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Design journey of an affordable manual standing wheelchair

SHAIKH-MOHAMMED, Javeed
DASH, Swostik Sourav
SARDA, Vivek
SUJATHA, S
2021

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Purpose: Only 1 in 10 people with disabilities can access assistive devices, underlining the critical need for low-cost assistive products. This paper describes the design evolution of a manual user-operated standing wheelchair (SWC), translating from prototype to product.


Methods: The SWC design has been refined over 5 years through multiple iterations based on comments from user trials. The SWC product, Arise, provides standing functionality, facile outdoor mobility, afford- ability, customisability, and is aesthetically pleasing. A one-time fitting and training ensure optimal effort for operation, correct posture, and comfortable user experience. The SWC accommodates users of differ- ent sizes and body weights (up to 110kg) and minimises user effort with the use of a gas spring. Incorporating discrete adjustments enables customisation while retaining the advantages of mass manu- facturing, which is necessary for ensuring affordability.

 

Results: The SWC has been field-tested and well received by over 100 wheelchair users, and Arise was launched recently by the industry partner.


Conclusions: It should be noted that RESNA cautions on the use of any standing device without medical consultation. Nevertheless, with appropriate dissemination and awareness, it is anticipated that the afford- able SWC product, Arise, will immensely benefit the eligible users and make a difference in their quality of life.

Inclusive Design: What if we built a world that was accessible to all?

McKINNON, Iain
CARR, Peter
PATRICK, Mikaela
MONGOLIA RESEARCH TEAM
ASTERINA, Nina
October 2020

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This webinar, hosted by Global Disability Innovation (GDI) hub, brings together a diverse panel of experts to discuss what inclusive design looks like in practice for them, who benefits and how it can offer methods to build a more accessible world that benefits all of us.

 

Speakers presentations were:

  • What inclusive design means to GDI Hub and why it matters, drawing on our experience working in both the UK and globally
  • An overview of inclusive design of the built environment in the UK and Kenya, including the role of access panels to embed the views of disabled people in planning and decision-making
  • An introduction to GDI Hub’s AT2030 programme including our Inclusive Infrastructure research sub-programme that is conducting six global case studies in LMIC cities around the world over the next 2-3 years.
  • The challenges and opportunities for an accessible Mongolia and the importance of Disabled People’s Organisations (DPO) engagement in decision-making
  • The importance of inclusive planning processes for accessible cities in Indonesia

Smartphone apps for transportation by people with intellectual disabilities: are they really helpful in improving their mobility?

ALANAZI, Adel
2020

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Purpose

The paper undertakes a critical assessment of the use of smartphone apps for transportation by people with intellectual disabilities. Although apps for transportation such as Uber and Careem have been developed to assist people with disabilities and have numerous benefits, people with intellectual disabilities tend to encounter their own set of difficulties in accessing these apps.

 

Materials and method

This paper presents the research findings drawn from a focus group discussion conducted with nine people with moderate to mild intellectual disabilities in Riyadh, by using a qualitative study focussed on the interpretative paradigm.

 

Results

From the interview findings, some relevant themes were identified. These were: transportation issues encountered by people with intellectual disabilities, the extent and manner of the use of smartphone apps for transportation, the benefits enjoyed by those individuals in using smartphone apps for transportation and the difficulties encountered by them.

 

Conclusions

The paper also discusses the implications for practice and presents some useful recommendations, including the need for family support and government assistance.

Use of technology by orientation and mobility professionals in Australia and Malaysia before COVID-19

DEVERELL, Lil
BHOWMIK, Jahar
LAU, Bee Theng
AL MAHMUD, Abdullah
SUKUNESAN, Suku
ISLAM, Fakir M Amirul
MCCARTHY, Chris
MEYER, Denny
2020

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Purpose

Orientation and Mobility (O&M) professionals teach people with low vision or blindness to use specialist assistive technologies to support confident travel, but many O&M clients now prefer a smartphone. This study aimed to investigate what technology O&M professionals in Australia and Malaysia have, use, like, and want to support their client work, to inform the development of O&M technologies and build capacity in the international O&M profession.

