Survey Study to Develop a Wheelchair-worn Computing and Health-monitoring System

Jongbae Kim, PhD1 and Patrick Smith2


1 University of Pittsburgh, Pittsburgh, PA
2 Juniata College, Juniata, PA

ABSTRACT

Both the raw number and percentage of people in need of a wheelchair are increasing every year. Unfortunately, wheelchair users are much more limited in access to conventional IT resources such as home computers and the Internet, than their non-disabled counterparts. Moreover, no computer systems specifically designed and optimized for wheelchair users exist today that match the powerful desktop PC systems. In this research, we envision a wheelchair-worn computing system that is as effectively usable by wheelchair users as other conventional high-performance PC systems are usable for general users. As a preliminary study for the development of the system, we surveyed the needs and usages of the computing and health-monitoring system for wheelchair users in order to fully identify and understand the design requirements for the system. We received 97 enthusiastic responses from wheelchair users via a voluntary online survey and could confirm the necessity of this kind of system.

KEYWORDS

Wearable Computer, Ubiquitous Computing, Health-Monitoring, Wheelchair Users, Survey.

BACKGROUND

The number and percentage of people in need of wheelchairs increase every year. In the U.S. alone, an estimated 2.7 million people over the age of 15 currently use wheelchairs for their daily mobility [1]. While these numbers are staggering, experts predict that the number of people who need wheelchairs will increase by 22% annually over the next ten years [2]. Although the widespread use of advanced computing technologies has generally enabled people to conveniently access vast amounts of information , persons with disabilities have benefitted much less. It has been reported that people with disabilities are less than half as likely as their non-disabled counterparts to have access to a computer at home (23.9% vs. 51.7%) [3]. Our goal is to narrow this gap.

For many years, wheelchair users have faced the issue of transportation to and from medical facilities, grocery stores, and/or department stores in order to complete their daily routine.  Those who have difficulty leaving their homes can now log in and order groceries, shop for appliances, research health questions, participate in online discussions, catch up with friends, or make new ones.  The computer system would allow wheelchair users to contact rehab specialists or healthcare providers and receive direct consultation without ever having to leave the comfort of their home. 

Today, unfortunately, no computer systems exist which are specifically designed and optimized for wheelchair users that can match the powerful desktop PC systems found on the market. To remedy this situation, we want to develop a computing system that wheelchair users can use whenever and wherever they want. We envision a wearable computer, worn on the wheelchair, which will provide a ubiquitous computing environment to people with mobility and manipulation limitations. It will allow people to independently perform valued and necessary activities so that they can fully participate in society. The ultimate economic benefit is to have more people educated, gainfully employed, and contributing to the tax and consumer bases.

RESEARCH QUESTION

The objective of this study was to determine the needs of wheelchair users who would use wheelchair-worn computing system and the tele-health monitoring system on a daily basis.  For a person with a disability who requires a wheelchair for mobility, the wheelchair becomes an extension of the person’s body. Therefore, this system would be a kind of wearable computing system. We aimed to find out how they would use this wearable system and for what tasks they plan to use the system.             

METHOD

We designed a survey study to determine the needs of wheelchair users who would use this system on a daily basis.  We aimed to find out how they would use the system and for what tasks they would use the system. For our survey, we grouped the questions into seven categories: the wheelchair users’ current physical condition; work status; educational situation; type of wheelchair; health service related questions; computer usage; and recommendation about the design.

We created a web-based survey tool on SurveyMonkey.com. We invited wheelchair users to this survey page on the internet by advertising in the internet community of wheelchair users such as Quad-List, SCI Network, WheelchairJuck.com, CareCure Forum and Korea Spinal Cord Injury Cybercenter. Because the principle investigator of this study, Dr. Kim, is a member of these internet communities, he could access this population. The questionnaires and survey procedure was approved by the Internal Review Board of the University of Pittsburgh (IRB approval number: PRO07070082). The participation in the survey was voluntary and participants were not paid for their participation.

RESULTS

105 persons visited our on-line survey web page and we received 97 responses that completed the survey during 44 days. Most responders were very enthusiastic to answer the questionnaire.

84% of responders were people with spinal cord injury (SCI) because we contacted the internet communities which are popular to people with SCI. 58% were quadriplegic and 60% could neither move their fingers nor grip with their hands. 59% were not able to control their trunk and 8% were unable to use their necks. 45% of responded that they are employed (this includes self-employment) and 58% of employed responders worked at home. While only 14% said they were students, 30% wanted to attend classes to improve their quality of life and 25% had the educational goal to earn a college degree. 41% were using a manual wheelchair, 74% power wheelchair, and 15% both of manual and power wheelchair. One of four responders had a tray on the wheelchair. 

As for the health-monitoring issues, currently 81% of responders see a doctor more than once a year, 51% at least every three months, and 27% more than once a month. The greatest number of responders wanted to monitor their Blood Pressure (68%) and Weight (65%) followed by Blood Sugar (36%), Pulse (33%), Temperature (33%), Blood Oxygen (23%), Peak Flow (21%), Fluid Status(19%), and ECG(11%). Some responders added the need to monitor Urinary Tract Infections, Skin Integrity, and Cholesterol. Only one person answered that he was monitoring his medical index via a tele-health system and 33% of responders have contacted a physician, rehab specialist, or other medical service provider using a computer system. 

