Complex rehabilitation technology devices are designed to treat diseases and certain types of injury and trauma that directly or indirectly affect the neuromuscular system. These types of conditions affect cognitive and motor function and can dramatically alter quality of life by limiting the afflicted individual's ability to do basic and instrumental activities of daily living, such as maintaining and changing body position, walking, bathing, eating, performing household tasks, looking after one's health, and communicating.
Many of the conditions listed in HR 750 affect the nervous system (both central and peripheral) and the muscular system. The central nervous system includes the brain and the spinal cord; the peripheral system comprises the intricate nerve networks that spread among the entire body including the arms, legs, and torso. Those nerves then go on to activate muscle groups that form basic and complex movement. Accordingly, diseases that affect both the nervous and muscular system are known collectively as neuromuscular diseases.
HR 750 specifically mentions congenital and progressive or degenerative neuromuscular diseases that directly and indirectly affect the neuromuscular system. Diseases and disorders such as cerebral palsy, muscular dystrophy, amyotrophic lateral sclerosis, multiple sclerosis, demyelinating disease, myelopathy, myopathy, progressive muscular atrophy, anterior horn cell disease, post-polio syndrome, cerebellar degeneration, dystonia, Huntington’s disease, spina bifida, and spinocerebellar disease all directly alter the neuromuscular system. In contrast, osteogenesis imperfecta and arthrogryposis indirectly affect the neuromuscular system by causing bones, the foundational structure of muscles, to deteriorate. Without a concrete foundation, muscles cannot exert force to cause movement, even though an affected individual still has a functional neuromuscular system.
In addition to diseases and disorders, HR 750 takes into account injuries and trauma that affect the neuromuscular system. Spinal cord injury and traumatic brain injury (TBI), both directly affecting the central nervous system, are caused by external forces such as a car crash or catastrophic fall. The spinal cord can be damaged by being stretched or displaced by vertebrae. As a result, neurons in the spinal cord are unable to communicate efficiently with one another, which disrupts nerve signals that flow from and to the brain. That disruption can cause mild to severe effects ranging from minimal to absolute loss of motor and sensory function.
Injury to the brain may have similar effects as a spinal cord injury; however, TBI can also have severe cognitive effects. Traumatic brain injury can result from violent hits to the head or an object piercing through the skull and entering the brain. Symptoms associated with it include behavioral or mood changes, a change in sleep pattern, trouble with memory, dizziness, loss of coordination, convulsions or seizures, and blurred vision.
According to the bill, due to the complexity of neuromuscular conditions and their side effects, CRTs require configurations based on the recipient's unique need. That means each device requires an interdisciplinary team who specializes in neuromuscular diseases and devices; the bill defines this team as composed of a doctor, licensed physical or licensed occupational therapist, a qualified CRT professional, the patient, and sometimes a care-giver.