 42(4): 447–58.
Wimalaratna, H.S., Tooley, M.A.,
Churchill, E., Preece, A.W., Morgan,
H.M. (2002). Quantitative Surface EMG
in the Diagnosis of Neuromuscular
Disorders. Electromyography and
Clinical Neurophysiology, 2002 Apr.–
May.; 42(3): 167–74.
Priority 8—RERC for Accessible Medical
Instrumentation
The aim of ‘‘The Surgeon General’s
Call to Action to Improve the Health
and Wellness of Persons with
Disabilities’’ is for people with
disabilities to achieve full access to
disease prevention and health
promotion services (The Surgeon
General’s Call To Action To Improve the
Health and Wellness of Persons with
Disabilities, 2005). Building upon the
American with Disability Act of 1990, as
amended, mandate of equal access to
public accommodations and services,
the second of four major goals within
the Surgeon General’s call-to-action is
to: ‘‘Increase knowledge among health
care professionals and provide them
with tools to screen, diagnose, and treat
the whole person with a disability with
dignity.’’
Many medical devices in use today
are not readily accessible to individuals
with disabilities. For example, research
examining the accessibility of
mammography equipment found that
inaccessible health care facilities and
medical equipment make it less likely
that women with disabilities will
receive breast cancer screening (Nosek,
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2000). In addition, accessibility issues
are apparent with many other medical
devices such as exam tables, x-ray
equipment, rehabilitation equipment,
and weight scales (Winters, et al., 2005).
Accordingly, NIDRR seeks to fund an
RERC that facilitates equitable access to,
and use of, healthcare facilities and
equipment by people with disabilities.
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References
U.S. Department of Health and
Human Services. The Surgeon General’s
Call to Action to Improve the Health
and Wellness of Persons with
Disabilities. U.S. Department of Health
and Human Services, Office of the
Surgeon General, 2005.
Nosek, M.A. (2000). The John Stanley
Coulter lecture. Overcoming the Odds:
The Health of Women with Physical
Disabilities in the United States.
Archives of Physical Medicine and
Rehabilitation, 81(2): 135–8.
Winters, J.M., Story, M.F., Barnekow,
K., Isaacson Kailes, J., Premo, B.,
Schwier, E., Winters, J.M. (2005)
Accessibility of Medical
Instrumentation: A National Healthcare
Consumer Survey, Proc. RESNA 2005
Annual Conference, Atlanta, GA, June,
2005.
Priority 9—RERC for Workplace
Accommodations
Individuals with disabilities
experience low rates of employment and
are less likely to be highly educated
than are individuals without
disabilities. Despite several national
programs and policies that address this
disparity, employment rates for people
with disabilities have remained stable or
declined in the past decade (2003 CPS
Employment Rates). The lack of an
accessible work environment may
partially explain the decline in
employment rates among individuals
with disabilities.
Functional limitations in areas such
as motor functioning, communication,
sensation and perception, and cognitive
functioning all present barriers to
employment and maintenance of
employment by people with disabilities
(Williams, M., Sabata, D., Zolna, J.
(2006)). Modifications in the work
environment often remove or reduce
these barriers. Examples of
modifications include ramps, automatic
door openers, alternate computer
systems, voice output devices for
persons with visual impairments, and
customized desks and worktables.
Evaluating the effectiveness of existing
individualized accommodations and
new technologies that can potentially be
integrated into the design of work
environments also may help to reduce
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employment barriers. Moreover, the
need persists for more comprehensive
empirical evidence about the human
factors of the workplace environment
and workplace technology used by
people with disabilities. For example,
workplace and task assessment using
ergonomic, anthropometric, and
kinematic analysis is needed for
individuals with disabilities. In
addition, new tools for assessing
changes in function, skills, and abilities
should be developed for individuals
with disabilities (Dowler, D. L., Hirsch,
A. E., Kittle, R. D., and Hendricks, D. J.
(1996)) and technology resources should
be systematically considered at all
stages of an individual’s employment
and overall rehabilitation process
(Langton, A.J., and Ramseur, H. (2001)).
Accordingly, NIDRR seeks to fund an
RERC that facilitates equitable access to,
and use of, workplace equipment and
facilities and otherwise promotes safety,
independence, and active engagement
in the workplace by individuals with
disabilities.
References
Vocational Economics, Inc. (2003).
2003 CPS Employment Rates. https://
www.vocecon.com/technical/DATA/
newcps.htm.
Williams, M., Sabata, D., Zolna, J.
(2006). A Survey of Workplace
Accommodation Needs of Older
Workers and Persons with Disabilities
Proc. RESNA 2006 Annual Conference,
Atlanta, GA, June, 2006.
Dowler, D. L., Hirsch, A. E., Kittle, R.
D., and Hendricks, D. J. (1996).
Outcomes of Reasonable
Accommodations in the Workplace.
Technology and Disability, 5 (1996)
345–354.
Langton, A.J., and Ramseur, H. (2001).
Enhancing Employment Outcomes
Through Job Accommodation and
Assistive Technology Resources and
Services. Journal of Vocational
Rehabilitation, 16 (2001) 27–37.
Priority 10—RERC for Rehabilitation
Robotics and Telemanipulation Systems
Rehabilitation of physical impairment
is labor intensive, often relying on oneon-one interactions and hands-on
manipulations by physicians and
therapists. Technologies are now
available to help replicate these
therapeutic manipulations so that
individuals can practice therapy on
their own in a clinic or possibly at
home. Several studies suggest that
appropriately designed robotic
rehabilitation therapy may be used for
the assessment and treatment of motor
impairments (Lum, Burgar, Shor,
Majmundar, & Van der Loos, 2002;
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Reinkensmeyer, Hogan, Krebs, Lehman,
& Lum, 2000; Riener, Lunenburger,
Jezernik, Anderschitz, Colombo, &
Dietz, 2005).
By replicating therapy techniques that
normally require one-on-one contact
with clinicians, robotic manipulators
could increase access to therapy,
increase time spent in therapy,
potentially reduce the cost of therapy,
and possibly achieve better outcomes
than traditional rehabilitation therapies.
Accordingly, NIDRR seeks to fund an
RERC that evaluates the efficacy of
rehabilitation robotic therapies and
researches and develops innovative
technologies and techniques to improve
the current state of the science and
usability of rehabilitation robotic
therapies for individuals with
disabilities.
References
Lum, P.S., Burgar, C.G., Shor, P.C.,
Majmundar, M., and Van der Loos,
H.F.M. (2002). Robot-Assisted
Movement Training Compared with
Conventional Therapy Techniques for
the Rehabilitation of Upper Limb Motor
Function Following Stroke. Archives of
Physical Medicine and Rehabilitation,
Jul.; 83(7): 952–9.
Reinkensmeyer, D., Hogan, N., Krebs,
H., Lehman, S., and Lum, P. (2000).
Rehabilitators, Robots, and Guides: New
Tools for Neurological Rehabilitation: In
Biomechanics and Neural Control of
Posture and Movement, J. Winters and
P. Crago, Eds., 2 ed: Springer-Verlag,
2000, 516–533.
Riener, R., Lunenburger, L., Jezernik,
S., Anderschitz, M., Colombo, G., Dietz,
V. (2005). Patient-Cooperative Strategies
for Robot-Aided Treadmill Training:
First Experimental Results. IEEE
Transactions on Neural Systems and
Rehabilitation Engineering, Sep.; 13(3):
380–94.
Priority 11—RERC for Emergency
Management Technologies
Although disasters and emergencies
may have a greater impact on
individuals with disabilities, their needs
and concerns in the areas of emergency
preparedness, response, and recovery
are often overlooked (National Council
on Disability, 2005). Many individuals
with disabilities rely on elevators,
accessible transportation, and accessible
communications, all of which can be
compromised during disasters or
emergency situations (Executive Order
13347, Annual Report, 2005). The aim
of Executive Order 13347 is to ensure
that the Federal Government
appropriately supports safety and
security for individuals with
disabilities. Accordingly, NIDRR seeks
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to fund an RERC that researches,
develops, and evaluates emergency
management technologies and
implementation plans to support the
full inclusion of people with
disabilities.
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References
National Council on Disability, Saving
Lives: Including People with Disabilities
in Emergency Planning. April 2005.
Available at: https://www.ncd.gov/
newsroom/publications/2005/
saving_lives.htm#purpose.
U.S. Department of Homeland
Security, Individuals with Disabilities
in Emergency Preparedness: Executive
Order 13347, Annual Report, July 2005.
Proposed Priorities
The Assistant Secretary for Special
Education and Rehabilitative Services
proposes seven priorities for the
establishment of (a) An RERC for Spinal
Cord Injury (Priority 5), (b) an RERC for
Recreational Technologies and Exercise
Physiology Benefiting Individuals with
Disabilities (Priority 6), (c) an RERC for
Translating Physiological Data into
Predictions for Functional Performance
(Priority 7), (d) an RERC for Accessible
Medical Instrumentation (Priority 8), (e)
an RERC for Workplace
Accommodations (Priority 9), (f) an
RERC for Rehabilitation Robotics and
Telemanipulation Systems (Priority 10),
and (g) an RERC for Emergency
Management Technologies (Priority 11).
