Wheelchairs are an assistive technology that play an essential role in providing people living with disabilities the opportunity to be productive members of their society. In low-resource settings, a lack of access to well-designed, appropriate wheelchairs, with proper training and maintenance, prevent many of those living with disabilities from becoming more mobile and engaged in their communities. The MIT D-Lab Comprehensive Initiative for Technology Evaluation (CITE) team conducted this research study to evaluate the design and performance of eight commonly distributed wheelchairs in low-resource settings, with the majority of this research being conducted in Bali, Indonesia with a local wheelchair distribution organization. At the time of the study, the organization was piloting a program to provide wheelchairs from several different manufacturers to their client base following a standardized protocol, allowing for direct comparisons between wheelchair types. In this study, the team used a mixed methods research approach including a series of interviews, skills test, laboratory tests, and sensors that were attached to the wheelchairs.
The results of this study highlight the complexity of the design, distribution, and usage of wheelchairs in Bali, Indonesia. During the technical testing phase of this evaluation, only one of the wheelchairs passed the International Organization for Standardization (ISO) 7176 minimum safety and performance metrics. The varying modes of failure in the chairs call attention to the difficulties in designing and manufacturing high-quality chairs that also meet a wide range of needs. This also highlights the need for more rigorous and improved testing standards. The wheelchair user skills test portion of the evaluation involved users testing their ability to complete a standard set of skills with different wheelchairs, and largely, the results show that no wheelchair is a one-size-fits-all solution with different strengths and weaknesses for the chairs. The CITE team observed low correlation between cost of wheelchair and performance of chair. Through interviews and sensor data analysis, it was observed that users had low wheelchair usage, with many users self-reporting traveling less than 500 meters/day and sensor data showing average daily distances of 77-741 meters/day, depending on the chair.
The results of this evaluation call for continued improvements in the design and provisions of wheelchairs, as well as further standards and accountability for wheelchairs. This evaluation highlights how a variety of factors including cultural context, training, user skills, and more can contribute to the adoption and impact wheelchairs shave on people living with disabilities.
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Kendra Letih, MIT D-Lab Associate Director for Research