Complex Rehabilitation Technology has made inspiring strides in recent years. These technologies are more than just tools, they are lifelines. They empower people to live, work, travel, and engage fully with their communities. For individuals with chronic or progressive conditions, a properly fitted wheelchair is not simply a mobility device, it is the daily foundation for health, autonomy, and dignity.
The good news is that innovation in CRT is moving forward with energy and imagination. Designers and engineers are partnering with clinicians and users to develop solutions that are more responsive, more personalized, and more effective than ever before. We see smarter power systems, lighter and more durable materials, and user-centered features such as Bluetooth integration and mobile app controls. The future of mobility is here, and it’s remarkable.
But innovation only matters if it reaches the people it’s designed to help.
That is where we face our greatest challenge. Despite these breakthroughs, too many individuals still encounter barriers, financial, bureaucratic, and systemic, that prevent them from accessing the technology they need. Without deliberate and determined action, we risk a future where advanced CRT exists only in theory or in showroom displays, while real people wait, struggle, or go without.
Developing a cutting-edge power wheelchair or fully customized manual system is no small feat. It takes a multidisciplinary effort, combining biomechanics, materials science, clinical insight, and data analysis. Every intervention must be tailored to an individual’s body, health condition, and lifestyle. These devices aren’t mass-produced gadgets; they are highly specialized medical tools, and the process to create and fit them is equally specialized.
Naturally, this complexity carries cost. CRT serves smaller populations and is subject to strict medical regulations. The involvement of highly trained professionals – clinicians, supplier professionals, and technicians – is essential for assessment, fitting, training, and ongoing support. This is not just an investment in equipment; it is an investment in people’s lives.
Unfortunately, these costs often become barriers. Public insurance programs may delay, limit, or deny CRT coverage, leaving users waiting months or stuck with devices that don’t meet their needs. This can result in discomfort, injury, hospitalization, and a loss of independence. Globally, the disparity is even more severe, with advanced CRT largely unavailable in many low- and middle-income countries.
Change is necessary.
The gap between technological possibilities and actual accessibility must be closed. CRT should be recognized as a medical necessity, not a luxury. A tilt-and-recline power wheelchair is not a comfort item; it is essential for individuals with limited trunk control or skin vulnerability. A rigid-frame manual chair is not a preference; it is a safeguard against repetitive strain injury and a pathway to independence.
Advocacy is the key to unlocking access. Policymakers must understand CRT’s value and fund it accordingly. Insurance systems must be responsive, flexible, and fair. Skilled clinicians and supplier professionals should receive adequate reimbursement and professional development support. Most importantly, the voices of those who rely on CRT daily must be elevated – they know what works, what is missing, and what is needed next.
The path forward will not be easy. But the advancements today are extraordinary, and the community driving them is resilient. Decades of advocacy, ingenuity, and perseverance have built a strong foundation. Now is the time to act – to push for policies that prioritize access, equity, and innovation.
Mobility, dignity, and full participation are not privileges for the few. They must be rights for all.
Andrea Madsen, ATP
Andrea may be reached at amadsen@nrrts.org.
Andrea Madsen, ATP is the Executive Director of iNRRTS, the International Registry of Rehabilitation Technology Suppliers. She has over 20 years’ experience providing Complex Rehabilitation Technology to adult and pediatric patients in Southern Minnesota, Western Wisconsin, Northern Iowa and Internationally through her work with Mayo Clinic. She holds a Bachelor of Science Degree in Business Management and Finance, is a credentialed Assistive Technology Professional and has been a Certified Complex Rehabilitation Technology Supplier®. She served for 10 years on the iNRRTS Board of Directors and as Committee Chair for the Midwest Association of Medical Equipment Services. She has lectured for the University of Minnesota Rochester, University of Wisconsin La Crosse, the Mayo Clinic College of Medicine and Science, and at ISS.