SIGNIFICANCE: Achieving independence and mobility are important treatment goals in occupational therapy. Innovative power wheelchair (PW) technology has the potential to provide independent mobility for a population that presently has none. This study tested an innovative method of driving PWs for individuals who are candidates for power mobility but whose impairments prevent them from operating commercial wheelchair controls. The device, referred to as the Self-referenced Personal Orthotic Omni-purpose Control Interface (SPOOCI), is worn by the user via a custom-formed orthosis as an alternative to mounting the joystick to the wheelchair frame. The orthosis can be worn on any body part. Thus, the user can operate the control from wherever his or her body is in space. SPOOCI is patented by the University of Florida, S. Hubbard Winker, and M. Rosen (U.S. Patent No. 8144655, 2012). Our hypothesis was that users will achieve greater independence in PW driving, as measured by the Power Mobility Program (PMP; Furumasu, Guerette, & Tefft, 1996), when using SPOOCI than when using a traditional joystick.

RESEARCH QUESTIONS: In this study, we attempted to answer the following research questions: How do individuals with severe motor impairment describe their experience of being in a research study? How do individuals with severe motor impairment describe their experience using SPOOCI?

METHOD: Individuals with severe motor impairment of the upper quadrants are limited in their use of technology (e.g., PWs, computers, and alternative and augmentative communication devices; Furumasu et al., 1996). Most existing interfaces to PWs require either upper-extremity or head control, ruling out standard interfaces for this population. Without independent mobility, this population has increased caregiver needs. Using a repeated-measures and mixed-measures design, quantitative data were collected before and after the 12-wk intervention. Qualitative data were collected postintervention. Data were collected during regularly scheduled outpatient therapy sessions at Shands Magnolia Park in Gainesville, Florida.

Potential subjects were informed about the study by their therapists. Five individuals aged more than 2 yr and candidates for PW use but who could not drive a PW both independently and safely were enrolled. Subjects were provided with a PW custom-fitted by an interdisciplinary team for the study. The PMP was to measure PW driving independence. Semistructured interviews (audio-recorded) were used to collect qualitative data. Descriptive methods were used to analyze quantitative data. Semistructured interviews were transcribed. Data were coded to identify themes. Mixed methods were used to corroborate quantitative and qualitative findings.

RESULTS: Four out of the five subjects completed the study. The change in PMP scores when using SPOOCI ranged from 9 to 44 compared to −3 to 26 when using the traditional joystick (a higher score indicates increased independence). Two qualitative themes emerged regardless of which controller the subject preferred: When the subjects used the custom wheelchair, their driving performance improved, and participation in the research study was “fun.” Individuals with severe disabilities can drive a PW more independently using SPOOCI than a traditional joystick. The SPOOCI prototype interface design will be improved prior to a subsequent study. Limitations included a small sample size; furthermore, because a prototype rather than a product was being tested, initially, it broke frequently.

Furumasu, J., Guerette, P., & Tefft, D. (1996). The development of a powered wheelchair mobility program for young children. Technology and Disability, 5, 41–48. http://dx.doi.org/10.3233/TAD-1996-5106