Participatory design and validation of mobility enhancement robotic wheelchair

Evaluation of Power Wheelchair Dynamic Suspensions for Tip Prevention in Non-ADA Compliant Surfaces

OBJECTIVE

To evaluate the driving performance and usability of a mobility enhancement robot (MEBot) wheelchair with 2 innovative dynamic suspensions compared with commercial electric powered wheelchair (EPW) suspensions on non-American with Disabilities Act (ADA) compliant surfaces. The 2 dynamic suspensions used pneumatic actuators (PA) and electro-hydraulic with springs in series electrohydraulic and spring in series (EHAS).

DESIGN

Within-subjects cross-sectional study. Driving performance and usability were evaluated using quantitative measures and standardized tools, respectively.

SETTING

Laboratory settings that simulated common EPW outdoor driving tasks.

PARTICIPANTS

10 EPW users (5 women, 5 men) with an average age of 53.9±11.5 years and 21.2±16.3 years of EPW driving experience (N=10).

INTERVENTION

Not applicable.

MAIN OUTCOME MEASURE(S)

Seat angle peaks (stability), number of completed trials (effectiveness), Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST), and systemic usability scale (SUS).

RESULTS

MEBot with dynamic suspensions demonstrated significantly better stability (all P<.001) than EPW passive suspensions on non-ADA-compliant surfaces by reducing seat angle changes (safety). Also, MEBot with EHAS suspension significantly completed more trials over potholes compared with MEBot with PA suspension (P<.001) and EPW suspensions (P<.001). MEBot with EHAS had significantly better scores in terms of ease of adjustment (P=.016), durability (P=.031), and usability (P=.032) compared with MEBot with PA suspension on all surfaces. Physical assistance was required to navigate over potholes using MEBot with PA suspension and EPW suspensions. Also, participants reported similar responses regarding ease of use and satisfaction toward MEBot with EHAS suspension and EPW suspensions.

CONCLUSIONS

MEBot with dynamic suspensions improve safety and stability when navigating non-ADA-compliant surfaces compared with commercial EPW passive suspensions. Findings indicate MEBot readiness for further evaluation in real-world environments.

Wheelchair users' perceptions of a system enabling them to traverse rough terrain controlling their own wheelchair

We recently developed a dynamic mimicking system that mounts a user's wheelchair onto a carrier platform capable of performing required manoeuvres using the wheelchair's own controls. Two wheelchair user studies were performed to evaluate users' perception of their own wheelchair and the proposed system. The first user study included ten wheelchair users who were interviewed in order to map their current perceptions toward their wheelchair and their views about its shortcomings when traversing rough terrains. In the second study, the system was explained to 33 participants who were then exposed to three simulations of its main features. Participants were interviewed and the experimenter wrote down their answers, which were analysed using IBM SPSS Statistics 27 software. The conclusions are that special consideration should be given to motorized wheelchair users, and that the designers of the system should include a user interface that explains and demonstrates the system to users.

User Participatory Design of a Wearable Focal Vibration Device for Home-Based Stroke Rehabilitation

Stroke often leads to the significant impairment of upper limb function and is associated with a decreased quality of life. Despite study results from several interventions for muscle activation and motor coordination, wide-scale adoption remains largely elusive due to under-doses and low user compliance and participation. Recent studies have shown that focal vibration has a greater potential to increase and coordinate muscle recruitment and build muscle strength and endurance. This form of treatment could widely benefit stroke survivors and therapists. Thus, this study aimed to design and develop a novel wearable focal vibration device for upper limb rehabilitation in stroke survivors. A user participatory design approach was used for the design and development. Five stroke survivors, three physical therapists, and two occupational therapists were recruited and participated. This pilot study may help to develop a novel sustainable wearable system providing vibration-based muscle activation for upper limb function rehabilitation. It may allow users to apply the prescribed vibratory stimuli in-home and/or in community settings. It may also allow therapists to monitor treatment usage and user performance and adjust the treatment doses based on progression.

