Rehabilitation: A Stretching and Flexing Market

Muscular-skeletal ailments are the second most common motivation for seeking medical care in the United States. As the baby boomer generation edges steadily toward retirement and senior status, muscle and joint problems are likely to become even more prevalent medical concerns in the future. This shift toward a larger elderly population is one reason the rehabilitation market has been changing in recent years. With the ever-evolving technology and a current trend toward more independent, active lifestyles among the elderly, many in the industry expect the rehabilitation market to grow and change even more rapidly over the next several decades.

Technology alone has dramatically expanded the opportunities to improve the quality of life for millions of people through enhanced rehabilitative processes and assistive devices. Advances in the knowledge base and skill sets of rehab therapists have significantly improved care and treatment. In addition, there has been a greater focus on prevention and wellness, as well as a strong emphasis on a more holistic approach that takes into account multiple aspects of a person?s life, health and medical history when considering treatment options.

Wellness programs, offered within care facilities or on an outpatient basis, are designed to ensure that participants achieve the maximum level of function and independence. Programs that incorporate exercise and education have been shown to help improve general health and well-being, as well as provide benefits such as decreased risk of injury, increased muscle strength and endurance, enhanced flexibility, improved cardiovascular endurance and enhanced socialization. Often, these wellness and fitness activities also can be continued at home, with a treatment program that includes stretching to improve flexibility; exercises for strength, endurance and balance; and walking, aerobic and alternative activities that help to maintain interest, such as yoga, tai chi and golf.

Many of today's seniors, and even more of those boomers who will soon be joining their ranks, understand the value of wellness. However, as the industry continues to grow and change, it is important to educate this population on the programs and options available.

Advances in assistive products

Over 15 million Americans use some type of assistive device or technology, and about half of those use mobility-related products. For most, the loss of access to their environment equals lost independence?and that loss often has a detrimental affect on their emotional well-being and self-confidence. The proliferation of new and improved assistive devices offers a broad spectrum of opportunities for improving the well-being of elderly persons who have lost strength, flexibility, balance, stamina and mobility due to aging, as well as people with non-age-related disabling conditions. Although many of these mobility aids and life-enhancing products have been available for several years, there continues to be an ongoing evolution of consumer-oriented improvements. Some examples include:

  • Motorized wheelchairs

  • Motorized wheelchairs, made of stronger, lighter-weight materials such as fiberglass, titanium and various alloys, are easier to propel and maneuver, and easier to transfer in and out of a car. Improved navigation and a tighter turning radius have improved access in small spaces or rooms and also help protect against collisions and damage to furniture and walls. Chairs are available with seats that elevate the user to another person's eye level or that can be lowered so the user is able to propel the chair with his or her feet. Other features allow easier maneuvering of a chair up and down stairs, provide the ability to tilt the chair in any direction, or allow adjustment of seat depth, width or back height to suit the person. Customizations of color, pattern, fabric/material, function and attachments to personalize a chair are also available.

  • Scooters

  • These motorized devices are smaller, lighter in weight and have more maneuverable than most wheelchairs. They are available in three-wheel and four-wheel-drive models with many customizable features. Scooters allow people to move around within their home, apartment, assisted living facility or community, sometimes dramatically enhancing their daily activities and socializing capabilities. The ability to move around freely offers greater independence and minimizes or eliminates the need for a caretaker's help in order to accomplish day-to-day tasks. Motorized mobility devices also have been shown to help conserve energy, reduce pain, minimize isolation and depression, and increase self-esteem.

  • Rollators and rolling walkers

  • Wheeled varieties of walkers made of lightweight aluminum, with comfortable seats, back rests, hand brakes and convenient baskets for carrying personal items, greatly improve accessibility within a facility, home or in the wider community. This is another product that offers personalization through the many choices in fabrics, colors and seat styles.

  • Canes

  • Offering a stylish, convenient mobility aid for many people, canes can be purchased in a wide array of styles, patterns, materials and colors. Lightweight collapsible versions are also available, which fit easily into a purse or briefcase. Safety lights and ergonomic handles or handgrips that improve body mechanics and better distribute a person's weight are other options.

  • Aids for daily living

  • An increasing number of useful tools designed for the aging or disabled market are available from specialty or retail stores, including larger print books, playing cards and alarm clocks; easy-to-grip cooking utensils, phones with amplified sound and safety items such as grab bars.

