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Open Minds Exhibition: Grit Leveraged Freedom Chair (interview)

April 6th, 2012 Justin Barad Exclusive, Rehab

The classic wheelchair is a well-known device and is very functional for people with basic mobility needs. Using hand propelled wheels is relatively straight-forward, for the most part, for people to go about their daily business. However, in some developing countries where paved streets and sidewalks are in the form of rocky terrain, hills and muddy roads, the basic wheelchair design suddenly starts showing its shortcomings. This observation is what led Amos Winter and his team at MIT to bring from concept to product the Grit Leveraged Freedom chair, a lever powered wheelchair. The rider can adjust the mechanical advantage by moving hands up and down the levers powering the wheelchair, allowing them to easily work in different terrain. In addition, the wheelchair is made from basic bicycle parts allowing for easy maintenance and repair.

We had a chance to ask Benjamin Judge from the team some questions about their product.

Justin Barad, MD, Medgadget: What gave you the idea to come up with this concept?

In 2005 Amos Winter, then a graduate student at MIT, traveled to Tanzania as part of an internship with Whirlwind Wheelchair International, a group that works with wheelchair riders around the world to design appropriate mobility aids. Amos wanted to understand how people who needed wheelchairs got around and how well current wheelchair technology met peoples’ mobility needs. What he quickly learned was that people in wheelchairs often could not travel where they needed to go. Individuals must cope with narrow doorways, steep hills, bumpy, muddy roads and long distances to destinations like school and work. All of these issues make it extremely difficult to get anywhere with a conventional wheelchair. The other existing option in developing countries is the hand-powered tricycle, but it’s too large for indoor use and too heavy to maneuver over rough terrain. Our team set about designing a wheelchair that would allow users to both travel long distances over rough terrain and also navigate indoor spaces. The product should empower users to independently travel where they want to go, allowing them to access resources and employment. And most importantly, it should be affordable.

Like a mountain bike, this new wheelchair had to have a large range of mechanical advantage; a low gear for traveling up hills and through mud and a high gear for traveling on smooth, flat ground. Amos realized that a lever grasped at different positions changes the effective lever length and creates the type of mechanical advantage needed.

Medgadget: What’s the make-up of your team?

The LFC was developed through the MIT Mobility Lab, which Amos created in 2007. The core team joined the project during their studies in MIT’s Department of Mechanical Engineering. The team has collaborated closely with wheelchair manufacturers and riders throughout the development of the LFC, engaging them in the design process. The team recently founded a non-profit, Global Research Innovation and Technology (GRIT), to manage the scale-up and distribution of the LFC. The GRIT team represents the core designers of Mobility Lab technology, all of whom have spent extensive time abroad to develop and field-test the LFC and were all MechE students in Amos’ wheelchair design program. They have 19 years of collective experience working as a team in the space.

Main team members:

Mario Bollini- Second year graduate student in mechanical engineering focusing on robotics in MIT’s Computer Science and Artificial Intelligence Laboratory. Mario has been working on wheelchair technology projects since 2007, developing much of the LFC’s intellectual property. He will be joining GRIT in the summer of 2012 as the Director of Engineering.

Ben Judge- MIT grad student in manufacturing. His SB mechanical engineering thesis on a US LFC design and market viability of the LFC United States and other developed countries. Ben has been leveraging an ongoing relationship with Continuum Design to explore wheelchair concepts and will be establishing collaborations on the project with bicycle and wheelchair component manufacturers as he continues the product development research with the support of the Singapore University of Technology and Design (SUTD).

Tish Scolnik- currently the Executive Director of GRIT, a nonprofit startup that aims to improve the quality of life for people around the world by bridging the gap between innovation in academia and implementation in the real world. She graduated from MIT in 2010 with an SB in Mechanical Engineering and a minor in Applied International Studies. While at MIT she made four trips to East Africa where she worked with local wheelchair technicians to help them improve their designs such they better meet user needs. She has previously worked at the World Bank and the US Department of Health and Human Services.

Amos Winter- founded the Mobility Lab upon his initial survey of wheelchair technology in East Africa. He has authored LFC academic papers and is completing his post-doctoral research and conducting field trials of the LFC in India in 2012. Amos will soon be joining MIT Mechanical Engineering Faculty and will lead a lab focusing on design for highly constrained environments, with a particular focus on emerging markets. He plans to facilitate the transition of his market viable research to be further developed by GRIT.

There are also countless others that have helped in various capacities to keep the LFC project going and now supporting GRIT as it gets off the ground.

