I recently received a physical copy of “Knowledge, Innovation, and Impact: A Guide for the Engaged Health Researcher”, co-edited by my co-founder Dr. Alex Mihailidis and featuring two book chapters that I had the privilege of authoring. Writing these chapters was a fairly unique, challenging, and fun experience as compared to others that were a lot more academic in nature. They really allowed me to reflect on my own experience in translating research that I worked on for more than a decade into a product that I eventually commercialized at Braze Mobility.
The first chapter (Chapter 42) was “Commercializing Research Innovations: An Introduction for Researchers”, which I co-authored with Lupin Battersby. In this chapter, Lupin and I present some food for thought to researchers who are thinking about or beginning the path of commercializing their research. Key concepts we outline are:
- Licensing vs. launching (which path is right for you?).
- Identifying your market, customers, and value proposition (who benefits?).
- Types of innovation and Intellectual property (discussed further in Chapter 45 by my friends and mentors Richard McAloney and Emanuel Istrate).
- Value chain and key stakeholders (how to get to market?).
- Funding (how to raise money, especially non-dilutive?).
- Creating a business model canvas (how do you put all the pieces together?).
- Sources of support within academia (who do you get help from?).
I hope the guidelines and suggestions above help you along your journey to creating real-world impact.
The next chapter (Chapter 43) was particularly exciting to write: “Case Study 1: Blind Spot Sensors for Wheelchairs – Increasing Access to Independent Mobility”. In this chapter, I describe various aspects of my entrepreneurial journey.
- The challenge: Safety is an issue while navigating in powered mobility devices, which can result in exclusion from the use of these devices. The objective was to find a solution that would enable independent mobility while increasing safety.
- Technology push vs. market pull: What the engineer believes to be the solution is not always what the customer needs and wants – how to avoid this?
- Separating academic and commercial activities (to keep clean records of intellectual property).
- The start-up “pivot”: After more than a decade of developing semi-autonomous systems for wheelchairs (e.g., automatic collision avoidance), I pivoted to creating warning/alert systems instead. Why? Read the chapter to find out!
- Outcomes and impact: a success story of a long-term care resident who nearly lost access to his powered wheelchair, but continues to remain independent and mobile today.
It was the summer of 2006 and I had just joined the Intelligent Assistive Technology and Systems Lab (IATSL) at the University of Toronto run by Dr. Alex Mihailidis. I still remember a lab meeting where Drs. Geoff Fernie and Rosalie Wang were introducing one of their projects, an anti-collision wheelchair. As a lab that primarily focused on technologies for older adults, the issue they were trying to solve was that of exclusion of older adults with dementia from the use of powered mobility. I got to see this problem myself when I visited a long-term facility for the first time along with my supervisor (Dr. Alex Mihailidis, who would become a RESNA President and Fellow, and my co-founder at Braze Mobility Inc. several years later). Many residents at the facility did not have the strength to self-propel their manual wheelchairs, and powered mobility use was prohibited due to safety concerns. Statistics showed that 60-80% of residents have dementia, and there was not a lot of research evidence at the time (still isn’t!) to provide guidance on who might and might not be able to operate a powered wheelchair safely.
Several solutions had already been implemented and tested with the intended users – one of the things that attracted me to this lab, as it was often the case that assistive technologies were tested with able-bodied individuals, or just in simulation experiments with no users at all.
One of these solutions included a bumper skirt, a bunch of panels installed around the powered wheelchair that would automatically stop the wheelchair when they made contact with an obstacle. The contact force required was small (1N from the time of first contact to the full stopping distance of the powered wheelchair).
Another interesting solution was a haptic joystick – a joystick that used a bunch of motors to prevent the user from pushing the joystick in the direction of an obstacle, as part of a multi-modal feedback system that provided user feedback to indicate which direction had the most free space around the obstacle (through arrows and audio cues). One study employed a “Wizard of OZ” paradigm. The simplest way I describe this is “fake it till you make it”. The obstacle detection part of the problem was solved by a human, the “wizard”, who was following closely behind the user and would activate the feedback module whenever the user approached an obstacle. The “wizard” is typically hidden so that the user believes he/she is interacting with a system that actually offers all the functionality being simulated.
This paradigm is fairly popular in the field of human computer interaction, especially in the early stages of research where complex technologies can be mocked or simulated by a human to understand their impact on the intended user. This approach can save a lot of resources that would otherwise be spent on building the technology, and can instead help quickly identify usability issues even before the technology is built. Wizard of OZ would eventually play a big role in my post-doctoral research, helping me to accelerate my own research and development efforts. Fun fact: the Wizard of OZ phrase and its use in human computer interaction was coined by Dr. Jeff Kelley. He was a usability expert who was inspired by the scene in the movie “The Wizard of Oz”, where Toto reveals that the wizard is just a man behind the curtain flipping switches and pulling levers.