 

Materials and Methods

A technology survey was completed by professionals (n = 36) attending O&M workshops in Malaysia. A revised survey was completed online by O&M specialists (n = 31) primarily in Australia. Qualitative data about technology use came from conferences, workshops and interviews with O&M professionals. Descriptive statistics were analysed together with free-text data.

 

Results

Limited awareness of apps used by clients, unaffordability of devices, and inadequate technology training discouraged many O&M professionals from employing existing technologies in client programmes or for broader professional purposes. Professionals needed to learn smartphone accessibility features and travel-related apps, and ways to use technology during O&M client programmes, initial professional training, ongoing professional development and research.

 

Conclusions

Smartphones are now integral to travel with low vision or blindness and early-adopter O&M clients are the travel tech-experts. O&M professionals need better initial training and then regular upskilling in mainstream O&M technologies to expand clients’ travel choices. COVID-19 has created an imperative for technology laggards to upskill for O&M tele-practice. O&M technology could support comprehensive O&M specialist training and practice in Malaysia, to better serve O&M clients with complex needs.

Required to be creative. Everyday ways for dealing with inaccessibility

WÄSTERFORS, David
2020

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Today’s society promises that people with disabilities can access anything, but in practice there are numerous obstacles, and the ways in which people deal with them can be easily missed or taken for granted by policy makers. This article draws on a project in which researchers ‘go along’ people with disabilities in Sweden who demonstrate and recount accessibility troubles in urban and digital settings. They display a set of mundane methods for managing inaccessibility: (a) using others, (b) making deals and establishing routines, (c) mimicking or piggybacking conventions, (d) debunking others’ accounts and performing local politics. The employment of these shared but tailored methods shows the difficulties to be accepted that people with disabilities still face, as well as the wide-ranging tension that exists between the grand rhetoric of inclusion and modest results. The tension implies that people with disabilities are required to be creative.

  • Declarations and policies often say that people with disabilities should have access to anything, but in practice this is not the case.
  • This study investigates what people with disabilities actually do when they have trouble accessing various places or resources. The results show their common and practical ways, and these ways are often taken for granted, overlapping, and combined.
  • People with disabilities ask others to support them when they face troubles to access places or resources, they make deals with important actors and they develop routines. They also observe, imitate and follow others’ actions, to pick out precisely those ways that suit their needs.
  • When people with disabilities find their ways in today’s society they also act with words. They argue against other people’s excuses or justifications for not providing access.
  • The study has found a lot of frustration among people with disabilities who get blocked, excluded or delayed. This gives them motives to engage in politics.

Disability, mobility and transport in Low- and Middle-Income Countries: A thematic review

KETT, Maria
COLE, Ellie
TURNER, Jeff
January 2020

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This paper discusses issues affecting the transport and mobility needs of people with disabilities in middle- and low-income countries and how disability intersects with a range of other factors to impact on transport needs, use and engagement. The paper is intended to stimulate discussion and identify areas for further research, and identifies a number of key issues that are salient to discussions around equitable and inclusive transport provision, including patterns of transport use, behaviour and experiences, solutions and policy directions, measuring access and inclusion, policies and intersectionality. The paper also identifies gaps in knowledge and provision, barriers to addressing these gaps, and some possible solutions to overcoming these barriers. These include shifting the focus from access to inclusion, reconceptualising how ‘special’ transport might be provided, and most importantly listening to the voices and experiences of adults and children with disabilities. Despite lack of transport often being cited as a reason for lack of inclusion of people with disabilities, there is surprisingly little evidence which either quantifies this or translates what this lack of access means to people with disabilities in their daily lives in low- and middle-income countries.

 

Sustainability 2020, 12(2), 589

https://doi.org/10.3390/su12020589

Disability at a Glance 2019: Investing in accessibility in Asia and the Pacific — Strategic approaches to achieving disability-inclusive sustainable development

TATA, Srinivas
et al
December 2019

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This report lays out foundational concepts and terminologies related to disability and accessibility, and outlines the tools and approaches for successful investment in accessibility. Furthermore, it identifies drivers and added values of investment, and analyses the status of disability-inclusive development and accessibility investment across Asia and the Pacific. Finally, it provides recommendations to governments across key areas of focus to ensure that societies are built to be sustainable and inclusive.

