HEAD and SHOULDERS ABOVE the REST Mobility Aid for The

HEAD AND SHOULDERS ABOVE THE REST

Mobility Aid for the Disabled April 2017

Industrial Design Thesis Report By Deena Cincinatus

Alpha – Mobility Aid for the Disabled

By Deena Cincinatus

Supervised by Dennis Kappen & Bruce Thomson

Submitted in Partial Fulfillment of the Requirements for the Degree of Bachelor in Industrial Design Humber College, Toronto

April, 2017

Consent for Publication in the Humber Digital Library (Open Access)

Consent for Publication: Add a (X) mark in one of the columns for each activity

Activity Yes No Publication I give consent for publication in the Humber Library Digital Repository which is an open access portal available to the public

Review I give consent for the review by the Professor only

The author grants Humber College of Technology and Advanced Learning the nonexclusive right to make this work available for non-commercial, educational purposes, provided that this copyright statement appears on the reproduced materials and notice is given that the copying is by permission of the author. To disseminate otherwise or to republish requires written permission from the author.

I warrant that the posting of the work does not infringe any copyright, nor violate any propriety rights, nor contain any libelous matter nor invade the privacy of any person or third party, nor otherwise violate the Humber Library Digital Repository Terms of Use.

Signature :

Student Name : Deena Cincinatus

ABSTRACT

The following report is an in-depth research and development document conducted and compiled by Deena Cincinatus as part of the Industrial Design thesis project at Humber College. This is documentation for the design of ALPHA, the revolutionary standing mobility device for the lower limb disabled. The aim of this thesis project is to design a better, lighter, more comfortable and stylish mobility aid with standing capabilities so that users can interact with more of the world around them. The report covers the entirety of the thesis project from initial research to final concept design

ACKNOWLEDGEMENTS

The Industrial Design program at Humber has been a completely amazing, and I would like to thank all of the faculty and staff who make the program possible. I had a lot of fun and learned a lot over the last four years. I would also like to thank my friends and colleagues for their support and friendship along way.

Special thanks (and maybe even praise) to my family for their awe- inspiring support during this project and the last four years I’ve spent at Humber. Without them this would not have been possible.

Because I promised, thank you to my awesome cousins who helped me during this project by letting me strap them down to my 1:1 buck. Thank you to my friends who let me do the same to them, but with a wheelchair.

Lastly, I would like to thank everything that made me laugh during this project. From the YouTube videos, the random fortune cookies my mom and I had a whole conversation with (us going back and forth), and my sister who always managed to make me smile when I was down. I couldn’t have made it through this without it all.

Sincerely, Deena Cincinatus

TABLE OF CONTENTS

Contents CHAPTER 1 ...... 1 1.1 Problem Definition ...... 2 1.2 Investigative Approach ...... 3 1.3 Background ...... 4 1.4 History ...... 7 1.5 Social Context ...... 8 CHAPTER 2 ...... 10 2.1 User Research ...... 11 2.1.1 User Profile/Persona ...... 11 2.1.2 Current User Practice ...... 15 2.1.3 Activity Mapping...... 18 2.1.4 Ergonomic Research (Existing Products)...... 22 2.1.5 Safety and Health Research ...... 24 2.2 Product Research ...... 25 2.2.1 Benchmarking – Benefits and Features ...... 25 2.2.2 Benchmarking – Functionality ...... 27 2.2.3 Aesthetics & Semantic Profile ...... 29 2.2.4 Benchmarking – Materials & Manufacturing ...... 30 2.2.5 Benchmarking – Sustainability ...... 31 CHAPTER 3 ...... 32 3.1 Needs Analysis ...... 33 3.1.1 Needs/Benefits Not Met by Current Products ...... 33 3.1.2 Latent Needs ...... 35 3.1.3 Activity/Experience Graph ...... 37 3.1.4 Categorization of Needs ...... 38 3.1.5 Needs Analysis Diagram ...... 39 3.2 Functionality ...... 40 3.3 Usability ...... 42 3.4 Aesthetics ...... 54

3.5 Sustainability – Safety, Health & Environment ...... 56 3.6 Commercial Viability ...... 58 3.6.1 Materials and Manufacturing Selection ...... 58 3.6.2 Cost ...... 60 3.7 Design Brief ...... 62 CHAPTER 4 ...... 63 4.1 Ideation ...... 64 4.2 Preliminary Concept Exploration ...... 66 4.3 Concept Refinement ...... 69 4.4 Detail Resolution ...... 71 4.5 Sketch Models...... 75 4.6 Final Design ...... 79 4.7 CAD Models ...... 80 4.8 Hard Model Fabrication History ...... 89 CHAPTER 5 ...... 94 5.1 Summary ...... 95 5.2 Design Criteria Met ...... 96 5.2.1 Ergonomics ...... 96 5.2.2 Materials, Processes & Technology ...... 98 5.2.3 Manufacturing Cost Report ...... 100 5.3 Final CAD Renderings ...... 101 5.5 Technical Drawings ...... 107 5.6 Sustainability ...... 108 CHAPTER 6 ...... 109 CHAPTER 7 ...... 111 CHAPTER 8 ...... 115 Discovery (i) ...... 116 Preliminary Information Search ...... 116 Expert Interview 1 ...... 125 Expert Interview 2 ...... 128 Surveys ...... 131 User Research (ii) ...... 134

User Profile Report ...... 134 Persona ...... 144 Blogs and Discussion Boards ...... 145 User Observation Report ...... 147 Product Research (iii) ...... 155 Product Research I Benchmarking ...... 155 Product Research II Benefits and Features ...... 166 Needs Analysis (iv) ...... 172 Needs Statement 1 ...... 172 Activity-Experience Graph ...... 175 CAD Models (v) ...... 176 Hard Model Photographs (vi) ...... 178 Technical Drawings (vii) ...... 181 Manufacturing Cost Report (viii) ...... 182 Sustainability Report (ix) ...... 183 Topic Approval Form (x) ...... 189 Advisor Meetings & Agreement Forms (xi) ...... 192 Other Supportive Raw Data (xii) ...... 195 Topic Specific Data, Papers, Publications (xiii) ...... 195

CHAPTER 1 PROBLEM DEFINITION

1.1 Problem Definition

Millions of people around the world are disabled in some

way that involves them using a wheelchair or other mobility aid to

move around. Many of these people are paraplegics, amputees,

people suffering from arthritis and/or muscular dystrophy; all of

these resulting in being unable to walk or stand without help. One

of the problems that they face is a matter of vertical reach.

Wheelchair bound individuals are unable to move beyond the

limits of their mobility aids and physical reach to objects from

heights that they interact with daily – whether it be their closet, a

shelf, the kitchen cupboards or the bathroom cabinet – and

current methods leave a lot to be desired. The goal of this thesis is

to develop a mobility device with vertical access for the lower

limb disabled.

1.2 Investigative Approach

Key information to be determined

 Target demographic  Wants and Needs

 Current products/solutions on the market  Ergonomics for users in seated mobility aids

 Possible product cost

 Materials  User experience

 Health and Safety concerns

Key questions to be answered

 Is there a real need for this product?  How will the user interact with/use the product?  How will different demographics fit in to the design?  What steps have been taken to solve the problem? How can they be improved?  How will the product interact with different environments?

Methods Used/Investigative Approach Plan

 Literary Research  Interviews  Field Research (experiencing the manual wheelchair, participants/volunteers, surveys, etc.)  Ethnography  Ergonomics

1.3 Background

Background – Numbers Involved

There are millions of disabled individuals all over the world and a good portion of them require a mobility aid, such as a wheelchair, as a means of mobility since they are unable to walk or stand on their own. The top 5 most wheelchair accessible countries in the world are Canada, The United States, The United Kingdom, Australia, and New Zealand due to the high number of people in wheelchairs living there. About 3.3 million of those people come from the U.S. alone; 1.825 million Wheelchair users are 65+ in age; and there are about 2 million new wheelchair users each year. (Reznik, 2015)

Background – Injuries and Safety Issues

While wheelchairs are for the most part safe, that doesn’t mean users can’t get injure while using one. The biggest issue for user safety is tipping/tilting. Wheeled mobility aids today are designed in such a way that the user is – for the most part – centered and Location % should therefore not be able to tip or tilt. However, Head and neck 50 that’s not to say it is impossible for the user to tilt or Trunk 9.5 Shoulder and arm 8.1 tip over; especially if the user leans too far forward Elbow and forearm 3.3 Wrist and hand 9.1 or to the side while reaching, or if too much Hip and thigh 8.1 Knee and leg 6.7 weight is added to the back. Ankle and foot 5.2

The worst injury is when falling forward through, as individuals not only might be unable to cushion their fall and/or brace themselves, they also have the entire weight of their mobility aid crashing and resting on top of them. These falls could result in a number of injures including the head and neck, the upper body, and the wrist and hand areas; these being the more common locations for injuries. These injuries could cause long-term damage if severe enough. Injuries can also be fatal if the damage caused was to the head and neck regions.

Background – Disadvantages

Wheeled mobility aid users are at a bit of a disadvantage when interacting with the wold around them, especially if they are unable to walk and stand, even for a short amount of time. The main two problems being reach and accessibility. With reach, individuals can have a gap of 2-3 ft. difference in max reach height when comparing sitting to standing ergonomics. While mobility aid accessibility is becoming more common, it still seems to be missing in important areas like ramps and automatic door buttons for building access. This can put some mobility aid users in quite the predicament and cause them frustration and anger.

1.4 History

History – Wheelchairs

Wheelchairs – and wheeled mobility aids – have been around for centuries, but it is unclear as to when they were first invented. They likely came from the need or desire to be able to move around even when one was unable to move specific parts of their body. The mobility device was not even originally called “wheelchair”, rather it was called an “invalids chair”. (Bellis, n.d.). As the year rolled on, so too did the design of the wheelchair; changing from a separate man-powered chair to the more familiar user-powered chair and even later to the motor-powered chair. However, one thing has stayed the same; purpose. The purpose of the wheelchair and other devices of the like was to help people who found walking difficult or impossible due to illness, injury, or disability, to move around.

Wheeled mobility aids have become a staple in today’s day and age for the disabled, especially those who cannot walk or stand. These devices come in a variety of styles for different purposes like sports, every day, manual, powered, rising, tilting, etc. With the technological advancements in the last few years, most of these aids have become powered devices; whether out of need, efficiency, function or simple desire. However, while they do solve the issue of horizontal mobility for the user, few mobility aids supply a means to help their user with vertical access or reach.

1.5 Social Context

Social Context – Trends

 Demographic o Most wheelchair/wheeled mobility aid users tend to be female, though both genders are involved. The age can range from anywhere between 6 years old to 65+; the majority being older adults and elderly. They are a mix of various ethnicities and tend to either be relatively poor – due to the costs needed to be covered for the mobility aid, alternative devices, medical bills and the like – or somewhere between middle and upper-middle class. Women may be the majority of wheeled mobility aid users, but that is likely due to the types of injuries or diseases they can get in comparison to their male counterparts and where it would affect them (e.g. arthritis).

 Lifestyle o Lifestyles differ from person to person but wheelchair users can be divided between those who use manual chairs and those who use power chairs. Those in manual chairs

tend to be more physically active and will participate in sports or other more taxing activities. They will be physically stronger due to them having to rely on their own strength to propel and steer themselves on a daily basis. Power chair users do not have this advantage, which is why they are less likely to be as active. They can still participate in the same activities, just not in the same ways. However, because of their chairs, if they get their chair fitted with a specific feature they can perform certain tasks that manual chair users would likely not have (e.g. seat elevating/lifting).

 Product o Mobility aids like wheelchairs tends to be very geometric and technical, and there is a very high value put on performance. Comfort, style, and efficiency are other important key aspects that are considered for mobility aids, especially wheelchairs as each wheelchair is designed and/or customized for each individual person so that the specific needs of that person are met.

CHAPTER 2 RESEARCH

2.1 User Research 2.1.1 User Profile/Persona

Primary User

Demographics Use Behavior Personality Cognitive aspect

Age 6 – 65+ Frequency Everyday ‘locus of ↑ Technical Skill ↑ of use control’ Gender Mostly female Duration 14-15hrs~ Self-efficacy ↑ Pre-req. content ↑ knowledge Culture / Very mixed Social/ Mixed Changeability ↑ Ethnicity Solitary

Income Middle class Level of High Uncertainty - Upper-middle Focus Avoidance - class - Educational Post 2ndary Location Worldwide Background

Demographics: Age: Any, but majority >65+ (~70%) Gender: Both (mostly female) Ethnicity: Mixed Income: Mid/High ($60,000 - $100,000 annually) Education: Post-Secondary Education.

User Behaviour: This study is looking for those who rely on their wheelchair for any form of personal transportation mobility (not vehicles). This means that more or less the user would rely on their mobility aid 24/7.

By factoring in at least 8hrs of sleep and another 1-2hrs to perform personal hygiene, a rough estimate of time where the wheelchair is in use would be about 14-15hrs per day. Depending on whether the wheelchair is manual or powered changes how often the user might need a break.

Wheelchair users are both social and solitary in a range of activities. Many of these being sport related which require a standard number for teams or equipment use (e.g. basketball would need a team while a kayak would by solitary).

Wheelchair users seem to pursue an active lifestyle. They do this through being outdoorsy, sporty, being more health oriented and fit, and even by joining the work force.

MEET Joan Holmes

Age: 49 Job: Marketing and Market Research (Market Manager) Income: $60 000 - $100 000 Education: University graduate Relationships: Married Location: Toronto, ON

Mobility Aid: Wheelchair Frequency: Every day Duration: 14-15 hrs/day Social/solitary: With her friends, sometimes solo

User Behavior

Since Joan is a paraplegic, she has to use her choice of mobility aid – manual wheelchair – to get around 24/7, all year long. She takes part in a number of activities including joining a few wheelchair sports at the local community sports club. She and her husband (who is not paraplegic) also travel for outdoor vacations where they enjoy kayaking during the summer months and skiing during the winter months. Joan loves to be able to do her own thing despite her disability and show just how strong she is.

Joan’s Relationship with her Wheelchair

Joan Holmes has three wheelchairs…an everyday wheelchair, a skiing wheelchair, and wheelchair designed for beaches/watery areas. Her first wheelchair was a basic manual wheelchair meant for the sole purpose of personal mobility. As she grew older and found a love for specific sports and activities, Joan purchased properly design chairs. Every five years Joan replaces or upgrades her wheelchair as she, her occupational therapist, and the wheelchair manufacturer see fit.

Joan and her fellow lower limb disabled friends swap stories/experiences on occasion during their times together. Due to this, Joan has a good appreciation for the different responses/recommendations of the wheelchairs and other mobility aids/devices. 13

Secondary User

The secondary user is similar to the primary user in that it is very difficult to create a definitive profile. Secondary users are the “Caregivers”; people who help the primary user with tasks like getting dressed or getting to work, or help the primary user adjust to their mobility aid like Occupational Therapists. The secondary user can be divided into two groups; family/friends and payed help.

Family and friends go without saying. They will help the primary user with tasks and be the most likely person(s) to look to.

Payed help are usually working class individuals who work part time for the user to help with minor tasks like bathing or transport. They will be around mid-20s to 40s and can be male or female, and of different backgrounds/ethnicities as well. For the secondary user who has more medical tasks or elderly employers, they might have a background in healthcare or nursing as well.

2.1.2 Current User Practice

Personality and Cognitive Aspect

Inference as to personality traits associated with the users of wheelchairs and other wheeled mobility aids is speculative, since that is not the area of expertise of the author. With that in mind, remarks can be made about wheelchair users.

Three elements of Personality addressed here are ‘locus of control’ and self- efficacy.

Locus of control: refers to the extent to which individuals believe they can control events affecting them. Self-efficacy: is the extent or strength of one's belief in one's own ability to complete tasks and reach goals Changeability: is the ability to change or be changed, depending on the situation.

The first two terms are similar, the one referring to control of one’s environment, the other based on goal attainment; whereas the final term focuses more on how one might change their environment to their own needs or adapt to the situation/environment themselves.

Two elements of Cognitive Aspect addressed here are technical skill and pre- requisite knowledge.

Mobility aid users find travelling outside of what is normally a mobility aid friendly environment to a not as accessible environment (e.g. home to the middle of a city) require increasing levels of technical skill to progress. However, having some pre-requisite knowledge wouldn’t hurt either so as to know where one can or can’t go while travelling on wheels.

Caregiver and User Interactions

After speaking with and interviewing individuals from both demographics, it became evident that there are some tasks that can be done alone while others require assistance. It also seems that certain tasks or situations bring out some rather strong emotions that have at one point or another resulted in immediate changes.

Summary Statements:

 People can adjust to using any mobility device/aid, but the time it takes is different for each person depending on whether they accept the device as part of their lives, they’re ability to move forward from their past version of themselves, and practice/comfort in using the device.

 Environments are a big part of a disabled individual’s life. While designing mobility devices/aids one has to keep in mind how they will be interacting with the world around them: size, shape, movements/maneuvers, etc.

 Wheelchairs, especially the motorized ones, are not built to fit the many. They are individually designed and customized for each individual user to maximize their comfort and experience.

 Wheelchairs and other mobility devices/aids are like a part of the user. It becomes are part of their lives and without it they can feel more helpless than ever, having to rely more heavily on those around them. Similar to pulling a back muscle or breaking your glasses, you don’t realize how much you need it till it’s gone or out of your ability to use.

 When a problem arises where the user is unable to complete their desired task due to their disability, the user can become frustrated and angry. Such tasks could be gaining access to a building, opening a door, or reaching for an object on a high shelf – all of which would be extremely hard for a lower limb disabled person, especially if there are no wheelchair accessible points of entry or lifting mechanism/person nearby to raise the user’s height.

2.1.3 Activity Mapping

Note: While the mobility device is designed to assist users in vertical access, its primary directive is to act as a mobility aid. It is also important to note that once a transfer has started, there is no stopping it, so it needs to be done right without hesitation.

The following is a step by step of a lower limb disabled individual moving from a bed to their mobility aid – a wheelchair – without assistance

1. User uses their core strength to rise into an upright position. This could be assisted by tugging the sheets or holding onto bedrails if they are there. 2. User stabilizes their position via the sheets, rails or the bed itself, or an alternate source of balance. E.g. their pants or some other piece of close furniture. 3. User adjusts leg position to the side and prepares for pivot into a sideways facing position. 4. User then relocates limbs to the side of the bed and braces for lift. 5. User then grips the mobility aid and the bed at the same time and begins transfer. 6. User secures and repositions themselves in their mobility aid for best comfort and mobility (straps, belts, alignment of legs/feet on bracers, sitting position, etc.). 7. Transfer and securement is complete. User is now free to roam.

The following Activity Mapping was observed from a YouTube “how to” video for lower limb disabled individuals transferring from their mobility aid to a chair.

Meet Vincent Name Vincent Age 48 Sex Male Location Unknown (Office?) Date of observation 19/11/16 Experience level Veteran (26yrs) Wheelchair used Unknown (manual) Disability status c6 spinal cord quadriplegic

Step by Step

Pull up to chair facing towards One has to think aboutyou. their position to the chair because once you start the transfer, you can’t stop.

Positioning not too close, but not too far away, and facing towards the chair. 1

Putting breaks on is optional for each and every user.

Positioning Feet Could be while on the wheelchair, but for better stability it’s best to place them on the floor about 1/3 to their final position when seated in the chair.

Positioning of body and prepping for

transfer movements Scoot forward close to the edge of the mobility aid

Place one hand on the chair – on the side it will end up while seated in the chair 3 Place the other hand on the mobility aid – either on the arm or the seat.

Positioning Correct methods are in green. Incorrect method is in red.

Begin and End

Transfer 4

**Remember, once you start you cannot stop. It has to be a fluid motion and it is done in a matter of seconds.

Used own strength to move self over in less than two seconds. It’s that fast.

Adjustment and Comfort

The user, once in the chair or other furnishing, is then able to readjust themselves to a more comfortable position should they so desire. 5 20

Summary: 1. The transfer technique shown is one of the more common and I would say one of the better ones since the alternatives (board or aided/helped) are either uncomfortable or not being analyzed for this thesis. 2. There are a lot of nitpicky details for set-up and positioning. While they can be annoying or tedious to the user, they provide stability for the transfer and safety for the user. 3. Relying on physical ability to move one’s self either through momentum (throwing) or arm strength. 4. Users become accustomed to these movements over time and just learn to live with them. None of them showed any annoyance or discomfort while using their methods of transfers.

2.1.4 Ergonomic Research (Existing Products)

After observing various users and the types of wheelchairs they used, an understanding was developed on ergonomics. There are many styles and types of wheelchairs, and each wheelchair is unique to the user. To make the ergonomics easier, a standard manual wheelchair was used for base measurements, layout, size, and space restrictions.

Due to the fact that anybody could end up needing a mobility aid, it became apparent that this theoretical product would need to serve users of all percentiles. The 5th percentile (female) and the 95th percentile (male) were researched through diagrams of “The Measure of Man and Woman” by Henry Dreyfuss. Measurements of wheelchairs and their occupants were researched through diagrams of “The Measure of Man and Woman” by Henry Dreyfuss and Wheelchair Accessibility Standards (WCA) of various cities, and through measuring of a standard manual wheelchair.

Adjustable features and electronic components are not considered under the ergonomics as they would be a standard size/shape and so cannot be changed or adjusted to fit one individual over another.

As it stands, the main areas of ergonomic consideration include:

Seat Height Front Wheels, Back Wheels (Angled)

Seat Width Distance between Wheels

Seat Depth, Foot Rest – Height above Backrest – from Seat to Bottom of the ground Backrest

Foot Rest – Distance from Seat Backrest – from Seat to Top of Backrest.

2.1.5 Safety and Health Research

Primary Users

Injury due to poor design and insufficient ergonomic considerations to user activity and/or behavior.

 This is not always noticed when buying the product and is usually found out by accident due to the user pushing the limits of their wheelchair.

Injury to self as a result of overexertion or pushing limits set by the body and wheelchair in relation to one another.

 Self-inflicted injuries tend to happen unintentionally, especially if the user is doing some action or activity they are not used to. E.g. reaching too far forward resulting in tipping. Propelling one’s self in a manual wheelchair a further distance than the body is used to resulting in strained muscles and pain.

Users who are lower limb disabled are unable to exercise their lower body which can lead to muscle atrophy and/or Osteoporosis/bone atrophy.

 Muscle Atrophy is the technical/medical term for when muscles waste away. A lack of physical activity in a body part/limb such as an arm or leg can lead to muscle wasting away.  Osteoporosis – or bone atrophy – is a common bone disease mostly seen in the advanced age group. It makes the bones more vulnerable to breaking. Although not extremely common in all ages, it has a 5% chance of appearing in those who are immobile.

2.2 Product Research 2.2.1 Benchmarking – Benefits and Features

Since this thesis aims to offer a mobility aid with vertical accessibility, this section will focus on wheelchairs with the feature and capability to “stand” or rise/raise the seat height. The user of this product will still be lower limb disabled individuals such as paraplegics. This section will compare existing wheelchairs in the hopes of understanding and distinguishing their strengths and weaknesses.