Within its designated priority research
area, each RERC will focus on
innovative technological solutions, new
knowledge, and concepts that will
improve the lives of persons with
disabilities.
(a) RERC for Spinal Cord Injury
(Priority 5). Under this priority, the
RERC must research, develop and
evaluate innovative technologies and
approaches that will improve the
treatment, rehabilitation, employment,
and reintegration into society of persons
with spinal cord injury. This RERC must
work collaboratively with the NIDRRfunded Spinal Cord Injury Model
Systems Centers program;
(b) RERC for Recreational
Technologies and Exercise Physiology
Benefiting Individuals With Disabilities
(Priority 6). Under this priority, the
RERC must research, develop, and
evaluate innovative technologies and
strategies that will enhance recreational
opportunities for individuals with
disabilities and develop methods to
enhance the physical performance of
individuals with disabilities;
(c) RERC for Translating Physiological
Data into Predictions for Functional
Performance (Priority 7). Under this
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priority, the RERC must determine the
physiological measurement tools that
are available in a specific sub-specialty
of rehabilitation. A sub-specialty may be
based on underlying disabling condition
(e.g., spinal cord injury, and Parkinson’s
disease), or on specific sequelae that
may be common to a wide variety of
disabling conditions (e.g., pain,
spasticity). The RERC must then
develop and evaluate models and
methods for determining the
relationships between basic
physiological measurements and
functional performance. These models
and methods must take the
characteristics of individuals and their
environments into consideration when
attempting to delineate these
relationships, so that the results of this
research are relevant to clinical practice
and the real-world experiences of
individuals with disabilities.
(d) RERC for Accessible Medical
Instrumentation (Priority 8). Under this
priority, the RERC must research,
develop, and evaluate innovative
methods and technologies to increase
the usability and accessibility of
diagnostic, therapeutic, and procedural
healthcare equipment (e.g., equipment
used during medical examinations, and
treatment) for individuals with
disabilities. This includes developing
methods and technologies that are
useable and accessible for patients and
health care providers with disabilities.
(e) RERC for Workplace
Accommodations (Priority 9). Under
this priority, the RERC must research,
develop, and evaluate innovative
technologies and implementation plans,
devices, and systems to enhance the
productivity of individuals with
disabilities in the workplace. This RERC
must emphasize the application of
universal design concepts to improve
the accessibility of the workplace and
workplace tools for all workers.
(f) RERC for Rehabilitation Robotics
and Telemanipulation Systems (Priority
10). Under this priority, the RERC must
research, develop, and evaluate humanscale robots and telemanipulation
systems that will provide or perform
rehabilitation therapies and address the
unique needs of individuals with
disabilities.
(g) RERC for Emergency Management
Technologies (Priority 11). Under this
priority, the RERC must research,
develop, and evaluate existing and
innovative emergency management
technologies to enhance emergency
outcomes for individuals with
disabilities. Areas of focus within this
priority research area may include but
are not limited to communications,
transportation, evacuation, and other
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Fmt 4701
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areas related to emergency
preparedness, response, and recovery.
In addition, this RERC must provide
input and expertise into the
development of standards to improve
emergency management for individuals
with disabilities. This RERC must work
collaboratively with the NIDRR-funded
Disability and Rehabilitation Research
Project: Inclusive Emergency Evacuation
of People with Disabilities.
Under each priority, the RERC must
be designed to contribute to the
following programmatic outcomes:
(1) Increased technical and scientific
knowledge-base relevant to its
designated priority research area. The
RERC must contribute to this outcome
by conducting high-quality, rigorous
research and development projects.
(2) Innovative technologies, products,
environments, performance guidelines,
and monitoring and assessment tools as
applicable to its designated priority
research area. The RERC must
contribute to this outcome by
developing and testing these
innovations.
(3) Improved research capacity in its
designated priority research area. The
RERC must contribute to this outcome
by collaborating with the relevant
industry, professional associations, and
institutions of higher education.
(4) Improved focus on cutting edge
developments in technologies within its
designated priority research area. The
RERC must contribute to this outcome
by identifying and communicating with
NIDRR and the field regarding trends
and evolving product concepts related
to its designated priority research area.
(5) Increased impact of research in the
designated priority research area. The
RERC must contribute to this outcome
by providing technical assistance to
public and private organizations,
individuals with disabilities, and
employers on policies, guidelines, and
standards related to its designated
priority research area.
In addition, under each priority, the
RERC must—
• Have the capability to design, build,
and test prototype devices and assist in
the transfer of successful solutions to
relevant production and service delivery
settings;
• Evaluate the efficacy and safety of
its new products, instrumentation, or
assistive devices;
• Provide as part of its proposal and
then implement a plan that describes
how it will include, as appropriate,
individuals with disabilities or their
representatives in all phases of its
activities, including research,
development, training, dissemination,
and evaluation;
E:\FR\FM\19SEN2.SGM
19SEN2
Federal Register / Vol. 71, No. 181 / Tuesday, September 19, 2006 / Notices
• Provide as part of its proposal and
then implement, in consultation with
the NIDRR-funded National Center for
the Dissemination of Disability Research
(NCDDR), a plan to disseminate its
research results to individuals with
disabilities, their representatives,
disability organizations, service
providers, professional journals,
manufacturers, and other interested
parties;
• Develop and implement in the first
year of the project period, in
consultation with the NIDRR-funded
RERC on Technology Transfer, a plan
for ensuring that all new and improved
technologies developed by the RERC are
successfully transferred to the
marketplace;
• Conduct a state-of-the-science
conference on its designated priority
research area in the fourth year of the
project period and publish a
comprehensive report on the final
outcomes of the conference in the fifth
year of the project period; and
• Coordinate research projects of
mutual interest with relevant NIDRRfunded projects, as identified through
consultation with the NIDRR project
officer.
ycherry on PROD1PC64 with NOTICES2
Executive Order 12866
This notice of proposed priorities has
been reviewed in accordance with
Executive Order 12866. Under the terms
of the order, we have assessed the
potential costs and benefits of this
regulatory action.
The potential costs associated with
this notice of proposed priorities are
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those resulting from statutory
requirements and those we have
determined as necessary for
administering this program effectively
and efficiently.
In assessing the potential costs and
benefits—both quantitative and
qualitative—of this notice of proposed
priorities, we have determined that the
benefits of the proposed priorities
justify the costs.
Summary of Potential Costs and
Benefits
The benefits of the Disability and
Rehabilitation Research Projects and
Centers Programs have been well
established over the years in that similar
projects have been completed
successfully. These proposed priorities
will generate new knowledge and
technologies through research,
development, dissemination, utilization,
and technical assistance projects.
Another benefit of these proposed
priorities is that the establishment of
new DRRPs and new RERCs will
support the President’s NFI and will
improve the lives of persons with
disabilities. The new DRRPs and RERCs
will generate, disseminate, and promote
the use of new information that will
improve the options for individuals
with disabilities to perform regular
activities in the community.
Intergovernmental Review
This program is not subject to
Executive Order 12372 and the
regulations in 34 part 79.
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54879
Applicable Program Regulations: 34
CFR part 350.
Electronic Access to This Document
You may view this document, as well
as all other Department of Education
documents published in the Federal
Register, in text or Adobe Portable
Document Format (PDF) on the Internet
at the following site: https://www.ed.gov/
news/fedregister.
To use PDF you must have Adobe
Acrobat Reader, which is available free
at this site. If you have questions about
using PDF, call the U.S. Government
Printing Office (GPO), toll free, at 1–
888–293–6498; or in the Washington,
DC area at (202) 512–1530.
Note: The official version of this document
is the document published in the Federal
Register. Free Internet access to the official
edition of the Federal Register and the Code
of Federal Regulations is available on GPO
Access at: https://www.gpoaccess.gov/nara/
index.html.
(Catalog of Federal Domestic Assistance
Numbers 84.133A Disability Rehabilitation
Research Projects and 84.133E Rehabilitation
Engineering Research Centers Program)
Program Authority: 29 U.S.C. 762(g),
764(a), 764(b)(2), and 764(b)(3).
Dated: September 13, 2006.
John H. Hager,
Assistant Secretary for Special Education and
Rehabilitative Services.
[FR Doc. E6–15548 Filed 9–18–06; 8:45 am]
BILLING CODE 4000–01–P
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Agencies
[Federal Register Volume 71, Number 181 (Tuesday, September 19, 2006)]
[Notices]
[Pages 54870-54879]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E6-15548]
[[Page 54869]]
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Part II
Department of Education
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Notice of Proposed Priorities for Disability and Rehabilitation
Research Projects and Rehabilitation Engineering Research Centers;
Notice
Federal Register / Vol. 71, No. 181 / Tuesday, September 19, 2006 /
Notices
[[Page 54870]]
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DEPARTMENT OF EDUCATION
National Institute on Disability and Rehabilitation Research--
Disability and Rehabilitation Research Projects and Centers Program--
Disability Rehabilitation Research Projects (DRRPs) and Rehabilitation
Engineering Research Centers (RERCs)
AGENCY: Office of Special Education and Rehabilitative Services,
Department of Education.
