Restoring Independent Mobility for Wounded Warriors and Severely Disabled Veterans: A New Class of Personal Transportation Vehicles

Timothy J. Ganous, MPA
COPE International-USA
Alexandria, Virginia

Abstract:

For many Wounded Warriors with acquired brain injury and severe physical musculoskeletal injuries, regaining independent driving abilities is a major life goal. The inability to drive can lead to a loss of esteem, self-reliance and mobility within the community. While driving rehabilitation and generous Federal and State grants to purchase adapted vehicles help to restore driving capabilities, many will have a life long dependence on others for their intra-community travel needs. A new class of vehicles is needed to overcome disabilities commonly occurring with Wounded Warriors who are unable to regain driving privileges. Slow speed electric vehicles, more commonly called Neighborhood Electric Vehicles (NEV) are ideal for intra-community travel for persons with limited driving abilities. These vehicles have the potential to mitigate driving problems associated with cognitive processing, visual spatial impairments and physical disabilities not readily accommodated in adapted mass produced vans and automobiles. NEVs can be designed and manufactured to meet specific needs of severely injured Wounded Warriors. Many Wounded Warriors with significant challenges to regaining driving abilities would be well served by specially designed NEVs as an interim recovery step or as a life long form of effective independent mobility.

Key Words:

Wounded Warriors, Personal Transportation, Electric Vehicles,

Introduction:

Advances in rehabilitative medicine promise not only to address the physical and cognitive injury suffered by the Wounded Warrior, but in many cases restore personal performance levels approximating pre-injury status. In that regard this newly empowered group of individuals are often referred to as “Tactical Athletes”. Because of their age and intense desire to regain ability to continue achieving life goals, programs like Achilles Running Club and USA Sports Network are a growing part of the evolving standard of care provided our Wounded Warriors and discharged veterans. Independent mobility is a key factor in achieving this level of success. Those who are severely injured and have not been able to regain driving privileges with adaptive technologies and driving rehabilitation therapy continue to rely on volunteers, family and social services programs for their mobility. It is unknown at this time how many Wounded Warriors will not be able to regain driving abilities. However, it is known that 78% of acquired brain injury patients in the civilian sector eventually resume independent driving in some form. It is likely that the percentage of wounded warriors who will not regain driving abilities will be less due to the severity of injuries being incurred in Operation Iraqi Freedom.

Various effects of acquired brain injury as well as other physical injuries may interfere with a person’s ability to learn to drive or return to driving after an accident. The cognitive, perceptual and physical problems that may affect driving skills include:

  • Reduced reaction time
  • Fatigue
  • Epilepsy, feinting or other medical reasons e.g. particular types of medication
  • Sensory impairment e.g. loss of hearing or vision neglect
  • Auditory and visual-spatial deficits
  • Poor concentration
  • Disorientation and memory problems
  • Poor judgment and decision-making
  • Impulsivity and poor self-control
  • Poor motor control and coordination
  • Hemiplegia or hemiparesis.

Driving – An Imperative to Recovery, Employment and Mitigation of Life Long Complications

From a purely practical point of view meeting daily transportation needs is essential component of the recovery process for Wounded Warriors and severely injured veterans. Getting to healthcare and rehabilitation services as well as establishing a daily living pattern that includes employment opportunity and socialization, and an active life style are critical. For the disabled the implications go far beyond these practical matters. Driving ones own car and being independently mobile is a cultural imperative in our society. We know from longitudinal research in gerontology and civilian rehabilitation medicine that driving is often the difference between success and a life with co-morbidities and complications such as depression and withdraw from society. Recent studies have shown those who could drive their own vehicle were more than six times as likely to be employed than those who had to rely on others for transportation. Other studies have shown a close correlation between driving cessation and entry into long term care for the elderly (four times as likely) not because of an underlying medical condition but because of the fear of not getting to needed healthcare. Anecdotally, physicians typically recommend to families of brain injury patients that recovery should try to include re-establishment of driving capability to increase daily activity to a sufficient level.

