TOPIC 7.
Research, Development, or Outcome Measurements
in Cross-Cutting Disability and Rehabilitation
Related Technologies and Software

• A Low-Cost, High-Performance Physical Activity Monitor (PAM)
• Fair and Appropriate Community Employment (FACE): A Management Information System (MIS) for Evaluating Impact of Employment Programs on Persons with Disabilities

SPONSORING OFFICE:
Office of Special Education and Rehabilitative Services

Abstract:
Many barriers restrict research that studies the health effects of children's physical activity or evaluates the implementation of public health guidelines for the promotion of physical activity. One such barrier is the lack of a simple, inexpensive, yet accurate tool to measure physical activity and sedentary behavior. At present, accurate measurement of physical activity is constrained in the preschool and school environments, especially in children who exhibit limited cognitive skills and less structured patterns of activity. The Phase I research program will focus on health-related physical fitness assessment and physical activity monitoring. In particular, the Team of Barron Associates, Inc. (BAI) and its subcontractor, the University of Virginia Motion Analysis and Motor Performance Laboratory, propose to develop a miniature, lightweight, low-profile, low-cost, high-performance multifunctional Physical Activity Monitor (PAM) to collect, store, and analyze translational and rotational motion and heart-rate data in children and other subjects. The proposed system addresses the deficiencies of current commercial activity monitors. Monitoring of both motion and heart rate will allow assessment of health-related physical fitness via computation of the Energy Expenditure Index in ambulatory children both with and without handicaps. All information collected and stored on the PAM device will be uploadable to a PC for off-line data analysis.

Summary of Anticipated Results and Implications:
In addition to providing low-cost, high-performance, health-related physical fitness assessment and activity monitoring, there are many direct potential commercial applications of the proposed technology, such as:

1. counting and characterizing falls in geriatric subjects to identify those persons who are at risk of hip fracture;
2. quantifying the exposure environment of a subjects wearing work or military gear; and,
3. sleep study activity monitoring.

A safe, lightweight, body-mounted recording system that included wireless electromyographic (EMG) sensors would permit simultaneous biomechanical and physiological data collection to allow the testing and evaluation of human exposure and tolerance in the area of musculoskeletal fatigue and injury. Applications include industrial ergonomics, athletic performance monitoring, and medical diagnostics/rehabilitation.

The fundamental PAM system could also be expanded to include electrocardiographic (ECG) sensing for detailed analysis of cardiac health at home, in the field, and during exercise, body temperature sensing for monitoring heat-related stress (e.g., heat exhaustion) and heat injury prevention, and Global Positioning System (GPS) receivers to track the position of the subject on the surface of the earth.

Abstract:
While several research efforts have employed rigorous research designs for relating services to outcomes, the retrieval of data from the records of over 7,000 community rehabilitation programs (CRPs) who serve nearly 4,000,000 persons with disabilities has met with much less success. There is a critical need for a comprehensive management information system (NHS) that CRPs can use to evaluate the relationship between services provided and outcomes achieved for consumers with various disabilities and backgrounds. Over the past five years, the Fair and Appropriate Community Employment (FACE) concept has been developed as a MIS for CRPs to evaluate the effectiveness and efficiency of their service interventions upon employment programs. This FACE MIS places powerful research and analytic tools directly into the hands of practitioners for improving outcomes for their consumers. This prototype is being developed at Career Development Center with an expected completion of August 2000. The purpose of this award is to develop a FACE MIS Beta version on MS Access for Phase II research and development employing a larger sample of CRPs.

Summary of Anticipated Results and Implications:
Translating the FACE concept from theory to practice has been under-way for several years now. The applicant is currently working with the staff of the Career Development Center (Eau Claire, WI) to develop the prototype FACE MIS in their MS DOS-based IPASS database. The product from Phase I will be a FACE MIS programmed on a universal database engine (MS Access) for custom installation at any CRP. Program and case managers will be able to utilize a rigorous pre-post research design that allows assessment of pre-program economic and support conditions of the consumer for comparison to these measures upon program exiting and at required follow-up periods. The MIS's Benefit-Cost methodology will evaluate the "value added" to each person (benefits/costs), effectiveness and efficiency of the rehabilitation processes within the CRP, and the effectiveness and efficiency to serve specific disability populations funded and/or referred by various agencies to the CRP.

The FACE MIS was designed to provide a common lexicon and evaluation system for consumers, service providers, funding agencies, researchers, and policy makers for programs to employ persons with disabilities. While such a goal is beyond the scope of the Phase I the development FACE MIS has considerable potential for improving service delivery and impacting on consumer's choice and employment outcomes.

The development of a standardized MIS with Benefit Cost analytic capabilities has great commercial potential. Such a system can be used by several employment programs such as CRPs, welfare to work agencies, and One Stop Career Centers for individuals with and without disabilities. Because the rehabilitation process is divided into three universal stages (Intake, Service Delivery, and Outcomes), it is applicable to other developed countries where local and cultural norms can be used to identify and analyze benefits and cost within each community.

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