ACTION: Notice of proposed priorities for DRRPs and RERCs.
-----------------------------------------------------------------------
SUMMARY: The Assistant Secretary for Special Education and
Rehabilitative Services proposes certain funding priorities for the
Disability and Rehabilitation Research Projects and Centers Program
administered by the National Institute on Disability and Rehabilitation
Research (NIDRR). Specifically, this notice proposes four priorities
for DRRPs and seven priorities for RERCs. The Assistant Secretary may
use these priorities for competitions in fiscal year (FY) 2007 and
later years. We take this action to focus research attention on areas
of national need. We intend these priorities to improve rehabilitation
services and outcomes for individuals with disabilities.
DATES: We must receive your comments on or before October 19, 2006.
ADDRESSES: Address all comments about these proposed priorities to
Donna Nangle, U.S. Department of Education, 400 Maryland Avenue, SW.,
room 6030, Potomac Center Plaza, Washington, DC 20204-2700. If you
prefer to send your comments through the Internet, use the following
address: donna.nangle@ed.gov.
You must include the term ``Proposed Priorities for DRRPs and
RERCs'' in the subject line of your electronic message.
FOR FURTHER INFORMATION CONTACT: Donna Nangle or Lynn Medley.
Telephone: (202) 245-7462 (Donna Nangle) or (202) 245-7338 (Lynn
Medley).
If you use a telecommunications device for the deaf (TDD), you may
call the Federal Relay Service (FRS) at 1-800-877-8339.
Individuals with disabilities may obtain this document in an
alternative format (e.g., Braille, large print, audiotape, or computer
diskette) on request to the contact person listed under FOR FURTHER
INFORMATION CONTACT.
SUPPLEMENTARY INFORMATION: This notice of proposed priorities is in
concert with President George W. Bush's New Freedom Initiative (NFI)
and NIDRR's Final Long-Range Plan for FY 2005-2009 (Plan). The NFI can
be accessed on the Internet at the following site: https://
www.whitehouse.gov/infocus/newfreedom. The Plan, which was published in
the Federal Register on February 15, 2006 (71 FR 8165), can be accessed
on the Internet at the following site: https://www.ed.gov/about/offices/
list/osers/nidrr/policy.html.
Through the implementation of the NFI and the Plan, NIDRR seeks to:
(1) Improve the quality and utility of disability and rehabilitation
research; (2) foster an exchange of expertise, information, and
training to facilitate the advancement of knowledge and understanding
of the unique needs of traditionally underserved populations; (3)
determine best strategies and programs to improve rehabilitation
outcomes for underserved populations; (4) identify research gaps; (5)
identify mechanisms of integrating research and practice; and (6)
disseminate findings.
One of the specific goals established in the Plan is for NIDRR to
publish all of its proposed priorities, and following public comment,
final priorities, annually, on a combined basis. Under this approach,
NIDRR's constituents can submit comments at one time rather than at
different times throughout the year, and NIDRR can move toward a fixed
schedule for competitions and more efficient grant-making operations.
This notice proposes priorities that NIDRR intends to use for DRRP and
RERC competitions in FY 2007 and possibly later years. However, nothing
precludes NIDRR from publishing additional priorities, if needed.
Furthermore, NIDRR is under no obligation to make an award for each of
these priorities. The decision to make an award will be based on the
quality of applications received and available funding.
For FY 2007 competitions using priorities that already have been
established and for which publication of a notice of proposed priority
is unnecessary (e.g., competitions for Field-Initiated Projects,
Advanced Rehabilitation Research Training Projects, Fellowships, and
Small Business Innovation Research Projects), NIDRR has published or
will publish notices inviting applications. In addition to this notice,
on June 7, 2006, NIDRR published a separate notice of proposed
priorities for a DRRP on Vocational Rehabilitation: Transition Services
that Lead to Competitive Employment Outcomes for Transition-Age
Individuals With Blindness or Other Visual Impairment (71 FR 32938).
More information on these other projects and programs that NIDRR
intends to fund in FY 2007 can be found on the Internet at the
following site: https://www.ed.gov/fund/grant/apply/nidrr/priority-
matrix.html.
Invitation to Comment: We invite you to submit comments regarding
these proposed priorities. To ensure that your comments have maximum
effect in developing the notice of final priorities, we urge you to
identify clearly the specific proposed priority or topic that each
comment addresses.
We invite you to assist us in complying with the specific
requirements of Executive Order 12866 and its overall requirement of
reducing regulatory burden that might result from these proposed
priorities. Please let us know of any further opportunities we should
take to reduce potential costs or increase potential benefits while
preserving the effective and efficient administration of the program.
During and after the comment period, you may inspect all public
comments about these proposed priorities in room 6030, 550 12th Street,
SW., Potomac Center Plaza, Washington, DC, between the hours of 8:30
a.m. and 4 p.m., Eastern time, Monday through Friday of each week
except Federal holidays.
Assistance to Individuals With Disabilities in Reviewing the Rulemaking
Record
On request, we will supply an appropriate aid, such as a reader or
print magnifier, to an individual with a disability who needs
assistance to review the comments or other documents in the public
rulemaking record for these proposed priorities. If you want to
schedule an appointment for this type of aid, please contact the person
listed under FOR FURTHER INFORMATION CONTACT.
We will announce the final priorities in one or more notices in the
Federal Register. We will determine the final priorities after
considering responses to this notice and other information available to
the Department. This notice does not preclude us from proposing or
using additional priorities, subject to meeting applicable rulemaking
requirements.
Note: This notice does not solicit applications. In any year in
which we choose to use these proposed priorities, we invite
applications through a notice in the Federal Register. When inviting
applications we designate the priorities as absolute, competitive
preference, or invitational. The effect of each type of priority
follows:
Absolute priority: Under an absolute priority, we consider only
applications that meet the priority (34 CFR 75.105(c)(3)).
[[Page 54871]]
Competitive preference priority: Under a competitive preference
priority, we give competitive preference to an application by either
(1) Awarding additional points, depending on how well or the extent
to which the application meets the competitive preference priority
(34 CFR 75.105(c)(2)(i)); or (2) selecting an application that meets
the competitive preference priority over an application of
comparable merit that does not meet the priority (34 CFR
75.105(c)(2)(ii)).
Invitational priority: Under an invitational priority, we are
particularly interested in applications that meet the invitational
priority. However, we do not give an application that meets the
invitational priority a competitive or absolute preference over
other applications (34 CFR 75.105(c)(1)).
Priorities: In this notice, we are proposing 4 priorities for DRRPs
and 7 priorities for RERCs.
For DRRPs, the proposed priorities are:
Priority 1--National Data and Statistical Center for the
Burn Model Systems.
Priority 2--Burn Model Systems (BMS) Centers.
Priority 3--Inclusive Emergency Evacuation of Individuals
with Disabilities.
Priority 4--Traumatic Brain Injury Model Systems (TBIMS)
Centers.
For RERCs, the proposed priorities are:
Priority 5--RERC for Spinal Cord Injury.
Priority 6--RERC for Recreational Technologies and
Exercise Physiology Benefiting Individuals with Disabilities.
Priority 7--RERC for Translating Physiological Data into
Predictions for Functional Performance.
Priority 8--RERC for Accessible Medical Instrumentation.
Priority 9--RERC for Workplace Accommodations.
Priority 10--RERC for Rehabilitation Robotics and
Telemanipulation Systems.
Priority 11--RERC for Emergency Management Technologies.
Disability and Rehabilitation Research Projects (DRRP) Program
The purpose of the DRRP program is to plan and conduct research,
demonstration projects, training, and related activities to develop
methods, procedures, and rehabilitation technology that maximize the
full inclusion and integration into society, employment, independent
living, family support, and economic and social self-sufficiency of
individuals with disabilities, especially individuals with the most
severe disabilities, and to improve the effectiveness of services
authorized under the Rehabilitation Act of 1973, as amended. DRRPs
carry out one or more of the following types of activities, as
specified and defined in 34 CFR 350.13 through 350.19: research,
development, demonstration, training, dissemination, utilization, and
technical assistance.
An applicant for assistance under this program must demonstrate in
its application how it will address, in whole or in part, the needs of
individuals with disabilities from minority backgrounds (34 CFR
350.40(a)). The approaches an applicant may take to meet this
requirement are found in 34 CFR 350.40(b). In addition, NIDRR intends
to require all DRRP applicants to meet the requirements of the General
Disability and Rehabilitation Research Projects (DRRP) Requirements
priority that it published in a notice of final priorities in the
Federal Register on April 28, 2006 (71 FR 25472).
Additional information on the DRRP program can be found at: https://
www.ed.gov/rschstat/research/pubs/res-program.html#DRRP.
