Brain Injury Professional Special Issue on Neurotechnology

Dr. Tina Trudel, President/COO of Lakeview has been working within the Lakeview programs and field of neurorehabilitation, to increase the use and development of technology.  She recently edited a special issue of the North American Brain Injury Society’s (NABIS) publication ‘Brain Injury Professional’, featuring articles on applications of technology in neurorehabilitation.  Her Guest Editor column notes:

For the last few years, I have been privileged to serve on the International Scientific Advisory Board of the World Congress of Neurotechnology, which met in Rome in 2010 with representatives from around the world, presenting papers on topics that at times seemed more science fiction than science.   The World Congress is now the World Association of Neurotechnology and has evolved as an international on-line forum (www.waneurotech.org) covering the areas of neuroresearch, neuropsychiatry, neuroplasticity, neurooncology and neurosurgery. Myself and others have sought a space for applied technology and neurorehabilitation within this realm of high-tech, heady science.  In this arena, technology transfer, venture capital, clinical trials, government approvals and intellectual property rights are as passionately discussed as any scientific findings, and clinical rehabilitation applications share the screen with nanobots carrying designer molecules across the blood brain barrier!

Technology is evolving far more rapidly than most of us realize.  In 2010, I was pleased to present clinical technology in applied neurorehabilitation pilot studies.  These included projects with colleagues at the Defense and Veterans Brain Injury Center-Charlottesville/University of Virginia on selection of GPS systems for community orientation (now completely outdated); driving  simulation (already into its next generation) and Lakeview’s pilot study in use of computerized instruction technology (being further developed and noted in this issue).  Other presenters at the 2010 World Congress of Neurotechnology were addressing early stages of device development, computerized assessment, use of advanced MRI, EEG, PET scan and related techniques, neuromodulation via application of transcranial magnetic stimulation, therapy avatars, robotic treatment, etc.  Now in this BIP issue, articles from Drs. Michael Borich and Lara Boyd of the University of British Columbia Brain Behaviour Lab, Matt Wilks and Dr. Nathan Zasler’s review of the iWALK system, Deepa Thimmaiah on individualized functional applications of diverse technology, and Trudel, Barth and Plotnick on instructional technology and computerized concussion biomarkers, all shed light on current state of the art applications and research advances in progress.  The science and interventions in these articles are a leap forward from 2010 – yet soon this information, too, will seem antiquated!

It is easy to get swept away by technology, its rapid change coming at us from all directions as we pass through time tethered to our various devices.  Scholar Bruno Latour of the Paris Institute of Technology writes eloquently in his essay on morality and technology, “Technology is always limited to the realm of means, while morality is supposed to deal with ends.”  And so in this whirlwind with the day to day invasion of technology into every arena of life, this BIP special issue also considers how as thoughtful, ethical clinicians, we participate in the process of meaningfully applying technology in a person-centered manner (Dr. Marcia Scherer’s article on matching person to technology) and how more broadly, applied technology progresses in our healthcare, resource, information, public policy and economic contexts (Schmidt, Scherer & Elias).

Technology holds great promise for all of us, with or without brain injury, to master its growing potential and enhance our lives across various domains.  However, in that process, we must exercise caution that technology does not master us.  Ultimately, quality of life hinges on relationships, a sense of accomplishment and productivity, personal empowerment, choice and control, enriching experiences, moments of awe and wonder, and so many other things that technology can either impede or enrich, depending on its implementation.  Further, there is always the risk that for every amazing new technologically advanced device, program or treatment that emerges to assist persons with TBI in rehabilitation and community integration, the general public’s use of technology to interact and communicate may further isolate people from one another, a phenomena that can have uniquely adverse impacts on individuals post-TBI.

No modern day Luddite, I write this on my laptop, with music from my iPhone, emails streaming on my iPad, and grounded in a world of apps that guide my life: work (videoconferencing,  word processing, spreadsheets, databases, sharepoint); travel (booking flights/hotels/cars, rating food, finding toilets, GPS); home (banking, bills, recipes, scheduling); health (calorie counter, fitness monitor, electronic record); activities (weather, tide table, google, events blogs, plant guide); and relationships (facebook, linkedin, email, face time, photo/file sharing).   While quantitatively I have experienced significant growth in speed, automation, and productivity, I am not always sure that such changes translate to ‘quality of life’.  Surely my greatest joy of the week was walking the woodlands with my family, quietly conversing and picking wild blueberries – slowly, by hand.

My many thanks to the outstanding contributors featured in this special issue, and to NABIS, for selecting and supporting a focus on technology in brain injury rehabilitation.  - TMT

Latour B, Morality and Technology: The Ends of the Means, Theory, Culture & Society, 19(5-6): 247-260, 2002.

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