A New Class of Vehicles:

Transportation Secretary Minneta, in a recent White Conference on the new Freedom Initiative for the disabled publicly proclaimed that the transportation industry and manufacturers will have to address the need for a new class of vehicles for the elderly and disabled driver. Recognizing that independent personal mobility is a cultural imperative, he called for innovative solutions to the rising demand for specialized transportation services. This white paper proposes to investigate the use of electric vehicles as a type of personal transportation technology particularly suited to Wounded Warriors who may not be independently mobile within their communities.

Zero Emissions Vehicles, commonly called slow speed electric vehicles, are a relatively mature personal transportation technology in Europe and Asia, meeting the transportation needs of many urban and township dwellers in those societies. These vehicles are typically manufactured as true automobiles for foreign markets with all-weather enclosed cabs and other driver comforts. Even with older lead acid battery technology these vehicles meet daily travel requirements of most urban dwellers, approximately 25 to 35 miles, with little inconvenience. Forty states in the USA now permit slow speed electric vehicles, more commonly called Neighborhood Electric Vehicles, on State roads designated 35 mph or less. NEVs, due to their slow speed (25 mph or less) and accommodation of other human factors associated with common driving impairments, e.g. reduced cognitive ability and reduced range of physical motion, can restore independent mobility for many Wounded Warriors who have not regained driving skills. Depending on locality, the driving range of these vehicles is well within the daily intra-community travel needs of Wounded Warriors in urbanized and semi-urbanized communities and possibly other less urbanized communities.

NEVs are relatively inexpensive to manufacture even with new start-up designs specific to the needs of the disabled. The human factors that would have to be accommodated by vehicles specifically designed for persons with disabilities would include the following in most cases:

  • Increase visibility around the vehicle (360 degrees).
  • Ease of entry and exit with or without a mobility aid (wheelchair, walker, prosthetics, etc.).
  • Accommodation and integration of at least one mobility aid (e.g. power wheelchair).
  • Incorporation of enhanced electronics to increase situational awareness of driver with respect to road conditions, collision avoidance, destination mapping and increased awareness of vehicle orientation and position on the road surface.
  • Inclusion of some autonomous mobility (AM) capability to handle 10 to 25 percent of driving tasks, e.g. parking, other hands free requirements.

Proposed Test and Evaluation of NEVs for Wounded Warriors:

It is proposed that a prototype NEV, focused on the most common driving impairments found within the Wounded Warrior community, be designed, fabricated and tested in a two year Limited Objectives Evaluation program hosted by Walter Reed Army Medical Center. The primary objectives for this research project would be to evaluate the success of the prototype design to accommodate the most common disabilities and other human factors associated with successfully mastering this type of personal transportation technology. The test would be limited to intra-campus travel needs of Wounded Warriors admitted to the WRAMC Rehabilitation Services Program. The on-campus travel destinations for these individuals are typically associated with the Rehabilitation Center, the Medical Center, the Molonge House and the Fisher House. One or two prototypes could be stationed at the hotel facilities at the Molonge house and patients could sign up to use the vehicles on a voluntary basis after sufficient indoctrination and driving training has occurred.

The prototype vehicles would be designed and fabricated by a consortium of companies with relevant experience in vehicle technologies and driving assistance technologies that may be incorporated in the test vehicles. A requirements document for the test vehicles is attached which addresses some of the research, development and engineering requirements.

Testing and evaluation during the LOE would include the following:

  1. Measure of accommodation created by the vehicle for specific driving impairments, both cognitive and physical.
  2. Quality of driving experience and driving confidence experienced by test subjects.
  3. Road worthiness of vehicle including success of maneuvering in limited traffic.
  4. Vehicle capabilities with respect to parking and other road use issues.
  5. Evaluation of the vehicles capability to be used on community roads in future testing programs.

Highlights

  • Source Ordered
  • No Tables
  • Very Compatible

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