International mobility technology research: a Delphi study to identify challenges and compensatory strategies.

We sought to identify logistical and ethical challenges to performing wheelchair-related research in low- and middle-income countries and to generate a list of compensatory strategies to address these challenges. Thirteen individuals with experience in the field participated in an online Delphi study. The surveys asked participants to identify research challenges, suggest strategies to address the selected challenges, and critique each other's strategies. Participants identified challenges in the use of research techniques, compensation for participation that does not result coercion, oral and written translation materials, funding for research, collaboration with local professionals, and "respect for persons." Effective international mobility research requires time, cultural sensitivity, collaboration, and careful planning. An understanding of these requirements can allow researchers to anticipate and compensate for common pitfalls of their work, thus making the research more productive and beneficial to subjects. Future research is required to verify the general effectiveness of compensatory strategies.

Relationship between wheelchair durability and wheelchair type and years of test.

OBJECTIVE: To investigate the relationship between the durability of wheelchairs according to American National Standard for Wheechairs/Rehabilitation Engineering and Assistive Technology Society of North America (ANSI/RESNA) Wheelchair Standards and wheelchair type as well as year of test. DESIGN: A retrospective study design with a sample of 246 wheelchairs that were tested in accordance with the ANSI/RESNA standards from 1992 to 2008 including four types of wheelchairs: manual wheelchair (MWC), electrical powered wheelchair (EPW), scooters and pushrim-activated power-assisted wheelchair (PAPAW). Unconditional binary logic regression analysis was chosen to evaluate the relationship between test results and test year as well as wheelchair type. SETTING: Rehabilitation Engineering Research Center. MAIN OUTCOME MEASURES: Wheelchair durability test result (fatigue test: pass or fail) RESULTS: There was no significant correlation between the year when tested and equivalent cycles. A significant relation was found between test results and wheelchair type (Wald score = 10.845, degree of freedom = 3, p = 0.013) with scooters having a significantly higher pass ratio than MWC (OR = 15.629, 95% CI = 2.026-120.579). EPW also had significantly higher pass ratio than MWC (OR = 1.953, 95% CI = 1.049-3.636). No significant difference on pass ratio was found between PAPAW and MWC. CONCLUSIONS: No significant improvements in wheelchair test results during the time frame from 1992 to 2008 were discovered. Wheelchair standard tests should be conducted to assure minimum quality of the wheelchairs and for improving the design of wheelchairs. Although the ANSI/RESNA wheelchair durability test procedures have remained consistent, it does not appear that the introduction of new materials, designs and the availability of test data have improved wheelchair fatigue life.

Current state of mobility technology provision in less-resourced countries.

This article reviews mobility technology in less-resourced countries, with reference to people with disabilities in several locations, and describes technology provision to date. It also discusses a recent collaborative study between a United States University and an Indian spinal injuries hospital of Indian wheelchair users' community participation, satisfaction, and wheelchair skills. The data suggest that individuals who received technology from the hospital's assistive technology department experienced increased community participation and improved wheelchair skills. This evidence may have already enabled the hospital to improve Indian governmental policies toward people with disabilities, and it is hoped that future research will benefit other people similarly.

Design, development and testing of a low-cost electric powered wheelchair for India.

PURPOSE: To design and develop an appropriate, low-cost electric powered wheelchair (EPW) for the Indian subcontinent. METHOD: We performed the following multi-phase design process: (1) Conceptual design; (2) System design, Prototype I fabrication, focus group testing with Indian stakeholders (n = 29); (3) System re-design, Prototype II fabrication and user trials with US (n = 5) and Indian (n = 25) subjects. RESULTS: (1) Preliminary investigations revealed that a conventional EPW design was infeasible due to the high component cost. Instead, we constrained our design to incorporate a single drive motor and manual steering, with the option of upgrading to power steering where economically feasible. (2) The first prototype was fabricated out of easily available, low-cost materials. Focus group testing demonstrated feasibility of the design and revealed differences between stakeholder groups. (3) Prototype II incorporated feedback from the first focus group and a needs assessment. US subjects provided valuable design advice prior to the India trials. Indian subjects travelled further in the SIMPL-EPW than their own manual wheelchair (MWC). Depending on spinal injury level, Indian subjects found the entire (tetraplegia) or outdoor portion (paraplegia) of the obstacle course significantly less challenging in the SIMPL-EPW compared with their own MWC. CONCLUSIONS: We demonstrated a useful and successful multi-phase design approach for developing assistive technology for developing regions.