Case studies from Australia, the Republic of Korea and India are presented.

Exploring barriers to physical activity of patients at the internal medicine and surgical wards: a retrospective analysis of continuously collected data

KOENDERS, Niek
WEENK, Mariska
VAN DE BELT, Tom H
VAN GOOR, Harry
HOOGEBOOM, Thomas J
BREDIE, Sebastian J H
November 2019

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Purpose: To analyse physical activity of patients during their hospital stay and to explore the relationship between physical activity and barriers to physical activity.

 

Methods: This was a secondary analysis of physical activity data for patients admitted to the internal medicine and surgical wards. Physical activity data, collected with a wireless patch sensor, was operationalized as time spent lying, sitting/standing, and walking. Barriers to physical activity included patients’ pain levels, the use of urinary catheters, intravenous tubing, oxygen lines, drains, and level of dependence. Regression analysis explored the relationship between physical activity and barriers to physical activity.

 

Results: Physical activity data were collected in 39 patients (aged 27–88, mean 54 years) during hospital stay. Patients were admitted for a median of 10 d (interquartile range [IQR]: 7–15 d). These patients were lying for a median of 12.1 h (7.6–17.7), sitting/standing 11.8 h (6.3–15.7), and walking 0.1 h (0–0.3) per day. Time lying during the day related to pain levels (β = 0.4 h per unit increase in pain, p < 0.01) and drain use (β = 3.1 h, p < 0.01).

 

Conclusions: Patients spent the most time during the hospital stay lying in bed. Improved pain management and decreased drain use may be worth exploring to increase inpatient physical activity.

Barriers and Facilitators to Community Ambulation in Maharashtra, India: Perception of Individuals with Stroke

SHAIKH, Atiya A
ATRE, Janhavi Jagdish
2019

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Purpose: The study aimed to understand the self-perceived environmental barriers/ facilitators to community ambulation among stroke survivors in Maharashtra State, India.

 

Method: The Facilitators and Barriers Survey /Mobility Questionnaire (FABS/M) was used to collect information from a convenience sample of 50 individuals with stroke. Data was analysed using descriptive statistics in Statistical Package for Social Sciences (SPSS) 22.00.

 

Results: Curbs, gravel surfaces, rain, noise, and crowd were marked as barriers by 56%, 58%, 52%, 36% and 50% of the participants, respectively. Ramps, elevators, and flat surfaces were reported as facilitators by 42%, 70% and 82% of the participants, respectively. Participants also mentioned the absence of automatic doors and escalators in community areas (92% and 88%), specialised exercise equipment, handrails and specialised bathroom equipment at home (92%, 50% and 52%), and inaccessibility to public places (50%), as barriers to easy mobility. 

 

Conclusions: To enhance community mobility of individuals with stroke, environmental barriers should be reduced and facilitators should be enhanced. The marked absence of facilitators in the environment should be rectified and appropriate steps should be taken to enhance ambulation. 

 

Limitations of the study are the small sample size. Factors like balance, economic status, physical activity of the stroke individuals and severity of stroke were also not considered.

Design of the user interface for “Stappy”, a sensor-feedback system to facilitate walking in people after stroke: a user-centred approach

JIE, Li-Juan
JAMIN, Gaston
SMIT, Kate
BEURSKENS, Anna
BRAUN, Susy
2019

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Introduction: 

Sensor-feedback systems can be used to support people after stroke during independent practice of gait. The main aim of the study was to describe the user-centred approach to (re)design the user interface of the sensor feedback system “Stappy” for people after stroke, and share the deliverables and key observations from this process.

 

Methods: 

The user-centred approach was structured around four phases (the discovery, definition, development and delivery phase) which were fundamental to the design process. Fifteen participants with cognitive and/or physical limitations participated (10 women, 2/3 older than 65). Prototypes were evaluated in multiple test rounds, consisting of 2–7 individual test sessions.