Medgadget: What was the biggest obstacle you have faced so far trying to make this concept a reality?

The biggest challenge we are facing is figuring out how to transition the LFC from an academic project to a viable product. In academia, we were rewarded for producing scholarly work, but in order to actually get the LFC into the hands of wheelchair riders across the globe, we need a whole different set of knowledge about manufacturing, intellectual property, distribution networks, and funding mechanisms. The research and development of the LFC was funded through a variety of academic sources, but these are not a viable long-term solution. We’re quickly learning how to run an actual organization; how to manage contracts, solicit donors, and build a strategy. With the founding of GRIT and the transition away from being a student group, we are on the right path, but dealing with growing pains. We currently have enough funding for only one full-time staff person, with other team members pitching in their spare time. We have big ambitions, but require additional funding and more manpower to make it happen. The lead time on grants can be significant, making it difficult to manage short-term cash needs. (We know that having experience struggling to get the LFC project implemented will give us the valueable knowledge in this space to take on new academic spin offs in the future – continuing the GRIT process.

Medgadget: What kind of user feedback have you gotten so far regarding your technology?

The LFC has progressed through four generations of iterative design and we have conducted three rounds of field trials on three continents. In 2009 we tested 6 chairs in East Africa (Kenya, Tanzania and Uganda). After four months of testing, biomechanical performance data was collected from the LFC riders. It illustrated that the chair was superior to existing mobility aids as far as rider efficiency and off-road performance, but still required refinement to be a viable product. The trial subjects identified that the LFC had to be narrower to fit indoors, lighter for transportation and more stable when climbing hills. Through the next year, we worked with community partners and stakeholders, principally with the Transitions Foundation of Guatemala and Antigua, to improve the design and prepare it for another user trial. A lighter, narrower chair was distributed for testing in Guatemala in 2010.

The final, pre-production trial of the LFC was completed in 2011 in India in collaboration with Jaipur Foot, the largest disability group in the world in terms of assistive device distribution. This trial verified the superiority of the LFC outdoors, showing it to be 75% faster than a conventional wheelchair on an average commute. Additionally, the streamlined size made it much easier to navigate indoors, with trial participants ranking it on par with conventional wheelchairs.

In the India trial, rural patients, who were previously using a standard wheelchair, had about 90% (10/11 patients) adoption rate. We saw drastic changes in quality of life, with most of these patients housebound before the LFC and now traveling 2-3km/day. Several have gained employment as a result of being able to travel in the LFC.

Medgadget: What kind of cost difference would there be between your technology and the currently available standard?

The LFC is being manufactured for the same cost as existing products, while offering greater capability. The LFC drivetrain is built from a simple, single-speed assembly of bicycle components. These bike parts are ubiquitous in developing countries, making it easy to maintain and repair the product, and contributing to its low cost.

Currently people have to choose between a hand-powered tricycle and a conventional push-rim wheelchair. The tricycle provides good mobility on long distances of flat terrain, but is too bulky to use indoors. The conventional wheelchair, while useful indoors, is inefficient for outdoor travel. And neither product performs well on hills or rough terrain. These products are typically charity-funded and cost about $150 per chair to the donor.

Of note:

While the LFC was designed for developing world users, many of the features of the LFC are of interest to manual wheelchair users in developed countries, too. US and European users have inquired about the product, citing the need for a versatile off-road device in their lives. In response, we have worked with Design Continuum to coneptualize a version of the LFC for the developed world market—the LFC Sport. Building upon the proven leveraged drivetrain of the original LFC, we are creating a mobility device that meets the unique demands of wheelchair users in developed countries. A US product concept is an interesting example of “trickle-up” engineering, using effective low cost mechanisms to decouples a user’s desire for more effective mobility from their need for insurance subsidy. It may even be offered at a price attractive enough for the user to pay for out-of-pocket as a complementary device. The LFC family would provide mobility for every terrain and every wallet in the world.

Link @ NCIIA: GRIT Leveraged Freedom Chair…

Justin Barad

Justin Barad is a board eligible pediatric orthopaedic surgeon. He did his fellowship at Boston Children's Hospital in the Harvard Combined Orthopaedic Surgery program and his residency at UCLA. He is also the Founder and CEO of Osso VR, a clinically validated surgical simulation platform. His interests include Virtual/Augmented Reality, robotics, surgical navigation and 3D Printing/Scanning, He is always looking to discuss the latest and greatest in medtech. He has been writing for Medgadget about medical technology since 2006 and also has several research publications and presentations.

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