Wheelchair models being compared

Otto Bock Xeno LSE Quickie Jive Up LSCT Karman Stand-Up Power Pegasus II (Semi-Powered Wheelchair Standing Wheelchair) Leo (Lightest Standing F5 CORPUS VS STANDING Wheelchair) WHEELCHAIR LSC Draco Standing Wheelchair

Some of the following wheelchairs had unique features, such as being lightweight, the way they changed the user’s height, being completely man-powered, or the flexibility and diversity of the reclining mechanism.

Product Matrix

This particular matrix approximately places the various wheelchairs on the graph after analyzing each model’s respective features. The two axis for this matrix focus on the type of wheelchair (powered or manual) and whether or not it has the capability to recline into various positions. The reason for this second axis is that many powered wheelchairs have this feature for health related reason and so it is not an uncommon for doctors or Occupational Therapists to recommend it to their clients.

From these ten wheelchairs, patterns were found in the features and benefits.

 Features: Style, wheels/driving ability, safety equipment/procedures, frame construction, adjustable, lifting/standing abilities.

 Benefits: easy to handle, comfortable, user/wheelchair stability, health aware/oriented, allows for more freedom and independence. 26

2.2.2 Benchmarking – Functionality F5 CORPUS VS STANDING WHEELCHAIR

Maximum User Weight: 300lbs, 136 kg Maximum Speed: 7.5 mph, 12 km/h Driving Range (1): 16 miles, 26 km Base Width: 25.5", 648 mm Base Length: 43", 1093 mm Minimum Turning Radius: 30", 762 mm Ground Clearance: 3", 75 mm Drive Electronics: R-net 120A Battery Type: Group 24 Gel Optional Seat Elevator: 14", 350 mm Seat to Floor Height: 17.5", 18.5", 19.5"/ 445, 470, 495 mm Power Tilt Options: 0° - 50° Posterior Recline Options: 85º-180° (power) Leg rest Elevation: 90° - 180° Armrest Pad Lengths: 10", 13", 16" & 18" Seat Widths: 17" - 23" (by 2" increments), 420 - 570 mm Seat Depths: 14" - 22" (by 1" increments), 370 - 570 mm Backrest Heights: 23" - 28" (by 1" incr.), 580 - 710 mm

LSCT

Quickie Jive Up Seat Width: 400mm - 500mm (40cm - 50cm) Seat Depth: 400mm - 520mm (40cm - 52cm) Overall Width: 630mm (63cm) Speed: 6, 10 and 13 kph Battery Size: 60 and 70 Ah Max. Range: 32 km (40 km with 70 Ah batteries) Seat Tilt: 0 - 22 Degrees Back Recline: 90 - 175 Degrees Turning Radius: 910mm (maximum) - (91cm maximum) Max Kerb Climb: 100mm (10cm) Max. User Weight: 120 kg (18.9 stone) Colours: Red, Blue & White

There are several trends that can be seen between the three selected models above. Some are obvious at first glance while others are seen once diving into the features and benefits. All three chairs are power wheelchairs with a tilting and reclining feature. The overall dimensions of all three are within the same range and they all go about the same max. speed as well. All three wheelchairs are also capable of standing. The seat, backrest, armrests and support systems are similar and fulfill the basic ergonomic need of the user

Below is a list of functions and features that could make a well-rounded and ergonomic mobility device/aid with vertical accessibility for the lower limb disabled.

Adjustable Reasoning

Leg Supports/Rests User Preference and Percentile Requirement

Arm Supports/Rests Height User Preference and Percentile Requirement

Seat Height User Preference

Chair Handles Percentile Requirement

Configurations Reasoning

Standard Power Wheelchair User familiarity/understanding of product

Three Wheeled Power Chair Similar to standard so easier user

understanding of product

Exoskeleton Space optimizing and lessening overall

weight of device used

Tread/Tank Chair Climbing capability and easier user

understanding of product

Note: Some of the configurations mentioned are not from the three wheelchairs shown, but they are possibilities.

2.2.3 Aesthetics & Semantic Profile

This section will analyze the aesthetic and sematic qualities of the selected benchmarked products. Aesthetics are important as they are the design of the product and can be one of the main reasons why a buyer may choose one model over another, even though they have the same features and/or benefits. The aesthetics are also a statement of the user or a fashion accessory with a primary function; similar to say styling glasses so they are not just a frame.

The other half of this analysis are the semantics of the products, which are the meaning behind the styling of a product; e.g. red on a medical/first-aid kit symbolizes urgency, emergency, and makes it stand out so it is easy to find. Part of the goal of this these is to create an intuitive product that users will either know how to operate or can easily figure out without too much assisted instruction, as well as to cross existing barriers in the current user/product culture. By understanding the reasoning behind certain styling choices and semantics a well-informed design decision can be determined for this thesis.

Aesthetics

Primary Colour: Black, Grey/White/Silver, Chrome

Secondary Colour: Red, Blue, Yellow, Bronze

Shape: Angular, Soft Angular, Semi-Organic in some areas, Round

and/or Softer Angles on touch points, boxy/square,

smooth/sleek around motor areas

Texture: Lustrous, smooth and rounded seating areas, Smooth motor

shell/cover, tactile grip points (handles or armrests)

Semantics

Primary Colour: Strong, Durable, Safe, Modest, Reliable

Secondary Colour: Splash of personality, character, communication

Shape: Structural integrity, Strong, Secure, Ergonomic, Modern

Texture: Easy to clean, Easy to use, sense of speed/capability,

relaxing/comfortable

2.2.4 Benchmarking – Materials & Manufacturing

Materials and Manufacturing processes tend to vary from product to product. For the sake of this benchmarking activity, standard manual wheelchairs’ designs was reviewed, and from those materials and manufacturing processes were compiled into a list of the most common trends. Part Process Wheels Aluminum frame with steel spokes Extrusion, welding, riveting Steel bearings Punched, grinding, polishing Pneumatic rubber or solid rigid tires Rolled, formed Frame Aluminum crass frame – meant for Extrusion, welding folding purposes Aluminum tube in the front and Extrusion, welding back of the frame Aluminum footrest attachments Extrusion, welding Seat Nylon foldable sling Machine woven Double foam padded vinyl Upholstered by hand

2.2.5 Benchmarking – Sustainability

Wheelchairs are not easy products to recycle (from the user’s perspective) and for many past users a wheelchair is treated similar to baby strollers or car seats – once the user is done with it, it either gets sent back to the manufacturer for deconstruction and part use, sent on to the next possible user, or trashed. The last option is actually the least likely to happen.

Companies actually have a good amount of ownership over the wheelchairs they produce and so when users need to switch or change their wheelchair every five years, the company reclaims a good majority of them so that they can strip them down for reusable parts or mechanisms and then recycle the majority of what’s left. The rest of the wheelchairs that don’t get collected are passed around from one user to another, either through simple hand-off or through a purchase (eBay or amazon being the more common sites).

Some models may also contain parts that are made from recycled materials like aluminum, stainless steel, elastomer composites, etc. It is unknown how companies recycle these components, however, as it seems to be a trade secret.

CHAPTER 3 ANALYSIS

3.1 Needs Analysis When paraplegics and other lower limb disabled individuals are told to get a wheelchair, the model and functions are often on the recommendations of the user’s occupational therapist and the wheelchair manufacturer. This typically covers aspects like mobility, long-lasting comfort, and maybe the tilt/recline feature. However, it is not required – or often recommended – to have a lifting/standing feature which leaves many lower limb disabled individuals with a limited vertical reach. There is a need for a product that offers vertical accessibility to the lower limb disabled community. Since users need to use a mobility aid almost 24/7, a mobility aid that offers the same safety, comfort, and maneuverability, with the added feature of easy vertical accessibility needs to be created.

3.1.1 Needs/Benefits Not Met by Current Products

The lower limb disabled often use one of two types of wheelchairs; manual or powered (motorized).

Manual wheelchairs, while light, don’t often have extra features like lift or standing capabilities. Users can also strain themselves or become tired from having to push themselves around for 14-15hrs a day. Also, while the body of the mobility aid is small, it is much harder to control or maneuver than its’ motorized counterpart.

Power wheelchairs, on the other hand, are heavy and bulky since they have not only a motor or battery, they also have the mechanisms for other features. They take up a lot of space and need a larger turning space/radius to move around. This usually makes powered wheelchairs rather intrusive and attracts unwanted attention.

Both types of wheelchairs tend to attract some form of attention that can make the user self-conscious, embarrassed, unnatural or “out-of-place”.

Some of the needs not being met by current solutions include, but are not limited to:

Independence – As human beings, we like to be independent, but with mobility aids that don’t change to meet our needs or mobility aids that are too bulky/hard to move to get close to certain areas/objects, we resort and rely on outside help to perform simple tasks. Therefore, the mobility aid should offer more independence.

Ease of interaction with environment – Bulky or hard to maneuver mobility aids make it hard to interact with different environments; such as getting through a door frame or avoiding obstacles in a tight space. Therefore, the design of the mobility aid should be compact.

Ease of use – A manual wheelchair user has to be strong enough to push their aid as well as turn, back up, etc. A power wheelchair user needs to treat their mobility aid almost like a vehicle in which they need to be aware of their size and control when driving around so as to not hit anything/anyone. The design of the mobility aid should be simple to understand and use, no matter the user.

Style and Safety – There is an emotional appeal to a nicely designed object. A mobility aid is almost like an extension of the user and so it needs to represent them in the best way possible. It needs to be a non-intrusive design, but still offer possible features or abilities. It should also not attract to much unwanted attention.

3.1.2 Latent Needs

For the lower limb disabled, using a mobility aid is typically a full-time need. Various models and features area available for a more personal device and are designed to be comfortable and structurally strong. While basic mobility is a must for any mobility aid, some disabled individuals find it hard to interact easily with the environment and even harder to interact with people due to height differences or other psychological problems (embarrassed, self- conscious, etc.).

The following chart relates the specific benefit/need to Maslow’s Hierarchy of Fundamental Human Needs

Benefit/Need Possible Corresponding Relationship Between Fundamental Human Benefits and FHN Needs Basic Mobility Psychological Strong Esteem Self-Actualization Independence Psychological Very Strong Love/Belonging Esteem Self-Actualization Easier interaction with Safety Strong people Love/Belonging Esteem Easier interaction with Safety Strong environment Esteem Self-Actualization Comfort and structural Safety Moderate strength

Basic Mobility is a must have for any mobility aid, since that is the devices’ main function. A mobility aid/device has to have basic mobility functions such as steering, moving in all horizontal directions, and stopping.

Independence in this context is the mobility aid user being able to complete tasks on their own while using their mobility aid. For a mobility user, being independent can improve how they see themselves and the usage of a mobility aid.

Easier interaction with people in the context of a mobility aid user is self-explanatory. It is how the user interacts with other people who either use or don’t use a mobility aid themselves. It is important that the user doesn’t feel out of place and can talk/interact with someone on even ground instead of always being looked down on or feeling inadequate.

Easier interaction with environment in the context of a mobility aid user is self- explanatory. With relation back to independence, the user wants and needs to be able to do a variety of tasks alone and in different environments. To be unable to perform these tasks can lower ones self-esteem. This is also a matter of personal safety for the user as some environments are not suitable for a mobility aid or lack proper access.

Comfort and structural strength go hand in hand when dealing with a good mobility aid. The mobility device needs to be comfortable for the user as they will be using it a great deal. It also needs to be structurally strong as it sees a lot of action throughout its lifespan and needs to keep up with whatever the user is doing.

Summary

The lower limb disabled rely on their mobility aids/devices – most often a form of wheelchair – for personal mobility and transportation. Current benchmarked products are both bulky and heavy making it harder to maneuver smaller spaces/environments or cause the user to tire/strain themselves and are equally difficult to maneuver. Both types of wheelchairs – manual and powered – tend to attract some form of unwanted attention that can make the user self-conscious, embarrassed, unnatural or “out-of-place”. All of this together can lower ones’ self-esteem as well as efficiency when performing tasks. There is a need for a mobility aid that offers not only mobility, long-lasting comfort, and the added feature here or there, but also some form of vertical access; a feature that is often overlooked when buying mobility aids/wheelchairs. The mobility aid/device should also offer independence for the user, easier interaction with people and environments, user safety and be pleasing to the eye, but not attract too much unwanted attention.

3.1.3 Activity/Experience Graph

Activities and Potential Improvements Steps Base User Potential Experience Improvement Needing/wan Locating item Usually simple or easy Nothing ting an item from high up

Obtaining Maneuvering mobility aid into position (forward or So many steps Lessen steps needed item sideways) Complicated Make experience quick, Adjusting body for stability Harder to do on one’s easy and not a hassle or Reaching own without a lifting chore Grabbing/obtaining mechanism. Readjust body into comfortable position Maneuvering away from area Using item Using item for whatever desired purpose Usually simple or easy Nothing Putting item Maneuvering mobility aid into position (forward or So many steps Lessen steps needed away/back in sideways) Complicated Make experience quick, Adjusting body for stability Harder to do on one’s easy and not a hassle or original place Reaching own without a lifting chore Putting back mechanism. Readjust body into comfortable position Maneuvering away from area

Areas of greatest potential for optimizing the user experience: 1) Reduce the effort and time needed to obtain an item from high up. 2) Reduce the effort and time needed to put away an item from high up.

3.1.4 Categorization of Needs

Latent Needs

 Doesn’t attract unwanted attention  Easy social interaction  Independence  Sense of safety/protection

Immediate Needs

 Easy environment interaction  Mobility control  Comfort  Health related features

Wishes/Wants

 Vertical accessibility feature  Simple operation/easy to understand device  Adjustable  Does not require assistance to use or get into

3.1.5 Needs Analysis Diagram

Immediate Needs Latent Needs

Easy environment interaction Doesn’t attract unwanted attention

Mobility control Easy social interaction

Comfort Independence

Health related features Sense of safety/protection

Innovation/

Design

Wishes and Wants Vertical accessibility feature

Simple operation/easy to understand device

Adjustable

Does not require assistance to use or get into

3.2 Functionality

Based on observational research, a workflow mapping exercise was conducted in order to determine what the everyday life of a lower limb disabled individual is like. This includes how they interact with their mobility aid and some obstacles they may face while using it. The observation is outlined below.

Objectives

1. Observe lower limb disabled individuals/wheelchair users in their natural environment and see how they interact with their mobility aid. 2. Determine some usability issues the user may be facing/having with their mobility aid/device. 3. Identifying the issues faced and determining where improvements can be made.

Description of Target User

Users being observed are lower limb disabled or simulated to have the lower body be unworkable. While users can be of a variety of ages, the main target is of an older demographic – adults to be specific. Some activities being observed are how one gets into their mobility aid (from a bed/chair), what sort of reach a user has at a seated level, and how the user interacts/uses it in various environments. Gender of lower limb disabled persons is not of concern; the vital information is the obstacles the user may face in their everyday life while utilizing the product. This may give insight on what and how the design of the product can be improve.

Description of Environment/Location(S) In This User Observation

Since this product is designed to be mobile, it would make sense that it could be used both indoors and outdoors in most environments. In the observation, the device was used indoors in various rooms and outdoors with pathways/wheelchair accessible areas (i.e. ramps, doors, hallways).

Results There were 6 participants during the test, one of which was myself. Participants were strapped into a wheelchair to simulate being lower limb disabled and were then asked to complete a number of tasks such as steering the wheelchair up/down a ramp, completing a turn, and reaching towards a wall from the front and the side. They were also asked to make the same reach while standing. Below are the results from the reaching test (max heights while sitting and standing). (Please refer to Appendix (i) Discovery for participants’ responses to the tests)

Participant Gender Max height Max height Max height number sitting - front sitting - side standing 1 Male 59.75” 65.25” 83.5” 2 Male 63.25” 72.75” 91.5” 3 Female 49.375” 59.5” 80.25” 4 Male 56.25” 68.5” 88” 5 Female 60.5” 63” 83” 6 Female 52.125” 61.75” 80.5”

As can be seen in the table, there can be a reach gap between 2-3 feet. This cements the need in this thesis that the proposed mobility device needs to have standing capabilities.

There are also several key points found in the Workflow Mapping and Activity Mapping that are addressed by the proposed thesis solution. Firstly, various points of interaction between the user and the mobility aid had to be taken into the design so that the user could still get in and out whenever they please. The design also has to be intuitive to use and incorporates seamless transfers. Furthermore, the overall design of the device insures the safety of the user and those around them (no pinching, clearance room, ergonomics, and centering weight/balance).

3.3 Usability Objective(s): The goal of this project was to evaluate the spatial, human interaction and volume constraints, as well as to identify the ergonomics to design a more efficient, functional, and ergonomic mobility aid with vertical accessibility.

Target User(s) Description: The target user(s) are individuals who are permanently lower limb disabled. The reason for their disability is limited to those who are paraplegic, who have an illness related to bone/muscle dystrophy, have arthritis (making it hard to walk/stand on their own), or the like. This means the target uses a mobility aid every day, all the time. The target is between the ages of a young adult to an elderly person

(~23 – 65+ yrs) and they are highly active. Users are employed and live within the greater Toronto area (or another wheelchair accessible area).

Evaluation Process: The evaluation process uses a full scale, 1:1 ergonomic buck of a proposed mobility aid design, which allowed for critical and detailed observation of the following:

1. Observing how the user is seated/positioned within the mobility aid

2. Observing how the user interacts with the device (strapping in, hand-to-wheel

position)

3. User stability while standing

4. Observing human ergonomics in “seat”/leg and back supports (how well they fit,

adjustments that need to be made, form of supports, etc.)

In order to obtain the best data possible, individuals of the 95th percentile man and 5th percentile woman were used in the layout and for the testing period.

Methodology

The base design/layout/dimensions of an average manual wheelchair were used to form a base. Before a 1:1 buck was made, several iterations done as mini models were developed to identify the optimal layout and balance to move forward with. Mini models were built using Lego©, Bionicle©, and K’NEX©. Twelve iterations where created where the wheel positions where modified for each version. These twelve iterations were used to determine the possible stability and/or balance of the mobility aid. The back wheels changed from straight to angle. The front wheels changed from standard to enlarged, from the seat’s edge to beyond the toe line. The decisions that needed to be made were:

1. Position of the back wheels 2. Size/position of the front wheels

Once a layout was chosen to move forward with, dimensions from existing manual mobility aids on the market and The Measure of Man and Woman – Human Factors in Design by Tilley (2002) were referenced and used to create a 1:1 ergonomic buck. There are 5 areas of measurement that needed to be resolved for the buck and future iterations in relation to the human body:

1. Seat width and seat depth 2. Seat height 3. Leg length (hip to knee, knee to bottom of foot) 4. Height of footrest to floor 5. Backrest height/size

And then there are the size of the wheels (front and back), the wheels placement in relation to the body (both sitting and standing), the balance one has in both positions, and base shapes for the proposed “seat”. All of the previously listed has been reviewed and tested. 43

Results and Analysis

As was said previously, two participants – one a 95th percentile man and the other a 5th percentile woman – used a 1:1 ergonomic buck of an average sized mobility aid. The main goal was to determine the ergonomics for a wide range of people for one product, however, much like shoes – which are very personal and unique to each user, so too are mobility aids. This makes mobility aids incredibly difficult to design for everyone. This was proven true when having the participants arrange themselves into two different configurations. 1) A sitting position, and 2) a standing position, which simulates the positions of the final mobility aid. This project focuses on the primary user as they are likely to be more self-sufficient in their day-to-day life than other mobility aid users. That being said, dimensions for the buck were recovered from ergonomic recommendations from study literature, existing products, and/or ergonomic testing using a mini model/mock up or participant study. The dimensions of the 1:1 ergonomic buck are as followed:

Seat Height______18”

Seat Width______21”~

Seat Depth______15”

Foot Rest – Height above the ground______2”

Foot Rest – Distance from Seat______5”

Front Wheels______7”ø x 1”

Back Wheels (Angled)______24”ø x 1”

Distance between Wheels______19.5”~

Backrest – from Seat to Bottom of Backrest______8”

Backrest – from Seat to Top of Backrest______12”

Key observations overall: the 95th percentile had a much easier time with the “seat”/leg and back supports than the 5th percentile. However, the 5th percentile had an easier time in finding a comfortable position for her hands on the rear wheels than the 95th percentile.

Limitations and Conclusions

As was stated earlier, mobility aids are designed for each individual user. From the ergonomic tests shown above, it is easily recognized that two people on opposite ends of the size spectrum will not fit the same device the same way; especially something like a mobility aid.

5th Percentile Woman – Primary User

Fig.2 Fig.3

Fig.1 is based on Henry Dreyfuss’ measurements for the 5th percentile woman (Tilley, 2002). As can be seen, the “seat” portion, which includes the backrest, thigh supports, calf supports, and the foot rest, have been shrunken down so that they fit this percentile’s size. However, the front and back wheels remained the same (7” in diameter and 24” in diameter respectively) to show the difficulty in which someone of this size would have in maneuvering them.

Fig.4 Fig.5

Fig.2-5 show the participant seated in the ergonomic buck. Unlike the drawn images shown in Fig.1, the rear wheels are angled, which have made it easier for the user to grip and use (Fig.3). Straps are used to simulate the support/securing mechanisms, which can be found around the upper and lower leg regions and around the stomach (Fig.4 and Fig.5).

Fig.6 Fig.7 Fig.8

Fig.6-8 show the participant in the standing position. It can be noted here that the dimensions used for an average person (50th percentile) is not suitable for someone of the 5th percentile. The upper leg supports and backrest are too large in size (Fig. 6 and Fig. 8). The upper leg support is too long for the user’s body and results in the backrest/support belt rising too high

(Fig.7). The structure doesn’t straighten the way it was intended to; instead the user is almost in a semi-squatted position, which can be both awkward and uncomfortable.

95th Percentile Man – Primary User

Fig.10 Fig.11

Fig.9 is based on Henry Dreyfuss’ measurements for the 95th percentile man

(Tilley, 2002). As can be seen, the “seat” portion, much like with the 5th percentile woman, have been fitted (enlarged) to the percentile’s size. The front and back wheels remained the same (7” in diameter and 24” in diameter respectively) to show how much easier someone of this size would be able to maneuvering the device compared to the 5th percentile.

Fig.12 Fig.13

Fig.10-13 show the participant seated in the ergonomic buck. Unlike the drawn images shown in Fig.9, the rear wheels are angled, which have made it easier for the user to grip and use (Fig.11). Straps are used to simulate the support/securing mechanisms, which can be found around the upper and lower leg regions and around the stomach (Fig.12 and Fig.13).

Fig.14 Fig.15 Fig.16

Fig.14-16 show the participant in the standing position. It can be noted here that the dimensions used for an average person (50th percentile) somewhat fit someone of the 95th percentile. The upper leg supports and backrest sit just about right for the user’s size (Fig. 15 and Fig. 16). The structure doesn’t straighten the way it was intended to; instead the user is slightly bent in the knee.

3.4 Aesthetics Styling Direction – symbolism and aesthetics

The way a product looks is key to good design, especially when it concerns incredibly personal items like mobility aids. Items/objects/products that are on a personal level tend to be a means of defining the user; similar to an accessory or the way someone might dress to promote/define themselves. There are several objectives that come in relation to colour/style and how they influence the user and those around them:

1. Increased functionality – makes an object more intuitive or easier to understand. E.g. red = hot or dangerous, blue = cold or calm. 2. Encourages desired emotional response(s) from user. 3. Reinforces the brand identity. 4. Promotes user identification/style to non-users.