At the time I joined the lab, non-contact sensors were being explored (i.e., sensors that could, unlike the bumper skirt technology, identify obstacles without needing physical contact with them). Drs. Alex Mihailidis and Jesse Hoey had just won a competition for a project that used an infrared sensor to automatically detect obstacles and stop the wheelchair in the case of an imminent collision. While the results seemed promising, an issue with infrared sensors is that they work by transmitting and receiving infrared waves, which are also found in direct sunlight. So, these sensors can fail in direct sunlight, unless more advanced techniques are used (such as using specific patterns or pulses that could be used to identify whether the infrared wave entering the receiver is similar to ones being transmitted by the sensor).
Interestingly, Alex’s research group had recently struck a collaboration with the University of British Columbia. This was particularly relevant to me as I had already been offered acceptance into UBC’s Computer Science program for Graduate Studies and would be starting there in Fall 2006. Researchers there had been doing interesting work with stereo-vision sensors. The advantage of these types of sensors over those being used previously was that, much like the human eyes, not only could stereo-vision sensors figure out how far away an obstacle is (proximity), but could also be used to automatically create maps from visual landmarks. The application of computer vision to smart wheelchair research had just begun, and I was excited to be part of this pioneering work.
Over the next 6 years, I would go on to learn not only about computer vision, but also artificial intelligence, robotics, machine learning, and human computer interaction, finally bringing all these fields together in a highly trans-disciplinary PhD dissertation. Join me in my next blog posts as I share my learnings.
Marcantonio ER. Dementia. In: Beers MH, Jones TV, Berkwits M, Kaplan JL, Porter R, eds. Merck Manual of Geriatrics. 3rd ed. Whitehouse Station, NJ: Merck & Co., Inc.; 2000:357-371.
Wang, R.H., Gorski, S.M., Holliday, P.J., and Fernie, G.R. (2011). Evaluation of a contact sensor skirt for an anti-collision power wheelchair for older adult nursing home residents with dementia: Safety and mobility. Assistive Technology, 23(3): 117-134.
Wang, R.H., Mihailidis, A., Dutta, T., and Fernie, G.R. (2011). Usability testing of multimodal feedback interface and simulated collision-avoidance power wheelchair for long-term-care home residents with cognitive impairments. Journal of Rehabilitation Research and Development, 48(6): 801-822.
John F. (“Jeff”) Kelley. 2018. Wizard of Oz (WoZ): a yellow brick journey. J. Usability Studies 13, 3 (May 2018), 119–124.
Viswanathan, P., Wang, R. H. and Mihailidis, A. (2013). Wizard-of-Oz and Mixed-Methods Studies to Inform Intelligent Wheelchair Design for Older Adults with Dementia. 12th European AAATE Conference, 19-22 Sept, Vilamoura, Portugal.
Mihailidis A, Elinas P, Boger J, Hoey J. An intelligent powered wheelchair to enable mobility of cognitively impaired older adults: an anticollision system. IEEE Trans Neural Syst Rehabil Eng. 2007 Mar;15(1):136-43. doi: 10.1109/TNSRE.2007.891385. PMID: 17436886.Read More
I took my first Wheel-Trans trip this past weekend, and had the chance to discuss the pros and cons of the system with someone who has much more experience with it than I do. I will share some of those thoughts with you, and hope to hear your opinion as well! Have you used Wheel-Trans or a similar service? Leave a comment below about your experience and let’s start a conversation about what is working well and how we can improve accessible transit.
Check out our blog post on accessible subway transit!
Wheel-Trans provides door-to-door transit service in Toronto for people who have a disability that prevents them from using the wider TTC (Toronto Transit Commission) transit system. This includes both temporary and permanent disabilities. If you are unable to use any conventional TTC transit, or are unable to access certain services offered by the TTC you may be eligible for Wheel-Trans services. For example, if you are able to use the subway but the location you need to go is close to an inaccessible subway station, you may be eligible for Wheel-Trans for all or part of that trip. To apply for Wheel-trans, click here.
The service is available 24h a day, 7 days a week and costs the same as a standard TTC fare.
Anywhere the TTC goes, Wheel-Trans offers a door-to-door service.
In order to book Wheel-Trans service, you can either call (416-393-4222), book online, or use their automated phone booking service (416-397-8000). Bookings can be made 7 days in advance, but must be made at least 4 hours prior to departure (between 5AM and 11PM). The driver will pick you up from your home, and will drop you off at the designated location. The driver will help you to enter and exit the vehicle and safely strap your mobility device in. If you require additional support during your trip, bring a support person free of charge with a Support Person Assistance Card.
