Wheelchairs through the millennia
|An 1800s photo portrays large wooden wheels and absence of push rims (the latter didn’t arrive until 1881). Photo courtesy of Robert Bogdan Collection|
People accustomed to the sophisticated wheelchairs of modern times might be surprised to learn that wheeled conveyances for human occupants have been around for more than 3,000 years.
Historical accounts describe Chinese chariots, circa 1300 B.C., that used spoked wheels. Scenes inscribed on a vase from ancient Greece (500 B.C.-plus) depict a gurney-like device, carrying a child, that traveled on wheels. About a millennium later, etchings on a Chinese sarcophagus plainly show a sitting person being transported in a wheeled chair.
European monarchs (Spain’s Philip II in the late 1500s and Louis XIV of France around 1700) both used wheelchairs, Louis after a medical procedure. His chair was called a roulette. Philip’s version, more a luxury than necessity, included a footrest and recliner option.
Between these two kingly models, a 22-year-old paraplegic watchmaker from Nuremberg named Stephen Farfler built his own hand-cranked chair in 1655. Resembling a cross between a soap box racer and child’s tricycle, it utilized a cog mechanism to engage the single front drive wheel.
A now-familiar form
In the subsequent two centuries, wheelchairs (initially referred to as “invalid chairs”) assumed much of the form we recognize today. A notable improvement arrived in 1881 when circular push rims were added to the outsides of chairs’ main wheels. Prior to then, users pushing on the main wheels wound up with handfuls of whatever the chair happened to be traveling through.
About 1900 came another significant advance: Wire-spoke wheels replaced wooden ones.
Prior to the 1930s, assorted efforts had been made to create commercially viable wheelchairs of both manual and power persuasions, but none caught on until 1933 when paraplegic Herbert Everest, a mining engineer, and Harry Jennings, a mechanical engineer, introduced the first folding manual wheelchair with mass market appeal.
|The iBOT’s combination of computers and gyroscopes brings the user to eye level and enables stair climbing.|
E&J, as the firm came to be called, monopolized the wheelchair market for decades. The U.S. Department of Justice eventually filed an antitrust suit against the company for rigging wheelchair prices, and the case was settled out of court. E&J survived that little mess and is still in business.
“The evolution of wheelchairs as a whole has mirrored the progress of the independent living movement,” said Mark Smith, program manager for Pride Mobility Products Corp. “As people with disabilities have found greater social independence, mobility products have evolved to bring them greater environmental access.”
Smith said power chairs in particular have undergone dramatic changes in the last 10 years.
“Prior to 1986, nearly all wheelchairs were based on a manual wheelchair platform,” he said. “Then in the late 1990s, mid-wheel drives began to appear. They brought us greater maneuverability, and users found them easier to operate. Also in the late 1990s, we saw advances such as six-wheel chairs and independent suspension systems that offered more comfort and the ability to traverse more varied surfaces.”
“Wheelchairs have become much more efficient and reliable,” agreed Mark Sullivan, vice president of the Rehabilitation Division for Invacare Corp. Among the most important milestones for power wheelchairs in recent years, said Sullivan, are digital electronic control systems and direct drive motor systems, as opposed to belt-drive systems where belts can come loose or wear out.
Digital controllers can accommodate a variety of plug-in function-enhancing equipment such as sip-and-puff controls, head-movement controls and power seating, allowing wheelchairs to easily accommodate the changing needs of their users.
“When their control systems became programmable, that generated a whole new market and industry,” observed Sullivan. “Some systems now even utilize SD [secure digital] memory cards as used in digital cameras, and GPS units to store data and images.”
|Innovation in Motion’s X4 Extreme features four-wheel drive that can traverse mud, snow and sand.|
Smith noted that, “Power chairs are now configured as combinations of optional components.” For example, users can add devices that alleviate pressure on their backsides or individually elevate the leg rests. Custom chairs designed for hunters can incorporate oversized wheels for rough terrain, camouflage paint and gun rests.
Other important advances in wheelchair evolution include the advent of lightweight and ultra-lightweight frame materials, said Ola Abou-Sabe, general manager of Independence Technology, which manufactures the iBOT wheelchair.