Colours most found (observed) in wheelchairs or other mobility aids used by the lower limb disabled:

 Primary Colour - Black, Grey/White/Silver, Chrome o Used to make a bold statement and make identifying the mobility aid quick and easy. o Tends to grab people’s attention when it goes by.  Secondary Colour - Red, Blue, Yellow, Bronze o User’s choice; tends to be a preference or style decision o Acts as an accent or detail used in branding/logo

Styling Direction – form development

The form of mobility aids advertise safety and comfort. However, many take on the same “box-like” form, which can also make the device seem rigid. If there happens to be a motor or hard base, then the casing takes on a sleek, almost speed-like form, advertising that it can be a quick mode of transportation. Based on benchmarked products and observation, many wheelchairs tend to follow a similar guide in terms of form. It has a seat, armrest, leg/foot rest, handles, a means of driving/steering, wheels, and a base where feature and/or the moto might go. While this may be comfortable for each individual user, the design is rigid in a way, as stated before. The hope is to design a mobility aid 54

that is not this box on wheels and rather something more ergonomic and/or organic. Conclusion: Mobility aids should convey a visual language that is:

 Welcoming  Strong yet comfortable  Safe  Easy to use/understand  Reliable  Age/gender neutral  Does not keep to the standard box/brick-like shape/structure

Styling Direction – semantics (style and technology)

Semantics in terms of design are how the user or others viewing the product interpret the meaning of colour, form, etc. For example, if a person is shown a red heart, the common response to the meaning of the image is “love”. The semantics are also the means in which someone might interact with an object or device (i.e. size, technology being used, acceptance of use, etc.). Style-wise, the design of the mobility aid must:

 Have a design language that makes the device easy to understand/use, especially first-time users.  Look like a mobility aid (form and colour).  Appear user friendly (no sharp edges to interact with, organic forms, etc.).  Appear easy to clean.  Appear strong, reliable, durable, and safe.  Have a splash of personality.

Technology-wise, knowing the components (battery, motor, computer) that reside within existing mobility aids (wheelchairs and exoskeletons), as well as their dimensions helps determine the minimum dimensions for possible housings of the mobility aid. Knowing these dimensions will help in designing and developing a form that can accommodate for these components.

3.5 Sustainability – Safety, Health & Environment After extensive research and analysis of existing mobility devices/aids/products, user needs, functionality and safety requirements, a concise list was compiled stating the key differentiating factors in safety, health and environmental sustainability.

Safety

The device designed for this thesis is first and foremost a mobility aid for the lower limb disabled. This means the product must allow seamless interactions for its users and insure their safety while the device is in use (i.e. no pinching or sharp edges, clearance room, ergonomics, and centering weight/balance while in either the standing or sitting position).

Additionally, to make sure that the user doesn’t fall out of the mobility aid while in the standing position, the device will have 2-3 straps that are attached to the mobility aid at the legs and upper waist to secure the user while in the vertical position.

Health

Health is a huge issue for those who are physically disabled, particularly the lower limb disabled as they are unable to stand and spend the majority of their time seated or “glued to their seat”. Being unable to stand causes several problems for these individuals such as loss in muscle and skeletal strength, slowed blood flow and a reduced psychological wellbeing.

According to Rehabilitation Engineering & Assistive Technology Society of North America (a.k.a. RESNA), “wheelchair standing devices are often medically necessary, as they enable certain individuals to:

 Improve functional reach to enable participation in ADLs (Activities of Daily Living (i.e. grooming, cooking, reaching medication)  Enhance independence and productivity  Maintain vital organ capacity  Reduce the occurrence of Urinary Tract Infections  Maintain bone mineral density  Improve circulation  Improve passive range of motion  Reduce abnormal muscle tone and spasticity  Reduce the occurrence of pressure sores  Reduce the occurrence of skeletal deformities, and  Enhance psychological wellbeing” (RESNA, 2007).

By incorporating a standing mechanism into the design of the product, the user would be able to keep their body healthy and in better condition than if they had a non-standing mobility device. Furthermore, the user would also have more individual/independent freedom, rather than depending on someone for assistance twenty-four seven.

Environmental Sustainability

As it stands, mobility aids such as wheelchairs, scooters and the like are not devices that can be “thrown out” as easily as your every-day trash. Many wheelchair manufactures have systems set up so they can recycle old mobility aids made by their company and will reuse as much as they can for a new mobility aid. Majority of mobility aids can be recycled or scrapped for parts, but not all of the device(s) can be reused, such as worn down rubber tires, specific plastic exteriors, and some cushioning/padding. While companies do try to reuse as much as they can, not everything in current models/designs can be reused and where the remains end up is unclear. For the devices that don’t get sent back to the manufacturer, mobility aid users tend to sell their old mobility aids online for someone else to use or give the device to friends and/or family who need them more. From both the customer’s and the manufacturer’s sides, the mobility aid is recycled in some way, shape or form. 57

3.6 Commercial Viability 3.6.1 Materials and Manufacturing Selection

After analyzing multiple existing products, their materials, components and requirements, a comprehensive list of materials has been compiled. This list is both cost effective and sustainable as parts can be recycled and/or reused by manufacturers.

Makroblend PC+PBT+PET blend (Bayer Mat. Science) Makroblend is a polycarbonate blend plastic. It has a high rigidity and toughness which reduces its susceptibility to cracking and daily impacts, scratches and other possible damages. It is also resistant to certain chemicals (solvents).

Bayblend PC+ABS blend; PC+ASA blend (Bayer Mat. Science) Bayblend is a polycarbonate blend plastic. It has a high rigidity and toughness which allows it to be a dimensionally stable material. This particular material is also a low moisture absorption plastic.

Makrolon Polycarbonate (Bayer Mat. Science) Makrolon is a polycarbonate plastic. It has a high toughness which helps reduce a product’s susceptibility to cracking from impact/alternate damage. It is an easily moulded plastic and it is perfect for transparent parts.

*All proposed plastics are to be injection molded in order to reduce costs and to perform properly in mass production conditions.*

T6 Aircraft Grade Aluminum T6 aircraft grade aluminum is a light yet strong and durable material used in many standard and customized mobility aids. It is an alloy material that offers great mechanical function, and is resistant to corrosion. (Smith, 2013).

PVC Composite Foam One of two components for the cushions. It is a soft yet structural material. It is also common and inexpensive.

Gel Foam One of two components for the cushions. An easily formed and soft material, gel foam provides pressure reduction which increases the user’s comfort.

12 Volt-40 Amp/Hr Battery Outsourced This battery is small, but powerful. It has a long life during a single use before it needs to be recharged.

3.6.2 Cost

Mobility aids come in a variety of shapes, sizes and with different features. For the majority of manual mobility aids of similar scale to ALPHA, the cost ranges between $300 and $1000+. For Powered or electrical mobility aids, prices skyrocket to $3000 to $10,000+ depending on the model. ALPHA is a manual mobility aid with a power assist for lifting purposes only, so its price should lie somewhere between $1000 to $3000+ given the two mobility aid categories.

Part # # of Parts Component Material Estimated Cost 1 1 Base Plate T6 Aircraft Grade Aluminum, $100 machined and cut 2 1 WA Left Side Makroblend, Injection molded $65 (painted/coloured) 3 1 WA Right Side Makroblend, Injection molded $65 (painted/coloured) 4 2 WA Front Makroblend, Injection molded $30 (painted/coloured) 5 1 Mirror WA Left Makroblend, Injection molded $65 Side (painted/coloured) 6 1 Mirror WA Makroblend, Injection molded $65 Right Side (painted/coloured) 7 2 Transparent Makrolon, Injection molded $60 Planes – Front and Back 8 1 Motor/ Makroblend, Injection molded $65 Battery Case (painted/coloured) 9 1 Leg Support Makroblend, Injection molded $30 (painted/coloured) 10 1 Seat 1 Bayblend, Injection molded $30 (painted/coloured) 11 1 Seat 2 Bayblend, Injection molded $15 (painted/coloured) 12 1 Back Support Bayblend, Injection molded $15 (painted/coloured) 13 1 Seat 1 PVC composite with gel foam $29 Cushion 14 1 Seat 2 PVC composite with gel foam $24 Cushion 15 1 Back Cushion PVC composite with gel foam $24

16 2 Front Wheels Bayblend, Injection molded $14 with rubber tires 17 2 Back Wheels T6 Aircraft Grade Aluminum $300 and rubber tires 18 2 Knee Steel $28 Fastener 19 2 Front Wheel Steel $14 Fastener 20 2 Seat Fastener Steel $28 21 1 Hydraulic T6 Aircraft Grade Aluminum, $300 Lifting Outsourced (most likely) with all Mechanism electronic components 22 4 Main Steel $28 Mechanism Fastener 23 12 WA Fastener Steel $84 24 2 Straps Outsourced $26 25 1 Battery Various Materials, Outsourced $180 TOTAL $1684

3.7 Design Brief Based on the gathered information from previous sections and after a thorough analysis, a list of 10 points detailing the key guidelines that will be used to create the design concepts for this thesis. These points will help ensure a safe, comfortable, and reliable product is created for the user.

1. Easy to clean.

2. Adjustable to fit user needs.

3. Compact design.

4. Intuitive design/easy to understand how to use.

5. Easy control of device/aid.

6. Feature for rising/lifting user higher up.

7. Design does not attract unwanted attention.

8. User comfort (in various positions).

9. Seamless user transfer (from aid to furniture and vice versa).

10. Sustainable material use.

CHAPTER 4 DESIGN DEVELOPMENT

4.1 Ideation Mind Mapping

Ideation started with mind mapping. As is shown in the image above, my mind mapping for this thesis had a lot of interconnecting ideas and thoughts. In a way, this helped in pointing out what was the most important to think about and consider for the final design. This included topics like possible diseases users could have, materials and manufacturability, and style choices.

Inspiration Board

I took inspiration from some of my favourite fandoms like Marvel’s Iron Man and the X Men. I wanted to have that whimsical and flare that the franchise has in my design. I also looked towards streamlined, aerodynamic and organic forms, as well as current technology and advancements in the world of bionics and exoskeletons.

4.2 Preliminary Concept Exploration Concept 1

FRONT

BACK

HARNESS-LIKE ON THE TOP

ARM STABILIZERS ATTACH TO LEG SUPPORTS W/ARM STABILIZERS PORTS ON THE *SUPPLIES LOWER LIMB SUPPORT AND SIDES OF FEET. USER MOVES THEIR OWN LEGS LIKE A PUPPET WITH USE OF THE ARM STABILIZERS.

Concept 1 is a set of exoskeleton legs. The lower half is easy to strap on and offers structural support for the user. The upper half of this concept is a harness that helps keep the user upright. The reason this concept is unique compared to other products on the market is that it is completely self-operated; the user is the only means of mobility, there is no battery or motor. The user uses the arm supports to move their legs and support their own body weight. This design is best suited to someone who’s active and has amazing upper body strength.

Concept 2

MAIN CHAIR MOVES UP AND DOWN ON A LIFTING MECHANISM.

CONNECTED TO THE BASE

POSSIBLE GYROSCOPE

Concept 2 is a gyroscope chair with vertical lifting and seating mechanisms. It is completely motorized and resembles more modern wheelchairs. It has four balancing wheels which can be removed at any time. As this design is on a gyroscope, falling over is highly unlikely and traveling on uneven surfaces become far easier. This design is also rather geometric, but has some elements of an organic form. This design is best suited to individuals who prefer to do as little work as possible when it comes to their mobility, but still has a flair for design or style and wants to stand out.

Concept 3

*SIMPLE CONTROL STICK FOR STANDING ADJUSTMENTS AND ACTIVATING LIFTING MECHANISM.

NOTE: THIS IS A SEMI- POWERED DESIGN. IT IS PRIMARILY MANUAL FOR THE ACTIVE USER.

STANDING

BATTERY AND CONTROL BOX THE BATTERY BOX ACTS AS A BASE WEIGHT SO IT DOESN’T TIP WHILE STANDING.

Concept 3 is a combination of a semi- BACK/SPINE SUPPORT EXOSKELETON/ powered wheelchair and an LEG SUPPORTS exoskeleton. It doesn’t have a full back

BACK – which makes it appear more like a VIEW sports wheelchair – and uses exoskeleton legs instead of a standard seat. It also has hub-less wheels. This SEATED creates the illusion of the device being

NO SEAT! IT IS BASICALLY lighter, almost like it were sitting on air. SITTING ON NOTHING/AIR. This design best suits active users LEG SUPPORTS/BACK SUPPORTS REPLACE SEAT (adults) who just want vertical elevation/standing.

4.3 Concept Refinement After the preliminary concepts and refining the ergonomics, the next stage in the design’s development is styling, keeping in mind basic movements of the user, semantics, safety and ergonomics. The following pages display the side-views of twenty possible stylings of the final thesis design.

4.4 Detail Resolution By this point I needed to figure out how parts are going to come together. The following sketches depict the final design and specific detail resolutions that not only define the thesis’ appearance but how someone will interact with the device.

THE BACK WHEELS USE A SANDWITCH TECHNIQUE TO HOLD NOT ONLY THE PLEXIGLASS PANELS, BUT THE ENTIRE BACK WHEEL

HOLES FOR BACK WHEEL *PLEXIGLASS HAS EXTENDED SECTIONS FOR SANDWITCHING

HOLE FOR FRONT WHEEL

WHEEL ATTACHMENTS/SUPPORTS

BACK WHEELS ARE HUB- LESS. THEY USE ROLLERS OR WHEEL AND DRIVE TO HELP MAKE MOTIONS SMOOTHER FOR THE USER AND TO PREVENT CATCHING ON THE WHEEL SUPPORTS.

BACK WHEEL MECHANISM

A HOLE TO FIT THE SMALLER FRONT WHEEL USES A PROTRUSION AT DIAMETER EXISTS ON THE THE TOP TO MOVE IN DIFFERENT LARGER WHEEL SUPPORT DIRECTIONS TO HELP STEAR THE MOBILITY AID

DUE TO THE CURVED HOLLOW UNDERNEATH SURFACE, THE HOLE FOR THE FASTENER IS INDENTED SO IT RESTS TIGHTLY ON A FLAT SURFACE

FRONT WHEEL WITH FRAME

FOUR MAIN JOINTS EXIST ON THE DESIGN (TWO AT THE KNEES AND TWO ON THE BACK OF THE SEAT. A SIMPLE HINGE IS USED FOR STRUCTURAL PURPOSES AND SMOOTH MOVEMENTS BETWEEN TRANSITIONS/STAGES CONNECTIONS AND FASTENING AT JOINTS

*STRAPS SLIDE INTO SLOTS LOCATED ON THE MAIN SEAT AND BACKREST.

THERE ARE TWO SETS OF STRAPS; AROUND THE UPPER LEGS, AROUND THE STOMACH, WAIST OR HIPS

BUTTON TO ACTIVATE THE STANDING/SITTING FUNCTION

STRAPS ACT SIMILAR TO SEATBELTS IN CARS. THEY AUTOMATICALLY TIGHTEN/ADJUST, BUT MORE THAN VEHICLE SEATBELTS SO THAT THE USER IS SECURE SEAT MECHANISMS AND OPERATIONS

4.5 Sketch Models Not including the ergonomic buck and the mini models composed of children building toys, a sketch model was created to better understand the overall volume and space the device would occupy in relation to the environment and to people.

This model is at 1:6 scale and is composed of insulation foam, foam core, construction board

and card stock.

It was designed to showcase possible part lines, aesthetics and joints for the final design. However, the main purpose was to get an idea for the dimensions that would be used in full scale or smaller.

The model was created with the idea of being able to simulate the mechanism under/behind the seat.

That being said, this small model not only showcases the seated position, but also the standing position.

Components like windows/panels, cushions, and support straps are also added to the model to get an idea on placements and future difficulties that may arise (e.g. impacting seat components).

The back mechanism on the sketch model shows where joints need to be for the seat to rise and fall smoothly. This also give a rough estimate about size and shape of the “fins” off the back of the three seat components.

Throughout this process, all joints had to be measured at least three times to insure that lengths were the same and that bends matched up.

All dimensions used in the making of this model were taken from benchmarked products and Henry Dreyfuss’ “The Measure of Man and Woman” (Tilley, 2002). The sketch model was designed with only the primary user in mind as they would be someone who is more independent and self-sufficient.

4.6 Final Design

The design process led up to this final design illustrated in the image above. This device has been dubbed “ALPHA” for not only elevating occupants to their max height, but for also attempting to be the best of its class. The name was also inspired by the Greek letter, which has become somewhat of a motif throughout the design.

4.7 CAD Models

The following images showcase some of the process that went into completing the CAD for ALPHA. This model consists of 34 individual parts (not including the straps) and 25 individual part files. These files were sent out to be 3D printed and were also used in the creation of this report and the renders on the thesis show banner.

Back Wheel Supports

Front Wheel Supports

Front and Back Wheels

Transparent Panels

Sitting Elements

Cushions

Base/Battery Box/Mechanisms

I design both the sitting and standing versions of the device’s mechanism and had both printed.

Even though only the standing configuration will be in the final model, both configurations were printed to show size and the possibility of sitting.

Final Assembly

4.8 Hard Model Fabrication History Once the CAD file were completed, the files were sent off to be 3D printed. The model parts are 1:4 scale. When the parts were delivered back to me, I sanded them down to remove bumps, rough edges and printing lines.

Some parts were missing material or were damaged and needed spot filler (Bondo) to fill in those areas. They were then sanded down until surface was smooth and flat.

All parts – not including fasteners and the straps – were then primed. Between priming and final paint, parts were dry fitted to confirm that no warping or size increase messed with parts naturally fitting.

All parts were painted individually over the course of two days. Luckily for me, no extra sanding or spot filling was required during this process. A final touch up of parts and a dry fit finished prepping for the final assembly.

Parts were attached using white glue or dry fitting (some parts snapped into place having been designed so they were wall to wall). Straps are made from cut toothpicks wrapped in metal tap attached to suede strips and glued onto the plastic parts of the seat.

CHAPTER 5 FINAL DESIGN

5.1 Summary Description

In the end, after defining the issue lower limb disabled individuals face and which ones are the most prominent in their lives/lifestyles, a solution was conceived through the product developmental phases of research, analysis, and design development. The final product solution was ALPHA, a mobility device for the active adult with standing capabilities and manual operation.

The aim of this product is to give individuals who can no longer stand or utilise their lower body the ability to “stand” and interact with the world around them at a more common level; whether this be interacting with their home or the outside world. This allows the user to also have a bit more freedom and independence.

Explanation ALPHA is designed in such a way to make it as light – both in actual weight and appearance – as possible while still being structurally sound and strong. It has a more modern look which allows it to be somewhat sporty, but at the same time practical. ALPHA uses a combination of angled wheels and a counterweight (created from the battery/motor under the seat and low to the ground) to keep the device balance in either the standing or sitting positions. The angled back wheels are also easier for the user to grip. Two safety straps – located at the legs and back – keep the occupant in place while standing. An easy button – located on the right side of the seat – is within easy reach in either position.

Benefits Statement

ALPHA is a lightweight, mobility device that allows for easy use, a wide range of interaction with environments, allows the user to stand – which helps the user health wise with muscle and bone structure – and maintains the user’s overall safety while in use.

5.2 Design Criteria Met 5.2.1 Ergonomics The ergonomics report shown in Chapter 3 displays the ergonomic study conducted and the various stages it took to get from the foam buck to the final design.

Smooth, organic forms were explored to fit that of a human body and to eliminate the possibility of self injury while using the device.

Easy access to elevation button located by the upper right leg, between the seat and the wheel.

Straps are in easy to reach locations, even while unable to move the body below the torso.

Enough space was added between the set and wheel that pinching cannot occur, but also enough so that the user does not accidentally push the button or undo the leg straps.

5.2.2 Materials, Processes & Technology Materials & Processes

The mobility device’s structural frame and lifting mechanism will be made from T6 aircraft grade aluminum as it is a light yet strong and durable material used in many standard and customized mobility aids. Another reason to use this grade of aluminum is that it is an alloy material that offers great mechanical function, and is resistant to corrosion. (Smith, 2013). Due to these traits, T6 aircraft grade aluminum is the ideal choice of structural material for this thesis. Fig. 1 – T6 Aluminum Bar

https://www.tormach.com/store/index.php?app=ecom&ns=prodshow&ref=35534

The base/frame/wheel supports uses polycarbonate blend materials (e.g. Makroblend and Bayblend) which are rigid, durable and chemical resistant. (Covestro, 2016). Additionally, these plastics feature more than 80% recycled content. These plastics are used in Fig. 2 – Makroblend Traits many medical related equipment http://www.plastics.covestro.com/en/Products/Makroblend/ProductList/201506110453/Makroblend-M525 which makes it an ideal material for this thesis product. These parts would be injection molded due to the organic shapes and interior supports.

Technology & Power

This mobility device uses a rechargeable GEL battery to power its lifting/lower mechanism. It only needs to power this section of the devices as it is a manually powered mobility aid most of the time. This makes the device low maintenance and easy to repair or recycle at the end of its lifetime.

The overall balance of this mobility aid relies heavily on the wheel layout and the counterweight created by the heavier materials (i.e. the aluminum). Based on past observations and research, manual mobility aids – such as wheelchairs – that have angled back wheels are more light weight, durable and

stable than other variants of the same product family. Being manual (or semi- powered) means that the mobility aid is actually more reliable and easily fixable should something become damaged. Also, while having angled (back) wheels creates a larger floor print of the overall size, it offers the user more stability both while sitting and standing which minimizes the amount of shaking a standard perpendicular wheel would offer. (Minkel, 2015), (Langtree, 2016)

The back of the mobility aid will weigh more than the standing person due to the materials used in the back wheel frame (Smith, 2013) and the added weight of the motor under the seat. This weight should counteract the imbalance so that the user and the mobility aid don’t fall and/or tilt.

The front wheels also play a part in the stability of the mobility aid. They are positioned so that the wheel’s “axle” is lined up with the toe of the footrest. This is different compared to most manual wheelchair-like mobility aids as they have the axle either slightly behind the toe-line or completely behind the footrest. This set-up offers a little more stability for the user while standing and additionally reduces the chances of tipping forward, resulting in the user sustaining injuries.

Additionally, all previously mention materials and technological components, such as the battery, can be recycled or reused if sent to the correct individuals.

5.2.3 Manufacturing Cost Report Part # # of Parts Component Material Estimated Cost 1 1 Base Plate T6 Aircraft Grade Aluminum, machined and $100 cut 2 1 WA Left Side Makroblend, Injection molded $65 (painted/coloured) 3 1 WA Right Side Makroblend, Injection molded $65 (painted/coloured) 4 2 WA Front Makroblend, Injection molded $30 (painted/coloured) 5 1 Mirror WA Left Side Makroblend, Injection molded $65 (painted/coloured) 6 1 Mirror WA Right Side Makroblend, Injection molded $65 (painted/coloured) 7 2 Transparent Planes – Makrolon, Injection molded $60 Front and Back 8 1 Motor/ Battery Case Makroblend, Injection molded $65 (painted/coloured) 9 1 Leg Support Makroblend, Injection molded $30 (painted/coloured) 10 1 Seat 1 Bayblend, Injection molded $30 (painted/coloured) 11 1 Seat 2 Bayblend, Injection molded $15 (painted/coloured) 12 1 Back Support Bayblend, Injection molded $15 (painted/coloured) 13 1 Seat 1 Cushion PVC composite with gel foam $29 14 1 Seat 2 Cushion PVC composite with gel foam $24 15 1 Back Cushion PVC composite with gel foam $24 16 2 Front Wheels Bayblend, Injection molded with rubber tires $14 17 2 Back Wheels T6 Aircraft Grade Aluminum and rubber tires $300 18 2 Knee Fastener Steel $28 19 2 Front Wheel Fastener Steel $14 20 2 Seat Fastener Steel $28 21 1 Hydraulic Lifting T6 Aircraft Grade Aluminum, Outsourced $300 Mechanism (most likely) with all electronic components 22 4 Main Mechanism Steel $28 Fastener 23 12 WA Fastener Steel $84 24 2 Straps Outsourced $26 25 1 Battery Various Materials, Outsourced $180 TOTAL $1684

100

5.3 Final CAD Renderings

101

102

103

5.4 Hard Model Photograph

104

105

106

5.5 Technical Drawings

These drawings are drawn in 1:4 scale (explaining the smaller measurements).

