Using engineering and assistive technologies for rehabilitation after electrical trauma.

A framework is presented for judging when, how, and why rehabilitation engineering and its related assistive technologies are appropriate interventions following electrically induced trauma or burns. Instead of relying on the World Health Organization's medically based classification scheme of "Impairment, Disability, and Handicap," this newer framework is built on a rational demarcation proposed by the National Center for Medical Rehabilitation and Research at the U.S. National Institutes of Health. This latter client-centered framework encompasses pathophysiology, impairment, functional limitations, "disability", and societal limitations. This framework is well suited to handle the varied sequelae of electrical trauma and burn injuries and provides guidance towards the most effective use of traditional rehabilitation interventions and of assistive technologies. For electrical injuries, rehabilitative technologies can be classified as those promoting job accommodations (i.e., that help an individual return to active employment, albeit possibly in a different role) or as aids to the other activities of daily living (ADLs) that provide an enhanced quality of life to the individual with disability. While the traditional rehabilitative focus has been on return-to-work, especially among professional tradesmen, a more productive rehabilitative effort in some cases may occur through psychosocial adjustments achieved via effective technological interventions that enhance ADLs.