What TTC is killin’ it on!
- Wheel-Trans is growing! The government just announced a $41 million investment in the service. This will provide 120 new accessible busses, create 18 new access hubs, as well as improving the digital presence of Wheel-Trans, and making booking easier!
- Wheel-Trans provided 4.1 Million rides in 2017
- You might be traveling on a Wheel-Trans bus, or a contracted accessible taxi- all for the price of a standard TTC fare! Typically the system is fairly direct from origin to destination.
- Travel between Toronto and other transit regions is made easier by agreements made with Durham, York and Peel Region
Areas that can be improved:
- Booking can be difficult over the phone. This is recognized as an issue by TTC, and they have begun to offer alternative services, such as an automated booking line and online booking. Phone services could still be improved though.
- The booking system is not good at determining optimized routes for the busses. Often, people traveling from the same location get sent separate busses, which adds unnecessary strain on wheel trans resources.
- When busses are running late, and or trips have been cancelled, the Wheel-Trans staff often call last minute, causing stress for the person relying on the ride.
Priority line: 416-393-4111
TTC customer service: 416-393-3030
Customer Service: email@example.com
If you have recently been prescribed a power wheelchair, there are quite a few things to consider. There are many different options to choose between, and ensuring that you are provided with a chair that is right for you is important. The following blog post offers some ideas about options that you have when choosing a wheelchair. Speak to your Occupational or Physical Therapist and your wheelchair vendor if you have any questions regarding your wheelchair order. The following post contains some ideas of things to consider, but is not meant to be an exhaustive list of all options available.
The optimal location for the drive wheels on your chair will depend on a few things. Often, once someone gets used to a certain location of drive wheels, any other location might feel weird. Each type of chair has different pros and cons, so there is no one best location. Check out this website for a full comparison of the wheelchair drive trains.
Rear wheel drive
Pros: These chairs usually have the highest top speeds, and are very stable navigating rugged terrain.
Cons: The turning radius is higher in rear-wheel drive chairs, making navigation in tight spaces more difficult. Additionally, the concentration of mass at the back of the chair makes tipping on uphills more likely.
Front Wheel Drive
Pros: You will be able to turn your front end very quickly, making rounding tight corners easier! These chairs are also very stable, because they distribute the overall mass of the chair the most evenly. Additionally, you will be able to get close to workspaces or tables easily.
Cons: going uphill these chairs have a higher chance of losing traction, as if the mass is concentrated on the rear of the chair the front wheels will have less ability to grip. When turning corners in a front wheel drive chair it may be difficult to maintain awareness of the rear of the chair. This could result in hitting more things with the back of the chair if you aren’t careful! At top speeds, these chairs have also been known to be difficult to maintain control.
Mid Wheel Drive
Pros: These chairs are the most maneuverable of any chairs! You do not require any extra space to turn than that which you already have. They are also the most stable on a slope, because the mass is centered in the middle! Often, people find mid wheel drive chairs the easiest to drive.
Cons: They can get stuck in uneven terrain if the front and rear castors suspend the middle wheels.
You can operate your chair using a few different methods depending on your abilities and preferences. These are some of the most common control types:
- The most common control used is a hand-held joystick controller. These are controlled by using your hand to move the control arm in the direction you wish to go. Operation of these requires motor control of your hand and arm.
- Chin control uses a chin instead of a hand to control the joystick. The controller will be mounted near your face, and you will use your chin to move the control arm.
- A head array is a control that you can trigger with your head. Pushing your head towards the sensors on either side will turn the chair, and pushing your head backwards will make it move forwards. To reverse, a switch is activated and then you can push your head back on the head array.
- Sip and puff users control their wheelchairs via air blown into or sucked out of a straw-like controller. For example a hard puff may mean forwards, and a hard sip backwards. Soft sip and soft puff may correlate to a left or right turn. This control method requires practice to drive smoothly, as the output is not intuitive.
- Touchpads do not require much force, but do require steady control of the hand and arm. Sliding your hand along a controller panel will move the chair in that direction.
Lights can be added to wheelchairs when ordering, however this option is typically quite expensive and often not covered by public insurance. Lights are important to ensure safety when driving, especially in traffic. This blog post discusses the importance of visibility in a wheelchair to prevent injury. If you do not want to spend hundreds of dollars on lights from the wheelchair manufacturer, many people create DIY solutions, including attaching battery powered lights to the chair. If you aren’t able to create a solution yourself, organisations like the Tetra Society may be able to help you make a custom light solution.
