Technology to Keep Up with You!
Mobility devices designed to fit your life & lifestyle
- By Laurie Watanabe
- Jul 01, 2021
Sometime in the future, George Jetson flies to work in his
space car to labor three hours a day, three days a week, at Spacely
Space Sprockets. Arriving at his office, George doesn’t need to
hunt for a parking space: His space car instantly folds into a
briefcase that George carries to his desk.
ASSISTIVE TECHNOLOGY: ISTOCKPHOTO.COM/VISUAL GENERATION
Wheelchairs don’t yet fold into briefcases. But assistive technology
is absolutely getting smarter, more responsive, lighter
weight, smaller, easier to use, and more convenient. Increasingly,
the best technology doesn’t just support your mobility needs; it
also conforms to your lifestyle and goals.
Extraordinary Exoskeletons
External skeletons — aka, exoskeletons — are best known in the
assistive technology world as wearable, motorized combinations
of hardware and software that help people to walk. For example,
the Parker Hannifin Indego exoskeleton
can be used for gait training,
i.e., helping people to improve their
walking.
But exoskeletons can have other
benefits. A recent study using Ekso
Bionics’ GT robotic exoskeleton
showed that study participants
with spinal cord injury experienced
decreased spasticity after
just one training session (Journal of
Rehabilitation Medicine, 2018). Other
studies involving people with spinal
cord injuries are examining the
impact of exoskeleton training on blood pressure, oxygen intake, and bowel function (U.S. National
Library of Medicine, ClinicalTrials.gov).
While exoskeletons are often associated with walking, manufacturers
are also developing upper-extremity exoskeletons for
people who have lost arm function, perhaps because of a stroke
or other brain injury. Those exoskeletons can be helpful for activities
of daily living, such as eating and grooming.
Wheelchair Riding: Safety First
Back-up cameras and blind-spot sensors have become common
in today’s cars and are hugely useful to drivers. Shouldn’t wheelchair
riders be able to access that same kind of technology?
Now they can! New sensor systems are making it safer for
wheelchair users to navigate with ease, confidence, and greater
independence… and with less worry for caregivers and family
members.
For example, Braze Mobility’s
blind-spot and proximity sensors
can be added to any wheelchair
to improve a rider’s awareness
of the environment. Alerts can
be transmitted to the wheelchair
rider visually, audibly, or via
vibration, and the system can be
customized — for example, while the Sentina system is typically
mounted to detect obstacles behind the wheelchair, riders can
contact Braze Mobility to discuss mounting the system to detect
obstacles in front of the wheelchair instead.
LUCI is the brainchild of
two brothers, one of whom has
a daughter who is a long-time
power chair user. Together, this
dad and this uncle imagined
smart technology that could
detect such common power
chair obstacles as curbs, other
drop-offs, and tip-over hazards, so that power chair riding would
be safer. LUCI was designed to detect those dangers, as well as
to detect and prevent potential collisions. And because LUCI is
compatible with Alexa and Google Assistant, the system can also
give wheelchair riders or caregivers information about battery
usage and battery life.
Empowering Manual
Wheelchair Riders
For most of their history,
power-assist systems were
thought of as reactive technology,
an intervention to call on after
shoulder, arm or hand injuries
made self-propelling a wheelchair
too difficult. As a result of
this perspective, power-assist
systems were typically used by people who’d self-propelled their
wheelchairs for decades and
eventually suffered pain from
years of repetitive stress and
strain.
Happily, a revolution is
underway. Wheelchair clinicians
are increasingly viewing power
assist as a proactive technology
that — when added to a wheelchair
early on — can prevent
those costly and debilitating injuries, as well as help wheelchair
riders to avoid weeks or months of down time and immobility
while they rest and heal.
Today’s power-assist systems do far more than lend a motorized
hand; they also demonstrate versatility in design and
function. Some power-assist systems are contained within a
wheelchair’s wheels; other systems are attachable to the wheelchair
in front or in the back and can be easily added or removed
according to the environment or the distances the wheelchair
rider wants to travel.
Today’s power assist gives the rider more customizable control
than ever, with on-the-fly adjustability and apps for seamless
operation. Many systems can adjust on ramps to prevent rollbacks,
and they can adapt if a rider has more strength in one arm
than the other.
The greater variety of
power-assist choices, along with
a more proactive way of using
them, make this technology one
to watch. Ask your wheelchair
team if power assist could make
your ride more efficient.
The Power of Positioning
If you’re a veteran power wheelchair rider, you might be very
familiar with seating functions such as tilt and recline. At the
touch of a button or switch, your power chair can tilt backward,
typically while maintaining your original center of gravity.
