Wheelchair research progress, perspectives, and transformation.

Rory A. Cooper, PhD There is a growing and rich body of wheelchair research and development being generated around the world. A simple search of PubMed using the search term “wheelchair” shows that 259 articles were published in the past year, 566 in the past 2 years, 1,315 in the past 5 years, and 2,241 over the past 10 years. If one narrows the search to “power wheelchair,” the number of publications drops precipitously to 31 articles in the past year, 70 in the past 2 years, 156 in the past 5 years, and 265 in the last 10 years. The number of published articles drops even further if the search is specific to the design of new wheelchair technologies. This simple investigation provides some insights worth examining. The output of wheelchair research has risen over the past 10 years: there was a 17 percent increase in the number of total articles published in the last 5 years versus the previous 5 years, although there are natural annual fluctuations. Similarly, there has been about an 18 percent increase in the number of articles related to power wheelchairs, although the overall numbers are quite small. Most of the articles are related to wheelchair usage and clinical assessment, with a few on training. Wheelchairs are an important modality for mobility, activity, and participation in life. For people with some forms of impairment (e.g., spinal cord injury [SCI]), wheelchairs are the primary means of mobility. Manual wheelchair research seems to be fairly healthy even though many unanswered questions remain. Recent studies have indicated that there are challenges to obtaining high-quality manual wheelchairs. Liu et al. have shown that many ultralight wheelchairs are not compliant with Rehabilitation Engineering and Assistive Technology Society standards and fail prematurely [1]. This research is supported by a study of maintenance and repairs by McClure et al. showing that wheelchairs require frequent repairs and that those repairs start within the first few months of using a new chair [2]. More recently, Riggins et al. showed that there are still gaps in our knowledge about when to provide a wheelchair, to whom, and what training is necessary, even for people with SCI [3]. This study indicated that people with incomplete SCI, who focused on gait training, did not fare as well as their counterparts with complete or higher level lesions who received wheelchair training in terms of community participation and quality of life. As a result of research conducted over the past 10 years, there is greater understanding of wheelchair activity, service-delivery processes, manual wheelchair skills training, and set-up of wheelchairs. There is a paucity of research into all aspects of power wheelchairs. This is somewhat surprising given the hundreds of thousands of people who use power wheelchairs, including scooters. Power-wheelchair users are also among the most vulnerable members of society in terms of ability to perform activities of daily living, community participation, and employment. Power-wheelchair