  • Barrier-free modular homes

  • Designed to provide easy accessibility to every room and appliance, these homes (or additions to existing homes) enhance opportunities for independent living with wide doorways, no-step entries, raised electrical outlets, roll-under cook-tops and sinks, roll-in showers, plus many other convenience and safety features. Modular units are also available for converting a bathroom to be more accessible.

    Technological developments

    Another area where fast-paced advances are revolutionizing the rehabilitation industry is technology. Computerized diagnostics provide faster, more accurate identification of patients' problems, advanced preventive care minimizes the occurrence of certain medical conditions, and numerous new assistive/rehabilitative products contribute to enhanced safety, accessibility and communication for the elderly and those who have lost functional mobility. The following are just a few examples of new technology introduced in recent years:

  • Visual tracking guide for home computers

  • For quadriplegics or people who have limited or no use of hands and arms, several companies offer hands-free computer systems that allow a person to control the computer with eye blinks and minimal head movements.

  • Communication tools

  • A cellphone is available that functions like a secretary for memory-impaired people. Talking photo albums, offered by several companies and retail stores, can be used for teaching, socializing and for rehabilitation purposes.

  • GPS personal security system for scooters or wheelchairs

  • People who tend to be easily disoriented may benefit from this device, which features a global positioning system (GPS) and a transmitter/receiver.

  • Wheeled walker with robotic scanning system

  • To assist those who are both visually and mobility impaired, this electronic device uses robotic technology and artificial intelligence to scan the environment and identify landmarks, obstacles and hazards while the person is moving around. The on-board computer uses voice messages to communicate warnings and directions to the user.

    Accessibility to rehab

    Technology is also being adapted to ensure that access to the rehabilitation process is more convenient for patients. A few examples include:

  • TeleRehab and video conferencing

  • A new option for delivering rehab services to rural markets allows a patient to be paired with a local hands-on trainer and then participate in therapy sessions via teleconferencing. The cost savings for the providers, as well as for the families who no longer have to travel back and forth for therapy sessions (sometimes a whole day of travel time) have been substantial, and in some circumstances, are covered by Medicare or insurance.

  • Cognitive exercises via computer

  • Speech Language Pathology professors at Northwestern University download and reformat daily newspaper articles, which can then be used as a cognitive exercise and emailed to their subscribers for home practice.

    To assist patients and families in choosing which options are appropriate for their needs, living environment and budget, many rehabilitation professionals make it a priority to keep up to date on current trends and products in order to provide advice. Several companies and organizations also offer recommendations to help rehab patients with decisions about accessibility and medical care options for the home. For example, a family might seek advice to determine if a hoyer lift or sling is needed -- or even practical -- for lifting a disabled loved one. Or a person may need advice on whether the wheelchair he or she has selected will fit through the doorways and maneuver around corners at home.

    Outlook for future

    For the most part, this extensive volume of evolving products and technology has been eagerly greeted within the industry and by consumers. Choice is an important factor for today's market, and consumers appreciate the level of choice that is provided by the numerous rehabilitative devices and services, as well as the options available for personalizing them. As the industry grows, customization will continue to be a major factor in the evolution of assistive technology and products.

    In addition, manufacturers of rehabilitative devices will need to remain very conscious of government regulations and the standards created by organizations such as the American National Standards Institute. While there are several challenges the industry faces in coming years, such as increasingly more complex government regulations and ever-rising health care spending, many factors point to continued growth across this market. With the approach of the sizeable baby boomer influx into the elderly population, and with medical and technological advances now making it possible to live longer and more active lives, it appears inevitable that rehabilitation services and products will play a significant role in a growing number of people's lives.

    References:

    Rehabilitation Market Trends, Accelerated Functional Rehabilitation Network, LLC, http://acceleratednetwork.com/AFRN10.htm, accessed July 19,2004.

    Statistics on the Use of Assistive Devices, Technologies and Related Services, Independence Through Enhancement of Medicare and Medicaid Coalition, 2003. Available at http://www.itemcoalition.org/press/AT_use.html. Accessed Aug. 3, 2004.

    Additional product information

    Two Web sites provide information that can be useful in making decisions on assistive technology and products:

    http://www.abledata.com
    A federally funded site that offers a database of more than 20,000 currently available assistive products from more than 2,000 companies, with detailed descriptions, features and benefits.

    http://TechForLTC.org
    A site sponsored by the Department of Health and Human Services that provides information on technology products that can be used by long-term-care professionals to improve the quality of life and care for seniors.

    This article originally appeared in the November 2004 issue of HME Business.

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