Every responder indicated familiarity and experience with computers and using the internet. The fact that we used an on-line survey attributes to this high level of computer usage result. Many responders said they were using a Music Player, Digital Camera, External Hard-drive, and/or Web-cam with the computer. 

Although the predominant pointing device was the mouse (60%), the responses showed that they were using very diverse kinds of adaptive pointing devices: Track ball(26%), Touch-screen (10%), Sip-puff, Head Mounted Stick, Eye-gazing, Switches, Touch Pad, Voice Recognition, Quadjoy, Head Tracker, Mouth stick with keyboard mouse, and Wireless mouse. As we can expect, the standard keyboard was used at the highest usage rate (70%) as the text entry device. Voice Input(18%), Screen Keyboard (16%), and Small Keyboard (14%) followed it. And specially adapted key entry devices such as EdgeWrite, Chopstick with BlueTac on tip, Typing Stick, Wireless Keyboard, Screen Magnifier, Ergonomically Styled Programmable Keyboard, and Ergoflex Split Keyboard also were reported. As for the output device, Speaker (73%) and Printer (69%) were used by many wheelchair users in addition to Monitor(86%).

33% carried a laptop when they traveled and 47% have used the laptop on the wheelchair. For the question of “Which of the following are obstacles that you face when trying to use the laptop from your wheelchair?”, their responses were ranked as follows: 

  1. To plug in the power connection (79%)
  2. To take out the laptop from your backpack or storage area (71%)
  3. To access the table (63%)
  4. To deploy and open the computer (58%)
  5. To use the pointing device (56%)
  6. Plug in the internet connection (45%)
  7. To use the keyboard (40%)
  8. To adjust the monitor angle and position (34%)
  9. To turn on the computer (29%)

Other reported obstacles were: inability to see screen outside; keeping it balanced on lap; plugging in peripherals; laptop keyboard not as user friendly as a desktop.

66% of laptop users and 68% of desktop users answered that they would pay morefor a wheelchair worn computer instead of a laptop or desktop if the PC was built into their chair andeasy to use. A third of responders did not. Accordingly, 76% agreed that this wheelchair-worn computing system would benefit them personally while 24% did not think it would. Oneof the central reasons for the negative responses was that the current PC is already more expensive than they can easily afford. 66% of positive responders were willing to paythe same price as a laptop and 22% at the double price as a laptop, but only one person responded at triple price and curiously 10% were willing to pay the unlimited amount of money. One impressive response was as follows: Yes - ever since my accident it has proven very difficult for me to continue to use my current laptop due to all of the reasons you state above and more.  I would be willing to pay more for a wheelchair worn laptop, since it sounds like I could be more productive at work, it would save me time and I would be less frustrated and more motivated to work. It would be worth its weight in GOLD!!!!!!!

As the last question, we asked the participants what features must be considered as the top priority for the development of this system. We can list the features inorder of highest to lowest responses as follows:

  1. Ease to retrieve (73%)
  2. Convenient Input device (73%)
  3. Durableness/Toughness (69%)
  4. Price (65%)
  5. Outdoor usage (53%)
  6. Ease to hide (52%)
  7. Powerful computing ability (51%)
  8. Convenient Output device (45%)
  9. Environmental protection (41%)
  10. Appearance (25%)

DISCUSSION

       We have demonstrated the need for a wheelchair-worn computing and health-monitoring system with this survey research. The survey study suggested us that the system should have at least the following 5 features: 1) Ease of retrieval and hiding the input/output unit; 2) Durable and weather protective; 3) Outdoor usage; 4) Powerful computing ability; 5) Embedded weight scale. 

Our survey study revealed that wheelchair users would like to have a way to easily measure their weight (65% of responders indicated as such). Weight management is one of most important facets of health monitoring for power-wheelchair users; however, mosthave limited opportunities to exercise and it is not easy to weigh themselves at home. Our solution is to integrate load cells under the seat pan of the wheelchair and integrate a body weight monitor into the wheelchair-worn computer system. Then weight also would be able to be  monitoredefficiently.

REFERENCES

  1. Steinmetz, Erika. "Americans With Disabilities: 2002." House Hold Economic Studies (2006): 1-3.
  2. R. A. Cooper and R. Cooper, “Trends and issues in wheele d mobility technologies”, Retrieved Oct. 17. 2006, from  h ttp://www.ap.buffalo.edu/idea/space%20workshop/Papers/ WEB%20%20Trends_Iss_WC%20(Cooper).htm.
  3. H. Kaye, “Computer and Internet Use Among People with Disabilities. Disability Statistics Report (13),” U.S. Department of Education, National Institute on Disability and Rehabilitation Research. 2003.

 

ACKNOWLEDGMENTS

The survey study was created and administered with the help of Patrick Smith during a summer internship program which was supported by the National Science Foundation and the National Institute of Disability and Rehabilitation Research.

Author Contact Information:

Jongbae Kim, PhD, University of Pittsburgh, 2310 Jane Street, Pittsburgh, PA, 15203. Office Phone (412) 586-6909  E-mail: jbkim@pitt.edu