Strategies for meaningfully involving users in the development of an intelligent power wheelchair
While it is known that power wheelchairs can positively impact on well-being, self-esteem, pain, activity and participation, health professionals who evaluate and train patients to use this technology report that it sometimes cannot be provided to individuals with cognitive, visual and motor problems. Over the past few years, technological advancements have allowed the development of wheelchairs that can drive themselves semi-autonomously according to a predetermined path and avoid obstacles.
Our multidisciplinary research team, consisting of researchers in the fields of rehabilitation (physical and occupational therapy), engineering and computer science, has been developing a prototype of an intelligent power wheelchair which could move around safely without requiring the individual to control it.
Our team sought user input in order to inform the development process. In order to do this, we had to define in the first place who the users were. We had to identify the relevant informants who would impact on eventual intelligent power wheelchair use. Second, we had to develop a strategy to elicit meaningful feedback regarding a technology that was still being developed and could not yet be used by the informants.
Identifying relevant informants
A first group of relevant informants that we identified were the intended future users of the intelligent power wheelchair. Many individuals who currently use power mobility devices have neurological or musculoskeletal disorders which are degenerative in nature. Hence, while they may be able at this time to use their power wheelchair effectively, they may have difficulties in the future should their condition deteriorate.
Caregivers of power wheelchair users were also considered to be relevant informants. In their role as caregivers, they assist wheelchair users in activities during which the wheelchair is used, and may need to increase or decrease the level of assistance provided with a different mobility device.
Additional intended users are those who are currently not eligible to receive a power wheelchair because of significant visual, cognitive or motor deficits, but who could potentially use the technology if it were available. Although extremely relevant, to date these informants have not been included in our studies. An important issue our team needs to address in order to include these participants in future studies is how to identify such individuals who could benefit from the new technology, but who are not currently using existing power mobility devices.
Another group of informants is health professionals who assess the need for and capacity to use wheelchairs since patients do not acquire wheelchairs without having them prescribed by their health professional. In Quebec, Canada, this is often done by an occupational therapist in technical aids departments in rehabilitation centers.
To date, the perspectives of twelve current power wheelchair users, five caregivers and ten health professionals have been collected through one-on-one interviews, and the analysis is currently underway.
Strategy to elicit meaningful feedback
When planning the interviews, the team had to consider how to elicit meaningful feedback regarding a technology that could not physically be experienced by the informant. Based on the experiences of studies in the field of telerehabilitation, the research team opted to make a short video that would demonstrate the intelligent power wheelchairs capabilities. While the team did consider describing the technology during the interview, it was felt that this would not provide sufficient information to the informant for them to share their perception of the relevance, safety and usefulness of the wheelchair’s features. Moreover, it was not possible to let the informants use the current prototype safely in an open setting such as the shopping mall — the context for which the wheelchair was being developed and within which we wanted to obtain feedback. Hence, a video was produced by having an actual power wheelchair user use a prototype of the intelligent power wheelchair in a shopping mall.
Several activities were filmed during which the wheelchair’s features were made obvious, such as stopping when there is a moving obstacle such as a person; going around a stable obstacle such as a trash can; following a person that is accompanying the wheelchair user; and following a predetermined path such as directing the wheelchair to go to the bank. For an example of the wheelchair features, you may watch this earlier version of the video that was developed.
The video was shown to the study participants during the interviews. Prior to showing the video, participants were asked to describe how the current wheelchair was used, what difficulties were experienced and what they believed an intelligent power wheelchair would be able to do. Interestingly, we found that the video reminded wheelchair users of familiar situations in where the intelligent power wheelchair would have been useful to them, or difficult situations that they did not think to mention in the first part of the interview and then elaborated on once they viewed the video. Furthermore, at times participants would laugh out loud while watching the videos and make comments such as "That happens all the time", such as when encountering people texting who were not looking where they were going. This confirmed that the video presented realistic situations and gave an accurate portrayal of what the wheelchair could do.
Our research team continues to develop the intelligent power wheelchair and is committed to continuing to include the users’ input throughout the process.
Research team: Paula Rushton, Robert Forget, Louise Demers, Joelle Pineau, Richard Gourdeau, François Routhier, Evelina Pituch, Paula Stone.
Funding sources: CRIR-PSI, RQRV, NSERC.
For more on the subject
Have a look at our User involvement dossier.
|Author :||Dahlia Kairy, Ph.D.
School of Rehabilitation
Université de Montréal