When the creators of The Jetsons imagined the automated world of the year 2062, they assumed robot technology would take care of life’s drudgery — shopping, washing dishes, vacuuming. We still hold on to that fantasy, even as we embrace a time in which microcomputers enhance our lives in countless invisible ways. Who wouldn’t want a robot that could change diapers? Admittedly today’s reality is subtler, but it’s no less exciting. Autonomous vehicle technology. Self-compensating drive control. Predictive maintenance apps. A virtual seating coach. All of these things are happening now in wheelchair technology — and they’re transforming our mobility, health and independence in this lifetime.
Two sleek, futuristic wheelchairs drove themselves through Tokyo’s Haneda International Airport this past August, one obediently following the other like a friendly robotic dog. They smoothly navigated a turn, traversed bumpy grates and sedately pulled up alongside a group of reporters who were there to record the future.
Their short journey is a promising sign of where the future of power wheelchair design is headed. Why? Because the first chair autonomously traveled to a woman standing nearby who summoned it using her cellphone, and the second followed independently.
The chairs were part of a demonstration of a new project to shuttle passengers through the airport when Japan hosts the 2020 Olympics. While these specific chairs will likely be of little use for most wheelchair users, the underlying technology — state-of-the-art mapping software and built-in sensors to avoid running into obstacles — could change the way you drive your power wheelchair, or … the way it drives you.
With all the similarities between driverless chairs and driverless cars, it makes sense that the autonomous chairs are made by WHILL, a company founded by former Japanese auto designers. They are not the only auto industry players getting involved in the mobility world. In 2016, Japanese car maker Nissan showcased the ProPilot, a self-driving chair designed for customers to sit on while waiting in line at restaurants. When the first person in line leaves their chair to go inside, the chair goes to the back of the line and the other chairs move forward.
And if you watched even a fraction of the recent Olympics, you probably saw at least five ads for Toyota’s “Start Your Impossible” campaign. Instead of just featuring Toyota’s traditional vehicles, each ad ended with quick shots of disabled athletes and an array of non-traditional mobility devices, including a peek at the long-promised iBot II. That didn’t happen by chance.
“Toyota believes that ‘mobility’ goes well beyond cars and that movement is a human right. This campaign, and our partnership with The Olympic and Paralympic Games, are a reflection of our commitment to providing freedom of movement for all,” said Ed Laukes, group vice president, Toyota Division Marketing, Toyota Motor North America, in an interview with CNET.
This overlap between the auto industry and the mobility industry is not new. It turns out many varieties of self-driving chairs are already being tested, and power chairs have had some of the “smart” features we might more readily associate with autonomous cars for quite a while.
Some of the similarities are obvious, like the integration of hands-free wireless technology, but you may not even know of others you’ve been taking advantage of every time you roll out. The impact is already huge, and will continue to grow, touching every aspect of chairs — from the drive systems, to how they navigate, to maintenance, to actually helping you monitor your health. It won’t happen overnight, and there are real challenges involving funding and regulations, but it is coming.
Dubbed the WHILL NEXT, the aforementioned driverless chairs look almost identical to WHILL’s better-known models, the Model A and the Model M. But unlike the A and M, NEXT — which WHILL and co-designer Panasonic refer to as a “mobility robot” — was designed specifically to transport ambulatory people who have difficulty walking long distances.
Airport visitors will be able to summon a WHILL NEXT by tapping on a smartphone app. The chair self-drives to their location, picks them up and delivers them to their destination. The app will even tell them how long it will take to get to their gate. With the aging population, it is easy to envision a growing market for similar mobility devices at resorts, malls, parks and other expansive destinations.
Ted Fagenson, former vice president of sales and marketing at WHILL, explains the simple economic incentive behind the chairs. “It costs X amount of dollars to pay an employee to push a person from the check-in terminal to the boarding area of the airplane. If you are doing that a thousand times a day, that adds up to a lot of money in labor. It is going to be economical for the airline, and for the user it will be a much better experience,” says Fagenson.
Testing of the NEXT at Haneda is expected to have been completed by March 2018.
While cool, the NEXT technology isn’t quite what full-time chair users need. “We would love an autonomous power chair that could navigate any sidewalk, and/or chairs that can perform obstacle avoidance for people using sip-and-puff or head array controls, but the technology isn’t there yet,” says Mark Smith, general manager of public relations for Pride Mobility/Quantum Rehab. “Obstacle avoidance and autonomous technology is moving into the power chair market for indoor use in the coming years because it’s easy for sensors to avoid vertical objects on a flat indoor surface, but outdoors is another story. Current technology can’t tell a puddle from a dark patch from a pot hole. And current sensors aren’t capable of distinguishing between curb angles, or if a curb is shaded by a tree.”