Proposed Priorities
Priority 1--National Data and Statistical Center for the Burn Model
Systems
Background
It is estimated that there are more than 1 million burn injuries in
the United States each year. Approximately 700,000 of these burn
injuries are treated in emergency departments annually, and 54,000 are
severe enough to require hospitalization (Esselman et al., 2006;
American Burn Association, 2002).
In recent years, burn survivability has increased dramatically.
This improvement in survival rates has brought rehabilitation issues to
the forefront of care for burn survivors and led to increased demands
for research-based knowledge about the post-acute experiences and needs
of burn survivors (Esselman et al., 2006).
NIDRR created the Burn Injury Rehabilitation Model Systems of Care
(BMS) in 1994 to provide leadership in rehabilitation as a key
component of exemplary burn care and to advance the research base of
rehabilitation services for burn survivors. The centers funded under
the BMS program (BMS Centers) establish and carry out projects that
provide a coordinated system of care including emergency care, acute
care management, comprehensive inpatient rehabilitation, and long-term
interdisciplinary follow-up services. In addition, the BMS program
carries out innovative projects for the delivery, demonstration, and
evaluation of comprehensive medical, vocational, and other
rehabilitation services to meet the wide range of needs of individuals
with burn injury.
The BMS Centers have developed a longitudinal database that
contains information on approximately 4,700 people injured since 1994
(BMS Database). The BMS Database is emerging as an important source of
information about the characteristics and life course of individuals
with burn injury. The BMS Database can be used to examine specific
outcomes of burn injury. NIDRR seeks to continue and build upon this
data source by funding a National Data and Statistical Center for the
BMS (National BMS Data Center) that will maintain the BMS Database and
improve the quality of information that is entered into it.
The BMS Database is a collaborative project in which all of the BMS
Centers are required to participate. The data for the BMS Database are
collected by the BMS Centers. The directors of the BMS Centers,
including the National BMS Data Center, in consultation with NIDRR,
determine the parameters of the BMS Database, including the number and
type of variables to be examined, the criteria for including BMS
patients in the database, and the frequency and timing of data
collection.
The specifications of the BMS Database as it is currently
implemented can be obtained from the BMS Database Coordination Center.
The BMS Database Coordination Center may be contacted on the World Wide
Web at https://bms-dcc.uchsc.edu/.
References
ABA National Burn Repository Report, 2002. https://
www.ameriburn.org/pub/NBR.htm.
Esselman, P., Thombs, B., Fauerbach, J., Magyar-Russell, G., &
Price, M. (2006). Burn State of the Science Review. In Press. American
Journal of Physical Medicine and Rehabilitation.
Proposed Priority
The Assistant Secretary for Special Education and Rehabilitative
Services proposes a priority for the establishment of a National Data
and Statistical Center for the Burn Model Systems (National BMS Data
Center). The National BMS Data Center must advance medical
rehabilitation by increasing the rigor and efficiency of scientific
efforts to assess the experience of individuals with burn injury. To
meet this priority, the National BMS Data Center's research and
technical assistance must be designed to contribute to the following
outcomes:
(a) Maintenance of a national longitudinal database (BMS Database)
[[Page 54872]]
for data submitted by each of the Burn Model Systems centers (BMS
Centers). This database must provide for confidentiality, quality
control, and data-retrieval capabilities, using cost-effective and
user-friendly technology.
(b) High-quality, reliable data in the BMS Database. The National
BMS Data Center must contribute to this outcome by providing training
and technical assistance to BMS Centers on subject retention and data
collection procedures, data entry methods, and appropriate use of study
instruments, and by monitoring the quality of the data submitted by the
BMS Centers.
(c) Rigorous research conducted by BMS Centers. To help in the
achievement of this outcome, the National BMS Data Center must make
statistical and other methodological consultation available for
research projects that use the BMS Database, as well as center-specific
and collaborative projects of the BMS program.
(d) Improved efficiency of the BMS Database operations. The
National BMS Data Center must pursue strategies to achieve this
outcome, such as collaborating with the National Data and Statistical
Center for Traumatic Brain Injury Model Systems, the National Data and
Statistical Center for Spinal Cord Injury Model Systems, and the Model
Systems Knowledge Translation Center.
Priority 2--Burn Model System (BMS) Centers
Background
The American Burn Association (ABA) reported that about 54,000
Americans, one-third under age 20, are hospitalized for severe burn
treatment every year. Of this number, 5,500 die (ABA National Burn
Repository Report, 2002; https://www.ameriburn.org/pub/NBR.htm). Burn
injury is a catastrophic event that can result in significant
impairment of an individual's physical function. Relatively little has
been written about physical rehabilitation of individuals following a
burn injury (Sliwa et al., 2005).
NIDRR created the Burn Injury Rehabilitation Model Systems of Care
(BMS) in 1994 to provide leadership in rehabilitation as a key
component of exemplary burn care and to advance the research base of
rehabilitation services for burn survivors. The centers funded under
the BMS program (BMS Centers) establish and carry out projects that
provide a coordinated system of care including emergency care, acute
care management, comprehensive inpatient rehabilitation, and long-term
interdisciplinary follow-up services. In addition, the BMS program
carries out innovative projects for the delivery, demonstration, and
evaluation of comprehensive medical, vocational, and other
rehabilitation services to meet the wide range of needs of individuals
with burn injury.
Currently, four BMS Centers conduct research activities designed to
improve rehabilitative and pharmacological interventions that can help
optimize levels of community participation, employment, and overall
quality of life for individuals with burn injury. Each center provides
comprehensive rehabilitation services to individuals with burn injury
and conducts burn research, including clinical research and the
analysis of standardized data in collaboration with other related
projects. The BMS Centers have developed a longitudinal database that
contains information on over 3,046 adults and more than 1,602 children
(BMS Database). Additional information on the BMS Database funded in
1998 can be found at https://bms-dcc.uchsc.edu).
Rehabilitation issues of concern to NIDRR include methods of
measuring functional outcomes following burn injury. Recently, it is
reported that the most widely used assessment of function following
injury, the functional independence measure (FIM), may not be
sufficient to measure functional outcomes following burn injuries
(Sliwa et al., 2005). NIDRR is also concerned about such issues as the
effectiveness of specific rehabilitation interventions; psychosocial
adjustment following burn injury; cognitive functioning following burn
injury; and long-term outcomes following burn injury, including
community integration and return to work.
In 2005, NIDRR conducted a review of its current BMS program. It is
NIDRR's intent that, through funding of BMS Centers under the following
proposed priority, the BMS program will serve as a platform for multi-
site research that contributes to the formulation of practice
guidelines to improve rehabilitation outcomes for individuals with burn
injury.
References
ABA National Burn Repository Report, 2002. https://
www.ameriburn.org/pub/NBR.htm.
Sliwa, J. A., Heinemann, A., Semik, P. (2005). Inpatient
Rehabilitation Following Burn Injury: Patient Demographics and
Functional Outcomes. Archives of Physical Medicine and Rehabilitation,
86: 1920-1923.
Raymond, I., Ancoli-Israel, S., Choiniere, M. (2004). Sleep
Disturbances, Pain, and Analgesia in Adults Hospitalization for Burn
Injuries. Sleep Medicine, 5(6): 551-559.
Proposed Priority
The Assistant Secretary for Special Education and Rehabilitative
Services proposes a priority for the funding of Burn Model Systems
(BMS) centers (BMS Center) under the Disability and Rehabilitation
Research Projects (DRRP) Program to conduct research that contributes
to evidence-based rehabilitation interventions and clinical as well as
practice guidelines that improve the lives of individuals with burn
injury. Each BMS Center must--
(a) Contribute to continued assessment of long-term outcomes of
burn injury by enrolling at least 30 subjects per year into the
national longitudinal database for BMS data maintained by the National
Data and Statistical Center for the BMS, following established
protocols for the collection of enrollment and follow-up data on
subjects;
(b) Contribute to improved outcomes for individuals with burn
injury by proposing one collaborative research module project and
participating in at least one collaborative research module project,
which may range from pilot research to more extensive studies; and
(c) Contribute to improved long-term outcomes of individuals with
burn injury by conducting no more than two site-specific research
projects to test innovative approaches that contribute to
rehabilitation interventions and evaluating burn injury outcomes in
accordance with the focus areas identified in NIDRR's Final Long-Range
Plan for FY 2005-2009 (Plan). Applicants who propose more than two
site-specific projects will be disqualified.
In carrying out these activities, each BMS Center may select from
the following research domains related to specific areas of the Plan:
Health and function, employment, participation and community living,
and technology for access and function.
In addition, each BMS Center must--
(1) Provide a multidisciplinary system of rehabilitation care
specifically designed to meet the needs of individuals with burn
injury. The system must encompass a continuum of care, including
emergency medical services, acute care services, acute medical
rehabilitation services, and post-acute services; and
(2) Coordinate with the NIDRR-funded Model Systems Knowledge
Translation Center to provide scientific results and information for
[[Page 54873]]
dissemination to clinical and consumer audiences.