Mini-review: Robotic wheelchair taxonomy and readiness

Robotic wheelchair research and development is a growing sector. This article introduces a robotic wheelchair taxonomy, and a readiness model supported by a mini-review. The taxonomy is constructed by power wheelchair and, mobile robot standards, the ICF and, PHAATE models. The mini-review of 2797 articles spanning 7 databases produced 205 articles and 4 review articles that matched inclusion/exclusion criteria. The review and analysis illuminate how innovations in robotic wheelchair research progressed and have been slow to translate into the marketplace.

The experiences, needs and barriers of people with impairments related to usability and accessibility of digital health solutions, levels of involvement in the design process and strategies for participatory and universal design: a scoping review

Objective

Globally, the number of digital health solutions is increasing, but they are not always designed with access and utilisation for people with impairments in mind. Development efforts have often not included the voice and requirements of people with impairments, who make up 15% of the world’s population, despite the fact that this can help ensure broad access and utilisation. Little attention to and limited inclusion of people with impairments in the development of digital health solutions results in continued and reinforced inequalities in health services provision for people with impairments. This review investigates the needs and barriers of people with impairments related to use of digital health solutions and strategies to foster user participation, access and utilisation of digital health solutions.

Methods

This scoping review, based on the Joanna Briggs Institute Manual, had five phases: 1) identification of aim and research questions, 2) literature search in five databases (April/May 2020), 3) literature screening based on predetermined inclusion and exclusion criteria, 4) data extraction, and (5) reporting results.

Results

The literature search resulted in 5968 sources, of which 25 met our inclusion criteria. People with impairments appreciate digital health solutions that are designed to meet their specific impairment-related challenges. The reported needs and barriers related to technological design varied depending on the individuals’ challenges. The literature reported different types of participatory co-design strategies to foster access and utilisation of digital health solutions.

Conclusion

This scoping review support needs for increased awareness among developers to design solutions that meet people’s needs, contexts and states of health. By applying universal design as a strategy and including people with different types of impairments, starting in the idea creation phase of digital health solutions and throughout the development, developers can design solutions with better accessibility. Digital health solutions that are accessible and usable have a tremendous opportunity to foster health equity and achieve health promotion, prevention and self-care. This in turn can contribute to closing the gap between different population groups, reduce disparities and get the most from available healthcare services.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-12393-1.

Curb Negotiation With Dynamic Human-Robotic Wheelchair Collaboration

Wheelchair users often face architectural barriers such as curbs, limiting their accessibility, mobility, and participation in their communities. The mobility enhancement robotic (MEBot) wheelchair was developed to navigate over such architectural barriers. Its application allows wheelchair users to negotiate curbs automatically while the user remains in control. The application was optimized from a manual to a semiautomated process based on wheelchair users' feedback. The optimized application was evaluated by experienced wheelchair users who navigated over curbs of different heights. Participants evaluated MEBot in terms of effectiveness, workload demand, and usability. Ten participants successfully ascended and descended curbs of different heights at an average completion time of 55.7 ± 19.5 and 30.3 ± 9.1 s, respectively. MEBot maintained stability during the process, while participants reported low levels of effort, frustration, and overall cognitive demand to operate MEBot. Furthermore, participants were satisfied with the ease of learning and using the MEBot curb negotiation application to overcome the curbs but suggested less wheel adjustment for comfort and a faster pace to overcome curbs during real-world conditions.

Quantifying Mobility Scooter Performance in Winter Environments

OBJECTIVES

To quantify mobility scooter performance when traversing snow, ice, and concrete in cold temperatures and to explore possible performance improvements with scooter winter tires.

DESIGN

Cross-sectional.

SETTING

Hospital-based research institute.

PARTICIPANTS

Two drivers (50 and 100 kg) tested 8 scooter models (N=8). Two mobility scooters were used for winter tire testing.

INTERVENTIONS

Scooters were tested on 3 different conditions in a random sequence (concrete, 2.5-cm depth snow, bare ice). Ramp ascent and descent, as well as right-angle cornering up to a maximum of 10° slopes on winter conditions, were observed. Winter tire testing used the same slopes with 2 scooters on bare and melting ice surfaces.