For now, the closest manifestation of this technology lies in the WHILL Model A’s iPhone app, which allows users to summon and drive their Model A. Imagine being able to easily move your chair away from a sofa or bed after transferring or being able to call it to you in a crowded room.
Emily Oakley, of Campbell, California, takes full advantage of the app whenever she is out with her WHILL. Oakley, 44, is able to walk, but has multiple sclerosis and uses the Model A to do what her body won’t always let her. The Model A is called a personal electric vehicle rather than a power wheelchair because it has not been submitted to the FDA for review and is typically not covered under insurance.
“I’ve always been very active and having four-wheel drive on the Model A enables me to go hiking again,” she says. The app comes in handy when she and her husband, Ken, are out and about. Oakley prefers to transfer into a regular seat at restaurants. She can then use the remote to drive the chair out of the way, usually into a corner. And when she transfers into the front seat of their van, she uses the remote to drive the Model A around the back of the van and onto the rear lift.
Sticking to the Straight and Narrow
The idea of software that keeps your wheelchair going in a straight line may not be quite as sexy as the possibility of ghost-driving your chair via remote, but for many users, such software is invaluable. Self-compensating drive control is one of the earliest smartchair systems, and it is so seamlessly integrated that most wheelers aren’t even aware it is on their chair.
It’s basically the wheelchair equivalent of the lane centering technology that is being rolled out on many high-end automobiles. Just like lane centering technology keeps your car in the lane, self-compensating drive control autonomously corrects a chair’s direction, keeping it going where controller input intended by compensating for uneven or bumpy surfaces. This makes driving with a joystick easier because you don’t have to make constant corrections while cruising down a sidewalk, path or off-camber surface.
Self-compensating drive makes a huge difference for those who use a switch control, like sip-and-puff or a head switch, to drive. Before self-compensating systems existed, a driver using switch input would have to make continuous adjustments to keep a chair going straight. Wheeling on sidewalks and streets required so much input to control the chair that it was difficult to carry on a conversation or enjoy the scenery. Self-compensating drive enables a switch driver to give an input and the chair stays in the intended direction until another input is given, which enables the driver to relax, talk and enjoy their surroundings.
Kenny Salvini, a C3-4 quad and frequent NEW MOBILITY contributor, drives an Invacare TDX SP using an ASL head array switch input control. He taps his head on a switch to his right or left to turn, while a switch at the back of his head controls forward, speed, stop and reverse inputs. He is a believer in G-TRAC, Invacare’s self-compensating drive system. “For a brief time, I didn’t have G-TRAC, and wow, it really gave me an appreciation for it. The road I wheel on in front of my house has a mild arc for water drainage and I had to constantly re-hit the switch input to course correct. It was fairly maddening to say the least and really gave me an appreciation of how important self-compensating drive control is.”
All the major power chair manufacturers now offer some sort of self-compensating drive control. Invacare has G-TRAC, Quickie has SureTrac, Quantum Rehab has Accu-Trac and Permobil has the boldly named Enhanced Steering Performance. Iterations of self-compensating drive control have been around since 2001, but manufacturers are continually working to improve it, resulting in new additions like Invacare’s Adaptive Load Compensation. It provides autonomous adjustments for consistent low speed driving on different surfaces from concrete, to padded carpet to grass. In addition, ALC adjusts motors as they wear so the ride stays consistent. For the wheelchair user, this means that ALC keeps the chair at a steady speed over changing surface textures, in addition to staying on the intended course.
Fix Problems Before They Start
You can’t keep on course if your chair isn’t working. Thankfully, a new wave of predictive maintenance apps is aiming to make it easier to keep your wheels on the road and not in the shop. Car drivers have grown so used to oil check warnings, tire pressure lights and other built-in warning systems that they take them for granted. But put similar systems on a power wheelchair and they could make the difference between getting out of the house and waiting weeks to months for someone to service what is often a minor problem.
Predictive maintenance apps continuously monitor the systems in your power chair. They allow you to see the basics, like battery status, driving habits and distance traveled, while also enabling real-time troubleshooting of error codes on your smartphone and sending complex information about systems on your chair to your dealer. This can make it easier to solve minor problems, like a joystick that suddenly isn’t working because a wheel-lock or attendant control is engaged.
A quick look at the predictive maintenance app on your phone will either show the problem or bring up a phone link to your dealer, who can look at your chair on their computer screen and diagnose the problem live. This would save the user down time and the dealer a service call. Sharing detailed information about your chair’s status with the dealer also allows you both to see if maintenance is coming up and plan for it well before parts fail.
