Move over technology: the human dimension of rehabilitation
The ACRM conference showcases a lot of rehabilitation technology and features a dedicated hall full of product exhibitors. As a change of focus, I therefore purposely invested my third day in exploring human perspectives of the challenges presented by life-changing injuries.
The day started with a candid presentation by Sam Schmidt, an Indy Car driver left C4 quadriplegic after a crash, who talked about rebuilding his life following spinal cord injury. He drives a specially adapted car operated via head controls; steering using head movements and accelerating or braking using his mouth. He has used the car to set a land speed record of 190 mph for a semi-autonomous vehicle and to race Mario Andretti round the famous Indianapolis circuit.
Those achievements have captured all the headlines, but for Sam, on a human level, the greatest value of the car project was that returning to driving was, he says, the first time that he felt ‘normal’ again following his accident. In a similar vein, he now fund-raises and aims to medically reverse his own spinal cord injury and achieve a personal dream of walking his daughter down the aisle on her wedding day.
The conference also offers education on alternative medicines and a later session presented some case studies on therapy dogs (as opposed to guide dogs for the visually impaired). These amazing animals are specially trained to help people overcome physical disability in numerous ways, including by pushing or pulling manual wheelchairs up slopes, opening doors, fetching and carrying items, supporting body conditioning exercises, and even activating medical alarms in an emergency.
A triple amputee without U.S. health insurance cover, who therefore could not afford carers, had regained his quality of life and recovered his mental health through the functional support of a therapy dog. He was pursuing a new goal of Paralympic cycling and had won a university sports scholarship.
Finally, I attended a session on the impact of traumatic brain injury (TBI) on families, referencing existing research that holistically supporting the family group, not just the injured person, promotes the best outcomes. Some new research suggests that rehabilitation delivery must also respect family culture and ethnicity. In Latin America for example, the risk of marital breakdown following TBI actually decreases with the severity of injury, due in part to the cultural importance of family loyalty.
The common theme was that rehabilitation delivery works best when personalised for human factors. In serious injury claims, defendants will rarely meet the claimant or family during the process and may have to rely on paper-based assumptions. My own experience has been that in fact such meetings, whether at multi-disciplinary reviews or otherwise, invariably help to unblock funding and explain some of the personal motivations for items that might otherwise be queried on paper. In our technological age, the fundamental human dimension to successful management of serious injury claims cannot be under-estimated.