History of the wheelchair and the evolution of mobility
Today the wheelchair is one of the most, if not the most, commonly used assistive device for the personal mobility of people with disabilities. It's estimated that 8 per cent of disabled people in the UK use a wheelchair. Im surprised it's not a larger percentage - but then again, disability is quite a broad term. (Source: CSR Europe, 'Disability: facts and figures' 2007).
Wheelchairs are considered a basic human right for people with limited mobility by the World Health Organisation, and they certainly offer the potential to open up a world of independence and enable greater participation in the social, economic and cultural life of the nation.
I suspect that, throughout history, wheelchairs have often been seen as a source of frustration, and a necessary evil; something that no one actually wanted to use. We will consider some of the reasons for this shortly.
Back in time
There is a great article on the Science Museum website that has some nice pictures of wheelchairs both ancient and modern. https://blog.sciencemuseum.org.uk/history-of-the-wheelchair/
It seems that wheelchairs have been around since at least the 6th century AD, and over the years have evolved with some ingenuity. Self propelled and attendant-propelled versions with changing materials very much a feature of the various designs.
I remember quite well the Model 8 designs of the NHS from the 1950’s, and even the wickerwork bathchair (mostly as a museam piece - im not that old).
Why does my chair not fit me?
As a young bioengineer working with disabled people in the 1970’s, I often met folks with clearly unsatisfactory wheelchairs provided by the State.
I could not understand how provision could be so poor. User’s were often unhappy. How hard can it be?
The chairs so often seemed to stifle independence rather than assist their users. It was common to see wheelchairs too large or too small for the user. Manual chairs were provided to people that really needed powered ones. The chair backs were shaped to push the shoulders forward encouraging a kyphosis and shoulder problems.
Financial constraints were certainly an issue in the 1970’s and probably still are today, but I also didn’t fully understand the actual complexity of the provision.
Today, we see a bewildering array of wheelchair possibilities - wheelchairs for sports, for standing, for all-terrain use and even powered chairs operated by thought or gesture.
Materials have changed too. Modern materials and improved designs have allowed chairs to be more easily lightweight, folding when necessary, or just simply looking better.
At the very least, if you have to use something like this, you would like it to look “designed” rather than put together with a scrap dealers left-overs.
It’s not just the product though
To the casual observer, creating a wheelchair probably doesn’t seem like a challenging task. After all, any chair has at least some wheels, a seat and a back section and the stature of the individual user constrains a lot of the design possibilities.
Of course, today’s users are quite right to expect more from design and to some extent wheelchair providers have delivered better products.
What matters though is that we consider a wheelchair just like any object we design - within the context of it’s use.
For example, is the home and greater environment compatible with the product? What is the true function of the product? Could it do more?
Can the user get through the internal and external doors? Can they access the bathroom and the garden? Can they transfer safely on and off the thing?
The point is we can’t judge the product design in isolation from it’s functional use in the envirnoment and the ambitions of the user.
If it is mobility we want..
If the primary purpose of a product is mobility, we should consider that there are alternative ways to do this that might make sense for home and work; especially when these environments are not always adapted to the requirements of a seated user.
So often we see clients spending thousands of pounds remodelling a kitchen so that they can use it from a wheelchair. And then - Ok so that problem was solved - now what else can I not do!
Of course there is no correct answer or perfect product (other than restoring the user so they no longer need any assistive product).
There are just different solutions that offer a different range of possibilities.
Enter the robots
Some persons would just love to stand and walk again since paralysis robbed them of this ability. That might just be possible with passive orthotic bracing that has improved in recent years thanks to advances in materials technology. But there are powered orthotic systems now such as the Indego on the market that allow the user to stand and walk upright. With origins in the design of “Soldier Enhancement Systems”, robotic technology to support human motion and control has emerged in recent years.
There is no doubt that the various exoskeletons can provide physical and mental health benefits to their users. Some offer a restorative ability in that they can serve as training devices. They can in suitable cases support a users muscles to generate power in a way that strength is built over time. No one ever got stronger from just sitting in a wheelchair.
We are proud to work with the Tek RMD from Matia Robotics.
As we have described in previous articles, the Tek RMD is neither a wheelchair or a standing device but it offers some features of both.
It’s a clever rethink of standing and mobility that allows users to enjoy a range of activities not possible in a wheelchair.
Standing is much healthier than being seated in a wheelchair, but for many disabled persons, they can only stand for limited periods of time with the equipment they have. I have visited many clients who have standing frames to use, but because these allow only that one thing, they get bored and then dont stand as often as they should. Standing wheelchairs exist but they are best suited for brief standing events as the user is normally tilted back to keep them stable.
The Tek RMD is narrower and shorter than a wheelchair and therefore can often reach the parts of the home not accessible to a typical chair. It allows the user to stand for much longer periods of time and relate, eye to eye, with people at work and at home.
Is it a great piece of equipment? - absolutely!
Is it perfect? Of course not.
Every situation will present different challenges for an individual. They will have very personal wants and desires as we have explained.
An exoskeleton is expensive compared with a Tek RMD but some users just want to stand and walk. Tek RMD users want to stand and move. Both users want to live life to the full. Take your pick.