Skip to main content
    Back to Insights
    Clinical Perspectives

    4 Myths About Complex Rehab Technology (CRT), Debunked

    By Angie Kiger, M.Ed., ATP/SMSSeptember 18, 20265 min read
    Four friends gathered in a bright kitchen prepping vegetables together, one of them using a power wheelchair with a mounted tablet

    In 2012, when I told my mother I'd decided to leave the pediatric hospital where my career began, after more than a decade there, to go work for a wheelchair and seating equipment company as a clinical educator, she was very concerned. Sandi knew I was her child who was passionate about the clients I worked with and wired to be a caretaker, so why in the world would I want to work for a company that makes wheelchairs and seating equipment? When I tried to explain more about the specific products the company designed and manufactured, her response was something like, “Oh, like the ones people use at the airport?” (Face palm.) No, Ma'am. These devices are way different.

    Admittedly, explaining what I do for a living, and the fields of assistive technology (AT) and complex rehab technology (CRT), to friends and family, much less complete strangers, is a struggle. Inevitably I get responses like “What's so complex about a wheelchair? It's literally wheels attached to a chair,” or “Oh yeah, I totally get that. When I broke my leg playing football in high school, I was in a wheelchair like those.” Ummmm, not exactly.

    In light of this being CRT Awareness Week, I thought this would be the perfect time to debunk a few of the myths I've heard over the years about CRT, both from people outside the industry and from people who should know better.

    What Is Complex Rehab Technology?

    Before we dive into the myths, let's break down what Complex Rehab Technology actually means. CRT is individually configured mobility equipment, including manual wheelchairs, power wheelchairs, seating systems, and positioning components. When standard, off the shelf equipment won't work for someone because of their medical condition, posture, or functional needs, CRT is the next step.

    Myth 1: CRT Is Just “Durable Medical Equipment” With a Higher Price Tag

    Nope. Standard DME is designed for general use and to work for the majority of the population. CRT is designed around a specific individual after an evaluation by a qualified team of professionals who evaluate how that person moves, sits, and functions. To put it simply, standard DME will not meet the medical or functional needs of a client who requires CRT.

    Truth be told, yes, mass production does bring real cost savings, which is exactly why DME is often less expensive than CRT. But if a standard wheelchair doesn't meet someone's medical needs, a custom configured one is justified, even though it comes with a higher price tag.

    Myth 2: Skipping the Clinical Process Doesn't Really Change the Outcome

    Ehhhh, not so much. Skipping out on a complete evaluation by a qualified PT or OT can not only impact funding and medical insurance coverage, it can also significantly change a client's outcomes. The beauty of the team approach is that each professional involved sees the same person through a different lens, and catches things the others might miss looking at that exact same moment. Over the years I've heard countless horror stories from friends and people I've met who use CRT, cases where someone skipped including both a clinician and a CRT provider, or ordered something with no professional input at all because they were paying out of pocket. My recommendation will always be the same, whether it's someone's first wheelchair or their 21st: get evaluated by a trained CRT provider and a clinician.

    Myth 3: Diagnosis Alone Determines the Equipment

    Have you ever seen two people with the same neuromuscular disease who look and function exactly the same? I have not. While I absolutely believe a client's diagnosis plays a vital role in the evaluation and recommendation process, clinical presentation is a more appropriate driving force when it comes to equipment selection. Looking at each client individually and matching their specific needs to the features of the CRT is what I've seen dramatically improve outcomes.

    Myth 4: Once a Client's CRT Is Delivered, the Process Is Done

    Delivery day marks a major milestone in the CRT provision process, however, it does not mark the finish line. Before the equipment is left with the client, it needs to be properly fit and adjusted, even if it was set up based on notes from the evaluation, because a lot can change in the time between evaluation and delivery. The client and caregivers should also be provided with proper training and resources for operating and caring for the equipment, including information on who to contact for service or questions. Then, after a successful delivery, it's highly encouraged that someone from the team reach out to the client to follow up on how things are going a few weeks later. Skip the follow through, and even a perfectly evaluated, perfectly configured system can end up failing the person it was built for.

    Next time someone tells you they “totally get” CRT because they broke a leg playing football, or that skipping the evaluation is basically the same thing, you'll know better.

    Keep adapting!

    Angie

    Angie Kiger, M.Ed., ATP/SMS, founder of Adaptation Labs, brings more than 25 years of clinical, industry, and consulting experience in AT, CRT, and adaptive equipment.

    Photo: Justin Kaneps, All In Frame Stock Library