Lay summary by Arman Mohseni
Edited by Rona Herzog and Crystal Han
This is a lay summary based on the research paper by Johanne Mattie, Jazzmin Tavares, Bryn Matheson, Emma Smith, Ian Denison, Dr. William C. Miller, Dr. Jaimie F. Borisoff. Read the original article here
Many products are emerging as motorized alternatives to manual wheelchairs. One of these products is a two-wheeled motorized mobility device known as the Nino®. The Nino features a small footprint, can turn on the spot, and relies on the user leaning forwards and backwards to brake and accelerate (i.e., Segway technology).
Given that conventional manual wheelchairs result in shoulder overuse injuries in 70% of users, in additional to many traditional motorized wheelchairs being bulky and resulting in some limitations for users when navigating in the community, the researchers wanted to investigate Nino® as an alternative mobility aid.
What was the purpose of the study?
This pilot study was intended to not only generate knowledge, but also to inform future studies of this kind regarding feasibility and design. This study focused on the comparison between the Nino® and other conventional manual wheelchairs. Specifically, the study focused on how the Nino® compared in terms of usability in performing wheelchair skills, user confidence while operating the Nino®, mental and physical demands of using the Nino®, and perceptions of the Nino®.
How was the study done?
This was a cross-sectional study with 12 adult participants ranging from the ages of 19-64. (A cross-sectional study measures participants at two specific points in time, as opposed to a longitudinal study which looks at participants over a period of time).
- All 12 participants were experienced manual wheelchair users, with an average of 22 years of experience operating a wheelchair
- The mental status of all participants was screened to ensure eligibility to participate in the study
- All participants received training on the Nino®, to ensure familiarity with the device
Participant performance was evaluated using four measures:
- The Wheelchair Skills Test: an obstacle course to be completed using the Nino® and using their own manual wheelchair
- The Wheelchair Use Confidence Scale: a written test that consists of items that are ranked on a 0-10 scale, which is an assessment of confidence while operating the devices
- The NASA-Task Load Index: a test for assessing how demanding a task is in six different domains: cognitive, physical, effort, frustration, time, and performance .
- A qualitative interview: conducted to ask participants about their perceptions and safety while operating the devices.
The experiment was conducted over two sessions, which were approximately two weeks apart:
- During the first session, participants were assessed while operating their own manual wheelchairs.
- During the second session, participants were assessed while operating the Nino®.
What were the results of the study?
On the Wheelchair Skills Test, participants performed significantly* better while using a manual wheelchair compared to the Nino®.
On the Wheelchair Use Confidence Scale,participants felt significantly* more confident using a manual wheelchair. However, their confidence rating for the Nino® did improve following training.
On the NASA-Task Load Index, the only domain where there was significant* difference between wheelchairs was cognitive load: it was significantly* higher in the Nino® as compared to the cognitive demand of a manual wheelchair.
The qualitative interviews revealed that most participants felt unsafe while braking, and that the Nino ® required a lot of focus to operate.
*all findings which were statistically significant
What is the importance of this study?
The findings imply that although the Nino® may have recreational uses, it seems to be unsuitable as a replacement for manual wheelchairs, because it requires a lot of focus from the operator during usage. Individuals who hope to use the Nino® in the community will likely require training.
Technologies like the Nino® are exciting for users and may prevent overuse injuries. However, without conducting studies such as this one, wheelchair users may overestimate the utility of a product and spend thousands of dollars acquiring that product before realizing that it may not suit their needs.
If you’re interested about the technical and safety aspects of the Nino® wheelchair, read this peer-reviewed conference paper here.
Nino®: A motorized, two-wheeled wheelchair that is gyroscopically stabilized like a segway.
Manual wheelchair: A human-powered wheelchair that has two small wheels in the front, and two large wheels which are pushed by the user