Many power wheelchairs are able to tilt, recline, and seat elevate electronically. These features can be especially useful for people who are unable to adjust themselves in their seats. Being able to tilt back is an easy way for care attendants to help someone adjust back in their seat. Being able to recline is important if you are going to spend a lot of time in your chair as it will allow you to stretch your back out. Elevation will allow you to rise up to eye level with people who are standing, and is useful to reach high cabinets, and to reach counters at cashiers and coffee shops etc. These features may be funded depending on the need for them. Without funding, electric tilt, recline and elevate can cost thousands of dollars. Speak to your therapist about whether or not these features are right for you.
There are many different things that you can buy to add on to your wheelchair. Many of our blog posts discuss add-ons, including those that increase safety, increase rear visibility and are just cool features. One feature that you can add on that fits into all three of these categories is the Braze Sentina, which is a blind spot sensor system designed for use with wheelchairs. Learn more about the Braze Sentina here!
When you first bring your wheelchair home, you may find it difficult to know what the footprint of the chair is, and as a result there is a high chance that you will bump some walls and doorways in your home. This can be avoided using various visual aids, such as blind spot sensors to monitor the environment behind your wheelchair. Braze Mobility Inc. makes blind spot sensors that can be added to any wheelchair, and provide the user with 180 degrees of rear view blind spot coverage. More information about these systems can be found here.
I hope this blog post has given you an idea of some of the options available to you in selecting your new wheelchair. Your OT and/or PT and wheelchair vendor are there to answer all of your questions and support you in your selection. Make sure that you advocate for yourself, and know your options in order to ensure that the chair you get is right for you. Please comment below if there are any other features you think should be included!Read More
s the world faces the COVID-19 crisis, it is time to evaluate what emergency preparedness means for the disability community and wheelchair-users in particular. The focus of this article is the development of the health care accessibility standard for people with disabilities. This advice is written by Terri-Lynn Langdon who is a resident of Ontario, Canada and uses a wheelchair. The opinions expressed are Terri-Lynns, and should not replace medical advice.
The healthcare concerns of the wheelchair-using community demands attention every-day in order to continue to make healthcare services and options increasingly accessible to all of us, and no time for this is more crucial than during the Covid19 crisis. Here are 5 things to consider when advocating for yourself in the healthcare system to ensure you are ready for whatever the happens.
- If you do not have a family doctor, reach out to your local health care network and inform them of your situation, and ask to be advised on next steps. In Ontario, contact Health Care Connect http://www.health.gov.on.ca/en/ms/healthcareconnect/pro/
- If there are non-essential medical needs during this time, speak to your healthcare provider about accessing your appointment remotely through tele-health or delaying it until after COVID-19 concerns are controlled.
- For essential care needs try to access a familiar clinic and use the same service as often as possible to help ensure continuity of healthcare and communications related to your healthcare visits. Make sure you let your healthcare team know what you need in order to make your healthcare experiences as accessible as possible, this includes transportation to medical appointments.
- In a medical emergency, you cannot control which hospital or medical team you receive care from. For this reason, keep a summary of your medical conditions, emergency contacts and medications in your wallet.
- Make sure that your medications are up to date and that you have access to them. Call your local pharmacy and see whether they will deliver your medications. Call ahead to pre-book delivery to ensure you are able to receive your medications on time.
Thank you for joining us! Come back next week for the second part of the Emergency Preparedness for People Who Use Wheelchairs series.
Health Care Connect Ontario. Accessed Online: http://www.health.gov.on.ca/en/ms/healthcareconnect/pro/
Lapofsky, D. (2019). Achieving a barrier-Free healthcare system. Osgood Hall Law School. Accessed on Youtube: https://www.youtube.com/watch?v=f2yuFz_z9V0
Medic Alert Canada (2020). Accessed Online: https://www.medicalert.ca/programs
Revoler (2020). Accessed Online: https://revolar.com/ Thompson, G. (2020). What Must Be Done to Make Ontario’s Health Care System Fully Accessible to Patients with Disabilities? Check Out the AODA Alliance’s Finalized Framework for the Promised Health Care Accessibility Standard. Accessed Online: https://www.aoda.ca/what-must-be-done-to-make-ontarios-health-care-system-fully-accessible-to-patients-with-disabilities-check-out-the-aoda-alliances-finalized-framework-for-the-promised-health-care-accessibility-st/Read More
When I joined Braze Mobility, I found all discussion of the design process fascinating, and the iterations undertaken by the design team are a great study in accessible design. The following blog series will discuss Universal Design and Accessible Design, and will profile some great design concepts that inspire and help.
