Concept proposal for a detachable exoskeleton-wheelchair to improve mobility and health

Wheelchair use has consequences to quality of life in at least two areas: 1) health issues such as pressure sores and chronic overuse injury; and 2) access problems due to the inaccessible nature of the built and natural environments that are most amenable to upright postures. Even with these concerns, wheelchairs are still the best form of mobility for many people (e.g. they are relatively easy to transfer into and propel). However, wheelchairs are simply not transformative, i.e. they do not allow a person with a disability to attain a level of mobility performance that approaches that of their non-disabled peers, nor do they typically allow for face to face interactions and full participation in the community. Wheelchairs also do not typically support ongoing therapeutic benefits for the user. To address the inadequacy of existing wheelchairs, we are merging two evolving technologies into a coherent new mobility device. The first is dynamic wheeled mobility, which adds significant functionality to conventional wheelchairs through the use of on-the-fly adjustable positioning. The second is powered walking exoskeletons, which enable highly desired standing and walking functions, as well as therapeutic benefits associated with rehabilitation gait training. Unfortunately, exoskeletons have significant usability concerns such as slow speed, limited range, potential to cause skin issues, and difficult transfers. A new concept of docking a detachable exoskeleton to a wheeled frame has been developed to address these issues. The design goal is a single mobility device that not only optimizes daily activities (i.e. wheelchair seating and propulsion with dynamic positioning), but also serves as an easy-to-use rehabilitation tool for therapeutic benefits (i.e. a detachable powered exoskeleton for walking sojourns). This has significant potential benefits for the lives of people with mobility impairments.

[1]  Hugh Herr,et al.  Exoskeletons and orthoses: classification, design challenges and future directions , 2009, Journal of NeuroEngineering and Rehabilitation.

[2]  Joy Wee,et al.  Factors affecting measures of activities and participation in persons with mobility impairment , 2009, Disability and rehabilitation.

[3]  Julianna Arva,et al.  RESNA Position on the Application of Wheelchair Standing Devices , 2009, Assistive technology : the official journal of RESNA.

[4]  I-Min Lee,et al.  Sedentary behaviour and life expectancy in the USA: a cause-deleted life table analysis , 2012, BMJ Open.

[5]  Jaimie F. Borisoff,et al.  The development of an ultralight wheelchair with dynamic seating , 2011 .

[6]  Sajay Arthanat,et al.  Consumer perspectives on the usability and value of the iBOT® wheelchair: findings from a case series , 2012, Disability and rehabilitation. Assistive technology.

[7]  K. Khunti,et al.  Sedentary time in adults and the association with diabetes, cardiovascular disease and death: systematic review and meta-analysis , 2012, Diabetologia.

[8]  Yasuhisa Hasegawa,et al.  Intention-based walking support for paraplegia patients with Robot Suit HAL , 2007, Adv. Robotics.

[9]  E. Biddiss,et al.  Upper-Limb Prosthetics: Critical Factors in Device Abandonment , 2007, American journal of physical medicine & rehabilitation.

[10]  L. V. D. van der Woude,et al.  Most essential wheeled mobility skills for daily life: an international survey among paralympic wheelchair athletes with spinal cord injury. , 2012, Archives of physical medicine and rehabilitation.

[11]  Albert M. Cook,et al.  Cook & Hussey's Assistive Technologies Principles and Practice , 2007 .

[12]  Dan Ding,et al.  Usage of tilt-in-space, recline, and elevation seating functions in natural environment of wheelchair users. , 2008, Journal of rehabilitation research and development.

[13]  J. Minkel,et al.  Study of the Independence IBOT 3000 Mobility System: an innovative power mobility device, during use in community environments. , 2004, Archives of physical medicine and rehabilitation.

[14]  Antoinette Domingo,et al.  Lower Limb Rehabilitation Following Spinal Cord Injury , 2014 .

[15]  Barry S Mason,et al.  Influence of Glove Type on Mobility Performance for Wheelchair Rugby Players , 2009, American journal of physical medicine & rehabilitation.

[16]  Michael L Boninger,et al.  Recent trends in assistive technology for mobility , 2012, Journal of NeuroEngineering and Rehabilitation.

[17]  Jose L Pons,et al.  Rehabilitation Exoskeletal Robotics , 2010, IEEE Engineering in Medicine and Biology Magazine.

[18]  R.A. Cooper,et al.  Engineering Better Wheelchairs to Enhance Community Participation , 2006, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[19]  Rosemarie Cooper,et al.  RESNA Position on the Application of Tilt, Recline, and Elevating Legrests for Wheelchairs , 2009, Assistive technology : the official journal of RESNA.

[20]  A. Esquenazi,et al.  Safety and tolerance of the ReWalk™ exoskeleton suit for ambulation by people with complete spinal cord injury: A pilot study , 2012, The journal of spinal cord medicine.

[21]  Roland R Roy,et al.  Basic concepts of activity-based interventions for improved recovery of motor function after spinal cord injury. , 2012, Archives of physical medicine and rehabilitation.

[22]  A. Esquenazi,et al.  The ReWalk Powered Exoskeleton to Restore Ambulatory Function to Individuals with Thoracic-Level Motor-Complete Spinal Cord Injury , 2012, American journal of physical medicine & rehabilitation.

[23]  M. Goldfarb,et al.  Preliminary Evaluation of a Powered Lower Limb Orthosis to Aid Walking in Paraplegic Individuals , 2011, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[24]  Julianna Arva,et al.  RESNA Position on the Application of Seat-Elevating Devices for Wheelchair Users , 2009, Assistive technology : the official journal of RESNA.

[25]  Paolo Bonato,et al.  Major trends in mobility technology research and development: Overview of the results of the NSF-WTEC European study , 2011, Journal of NeuroEngineering and Rehabilitation.

[26]  Jerry E Pratt,et al.  Design and evaluation of Mina: A robotic orthosis for paraplegics , 2011, 2011 IEEE International Conference on Rehabilitation Robotics.