A Man-Machine System Approach in the Field of Rehabilitation: A Challenge or a Necessity

Abstract

Summary Rehabilitative medicine and curative medicine differ significantly. Rehabilitative medicine forcuses on compensation, using intact residual functions in the presence of permanent damage to improve impaired functions, whereas curative medicine aims to restore the body to normal functioning in various ways. For its part, rehabilitative medicine is an excellent example of a multidisciplinary activity, which is also true of supervisory control. Rasmussen’s familiar three–level classification (1983) of complex cognitive behaviors into Skill–based, Rule–based, and Knowledge–based behaviors provides a perspective with three hierarchically ordered levels, as does the classification of Wood and Badley (1985) regarding rehabilitation concerns into impairment, disability, and handicap. Similarities between the two disciplines are varied and significant. They include: a) the cybernetic modelling approaches and techniques used; b) the description of human behavior; c) the design of man-machine interfaces (MMIf); d) the use of human decision support systems and field evaluation studies; and e) the functional interaction of the disabled person/supervisor with his/her physical environment. At the same time, the two fields are characterized as well by significant differences. For example, in rehabilitative medicine: a) phycho–social considerations are far more pervasive and significant; b) intra– and inter–subject variability are often sufficiently great to warrant individualized solutions; c) financial mechanisms and motives are different, as are the economic consequences of achieving successful solutions; and d) it is the more multidisciplinary field. Two case studies will be reported in detail by way of illustration. These include an application of expert systems and the development of treatment support systems, and alternative communication devices and assistive devices for visually impaired individuals. A prognosis for the developing field of rehabilitation will be given. We will discuss how the current emphasis on information technology and the change of our society into an information society may affect various disability groups differentially, affecting the prognosis for visually impaired, hearing impaired and motorically impaired individuals. The discussion characterizes likely directions of the field in several selected countries, including the Netherlands, the USA, and Japan. Finally, we argue the the Man–Machine Systems aspects of industry and rehabilitation should be more closely allied and integrated, not only as a challenge, but of necessity to specialists in both fields.