There is no such thing as disability, only poor design*. Of course, some people have a harder time navigating the built environment than others, and there are people who have physical and cognitive abilities that change the way in which they interact with the world. But, when a person is unable to go into a restaurant because someone built stairs instead of a ramp, is it their disability holding them back, or the short-sightedness of the architect who failed to realize not everyone gets around using two legs? Likewise, if someone who is on the Autism spectrum has difficulty visiting a shopping mall at during the holiday times, the poor overstimulating design is to blame for their inability to interact with the environment.
The world is beginning to become more accessible. Governments are producing legislation that forces businesses to ensure their premises are as accessible as possible, such as the AODA (Accessibility for Ontarians with Disabilities Act). Ensuring that spaces and products are able to be used specifically by people with disabilities is important. People regardless of ability and mobility should have the same opportunities to succeed and interact with their environment, no question. Ensuring that a business is accessible also benefits the business itself. By being inaccessible, not only are you losing the business of the person who can’t get into the store, but also everyone who is with them. Accessible design benefits everyone.
But, design for people with disabilities has an added benefit- spaces and products designed to be used by people with disabilities also tend to be easier to use for people without disabilities as well. Take the example of the curb cut, for instance. (If you haven’t heard the story of the Rolling Quads at Berkeley in the 1970’s, there is a great 99% invisible podcast that outlines the story.)
The positive impact of curb cuts benefits everyone, not just those with disabilities. Whether a person using a wheelchair, a parent pushing a stroller, an elderly person wheeling their groceries or just someone crossing the road who doesn’t want to take a step up, curb cuts help make travelling on sidewalks easier. Studies have shown that 90% of people will alter their course to use a curb cut instead of stepping up onto a curb, regardless of physical ability.
This phenomenon is known as the “curb cut effect”, and is a widespread aspect of design.
So, how can we design things to be universally accessible, and therefore a better design for everyone? Follow this blog series to follow our accessible design process! I would love to hear from you if you have any thoughts about accessible design. You can reach me at firstname.lastname@example.org!
*This statement is intended to demonstrate the necessity of considering all abilities in design, and how good design can enable all people to interact with their environment. It is not intended to minimize the impact a disability has on someone’s life.
Further reading: https://ssir.org/articles/entry/the_curb_cut_effectRead More
As self-driving cars begin to enter the market, it becomes increasingly likely that self-driving wheelchairs will be developed. The implications of this are incredible, and will certainly change the way people roll! This blog series will look at where we are now on the journey towards fully autonomous wheelchairs, as well as some of the pros and cons of self-driving chairs. While I am not an expert on robotics (I’ll leave that to our CEO Pooja), I hope that these insights will help you understand what autonomous technology is and can do!
Self-Driving Wheelchairs: What Are They?
Self-driving vehicles are trickling their way into the market slowly, with Google’s Waymo leading the way towards a 2020 projected launch. The adapted cruise control to maintain distance between 2 vehicles, the lane monitoring software to alert drivers when they are crossing over the line in a road are all already implemented in cars. These technologies make cars safer and easier to drive and are generally considered to be good advances in safety technology. However, trouble arises when you take the human completely out of the equation. Complete reliance on a computer’s ability to make life-or-death decisions properly raises concerns, and the ethics of programming a computer to make those decisions poses issues. Despite this, self-driving cars have been on the streets for a fair while, logging over 10 million test hours (England, 2018), and feeding the AI with data about traffic navigation. This process will take years and millions of dollars to reach the point where you could own a car without a steering wheel or brake pedal.
How it works:
The basic model is that the computer is teaching itself how to drive. By using artificial intelligence (a computer that can teach itself), and inputting millions of hours of driving data into the framework, the computer essentially learns to identify situations. When a car encounters, say a person on the side of the road, it will compare this to the millions of other humans that have been encountered in the past and compute the risk of collision. This will include identifying the probability that the person will step out in front of the car, the speed at which the person is moving, the degree of turning which must occur to avoid the person, the amount of brake that must be applied to avoid hitting them, etc. The car will also need to calculate whether steering around the person will put the driver or other cars at risk, and if so will require a pre-programmed decision-making process to decide whether to swerve, brake or neither. Of course, it is all infinitely more complicated than this, and there are many other factors being considered.
But, we aren’t talking about automobiles, we are talking about wheelchairs, which will likely be more difficult to program to drive safely. Cars operate in fairly controlled environments. On roads, cars and pedestrians observe clear traffic rules (even if they aren’t always followed well- I’m looking at you Toronto drivers!), and although there is some level of unpredictability this is limited. Wheelchairs, on the other hand should be able to travel anywhere someone could walk, meaning the situations that the wheelchair will encounter are pretty much as diverse, unpredictable and lawless as walking through Union Station during rush hour. Additionally, it is likely that self-driving cars will be able to communicate with each other, creating network effects, and helping cars to avoid colliding with each other. People who drive wheelchairs often face challenges with people not getting out of their way, or even walking right into their chair. Communicating with humans is a difficult challenge for autonomous wheelchairs, as warnings would need to be inclusive of people with low vision and/or hearing.