Priority 3--Inclusive Emergency Evacuation of Individuals With
Disabilities
Background
Executive Order 13347, Individuals with Disabilities in Emergency
Preparedness, directs the Federal Government to protect the safety and
security of individuals with disabilities in disasters. Legal
requirements related to nondiscrimination, architectural and
communications access, technology, transportation, and other areas,
such as those contained in the Americans with Disabilities Act of 1990,
as amended, 42 U.S.C. 12101 et seq. (ADA) and relevant court decisions,
apply in emergency situations as well.
Incorporating disability considerations into emergency evacuation,
planning, preparation, and other activities is critical. Currently,
there is insufficient evidence on demonstrating the most effective ways
to ensure the safety of individuals with disabilities during emergency
situations. For example, many individuals with disabilities rely on
elevators, accessible transportation, and accessible communications,
all of which can be compromised during disasters or other emergency
situations (Executive Order 13347, Annual Report, 2005). Additional
research is needed on approaches to evacuation that include the
evacuation of individuals with disabilities (e.g., physical, sensory,
mental impairments).
A study by the National Council on Disability states that, while
there is a wealth of anecdotal reports by the disability community
about their experiences in disaster situations, there is scarce
research related to people with disabilities in disaster planning,
mitigation, preparedness, response, and recovery. This study also
reports that: ``a common theme emerging after 9/11 is there are
virtually no empirical data on the safe and efficient evacuation of
persons with disabilities in emergency planning'' (National Council on
Disability, 2005). Increased knowledge about devices, systems, plans,
standards, and the incorporation of disability considerations into
mainstream emergency management initiatives are needed in order to
build system capacity and improve outcomes for individuals with
disabilities in emergencies.
References
Americans with Disabilities Act of 1990, as amended, 42 U.S.C.
12101 et seq.
National Council on Disability, Saving Lives: Including People with
Disabilities in Emergency Planning. April 2005. Available at: https://
www.ncd.gov.
U.S. Department of Homeland Security, Individuals with Disabilities
in Emergency Preparedness: Executive Order 13347, Annual Report. July
2005. Available at: https://www.dhs.gov/disabilitypreparednessicc.
Proposed Priority
The Assistant Secretary for Special Education and Rehabilitative
Services proposes a priority for a Disability Rehabilitation Research
Project (DRRP) on Inclusive Emergency Evacuation of Individuals with
Disabilities to conduct research that contributes to the development of
evidence-based emergency evacuation procedures to improve outcomes for
individuals with disabilities. Under this priority, the DRRP must be
designed to contribute to the following outcomes:
(a) Increased evidence-based knowledge about the inclusive
evacuation of individuals with disabilities from one or more of the
following areas: buildings, transportation systems, and geographic
locations (e.g., cities and States). The DRRP must contribute to this
outcome by--(1) Synthesizing the current evidence base in one or more
of the following areas: disability-related evacuation devices, plans,
exercises, protocols, models, systems, networks, and standards; (2)
identifying, for the areas identified in (a)(1) of this priority, the
components and specifications needed for reliable, usable, accessible,
safe, and effective evacuation of individuals with disabilities; and
(3) assessing the degree to which the areas selected in (a)(1) of this
priority contains the components or specifications identified in (a)(2)
of this priority.
(b) Increased implementation of disability-related evacuation
solutions within existing emergency management initiatives. The DRRP
must contribute to this outcome by--(1) Examining barriers and
facilitators to effective implementation of disability-related
evacuation solutions within existing emergency management initiatives
(including but not limited to communication between key stakeholders
and attitudinal barriers); and (2) working with the emergency
management community to propose solutions to the barriers identified in
accordance with paragraph (b)(1) of this priority.
In addition to the above outcomes, applicants must:
Define, in their applications, the parameters and units of
analysis for their proposed activities. Applications must include a
description of each of the following: (1) Type of evacuation (i.e.,
evacuation from buildings, transportation systems, geographic locations
such as cities or States); (2) target population (e.g., with physical,
sensory, mental impairments); and (3) type of response (e.g., devices,
plans, exercises, protocols, models, systems, networks, or standards).
Demonstrate in their applications how they plan to
implement a sustained, meaningful, and integrated collaboration
throughout the project with key stakeholders, including but not limited
to the following: (1) Disability and aging advocates, organizations,
disability subject matter experts, and qualified individuals with
disabilities; (2) fire engineers, homeland security and preparedness
personnel, and other mainstream emergency management professionals and
associations; (3) industry, standard-setting organizations, and other
relevant stakeholders involved in standards development; (4)
researchers (including researchers working on projects funded by NIDRR,
other government agencies, and researchers in the private sector); and
(5) relevant Federal agencies, including but not limited to those
participating in the Interagency Coordinating Council on Emergency
Preparedness and Individuals with Disabilities.
Priority 4--Traumatic Brain Injury Model Systems (TBIMS) Centers
Background
The Centers for Disease Control and Prevention (CDC) report that at
least 1.4 million people sustain a traumatic brain injury (TBI) in the
United States each year (Langlois, Rutland-Brown, & Thomas, 2004). Of
these, approximately 50,000 die, 235,000 are hospitalized, and 1.1
million are treated and released from emergency departments. These
estimates do not include those individuals who sustained a TBI and did
not seek medical care or were seen only in private doctors' offices.
The three leading causes of TBI are motor vehicle/traffic collisions,
falls and assaults.
Disabilities resulting from TBI depend on several factors such as
the severity and location of the injury, length of impaired
consciousness, age and general health of the patient, and the intensity
of rehabilitation services (Cifu, Kreutzer,
[[Page 54874]]
Kolakowsky-Hayner, Marwtiz & Englander, 2003; Dikmen, Machamer, Powell
& Temkin, 2003; Sarajuuri, Kaipio, Koskinen, Niemela, Servo & Vilkki,
2005). Common disabilities resulting from TBI include problems with
cognition, sensory processing, communication, and behavioral or mental
health; and some TBI survivors develop long-term medical complications
(National Institute of Neurological Disorders and Stroke, 2002). CDC
reports that each year an estimated 80,000 to 90,000 Americans sustain
TBI resulting in permanent disability. At least 5.3 million Americans
have a long-term or lifelong need for help to perform activities of
daily living as a result of TBI (Thurman, Alverson, Dunn, Guerrero, &
Sniezek, 1999).
The Traumatic Brain Injury Model Systems (TBIMS) program was
created by NIDRR in 1987 to demonstrate the benefits of a coordinated
system of neurotrauma and rehabilitation care and to conduct innovative
research on all aspects of care for those who sustain TBI. NIDRR
currently funds 16 TBIMS centers throughout the United States. These
centers provide comprehensive systems of brain injury care to
individuals who sustain TBI and conduct TBI research, including
clinical research and the analysis of standardized data in
collaboration with other related projects. The mission of the TBIMS is
to improve the lives of persons who experience TBI, and of their
families and communities by creating and disseminating new knowledge
about the natural course of TBI and rehabilitation treatment and
outcomes following TBI.
For purposes of the TBIMS, TBI is defined as damage to brain tissue
caused by an external mechanical force as evidenced by loss of
consciousness or post-traumatic amnesia due to brain trauma or by
objective neurological findings that can be reasonably attributed to
TBI on physical examination or mental status examination. Both
penetrating and non-penetrating wounds that fit this criteria are
included, but, primary anoxic encephalopathy is not.
Each TBIMS center funded under this program should be designed to
offer a multidisciplinary system for providing rehabilitation services
specifically designed to meet the special needs of individuals with
TBI. These services span the continuum of treatment from acute care
through community re-entry. TBIMS centers engage in initiatives and new
approaches and maintain close working relationships with other
governmental and non profit institutions and organizations to
coordinate scientific efforts, encourage joint planning, and promote
the interchange of data and reports among TBI researchers. As part of
these cooperative efforts, TBIMS centers participate in collaborative
research module projects, which range from pilot research to more
extensive studies.
A committee consisting of the individual TBIMS project program
directors has, since its inception, guided the TBIMS program. This
group meets bi-annually in Washington, DC, and, in consultation with
NIDRR, develops and oversees the policies of the TBIMS. NIDRR intends
for the work of this group to continue.
Since 1989, the TBIMS centers have collected and contributed
information on common data elements for a centralized TBIMS database,
which is maintained through a NIDRR-funded grant for a National Data
and Statistical Center for the TBIMS. (Additional information on the
TBIMS database can be found at https://tbindc.org). The TBI National
Data and Statistical Center for the TBIMS coordinates data collection,
manages the TBIMS database, and provides statistical support to the
model systems projects. To date, TBIMS centers have contributed 5,756
cases to the TBIMS database, with follow up data extending to 15 years
post injury.
References
Cifu, D.X., Kreutzer, J.S., Kolakowsky-Hayner, S.A., Marwitz, J.H.,
& Englander, J. (2003). The Relationship Between Therapy Intensity and
Rehabilitative Outcomes after Traumatic Brain Injury: A Multicenter
Analysis. Archives of Physical Medicine and Rehabilitation, 84(10):
1441-8.
