Assistive Technology Solutions from CRT’s Custom Fabrication Shop

Here’s just a few of our recent creations that have changed people’s lives

Why is it always busy at the Center for Rehabilitation Technology’s Custom Fabrication Shop? That’s because there are many commercially-available assistive technology solutions, but if the product doesn’t exist or doesn’t “fit just right” for the patient, we often turn to Frank Lambert, CRT’s Adaptive Equipment Specialist. Here are some of the custom solutions that have emerged from “Frank’s Kitchen” (the shop’s nickname) over the past few months.

1. No-Grasp Pointer Adapted For Tablets & Cell Phones

Since her CVA 15 years ago, CJ has used a series of augmentative communication (AAC) devices. Because of her difficulty with finger isolation she’s always used a pointer to press the keys to type out her messages. Now her AAC device is an iPad, and she tires from maintaining her grip on the pen-like pointer.
CJ liked the minimalist Hand Typer from Alimed®, but it hadn’t been adapted to work with capacitive screens. Frank’s solution maintained the simplicity of the initial product, adding just a rivet, a wire, a metal band and a capacitive tip. It’s an elegant solution that allows precise direct selection, as well as smooth swiping.

2.The Anti-Scissor Rolling Walker

The patient’s physical therapist wrote, “Frank is a genius!” As soon as he stood up with Frank’s modified walker, my patient’s abilities changed. He went from needing the maximal assistance of two people and still struggling for just 1 or 2 steps, to walking 30 feet with minimal assistance. Frank modified a rolling walker with an anti-scissor spacer panel. No one manufactures this product. There are similar items, but they have poles that tend to hurt the inside of the users’ ankles. Frank made a panel that is adjustable in all ways, and avoids that ankle pain.

3. T-Handle Pointer For Tablets & Cell Phones

This version of a pointer for capacitive screens is a novel but straightforward design from CRT. Initially made for someone with intact grasp, it can be modified with grip-handles of different thickness, weight and coatings. For users with weak grasp, an elastic strap around the back of the hand is another easy option.

4.Vibe Stick Gives Walking Feedback

The Vibe Stick is a vibrating cane / walking stick that was used by MB who had a stroke. She had left-side neglect and although was able to ambulate she bumped into obstacles such as hitting her left shoulder on the doorframe when walking through doorways. She held the vibrating cane in her left hand to provide sensory feedback to essentially force her attention to her left side. MB gradually recovered her independent ambulation without the need for a cane, but the Vibe Stick was a useful tool during her inpatient therapy.

5.Wheelchair Joystick Control By Mouth: Proportional and Pneumatic

SF uses a short-throw proportional joystick to control his power wheelchair (PWC) with his tongue. Two additional switches are needed to turn the PWC on/off and to change modes to seat adjustment. Mimicking a similar computer-access product Frank added a sip-n-puff dual switch to the stem of the joystick.

6.Cell Phone & Tablet Wheelchair Mount: Sturdy, Adjustable and Affordable

All CC wanted was to mount her iPhone next to her wheelchair joystick. She couldn’t believe the $500+ price tag for the product sold in a rehab product catalogue. Frank adapted a flange to connect to the joystick mount and searched for the equivalent RAM® mounting parts from www.rammount.com. Total price was about $50. Best of all, the phone swings-away with the joystick when CC transfers from her PWC.

7. No-Grasp Spatula with Thermal Glove

In his house, ZH is a famed hamburger chef. Returning home after a spinal cord injury at C6-C7 level, ZH discovered that from wheelchair height he couldn’t flip those burgers without putting himself at risk for severe burns on his arm.

8. Bed Control – Adapted for Sip-n-Puff Switch Use

Hospital beds come with a wired hand-control called a pendant. None are produced with alternate access in mind. Only a few third-party companies even take the trouble to make hospital bed adapter interfaces. The adapters are expensive ($1,200 to $3,000) and limited to particular brands and models. A Hill-Rom® bed for a patient with a spinal cord injury needed to be adapted for use with sip-n-puff controls. Not a problem at Frank’s Kitchen!

9. Solenoid Fingers for Control of Complex Hospital Bed Remote

On the Hill-Rom® bed control pendant above there was no problem adding wires to the remote, but the high-tech Voelker® bed’s remote control was electronically more complex. Frank opened it to rewire it, but decide it’d be neater and easier to have “robot fingers” press the remote control buttons. He imbedded the remote in a plastic box and mounted a set of 4 solenoid “fingers” that press the buttons according to our electronic command. One finger does head up, another head down, then feet up, and finally feet down. Rosie says, “Thank you Frank! It works like a charm!”

10. Laser Pointer for AAC – with On/Off Switch Control

Laser pointers are low-cost solution used to help individuals with disabilities communicate. A laser pointer can be used to point to words, letters, images, or objects to assist with communication. The pointer is attached to a body part the person is able to easily move. The therapists at Helen Hayes have mounted pointers to hats, eyeglasses, hand splints and even a wooden spoon! If the patient finds it difficult to turn on the laser light, Frank can adapt the switch to make it much easier. This quick and easy solution has been used successfully for individuals with ALS, cerebral palsy, stroke and other diagnoses. One of the great things about using a laser pointer in combination with a communication board is the ease of set-up. Families can be communicating in only minutes, with no power outage or computer virus problems they might encounter with more complex electronic communication devices.

*If you are a DIY-person, follow step-by-step directions for adapting your own laser pointer at http://neurology2.ucsf.edu/brain/als/PDFs/Laser_Pointer_Instructions.pdf

11. Voice Switch: Four Unique Utterances = 4 Switches

It seems like voice recognition is everywhere, but it’s always imbedded in a device. Siri lives in iPhones, Dragon Naturally Speaking lives on PCs and Dragon Dictate on Macs. Can’t my voice control specific individual items like a door opener, bed control or a light switch? In the CRT Custom Fabrication Shop your voice can do just that we’ve assembled and tested a 4-output speech recognition kit and feel that it’s reliable enough to be ready for prime time. We’re waiting for the right person to beta test our switch setup in their home!

12. Refrigerator Door Woes!

Are you lacking the strength or balance to safely open the refrigerator door?

Frank is working on an elegant electronic solution.

Stay tuned…

The Helen Hayes Hospital Special Apparatus staff sets the Center for Rehabilitation Technology apart from other centers by supporting our staff with many creative solutions to adapt many commercially and non-commercially available equipment to help the patients we service. Creating a mount for a cellular phone on an electronic wheelchair to help with communication, or customizing a stylus pen holder for an individual with poor fine motor control to access a tablet computer, are just samples of what we can accomplish for our patients.

-Eddy Ehrlich, BEME, OT, ATP
Coordinator, Computer Access & Smart Apartment Services
Center for Rehabilitation Technology