Rehabilitation Technology Unit

Rehabilitation Technology Unit is a State service for rehabilitation engineering, orthotics, prosthetics and augmentative and alternative communications specialties. Hospital and community based services are delivered from and in support of the State Rehabilitation Service at Fiona Stanley Hospital and the manufacturing / patient service facility at Royal Perth Hospital.

The unit has a primary role in supporting patient rehabilitation and in providing the contemporary technology to optimise functional independence for the individual to deliver their safe, effective and reliable discharge into the community, including:

  • Rehabilitation Engineering Services / Clinic provides a range of enabling and adaptive technologies including wheelchair mobility (manual and electric), specialised control systems, custom seating to assist posture and function and pressure management services to prevent decubitus ulceration (pressure sores) due to sensory impairment. The Service provides temporary loan equipment (e.g. wheelchairs) to assist rehabilitation prior to the provision of definitive equipment that is issued on permanent loan to the patient through consultation and assessment conducted when a reasonable functional status is achieved.
     
    Assistance to the patient in the community can be provided to replace the equipment issued on discharge or for other equipment options required by the client, subject to the Community Aids and Equipment Program (CAEP) or the National Disability Insurance Scheme (NDIS) criteria.
     
  • Orthotic Services provides a State service for provision of orthotic devices to adult clients who require clinical assessment, as well as design and/or specification and fitting of a commercial or custom appliance. Provision covers a full range of appliances for head, spinal, upper and lower limb injury or motor-skeletal deficiency. Specialist services are provided in relation to spinal injury/surgery and scoliosis management and devices are maintained to ensure safe, reliable and effective function. Assistance to the patient in the community applies.
     
  • Prosthetic Services provides interim prosthetic device required for the rehabilitation of the amputee patients and their effective discharge in to the community pending provision of a definitive appliance. Services include provision of rigid removable dressings to manage stump healing and oedema in preparation for the fitting and management of the prosthetic device as rehabilitation progresses. The definitive device is supplied in the community by providers accredited under the WA Limb Service to Amputees.
     
  • Communication and Assistive Technology Services provides a range of technologies in support of treating clinicians attending to patients with a physical, speech, language or cognitive impairment of functional independence and/or communication. Commercial and custom options are based on electronic, computer and software derived technologies and their adaptation to meet the clients particular need. Loan equipment is used, maintained and adapted to meet the changing demands of impairment and the progressive nature of conditions such as motor-neurone disease and stroke.

The RTU employs tertiary qualified Rehabilitation Engineers, Orthotists, Prosthetists, Clinical Nurses, Senior Occupational Therapists and Speech Pathologists, Technical Officers and Technical Assistants related to its various services.

Foundations of the RTU as a State Service

The Rehabilitation Technology Unit (RTU) was formed from the combination of multiple clinical service facilities with the common mission of providing technology solutions to assist in the rehabilitation of the patient, to maximise functional independence and to facilitate a safe and effective return to the community, including:

Involving Rehabilitation Engineering in the management of patients with motor-skeletal disability was as a primary factor in establishing a Bioengineering Service at RPH in 1969. Early focus was on patients with spinal injury and in 1976 a Project Bioengineer was employed to work directly with the Spinal Unit at the Royal Perth Rehabilitation Hospital in Shenton Park (RPRH), to provide a systematic approach to the prevention of decubitus ulceration (bed sores or pressure injuries) related to seating and wheelchair mobility of paraplegic/tetraplegic patients with sensory deficits. The project was to build on the early clinical work conducted by Specialty Registrar Lynette Cox in the Spinal Unit, under the direction of Sir George Bedbrook. This work established the relationship between the patient’s functional status and the technology specific to the seating interface (eg. pressure prevention cushioning) and the wheelchair specification. The developmental work of the evolving Rehabilitation Engineering Clinic (REC) was summarised in a monograph “The Prevention of Pressure Sores in Persons with Spinal Cord Injuries” by P.C.Noble and published by the World Rehabilitation Fund in 1981. Nursing involvement in the management of soft tissue and pressure prevention has been a hallmark of the REC service, delivered by a multi-disciplinary team, which continues to date. Close involvement with the spinal and orthopaedic services led to project investigations in areas such as scoliosis (diagnostic techniques using Moire topography in 1985), functional electrical stimulation (1995), gait analysis and the integration of the electric wheelchair, communication and environmental control systems.

Adult Orthotic Services were originally provided as a visiting service to RPH and was based on services provided at the Princess Margaret Hospital for Children (PMH). In the early 1980s the Adult Orthotic Service was re-sited to RPRH, while maintaining a paediatric sub-centre at PMH. Co-location with the REC services was the forerunner to inclusion under the Medical Engineering and Physics division (now Bioengineering) in March 1987.

Prosthetic Services in WA were traditionally delivered through Department of Veterans Affairs (DVA), Regional Artificial Limb and Appliance Centre (RALAC) at the Hollywood Repatriation Hospital, and the Civilian Maimed and Limbless Association (CMLA) located in the Quadriplegic Centre at Shenton Park. Medical follow up was delivered at RPRH, supported by the Orthotics Service, based on the skills resulting from introduction of degree based training which covered both orthotics and prosthetics. With changes to DVA services in 1996/97, prosthetic service provision in WA was reorganised under the WA Limb Service for Amputees (WALSA) and the Orthotics Service developed a formal role in providing interim prosthetic support to the Amputee Service provided through RPRH. The Interim Service supported the rehabilitation of amputee patients and provided prosthetic devices suitable for their safe and effective discharge into the community. Delivery of the definitive device once in the community, was passed to the private sector.

Augmentative and Alternative Communication Services(AAC, latterly Communication and Assistive Technology Services (CATS)) developed out of growing recognition of the part to be played by electronic and computer based technologies in the rehabilitation of patients with sensory and musculo-skeletal disability. This was the focus of a Churchill Fellowship (1991) conducted by Mr. Trevor Jones (Scientific Officer) that resulted in the development of routine assistive technology services to neurologically impaired (motor neurone disease, multiple sclerosis, guillain-barre) neuro-surgical (acquired brain injury, trauma) and spinal trauma (quadriplegia) patients.

The combination of services at RPRH established the RTU’s role as a State Service operating under the HTMU. This was continued with the decommissioning of the Shenton Park campus in October 2014 and the transfer of services to the State Rehabilitation Service at Fiona Stanley Hospital (FSH). To support this transition and the delivery of spinal surgical services at RPH, service delivery and workshop capacity was developed. This was later extended to provide workshop capacity and access to manufacturing technology in support of the Orthotic Service transferred from PMH to the new Perth Children’s Hospital (PCH) in July 2015. Service provision is the subject of detailed service level agreements between the HTMU, WALSA, FSH and PCH.

Further information on the RTU and the history and the role of Shenton Park as the State Rehabilitation Service for WA can be referenced in the following:

Last Updated: 15/04/2021