MAIN OUTCOME MEASURES

Maximum achievable angle (MAA) and tire traction loss for ramp ascent and descent performance. The ability to steer around a corner on the ramp.

RESULTS

All scooters underperformed in winter conditions, specifically when traversing snow- and ice-covered slopes (χ² [2, N=8]=13.87-15.55, P<.001) and corners (χ² [2, N=8]=12.25, P<.01). Half of the scooters we tested were unable to climb a 1:12 grade (4.8°) snow-covered slope without losing traction. All but 1 failed to ascend an ice-covered 1:12 grade (4.8°) slope. Performance was even more unsatisfactory for the forward downslopes on both snow and ice. Winter tires enhanced the MAA, permitting 1:12 (4.8°) slope ascent on ice.

CONCLUSIONS

Mobility scooters need to be designed with winter months in mind. Our findings showed that Americans with Disabilities Act-compliant built environments, such as curb ramps that conform to a 1:12 (4.8°) slope, become treacherous or impassible to mobility scooter users when covered in ice or snow. Scooter manufacturers should consider providing winter tires as optional accessories in regions that experience ice and snow accumulation. Additional testing/standards need to be established to evaluate winter mobility scooter performance further.

TECHNOLOGY TRANSFER ASSISTANCE PROJECT BRINGS VA HEALTH CARE IDEAS TO LIFE

Clinicians and staff of the Department of Veterans Affairs Health Care System (VA), who provide services to veterans, have invented many devices and methods for improving veterans' lives. However, translating those inventions to the market has been a challenge due to limited collaboration between the clinical inventors and the scientists, researchers, and engineers who can produce the prototypes necessary for licensing the technology. The VA Technology Transfer Program office and the Human Engineering Research Laboratories, a research laboratory with experience with developing prototypes and licensing technology, jointly developed a program called the Technology Transfer Assistance Project (TTAP) to bridge the gap between clinical inventors and prototypes ready for licensing. This paper describes TTAP and provides examples of the first inventions that were developed or enhanced through TTAP.

Design of an adjustable wheelchair for table tennis participation

PURPOSE

Physical activity and recreation are very important for people with disabilities and provide benefits for self-esteem, social relationships, employment, rehabilitation, and education. Para Table Tennis is an adaptive sport where participants compete in table tennis while sitting in a wheelchair. However, athletes generally use their everyday wheelchair instead of a device specifically designed for the sport. The specific support, movements, and posture needed to participate in table tennis at the highest level are different than general day-to-day mobility and a device could be optimized for the sport. This research describes the development of a wheelchair specifically designed for para table tennis.

MATERIALS AND METHODS

The design followed a participatory action design approach which identified the specific needs for a wheelchair to be used during para table tennis.

RESULTS

Three design needs were identified which included 1) locking the casters in the forward direction, 2) ability to raise the seat height as high as possible while allowing the user's knees to fit under the table, and 3) adjustable seat angle which will allow some users to have anterior tilt to get their trunk even higher while other users could have posterior tilt for stability. A new chair meeting these needs was designed and prototyped.

CONCLUSIONS

Para table tennis has some specific requirements related to movements and posture which were improved by a new wheelchair design specific for the sport.IMPLICATIONS FOR REHABILITATIONMany adaptive sports are improved with sport specific technology.A model client was used to develop a wheelchair specifically for adaptive table tennis.The height and angle of the seat of the new wheelchair can be adjusted for optimal stability and reach.The casters of the new wheelchair can be locked to allow only forward and backward motion.

