H.7 Fostering independence for manual wheelchair users with hemispatial neglect

At the Shepherd Center we serve individuals recovering from traumatic brain injury and stroke, a significant portion of which struggle with hemispatial neglect. Hemispatial neglect effectively reduces an individual’s ability to attend to objects on one side of their environment and might be seen with or without the presence of other sensory or visual impairments. As a result, their safety with mobility is significantly limited and these patients risk injury to hemiparetic extremities during wheelchair propulsion from colliding with obstacles on the side of hemispatial neglect. This results in increased burden of care for caregivers, decreased opportunities to practice wheelchair mobility skills outside of therapy, and overall decreased rate of progress towards independent mobility. 

There are current technologies available for individuals with visual or attention impairments for use on power wheelchairs. Devices such as blindspot monitors, including ones produced by Braze Mobility or LUCI Mobility, can alert power wheelchair users to upcoming obstacles. While this is helpful for power wheelchair users, much of our patient population in brain injury are unable to safely use power wheelchairs due to other cognitive or environmental limitations. I am not aware of any similar device that can be used on a manual wheelchair to alert the user of upcoming obstacles in visual fields they are unable to see or process effectively. To my knowledge, there is not a device that could be applied to a manual wheelchair, have an independent battery powered source, alert users of upcoming obstacles on the side of hemispatial neglect, and/or be capable of stopping the manual chair if the user does not heed to feedback provided. 

If such a device existed, we could decrease the risk of injury to hemiparetic limbs from colliding with environmental obstacles. This device could also decrease the burden of care for individuals providing for those with brain injury and hemispatial neglect. Ultimately, use of this device in our inpatient rehab setting could allow for more frequent and safe practice of wheelchair propulsion skills to expedite recovery of more independent mobility.