While standing, the device is 57.48” tall.

While sitting, the device is 40.36” tall with a seat height of 20”.

The back wheel is 24” diameter and the front wheel is 7” diameter.

107

5.6 Sustainability

Materials, Processes & Environmental Sustainability ALPHA is design using T6 aircraft grade aluminum and a mixture of various polycarbonate plastics. All these materials are light, strong, and resistant to corrosion and/or chemicals. Due to the fact that majority of wheelchairs and other mobility aids are replaced every five years, on recommendation by doctors and manufacturers, parts and materials were chosen to be recyclable and reusable for several life cycles.  Plastics and metals can be reused/recycled for a new mobility aid.  The battery can be recycled and even turned into a new battery if disposed of properly.

Safety Although it may not seem all too relevant, safety is a huge part in increasing the product’s life-cycle. The less incidents in which damage occurs to the user, then the less damage the mobility device sustains. The large angled back wheels coupled with the larger-than-average front wheels (placed at the toe-line) provide greater balance while in the standing and sitting positions.

A low center of gravity reduces the risk of tipping.

108

CHAPTER 6 CONCLUSION

109

Setting out to design a product for an industry that is riddled with copy after copy of the same design is not an easy task, especially when your mind starts to focus on that same cookie cutter image. Looking past stereotypes and preconceived notions to see the bigger picture was the starting point. Talking to people who use or know someone who uses a mobility device created the level of understanding needed to get this project off its feet and designed for its’ particular target market. ALPHA was designed to bring users to new heights; literally! While other mobility aids either don’t have this feature or are too “chunky and heavy”, ALPHA looks clean, new, light and even futuristic. Overall, ALPHA very well could just be the transition point between the classic wheelchair and more innovative, inspired and crazy mobility devices.

110

CHAPTER 7 REFERENCES

111

Bellis, M. (n.d.). History and Timeline of the Wheelchair. Retrieved November 07, 2016, from http://inventors.about.com/od/wstartinventions/a/wheelchair.htm

Blue Streak Wheelchair w/ Flip-Back Arms. (n.d.). Retrieved January 02, 2017, from http://www.1800wheelchair.ca/product/blue-streak-wheelchair-w-flip-back-arms/

Brewster, S. (2016, February 08). This $40,000 Robotic Exoskeleton Lets the Paralyzed Walk. Retrieved April 10, 2017, from https://www.technologyreview.com/s/546276/this-40000-robotic-exoskeleton-lets-the-paralyzed-walk/

CMHC. (2014). Accessible Housing by Design — Kitchens. Retrieved September 19, 2016, from https://www.cmhc- schl.gc.ca/en/co/acho/acho_004.cfm

Comfort Hero 4 Power Standing Wheelchair. (n.d.). Retrieved February 06, 2017, from https://www.wheelchairindia.com/1206/Comfort-Hero-4-Power-Standing-Wheelchair

Communications, C. A. (2016, July 6). Bayblend® (PC ABS blend; PC ASA blend) product description. Retrieved February 06, 2017, from http://www.plastics.covestro.com/Products/Bayblend.aspx

Communications, C. A. (2016, July 6). Makroblend® (PC PBT; PC PET blend) product description. Retrieved February 06, 2017, from http://www.plastics.covestro.com/Products/Makroblend.aspx

Determining the Seat Width for a Wheelchair. (n.d.). Retrieved January 01, 2017, from https://www.karmanhealthcare.com/determining-the-seat-width-for-a-wheelchair/

Gavin-Dreschnack, Deborah. "Wheelchair-related Falls: Current Evidence and Directions for Improved Quality Care." ResearchGate. Lippincott Williams & Wilkins, Inc., 2005. Web. 02 Oct. 2016. https://www.researchgate.net/publication/232208758_Wheelchair- related_Falls_Current_Evidence_and_Directions_for_Improved_Quality_Care

"How Safe Is Your Wheelchair? - WC Transportation Safety." Wheelchair Transportation Safety. University of Michigan Transportation Research Institure, n.d. Web. 02 Oct. 2016. http://wc-transportation-safety.umtri.umich.edu/consumers/how-safe-is-your-wheelchair

How Wide Does a Doorway Need to be for a Wheelchair? (n.d.). Retrieved January 01, 2017, from https://www.karmanhealthcare.com/how-wide-does-a-doorway-need-to-be-for-a-wheelchair/ http://levousa.com/c3/c3.html http://levousa.com/lae/lae.html http://www.1800wheelchair.ca/product/karman-stand-up-power-wheelchair/ http://www.cyclonemobility.com/lifestand/lsc http://www.cyclonemobility.com/lifestand/lsct http://www.cyclonemobility.com/lifestand/lse http://www.midshiresgroup.co.uk/specialist-retail-products/powered-wheelchairs/standing-chair/otto-bock-xeno/ http://www.midshiresgroup.co.uk/specialist-retail-products/powered-wheelchairs/standing-chair/quickie-jive/ http://www.rev-a-shelf.com/p-243-cabinet-pull-down-shelving-system-wall-accessories.aspx http://www.scottsmedical.com/permobil-f5-corpus-vs-standing-wheelchair-detail.htm?productId=22562604 http://www.strategyr.com/Marketresearch/Wheelchairs_Powered_and_Manual_Market_Trends.asp https://freedomliftsystems.com/closet-lift/720-10063 https://www.wheelchair88.com/product/draco-standing-wheelchair/ https://www.wheelchair88.com/product/leo/ https://www.wheelchair88.com/product/semi-power-standing-wheelchair/

K. (n.d.). XO-505 Standing Wheelchair w/ Multiple Power Functions. Retrieved February 06, 2017, from https://www.karmanhealthcare.com/product/xo-505/

Kirby, R. Lee. "Wheelchair Stability : Effect of Body Position." Journal of Rehabilitation Research and Development 32.4 (1995): 367-72. Web. http://www.rehab.research.va.gov/jour/95/32/4/pdf/kirby.pdf

112

Langtree, I. (2016, September 23). Wheelchairs: Information & Reviews. Retrieved February 06, 2017, from https://www.disabled-world.com/assistivedevices/mobility/wheelchairs/

LaPlante, M. P. (2003, October 7). Demographics of Wheeled Mobility Device Users [Doc.]. San Francisco. http://kdsmartchair.com/blogs/news/18706123-wheelchair-facts-numbers-and-figures-infographic

Medical Health Issues Requiring Wheelchair. (n.d.). Retrieved April 10, 2017, from https://www.karmanhealthcare.com/medical-health-issues/

"Medical Supplies and Equipment Benefits." Medical Supplies and Equipment. Health Canada, 01 June 2016. Web. 02 Oct. 2016. http://www.hc-sc.gc.ca/fniah-spnia/nihb-ssna/provide-fournir/med-equip/criter/general-eng.php#a4

Minkel, J. (2015). 1.3. A guide to wheelchair selection. Retrieved February 06, 2017, from http://www.spinalcord.org/resource-center/askus/index.php?pg=kb.page&id=1412

Phoenix II - Electric standing wheelchair. Stand, sit and recline by power. (n.d.). Retrieved February 06, 2017, from https://www.wheelchair88.com/product/phoenix-ii/

PICARD, A. (2010, December 14). More than 85,000 Canadians have spinal cord injury, report says. Retrieved April 10, 2017, from http://www.theglobeandmail.com/life/health-and-fitness/more-than-85000-canadians-have-spinal-cord-injury- report-says/article1319747/

R. (2007). RESNA Position on the Application of Wheelchair Standing Devices. Retrieved February 6, 2017, from http://www.rstce.pitt.edu/RSTCE_Resources/Resna_position_on_wheelchair_standers.pdf

Reznik, Roland. (2015, January 29). Wheelchair Facts, Numbers and Figures [Infographic]. Retrieved November 7, 2016, from http://kdsmartchair.com/blogs/news/18706123-wheelchair-facts-numbers-and-figures-infographic

Saskatchewan Wheelchair Sports (n.d.). Retrieved November 7, 2016, from http://www.swsa.ca/

Shahrom, S. K. (2015). Universal Design in Housing for People With Disabilities: A Review. Journal of Design and the Built Environment, 15(1), 33–42. Retrieved from https://umexpert.um.edu.my/file/publication/00007619_123440.pdf

Smith, M. (2015, May 20). Durable Wheelchairs: What is the best type of material. Retrieved February 06, 2017, from https://www.karmanhealthcare.com/blog/2013/07/30/durable-wheelchairs-best-material/

Stakeholders Forum – Wheeled Mobility - Materials. (n.d.). Retrieved February 6, 2017, from https://www.wheelchairnet.org/WCN/WCN_WCU/Research/StakeholderDocs/PDFs/materials.pdf

Tilley, A. R. (2002). The measure of man and woman: human factors in design. New York: Wiley.

Tyre for Wheelchair: Schwalbe Marathon Plus. (n.d.). Retrieved January 01, 2017, from https://www.loopwheels.com/product/tyre-for-wheelchair-schwalbe-marathon-plus/

Watanabe, L. (n.d.). Justify It: Standing Frames & Wheelchairs. Retrieved February 06, 2017, from https://mobilitymgmt.com/articles/2014/06/01/standing-frames-wheelchairs.aspx

Will Groulx of the USA, Up Ended (2012). Retrieved November 7, 2016, from http://i.dailymail.co.uk/i/pix/2012/09/05/article-2198689-14D9E9CC000005DC-392_634x433.jpg

Wheelchair Parts.net | Wheelchair & Scooter Parts, We Have It! (n.d.). Retrieved April 10, 2017, from http://www.wheelchairparts.net/

When Injury Occurs (2013). Retrieved November 7, 2016, from http://www.wheelchairrugbyready.com/images/injury-1.jpg

113

IMAGES CliQQ Photography. (n.d.). Retrieved November 2, 2016, from http://cliqq.co.uk/project/access-magazine-wheelchair-basketball/ http://bestreviews.com/best-wheelchairs?cid=224370881&aid=26892716441&eid=&tid=kwd- 31364324971&ul=9000992&mt=b&n=g&d=c&dm=&dt=&sn=&adid=125158779521&k=%2Bbest+%2Bwheelchair&p=&pc=&ap=1t1&gclid=CNv7 9Ou_qM8CFQ1ahgodVVYJoA http://kdsmartchair.com/blogs/news/18706123-wheelchair-facts-numbers-and-figures-infographic http://levousa.com/c3/c3.html http://levousa.com/lae/lae.html http://seatingmatters.com/reducing-the-risk-of-falls-and-sliding-from-chairs/ http://www.1800wheelchair.ca/product/karman-stand-up-power-wheelchair/ http://www.cyclonemobility.com/lifestand/lsc http://www.cyclonemobility.com/lifestand/lsct http://www.cyclonemobility.com/lifestand/lse http://www.midshiresgroup.co.uk/specialist-retail-products/powered-wheelchairs/standing-chair/otto-bock-xeno/ http://www.midshiresgroup.co.uk/specialist-retail-products/powered-wheelchairs/standing-chair/quickie-jive/ http://www.plastics.covestro.com/en/Products/Makroblend/ProductList/201506110453/Makroblend-M525 http://www.rev-a-shelf.com/p-243-cabinet-pull-down-shelving-system-wall-accessories.aspx http://www.scottsmedical.com/permobil-f5-corpus-vs-standing-wheelchair-detail.htm?productId=22562604 http://www.toptenreviews.com/health/senior-care/best-electric-wheelchairs/ https://freedomliftsystems.com/closet-lift/720-10063 https://s-media-cache-ak0.pinimg.com/originals/1c/34/23/1c34235f06204e2d4ffc9f9f434d008e.jpg https://s-media-cache-ak0.pinimg.com/originals/ad/5e/3e/ad5e3eef8082f76a33998a5bb6f2e61b.jpg https://www.tormach.com/store/index.php?app=ecom&ns=prodshow&ref=35534 https://www.wheelchair88.com/product/draco-standing-wheelchair/ https://www.wheelchair88.com/product/leo/ https://www.wheelchair88.com/product/semi-power-standing-wheelchair/

New Mobility (n.d.). Retrieved November 2, 2016, from http://www.newmobility.com/magazine-for-active-wheelchair-users/ ParaSport Ontario Magazine (2015). Retrieved November 2, 2016, from http://www.parasportontario.ca/ PN Magazine (n.d.). Retrieved November 2, 2016, from http://www.pva.org/site/c.ajIRK9NJLcJ2E/b.6547843/k.485F/Subscribe_to_PN_and_SPORTS_N_SPOKES.htm Saskatchewan Wheelchair Sports (n.d.). Retrieved November 2, 2016, from http://www.swsa.ca/ SPORTS ‘N SPOKES (2011). Retrieved November 2, 2016, from https://www.prlog.org/11644039-sports-spokes-wheelchair-recreation- magazine-readers-enjoy-life-after-spinal-cord-injury.html SPORTS ‘N SPOKES (n.d.). Retrieved November 2, 2016, from http://www.pva.org/site/c.ajIRK9NJLcJ2E/b.6547843/k.485F/Subscribe_to_PN_and_SPORTS_N_SPOKES.htm Sports and Programs (n.d.). Retrieved November 2, 2016, from http://www.victoriawheelchairsports.com/sports-programs Vector - Portraits of smiling aged man in wheelchair and caregivers (n.d.). Retrieved November 2, 2016, from http://www.123rf.com/photo_38783510_stock-vector-portraits-of-smiling-aged-man-in-wheelchair-and-caregivers.html Wheelchair Basketball (n.d.). Retrieved November 2, 2016, from http://www.cumbriawsc.org/ Wheelchair Basketball Club (n.d.). Retrieved November 2, 2016, from http://recsports.oregonstate.edu/wheelchair-basketball-club Woman with Disabilities: How Accessible is the Road to Motherhood? , Retrieved Nov 11, 2016 from

114

CHAPTER 8 APPENDIX

115

Discovery (i) Preliminary Information Search Search Engine: Humber Library

Keywords Used in Search: Universal design disabled people (review)

APA Citation Shahrom, Siti Kalkhalah (January 06, 2015). Universal design in housing for people with disabilities: A review. Journal of Design and the Built Environment, 15, 1, 33 - 42.

Abstract

Housing standard for disabled people is a new dimension in quality of life. To the disabled people who are housebound, the house is the central focus of their existence. Over the last ten years, more focused studies have been conducted on the relationship between housing and people with disabilities. This paper reveals the needs of universal design in housing for disabled people and policies that can be improved. The main focus is on housing design for people with disabilities that begins with an overview on housing needs concept, theory and model, and followed by the topics on housing crisis for disabled people. These reviews looked at the existing literatures on universal design in residential remodeling including the principles of universal design, housing features, design, space and accessibility. It concludes by providing housing strategy for people with disabilities including disabled rights, information and advocacy from various countries.

Introduction

For disabled people, normally rehabilitation occurs in a specific period of time, but it can include a single or multiple interventions delivered by an individual or a group of rehabilitation members. Rehabilitation is needed from an acute or preliminary phase instantaneously following recognition of a health condition through the post- acute and maintenance phases (Unsworth et al., 1995). Rehabilitation is included in identifying the problems and needs of a person, connecting the problems to significant factors of the person and environment, defining the goals of rehabilitation, planning and implementing the methods and measures, and also evaluating the impacts and results (Helander, 2000). Rehabilitation in housing increases the quality of life. People want to stay living in their own homes and be part of the community. People with disabilities and aged people need freedom, independence and security to ease their accessibility around the house (Duncan, 2007; Verwer, 2012). Therefore, a house design is important to not only minimize the risk of trips but also to be easily accessible and effective.

The United Nations Convention is a potential medium for the ‘shifting phenomenon’ of the right and dignity for disabled people (Lang, 2009; WHO, 2003). Human rights concepts are now involved with disability rights and policy that are being implemented nationwide (Thomas & Thomas, 1999). This paper focuses on housing design for people with disabilities (Gibson et al., 2011; Krahn, 2011; WHO, 2003). It begins with an overview of housing need’s concept, theory and model. This is followed by a brief concept of disabled and housing crisis for disabled people that involve the housing owner and tenant. This review continues examining the existing literature review on universal design in residential remodeling including the principles of universal design, housing features i.e. door, entrance, window, stair etc., design, space and accessibility. Besides, this paper compares some previous writing in terms of applying the universal design index for the housing study. As the universal design is a worldwide concept, this paper includes recent acts and policy related with disability including, disabled right, information and advocacy from various countries (Dalilah, 2011; SFELP, 2002).

116

Conclusions

In conclusion, there are already research and studies done by researchers that relate housing design for people with disabilities. Disabled people have the same needs and right as normal people. Suitable housing design is applicable for disabled by practicing universal design concept in housing development. Moreover, many nations worldwide has applied the universal standard. Local authority, community, family and individuals need knowledge, advice and advocacy to the concept and guideline of housing for disabled. Many acts, policies and laws arise from time to time to promote universal design. The management control and maintenance is important to make sure every housing development obeys the law. Awareness on the needs of the disabled should also be disseminated to everyone to provide clear understanding among stakeholders.

Summary Statements

1. To the disabled people who are housebound, the house is the central focus of their existence.

2. Universal design is a must in homes for the disabled

3. Policies surrounding the physically disabled and handicapped can be improved.

4. Just because someone is disabled or handicapped, it doesn’t make them any less of a human being. They can be of old age or have a disability of some kind, but they still want the same things; a. To stay living in their own homes and be part of the community. b. Freedom in how they live their life. c. Independence and security to ease their accessibility around the house.

5. House design is important to not only minimize the risk of trips but also to be easily accessible and effective.

6. Suitable housing design is applicable for disabled by practicing universal design concept in housing development.

7. Awareness on the needs of the disabled should be spread to everyone – not just the target audience – to provide a clear understanding. E.g. stakeholders, furniture/design companies, etc.

117

Search Engine: Google Keywords Used in Search: review accessible home kitchen APA Citation “Aging in Place”. (n.d.). Accessible Housing by Design - Kitchens | CMHC. Retrieved September 11, 2016, from

Universal Design People who inhabit and visit the houses we live in come in all shapes and sizes, ranging from infants to seniors, with various ever-changing abilities and skills. As we grow up, grow old and welcome new people to our homes, our housing needs change. A house that is designed and constructed to reflect the principles of universal design will be safer and more accommodating to the diverse range of ages and abilities of people who live in and visit these homes.

Everyone appreciates having a kitchen that is safe, spacious and easy to use. The successful design of a universally accessible kitchen starts with identifying potential users and anticipating their needs.

Design Requirements:

Efficient Design Traditionally, kitchen designers have focused on a compact work triangle formed by the sink, stove and refrigerator. In reality, we must expand the triangle to include all work areas as well as garbage disposal and the dishwasher. If your ability to move around the kitchen while carrying things is limited, it is even more important to consider these additional elements within the traditional work triangle.

An efficient kitchen that maximizes independence and convenience is the cornerstone of good design.

Designing an efficient kitchen also involves keeping the work triangle compact. Logical, sequential, routine movements will define the way your family use the kitchen and will help you design a kitchen with a work triangle that meets your needs.

A U-shaped kitchen (see Figure 1) may be the most convenient layout for one or two people working in a kitchen, but having a work area that is accessible from outside the “U” is also advisable.

A galley-style kitchen requires less space and sometimes provides people with more than one entry and exit point (see Figure 2). However, a galley-style kitchen usually limits a person using a wheelchair to a side approach to counters and appliances and can limit the amount of turning space.

Figure 1 (Above) Figure 2 (Bellow)

An L-shaped kitchen, with or without an island, provides several work surfaces, including some outside the primary work triangle, which means people can work without bumping into each other (see Figure 3).

118

All kitchens have various routes, some that everyone uses and others that are only occasionally used. Primary throughways should be designed outside the expanded work triangle. Remember that dishwasher and refrigerator doors may be open when the family is racing through the kitchen. An island creates alternate work areas. A sink and an electrical outlet in the island can maximize usability and convenience for everyone.

Appropriate size and location of both garbage bins and recycle bins in the kitchen is appreciated by everyone and reduces clutter. Consider using a system that can be contained within a cabinet (i.e., under the sink) to maximize usage of space.

For people with limited agility or mobility, a wheeled trolley can be useful for carrying food from the kitchen to the dining area. Figure 3

Also remember to consider window height. People should be able to see through windows when sitting and there should be easy access to window controls.

It is a good idea to reduce the number of doorways that open into a kitchen. If a door is necessary, it should provide at least 810 mm (32 in.) of clear passage width when it is open, but a clear space of at least 860 mm (34 in.) is better. Installing a 915 mm (36 in.) wide door will usually provide the recommended clear passage width.

Maneuvering Space A design for someone who uses a walker or wheelchair should allow maneuvering space of 750 x 1,200 mm (30 x 47 in.) in front of controls, work areas and appliances. This work area can be part of the overall required minimum maneuvering space of 1,500 x 1,500 mm (59 x 59 in.) in the work triangle.

Power wheelchair and scooter users need a larger turning radius and the required minimum maneuvering space is 1,800 x 1,800 mm (71 x 71 in.).

Minimal Effort Designing for minimal effort is an important principle of universal kitchen design. Planning for efficiency considers the location and relationship of all major elements within the kitchen. This will result in the placement of similar or related items in the same location within the kitchen.

Emptying the dishwasher is easier if the dishes and glasses are stored nearby. Baking is easier if baking supplies are close to a work surface and the oven. Meal clean-up is easier if the table is located close to sink, dishwasher and garbage.

Flexibility and efficiency of effort can be achieved through such design considerations as providing storage options at a variety of heights.

Planning for efficiency of effort and ease of use incorporates features such as more lighting, a place to sit down to work, a lower workstation, and storing materials where they can be easily seen and reached.

Adaptability Adaptability can be achieved by:  installing adjustable-height counters  buying a refrigerator with a left-right-hinged reversible door  installing adjustable shelving in cupboards, and  Installing drawers for storage rather than under-counter cabinets.

119

Ease of Cleaning When making decisions about new appliances, floors and countertops, remember to consider surface finishes. For example, glass cooktops tend to be easier to clean whereas stainless steel appliances show fingerprints and may require specialized cleaning products. Some countertop surfaces need yearly maintenance with a sealer to protect them from staining and harbouring bacteria.

Kitchen cleaning products should be stored in easy-to-reach locations, preferably in drawers or baskets that slide out. If family members include children, people with Alzheimer’s, people who are very forgetful or who have developmental disabilities, give careful thought to the storage and security of these products.