 

Results: 

Seven deliverables were created: a list of design requirements, a personae, a user flow, a low-, medium- and high-fidelity prototype and the character “Stappy”. The first six deliverables were necessary tools to design the user interface, whereas the character was a solution resulting from this design process. Key observations related to “readability and contrast of visual information”, “understanding and remembering information”, “physical limitations” were confirmed by and “empathy” was additionally derived from the design process.

 

Conclusions: 

The study offers a structured methodology resulting in deliverables and key observations, which can be used to (re)design meaningful user interfaces for people after stroke. Additionally, the study provides a technique that may promote “empathy” through the creation of the character Stappy. The description may provide guidance for health care professionals, researchers or designers in future user interface design projects in which existing products are redesigned for people after stroke.

Safe and accessible public transport for all. Making SDG 11.2 a reality

HUMANITY & INCLUSION (HI)
INTERNATIONAL ASSOCIATION OF PUBLIC TRANSPORT (UITP)
May 2019

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The importance of addressing both safety and accessibility for inclusive urban mobility is discussed. 

Case studies provided are:

  • Accessible public transport for employment, Senegal
  • Training and ICT solutions, Kenya
  • Tuk Tuk drivers certified on accessibility, Laos
  • Designing Bus Rapid Transport (BRT) systems for accessibility, South Africa
  • Improving accessibility to transport, Brazil
  • Making public transport more inclusive with technology, Singapore
  • Taking efforts to be more inclusive, France
  • A model city for accessibility, Brazil
  • Prioritising accessibility, Czech Republic
  • Getting all residents and visitors to engage in all aspects of city life, Luxembourg
  • Communications training, Russia
  • Metro access audits, India

Recommendations are made to governments concerning strengthening poicy frameworks and removing barriers to accessible mobility

 

 

 

Developing country-specific wheelchair service provision strategic plans for Romania and the Philippines

GOWRAN, Rosemary
et al
March 2019

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The process used to support the development of wheelchair service strategic plans in Romania and the Philippines is described. The paper considers the influences, meaning, challenges and developments when producing strategic priorities within two different contexts.

 

Journal of Disability and Rehabilitation: Assistive Technology, Volume 14, 2019 - Issue 6

Report on accessibility audit in Kathmandu, Nepal

December 2018

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In Nepal, the Accessible Physical Infrastructure and Communication Services directive for People with Disability 2013, is a key legal measure taken by the government for promoting accessibility. To supplement the government’s initiation in achieving the goal of making inclusive society for all, National Federation of the Disabled – Nepal (NFDN), in partnership with CBM, carried out accessibility audit of 150 public infrastructures as a model initiative. This included government buildings, public parks and open spaces, roads and streets, corporate sectors, commercial sectors and other infrastructures within Kathmandu valley and identified the remedial actions needed to make these sectors accessible for all including Persons with disabilities. To achieve this, a set of comprehensive audit tools and checklists were developed. The Kathmandu district, Lalitpur District and Bhaktapur District were assessed.

Making cities inclusive: safe mobility for persons with disabilities in developing countries

HUMANITY & INCLUSION (HI)
June 2018

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A policy brief concerning safe and inclusive urban mobility is presented. Safe and inclusive mobility is not currently a universally recognised concept in international human rights instruments and development framework. The relationship of various global legal & policy frameworks with safe and inclusive urban mobility is discussed including:

  • The UN Convention on the Rights of Persons with Disabilities
  • The 2030 Sustainable Development Goals
  • The New Urban Agenda
  • The UN Road Safety Decade of Action

Recommendations for improved policies and actions are made:

  • Recommendation 1: Recognise safe and inclusive mobility as a transversal issue for realising the Sustainable Development Goals and human rights
  • Recommendation 2: Agree strong political and financial commitments to improve the safety of roads with a focus on vulnerable road users
  • Recommendation 3: Provide safe and accessible urban mobility infrastructures applying universal design approach, all along the mobility chain
  • Recommendation 4: Enhance participatory and evidence-based policy-making for a better governance of road safety, mobility management and urban planning

