Date: Wednesday, January 27, 2016
Editor’s Note: Ride Designs has graciously donated their blog post space to Sharon Sonenblum, a rehabilitation engineer and researcher at Georgia Tech, to share her thoughts and research findings on some very important topics: sitting mechanics, pressure ulcers, wheelchair cushions, and butts. Sharon is Senior Research Scientist at Georgia Tech, and she has been studying wheelchair use, ulcer prevention, and the response of buttocks to loading for over a decade. This is the third and final post in a series.
Thank you to the RESNA community for what has been an opportunity for me to share the work that I love – the research we’ve done at Georgia Tech on biomechanical risk, cushions, and seating. I’ve appreciated all those who have submitted comments. Now that you know a little bit about me and my research, this post is more personal. I’d like to ask, “How can we get the wheelchair some love?”
My colleagues at Georgia Tech and I are very interested in developing easy-to-use tools, such as an app, that will help clinicians match cushions to buttocks and prevent sitting-acquired pressure ulcers for wheelchair users. Our efforts have been limited by the difficulty in securing funding. In fact, funding for wheelchair and wheelchair seating related research has taken a hit all around in recent years.
I’d argue that the decrease in attention and funding for wheelchairs and seating has been largely fueled by the common misconception that wheelchairs are bad. The disparaging of wheelchairs in the media and even within the worlds of rehabilitation and research has become all too common. On the one hand, the wheelchair is an incredible enabling device, providing function for millions of individuals. Yet I frequently hear people who use wheelchairs referred to as “wheelchair-bound” and “confined to a wheelchair,” suggesting that the individuals are trapped by their wheelchair, instead of being enabled by their wheelchairs to get out and be active. At the same time, I often see wheelchair-disparaging headlines like: “Paralyzed hockey teen dreams of a world without wheelchairs” and “Good-bye wheelchair, hello Exoskeleton.”
Now, don’t get me wrong, exoskeletons are really cool. Hopefully, development of this technology will continue to include people with disabilities, and not be dominated by those who wish to build Ironman suits for soldiers. But should it come at the expense of wheelchair research?
It already has. NIDILRR (formerly NIDRR), who for 30 years sponsored a Rehabilitation Engineering Research Center (RERC) dedicated to studying and improving Wheeled Mobility, is now funding multiple Mobility and Manipulation RERCs largely focused on exoskeletons and robotics. The Wheeled Mobility RERC no longer exists as an entity. At Georgia Tech, we’re continuing to do a little bit of research through other grants, but most of that will dry up soon.
While the work being done by the Mobility and Manipulation RERCs certainly has value, the belief that you can replace a wheelchair with a technology designed to support ONE task only (walking) is misguided. Full time manual wheelchair users in our research only wheeled for 1 hour per day, meaning that the other 9-10 hours that they spent in their wheelchair they were stationary. None of the exoskeleton and robotics devices or interventions currently being funded can be an extension of the human body, nor provide a base for stationary activity AND mobility in the same way as a wheelchair, allowing people to engage in family life, employment, sports, and more.
Why must it be either/or? The wheelchair is one of the most cost-effective assistive technologies ever developed. It is time to change the conversation and encourage the media, researchers, and clinicians alike to stop disparaging the wheelchair, start acknowledging its many benefits, and bring back the necessary funding and interest to help improve the individualized prescription and designs of wheelchairs and wheelchair cushions.
Please share your outrage at how little respect wheelchairs get, and your ideas about what we can do to improve their reputation. Or, alternatively, feel free to make your case for why I am wrong. I look forward to hearing your thoughts!