Audibility Special thought should be given to the ways that people who are hard of hearing or deaf will be alerted to timer buzzers and smoke alarms. Appliances that provide information in two different formats (visual and audio signals for example) are widely available. See CMHC’s About Your House: Accessible Housing by Design — Appliances for more information.

Efforts should be made to limit sources of noise, especially when the kitchen is used by people who are hard of hearing. Soft, absorbent surfaces such as cork flooring can reduce noise in the kitchen. Also consider creating a quiet work area outside the main kitchen as it may be helpful for people with learning disabilities or attention deficit hyperactivity disorder, and may reduce the busyness of the kitchen.

Safety Safety considerations in the kitchen deserve the highest consideration. Small rugs and mats in the kitchen should be avoided because they are a tripping hazard and an obstacle for many people who use mobility devices.

There are situations where it is safest to limit access to appliances in the home, for example, when a member of the household has Alzheimer’s disease or dementia. If this is the case, consider installing an override switch that must be activated before using an appliance or outlet in the kitchen. Install the switch in a place that is inaccessible to those who might be at risk of injuring themselves.

Consider providing wall space in the kitchen for a notice board. Although a notice board is a useful feature for everyone, it is of particular benefit to people whose cognitive abilities are changing or who are losing their memory. Post reminders and safety notes on the board.

Plan for easy access to water, a fire extinguisher and the gas shut-off valve in case of emergency.

Design Elements:

Countertops Countertops are traditionally 920 mm (36 in.) high, but a countertop 860 mm (34 in.) high is more convenient for children, shorter people and people who use a wheelchair. If the person who uses the wheelchair is a child or a shorter person, they may appreciate 730 mm (29 in.) high counter and work areas.

Installing counters at a variety of heights is a universally accessible approach to meeting the needs of people of different heights and reach abilities, but remember, a traditional dishwasher requires a minimum counter height of 920 mm (36 in.) so the height of the counter should be carefully considered in that location. Adaptability can also be achieved by installing counters with electrically adjustable heights, which are available from a number of innovative kitchen designers.

120

A toe space of 100 mm (4 in.) under cabinets will enable a person who uses a mobility device to approach the counter more closely. A high toe space has the added benefit of raising the height of the bottom shelf in the lower cabinet or drawer, reducing the reach range.

Clear counter space should be provided beside all major appliances for food or dishes as they are taken out of the refrigerator, oven or cupboard.

There should be multiple work surfaces in the kitchen, at least one with a minimum size of 800 mm (31 in.) wide x 600 mm (24 in.) deep, at a height of 730 – 860 mm (29 – 34 in.), with a minimum footprint in front of 750 x 1,200 mm (30 x 47 in.) to accommodate someone who is seated.

People with reduced vision should avoid countertop surfaces with busy patterns and many prefer to have a solid colour that will provide some contrast with their appliances and dishes. Some people select contrasting edging on the countertop to help in identifying the edge.

A backsplash in a contrasting colour can also help people with low vision better identify the extent and configuration of the counters.

Rounded or bull-nose edges on counters increase safety by eliminating the danger of sharp corners.

Cupboards, Drawers and Pantries Storing related things in the same cupboard where they are easy to find is especially important for people with limited mobility and a visual impairment.

A large pantry with swing-out doors or large drawers allows food and condiments to be stored where they can be easily reached at a variety of heights.

Upper cupboards should be installed with the bottom edge 410 mm (16 in.) above the countertop, instead of the more traditional 460 mm (18 in.), to ensure that the lower shelf is within reach of someone seated. Cupboards should not be installed less than 410 mm (16 in.) above the counter, as this reduces storage space for appliances on the counter.

Upper cupboard systems are available that can be electrically raised or lowered. In addition, there are shelving and rack systems that can be installed in existing cupboards, which enable the entire rack to be pulled out and down, increasing the usability of the upper cupboards for everyone.

Installing lower cabinet drawers that pull out fully to display their contents for easy retrieval is an excellent approach. Another strategy for providing accessible storage is using a series of small and large drawers instead of cupboards. Cupboards and drawers should have “D”-type pull handles, which are easier for people with reduced mobility or agility to use.

Touch-and-release drawers and cupboards are universally accessible to 121

everyone, including people with limited dexterity.

People with reduced vision may prefer to have handle colours that contrast with the background colour. A contrasting colour for the interior of drawers and cupboards may also increase visibility for people with limited vision.

A drawer or shelf that pulls out beneath a wall oven or microwave with a side opening door can be used as a heat-resistant surface. This reduces the necessity of carrying hot pans and can provide a place for hot items to cool before they are moved. These drawers or shelves can also provide additional work surface in smaller kitchens.

Pantry cupboards with doors that open fully, using 180-degree hinges, allow everyone to easily see the contents and to reach the shelves. In addition, internal lighting adds greater visibility for people searching for items in pantries and cupboards.

Sinks and Cleanup Areas Two sink areas should be considered in busy kitchens and in kitchens where there are people working at various heights.

Locating an accessible sink in a corner location is not recommended as it restricts access to the surrounding area and limits the usability of the counter areas.

When a sink will be used from a seated position, a shallow sink with the drain offset to the rear is recommended. This will allow sufficient knee space and will result in the drainage pipes being out of the way, eliminating the hazard of someone burning their legs. Alternately, the drainage pipes can be insulated rather than offset.

The visual continuity of the kitchen cupboards can be maintained with cupboard doors under the sink. The doors can be opened and slid back under the counter to create adequate knee space (see Figure 10). An accessible sink should provide knee space clearance — 750 mm (30 in.) high, 800 mm (31 in.) wide and 600 mm (24 in.) deep — to allow someone using a wheelchair to wheel under the sink.

A faucet controlled by a single lever or a motion detector is the most convenient. A lever faucet and a pull-out hose with a spray nozzle provides convenience for everyone, especially if there is a soap dispenser incorporated into the faucet design. This provides flexibility and ease of use for all family members. It is a good idea to avoid gooseneck faucets as they can splash excessively.

Food Preparation Workstations An accessible workstation integrated into the design of a kitchen is most advantageous for people who work from a seated position. A workstation where someone can prepare food and have easy access to accessories in that same area is efficient and convenient. An accessible workstation is equally appreciated by a child who wants to participate in kitchen activities.

The workstation should have at least one accessible counter or pull-out shelf, accessible storage within easy reach, as well as an electrical outlet and sink.

There should also be task lighting if this is going to be a primary work area.

Switches and Controls Electrical outlets should be strategically located at the front of counters within the reach of someone seated and others with a limited reach range. However, careful consideration should be given to locating outlets out of the 122

reach of children. For added safety you could consider installing an override switch.

Other controls and switches, including the switch for the vent hood over the cooktop, should be located at a maximum height of 1,200 mm (47 in.) from the floor.

Switches and controls should be easy to operate. Try to avoid controls that require the use of two different motions to operate in order to accommodate people who have the use of only one hand; whether they are wheeling a wheelchair, carrying a baby, using a cane for support or have only one arm.

Summary Statements

1. A house that is designed and constructed to reflect the principles of universal design will be safer and more accommodating to the diverse range of ages and abilities of people who live in and visit these homes.

2. A universally designed home follows a series of basic Design Requirements: a. Efficient Design - An efficient kitchen that maximizes independence and convenience is the cornerstone of good design. b. Maneuvering Space c. Minimal Effort d. Adaptability e. Ease of Cleaning f. Audibility g. Safety

3. In an efficient kitchen set-up, primary throughways should be designed outside the expanded work triangle; a sink and an electrical outlet in the island can maximize usability and convenience; and for people with limited agility or mobility, a wheeled trolley can be useful for carrying food from the kitchen to the dining area.

4. Power wheelchair and scooter users need a larger turning radius than their non-motorized counterparts when dealing with space and maneuverability.

5. There are also Design Elements that need to be followed for a universally designed kitchen. They are as followed; a. Countertops b. Cupboards, Drawers and Pantries c. Sinks and Cleanup Areas d. Food Preparation Workstations e. Switches and Controls

6. Installing counters at a variety of heights is a universally accessible approach to meeting the needs of people of different heights and reach abilities. Adding a backsplash in a contrasting colour can also help people with low vision better identify the extent and configuration of the counters.

7. Storing related items in the same cupboard where they are easy to find is especially important for people with limited mobility and a visual impairment.

8. A large pantry with swing-out doors or large drawers allows food and condiments to be stored where they can be easily reached at a variety of heights.

123

9. Upper cupboard systems are available that can be electrically raised or lowered. In addition, there are shelving and rack systems that can be installed in existing cupboards, which enable the entire rack to be pulled out and down, increasing the usability of the upper cupboards for everyone.

10. Installing lower cabinet drawers that pull out fully to display their contents for easy retrieval is an excellent approach.

11. Cupboards and drawers should have “D”-type pull handles, which are easier for people with reduced mobility or agility to use.

12. Touch-and-release drawers and cupboards are universally accessible to everyone, including people with limited dexterity.

13. In a busy kitchen, there should be two sinks at varying heights and the lower sink (at sitting height) should be a shallow sink with the drain offset to the rear.

14. The workstation should have at least one accessible counter or pull-out shelf, accessible storage within easy reach, as well as an electrical outlet and sink.

15. Switches and controls should be easy to operate. Avoid controls that require the use of two different motions to operate in order to accommodate people who have the use of only one hand; whether they are wheeling a wheelchair, carrying a baby, using a cane for support or have only one arm.

124

Expert Interview 1 Expert: Carrie Bernard

Basis of Expertise: Organization, Academic, Caregiver, Occupational Therapist

Date of Interview: October 19th, 2016 at 2:13PM

How the interview was conducted: Phone

Caregiver Profile

1. What is an Occupational Therapist and what do they do? Expert: Occupational therapy/therapists work in a variety of areas. They mostly looking at when somebody has been ill for some reason that interferes with/meeting their occupation. For example, if someone has gone through an event and has become dressed or something of the like, then it can make the individual unable to be able to participate in the activities that they used to do. Which is where OTs come in to help by aiding these individuals learn, adjust and continue to live in a manner similar to that of their life before the illness of disability.

Occupational therapy departments will work with people who had neurological problems, people with physical problems. They work in pediatrics for children who have severe disabilities. Also looking at whatever the person needs in an occupation is, so for kids it would be going to school. What are those abilities, asses their abilities, participating in their education.

2. How would you sort of describe the role as the caregiver either from outside looking in or as a part of the person’s life? Expert: It really depends because there are many disabled people who have no caregivers. Some live completely independently with adaptations based on the nature of their disabilities. Some might start of very independent, but as time wears on, they become weaker and more dependent on others like personal caregivers to help them.

There are two different kinds of caregivers; there’s family caregivers and then there are paid caregivers. For some people, all they need is someone to help them bathe. So they have home care twice a week that help them with just that need and that allows them to be independent, and that’s very different from a family caregiver in emotional terms and they aren’t getting paid. You don’t feel like you’re a burden on them, per say. I think that anything that makes a person feel more independent and not dependent on their caregivers can make a difference. It’s like saying, “I can get dressed on my own! I don’t need help, I don’t need to look to someone else”.

Then you have paid caregivers and the problems relating to them; what if they’re late? What if they’re sick? That can absolutely affect somebody’s ability to get to work, who could be quite independent otherwise. For example, what would happen if there was a pandemic and they had to bring in more healthcare workers? Someone might not be able to get to work since their paid caregiver wasn’t there to help them get ready for the day.

Needs 3. Why might a user chose one mobility device over another – for example a motorized wheelchair versus a manual wheelchair? Expert: Well one reason could be price as the more motorized/mechanical wheelchairs tend to be quite pricy. The other reason has to do with maximizing. By maximizing I mean finding the best solution for a specific individual. For example, if you’re trying to maximize, let’s say, someone who is athletic and wants to keep active they might go for

125

something lighter; they’re not going to want something that has additional mechanisms. They prefer to have that structure that actually addresses their needs.

User Difficulties 4. What sort of areas are the most troublesome or in the most need of wheelchair accessibilities concerning the home? Expert: Doorways and bathrooms. Those areas are really a problem since you need to have enough space to move around with enough clearance. Of course there are also other areas like the kitchen and appliances that wouldn’t work for a wheelchair user as they simply do not have the height needed. However, there are people who’ve lost mobility that are able to use washers and can make sure there’s no safety issues with carpets or other things that could cause tripping hazards.

5. Are there any means for those who are using wheelchairs as a mobility aid or even a mobility scooter to get around height/reach challenges? Expert: Ok, I haven’t done this for 20yrs, so, yeah, I don’t know. For basic reaching there are always extensions; ways to extend your reach while in the confines of assistive devices, like if you can’t reach into your closet to grab things. Like to be able to actually cook on a counter top if it was too high, I’m not sure how you would adapt that if it was too high. If you were cooking and you’re likely to spill or pick it unless wheelchairs can be adapted to ride them lower, but I wouldn’t know the current devices that exists at this point in time.

Training and Adjustment 6. How would someone who recently, say became paraplegic go about learning to interact with their mobility device? Expert: For a newly paraplegic it would be looking at how this new disability affects their ability to function at work, at home, and with hobbies. So, physio therapy looks at sort of the physical rehabilitation; Occupational therapy looks at that, but it’s all in relation to function. So the question that needs to be asked is what area of function needs to be adapted? They will look at things from the perspective of maximizing someone’s abilities; so retraining, getting them stronger or adapting the environment to better suit their body and getting it able to do what they need it to do would be the main priority.

7. What sort of things (environment, thought patterns, etc.) need to change for paraplegic individuals? Expert: So, now you’re in a wheelchair, you weren’t before; what do we need to adapt in your environment? What do we need to adapt in your activities? Is there something that we could do differently – what if you were always interacting with, let’s say, anything involved with painting and now your easel is at the wrong height, so how do we adapt those? How do we make sure that you can get to your actual easel? How do we maximize your core strength and transferring so that you can still get dressed? All these activities of daily living. How do I need to be adaptive? What types of new devices might you need to be able to get dressed for the day that didn’t before? Before you could walk to your closet and get your things out of the closet, but now you can’t. What do we need to adapt so you can actually still be independent in all dressing? All that sort of stuff. These are the questions that new users need to ask themselves.

8. How do caregivers adapt or work in relation with the individuals in their care (i.e. the wheelchair users)? Expert: You always work as a team. We have an OT as part of our team and the OT regularly does home assessments, so if I’m worried that someone is just getting weaker or they have a new disability, they’ll (the OT) will go into the home to look at it and say “ok, what needs to be adapted here?” They’ll meet with the family, like the patient and the family, taking them through their day, like, what happens first and what happens second, are there any safety issues in terms of the home? They’re not just looking at physical things, so for example, if I had somebody who has had a stroke and they have been effected cognitively as well, the OT will make sure they’re safe at home. Is it ok if they cook? Can they remember to turn the stove off? The whole purpose is looking at function

126

and all the meaningful things the person does in the day, how to get them back to being able to do it, or identifying what things they can’t do anymore.

9. How difficult would you say it is to adapt from possibly being once able to walk on your own to then having to adjust to a mobility aid, of any sort? Expert: It’s NOT just a typical adjustment, right? It’s a full on adjustment of who you are and trying to get a new self-identity and that can take…years. It depends on what people are ready for. For example, if a mountain biker is injured in a way that doesn’t allow them to walk anymore, then he has to change a big part of his life and his current understanding of his identity since he can no longer use a bike. It really depended on the person and what kind life they had; if they can’t envision how they can have a meaningful life outside of how they used to see themselves, then it can take a really long time, but that’s where occupational therapy tends to focus. If you were a mountain biker before what did mountain biking mean? What else can you do? What can we help you get that sense of adventure in your new life? It’s not just a physical thing, I mean it’s a whole self-identity thing and the more tasks/abilities that somebody can obviously be made to feel like they can do; the easier it is.

10. For someone who is first time, maybe a few year adjusted to being in a wheelchair, what would you say would be their sort of mindset when it comes to having to ask for assistance; whether it be reaching for something or opening a door? Expert: I that it really depends. If they’re in an environment that is not accessible it can be extremely frustrating, like if there wasn’t something that could easily be adapted so they didn’t always need to ask others, I think people become very frustrated. It’s just something realistic that you have to do and that’s how you move on.

Most people adjust pretty well because they realize that’s what makes them independent. Everybody needs help here and there, and they ask for something that allows them to be more independent. If they didn’t ask, they could do the things they need to do. Just like some people take a long time to adjust, for example, to using a walker. People often don’t want to use a walker until they realize that it makes them more independent. They don’t want to look like they’re disabled, so once they have a walker they’re safe, they can walk, they can move, and they feel much better and have a better sense of self-esteem. Once people adjust to asking when they really need to, I think they do quite well, but if it’s a sort of systemic thing that should be easily adjusted, as in things like a bathroom should have the ability for somebody to be able to go in/out with pushing a button and when people haven’t adapted the environment when it easily could be, it is extremely frustrating.

At first when you have a disability you feel less whole. Once you learn to use the devices that you need to make yourself more whole, they become a part of you and you no longer feel less than. Once in a while when people need to ask for something they feel maybe less than, but I think that people who are empowered, something that really should be there, those that don’t feel even less than or frustrated, sometimes take action. Though things are getting a lot better. We have a lot more frustration related to accessibility in most public spaces, so things ARE getting better. However, it’s going to take some time.

Finishing the Interview 1. Is there someone who would be good to follow up with? Expert: So, if you want, do you want me to connect you with our OT from our family health team? Do you think you have enough? Because I can see if she can chat with you and then I have another friend, I’ll you her email, she is in management as an OT at Holland Bloorview, which is children with disabilities. Yeah, so if you were looking at – like they do major adaptations for those of a young age who are going to be disabled for the rest of their lives, so she may be able to connect you up with some people as well, so I can send you her email address, and when I get back into town next week I can ask our OT if she can chat with you too.

127

Expert Interview 2 Expert: Alessia Di Virilio

Basis of Expertise: Organization, Academic, Caregiver, User

Date of Interview: November 4th, 2016 at 9:45AM

How the interview was conducted: In Person

The Market 1. What are current product on the market that lower limbed/wheelchair users’ use? Expert: People is probably the most common answer. Asking people for assistance or help when something is out of range of their abilities. The next obvious product/device would be the wheelchair as it comes in a variety of styles with different modifications. Some can assist you in standing up; or seat elevation. There are even some with manual reachers, almost like the claw that’s mounted to the side or back or the wheelchair. However, most of those are applied to power wheelchairs as they are becoming more common use.

2. Is there any particular reason for why that specific product/item(s)? Expert: People and wheelchairs are the most common and available. However, it’s not so much up to the user on which wheelchair they get. Most wheelchairs are owned/supported by the Assistive Device Program (ADP) and are funded somewhere between 80-85%. In order for the right wheelchair to be chosen for each individual, the future user has to speak with an OT to figure out what they need and then go to a manufacturer/distributer and see which models/components fit their needs and which need to be adjusted for just the right fit/comfort/practical usage.

Outside of wheelchairs and people, assistive aids like pulldown shelves/railings, reach extenders/claws, and the like are used. These are especially important when dealing with solo interactions – meaning that the user’s wheelchair/mobility aid does not have features for certain situations and other people are not around.

3. Why might one of these individuals choose something manual over something powered? Or vice versa? Expert: It has to do with a number a factors, all of which matter in deciding since whatever wheelchair you get you have for the next 5 years and it can’t be swapped or changed out until those 5 years are up. Such factors include, but are not limited to; lifestyle of the user, current muscle strength, mobility, and style of the device. All wheelchairs are different; in size, shape, colour, functions, etc.

Power wheelchairs are also becoming more common due to the comfort, ease of use and accessibility. Not to mention the technical advancements of the past few years.

4. Are there any benefits or options that are not available on the current market that should be? If so, what are they? Expert: A big disadvantage that doesn’t get addressed or used often is the option of “Seat Elevation”. It is not seen as a requirement and so is not available to a lot of people.

Another problem is that even though someone may have the right height, how do they manage with personal mobility or dexterity? Disabled individuals tend to not only have the incapacity to walk or stand without help, but they may have problems elsewhere like being able to hold items properly. How would they keep a good grip on the item they want to hold? There are extendable arms that can be added to wheelchairs, but again, they are not common or overly widely used.

128

User and Product Difficulties 5. What is the most difficult part of needing/using a mobility aid? (first time/long term users) Expert: When it breaks you realize just how much you need it. It’s like someone going without glasses when they need them or if you pulled a muscle you never knew you had. Everything you do becomes impacted by the sudden change and more often than not it causes a lot of problems for the user.

Another difficulty is space. Having spaces properly designed for all wheelchair/scooter/mobility aid users; not just the manual ones. Since power/motorized wheelchairs are becoming more and more popular, the old standards are just not good enough anymore; they are too small. Some changes have already been made though, like with wheelchair accessible parking spaces. 6. How safe are wheelchair users with today’s product line? If they are not safe, then where do you see problems? Expert: Motorized wheelchairs are actually similar in many regards to cars, in respect to comfort and size/fit. On an operational/robotic level, they are pretty safe what with features like automatic reducing speeds, safety locks, etc.

Another problem with safety is falling forward. Falling forward is the worst possible fall since the weight of the chair falls on the user and they might be physically unable to protect/cushion themselves. However, the bases of wheelchairs are fairly sturdy and the chairs are specifically designed to keep people as centered as possible. That doesn’t mean falls don’t still happen though; just that they are less likely to happen.

Product Life 7. What happens once the product (mobility aid) is outdated/replaced? What happens to the disposed product? Expert: I’m not sure about other chairs, but those with a tilt option are definitely owned by CEP (the Central Equipment Pool with Motion Specialties). They team up with your OT and make the “perfect” wheelchair for you, but once you need a new wheelchair they take it back and use it for parts. This is because with each new version/revision of their product, certain parts no longer apply while others can be used again. What happens to the other unused parts, I do not know.

As for other wheelchairs, they might be yours to keep and do with as you please until it becomes obsolete or broken. You can see this if you go onto sites like Kijiji where you can see people selling their wheelchairs. Others might treat their wheelchairs the same way some treat children’s car seats – passing it along to whoever needs it next.

Training and Adjustment 8. Do mobility aid users have any difficulties socially/physically/mentally when adjusting to their aids? If so, what are they and how do they affect the user? Expert: There are two sorts of communities in the wheelchair user world: new comers who started as standing individuals and at some point found they needed a wheelchair, and long lasting/whole life users who either have been using a wheelchair for majority of their life or have lots of experience. How they react to the different situations they find themselves in. for example, new comers tend to be more mentally or emotionally effected at first.

It also takes a lot of time to perform tasks. It’s all about individual experiences. It’s exhausting, frustrating and tedious, all at once.

Another problem is the method in which users need to figure out their needs for their wheelchair and getting the right components for your needs. The slightest change on your device can have a huge effect on your way of living and you have to wait 5 years until you can change it. For example, a slight height change from one wheelchair to the next changes how you interact with your environment and people. Not to mention the cost and meeting with all the people involved/organizing everything around multiple daily lives.

129

9. What do you believe would help/ease the user overcome the difficulties mentioned in question #8? Expert: The process used and needed to get just the right wheelchair is long and can be overwhelming, as I said in the last question. If anything, I would say to make the process as consumer driven as possible.

Reaching Out 10. Is there anyone you could recommend/introduce me to who could help further my research? Expert: The CEP is a good place to start. You can get more information about people interactions, the mechanics, and they could even connect you to a vendor who could further your knowledge. (CEP#: 416-701-1351).