Another challenge will be inputting the desired destination for the wheelchair. While cars can be programmed to travel to a specific address, the input for a wheelchair destination is much more complex due to the large diversity of places a wheelchair can travel.
Take, for example someone at a stadium needs to use the washroom. One possibility is that the person will click a button on their chair that says “bathroom”. The chair will then need to have either a blueprint map of the building, or cameras that can monitor the environment in search of the accessible washroom sign. Using this information, the chair has located the closest washroom! Now, the computer will decide the optimal path towards that washroom. This will require the computer to know the location of all stairways to avoid, and all ramps and elevators (assuming chairs are unable to climb staircases at this point). The path is set, and the chair begins on its way! Dodging people and alerting them to move out of the way, the chair approaches the bathroom. When it approaches, the chair deploys a signal to the door to open, or a mechanical hand to push to automatic door opener. The chair registers that the door is open and is able to move into the washroom!
Once in the bathroom, the chair must be able to choose between the available stalls to locate the accessible one, and the person using the wheelchair may want to back into a specific bathroom stall at a certain angle to make transferring easier. While the wheelchair driver or a human attendant may be able to use their past experience about the easiest transfer method, and therefore best location to park in, a computer may have difficulty accounting for all variables. Assuming this chair has learned from its driver, it successfully docks, and the process must be repeated to return the person to their place in the stadium. The complexity of this decision-making process is high, and potential for mistakes is high as well! A wheelchair colliding with a person is dangerous.
A bathroom is an easy target- what if the driver is hoping to travel to a more specific environment (ie the coffee table to the right of the doorway separating the kitchen and living room). Considering input method must be adaptable for people who have a difficult time speaking or typing the challenge increases. All of these challenges will be faced by developers looking to create self- driving technology for wheelchairs.
While Google Maps and other automobile tracking software has been perfecting available maps of streets and traffic, there are no such maps making blueprints of buildings- this means that autonomous vehicle technology must either find ways of interpreting the environment at a human level of understanding (ie- reading signs, sensing walls and obstacles etc), or every building that self-driving wheelchairs are in must be carefully mapped and categorized.
All autonomous technology is a challenge. It will be years before self-driving cars begin to emerge on the market. As you can see, self-driving wheelchairs pose even greater of a challenge for software developers and thus will likely take even longer to emerge onto the market.
The benefit that self-driving wheelchairs will inevitably bring to the population who uses them is incredible. Working towards an autonomous future for wheelchair controls is certainly a good thing- but the challenges are real as well. Our next post will look at the ethical implications of self driving chairs- the good and the bad!Read More
We talked about what autonomous wheelchairs are, and some of the barriers that will need to be overcome before fully autonomous wheelchairs enter the marketplace in our last blog post. We will now examine some of the ethical limitations of autonomous wheelchairs, as well as the benefits that they will bring to people who use wheelchairs and their caregivers. Have thoughts about autonomous wheelchairs? I’d love to hear from you at email@example.com!
Last summer, I went to visit the camp for kids and young adults with physical disabilities that I used to work at. While there, I was heading back with a group to their cabin after a campfire- it was very dark, and the path was unlit. One of the campers that I have known for many years asked if I could navigate his chair through the darkness until we got to an area that was better lit up. We got chatting, and he told me that he very rarely asks others for help with navigating his wheelchair- unless he feels that there could be danger to himself or others he will maintain control. He said that having grown up all of his life with CP, his power wheelchair is one of the few things that he has total physical control over, and giving up control is almost unthinkable. This made me stop and think about the future of power mobility, and how it will affect the relationship between a person and their wheelchair.
There are many potential benefits to autonomous power mobility. Power wheelchair accidents are common (as per our wheelchair collision blog post series!) and can be deadly, especially among the older population. In Canada, falls among elderly people resulted in over 7,000 deaths between 2000-2002 (Public Health Agency of Canada, 2005). In institutions with many elderly people, having an power wheelchair can be seen as a danger to the other residents, and some facilities ban the use of power mobility altogether. Autonomous wheelchairs have the opportunity to prevent accidents, by sensing their environment completely and predicting the safest path, removing or reducing the probability of driver error causing an accident.
