I recall when I first heard about the Johnson & Johnson iBOT stair-climbing
wheelchair. I was working at a motorcycle industry magazine at the time,
so I knew something about wheels, but nothing about wheelchairs. I saw a
video clip of the iBOT climbing stairs and thought, “What a great innovation.”

Months later, I became editor of a new publication named Mobility
Management, and my perspective changed about a lot of things, including
how important it was, all things considered, for a
wheelchair to climb stairs.

Earlier this year, iBOT, discontinued years ago,
was revived via a promised collaboration with
Toyota. iBOT is back in the news, and recently,
NPR did a story that discussed iBOT as well as
walking exoskeletons.

The story was for mainstream readers and
therefore pretty basic. A veteran with quadriplegia
described how he valued being able to visit friends’ homes that have
steps or stairs, and how great it is to talk to people face to face (a relatively
under-discussed iBOT ability is seat elevation). Then a pair of physicians
who’ve studied the longer-term effects of paralysis sort of downplayed seat
elevation to tout the supposedly greater benefits of walking.

More informed during iBOT’s second go-round, I had two thoughts about
the NPR report:

• The benefits of walking as described in the story — improved respiration,
  digestion, bowel and bladder function — are also benefits of standing. While
  a limited number of wheelchair users can walk via exoskeleton, a relatively
  high number can successfully stand via a standing device.
• Is climbing stairs — or walking — truly the highest priority for most
  wheelchair
  users?

A researcher at the University of California, San Francisco, believes not.
After studying surveys completed by wheelchair users with spinal cord
injuries
(SCI), Linda Noble-Haeusslein, Ph.D., and her colleagues chose to
focus on trying to restore bowel and bladder function and reduce chronic
pain, because those were the top priorities listed in the surveys. If you’re in
debilitating pain, if bowel and bladder accidents are a constant worry, how
much less active will your days be? How often will those worries confine you?

Everyone is different, so surely some wheelchair users do value stair
climbing or walking above all other abilities. Fair enough. But I also think
Dr. Noble-Haeusslein is likely right: Researchers, engineers and inventors
might assume that wheelchair users yearn to walk above all else simply
because that inability is clearly visible.

Maybe this is a reminder that as technology continues to level the playing
field for people with disabilities, clinicians and engineers need to keep
talking to consumers. There are many forms of mobility, from standing to
walking to climbing stairs, and they all have value. Sometimes, the clinical
benefit that first springs to mind or the physical limitation that is most visible
isn’t what’s most important to the client in front of us. But we could find out
if we ask.