Finishing the Interview 1. If I have more questions, would it be alright to contact you again; either in person or by email? Expert: Yes, you can contact me. Do it by email first though and if we need to speak face to face we can set up an appointment.

130

Surveys The following responses are from people who willingly participated in a test on wheelchair mobility and filled out surveys after the tests were completed. They are written in the same order as seen in Chapter 3. Additionally, all of the participants were not natural wheelchair users (could walk and/or had no reason to previously use a wheelchair).

Q1: On a scale of 1-5 (1=very easy, 5=very hard), How would you describe maneuvering a wheelchair? Why? 1 3: I found that I had to continually correct the direction that I wanted to travel in. the wheelchair didn’t stay on course by itself. 2 3.5: Forward and back was easy, but left and right especially while going down or up the ramp. 3 4: It was difficult to change direction. Also, if I wanted to end up in a precise spot, it was difficult to go through the fine movements required to get there. 4 2: maneuvering was easy in an open space. Small spaces might be harder. Ingress and egress would also be a challenge. 5 4: kind of hard because I don’t have enough strength and the chair is tricky to use. 6 2: I have actually driven a wheelchair before for shits and giggles and I had a bit of practice ahead of time (oops, cheated a bit). Doesn’t means it wasn’t hard at times, but maneuvering wasn’t my challenge. Q2: What was the easiest movement you made? Why? 1 Moving forward. I could see where I was going and any obstacles in my way. 2 Spinning in place. Required less muscle strength. 3 Going down the ramp! This was because I did not need to push the wheels and just relied on gravity to move me. 4 Forward. Required little co-ordination. 5 Just going forward. The ramp. 6 Forward, backward, and turning (the basics). Like I said, I had some experience with wheelchairs so maneuvering isn’t hard, especially once you get a feel and rhythm for the wheelchair. Q3: what was the hardest movement you made? Why? 1 Slowing the chair down on the downhill ramp. The chair rolled faster than expected and the handbrake surface wasn’t as smooth as I would have liked. 2 Moving up the ramp. Pushing up is difficult, but controlled by the fact that the wheelchair veers to the right. Makes moving in a straight line difficult at best. 3 Probably “pulling up” sideways against the window/wall (for the second reaching exercise). Just the fine, precise movements required were rather difficult. 4 Front wheels hit my knees when doing anything but forward. 5 Turning; I couldn’t figure out how to move the wheelchair. 131

6 Slowing down on the ramp and then having to get back up the damn thing. I’m not really upper body strong, so performing the latter is tiring, whereas the former was due to not having something in good condition to slow me down (breaks were smoothed over time and the grips could injure my hands). Q4: What, if any, difficulties did you face while in the wheelchair? E.g. bumping into objects, tiredness, obstacles that you couldn’t get around, etc. 1 I found it impossible, when my side was to the wall, to reverse and drive away from the wall. I had to move forward. 2 Tiredness. Moving in close to objects takes a certain finesse. 3 Turning, going uphill, reaching/leaning forward. Some of these things, however, could become easier with practice. 4 No stairs, terrain, etc. (Deena here. I would just like to mention that participant 4 drove himself into a ditch after he completed the tests and got stuck…) 5 Tiredness, turning. 6 Tiredness was huge as well as going uphill; even though it was the least steep ramp in the area. Q5: Which position was easier, forward or from the side, when performing a reach in the wheelchair? Why? 1 The side was because I didn’t have to use my lower back to lean forward. 2 From the side. You can be closer to you work-space and have more space for reach/movement. 3 It was easier to reach from the side, but it was difficult to maneuver the wheelchair into the proper position. 4 Side. Torso closer to the wall. 5 Forward. I can move my torso easily. 6 Side. I was able to reach higher and it put less strain on my body. Not to mention falling forward into the wall wasn’t a likely option this way. Q6: Which position was easier, forward or from the side, when performing a reach in the standing position? Why? 1 The side. My arm muscle is stronger from that direction. 2 Forward. Better balance and leaning for reaching up high. 3 N/A. I did not perform the reach from the side while standing, but based on daily experience, approaching high-up places head-on is usually easier. 4 N/A 5 Side. I have more reach but it’s almost the same (as forward). 6 Forward. It puts less strain on my body. If I was reaching over a horizontal surface, then I might switch to sideways. Q7: Looking at the height difference from your testing, what do you think about the gap? Were you surprised? Why? 1 Yes. I didn’t think that seated front reaching would be at such a disadvantage when front reaching is the most used type of reaching.

132

2 Not surprised because it’s obvious that a height advantage when reaching high up means a greater reach. 3 Yes, I was surprised. Mostly because I do not habitually reach for things while sitting. It just doesn’t make sense when I can stand! 4 More height would be better. 5 Not surprised. I can’t reach higher than the other. 6 I knew there was going to be a gap, I just didn’t expect it to be 2-3 feet for almost everyone who participated in these tests. Q8: What was it like for you to not being able/allowed to move your lower body? 1 It was ok because I knew it was only a test. 2 Debilitating. 3 Due to the novelty, it was quite fun, actually, to wheel myself around in a wheelchair. However, I think it would become tiresome and dull fairly quickly. 4 Comfortable during this short test. Might be different for longer. 5 Weird and fun, but as well I can’t imagine doing this every day. 6 Interesting to say the least. Although, if you told me that today I was never going to walk again, I might feel more debilitated and troubled. Q9: How was your overall experience during the test? 1 It was informative and enjoyable. Thanks Deena! 2 Tiring and insightful into how paraplegic individuals are forced to work and live. 3 It was fun. However, it was also sobering, to realize how limited by way of movement people in wheelchairs are. 4 I felt frustrated by the terrain limitations (…again, drove himself into a ditch…) 5 It was fun. I didn’t expect anything, but I did realize how hard it is to move around if there wasn’t proper space for disabled people. 6 Tiring, but fun. I would definitely do it again, but with a better wheelchair. This one was rundown and broken in some areas.

All participants read the Information Letter regarding this test and signed off on the Consent Form. However, these documents will not be provided in this report. If asked by supervisor/teacher for proof, documentation will be presented.

133

User Research (ii) User Profile Report DEMOGRAPHICS: Image Search

Images Keywords used: Wheelchair + clubs Wheelchair + clubs + sports Wheelchair + caregivers Wheelchair + users + age

Clubs: Victoria Wheelchair Sports Club Age: 18-70(ish) Gender: mixed Income: middle to upper middle income (inferred) (Group uniforms, individual/personal wheelchairs) Education: University Motivation: Fitness, Competition, Play Social environment for: training, possible relationships Level of motivation: high

Clubs: Saskatchewan Wheelchair Sports Age: 10-65+ Gender: mostly male Income: middle-upper middle income (inferred) (Group uniforms, individual/personal wheelchairs) Ethnicity: White, some mixed Education: Elementary to University Motivation: Fitness, Social environment, Competition, Play Level of motivation: high

Clubs: Oregon State University Age: 18-25 Gender: mixed Income: middle-upper middle income (inferred) (Group uniforms, individual/personal wheelchairs) Education: university / college Ethnicity: White Motivation: Fitness, Social environment, Competitive Level of motivation: high

Club: Cumbria Wheelchair Sports Club Age: 10-50 Gender: mostly male Income: middle-upper middle income (inferred) (Group uniforms, individual/personal wheelchairs) Education: Elementary to University / college Ethnicity: White Motivation: Fitness, Social environment, Play Level of motivation: high

134

Mountain Bike Magazines: Male and female, white, young, sporty, adventurous, active, wheelchair related

Caregivers Age: 20-35 Gender: mixed Income: mixed Education: University/College Ethnicity: White in this photo, but could be mixed Motivation: Helping wheelchair individuals, part-time job, money, experience, etc. Level of motivation: medium to high

Acknowledgements and Permissions

CliQQ Photography. (n.d.). Retrieved November 2, 2016, from http://cliqq.co.uk/project/access-magazine-wheelchair- basketball/

SPORTS ‘N SPOKES (2011). Retrieved November 2, 2016, from https://www.prlog.org/11644039-sports-spokes-wheelchair- recreation-magazine-readers-enjoy-life-after-spinal-cord-injury.html

SPORTS ‘N SPOKES (n.d.). Retrieved November 2, 2016, from http://www.pva.org/site/c.ajIRK9NJLcJ2E/b.6547843/k.485F/Subscribe_to_PN_and_SPORTS_N_SPOKES.htm

PN Magazine (n.d.). Retrieved November 2, 2016, from http://www.pva.org/site/c.ajIRK9NJLcJ2E/b.6547843/k.485F/Subscribe_to_PN_and_SPORTS_N_SPOKES.htm

New Mobility (n.d.). Retrieved November 2, 2016, from http://www.newmobility.com/magazine-for-active-wheelchair-users/

ParaSport Ontario Magazine (2015). Retrieved November 2, 2016, from http://www.parasportontario.ca/

Sports and Programs (n.d.). Retrieved November 2, 2016, from http://www.victoriawheelchairsports.com/sports-programs Saskatchewan Wheelchair Sports (n.d.). Retrieved November 2, 2016, from http://www.swsa.ca/

Wheelchair Basketball Club (n.d.). Retrieved November 2, 2016, from http://recsports.oregonstate.edu/wheelchair-basketball- club

Wheelchair Basketball (n.d.). Retrieved November 2, 2016, from http://www.cumbriawsc.org/

Vector - Portraits of smiling aged man in wheelchair and caregivers (n.d.). Retrieved November 2, 2016, from http://www.123rf.com/photo_38783510_stock-vector-portraits-of-smiling-aged-man-in-wheelchair-and-caregivers.html

135

DEMOGRAPHICS: Information Search Keywords used: Wheelchair + demographics Wheelchair + market research Wheelchair + blogs Wheelchair users' age and gender

Age & Gender Users of wheeled mobility devices are slightly more likely to be elderly. In the NHIS-D, 933,000 are ages 65 and over out of 1.7 million, or 55.6 percent of all users. The percentage is exactly the same in the SIPP. However, users of electric wheelchairs are more likely to be nonelderly (70%) as are users of scooters, although only 54.9 percent are nonelderly. (LaPlante, 2003).

Table 1. Number of Persons Using Wheelchairs: United States 1969-1995 1969197719901995 Ratio 1995: Age group 1969 6 and over 40964514111679 4.11 6-64 194310611746 3.85 65+ 215334800933 4.34

Data source: National Health Interview Survey Wilder, CS. 1980. Use of Special Aids: United States -1969. Vital Health Stat 10(78): 1-23. Black, ER. 1980. Use of Special Aids: United States -1997. Vital Health Stat 10(135): 1-40. Kaye, HS, Kang, T, LaPlante, MP. 2000. Mobility Device Use in the United States. Disability Statistics Report (14): 1-60. Washington, DC: US Dept Education, NIDRR. (includes scooters) LaPlante, MP, Hendershot, GE,Moss, AJ. 1992. Assistive Technology Devices and Home Accessibility Features: Prevalence, Payment, Need, and Trends. Advance Data (217).

Table 2. Number of Persons Using Wheelchairs: United States 1991-1999 Oct91-Jan92 Oct94-Jan95 Aug-Nov97 Aug-Nov99 Ratio 1999: Age group 1992 6 and over 1494 1812 2155 2283 1.53 6-64 529 NA 938 1012 1.91 65+ 965 NA 1216 1271 1.32

Data source: U.S. Census Bureau Survey of Income and Program Participation McNeil, JM. 1993. Americans with Disabilities: 1991-92. U.S. Bureau of the Census, Current Population Reports, P70-33 (ages 15 and older) McNeil, JM. 1997. Americans with Disabilities: 1994-95. U.S. Bureau of the Census, Current Population Reports, P70-61 (ages 6 and older) McNeil, JM. 2001. Americans with Disabilities: 1997. U.S. Bureau of the Census, Current Population Reports, P70-73 (ages 15 and older) McNeil, JM. 2001. Prevalence of Disabilities and Associated Health Conditions Among Adults — United States, 1999. MMWR 50(7): 120-125. (ages 18 and older)

There are an estimated 3.3 Million wheelchair users in the United States and the number is increasing every year. 1.825 million Wheelchair users are the age 65 or older. The demand for wheelchairs is increasing due to the large need among the baby boomer generation. (REZNIK, 2015).

More females use wheeled mobility devices than men. In 1995, the rate of male use of wheelchairs was 5.5 per 1,000 persons, whereas female use was 7 per 1,000 (Kaye, Kang, and LaPlante, 2000). The rates of wheelchair use among men ages 18-44 is actually higher than that among women, but after age 44, 136

the rates are higher for women than men. Thus, part of the higher use of wheeled mobility devices by women is due to their older age as a population group, but there is a tendency for women to have higher rates of use regardless of age. This is likely due in part to higher rates of mobility impairment among women. (LaPante, 2003).

Figure 3. Proportion of the population unable to walk by themselves one-quarter mile, by age and gender: United States 1995-1997

Men 30 Percent

Age

Ethnicity / Culture

Rates of use of wheeled mobility devices parallel rates of disability in general and mobility impairment in particular. About 8 in 1000 Native Americans use wheelchairs, followed by 6 in 1000 Whites and the same for African Americans, compared to 4 in 1000 Asian Americans. Use of wheelchairs is as low for persons of Hispanic origin at 4 per 1000 compared to 6 per 1000 for persons not of Hispanic origin. (LaPante, 2003).

137

Education and Income

Wheeled mobility devices can be expensive. Although a hospital version manual chair may cost only a few hundred dollars, a lightweight or ultralight manual chair costs at least $1500, and high end electric wheelchairs can exceed $20,000.

While reimbursement options may have become more available, it remains the case that about half of people or their families pay for devices solely on their own (LaPlante, Hendershot, and Moss, 1992). Users of wheeled mobility devices and their families manage to do this, despite having low financial resources.

Few people who use wheeled mobility devices work. Among those 18-64 years old, only 17-18 percent are employed. Not only does this mean that the personal income of users of wheeled mobility devices is low, it in turn affects the income of their families. The result is that many users of wheeled mobility devices are poor. In the working ages, 23 percent of wheelchair users live below the poverty line, double that of the general population. The cost of wheeled mobility devices, combined with low financial resources of people who need them, appears to result in substantial unmet need. (LaPante, 2003). 3.3 million people in America use a wheelchair, and ~17.4% of them are employed. (2011).

As to how much income wheelchair users actually get, that is not determined. They are either well enough off to be middle class to upper-middle class, or they are somewhat struggling and are relatively poor.

Based on the age range, education can be ranged between elementary to university depending on the person, how long they’ve been using a wheelchair, and how/if they plan to continue their studies.

Demographics: Summary Primary, Secondary, Tertiary Users

Primary User: Lower Limb Disabled individuals Secondary User: Nurses/Family/Caregiver to the disabled Tertiary User: Wheelchair sales personnel and Family

Demographics of Wheelchair Reference Users Age 6 – 65+ LaPlante, M. P. (2003, October 7). Demographics of Wheeled Mobility Device Users [Doc.]. San Francisco. http://kdsmartchair.com/blogs/news/18706123-wheelchair-facts-numbers-and-figures-infographic Gender Mostly female LaPlante, M. P. (2003, October 7). Demographics of Wheeled Mobility Device Users [Doc.]. San Francisco. Culture / Ethnicity Very mixed LaPlante, M. P. (2003, October 7). Demographics of Wheeled Mobility Device Users [Doc.]. San Francisco. Income Poor LaPlante, M. P. (2003, October 7). Demographics of Wheeled Mobility Device Users [Doc.]. San Middle – upper Francisco. http://kdsmartchair.com/blogs/news/18706123-wheelchair-facts-numbers-and-figures-infographic middle class http://www.strategyr.com/Marketresearch/Wheelchairs_Powered_and_Manual_Market_Trends.asp Educational Background Post 2ndary Educated guess based on age and income found.

138

USER BEHAVIOR: Information Search

Frequency No direct information was found on this aspect.

As it stands, wheelchair users in terms of frequency can be divided in terms of illness, injury and disability. Some illnesses and/or injuries can be short term, and the use of a wheelchair is only needed until the illness or injury passes. This could amount to a few months or less for an entire year. However, this is not the focus of this study, which is permanent disability, illness or an injury that has caused the previously mentioned options. In the case of a permanent disability, illness or injury, the user would be in need of/using a wheelchair – or other mobility aid – the rest of their life from the moment they needed an aid permanently. The only times that they may not use wheelchairs are during personal maintenance/grooming (toilet, showering/bathing, etc.), or when they transfer to another piece of furniture (bed, chair, couch, etc.).

Frequency As said above, the specific group this study is looking for are those who rely on their wheelchair for any form of personal transportation mobility (not vehicles). This means that more or less they would rely on their mobility aid 24/7.

Duration By factoring in at least 8hrs of sleep and another 1-2hrs to perform personal hygiene, a rough estimate of time where the wheelchair is in use would be about 14-15hrs per day. Depending on whether the wheelchair is manual or powered changes how often the user might need a break.

Social and solitary activities Wheelchair users are both social and solitary in a range of activities. Many of these being sport related which require a standard number for teams or equipment use (e.g. basketball would need a team while a kayak would by solitary).

User Behavior: Motivation and Lifestyle No direct information was found on this aspect.

Wheelchair users seem to pursue an active lifestyle. They do this through being outdoorsy, sporty, being more health oriented and fit, and even by joining the work force. Wheelchair users are still human beings and want to live their lives to the fullest, to show they can still function like those not in wheelchairs or other mobility aids. I would equate wheelchair and other mobility users to that of a subculture or group that makes up the human race.

139

Income Level and Purchasing Behavior

Income Level Purchasing Behavior How do mobility aid users afford these Wheelchair users usually own one or two wheelchairs/mobility aids/devices; expenditures? each used for different reasons like one for a specific sport and another for everyday use. However, wheelchairs can only be changed every 5yrs, so they In general, many of them are middle – have those years to save up again. upper-middle class and so can afford their wheelchair. However, some are Each wheelchair/mobility aid is designed with specific features for the rather poor, and so struggle with gaining specific user. Each component changes the price. their wheelchair and paying for the medical supplies/bills related to their As well, transportation of the device(s) to other locations is not an disability/illness/injury. inconsequential expense. Trending This sets some into a community of sorts. Style and modifications are the main trending point, which usually adds to the overall cost.

Location Wheelchairs are used the world over. The five most wheelchair accessible places in the world being Canada, the United States, the United Kingdom, Australia and New Zealand.

http://kdsmartchair.com/blogs/news/18706123-wheelchair-facts-numbers-and-figures-infographic

140

USER BEHAVIOR: Summary Frequency As said above, the specific group this study is looking for are those who rely on their wheelchair for any form of personal transportation mobility (not vehicles). This means that more or less they would rely on their mobility aid 24/7.

Lifestyle No direct information was found on this aspect.

141

Personality and Cognitive Aspect

No direct information was found on this aspect.

Three elements of Personality addressed here are ‘locus of control’ and self efficacy. Locus of control: refers to the extent to which individuals believe they can control events affecting them. Self-efficacy: is the extent or strength of one's belief in one's own ability to complete tasks and reach goals Changeability: is the ability to change or be changed, depending on the situation.

Two elements of Cognitive Aspect addressed here are technical skill and pre-requisite knowledge. Mobility aid users find travelling outside of what is normally a mobility aid friendly environment to a not as accessible one (e.g. home to the middle of a city), and require increasing levels of technical skill to progress. However, having some pre-requisite knowledge wouldn’t hurt either so as to know where one can or can’t go while travelling on wheels.

These assessments are summarized in the table below.

Personality Cognitive aspect ‘locus of control’ ↑ Technical Skill ↑ Self-efficacy ↑ Pre-req. content knowledge ↑ Changeability ↑ Uncertainty Avoidance ---

142

USER PROFILE

Primary, Secondary, Tertiary Users Primary User: Lower Limb Disabled individuals Secondary User: Nurses/Family/Caregiver to the disabled Tertiary User: Wheelchair sales personnel and Family User Profile of Primary User

Demographics Use Behavior Personality Cognitive aspect

Age 6 – 65+ Frequency of use Everyday ‘locus of control’ ↑ Technical Skill ↑ Gender Mostly female Duration 14-15hrs~ Self-efficacy ↑ Pre-req. content knowledge ↑ Culture / Ethnicity Very mixed Social/Solitary Mixed Changeability ↑

Income Poor Level of Focus High Uncertainty Avoidance --- Middle – upper middle class Educational Bkgd Post 2ndary Location Worldwide

Demographics: Overall, US wheelchair users tend to be older, female, and of a variety of ethnicities, with middle to upper-middle class levels of income.

Age: Majority >65+ (~70%) Income: Unidentified but assumed to be somewhere between poor/middle class to upper-middle class. Education: More likely than the average American to have completed post-secondary education.

Use Behavior: This study is looking for those who rely on their wheelchair for any form of personal transportation mobility (not vehicles). This means that more or less the user would rely on their mobility aid 24/7.

Benefits: Wheelchair users seem to pursue an active lifestyle. They do this through being outdoorsy, sporty, being more health oriented and fit, and even by joining the work force.

Income: In general, many of them are middle – upper-middle class and so can afford their wheelchair. However, some are rather poor, and so struggle with gaining their wheelchair and paying for the medical supplies/bills related to their disability/illness/injury.

143

Persona Persona Name: Joan Holmes Age: 49 Job: Marketing and Market Research (Market Manager) Income: $60 000 - $100 000 Education: University graduate Relationships: Married Location: Toronto, ON

Mobility Aid: Wheelchair Frequency: Every day Duration: 14-15 hrs/day Social/solitary: With her friends, sometimes solo

Other Activities: Active lifestyle Enjoys the outdoors Community wheelchair sports club Profile Joan Holmes is 49, Caucasian, university educated. She has been working for 26 years, and his income is now $140,660.

Joan was born a paraplegic and has been using a wheelchair for the majority of her life. She prefers to use a manual wheelchair, but knows that later down the line she’ll likely need to get at least a partially motorized wheelchair. Her home – current and past – have been modified for easier movement and everyday life.

Keeping in shape started at a young age so as to be able to use her wheelchair properly and manage certain tasks on her Woman with Disabilities: How Accessible is the Road to Motherhood? , own. This has continued for years to the present day. Retrieved Nov 11, 2016 from

https://s-media-cache- Use Behavior ak0.pinimg.com/originals/ad/5e/3e/ad5e3eef8082f76a33998a5bb6f2e61b.jpg Since Joan is a paraplegic, she has to use her choice of mobility aid – manual wheelchair – to get around 24/7, all year long. She takes part in a number of activities including joining a few wheelchair sports at the local community sports club. She and her husband (who is not paraplegic) also travel for outdoor vacations where they enjoy kayaking during the summer months and skiing during the winter months. Joan loves to be able to do her own thing despite her disability and show just how strong she is.

Joan’s Relationship with her Wheelchair Joan Holmes has three wheelchairs…an everyday wheelchair, a skiing wheelchair, and wheelchair designed for beaches/watery areas. Her first wheelchair was a basic manual wheelchair meant for the sole purpose of personal mobility. As she grew older and found a love for specific sports and activities, Joan purchased properly design chairs. Every five years Joan replaces or upgrades her wheelchair as she, her occupational therapist, and the wheelchair manufacturer see fit.

144

Blogs and Discussion Boards Name of Blog Google Search Keywords Contact information ‘blog + group or product 1 http://cewha.ca/category/blog/ wheelchair group blogs Contact Person: Bob Cassidy Canadian Electric Wheelchair Phone: (416) 757-8544 Hockey Association Blog Email: [email protected]

145

Name of Blog Google Search Keywords Contact information ‘blog + group or product 2 http://wordsiwheelby.com/ wheelchair group blogs Contact Person: Emily Words I Wheel By [email protected] Facebook, LinkedIn, and Twitter available too.

146

User Observation Report Thesis Topic: Mobility Aid/Device with Vertical Accessibility for the Lower Limb Disabled Objective(s):  To identify techniques for wheelchair transfers in and out of mobility aids unaided/solo.  To determine any difficulties in current transfer methods.

Decision(s) to be made: (The ‘why’ of doing your observation) As my thesis is centered on a mobility aid for the lower limb disabled (i.e. paraplegics), it is prudent to understand current methods being used for mobility/transfers, how individuals interact in different scenarios, and identifying any problems observed. These tidbits of information can then be used to design a more efficient and ergonomically designed mobility device/aid.

Information required:

 Step-by-step movements for transfers from wheelchair to furniture o Wheelchair to chair o Wheelchair to bed  Step-by-step movements for transfers from furniture to wheelchair o Bed to wheelchair

Target (individual or group): (Selection criteria used: age, sex, income, education, location, specific target, special interest (web forum, friends) etc.) Target group ranges in age from young adult to older adult. They can be of either gender and has an income between $60,000 and $100,000. They live in North America and have a post-secondary education.

Target Background: (Age, sex, commonality, group) Age: young adult to older adult/elderly Sex: Male or Female Group: C6 Quadriplegic/lower limb disabled

Observation Method (Video, Photographs, General, Scaled Mock-ups)) Video (YouTube (in this report) and personally taped with volunteers (not in this report))

147

Video Internet Search

Video #1 URL: https://www.youtube.com/watch?v=JxiTqYuWjnQ Title: wheelchair to chair transfer Length: 1min 40sec

Brief Description Transfer techniques from a c6 spinal cord quadriplegic. A man in his 40s showing step-by-step how to transfer from a manual wheelchair into a standard chair.

Relevance to Thesis Topic At base level, I am designing a mobility aid and so what I design will need to act/interact like a mobility aid. This includes being able to get in and out of said mobility aid/device with ease. By observing current methods for this action I hope to take some elements and use them in the final designs of my thesis.

Video #2 URL: https://www.youtube.com/watch?v=0e2EjrQS04s Title: Cindy paraplegic transfer from bed to wheelchair with transfer board Length: 1min 13sec

Brief Description An older adult/elderly looking woman demonstrating step-by-step instructions on how to transfer from the bed to a manual wheelchair while using a transfer board.

Video #3 URL: https://www.youtube.com/watch?v=v_u0081a0Rw Title: C6 Quadriplegic - Bed Mobility & Transferring Length: 6min 56sec

Brief Description Young adult male demonstrates how to get in and out of a bed to/from wheelchair. He gives detailed step-by- step instructions as well as gives various options for the same tasks. In addition, he gives advice on how to position yourself while in bed for easier mobility to get in and out while still being comfortable.

148

III Selection of Specific Activity to Observe (After looking at the overall activity, make a decision on where you are going to focus) Specific Activity #1: Vertical reaching points – Standing vs Forward Sitting vs Sideways Sitting

Objective(s): To determine the gap/difference in maximum reaching heights depending on body position.

Target (individual or group): Young adults (volunteers from class)

Observation Method Notes, Survey/Questionnaire (Photographs, Video, Scaled Mock-ups, Other)

Specific Activity #2: Mobility control – movement, turning, and ramps

Objective(s): To determine how well individuals can control and maneuver a manual wheelchair (that does not have vertical accessibility features) through basic tasks of the everyday user. To determine difficulties or problems faced by users using current methods of manual mobility/transportation. Target (individual or group): Young adults (volunteers from class)

Observation Method Video, Notes, Survey/Questionnaire (Photographs, Video, Scaled Mock-ups, Other)

IV Set-up of Observation Session Date (tentative): Late October – Early November Location: Humber College (North Campus) Activity to be undertaken Both Activities mentioned above

Equipment Required: Manual Wheelchair, bungie straps/cords, measuring tape, video recording device (Real / scaled mock-up) (my phone), tape, notepad (on phone), and survey sheets.

149

Thesis Topic: Mobility aid/device with vertical accessibility for the lower limb disabled Name: Deena Cincinatus

Major Activity Description of Major Activity Steps Point-form description of step Preparation for Activity 1 Set-up tape line as an indicator of distance to wall for reaching test. 2 Have participants sign consent forms and read over other important documents concerning the tests 3 Go over one more time what is expected of the participant during the tests and safety procedures. Key Activity 1 Participants will be demonstrating how far 1 Have participant stand up to marked tape line and they can reach vertically on a wall both reach as far upward on the wall as they can. while confined to a wheelchair and while 2 Mark the height with tape and then record the standing normally. This will also give a height for standing. chance to observe how well they (the 3 Strap participant into wheelchair with bungie cords participants) are able to control and to simulate being lower limb disabled. maneuver the mobility aid within a given 4 Have the participant pull up sideways to the wall at space. the tape line and reach as far upward on the wall as they can. Note: I did not inform participants on how 5 Mark the height with tape and then record the to work the wheelchair in any way sitting sideways height. (steering, breaking, turning, or stopping). 6 Have the participant maneuver themselves into a This was left to the participant to figure out forward facing position to the wall, feet pressed as to see how well they could understand the close to the wall as possible, and then reach as far current design. forward and upward on the wall as possible without lifting themselves and adjusting positions. 7 Mark the height with tape and then record the sitting forward height. Key Activity 2 Participants will demonstrate how well they 1 Have participant maneuver over to the beginning can control the wheelchair by going down a of the ramp. ramp, turning around, and coming back up 2 Observer (me) is to get into position for video the same ramp. To make this somewhat recording. easier on the participants, I chose the least 3 When she says “go”, the participant is to make steep ramp I could find on the campus. their way down the ramp in whichever way they see fit (e.g. slow and steady) and the observer is to Note: I did not inform participants on how have started recording. to work the wheelchair in any way 4 Once at the bottom, participants must turn around (steering, breaking, turning, or stopping). and once again face the ramp. This was left to the participant to figure out 5 Participants must then return up the ramp in to see how well they could understand the whichever method they see fit (e.g. hard pushes) current design. 6 Once at the top of the ramp, participants will maneuver the wheelchair away from the ramp area and “park” themselves. 7 Observer will then stop recording. ‘Ending’ Activity Once the participants are free from the 1 Untie participant from wheelchair. wheelchair, they will be given a 2 Hand the participant their questionnaire to fill out. questionnaire/survey to fill out in relation to the tasks they just performed. 3 While participant is filling out sheets, observer (me) will clean up area if no other participants are helping that day. 4 Retrieve filled sheets from participants and thank them for their help. Remind participants that they may be asked to aid further or for permissions. 5 If there are no other participants that day, return wheelchair to storage until next participant. 6 If there is another participant that day, return to the beginning of this sheet and go through the same tasks with the next participant.

150

Objective(s): (Needs Statement) A mobility device/aid that provides vertical accessibility/reach

Objectives: 1. To identify techniques for wheelchair transfers in and out of mobility aids unaided/solo. 2. To determine any difficulties in current transfer methods.

Description of Users Targeted by Product: (Selection criteria used: age, sex, income, education, location etc.)

Target group ranges in age from young adult to older adult. They can be of either gender and has an income between $60,000 and $100,000. They live in North America and have a post- secondary education.

Description of User Observation Environment Used in this Study: (Environment/surroundings user is accustomed to or new…etc)

This study/observation is based entirely on videos. The environment shown in all videos are of a bedroom or mostly empty space with the desired furnishings for said video (i.e. a chair).

Date of Observation(s): 19/11/16 (film/video only)

Location of Observation(s): User’s home, living space, or filming dedicated space.

151

User Observation Observing the user(s) transferring from their mobility aid/device to furniture and/or from furniture to their mobility aid/device. (Note: only the transfer from wheelchair to chair will be shown. Further explanations will be explained near the end)

Pull up to chair facing towards you

 Words of advice: you have to think about your position to the chair because once you start the transfer, you can’t stop.

 Positioning not too close, but not too far away, and facing towards the chair.

 I didn’t see him do this and he never mentioned it, but he never put breaks on after positioning his chair. Other people may do this step before moving on.

Positioning Feet

 This could be while on the wheelchair, but for better stability it’s best to place them on the floor about 1/3 to their final position when seated in the chair.

 He has leg spasms, which is another reason he’s preferred to rest his feet on the ground, rather than leave them on the wheelchair.

Posi tioning of body and prepping for transfer movements

 Scoot forward close to the edge of the mobility aid

 Place one hand on the chair – on the side it will end up while seated in the chair

 Place the other hand on the mobility aid – either on the arm or the seat.

Begin and End Transfer

 Remember, once you start you cannot stop. It has to be a fluid motion and it is done in a matter of seconds.

 While he was shaky, he used his own strength to move himself over in less than two seconds. It’s that fast.

152

Adjustment and Comfort  The user, once in the chair or other furnishing, is then able to readjust themselves to a more comfortable position should they so desire.

Organizing the Data Assembling activity data, or grouping of similar observations. Positioning of body  It’s a different method for each user, but they all have similarities like leg, feet, hand, and torso positions.  Every detail counts for each method.  It’s not just a matter of ease in use, but safety.  Users have to either face either the furniture or be parallel to it while sitting (it must be within their sights.

Wheelchair to furniture (and vice versa)  There are multiple methods for these actions. Some being easier than others.  The process of transfer is generally the same with a few added steps here and there for different furnishings. o E.g. beds need extra steps for getting the user into a sitting position and moving the legs into a proper shift/transition position.  These video sources only show manual wheelchair users. Similar methods might be taken for power wheelchair users, but it is more likely that they have assisted help due to the height difference between manual and powered mobility devices.  Performing transitions “uphill” is much harder than transitioning “downhill” or on a level plane.  Transitions should be quick and fluid.

Alternative transfer methods  Outside help or assistance in which someone or a machine carries you to your mobility aid.  Transfer boards: boards that need to be wedged under the body so that the user can scoot their way across into their mobility aid or to the furniture. It’s likely the least comfortable and the most exhausting.

153

Activities and Potential Improvements Steps Base User Potential Experience Improvement Prepping Pull up to chair facing towards you. Not bad when using this method – Providing a Transfer alternate methods include being aided quicker/easier way to set from Position feet. This could be while on the wheelchair, but for by another or using a transfer board, up a transfer. wheelchair to better stability it’s best to place them on the floor about 1/3 to which isn’t fun. chair their final position when seated in the chair. Takes a lot of nitpicky steps. Scoot forward close to the edge of the mobility aid and place one hand on the chair – on the side it will end up while seated in the chair – and one hand on the mobility aid – either on the arm or the seat. Transfer/ Begin transfer by using muscles to lift/fling body over to Not bad when using this method – Nothing can be done to Transition desired furnishing. alternate methods include being aided fix this. by another or using a transfer board, Continue in a smooth motion over to the chair until seated. which isn’t fun. Adjustments Once in the chair, the user can readjust themselves into a more Excellent. Nothing for comfort comfortable position.

Needs Statement Design focus will be on those activities that show the greatest potential for optimizing the user experience. To design a mobility device with vertical accessibility that will: 1) Reduce the effort and time need to transfer from a mobility device to furniture 2) Reduce the effort and time need to transfer from furniture to a mobility device.

Concluding Statements Informing Design Summary of Major Findings (3 min’m), which will inform design

1. The transfer technique shown is one of the more common and I would say one of the better ones since the alternatives (board or aided/helped) are either uncomfortable or not being analyzed for this thesis.

2. There are a lot of nitpicky details for set-up and positioning. While they can be annoying or tedious to the user, they provide stability for the transfer and safety for the user.

3. Relying on physical ability to move one’s self either through momentum (throwing) or arm strength.

4. Users become accustomed to these movements over time and just learn to live with them. None of them showed any annoyance or discomfort while using their methods of transfers.

Some User Needs That Are Still Not Yet Resolved

Mobility aid/device transfers to other pieces of furniture are actually well done and well thought out. Since each wheelchair is different and customized to fit the user, it would make sense that the techniques involved are equally unique from person to person. However, that isn’t to say that steps can’t be taken to make these techniques easier. Depending on the furniture, users might have to transfer “uphill” which is a difficult task. It tires out the user rather easily. So there is still the opportunity to address these needs.

154

Product Research (iii) Product Research I Benchmarking 1 Otto Bock Xeno http://www.midshiresgroup.co.uk/specialist-retail-products/powered-wheelchairs/standing-chair/otto-bock-xeno/

Search: Google: standing wheelchair Description

Enjoy the freedom of being able to stand up at a cashpoint, or in a personal conversation with friends and family with the Otto Bock Xeno.

Moving from a sitting position to the physiologically important stretching of the entire body in a short time has a positive effect on circulation and protects joints. Supporting belt and pad systems make safe driving and standing possible – even at the same time.

The Xeno also has the new innovative one wheel steering S³ (single servo steering). Ideal for indoor or outdoor use, Xeno also offers and electrical seat tilt and backrest adjustment and a battery drawer for better service.

Specifications (Features)

Standard Equipment

“enAble 50” electronics

6 km/h

63 Ah (C5) gel batteries

Battery charger (C5)

9" caster wheels

Rims, black

Tyres with lug tread, grey

Drive wheel suspension

Seat with stand up function, includes armrests, footrest, black/grey seat and back upholstery, lap belt, chest belt, and kneepads

Dual-servo direct steering system 155

2 Quickie Jive Up http://www.midshiresgroup.co.uk/specialist-retail-products/powered-wheelchairs/standing-chair/quickie-jive/

Search: Google: standing wheelchair Description

Discover the next evolution of the JIVE family

Combining the indoor agility and outdoor high performance of the Jive-M with a multi- functional seat, you‘re now able to enjoy both seated and standing positions from the comfort of your Quickie Jive Up. With a simple touch of a button, be eye-to-eye with the world around you and enjoy all of the benefits of a standing wheelchair – combined with the freedom and independence that only the Jive Up. Stand up for the life you want to live. Specifications (Features)

Seat Width: 400mm - 500mm (40cm - 50cm) Seat Depth: 400mm - 520mm (40cm - 52cm) Overall Width: 630mm (63cm) Speed: 6, 10 and 13 kph Battery Size: 60 and 70 Ah Max. Range: 32 km (40 km with 70 Ah batteries) Seat Tilt: 0 - 22 Degrees Back Recline: 90 - 175 Degrees Turning Radius: 910mm (maximum) - (91cm maximum) Max Kerb Climb: 100mm (10cm) Max. User Weight: 120 kg (18.9 stone) Colours: Red, Blue & White

156

3 Karman Stand-Up Power Wheelchair http://www.1800wheelchair.ca/product/karman-stand-up-power-wheelchair/

Search: Google: standing wheelchair canada Description

The Karman Power Wheelchair with Stand-Up functionality offers many health benefits previously unavailable to those in a wheelchair. By extending the body into a standing position, this chair promotes circulation, allows for optimal kidney and bladder function, and improves muscle tone. Standing also helps to prevent bone decalcification, thereby reducing the risk of osteoporosis.

In addition to its therapeutic benefits, this model looks and feels great! It features comfortable seat and back gel cushions, along with height and angle adjustable footrests. Running off of 2 (12V) batteries, it has a 25-mile range. Bottom line: Karman’s Stand-up chair will take you where you want to go!

Specifications (Features) Quick Overview Denmark Linak Stand-up Control Box  Gently lifts users to a standing position Dynamic controller  Allows users to speak eye-level with others Seat and back gel cushions  Free Anti-tippers Improves blood circulation and muscle tone  Batteries and Charger Included Promotes kidney and bladder functioning  Free Seat belt Reduces muscle contracture  Free Shipping Reduces bone decalcification and osteoporosis risk Prevents and heals pressure sores Anti-tippers come standard Batteries and Charger Included Seat belt included

Weight Capacity 250 lbs.

Product Weight 178 lbs.

Heaviest piece 150 lbs.

Seat Width 16", 18"

Seat Depth 16"

Seat-to-Floor Height 17.5"

Driving Range 25 Miles

Battery Weight 68 lbs.

Warranty on Frame Three Year Limited

Warranty on Wearable Parts One Year Limited

Warranty on Batteries One Year Limited

157

4 Leo (Lightest Standing Wheelchair) https://www.wheelchair88.com/product/leo/

Search: Google: standing wheelchair canada

Description It is scientifically proven that regular standing can prevent problems associated with “long periods of sitting on wheelchair” including: bedsore, skin breakdown, urinary tract infections, bone demineralization, poor blood circulation, spasticity, muscle contractures and more. So standing wheelchair not only helps you to gain independence & self-confidence, it also improves the quality of life. Please check out the video below to see how easy it is to stand by yourself.

You can hardly find a standing wheelchair that is so stylish, lightweight, user friendly, and it is also the lightest standing wheelchair in the world. If you enjoy using a manual wheelchair and would like to stand-up regularly by yourself, Leo is really your best choice. Kindly check out the details and specifications to find out which size suits you the most. *Normally it will take about 3 weeks maximum to prepare the unit. And DHL/UPS will take about 3-4 days to reach your door steps.

As the lightest standing wheelchair in the world, Leo has a lot of great features beyond your imagination: Proprietary user-controlled stand-up & sit-down mechanisms controlled by our unique hydraulic system. Total operational weight of 26.5 kg (58 lbs), decreasing to only 21.5 kg (47 lbs) after detaching the front and rear wheels. Quick release function for taking off the rear and front wheels for easy handling and storage during travel. Multiple adjustable parts (Seat depth, backrest height & footrest height and footrest angle) to fit different body sizes and needs. Angle adjustable footrest helps to stretch your calf muscles and tendons during sitting and standing exercise. Polyurethane rear wheel suspension for better riding comfort over rough surfaces. This full aluminum standing wheelchair is very stylish, and also made of top quality materials and workmanship to meet the highest safety & durability requirements.

Specifications (Features)

Seat Width Choices 16″ / 18″

Seat Depth (Adjustable) 18″, 19″, 20″

Seat Height 20.5″

Total Width 16″ / 18″ 25.8″ / 27.8″

Total Length 40″

Total Height (Adjustable) 33.5″ – 37.4″

Backrest Height (Adjustable) 13.8″ – 17.7″

Footrest To Seat Length (Adjustable) 17.5″ – 20.5″

Travel Weight – 16 ” / 18″ 21.5 KG / 22KG

Total Weight – 16″ / 18″ 27.0 KG / 27.5KG

Packing Size – 16″ / 18″ 100X63X60cm /100X67X60cm

158

5 LSC http://www.cyclonemobility.com/lifestand/lsc

Search: Google: standing wheelchair manual

Description

The Most Compact Standing Solution with Electric Mobility!

The LS Compact uses a retro vertical-lifting patent. The chair which when designed was studied down to every finest detail, benefits from the smallest footprint in the upright position than any other power standing chair. (even smaller than the seated position and almost identical to the natural able bodied position), while retaining excellent stability. Initially designed for indoor use like bathroom, lift, office and kitchen there is now an outdoor version http://www.cyclonemobility.com/lifestand/lsco specially designed to be equally at ease outside, thanks to the power of the motors and the diameter of the front wheels, which make ease of larger obstacles.

LSC Indoors - LSCI

As a wheelchair suited for indoor use, this model is equipped with VR2 - PG Drive Technology. Its simple but efficient design enables it to be accessible at a competitive price. Specifications (Features)

Well positioned Perfect alignment of hips, knees and ankles

Secure central locking of keen pads Prevents accidental opening.

Anti-tip wheels with variable height (engage automatically during standing-up process).

Standard LED with LED lighting kit (Except LSCI)

Adjustable seat depth (+ /- 14 cm).

Hand control, fixed on a swing away pantograph which can be manoeuvred independently of the armrest.

Constant armrest angle whatever the backrest slant ; especially practical for tray-table use. 4 functions : chest support, trunk extension through armrest propping, safe standing process, comfortable armrests.

159

6 LSE http://www.cyclonemobility.com/lifestand/lse

Search: Google: standing wheelchair manual

Description

LSE SEMI-ELECTRIC

The original with electric power to help you Stand

At time of purchase or retrofitted the LifeStand semi-electric, LSE, gives you the possibility to stand up electrically while conserving the characteristics of a manual wheelchair (manual propulsion with hand rims). Additionally you can stop and rest in any position between sitting and standing allowing yourself to ease those spasms and tightness out gently.

Specifications and Features

Stand-up kit, the power in the batteries allows a hundred standing cycles before recharging. You can stop and rest in any position between.

Well positioned, thanks to the curved armrests, the shoulders are stable and the spinal column is held straight.

Natural propping, on the armrests affords a unique relaxed and secure position

Armrests, 2 lengths, adjustable in depth and height. 4 functions: swing-away (transfer), armrest (seated position), security chest support (standing position), relaxed posture (standing position)

Innovative design and high-tech materials for a new, outstanding chair!

Backrest angle adjustable, 3 possible indexations, Stepless angle adjustment -15°/+10°, 3 backrest heights available.

Quick release, Front and back wheels are removable easily with quick release axles.

160

7 LSCT http://www.cyclonemobility.com/lifestand/lsct

Search: Google: standing wheelchair manual

Description

The LSCT is one of the most remarkable electric wheelchairs available, not only is it typical of the neat compact design associated with all LifeStand electric propelled wheelchairs it has tilt in seating and full recline features.

Product Specification

161

8 Pegasus II (Semi-Power Standing Wheelchair) https://www.wheelchair88.com/product/semi-power-standing-wheelchair/

Search: Google: standing wheelchair manual Description

Pegasus II: The Lightest Semi-Power Standing wheelchair, which allows you to roll manually and practice stand-up or sit down by power control function. Frequently stand-up can greatly improve user's health. It has all the great features that Leo has (Our fully manual standing wheelchair), including

Adjustable leg length, seat depth and footrest tilting angle. Quick release wheels and backrest foldable for easier transport. Great to serve as a physio therapy equipment for home, hospital or rehab centre. The up/down position can be controlled by a small controller at the tip of armrest.

Pegasus II: The Lightest Semi-Power Standing wheelchair Roll manually with power stand up/sit down function. Improves health by frequently standing position. Excellent for user works with one hand or one finger only. Up/Down movement to be controlled by a small controller at the tip of armrest. Adjustable leg length, seat depth and footrest tilting angle. Quick release wheels and backrest foldable for easier transport. Great to serve as a physio therapy equipment for home, hospital or rehab centre. Total weight at only 35kg even though it is equipped with power up/down feature Available in 16″ and 18″ seat width (14″ by special request”)

Specifications (Features)

162

9 F5 CORPUS VS STANDING WHEELCHAIR http://www.scottsmedical.com/permobil-f5-corpus-vs-standing-wheelchair-detail.htm?productId=22562604

Search: Google: standing wheelchair power

Description

With the F5 Corpus VS, there are no compromises. We combined all of the features of the world-renown Corpus seating system, along with standing functionality. With the F5 Corpus VS, users may stand and drive at any point of the stand sequence, and the redesigned chest bar offers added comfort and stability. The F5 Corpus VS provides an array of benefits from social interactions like being able to talk to someone face-to-face to positive health outcomes like greater pressure relief and improve circulatory, GI and respiratory systems.

Specifications (Features)

Maximum User Weight: 300lbs, 136 kg Maximum Speed: 7.5 mph, 12 km/h Driving Range (1): 16 miles, 26 km Base Width: 25.5", 648 mm Base Length: 43", 1093 mm Minimum Turning Radius: 30", 762 mm Ground Clearance: 3", 75 mm Drive Electronics: R-net 120A Battery Type: Group 24 Gel Optional Seat Elevator: 14", 350 mm Seat to Floor Height: 17.5", 18.5", 19.5"/ 445, 470, 495 mm Power Tilt Options: 0° - 50° Posterior Recline Options: 85º-180° (power) Legrest Elevation: 90° - 180° Armrest Pad Lengths: 10", 13", 16" & 18" Seat Widths: 17" - 23" (by 2" increments), 420 - 570 mm Seat Depths: 14" - 22" (by 1" increments), 370 - 570 mm Backrest Heights: 23" - 28" (by 1" incr.), 580 - 710 mm

163

10 Draco Standing Wheelchair https://www.wheelchair88.com/product/draco-standing-wheelchair/

Search: Google: standing wheelchair power

Description

Draco standing wheelchair is the best power standing wheelchair that equips with full function capability allows you to move, stand, sit, recline and lie down in safe and comfortable positions. The footrest, armrest and backrest move in a coordinated way simultaneously, so user will not feel the muscle pull when changing from standing-sit-lie down position.

With Draco, you can minimise the risk and effort of transferring user during day time as user can take a nap in lie-down position.

Draco Standing Wheelchair Fully powered for lie down, stand, sit and recline positions. Maximum speed up to 8 km/hr (5 miles/hr). Travels up to 30 km (18.5 miles) with a full charge. Equipped with Dynamic LED graphic display Controller (DX2) for precise user control. Adjusts speed automatically during standing position for safety. 8 wheels to provide excellent stability especially during standing and lie down position. Motorized wheels locate in the center to ensure tight turning radius of 66 cm (30″). Energy saving LED lights for night out. Adjustable headrest for extra comfort. H-shaped safety harness. Spring suspensions for extra comfort over rough terrains. Angle adjustable footrest to allow standing posture in different stages. Adjustable leg length and seat depth to fit users with different leg length.

Specifications (Features)

164

Design Take-Aways Other Criteria which can be used Power vs. Manual – what seems more popular  Max speed  Price Reclining is not a “must have” feature  Interface: ease of use for the muscularly weak Mechanisms for lifting and lowering user  Interface: ease of use for arthritic users

Safety measures and physical supports

165

Product Research II Benefits and Features Product #1 Standing Wheelchair – Manual http://levousa.com/lae/lae.html

Promotional Piece (Highlight the Benefit)

The LEVO LAE standing wheelchair is an everyday manual wheelchair that is designed for active wheelchair users who also want to elevate and stand. Push yourself up into your standing position by simply using the elevating armrests - the integrated gas springs adjusted to your weight lift you up and up to any and all positions you choose. With a total weight of 37 pounds, the LEVO active-easy LAE (manually propelled and manually standing) is one of the lightest stand-up wheelchairs in the world.

Features (Highlight the Features)

1. Responsive maneuverability, compact size and aluminum frame 2. Full range of wheel sizes, styles and camber 3. Gas-Spring assisted manual elevation to any angle between seated and standing 4. Patented 6 point base for secure and stable standing 5. Rated user weight to 265 lbs in standing 6. Transport friendly quick release wheels, castors and folding backrest 7. Crash tested 8. Compatible with multiple backrest and cushion brands 9. Many color options, accessories, seat widths and leg lengths

166

Product #2 Standing Wheelchair – Power http://levousa.com/c3/c3.html

Promotional Piece (Highlight the Benefit)

The LEVO C3 - Combine smooth, low shear standing technology with a tight turning mid-wheel system that automatically transforms into a 4 wheel drive action base and you are experiencing the latest innovation from the experts in standing -- LEVO! Become "RE-ABLED" with the curb climbing, full traction standing wheelchair that automatically adapts to the tights turns within your home or to the outdoor conditions of your daily commute.

Features (Highlight the Features)

1. Compact Size -- W - 25" and L - 41" 2. Center Wheel Drive = tight 21.5" turning radius 3. 4-Wheel Drive climbs over 4" curbs and up 33% grades 4. Low Shear standing technology and up to 35 degree power tilt 5. Adjustable seat width/length for full range child to adult 6. Rated for users up to 310 lbs in the full standing position 7. Whisper quite motor and actuators drive capability in all seated/standing positions 8. Optional colors including blue, red, yellow and black 9. Multiple accessories including R-Net drive, Bluetooth, knee supports and more

167

Product #3 Wheelchair Accessible Closets https://freedomliftsystems.com/closet-lift/720-10063

Promotional Piece (Highlight the Benefit)

The Electric Wardrobe Lifts lower clothes outside the wardrobe, within comfortable reach of a person seated in a wheelchair. Wardrobe lift closet organizer makes daily tasks easy, like getting dressed or ready to go out.

An Adjustable Closet Lift That's Fast and Flexible

This automated wardrobe lift is adjustable to fit between 39.4”-63”. The motor driven closet lifts take up very little space and are easy to install.

Features (Highlight the Features)

1. Travels 2”/second 2. Max load: 66lbs 3. Motor drive, continuously adjustable 4. Steel parts in chrome finish 5. Compact design 6. Hand held remote control operation 7. Closet lifts are made by Granberg in Sweden.

168

Product #4 Wheelchair Accessible Cupboards http://www.rev-a-shelf.com/p-243-cabinet-pull-down-shelving-system-wall-accessories.aspx

Promotional Piece (Highlight the Benefit)

No need to drag a chair into the kitchen to reach everything in your wall cabinet with Rev-A-Shelf’s magnificent Pull-Down Shelving System. The 5PD Series is a chrome-plated two-tier pull-down shelf that brings hard-to-reach items down 10" while pulling out 14-3/4" from the cabinet. This functional pullout features a unique gas assisted lifting/lowering mechanism that provides unparalleled stability through the entire range of motion and the arms lock into the down position for complete accessibility. The Pull-Down Shelving System has a sleek wire design and includes both side and bottom mount brackets, fully assembled wire baskets for easy installation and is available for Wall 24" and 36" cabinets.

Features (Highlight the Features)

5PD-24CRN 1. 24" Pull-Down Shelf 2. 5PD-24CRN has locking arm feature that holds shelf in down position for complete accessibility 3. Bottom or side mounting to cabinet 4. Brings item 14-3/4 out of cabinet 5. Gas-assist mechanism assists in raising and lowering unit 6. Heavy-Duty construction 7. Sleek Wire Design

5PD-36CRN

1. 36" Pull-Down Shelf 2. 5PD-36CRN has locking arm feature that holds shelf in down position for complete accessibility 3. Bottom or side mounting to cabinet 4. Brings item 14-3/4 out of cabinet 5. Flip-Up cabinet image is of the 5PD-24CRN side mounted. 6. Gas-assist mechanism assists in raising and lowering unit 7. Heavy-Duty construction 8. Sleek Wire Design

169

Gather up Benefits and place in a column in Excel (left-hand column below)

170

Gather up Features and place in a column in Excel (left-hand column below)

171

Needs Analysis (iv) Needs Statement 1 Product Level changing wheelchairs

Description A motorized or man powered wheelchair that changes vertical height according to the users wishes/needs.

Product: Motorized wheelchair vs Manual wheelchair

I Initial Statement of Benefit

NEEDS “A chair fitted with wheels for use as a means of transport by a person who is unable to walk as a result of illness, injury, or disability.”

Motorized or power wheelchairs require less work from the user and are much more comfortable. They can be adjusted to the needs of the user in terms of height, angle and even the speed at which they move.

Manual wheelchairs are easily stored and portable. They are light weight as well. If a slightly more “heavy duty” version of the chair is used, it can be slightly adjusted, but not to the extent of power wheelchairs. The manual wheelchair is also far cheaper and can be mass produced more easily.

172

II Break it down to individual benefits

FUNCTIONALITY Wheelchairs are meant to act as personal transport by someone who is unable to walk due to illness, injury, or disability.

FEATURES Armrests – they come in a number of styles such as desk length, full length, swing away, tubular and space savers.

Footrests, footplates and leg rests – important for comfort and protection.

Drive controls – motorized with a control panel/stick or manual wheel turning?

Frame materials.

Removable seat and seat cover.

AESTHETICS (APPEARANCE)

These are the top manual (left) and motorized (right) wheelchairs of 2016.

Wheelchairs are designed to look strong and reliable while at the same time comfortable. Adding splashes of colour or a pattern makes an appeal to all users as it can be seen as a sort of accessory instead of just a mean of mobility.

The second and third runners up for the manual wheelchair do not look all that special or appealing. They are black cloth, folding wheelchairs that pretty much look the same minus one having a blue painted frame. They are easily ignored for the one above as it has some form of personality to it. http://bestreviews.com/best-wheelchairs?cid=224370881&aid=26892716441&eid=&tid=kwd- 31364324971&ul=9000992&mt=b&n=g&d=c&dm=&dt=&sn=&adid=125158779521&k=%2Bbest+%2Bwheelchair&p=&pc=&ap=1t1&gclid=CNv79Ou_qM8CFQ1ahgo dVVYJoA

The second and third runners up for the motorized wheelchair actually do look better – in my opinion – than the one shown above. They are also black, though one has red accents much like the one above, and have very nice seating elements. However, the one above is more “slick” or shaped than the other two and this can be appealing to many. It looks like a more relaxing and comfortable wheelchair than the runners up. http://www.toptenreviews.com/health/senior-care/best-electric-wheelchairs/

173

USER PROFILE (MARKET) The people who buy these kind of wheelchairs tend to be the user themselves or a loved one/ family member who is buying it on their behalf/for their wellbeing.

The customer – I’m going to assume will be the actual user – is generally any human being that needs a mobility aid that involves moving around without the need/use of one’s legs or lower body. This can literally mean anyone who may have suffered an illness, injury, or disability that prevents them from moving their lower to entire body. However, majority are in the area of being unable to walk for one reason or another.

As I said above, the need and/or use of a wheelchair is open to pretty much any human being. There are wheelchairs for pretty much all age groups and it can’t really be divided by sex either. The only thing that divides the users is why they need a chair in the first place, such as obesity, paralysis from the waist down, a broken limb on the lower spectrum of the human body, etc.

What is the breakdown of the market (as a % of market ( estimate))? It is difficult to give a percentage of the market, especially for this particular product. However, I can tell you that there are over 2 million people in the USA who need to use a wheelchair and that majority are around 65+ years old. That’s not to say that not a fair share of them are not younger as well though. And this is just looking at the United States.

USEABILITY (ERGONOMICS/ INTUITIVE USEAGE) How easy/simple is it to understand how to use the product? A manual wheelchair is easy to understand as it is the user physically moving and driving it around. A motorized wheelchair might be more difficult to understand how to use as different models have different methods for controlling movement and then there is the maintenance required to keep it in working order.

How easy/simple is it to use the product? A manual wheelchair takes time to use easily as it requires the user to find their own “groove” in maneuvering and how to gain movement in the first place. It’s a learning experience and after some time it becomes natural to the user. A motorized wheelchair, depending on the controls, does not take too much effort in using it. It is similar to someone playing a game – once you know the basics and rules, it becomes easy. Again, practice is what makes the product easy or simply to use. There is still a learning experience required.

III Create questions that can be used to assess that (or similar products)

When looking for a wheelchair, how do you know you need a manual or a motorized wheelchair?

What makes one more comfortable than the other?

Which method is better for a smooth ride?

What sort of design catches more attention? (what appeals aesthetically to the consumer?)

174

Activity-Experience Graph

Activities and Potential Improvements Steps Base User Potential Experience Improvement Needing/wan Locating item Usually simple or easy Nothing ting an item from high up

Areas of greatest potential for optimizing the user experience: 3) Reduce the effort and time needed to obtain an item from high up. 4) Reduce the effort and time needed to put away an item from high up.

175

CAD Models (v) Fasteners

Knee Fastener Seat Fastener

Front Wheel Fastener Back Mechanism Fastener

176

Exploded Views

177

Hard Model Photographs (vi)

178

179

180

Technical Drawings (vii)

181

Manufacturing Cost Report (viii) Part # # of Parts Component Material Estimated Cost 1 1 Base Plate T6 Aircraft Grade Aluminum, machined and $100 cut 2 1 WA Left Side Makroblend, Injection molded $65 (painted/coloured) 3 1 WA Right Side Makroblend, Injection molded $65 (painted/coloured) 4 2 WA Front Makroblend, Injection molded $30 (painted/coloured) 5 1 Mirror WA Left Side Makroblend, Injection molded $65 (painted/coloured) 6 1 Mirror WA Right Side Makroblend, Injection molded $65 (painted/coloured) 7 2 Transparent Planes – Makrolon, Injection molded $60 Front and Back 8 1 Motor/ Battery Case Makroblend, Injection molded $65 (painted/coloured) 9 1 Leg Support Makroblend, Injection molded $30 (painted/coloured) 10 1 Seat 1 Bayblend, Injection molded $30 (painted/coloured) 11 1 Seat 2 Bayblend, Injection molded $15 (painted/coloured) 12 1 Back Support Bayblend, Injection molded $15 (painted/coloured) 13 1 Seat 1 Cushion PVC composite with gel foam $29 14 1 Seat 2 Cushion PVC composite with gel foam $24 15 1 Back Cushion PVC composite with gel foam $24 16 2 Front Wheels Bayblend, Injection molded with rubber tires $14 17 2 Back Wheels T6 Aircraft Grade Aluminum and rubber tires $300 18 2 Knee Fastener Steel $28 19 2 Front Wheel Fastener Steel $14 20 2 Seat Fastener Steel $28 21 1 Hydraulic Lifting T6 Aircraft Grade Aluminum, Outsourced $300 Mechanism (most likely) with all electronic components 22 4 Main Mechanism Steel $28 Fastener 23 12 WA Fastener Steel $84 24 2 Straps Outsourced $26 25 1 Battery Various Materials, Outsourced $180 TOTAL $1684

182

Sustainability Report (ix) Abstract

This sustainability report looks to evaluate, analyse and justify the sustainability of a manually propelled, semi powered mobility aid from the standpoint of two divisions of product sustainability; 1) Safety, Health & Environment, and 2) Materials, Process & Technology. The first section covers the sustainable aspects of the product from a macro level while the second section overs the sustainable aspects of the product from a micro level. From the research gathered and relating it back to the design of the mobility aid, it can be identified that the materials required will need to be strong, durable, and – if possible – recyclable/reusable so as to keep the user safe and healthy while also keeping in mind the product’s life cycle and what will happen to it at the end. Strong and durable materials like T6 aircraft grade aluminum and makroblend plastic are two materials that are considered reliable due to the fact that they are commonly used in support frames or medical equipment. They, along with other materials, mechanisms and technology, can be reused for the next generation of mobility aids, which is why they became the materials of choice for this mobility aid’s design. Taking these design and material considerations into the final design will help in creating a strong and reliable device and increasing the sustainability aspects of the mobility aid overall.

183

Mobility Aid with Vertical Accessibility for the Lower Limb Disabled: Sustainability

Evaluation and Justification

1. Introduction

Mobility aids around the world come in all sorts of shapes, sizes and use a variety of materials. These traits are defined by the user and what kind of life they live, whether they be athletic and active or slow-paced and only require their mobility aid(s) for day to day life.

However, one of the few traits all mobility aids and devices have is a form of sustainability.

Sustainability – specifically for products – is defined as products that offer environmental, social and economic benefits while protecting public health and environment over the entirety of their life cycle. This life cycle covers from the moment the materials are gathered/harvested to the time when the product eventually breaks, is thrown out, or recycled in some way. The following information was compiled to identify, evaluate and justify the use of specific materials, processes, and technology in the final product’s design and how they will increase the product’s sustainability. These individual attributes will also be discussed in relation to the sustainability of the user’s health and safety, and the product’s effect on the environment.

2. Literary Review

The following sustainability research and information has references to several wheelchair material and health/safety guides as well as companies (both product and material related) and existing wheelchair products. 184

3. Sustainability 3.1 Sustainability – Safety, Health & Environment After extensive research and analysis of existing mobility devices/aids/products, user needs, functionality and safety requirements, a concise list was compiled stating the key differentiating factors in safety, health and environmental sustainability. 3.1.1 Safety The device designed for this thesis is first and foremost a mobility aid for the lower limb disabled. This means the product must allow seamless interactions for its users and insure their safety while the device is in use (i.e. no pinching or sharp edges, clearance room, ergonomics, and centering weight/balance while in either the standing or sitting position). Additionally, to make sure that the user doesn’t fall out of the mobility aid while in the standing position, the device will have 2-3 straps that are attached to the mobility aid at the legs and upper waist to secure the user while in the vertical position.

3.1.2 Health Health is a huge issue for those who are physically disabled, particularly the lower limb disabled as they are unable to stand and spend the majority of their time seated or “glued to their seat”. Being unable to stand causes several problems for these individuals such as loss in muscle and skeletal strength, slowed blood flow and a reduced psychological wellbeing. According to Rehabilitation Engineering & Assistive Technology Society of North America (a.k.a. RESNA), “wheelchair standing devices are often medically necessary, as they enable certain individuals to:  Improve functional reach to enable participation in ADLs (Activities of Daily Living (i.e. grooming, cooking, reaching medication)  Enhance independence and productivity  Maintain vital organ capacity  Reduce the occurrence of Urinary Tract Infections  Maintain bone mineral density  Improve circulation  Improve passive range of motion  Reduce abnormal muscle tone and spasticity  Reduce the occurrence of pressure sores  Reduce the occurrence of skeletal deformities, and  Enhance psychological well being” (RESNA, 2007). By incorporating a standing mechanism into the design of the product, the user would be able to keep their body healthy and in better condition than if they had a non-standing mobility

185

device. Furthermore, the user would also have more individual/independent freedom, rather than depending on someone for assistance twenty-four seven.

3.1.3 Environmental Sustainability As it stands, mobility aids such as wheelchairs, scooters and the like are not devices that can be “thrown out” as easily as your every-day trash. Many wheelchair manufactures have systems set up so they can recycle old mobility aids made by their company and will reuse as much as they can for a new mobility aid. Majority of mobility aids can be recycled or scrapped for parts, but not all of the device(s) can be reused, such as worn down rubber tires, specific plastic exteriors, and some cushioning/padding. While companies do try to reuse as much as they can, not everything in current models/designs can be reused and where the remains end up is unclear. For the devices that don’t get sent back to the manufacturer, mobility aid users tend to sell their old mobility aids online for someone else to use or give the device to friends and/or family who need them more. From both the customer’s and the manufacturer’s sides, the mobility aid is recycled in some way, shape or form.

3.2 Sustainability – Materials, Process & Technology Sustainability doesn’t only derive from safety, health and environmental related needs/requirements. For a product to be considered “sustainable”, it has to be long lasting, durable, reduce waste (created during and after the product has run its’ course) and minimize the energy used to make/deliver the product. In other words, the product must have a long life cycle. The key points to consider to achieve this long product life cycle are materials, process and technology. However, for this product, safety is also a factor that can play into the longevity of the mobility device. 3.2.1 Materials & Processes The mobility device’s structural frame and lifting mechanism will be made from T6 aircraft grade aluminum as it is a light yet strong and durable material used in many standard and customized mobility aids. Another reason to use this grade of aluminum is that it is an alloy material that offers great mechanical function, and is resistant to corrosion. (Smith, 2013). Due to these traits, T6 aircraft grade aluminum is the ideal choice of structural material for this thesis.

Fig. 2 – T6 Aluminum Bar

https://www.tormach.com/store/index.php?app=ecom&ns=prodshow&ref=35534 186

The base/frame/wheel supports uses polycarbonate blend materials (e.g. Makroblend and Bayblend) which are rigid, durable and chemical resistant. (Covestro, 2016). Additionally, these plastics feature more than 80% recycled content. These plastics are used in many medical related equipment which makes Fig. 1 – Makroblend Traits it an ideal material for this thesis product. http://www.plastics.covestro.com/en/Products/Makroblend/ProductList/201506110453/Makroblend-M525 These parts would be injection molded due to the organic shapes and interior supports.

3.2.2 Technology & Power This mobility device uses a rechargeable GEL battery to power its lifting/lower mechanism. It only needs to power this section of the devices as it is a manually powered mobility aid most of the time. This makes the device low maintenance and easy to repair or recycle at the end of its lifetime. The overall balance of this mobility aid relies heavily on the wheel layout and the counterweight created by the heavier materials (i.e. the aluminum). Based on past observations and research, manual mobility aids – such as wheelchairs – that have angled back wheels are more light weight, durable and stable than other variants of the same product family. Being manual (or semi-powered) means that the mobility aid is actually more reliable and easily fixable should something become damaged. Also, while having angled (back) wheels creates a larger floor print of the overall size, it offers the user more stability both while sitting and standing which minimizes the amount of shaking a standard perpendicular wheel would offer. (Minkel, 2015), (Langtree, 2016) The back of the mobility aid will weigh more than the standing person due to the materials used in the back wheel frame (Smith, 2013) and the added weight of the motor under the seat. This weight should counteract the imbalance so that the user and the mobility aid don’t fall and/or tilt. The front wheels also play a part in the stability of the mobility aid. They are positioned so that the wheel’s “axle” is lined up with the toe of the footrest. This is different compared to most manual wheelchair-like mobility aids as they have the axle either slightly behind the toe- line or completely behind the footrest. This set-up offers a little more stability for the user while standing and additionally reduces the chances of tipping forward, resulting in the user sustaining injuries.

187

3.2.3 Safety Safety is a large factor in the overall design. However, in relation to the product’s overall sustainability, the main factor that allows the mobility aid to last longer is that it is less likely to tilt/tip over. For any product the more damage it takes in its lifetime results in a shorter life expectancy for said product. By reducing the risk of tilting/tipping, the mobility device has a higher lifecycle as less damage is likely to come to it (and by relation, its’ occupant). This risk of tilt is dealt by having large angled back wheels, larger front wheels placed at the toe-line, and having a Fig. 3 – Fallen Mobility Aid counterweight – created from the material weight, http://seatingmatters.com/reducing-the-risk-of-falls-and-sliding-from-chairs/ battery and motor – low to the ground and under/behind the product user.

4. Conclusion Mobility aids may come in all sort of shapes and sizes and be made of a wide range of materials, but they all have a certain level of sustainability. From the information gathered above, one can identify that for this mobility aid to not only support itself and its’ user, but also identify as sustainable it must be durable, reduce waste (created during and after the product has run its’ course) and minimize the energy used to make/deliver the product. The product must also ensure the safety, well-being and health of the user during the time spent together over the product’s lifetime. These sustainability goals are achieved through the specific materials (T6 aircraft grade aluminum, markoblend), processes (injection molding) and technology (GEL battery, motor, lifting mechanisms) that will define and create this specific mobility aid.

188

Topic Approval Form (x)

189

190

191

Advisor Meetings & Agreement Forms (xi)

192

193

194

Other Supportive Raw Data (xii)

Topic Specific Data, Papers, Publications (xiii)

195