Usability evaluation of attitude control for a robotic wheelchair for tip mitigation in outdoor environments

Tips and falls are the most prominent causes of wheelchair accidents that occur when driving on uneven terrains and less accessible environments. The Mobility Enhancement Robotic Wheelchair (MEBot) was designed to improve the stability of Electric Powered Wheelchairs (EPW) when driving over these environments. MEBot offers six independently height-adjustable wheels to control attitude of its seat over uneven and angled terrains. Its attitude control application uses an inertial measurement unit to detect seat angles changes to adjust each wheel-height accordingly. MEBot was compared to commercial EPWs in terms of EPW performance (seat angle changes and response time) and participant perception (satisfaction and task-load demand) towards each device. Ten participants drove their own EPW and MEBot for five trials each through driving tasks that replicated outdoor environments. Results showed less change in the pitch angle when driving up and down a 10° slope using MEBot (5.6 ± 1.6°, 6.6 ± 0.5°) compared to the participants' own EPW (14.6 ± 2.6°, 12.1 ± 2.6°). However, MEBot required 7.8 ± 3.0 s to self-adjust to the minimum angle when driving over the tasks. Participants reported no difference in satisfaction and task load demand between EPWs due to similarities in comfort and ease-of-use. Improving the speed and efficiency of MEBot's attitude control application will be addressed in future work based upon participants' feedback.

Winter Mobility and Community Participation Among People Who Use Mobility Devices: A Scoping Review

OBJECTIVE

To identify the knowledge, products, and strategies for individuals with mobility-related disabilities used to address challenging winter conditions.

DATA SOURCES

AgeLine, OVID, Scopus, and CIHAHL were searched for studies that met the inclusion criteria, from inception to April 2018. Sources for gray literature, or information outside commercial publishing, included ProQUEST, government websites, and manufacturers, vendors, and consumer organization websites.

SOURCE SELECTION

Population of people with limited or reduced mobility or mobility device users involved in winter-related environmental conditions; aim was to increase activity, participation, or safety.

DATA EXTRACTION

Two reviewers independently applied the inclusion criteria to select eligible sources. Two reviewers independently extracted the data from each source.

DATA SYNTHESIS

Twenty-three published peer-reviewed papers were located. Study populations were predominantly those who used wheelchairs (mixed wheelchair type, n=7; power, n=4; manual, n=2), canes (n=3), or specialized winter footwear (n=2). The primary focus of these papers was determined to be tool or device (n=10), recommendations (n=9), strategy (n=2), or resource (n=2). Civic policy documents were variable in citizen responsibility for snow clearing. Limited winter-related supports were identified on consumer organization websites. Although some winter-specific products exist, very few studies have examined the effectiveness of any of these products.

CONCLUSIONS

Despite the common experience of challenging winter conditions, a paucity of winter-specific research and innovation relevant for individuals who use mobility devices exists. Researchers, consumers, and industry need to partner to develop novel tools, strategies, resources, and evidence-based recommendations.

A Heuristic Approach to Overcome Architectural Barriers Using a Robotic Wheelchair

The Mobility Enhancement roBotic (MEBot) wheelchair was developed to improve the safety and accessibility of wheelchair users when facing architectural barriers. MEBot uses pneumatic actuators attached to its frame and six wheels to provide curb ascending/descending for heights up to 20.3 cm. To improve MEBot's application, this study used a heuristic approach with power wheelchair users to evaluate and improve the MEBot application at different curb heights. Wheelchair users were trained on MEBot's features to operate its curb ascending/descending application. Three trials were carried out with wheelchair users ascending and descending three curbs of different height. Quantitative variables were analyzed to improve the sequential steps to ascend/descend curbs. Additionally, the application's effectiveness and efficiency were measured by the number of completed tasks, change in seat angle, and task completion time. Results showed that participants completed each trial and applied alternative strategies to traverse different curb heights. Furthermore, results suggested the combination and/or re-arrangement of steps to reduce task completion time. MEBot demonstrated its effectiveness to ascend/descend different curb heights with a heterogeneous participant sample. Future work will incorporate participant's most efficient strategies to improve the ascending/ascending process and the efficiency of the MEBot application.

Assessment of Usability and Task Load Demand Using a Robot-Assisted Transfer Device Compared With a Hoyer Advance for Dependent Wheelchair Transfers

OBJECTIVE

Manual lifting can be burdensome for people who care for power wheelchair users. Although technologies used for dependent transfers are helpful, they have shortcomings of their own. This study compares the usability and task load demand of a novel robot-assisted transfer device to a clinical standard when performing dependent transfers.