Inclusive urban mobility and road safety in developing countries

HUMANITY & INCLUSION (HI)
June 2018

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Between 20 to 50 million people worldwide suffer non-fatal injuries in road crashes every year; around 1.25 million are killed. Unsafe roads also represent a major factor of social exclusion, especially for ‘vulnerable road users’. These include notably pedestrians, persons with disabilities, cyclists and children. They represent 46% of road casualties. Persons with disabilities are at higher risk of sustaining injuries from road crashes.

In this thematic brief, the importance of inclusive urban planning is emphasised. Urban mobility and road safety challenges discussed include: safe crossing points over roads; signage and information; collective transport (particularly buses); road design and layout, poor road markings or signposts and the lack of street lighting.

 

Case histories provided are: Engaging government and DPOs to improve safe and inclusive mobility in Burkina Faso; and  Data, road safety and urban mobility in Vientiane, Laos

 

Recommendations for improvements in policies and actions are given under the headings: 

1. Strengthening the policy and financial framework for safe and inclusive mobility action, based on evidence and through participative processes

2. Removing the barriers to safe and accessible mobility, focusing on: the built environment; transport and vehicles; people

Inclusive and safe urban mobility and Disaster Risk Management in developing countries

HUMANITY & INCLUSION (HI)
June 2018

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Disabled people are disproportionately affected by disasters owing to mobility difficulties in evacuation, lack of access to information or services and discrimination. When disasters occur, constraining external factors, such as unsafe roads and lack of accessible pedestrian and transport routes, create additional difficulties for coping with the situation. Developing cities vulnerable to disasters also are likely to have a greater proportion of the population with a disability, due to past injuries.

In this thematic brief, the importance of inclusive urban planning is emphasised. Urban mobility challenges relating to disasters discussed include: inaccessible disaster shelters, inaccessible means of evacuation and lack of information.

 

Case histories provided are: Building back better in Haiti; a focus on inclusive access and mobility; and Improving universal accessibility in Kathmandu, Nepal

 

Recommendations for improvements in policies and actions are given under the headings: 

1. Strengthening the policy and financial framework for safe and inclusive mobility action, based on evidence and through participative processes

2. Removing the barriers to safe and accessible mobility, focusing on: the built environment; transport and vehicles; people

Learning From Experience: Guidelines for locally sourced and cost-effective strategies for hygiene at home for people with high support needs.

World Vision/CBM Australia
May 2018

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This learning resource is the result of a partnership between World Vision Australia and CBM Australia that aims to improve inclusion of people with disabilities in World Vision’s Water, Hygiene and Sanitation (WASH) initiatives, including in Sri Lanka. The guidelines are based on experiences and observations from World Vision’s implementation of the Rural Integrated WASH 3 (RIWASH 3) project in Jaffna District, Northern Province, funded by the Australian Government’s Civil Society WASH Fund 2. The four year project commenced in 2014. It aimed to improve the ability of WASH actors to sustain services, increase adoption of improved hygiene practices, and increase equitable use of water and sanitation facilities of target communities within 11 Grama Niladari Divisions (GNDs) in Jaffna District.

To support disability inclusion within the project, World Vision partnered with CBM Australia. CBM Australia has focused on building capacities of partners for disability
inclusion, fostering connections with local Disabled People’s Organisations, and providing technical guidance on disability inclusion within planned activities. World Vision also partnered with the Northern Province Consortium of the Organizations for the Differently Abled (NPCODA) for disability assessment, technical support and capacity building on inclusion of people with disabilities in the project.

HYGIENE AT HOME FOR PEOPLE WITH HIGH SUPPORT NEEDS
This document is one of two developed in the Jaffna District and describes strategies that used to assist households and individuals in hygiene tasks at home. The strategies were designed to be low cost and were developed using locally available materials and skills in the Jaffna District of Sri Lanka.