Dikmen, S.S., Machamer, J.E., Powell, J.M., & Temkin, N.R. (2003).
Outcome 3 to 5 Years After Moderate to Severe Traumatic Brain Injury.
Archives of Physical Medicine and Rehabilitation, 84(10): 1449-57.
Langlois, J.A., Rutland-Brown, W., & Thomas, K.E. (2004). Traumatic
Brain Injury in the United States: Emergency Department Visits,
Hospitalizations, and Deaths. Atlanta, GA: Centers for Disease Control
and Prevention, National Center for Injury Prevention and Control.
National Institute of Neurological Disorders and Stroke (NINDS).
(2002, February). Traumatic Brain Injury: Hope Through Research.
Bethesda, MD: National Institute of Health. NIH Publication No. 02-
2478. Retrieved February 2, 2006, from the NINDS Web site: https://
www.ninds.nih.gov/disorders/tbi/detail_tbi.htm.
Sarajuuri, J.M., Kaipio, M.L., Koskinen, S.K., Niemela, M.R.,
Servo, A.R., & Vilkki, J.S. (2005). Outcome of a Comprehensive
Neurorehabilitation Program for Patients with Traumatic Brain Injury.
Archives of Physical Medicine and Rehabilitation, 86(12): 2296-302.
Thurman, D.J., Alverson, C.A., Dunn, K.A., Guerrero, J., & Sniezek,
J.E. (1999). Traumatic Brain Injury in the United States: A Public
Health Perspective. Journal of Head Trauma Rehabilitation, 14(6): 602-
615.
Proposed Priority
The Assistant Secretary for Special Education and Rehabilitative
Services proposes a priority for Traumatic Brain Injury Model Systems
(TBIMS) centers under the Disability and Rehabilitation Research
Projects (DRRP) program to conduct research that contributes to
evidence-based rehabilitation interventions which improve the lives of
individuals with traumatic brain injury (TBI). Each TBIMS center must
contribute to the following outcomes:
(a) Continued assessment of long-term outcomes of TBI by enrolling
at least 35 subjects per year into the longitudinal portion of the
TBIMS database maintained by the National Data and Statistical Center
for the TBIMS, following established protocols for the collection of
enrollment and follow-up data on subjects.
(b) Improved outcomes for individuals with TBI by proposing one
collaborative research module project and participating in at least one
collaborative research module project, which may range from pilot
research to more extensive studies (At the beginning of the funding
cycle, the TBIMS directors, in conjunction with NIDRR, will select
specific modules for implementation from the approved applications).
(c) Improved long-term outcomes of individuals with TBI by
conducting no more than two site-specific research projects to test
innovative approaches that contribute to rehabilitation interventions
and evaluating TBI outcomes in accordance with the focus areas
identified in NIDRR's Long-Range Plan for FY 2005-2009. Applicants who
propose more than two site-specific projects will be disqualified.
In carrying out each of these research activities, each TBIMS
Center may select from the following research domains related to
specific areas of the Plan: Health and Function, Employment,
Participation and Community Living, and Technology for Access and
Function.
In addition, each TBIMS Center must--
[[Page 54875]]
(1) Provide a multidisciplinary system of rehabilitation care
specifically designed to meet the needs of individuals with TBI. The
system must encompass a continuum of care, including emergency medical
services, acute care services, acute medical rehabilitation services,
and post-acute services; and
(2) Coordinate with the NIDRR-funded Model Systems Knowledge
Translation Center to provide scientific results and information for
dissemination to clinical and consumer audiences.
Rehabilitation Engineering Research Centers Program General
Requirements of Rehabilitation Engineering Research Centers (RERCs)
RERCs carry out research or demonstration activities in support of
the Rehabilitation Act of 1973, as amended, by--
Developing and disseminating innovative methods of
applying advanced technology, scientific achievement, and psychological
and social knowledge to: (a) Solve rehabilitation problems and remove
environmental barriers; and (b) study and evaluate new or emerging
technologies, products, or environments and their effectiveness and
benefits; or
Demonstrating and disseminating: (a) Innovative models for
the delivery of cost-effective rehabilitation technology services to
rural and urban areas; and (b) other scientific research to assist in
meeting the employment and independent living needs of individuals with
severe disabilities; and
Facilitating service delivery systems change through: (a)
The development, evaluation, and dissemination of consumer-responsive
and individual and family-centered innovative models for the delivery
to both rural and urban areas of innovative cost-effective
rehabilitation technology services; and (b) other scientific research
to assist in meeting the employment and independence needs of
individuals with severe disabilities.
Each RERC must be operated by or in collaboration with one or more
institutions of higher education or one or more nonprofit
organizations.
Each RERC must provide training opportunities, in conjunction with
institutions of higher education and nonprofit organizations, to assist
individuals, including individuals with disabilities, to become
rehabilitation technology researchers and practitioners.
Additional information on the RERC program can be found at: https://
www.ed.gov/rschstat/research/pubs/.
Priorities 5, 6, 7, 8, 9, 10, and 11--Rehabilitation Engineering
Research Centers (RERCs) for Spinal Cord Injury (Priority 5),
Recreational Technologies and Exercise Physiology Benefiting
Individuals With Disabilities (Priority 6), Translating Physiological
Data Into Predictions for Functional Performance (Priority 7),
Accessible Medical Instrumentation (Priority 8), Workplace
Accommodations (Priority 9), Rehabilitation Robotics and
Telemanipulation Systems (Priority 10), and Emergency Management
Technologies (Priority 11)
Background
Individuals with disabilities regularly use products developed
through rehabilitation and biomedical research to achieve and maintain
maximum physical function, live independently, study and learn, and
attain gainful employment. The range of engineering research
encompasses not only assistive technology but also technology at the
systems level (e.g., the built environment, information and
communication technologies, and transportation) and technology that
interfaces between individuals and systems and is basic to community
integration.
The NIDRR RERC program has been a major force in the development of
technology to enhance independent function for individuals with
disabilities. The RERCs are recognized as national centers of
excellence in their respective areas and collectively represent the
largest federally supported program responsible for advancing
rehabilitation engineering research. For example, the RERC program was
an early pioneer in the development of augmentative communication and
has been at the forefront of prosthetics and orthotics research for
both children and adults. RERCs have played a major role in the
development of voluntary standards that the medical equipment and
technology industries use when developing wheelchairs, wheelchair
restraint systems, information technologies, and the World Wide Web.
RERCs also have been a driving force in the development of universal
design principles that can be applied to the built environment,
information technology, and consumer products.
Advancements in basic biomedical science and technology have
resulted in new opportunities to further enhance the lives of
individuals with disabilities. Specifically, recent advances in
biomaterials research, composite technologies, information and
telecommunication technologies, nanotechnologies, micro electro
mechanical systems (MEMS), sensor technologies, and the neurosciences
provide a wealth of opportunities for individuals with disabilities and
could be incorporated into research focused on disability and
rehabilitation.
Through the following proposed priorities, NIDRR intends to fund
RERCs that advance rehabilitation engineering in the following research
areas: Spinal Cord Injury, Recreational Technologies and Exercise
Physiology Benefiting People with Disabilities, Translating
Physiological Data into Predictions for Functional Performance,
Accessible Medical Instrumentation, Workplace Accommodations,
Rehabilitation Robotics and Telemanipulation Systems, and Emergency
Management Technologies.
Priority 5--RERC for Spinal Cord Injury
It is estimated that the number of Americans living with traumatic
spinal cord injury (SCI) ranges from 222,000 to 285,000, with an
incidence of approximately 11,000 new cases each year (Spinal Cord
Injury: Facts and Figures at a Glance, 2004).
Technology plays a pivotal role in the lives of individuals with
SCI, starting with the onset of injury and continuing into the
individual's reintegration into community life (Cooper, 2004). The
development of cutting-edge devices and the application of existing
technologies such as integrated control systems, robotics, and
neuroprosthetics can help individuals with SCI perform activities of
daily living and work, and participate in their communities. These
devices can enhance the mobility and function of users with SCI, which
in turn, aids in the preservation of their overall health. Enhanced
mobility, function and overall health are vital to the independence and
quality of life of individuals with SCI. Accordingly, NIDRR seeks to
fund an RERC that focuses on improving the quality of life of
individuals with SCI and promotes health, rehabilitation, independence,
and community participation.
References
Spinal Cord Injury: Facts and Figures at a Glance. (2004).
Retrieved February 13, 2006 from the National Data and Statistical
Center for Spinal Cord Injury Model Systems Web site: https://
www.spinalcord.uab.edu.
Cooper, R.A. (2004). Bioengineering and Spinal Cord Injury: A
Perspective on the State of the Science. The Journal of Spinal Cord
Medicine; 27: 351-364.