Sam Redman, national sales manager of Redman Power Chairs, pointed to technological advances that allow users to experience the full range of motion — sitting, standing or fully reclining. He cited the use of gyroscopes as a major breakthrough in wheelchair evolution that should play an important role in many makers’ chairs within the next 10 years.
Enter the iBOT
One of the most unusual wheelchairs available today is the iBOT. Its $26,000 base price tag reflects some of its bells and whistles that — relying on a combination of computers and gyroscopes — include the wheelchair’s ability to climb stairs, clamber over curbs up to 5 inches high, elevate the user to eye level and travel over uneven surfaces and beach sand.
|An 1894 patent application depicts a wide assortment of wheelchair gadgetry. Schematics courtesy of U.S. Patent and Trademark Office.|
“Giving people the ability to rise to eye level is important for interpersonal communications, but that’s not all,” said Abou-Sabe. “People in wheelchairs need to access hotel check-in desks; they need to reach airline ticket counters.”
Not always a power play
Although many recent wheelchair advances apply to the motorized version, some have given new versatility to manual chairs.
MagicWheels is a two-gear wheelchair drive (actually two carbon fiber composite wheels with an internal two-gear mechanism) that replaces a manual chair’s standard wheels.
Geared wheels give users the ability to handle rougher terrain, giving an extra boost, just by flipping a lever on the hub, for climbing hills, or extra braking for descending them. And, there’s a hill-holding function.
Manual chairs also are going “hybrid,” as in the e.motion manual/motor wheel system from Frank Mobility Systems. The system includes a battery-powered motor assist inside the wheel hubs that delivers a power surge (either forward or backward) simply by exerting slight finger pressure on the push rims. With 10 programmable indoor and outdoor performance levels, this innovation is a shoulder-saving option for those who aren’t ready for a full power chair.
A niche market
|The e.motion system from Frank Mobility Systems has a motorized assist for manual wheelchairs.|
Some wheelchair manufacturers are now adapting their operations to accommodate people of ample girth.
Gendron, which has been in the medical supply business since 1871, describes itself as “the leader in total solutions for bariatric [medical term for obese] patient care.” Its wheelchair options include custom-widened models and chairs with weight-carrying capacities that have been increased from the typical 250-300 pounds to 750, even 1,000, pounds.
On the horizon
Research is well under way toward developing a power wheelchair that can be controlled by intercepting brain signals users send to their larynx (voice box). For the system to work, users still must be able to control their larynx, even though they may not be able to produce coherent speech.
Designed by University of Illinois researchers Michael Callahan and Thomas Coleman, the larynx-control system (called Audeo) relies on a neckband of sensors that pick up and latch onto electrical impulses generated when the brain sends a command to the larynx to vocalize particular words. The sensors then relay the impulses (via wireless transmission) to a computer that translates them into commands that can direct wheelchair controls.
|Now in the Railroad Depot Museum in Columbus, N.M., this wheelchair saw use around the time Pancho Villa made an ill-fated military incursion to the United States at Columbus in 1916.|
Callahan and Coleman formed Ambient Corp., based in Champaign, Il., which now is working with the Rehabilitation Institute of Chicago to refine the technology.
Impediments to evolution
The only downside to these otherwise optimistic developments comes in the form of bureaucratic involvement.
Recently, the federal government advised wheelchair manufacturers and users that it intends to cut back on the amount that Medicare will reimburse wheelchair buyers for their chairs. One recent report from the U.S. Department of Health and Human Services determined, “Medicare fee schedule amounts for power wheelchairs were 45 percent higher than median Internet prices available to consumers in the first quarter of 2007.”
IBOT’s Abou-Sabe takes strong issue with that conclusion. “One of the biggest stumbling blocks to purchase of wheelchairs … and innovation … today is the level of government reimbursement. Internet chairs are typically low-end. Their cost doesn’t reflect all the many multiple costs associated with fitting chairs to individual users. Having your wheelchair dropped off at your front door with no further involvement is not what we consider to be ‘life-participatory.’”
The wheeled-chair users of 3,000 years ago might well be terrified if they encountered the zoom-whiz chair technology of today. Even for us, however, the future holds more scientific advances than we can imagine, with a concomitant boost to individual independence.
Disability History Museum