Beware the Wheelchair Performance Gap – Erik Kondo

Dealing with stairs in Malta.

In the active wheelchair world, there are a lot of people looking to obtain or create a device that makes using a manual wheelchair easier. