December 1, 2003
Real Living with Multiple Sclerosis
A WHEELCHAIR RAMP might be a thing of the past.
Most persons who use wheelchairs or electric carts can maneuver pretty well on even surfaces like cement or hard earth. But when it comes to stairs, they need to find a ramp or an elevator to reach a higher level.
That may have changed.
The Food and Drug Administration (FDA) has authorized the sale of the iBOT, a stair-climbing wheelchair that uses sensors and gyroscopes to climb up and down stairs. It also can shift into four-wheel drive to navigate grassy hills and lift its occupant to standing height.
Independence Technology, a Division of Johnson and Johnson, claims, "The Independence iBOT 3000 Mobility System, is a breakthrough innovation in mobility products. Independence Technology has spent 8 years and over $150 million to bring the iBOT Mobility System to market, creating the most thoroughly tested, studied, and sophisticated device ever manufactured for the disability community."
Independence Technology says that the iBOT Mobility System will be available over the next few months in strategically located clinics across the country. By year-end, they expect to expand to more rehabilitation facilities nationwide.
The iBOT Mobility System is designed to have a combination of features unlike any other mobility device ever created. The iBOT Mobility System offers five operating functions:
Balance function: The iBOT Mobility System allows you to move around at eye level and to reach high places independently, allowing you to see, feel, and touch the world from a new perspective.
Stair-climbing function: The iBOT Mobility System allows you to climb up and down stairs with or without assistance, allowing you to gain access to previously difficult to reach places.
4-wheel function: The iBOT Mobility System can climb curbs as high as 4 inches and travel over grass, gravel, sand, and other forms of uneven terrain. Users can easily get around in the backyard or local park with the iBOT Mobility System.
Standard function: The iBOT Mobility System operates indoors or outdoors, just as today's current power chairs do.
Remote function: The remote function allows you to detach the joystick and, via cable wire connection, drive the empty iBOT Mobility System into the back of a vehicle for easy transporting.
The iBOT is a complicated machine and quite expensive, but the PDA-approved wheelchair seems to promise some of the nation's 2 million wheelchair users new freedom of movement, especially because it will allow them to climb stairs.
Physicians find the new technology potentially revolutionary. The FDA called the iBOT a "break-through." The technology is complex and, unlike other wheelchairs, will require a doctor's prescription and special training before patients can buy it.
Lauren Neergaard of the Associated Press reports, "The iBOT will cost $29,000, less than some of the top-of-the-line wheelchairs for the severely impaired, but far more than basic wheelchairs. Its manufacturer, Johnson and Johnsons subsidiary Independence Technology, is negotiating with Medicare and other insurers to pay for the wheelchair but could not say if that is likely."
Sales will begin by year-end, a Johnson and Johnson spokesman said.
Dean Kamen, inventor of the Segway scooter, created iBOT and licensed it to Johnson and Johnson. He invented it, not only for its stair-climbing ability but also for the extra elevation, because wheelchair users told him they longed to carry on eye-level conversations with people standing nearby and to reach top grocery shelves by themselves.
There are dozens of wheelchair models on the market today. Wheelchairs have become more sophisticated, allowing their user to raise a few inches to reach high objects. More agile models are designed to zip around tracks, basketball courts, or tennis courts. Back in the early 1990s, the FDA approved one model for the sole purpose of stair climbing, but that model never became popular because it didn't provide more routine transport, said Robert DeLuca, the FDA scientist who led the iBOT evaluation.
The iBOT is an all-purpose wheelchair that can climb stairs. "We think this is something that can really benefit patients," DeLuca said. "It offers many advantages over anything else we've ever seen."
A typical wheelchair has two big back wheels, and two smaller front wheels. The iBOT has four wheels, all the same size. These can rotate up and over one another to go up and down stairs or steps. The person leans forward or backward to direct the chair to climb up or down as the gyroscopes sense and adjust to the person's center of gravity.
There are some safety issues with the iBOT, however, and it is not an option for all wheelchair users. To operate the iBOT controls, persons must have the use of at least one arm. They must hold onto a stair railing to help guide the iBOT, although another person could hold the back of the chair and assist a person who is more severely disabled go down the stairs.
To date, the iBOT is not approved for use by children or by persons who weigh more than 250 pounds.
Before gaining FDA approval, the iBOT was tested by 18 wheelchair users who drove it for 2 weeks. Scientists compared maneuverability in the iBOT with users' regular wheelchairs in everyday situations and in special road tests.
Twelve of 18 participants could navigate stairs alone with the iBOT, while the rest used an assistant. In regular wheelchairs, one patient could bump his way down stairs, but no one could go up a single step.
Three of eighteen participants fell out of the iBOT and two fell out of their own wheelchairs-none on the stairs and none seriously injured-suggesting the iBOT was as safe as today's technology, the FDA concluded.
There are other safety concerns with the iBOT. It's a complex machine, so that the wrong person using it could get hurt or injure bystanders. Independence Technology set up an FDA-approved program to strictly control sales.
Rehabilitation specialists and doctors must be licensed to prescribe iBOT. They would have to test their patients to determine if they could physically handle the machine and have the right judgment skills to discern obstacles, such as hills that are too steep to try climbing.
More detailed information is available on the Independence Technology Web site (http://www.independencetechnology.com), including an explanation of the iBOT's computer-gyroscope technology; a personal survey to determine if you might physically qualify to use the iBOT; a list of safety regulations and responsibilities, and a list of potential adverse health effects.
Just like a car, boat, standard wheelchair, or electric cart, a person using any mobility device needs to drive sensibly and with courtesy and caution.
It might sound funny, but users of any device (wheelchairs, electric carts, or the new iBOT) should not use cell phones or drink and drive while operating their vehicles!
To find out if the iBOT Mobility System is right for you, call the Independence Technology Customer Zone toll-free at 1-866-813-0761.
For more information,
also visit the Food and Drug Administration at http://www.fda.gov.
Copyright © 2003, Real Living with Multiple Sclerosis