[[Page 54876]]
Priority 6--RERC for Recreational Technologies and Exercise Physiology
Benefiting Individuals With Disabilities
Individuals with disabilities are generally less likely to be
physically active than their non-disabled peers. However, regular
physical activity, sports participation, and active recreation are
important contributors to the prevention of disease, promotion of
health, and maintenance of functional independence for all individuals,
including individuals with disabilities. Several studies have
demonstrated that many persons with a variety of disabilities benefit
from increased levels of physical activity, as evidenced by alterations
in various components of their physical fitness (Ada, Dean, Hall,
Bampton, Crompton, 2003; Hicks, Martin, Ditor, Latimer, Craven,
Bugaresti, McCartney, 2003; Husted, Pham, Hekking, Niederman, 1999;
Romberg, Virtanen, Ruutiainen, Aunola, Karppi, Vaara, Surakka,
Pohjolainen, Seppanen, 2004).
Accessible recreation requires more than ramps or automatic door
openers at buildings containing recreational space. In a recreational
facility, equipment and programs themselves contribute to an
environment that promotes equal access or creates a barrier to pursuing
recreational goals. Recreational equipment needs obvious and easy
adjustability, variable range of motion, adequate surrounding space,
and transferability (North Carolina Office on Disability and Health
(2001)). Furthermore, recreational spaces are in need of accessible
points of entry and accessible surfacing (North Carolina Office on
Disability and Health (2001)).
Although modifications to recreational equipment have been made,
such as swing away seats to allow use from a wheelchair or the addition
of Braille instructions, these modifications are not universal and
recreational equipment remains a primary barrier to physical activity
participation (Rimmer, J.H., Riley, B., Wang, E., Rauworth, A. (2005)).
Existing recreational technologies are in need of new features to
increase access to and participation in recreational environments by
individuals with disabilities. In addition, newly improved and novel
recreational technologies need to be researched and tested to
demonstrate the degree to which they can increase access to and
participation in recreational environments by individuals with
disabilities.
Accordingly, NIDRR seeks to fund an RERC that facilitates equitable
access to, and safe use of, recreational equipment, facilities, and
programs, and will reduce debilitating secondary conditions associated
with disability and sedentary lifestyle.
References
Ada, L., Dean, C.M., Hall, J.M., Bampton, J., Crompton, S. (2003).
A Treadmill and Overground Walking Program Improves Walking in Persons
Residing in the Community After Stroke: A Placebo-Controlled,
Randomized Trial. Archives of Physical Medicine and Rehabilitation,
Oct.; 84(10): 1486-91.
Hicks, A.L., Martin, K.A., Ditor, D.S., Latimer, A.E., Craven, C.,
Bugaresti, J., McCartney, N. (2003). Long-term Exercise Training in
Persons with Spinal Cord Injury: Effects on Strength, Arm Ergometry
Performance and Psychological Well-Being. Spinal Cord, Jan.; 41(1): 34-
43.
Husted, C., Pham, L., Hekking, A., Niederman, R. (1999). Improving
Quality of Life for People with Chronic Conditions: The Example of T'ai
Chi and Multiple Sclerosis. Alternative Therapies in Health Medicine,
Sep.; 5(5): 70-4.
Romberg, A., Virtanen, A., Ruutiainen, J., Aunola, S., Karppi,
S.L., Vaara, M., Surakka, J., Pohjolainen, T., Seppanen, A. (2004).
Effects of a 6-Month Exercise Program on Patients with Multiple
Sclerosis: A Randomized Study. Neurology, Dec. 14; 63(11): 2034-8.
North Carolina Office on Disability and Health (2001). Removing
Barriers to Health Clubs and Fitness Facilities. Chapel Hill, NC: Frank
Porter Graham Child Development Center.
Rimmer, J.H., Riley, B., Wang, E., Rauworth, A. (2005).
Accessibility of Health Clubs for People with Mobility Disabilities and
Visual Impairments. American Journal of Public Health, Nov.; 95(11):
2022-8.
Priority 7--RERC for Translating Physiological Data Into Predictions
for Functional Performance
The fields of biomedical and rehabilitation engineering have
produced and applied a wide variety of instruments and devices to
measure the physiological capacity of the human body. Many of these
measurement tools, which examine parameters such as range of motion,
force, gait, and electrophysiological features, have been applied by
physiatrists and other allied professionals in research or practice in
physical medicine and rehabilitation (Hesse, et al., 2002; Koontz, et
al., 2005; Wimalartna, et al., 2002).
To realize the potential for these physiological measures to shape
clinical practices and services, biomedical engineers and
rehabilitation clinicians must develop methods for translating
physiological measures into predictions for functional performance. One
example would be translating the results of a strength measure into a
prognosis for the capacity to carry out a particular activity of daily
living (ADL). NIDRR, therefore, seeks to fund an RERC that develops and
evaluates models and methods to determine the relationship between
physiological measures and the capacity to perform basic tasks among
individuals with disabilities.
References
Hesse, S., Schmidt, H., Werner, C., Bardeleben, A. (2002). Upper
and Lower Extremity Robotic Devices for Rehabilitation and for Studying
Motor Control. Current Opinion in Neurology, Dec.; 16(6): 705-10.
Koontz, A.M., Cooper, R.A., Boninger, M.L., Yang, Y., Impink, B.G.,
van der Woude, L.H. (2005). A Kinetic Analysis of Manual Wheelchair
Propulsion During Start-Up on Select Indoor and Outdoor Surfaces.
Journal of Rehabilitation Research and Development, Jul.-Aug.; 42(4):
447-58.
Wimalaratna, H.S., Tooley, M.A., Churchill, E., Preece, A.W.,
Morgan, H.M. (2002). Quantitative Surface EMG in the Diagnosis of
Neuromuscular Disorders. Electromyography and Clinical Neurophysiology,
2002 Apr.-May.; 42(3): 167-74.
Priority 8--RERC for Accessible Medical Instrumentation
The aim of ``The Surgeon General's Call to Action to Improve the
Health and Wellness of Persons with Disabilities'' is for people with
disabilities to achieve full access to disease prevention and health
promotion services (The Surgeon General's Call To Action To Improve the
Health and Wellness of Persons with Disabilities, 2005). Building upon
the American with Disability Act of 1990, as amended, mandate of equal
access to public accommodations and services, the second of four major
goals within the Surgeon General's call-to-action is to: ``Increase
knowledge among health care professionals and provide them with tools
to screen, diagnose, and treat the whole person with a disability with
dignity.''
Many medical devices in use today are not readily accessible to
individuals with disabilities. For example, research examining the
accessibility of mammography equipment found that inaccessible health
care facilities and medical equipment make it less likely that women
with disabilities will receive breast cancer screening (Nosek,
[[Page 54877]]
2000). In addition, accessibility issues are apparent with many other
medical devices such as exam tables, x-ray equipment, rehabilitation
equipment, and weight scales (Winters, et al., 2005). Accordingly,
NIDRR seeks to fund an RERC that facilitates equitable access to, and
use of, healthcare facilities and equipment by people with
disabilities.
References
U.S. Department of Health and Human Services. The Surgeon General's
Call to Action to Improve the Health and Wellness of Persons with
Disabilities. U.S. Department of Health and Human Services, Office of
the Surgeon General, 2005.
Nosek, M.A. (2000). The John Stanley Coulter lecture. Overcoming
the Odds: The Health of Women with Physical Disabilities in the United
States. Archives of Physical Medicine and Rehabilitation, 81(2): 135-8.
Winters, J.M., Story, M.F., Barnekow, K., Isaacson Kailes, J.,
Premo, B., Schwier, E., Winters, J.M. (2005) Accessibility of Medical
Instrumentation: A National Healthcare Consumer Survey, Proc. RESNA
2005 Annual Conference, Atlanta, GA, June, 2005.
Priority 9--RERC for Workplace Accommodations
Individuals with disabilities experience low rates of employment
and are less likely to be highly educated than are individuals without
disabilities. Despite several national programs and policies that
address this disparity, employment rates for people with disabilities
have remained stable or declined in the past decade (2003 CPS
Employment Rates). The lack of an accessible work environment may
partially explain the decline in employment rates among individuals
with disabilities.
Functional limitations in areas such as motor functioning,
communication, sensation and perception, and cognitive functioning all
present barriers to employment and maintenance of employment by people
with disabilities (Williams, M., Sabata, D., Zolna, J. (2006)).
Modifications in the work environment often remove or reduce these
barriers. Examples of modifications include ramps, automatic door
openers, alternate computer systems, voice output devices for persons
with visual impairments, and customized desks and worktables.
Evaluating the effectiveness of existing individualized accommodations
and new technologies that can potentially be integrated into the design
of work environments also may help to reduce employment barriers.
Moreover, the need persists for more comprehensive empirical evidence
about the human factors of the workplace environment and workplace
technology used by people with disabilities. For example, workplace and
task assessment using ergonomic, anthropometric, and kinematic analysis
is needed for individuals with disabilities. In addition, new tools for
assessing changes in function, skills, and abilities should be
developed for individuals with disabilities (Dowler, D. L., Hirsch, A.
