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.

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.