DESIGN

A cross-sectional study was conducted to assess caregivers (N = 21) transferring a 56-kg mannequin with the Strong Arm and Hoyer Advance at three transfer locations. Feedback was gathered through qualitative surveys.

RESULTS

Usability was significant in multiple areas important for transfers. Caregiver fatigue and discomfort intensity were reduced, and the Strong Arm was preferred at the three transfer locations. Device ease and efficiency favored Strong Arm at two stations as was discomfort frequency. In addition, physical demand, frustration, and effort were significantly lower using Strong Arm compared with the Hoyer Advance.

CONCLUSIONS

Compared with the Hoyer, participants favored Strong Arm for transfer usability and task load demand. However, further Strong Arm developments are needed.

Usability Evaluation of a Novel Robotic Power Wheelchair for Indoor and Outdoor Navigation

OBJECTIVE

To compare the Mobility Enhancement roBotic (MEBot) wheelchair's capabilities with commercial electric-powered wheelchairs (EPWs) by performing a systematic usability evaluation.

DESIGN

Usability in effectiveness, efficacy, and satisfaction was evaluated using quantitative measures. A semistructured interview was employed to gather feedback about the users' interaction with MEBot.

SETTING

Laboratory testing of EPW driving performance with 2 devices in a controlled setting simulating common EPW driving tasks.

PARTICIPANTS

A convenience sample of expert EPW users (N=12; 9 men, 3 women) with an average age of 54.7±10.9 years and 16.3± 8.1 years of EPW driving experience.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

Powered mobility clinical driving assessment (PMCDA), Satisfaction Questionnaire, National Aeronautics and Space Administration's Task Load Index.

RESULTS

Participants were able to perform significantly higher number of tasks (P=.004), with significantly higher scores in both the adequacy-efficacy (P=.005) and the safety (P=.005) domains of the PMCDA while using MEBot over curbs and cross-slopes. However, participants reported significantly higher mental demand (P=.005) while using MEBot to navigate curbs and cross-slopes due to MEBot's complexity to perform its mobility applications which increased user's cognitive demands.

CONCLUSIONS

Overall, this usability evaluation demonstrated that MEBot is a promising EPW device to use indoors and outdoors with architectural barriers such as curbs and cross-slopes. Current design limitations were highlighted with recommendations for further improvement.

Consumer Feedback to Steer the Future of Assistive Technology Research and Development: A Pilot Study

Objective: The overall objective of this project was to identify consumers' opinions of their needs and wants related to assistive technology (AT) in a systematic and quantitative manner via a questionnaire that can be used to validate existing and establish new research priorities. Methods: This pilot study describes questionnaire development, online implementation, and revisions considered to the questionnaire in preparation for conducting a nationwide survey. Data from a sample (N = 112) are presented. The pilot study was critical to refine the questions and ensure that meaningful information was being collected. Results: It was identified that revisions were warranted to provide more structure and allow for consumers to prioritize AT research efforts. Conclusion: The questionnaire results, although positively in favor of many of the technologies presented, are inconclusive to identify generalizable research priorities, thus expansion to a nationwide population is warranted.

Step-Climbing Power Wheelchairs: A Literature Review

Background: Power wheelchairs capable of overcoming environmental barriers, such as uneven terrain, curbs, or stairs, have been under development for more than a decade. Method: We conducted a systematic review of the scientific and engineering literature to identify these devices, and we provide brief descriptions of the mechanism and method of operation for each. We also present data comparing their capabilities in terms of step climbing and standard wheelchair functions. Results: We found that all the devices presented allow for traversal of obstacles that cannot be accomplished with traditional power wheelchairs, but the slow speeds and small wheel diameters of some designs make them only moderately effective in the basic area of efficient transport over level ground and the size and configuration of some others limit maneuverability in tight spaces. Conclusion: We propose that safety and performance test methods more comprehensive than the International Organization for Standards (ISO) testing protocols be developed for measuring the capabilities of advanced wheelchairs with step-climbing and other environment-negotiating features to allow comparison of their clinical effectiveness.