Use tilt with power recline, and you can shift your weight to
alleviate pressure and redistribute your body weight. Or you
might routinely ride while tilted slightly back because that position
makes you feel more stable.
But powered seating now includes much more than tilt and
recline. Many powered seating manufacturers now offer an
anterior (forward) tilt option, in addition to traditional posterior
(backward) tilt.
By moving the rider forward, anterior tilt can help with activities
ranging from transferring out of the power chair to reaching
for objects while eating or grooming. Used in combination with
power seat elevation — which lifts the rider straight up — anterior
tilt can improve visual angles so, for example, a power chair
rider can see into pots and pans on a stovetop and reach forward
to stir or serve.
The ITEM Coalition and the National Coalition for Assistive & Rehab Technology (NCART) are among the organizations
lobbying the Centers for Medicare & Medicaid Services to
provide Medicare coverage of power seat elevation and power
standing options for beneficiaries. Keep track of their ongoing
progress at itemcoalition.org and ncart.us.
Picture Yourself (& Your Chair) Here
A wheelchair is an intensely personal extension of its rider…
which is why it’s so important there are no “surprises” when a
new wheelchair arrives.
When Sunrise Medical
launched its Nitrum ultralightweight
wheelchair in 2021, along
with it came the 3D Visualizer,
a tool that shows what your
personal Nitrum will look like
as you and your wheelchair
team build it. From frame to
backrest, from caster wheels to
rear wheels, frame accessories,
side guards and footrest, the
3D Visualizer shows you how
each component and choice
looks within the overall chair…
no imagination necessary. You
can even see and compare color
choices in real time.
After you configure your
Nitrum, you can go one step
further with Sunrise Medical’s
Augmented Reality feature.
Augmented Reality takes your
personally configured Nitrum
and places it within your
personal environment. Want to
know how the Nitrum will look
inside your actual bathroom?
Or how it will look in a narrow
hallway? Augmented Reality gives you a look before you order
your wheelchair.
Your Own Power Positioning Personal Assistant
If your power chair includes tilt and recline, you no doubt have
received instructions on how often to tilt and recline to change
positions and relieve pressure on your skin and underlying
tissues. But how often are you supposed to tilt and recline? Once
you’ve tilted and reclined, how long do you need to stay in that position? Do you activate tilt first, then recline? Or vice versa?
Keeping track of it all — and also counting the number of
times you’ve repositioned per day, and how many days you
ful lled your repositioning goals this week — can be an entire
regimen in itself. And who has time for that?
If you’d love a personal assistant to keep track of your positioning,
ask your seating team about “memory” options that can
retain data such as how far back to tilt. Memory systems, which
are part of your power chair’s electronics, can be programmed
by your seating team so you or a caregiver just need to press a
button or switch when it’s time to reposition. The seating system
does the rest: It will tilt and recline the prescribed amount… and
yes, it will remember which function to activate first.
Some systems can also keep track of how long you remain
tilted/reclined, and how many times a day you did your repositioning.
You’re busy enough: Let your power chair electronics
keep track of your positioning.
Standing Can Be a Power Move
You’ve probably heard healthcare researchers say that sitting for
long periods — at a work desk all week, for example — can negatively
impact your health over time. Human anatomy is designed to stand, which is why standing desks have become so popular in
workplaces and home offices. Changing positions regularly can
be good for our health and can positively affect a wide range of
body functions.
If you’re a full-time power wheelchair user, standing can
provide pressure relief by
shifting your weight off of your
main “sitting surface” — aka,
your rear end — so that blood
has the chance to re-circulate to
the skin and tissues that you’ve
been sitting on.
But standing can do a lot more
than just help your skin and its
underlying tissues. Standing can
also improve your respiration:
When you stand, your chest
opens up to make breathing
easier, and you might also find
that you can speak more easily
and with greater volume.
Standing can help your
digestive system, as well as help to improve bowel and bladder
function. And standing can help to maintain or improve bone
integrity, while the motion of
going from sitting to standing
and back again can keep
your hips, knees, and trunk
moving. Those activities can
help to prevent painful muscle
tightness and can help you
to retain your body’s range of
motion.
For these reasons, more
and more power wheelchairs
are now available with power
standing options, making it
easier than ever for power
chair riders to change position
and see the world from a whole new perspective. Standing wheelchairs
can have a more limited standing range than standing
frames do — i.e., standing wheelchairs stop short of full vertical
standing — but the advantages include being able to move into a
standing position without needing to leave the power chair.
And standing wheelchair options aren’t just for adults:
Pediatric power chairs can also be capable of standing. So how
do you know whether a standing regimen could be for you? Ask
your wheelchair clinician or provider.