A new research initiative based at UBC aims to provide users of powered wheelchairs with helping hand. Funded by a six-year, $1.5 million Emerging Team Grant from the Canadian Institutes of Health Research, a multidisciplinary team of researchers will investigate how older adults are currently using powered wheelchairs, how they can be used better, and how the chairs themselves can be improved. The answers to these questions will improve knowledge and understanding in the field of aging and mobility research.  

Led by Prof. William Miller of the UBC Department of Occupational Science and Occupational Therapy, the Pan-Canadian team of 14 clinical researchers, scientists and engineers will conduct a number of research activities. These include an assessment of measures to improve research and clinical practice, and the development of a wheelchair skills program and a new, collaboratively controlled wheelchair.  

Background: In Canada, 250,000 residents rely on wheelchairs to move around, the majority of them older adults (60+ years). In fact, 5% of community- and over 50% of institutional-based older Canadians, representing >800,000 people, use wheelchairs. In addition, over half of wheelchair users require assistance using their wheelchairs. Given the anticipated ‘boom’ in the older adult demographic over the next 40 years and the fact that the availability of human help will potentially decline during this period of time, there will be an increased demand on devices that can assist with independent mobility and training programs that effectively promote independent wheelchair use. Power wheelchairs are an expensive yet essential form of assistive technology that can compensate for impaired mobility and improve quality of life, including social participation opportunities, for older adults. Despite this benefit, the safe use of these devices can be compromised by decreased cognition and/or functional ability as well as insufficient training. Moreover, it is not uncommon for these devices to be abandoned because they do not meet the needs of the wheelchair user.

Figure 1 (above): (a-left) the camera view of a person with a walker in front of the chair, (b-centre) the corresponding distance (depth) map, and (c-right) the 2D, bird’s-eye view of the environment. In (b), the closer an object is, the brighter it is. In (c), black represents known obstacles, white represents free space, and grey represents unknown regions. Any object that is detected within three feet of the chair in (c) will cause the forward motion of the chair to stop in order to avoid collision with the obstacle. The free space to either side of the obstacle is calculated from (c) and an audio prompt is played to the driver suggesting the best direction to steer (e.g., "Try turning left" or "Try turning right") to get around the obstacle.

Purpose: The overall purpose of this Emerging Team Grant is to improve the mobility opportunities of older adults who use power wheelchairs. In order to accomplish our team’s “raison d'être”, we will address three basic questions:

1)How are power wheelchairs used now?
2) How can power wheelchairs be used better?, and,
3) How can power wheelchairs be better?

Figure 2:  A stereovision camera is positioned in front of the driver’s knees to ensure a clear field of view.

The answers to each of these questions will substantially enhance our knowledge and understanding in the field of aging and mobility research. By addressing these questions in a systematic, comprehensive and unified fashion, our team of basic and clinical scientists, aided with unprecedented community partners (i.e. advocacy agencies, federal and provincial decision makers, and industry), will accelerate discovery in this field.

Figure 3 (above): The system's components consist of a laptop, which analyses incoming stereo images, and passes information to the direction control logic module that sends signals to the chair controls, dictating which direction(s) the driver is allowed to go.

The research plan will specifically enable them to: 1) describe the trajectory of mobility status in older power wheelchair users; 2) develop and assess strategies to maintain and restore wheeled mobility; 3) assess a toolkit of subjective and objective measures to improve research and clinical practice through better assessment of power wheelchairs; and 4) develop clinical approaches and technology to provide environmental support enhancing mobility for existing power wheelchair users as well as an estimated 61-91% of current manual wheelchair users who could benefit from these advances.

Plan: By building on existing, and developing new, alliances we have formed a pan-Canadian (Nova Scotia, Quebec, Ontario, and British Columbia) team of 14 clinical researchers (i.e. occupational therapists, gerontologists, physicians) and basic scientists (i.e. engineers, computer scientists). Together, we have developed a program of research that will use a mixed-methods approach, including lab-based, qualitative and quantitative methodologies, spanning five key research projects.

• Project I: Evaluating the Needs and Experiences of Older Adults Using Power Wheelchairs  
• Project II: The Natural History and Measurement of Power Mobility Outcomes
• Project III: Strategies and Platforms for Collaboratively-controlled, Environmentally-aware Wheelchair Innovation
• Project IV: Activity and Status Monitoring System (data logger)
• Project V: Evaluation of the Safety, Efficacy and Impact of the Wheelchair Skills Program for Power Mobility Users and their Caregivers

These five projects will ultimately converge at the end of the six-year team grant when we will leverage our results into a new proposal and funds to conduct a randomized controlled trial in year seven of the team’s existence. Our plan is to assess the effectiveness of our new, collaboratively-controlled wheelchair, in combination with the Wheelchair Skills Program, using the outcome toolkit we will have validated during the tenure of this team grant.

Finally, our emerging team will build research capacity in the aging and mobility field by attracting highly qualified senior and junior scholars while providing superior research career opportunities for our trainees.

Figure 4 (below):  Pooja Viswanathan, a former Precarn Scholar, is one of the researchers on the team who will be using the chair for project activities.

Unique Team Approach:
Using a community team-stakeholder approach, this team brings key people, equipment and facilities together in a synergistic and integrated way to develop creative and novel solutions to the problem of wheeled mobility for older Canadians.

The team of applicants leading this research program is comprised of noted senior and junior scholars from across Canada, spanning a range of disciplines including biomechanics, computing sciences, engineering, gerontology, physiatry and rehabilitation sciences. All are nationally and/or internationally-recognized experts in the fields of assistive technology, measurement and/or creation and evaluation of interventions designed to maximize use of wheelchairs.The cross-fertilization of these very different milieus – clinical research and engineering/computer science – allows the team to “think beyond the box”.  

The team has partnered with key stakeholders who will be influential and unique contributors to the research process. Traditional (wheelchair users, caregivers, clinicians, policy decision makers, and advocacy agencies) AND non-traditional (city planners and device manufacturers) stakeholder groups will be involved from the outset of the project. This unique and diverse mix of partners will allow the emerging team to produce relevant and tangible outcomes, close the innovation gap, and accelerate the dissemination and uptake of the study findings to the public domain.

For more information:
Ann-Marie McLellan, Ph.D.
Interdisciplinary Team Specialist, HeRRO Division of the VP Research & International, UBC
email: ann-marie.mclellan@ubc.ca
phone: (604) 827-5661
website: www.herro.ubc.ca

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