Research done at Human Engineering Research Laboratories at University of Pittsburgh shows that waiting for parts can leave a power chair user without access to their chair for an average of three months.
“With predictive maintenance, a dealer’s computer and the wheelchair user’s smart phone will say, ‘based on wear patterns you’re going to need a new battery or certain part within so many months, now is a good time to set up an appointment to have the part changed,’ and the dealer has time to order the part and you have a fast turn-around,” says Rory Cooper, founder and director of HERL [see “Rory Cooper: The Man Behind the Technology, May 2017]. “For the consumer, it means they won’t be stuck with a broken chair sitting in the shop waiting for parts.”
Cooper, a wheelchair user himself, helped oversee development of Permobil’s predictive maintenance app at HERL, and thinks it can help reduce the frustrating waits for service that many power wheelchair users deal with. “It benefits the user and the wheelchair dealer,” he says. “The dealer monitors the chair and can order parts in advance, before they wear to the point of failure. This means fewer trips for the technician, one trip to swap out the battery or replace a part, rather than one trip to troubleshoot and another to fix the chair.”
Permobil launched its predictive maintenance technology, Permobil Connect, in December 2017 and it now comes standard on all Corpus model chairs. The system has a Connect module that uploads chair information to the web via an AT&T Global SIM card. Dealers access the information via a portal, with chairs needing attention showing at the top of the list. Permobil users can log into the My Permobil app on their smartphone to view graphs that show battery charge status, seat function usage summaries, mileage, and any error codes, which also send an automatic alert to their dealer.
If a Permobil user’s app does show an error code, or they have a chair issue, they can call their dealer and the technician can log into the portal and troubleshoot the problem. “The goal is to reduce the amount of service calls that are simply done to diagnose a problem,” says Brandon Edmondson, director of clinical sales at Permobil. “Although the system can’t see things like when your armrest pad needs to be replaced, we can mine the data, tracking parts, order history and chair usage and in time, know on average how often our users are changing their arm pads or other mechanical parts and be able to make suggestions to consumer and dealers. The data from all the chairs can be aggregated to help us predict problems, see trends, update electronics remotely and ultimately design a better chair that is in tune with how our clients actually use them.”
As a self-professed technology geek, Todd Stabelfeldt is already enjoying the benefits of the My Permobil app after less than a month of using it with his Permobil F5 Corpus. “I forgot to plug in my battery one night. I logged into my Connect app later that morning and saw I didn’t charge the battery last night,” says Stabelfeldt, 39, in his 31st year as a C4 quad. [See “Todd Stabelfeldt: Titan of Tech,” October 2017.]
Invacare also launched its own predictive maintenance app last year. Called MyLiNX, it’s available on the TDX SP2 power chair. MyLiNX sends information about the chair through the web to the cloud, allowing dealers to monitor systems on chairs they have sold through a dashboard program on their computer. In addition to monitoring systems and electronics, the dashboard tracks driving and battery charging habits and flags technicians to potential issues. Invacare customers can use the MyLiNX app to view graphs showing battery information including charge, usage, and drive time remaining as well as any fault codes, which automatically send an alert to their dealer.
“This data can give more insight into their chair and empower them to spot issues before they become a larger problem,” says Brad Peterson, vice president of professional affairs and clinical education for Invacare. “The whole key is to reduce the number of tech visits, and when they do occur, make them more efficient with the goal of more time with the technology and less time in the shop.”
Automated Butt Protection
Every wheeler wants their chair to spend less time in the shop, but what if your chair could actually keep you out of the hospital? A new app from Permobil promises to help do just that by providing management and motivation for your pressure releases. Permobil’s Virtual Seating Coach is a weight shift coach built into the Permobil Connect module and available on the Corpus line of power chairs. Ideally, a user with VSC will work with a therapist to program a custom seating regimen for their needs that includes optimal tilt angles, recline and leg rest height, as well as frequency and duration of weight shift. VSC users also have the option of choosing one of 10 pre-programmed weight shift schedules.
Stabelfeldt hasn’t had his virtual coach for too long, but he is loving the immediate impact it has had.
“I’ve had a lot of skin problems and multiple skin flaps,” says Stabelfeldt. “I’ve been hoping for something like VSC for a long time … it has already been a huge blessing. I’m setting up an appointment with a therapist to design a custom program.”
For now, he has his VSC set on one of the pre-programmed settings — tilt and recline for three minutes every hour — which are called exercises. “When the app on my phone gives me a notification, I hit Memory 3 on my Permobil, which takes me to the exact amount of tilt and recline I’m supposed to have. I call it ‘super-chill mode.’ At that point, a timer and a green light starts, and after three minutes my phone says ‘Good Job!’ which is like an ‘atta boy’ that you get on a Fitbit. I really like the reward because it makes me feel normal — it’s the first time I’ve been able to receive the ‘congratulations’ from a smart device, and I like getting my ‘Good Job!’ stars.”