Autonomous wheelchairs also have the ability to provide access to independent mobility for people who otherwise need to rely on attendant care to mobilize. Having the ability to move throughout the environment is important for mental health and well-being. For people who do not have access to 24-hour one-on-one care, relying on attendants for mobility could be frustrating. Autonomous wheelchairs would provide independence for the person using the chair, and would reduce the burden on caregivers. Take for example meal times. Often, with limited numbers of staff, getting all residents into place at tables can take up to an hour. With the use of autonomous chairs, that process could be streamlined and staff would be able to focus on getting everyone their food!
Despite these potential positives, the most important factor to consider is the impact for the people who would use the autonomous wheelchairs, including feelings of autonomy and independence. Autonomous chairs must be designed in such a way that people are able to feel that they fully control the chair, and not that the chair is moving them of its own volition. This presents and interesting design challenge for technology developers (spoiler alert- our next blog series will look at accessible & inclusive design!)
An alternative to fully autonomous chairs is giving the driver the information that they need to safely operate their power wheelchair, while maintaining their full control over the chair. This can be done through the use of visual aids, including blind spot sensors to alert drivers to obstacles in their environment- check out the Braze Sentina for more information!
Public Health Agency of Canada. Report on seniors’ falls in Canada. 2005. http://www.phac-aspc.gc.ca/seniors-aines/alt-formats/pdf/publications/pro/injury-blessure/seniors_falls/seniors-falls_e.pdf.Read More
I recently saw an article on the accessibility of transit systems around the world, which was fascinating. The article is available here: https://www.theguardian.com/cities/2017/sep/21/access-denied-disabled-metro-maps-versus-everyone-elses. It is good to see that transit commissions around the world are working towards a more accessible future (albeit slowly). The Toronto Transit Commission was left off of the list, so I decided to investigate. Being much newer than Paris and much less extensive than NYC, Toronto has a clear advantage in the ease of transforming their transit system to being 100% accessible. The following blog series will focus on the accessibility of the Toronto Transit Commission, where we are now, and how far we have to go to reach full accessibility.
TTC Subway Accessibility
The TTC has been making strides towards a fully accessible subway system, a goal which AODA requires is met by 2025. They boast on their website that 50% of stations are accessible. In addition, all subway cars are accessible, and able to be both wheeled onto and off of as well as with designated spots for wheelchairs to park on the trains.
So far, the accessible map of the TTC subway system looks like this:
Many stops are accessible, which means they have elevator access, accessible fare gates, automatic sliding doors and are hubs for accessible busses and Wheel-Trans. These stations also include highly visible signage. All subway cars have accessible access, and each car has at least one designated wheelchair space.
Challenges with subway transit:
- Elevators often malfunction or break, rendering “accessible” stations inaccessible.
- Crowded trains may be difficult to navigate towards the designated accessible seating areas
- Seats with blue covers are specifically for people with disabilities, and able-bodied people are required by law to vacate the seat if someone with a disability requires it. If the train is full, or if the people in the seat do not cooperate it is difficult to enforce this law
How the TTC is working towards solutions:
- The TTC provides up-to-date status updates on elevator and escalator function. As per the TTC website, “before you begin your subway trip call the TTC 24-hour Information Line at 416 393-4636 (INFO) and press 5 to confirm whether or not the elevators or escalators you plan to use on your trip are operating or scheduled for maintenance. Elevator information is also available at 416 539-5438 (LIFT) or on our Elevators and Escalators page.”
- Posters alerting people that they must vacate seats for people with disabilities are now on most TTC subway trains.
- Wheel-Trans vehicles are available to transport people who use wheelchairs to areas serviced by inaccessible stations.
What you can do to make transit easier via subway
- Use a blind spot sensor system, such as the Braze Sentina to help navigate safely towards to accessible seating in crowded trains (watch this video to see the Braze Sentina used to navigate off of a city bus).
- Ensure that you enter the subway car straight, not allowing front wheels to turn and get stuck in the gap
- Advocate for yourself, and alert people to the laws requiring them to vacate seats if required
- Plan ahead, and ensure elevators are running along the stops you need.
Thank you for reading this post. If you have ridden the TTC or other transit system subway and want to share your story, please contact me at firstname.lastname@example.org, or leave a comment below!Read More
Recently, I took a power wheelchair for a test drive through downtown Toronto, Ontario. Within a two hour period, I had hit at least 2 doorways, and narrowly missed the ankles of more than one person with my footrests (thankfully being Canadian they jumped out of the way of my rampaging chair with a cheerful “sorry”). This experience made it very clear the challenges associated with driving a power wheelchair- especially in a tight space. The following blog series will focus on the danger associated with operating power mobility devices, and how we can reduce that danger and improve access to power wheelchairs.
It is important to understand the risks associated with power wheelchair use in order to find ways to minimise risks while maximising the independence of users. It is, however, difficult to measure the prevalence of collisions incurred by power wheelchair users. Statistics are difficult to obtain, as there is no central reporting centre for power wheelchair accidents. There are some research studies that have been done to evaluate the incidence of collisions for power wheelchair users.