NOTE: The development of this learning resource was funded by the Australian Government's Civil Society WASH Fund 2.

Effect of wheelchair design on wheeled mobility and propulsion efficiency in less-resourced settings

STANFILL, Christopher J.
JENSEN, Jody L.
2017

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Background: Wheelchair research includes both qualitative and quantitative approaches, primarily focuses on functionality and skill performance and is often limited to short testing periods. This is the first study to use the combination of a performance test (i.e. wheelchair propulsion test) and a multiple-day mobility assessment to evaluate wheelchair designs in rural areas of a developing country.


Objectives: Test the feasibility of using wheel-mounted accelerometers to document bouts of wheeled mobility data in rural settings and use these data to compare how patients respond to different wheelchair designs.


Methods: A quasi-experimental, pre- and post-test design was used to test the differences between locally manufactured wheelchairs (push rim and tricycle) and an imported intervention product (dual-lever propulsion wheelchair). A one-way repeated measures analysis of variance was used to interpret propulsion and wheeled mobility data.


Results: There were no statistical differences in bouts of mobility between the locally manufactured and intervention product, which was explained by high amounts of variability within the data. With regard to the propulsion test, push rim users were significantly more efficient when using the intervention product compared with tricycle users.


Conclusion: Use of wheel-mounted accelerometers as a means to test user mobility proved to be a feasible methodology in rural settings. Variability in wheeled mobility data could be decreased with longer acclimatisation periods. The data suggest that push rim users experience an easier transition to a dual-lever propulsion system.

Motivation Peer Training – Bridging the gap for people with mobility disabilities

NORRIS, Lucy K.
2017

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Background: Only 2% of people with disabilities in developing countries have access to basic services and rehabilitation.


Objectives: To bridge this gap, Motivation has been running Peer Training activities since 1993 and has identified that there is a growing need for Peer Training. The overall aim of Peer Training is for wheelchair users (Peer Trainers) to provide others (with similar disabilities) with the relevant knowledge on health issues, rights and skills to achieve a basic level of independence and greater quality of life.


Method: To test the impact of Peer Training, Motivation created a knowledge, skills and well-being questionnaire, which has been trialled in two locations: Kenya and Malawi.


Results: Overall, Motivation found that most participants reported an increase in knowledge, skills and well-being, supporting their experience that this training provides vital information and support mechanisms for wheelchair users in low- and middle-income countries. Further work is needed to ensure this tool measures the impact of Peer Training and lessons learnt have been identified to strengthen the methodology.


Conclusion: Although Peer Training is not a replacement for rehabilitation services, Motivation believes it is an effective way to not only increase knowledge and skills of persons with disabilities but also reduce the sense of social isolation that can often be a result of disability.

Wheelchair users, access and exclusion in South African higher education

CHIWANDIRE, Desire
VINCENT, Louise
2017

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Background: South Africa’s Constitution guarantees everyone, including persons with disabilities, the right to education. A variety of laws are in place obliging higher education institutions to provide appropriate physical access to education sites for all. In practice, however, many buildings remain inaccessible to people with physical disabilities.


Objectives: To describe what measures South African universities are taking to make their built environments more accessible to students with diverse types of disabilities, and to assess the adequacy of such measures.


Method: We conducted semi-structured in-depth face-to-face interviews with disability unit staff members (DUSMs) based at 10 different public universities in South Africa.


Results: Challenges with promoting higher education accessibility for wheelchair users include the preservation and heritage justification for failing to modify older buildings, ad hoc approaches to creating accessible environments and failure to address access to toilets, libraries and transport facilities for wheelchair users.


Conclusion: South African universities are still not places where all students are equally able to integrate socially. DUSMs know what ought to be done to make campuses more accessible and welcoming to students with disabilities and should be empowered to play a leading role in sensitising non-disabled members of universities, to create greater awareness of, and appreciation for, the multiple ways in which wheelchair user students continue to be excluded from full participation in university life. South African universities need to adopt a systemic approach to inclusion, which fosters an understanding of inclusion as a fundamental right rather than as a luxury.

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