E., Kittle, R. D., and Hendricks, D. J. (1996)) and technology
resources should be systematically considered at all stages of an
individual's employment and overall rehabilitation process (Langton,
A.J., and Ramseur, H. (2001)). Accordingly, NIDRR seeks to fund an RERC
that facilitates equitable access to, and use of, workplace equipment
and facilities and otherwise promotes safety, independence, and active
engagement in the workplace by individuals with disabilities.
References
Vocational Economics, Inc. (2003). 2003 CPS Employment Rates.
https://www.vocecon.com/technical/DATA/newcps.htm.
Williams, M., Sabata, D., Zolna, J. (2006). A Survey of Workplace
Accommodation Needs of Older Workers and Persons with Disabilities
Proc. RESNA 2006 Annual Conference, Atlanta, GA, June, 2006.
Dowler, D. L., Hirsch, A. E., Kittle, R. D., and Hendricks, D. J.
(1996). Outcomes of Reasonable Accommodations in the Workplace.
Technology and Disability, 5 (1996) 345-354.
Langton, A.J., and Ramseur, H. (2001). Enhancing Employment
Outcomes Through Job Accommodation and Assistive Technology Resources
and Services. Journal of Vocational Rehabilitation, 16 (2001) 27-37.
Priority 10--RERC for Rehabilitation Robotics and Telemanipulation
Systems
Rehabilitation of physical impairment is labor intensive, often
relying on one-on-one interactions and hands-on manipulations by
physicians and therapists. Technologies are now available to help
replicate these therapeutic manipulations so that individuals can
practice therapy on their own in a clinic or possibly at home. Several
studies suggest that appropriately designed robotic rehabilitation
therapy may be used for the assessment and treatment of motor
impairments (Lum, Burgar, Shor, Majmundar, & Van der Loos, 2002;
Reinkensmeyer, Hogan, Krebs, Lehman, & Lum, 2000; Riener, Lunenburger,
Jezernik, Anderschitz, Colombo, & Dietz, 2005).
By replicating therapy techniques that normally require one-on-one
contact with clinicians, robotic manipulators could increase access to
therapy, increase time spent in therapy, potentially reduce the cost of
therapy, and possibly achieve better outcomes than traditional
rehabilitation therapies. Accordingly, NIDRR seeks to fund an RERC that
evaluates the efficacy of rehabilitation robotic therapies and
researches and develops innovative technologies and techniques to
improve the current state of the science and usability of
rehabilitation robotic therapies for individuals with disabilities.
References
Lum, P.S., Burgar, C.G., Shor, P.C., Majmundar, M., and Van der
Loos, H.F.M. (2002). Robot-Assisted Movement Training Compared with
Conventional Therapy Techniques for the Rehabilitation of Upper Limb
Motor Function Following Stroke. Archives of Physical Medicine and
Rehabilitation, Jul.; 83(7): 952-9.
Reinkensmeyer, D., Hogan, N., Krebs, H., Lehman, S., and Lum, P.
(2000). Rehabilitators, Robots, and Guides: New Tools for Neurological
Rehabilitation: In Biomechanics and Neural Control of Posture and
Movement, J. Winters and P. Crago, Eds., 2 ed: Springer-Verlag, 2000,
516-533.
Riener, R., Lunenburger, L., Jezernik, S., Anderschitz, M.,
Colombo, G., Dietz, V. (2005). Patient-Cooperative Strategies for
Robot-Aided Treadmill Training: First Experimental Results. IEEE
Transactions on Neural Systems and Rehabilitation Engineering, Sep.;
13(3): 380-94.
Priority 11--RERC for Emergency Management Technologies
Although disasters and emergencies may have a greater impact on
individuals with disabilities, their needs and concerns in the areas of
emergency preparedness, response, and recovery are often overlooked
(National Council on Disability, 2005). Many individuals with
disabilities rely on elevators, accessible transportation, and
accessible communications, all of which can be compromised during
disasters or emergency situations (Executive Order 13347, Annual
Report, 2005). The aim of Executive Order 13347 is to ensure that the
Federal Government appropriately supports safety and security for
individuals with disabilities. Accordingly, NIDRR seeks
[[Page 54878]]
to fund an RERC that researches, develops, and evaluates emergency
management technologies and implementation plans to support the full
inclusion of people with disabilities.
References
National Council on Disability, Saving Lives: Including People with
Disabilities in Emergency Planning. April 2005. Available at: https://
www.ncd.gov/newsroom/publications/2005/saving_
lives.htm#purpose.
U.S. Department of Homeland Security, Individuals with Disabilities
in Emergency Preparedness: Executive Order 13347, Annual Report, July
2005.
Proposed Priorities
The Assistant Secretary for Special Education and Rehabilitative
Services proposes seven priorities for the establishment of (a) An RERC
for Spinal Cord Injury (Priority 5), (b) an RERC for Recreational
Technologies and Exercise Physiology Benefiting Individuals with
Disabilities (Priority 6), (c) an RERC for Translating Physiological
Data into Predictions for Functional Performance (Priority 7), (d) an
RERC for Accessible Medical Instrumentation (Priority 8), (e) an RERC
for Workplace Accommodations (Priority 9), (f) an RERC for
Rehabilitation Robotics and Telemanipulation Systems (Priority 10), and
(g) an RERC for Emergency Management Technologies (Priority 11). Within
its designated priority research area, each RERC will focus on
innovative technological solutions, new knowledge, and concepts that
will improve the lives of persons with disabilities.
(a) RERC for Spinal Cord Injury (Priority 5). Under this priority,
the RERC must research, develop and evaluate innovative technologies
and approaches that will improve the treatment, rehabilitation,
employment, and reintegration into society of persons with spinal cord
injury. This RERC must work collaboratively with the NIDRR-funded
Spinal Cord Injury Model Systems Centers program;
(b) RERC for Recreational Technologies and Exercise Physiology
Benefiting Individuals With Disabilities (Priority 6). Under this
priority, the RERC must research, develop, and evaluate innovative
technologies and strategies that will enhance recreational
opportunities for individuals with disabilities and develop methods to
enhance the physical performance of individuals with disabilities;
(c) RERC for Translating Physiological Data into Predictions for
Functional Performance (Priority 7). Under this priority, the RERC must
determine the physiological measurement tools that are available in a
specific sub-specialty of rehabilitation. A sub-specialty may be based
on underlying disabling condition (e.g., spinal cord injury, and
Parkinson's disease), or on specific sequelae that may be common to a
wide variety of disabling conditions (e.g., pain, spasticity). The RERC
must then develop and evaluate models and methods for determining the
relationships between basic physiological measurements and functional
performance. These models and methods must take the characteristics of
individuals and their environments into consideration when attempting
to delineate these relationships, so that the results of this research
are relevant to clinical practice and the real-world experiences of
individuals with disabilities.
(d) RERC for Accessible Medical Instrumentation (Priority 8). Under
this priority, the RERC must research, develop, and evaluate innovative
methods and technologies to increase the usability and accessibility of
diagnostic, therapeutic, and procedural healthcare equipment (e.g.,
equipment used during medical examinations, and treatment) for
individuals with disabilities. This includes developing methods and
technologies that are useable and accessible for patients and health
care providers with disabilities.
(e) RERC for Workplace Accommodations (Priority 9). Under this
priority, the RERC must research, develop, and evaluate innovative
technologies and implementation plans, devices, and systems to enhance
the productivity of individuals with disabilities in the workplace.
This RERC must emphasize the application of universal design concepts
to improve the accessibility of the workplace and workplace tools for
all workers.
(f) RERC for Rehabilitation Robotics and Telemanipulation Systems
(Priority 10). Under this priority, the RERC must research, develop,
and evaluate human-scale robots and telemanipulation systems that will
provide or perform rehabilitation therapies and address the unique
needs of individuals with disabilities.
(g) RERC for Emergency Management Technologies (Priority 11). Under
this priority, the RERC must research, develop, and evaluate existing
and innovative emergency management technologies to enhance emergency
outcomes for individuals with disabilities. Areas of focus within this
priority research area may include but are not limited to
communications, transportation, evacuation, and other areas related to
emergency preparedness, response, and recovery. In addition, this RERC
must provide input and expertise into the development of standards to
improve emergency management for individuals with disabilities. This
RERC must work collaboratively with the NIDRR-funded Disability and
Rehabilitation Research Project: Inclusive Emergency Evacuation of
People with Disabilities.
Under each priority, the RERC must be designed to contribute to the
following programmatic outcomes:
(1) Increased technical and scientific knowledge-base relevant to
its designated priority research area. The RERC must contribute to this
outcome by conducting high-quality, rigorous research and development
projects.
(2) Innovative technologies, products, environments, performance
guidelines, and monitoring and assessment tools as applicable to its
designated priority research area. The RERC must contribute to this
outcome by developing and testing these innovations.
(3) Improved research capacity in its designated priority research
area. The RERC must contribute to this outcome by co