The value of positive reinforcement should not be underestimated. Keeping track of weight shifts has been shown to keep users motivated to shift or stand on schedule.
“In our studies with Virtual Seating Coach at HERL, we saw a four-fold increase in compliance in weight shifts,” says Cooper, whose HERL team helped design the program. “We estimate that this will drastically reduce the number of people who develop pressure ulcers, which could add up to a savings of $1 billion a year in hospital costs in the U.S.”
VSC can also be used to coach standing programs on Permobil standing chairs. Once programmed, the app alerts the user when “It’s time to reposition your chair” or “Time to stand.” At that point, the user starts moving the seat and a graph appears showing seating angles. When the proper angles have been reached, a countdown clock appears and starts. When the weight shift or stand is finished, the app shows “Good Job!” The VSC app can also share info to the wheelchair user’s therapist so they can see how their client is doing and make adjustments online as needed. An anticipated bonus of VSC is that it will generate information that clinicians and researchers can use to improve optimal weight shift angles and times, and/or standing times.
On the Horizon
Looking toward the future, it’s a good bet the parallels between cars and power chairs will continue to grow. Whether this means that the long-promised arrival of flying cars also brings flying wheelchairs, or perhaps something cooler, remains to be seen. The folks at HERL are already looking beyond self-driving chairs and obstacle avoidance. “Rather than avoiding obstacles like curbs and grass, we are working on a chair that says, ‘You are driving up to a curb, do you want to climb it? Yes? OK,’” says Cooper. “Our idea is to build a cool chair that not only recognizes different types of surfaces and obstacles, it enables you to travel over them.”
Bluetooth Technology: Not New But So Powerful
Bluetooth technology has been connecting people wirelessly with their beloved gadgets since the 1990s and was first introduced on power chairs in 2005 by Quantum Rehab. “Our philosophy has been that that complex rehab power chairs should interface with the user’s environment,” says Mark Smith, general manager of public relations for Pride Mobility/Quantum Rehab.
For users like Tim Gaynord, 35, an accountant from Scranton, Pennsylvania, Bluetooth is a game changer. “Q-Logic controls give me independence and control over my environment,” he says. “I have SMA 2, a form of muscular dystrophy, and have very little arm and hand mobility and have my joystick mounted on my lap tray.” Gaynord lives in an apartment in his parent’s house. Before Q-Logic, he would frequently have to call them to help with various controllers. “With Q-Logic I’m able to control the television, computer and mouse, iPhone and even the fireplace. A screen shows the mode I’m in and part of the system includes micro buttons to switch from various modes, seat control, computer, television, etc.”
Quantum’s newest Bluetooth software, standard on the Q-Logic controls, can control up to 16 devices ranging from televisions, computers, and phones to lights, fans and door locks through the power chair’s drive control. Permobil, Invacare and Sunrise-Quickie all now have Bluetooth offerings as well.
The Cost of Innovation
So why don’t we see more innovation for power chairs? A big reason is the lack of financial return for the companies because of the way insurance reimburses. If a new smart car function introduced by an auto manufacturer is cool enough, people will be willing to pay more for that car. Insurance doesn’t work that way. The difficulty with introducing smartchair functions like Virtual Seating Coach and Predictive Maintenance is the extra technology isn’t initially reimbursable by insurance.
“Companies are doing it to benefit their customers and to differentiate their product, but there is no financial incentive,” says Cooper. On the other hand, you have to have the product in the field to collect the evidence that it should be covered. “When ultralight chairs first came out they were considered ‘sports chairs’ and you had to pay cash. Now that Virtual Seating Coach and Predictive Maintenance are in the field, there will be data to show benefits that can be used to build a case for insurance coverage.”
An example of the cost of bringing a smartchair function into the power market is the remote-control iPhone app for the WHILL Model A. “Although it was already developed, tested and in use on the Model A, the remote-control app isn’t available on the Model M — which is an FDA approved wheelchair similar to the Model A. This is because FDA testing requirements would involve a great deal of documentation, including 100-people testing the app over many cycles, and cost several hundred thousand dollars,” says Fagenson. “So it isn’t cost effective.”
• Invacare LiNX, rehab.invacare.com/rehab-redefined-home
• Permobil, permobilus.com/products/power-wheelchairs-by-permobil
• Quantum Rehab, quantumrehab.com
• Sunrise Medical, sunrisemedical.com
• WHILL, whill.us
• Virtual Seating Coach, vsc-us.permobil.com/#/home/en_US