Wheeled Mobility Device Users Research Articles

Restricted vs. Unrestricted Space for L-Turns: A Debate in Environmental Design

Wheeled mobility device users face challenges in terms of access to the built environment and maneuverability within the built environment has received limited attention. As the wheeled mobility device user population has changed drastically in the recent years, there is a need to update accessibility standards and develop reliable methods for testing user performance in the built environment. This paper presents a comparison of restricted and unrestricted space requirements for angle turns (L-turns) with the aim of highlighting differences between space requirements in these situations and comparing the results to current accessibility standards. One hundred forty wheeled mobility device users completed L-turns to the best of their ability in a restricted space environment, and thirteen performed the same maneuver in an unrestricted space environment. Data indicates that although entrance dimensions of the turns are similar between the restricted space and unrestricted space groups, there is a significant difference between exit dimensions. This suggests that when unrestricted space is utilized, users may adopt different strategies and paths when executing their turns. Additionally, a comparison of the study results, both in the restricted and unrestricted conditions, to current accessibility standards indicates that a large proportion of individuals may not be able to successfully complete L-turns in compliant built environments. In the design of the built environment, researchers and designers should consider space requirements, ease of execution and time of execution simultaneously to create comfortable and accessible environments for normal and urgent circumstances.

Design Features That Affect the Maneuverability of Wheelchairs and Scooters

Koontz AM, Brindle ED, Kankipati P, Feathers D, Cooper RA. Design features that affect the maneuverability of wheelchairs and scooters. Objective To determine the minimum space required for wheeled mobility device users to perform 4 maneuverability tasks and to investigate the impact of selected design attributes on space. Design Case series. Setting University laboratory, Veterans Affairs research facility, vocational training center, and a national wheelchair sport event. Participants The sample of convenience included manual wheelchair (MWC; n=109), power wheelchair (PWC; n=100), and scooter users (n=14). Intervention A mock environment was constructed to create passageways to form an L-turn, 360°-turn in place, and a U-turn with and without a barrier. Passageway openings were increased in 5-cm increments until the user could successfully perform each task without hitting the walls. Structural dimensions of the device and user were collected using an electromechanical probe. Mobility devices were grouped into categories based on design features and compared using 1-way analysis of variance and post hoc pairwise Bonferroni-corrected tests. Main Outcome Measure Minimum passageway widths for the 4 maneuverability tasks. Results Ultralight MWCs with rear axles posterior to the shoulder had the shortest lengths and required the least amount of space compared with all other types of MWCs ( P<.05). Mid-wheel-drive PWCs required the least space for the 360°-turn in place compared with front-wheel-drive and rear-wheel-drive PWCs ( P<.01) but performed equally as well as front-wheel-drive models on all other turning tasks. PWCs with seat functions required more space to perform the tasks. Conclusions Between 10% and 100% of users would not be able to maneuver in spaces that meet current Accessibility Guidelines for Buildings and Facilities specifications. This study provides data that can be used to support wheelchair prescription and home modifications and to update standards to improve the accessibility of public areas.

Retrospective review of adverse incidents involving passengers seated in wheeled mobility devices while traveling in large accessible transit vehicles

Objective Characterize wheeled mobility device (WhMD) adverse incidents on large accessible transit vehicles (LATVs) based on vehicle motion, WhMD activity during incident, incident scenario and injury. Design Retrospective records review. Subjects/patients WhMD passengers traveling on LATVs while remaining seated in their. Methods Adverse incidents characterized based on vehicle motion, WhMD activity during incident, and incident scenario. Injury characterized based on outcome, medical attention sought, vehicle activity, WhMD activity and incident scenario. Results 115 WhMD-related incident reports for years 2000–2005 were analyzed. Most incidents occurred when the LATV was stopped (73.9%), during ingress/egress (42.6%), and at the securement station (33.9%) when the LATV was moving. The combination of WhMD tipping and passenger falling (43.4%) occurred most frequently, and was 1.8 times more likely to occur during ingress/egress than at the securement station. One-third (33.6%) of all incidents resulted in injury, and injuries were equally distributed between ingress/egress (43.6%) and at the securement station (43.6%). Conclusions WhMD users have a greater chance of incurring injury during ingress/egress than during transit. Research is needed to objectively assess real world transportation experiences of WhMD passengers, and to assess the adequacy of existing federal legislation/guidelines for accessible ramps used in public transportation.

Usability Study of a Powered Lift for Wheelchair Users

Stairways into building or public vehicles are important environmental barriers that limit accessibility to users of wheeled mobility devices. Powered van lifts can serve as an alternative to stairs, ramps or porch lifts, but they have not yet been carefully evaluated for this purpose. The objectives of this study were to characterize the usability of a powered van lift device for wheelchair users and demonstrate the utility of using a multi-method evaluation approach to identify opportunities for design improvements. Twenty experienced wheeled mobility device users either alone (n=11) or with the assistance of a caregiver (n=9) completed tasks using a powered van lift. Measurements were made on the unrestricted space required to enter and exit the lift, time required to enter and exit the lift, errors made during the operation of the lift's control, and self-reports of device usability obtained with a questionnaire. Results indicated that the clear space required for the lift was less than what would be expected for a ramp and that the self-reported usability of the device was reasonably good. However, the time required to use the lift was high and participants had difficulty operating the lift's safety-belt. Improvements should be made to the design of the safety-belt to increase usability. Additional studies that include other user populations are recommended to investigate the efficacy of the device as an alternative to stairs, ramps and “porch” lifts.

Conceptual issues in the measurement of participation among wheeled mobility device users

Purpose. To review current measurement approaches to activity and participation among wheeled mobility users and suggest key factors researchers should consider as they continue to develop and refine both the concept of participation and its measurement.Methods. Literature review and expert opinion.Results. Four issues are reviewed:Participation as a concept and as a key domain of the revised International Classification of Functioning, Disability and Health (ICF).The ‘perspective’ of current participation self-reports as they reflect the underlying cultural values of autonomy and independence.The lack of sensitivity in current participation measures to assistive technology.The significance of the ICF qualifiers ‘capacity’ and ‘performance’ to the accurate assessment of activity and participation among wheeled mobility users.Conclusions. The following suggestions are offered as researchers continue to develop increasingly sophisticated instruments and methods: (1) participation measures need to be device-specific; (2) measures ought to capture both ‘capacity’ and ‘performance’; (3) methods need to be sensitive to those factors that impact mobility device use over time; (4) methods need to be sensitive to the complexities of both the social and physical environment as they impact device use; and (5) measures need to reflect the impact of multiple mobility device use.

Evaluating a new mobility device: feedback from women with disabilities in India

Purpose: To gather the opinions of potential wheeled mobility device users at an early stage in the design process to ensure the development of technology which would meet their functional needs. Method: Eight women with bilateral lower extremity disabilities living in Gujarat state, India, participated in this study. The women were introduced to a working model of a new wheeled ground mobility device (GADI2) for a brief trial and participated in a feedback interview which solicited information on different aspects of the design, specifically the interface between the device and the user, the physical environment and the sociocultural environment. Both qualitative and quantitative data were collected and analysed. Result: Although the overall response to the device was positive, there was a lack of consensus in some of the feedback gathered. There were varying opinions across the participants and recommendations were often in opposition to what would typically be recommended in a traditional rehabilitation setting. Conclusions: This study investigates and discusses the research findings from a rehabilitation perspective with a focus on the functional versus technical design aspects. The importance of involving potential consumers in the design of technology is highlighted. The small sample size and lack of consensus in some of the results indicates the need for further research and field testing of this new mobility device design.