A wheelchair first

2002-11-21 11:30

Maryland - Stairs soon may no longer be insurmountable obstacles for some wheelchair users.

The first wheelchair that can climb stairs - plus scoot up a grassy hill and even elevate its occupant for eye-level conversation - took a major step toward the market on Wednesday as advisers to the Food and Drug Administration unanimously recommended it be allowed to sell.

But the panel backed a few limitations on the Independence iBOT 3000 Mobility System - which uses sensors and gyroscopes to balance on two wheels and navigate stairs - including that it sell only with a doctor's prescription and strict training to ensure users can drive it safely.

The FDA isn't bound by its advisers' recommendations, but usually follows them. It granted the iBOT a special fast-track review, meaning a decision could come in a few months.

Features

How does it climb? Most wheelchairs have two big back wheels and two smaller front wheels. The iBOT has four wheels the same size that rotate up and over one another to go up and down steps.

Inventor Dean Kamen created the iBOT, and says wheelchair users tell him another feature is as appealing: The chair lifts onto two wheels so that its occupant, although still sitting, is elevated enough to reach high bookshelves and carry on eye-level conversations with people standing nearby.

"One reason I built it was to let people stand up," said Kamen, who licensed the iBOT to Johnson & Johnson. "We treat a lot of adults like children because they can't stand up."

"I wanted to take it home and keep it," said Karl Barnard of Tilton, New Hampshire, who tested the iBOT.

Barnard, who lost use of his legs 25 years ago, has no stairs in his home but said he was impressed with the four-wheel drive that let him roll up hills and through gravel on his farm.

'A luxury item'

But with a predicted $29 000 price tag, Barnard (46) calls it "more a luxury item" that he probably wouldn't spring for until he's too old to push his manual wheelchair easily.

FDA advisers also cautioned that it's not for everyone.

Patients must have the use of at least one arm to operate the chair, moving it with a joystick and other controls, and so far it's built only for large teenagers and adults.

Also, it requires some exertion: Users lean forward or backward, directing the chair to climb up or down as it senses and adjusts to the person's centre of gravity. They must hold onto a stair rail to help guide it, although there is a feature that allows someone else to hold onto the chair back and assist the more severely disabled on stairs.

Pass a test

Sales will be strictly controlled, responded manufacturer Independence Technology, a Johnson & Johnson subsidiary. Doctors and rehabilitation therapists must undergo special training to prescribe the iBOT, and potential users would have to pass a test proving they can drive it safely before taking it home.

To prove iBOT works, 20 wheelchair users test-drove it for two weeks, allowing scientists to compare manoeuvrability, falls or other problems with their regular wheelchairs. They also took a road test, scooting up hills and over bumpy sidewalks, crossing curbs, reaching shelves and climbing stairs.

The patients performed most of the challenges more easily with the iBOT, said study leader Dr Heikki Uustal of New Jersey's Johnson Rehabilitation Institute. For example, everyone had to ask for help to reach a book atop a bookcase while in their own chairs, but merely pushed a button on the iBOT to slowly rise and reach it themselves.

Twelve patients could navigate stairs alone with the iBOT, while the rest used an assistant. In regular wheelchairs, two patients could literally bump their way down stairs, but no one could go up a single step.

Three people fell out of the iBOT and two fell out of their own wheelchairs during the study, suggesting the iBOT was as safe as today's technology.

The iBOT's $29,000 tab is less than some top-of-the-line models for the severely impaired, but far more than basic chairs. But Independence Technology president Jean-Luc Butel said the average cost for ramps, elevators and other home modifications for someone unable to walk is $40,000, expenditures largely unnecessary with the iBOT.

On the web:

Johnson & Johnson

US Food and Drug Administration

Sapa-AP

- SAPA