Many of these studies are focused on the use of power mobility devices in an institutional setting. Here is a brief summary of the results of some of these studies:
- Frank et al. (2000) found that within 4 months of receiving a power mobility device, 13% (15 out of 113) of people surveyed reported at least one accident, including tipping from chairs and falls during transfers.
- Mortenson et al. (2005) report that The Vancouver Coastal Health (VCH) residential facility which has 82 residents using power wheelchairs, reported 16 incidents of property damage in one year from power wheelchair use. This is a conservative estimate, as the author notes that only serious accidents were reported. There were likely far more minor incidents that were not reported.
- Reed, Yochum and Schloss (1993) reported that 30% of long-term care residents surveyed felt that other drivers within the facility drove unsafely.
Clearly, within an institutional setting, many power wheelchair users have difficulty safely navigating their environment. In such institutions, there is a very high density of power wheelchair users, along with narrow corridors and many obstructions in hallways which present challenges to drivers. One major factor identified as contributing to decreased safety in high density areas is a lack of conformity between drivers. Mortenson et al. (2005) write that a lack of driving rules for wheelchair drivers in an institution can result in animosity between and towards power wheelchair drivers. For example, not designating a regulated side of the hallway to drive on increases the likelihood of collision and creates an atmosphere of blame and animosity towards power wheelchair drivers (Mortenson et al., 2005).
Measuring statistics only in institutions provides an incomplete view of the magnitude of the prevalence of collisions among power mobility device users. Many wheelchair users that live in the community also suffer accidents, and when navigating through traffic the consequences can be catastrophic. Mortenson et al. (2005) found that six out of ten interviewed power wheelchair drivers report that driving in the community is more difficult than diving in an institution. A survey of wheelchair users by Arthanat et al. (2009) found that the usability of power wheelchairs in the community is low. 40-50% of those surveyed reporting that usability was moderate to very low in the community. The difficulty in navigating in the community with a power wheelchair has been observed by multiple surveys.
- Navigating a wheelchair in traffic is a large hazard of navigating within the community. LaBan & Nabity (2010) found that sixty fatal accidents occurred between a motorized vehicle and a wheelchair in one year. Of these accidents, 94% involved a power wheelchair.
- Chen et al. (2011) surveyed 95 active community wheelchair users about the number of collisions experienced. 52 (54.7%) of wheelchair users reported experiencing at least one collision, and 16 (16.8%) reported experiencing 2 or more collisions within a three year period.
- A report from Edwards and McClusky (2010) of Australian power mobility device users found that one-fifth of respondents (21%) reported having an accident in the previous year when using their device. The most commonly reported accidents were caused by running into doors and walls, the device tipping over, being hit by a car or knocking into/over objects such as shop displays.
- Arthanat et al. (2009) found that 52.8% of wheelchair users surveyed had experienced at least one accident (collision or fall) that resulted in injury.
Clearly, the issue of accidents in power wheelchair driving is prevalent. It is important to start a conversation regarding the risks and rewards of power wheelchair use! If you have experienced a collision in your power wheelchair, or know someone who has, leave a comment!
Want to learn more about what Smart Wheelchairs can do to prevent wheelchair collisions? Download our FREE E-Book on Smart Wheelchair Technology!
Arthanat, S., Nochajski, S. M., Lenker, J. A., Bauer, S. M., & Wu, Y. W. B. (2009). Measuring usability of assistive technology from a multicontextual perspective: the case of power wheelchairs. The American Journal of Occupational Therapy, 63(6), 751.
Chen, W. Y., Jang, Y., Wang, J. D., Huang, W. N., Chang, C. C., Mao, H. F., & Wang, Y. H. (2011). Wheelchair-related accidents: relationship with wheelchair-using behavior in active community wheelchair users. Archives of physical medicine and rehabilitation, 92(6), 892-898.
Edwards, K., & McCluskey, A. (2010). A survey of adult power wheelchair and scooter users. Disability and Rehabilitation: Assistive Technology, 5(6), 411-419.
Frank AO, Ward J, Orwell NJ, McCullagh C, Belcher M. Introduction of a new NHS electric powered indoor/outdoor chair (EPIOC) service: benefits, risks and implications for prescribers. Clinical Rehabilitation. 2000;14:665–673. [PubMed]
Mortenson, W. B., Miller, W. C., Boily, J., Steele, B., Odell, L., Crawford, E. M., & Desharnais, G. (2005). Perceptions of power mobility use and safety within residential facilities. Canadian Journal of Occupational Therapy, 72(3), 142-152.Read More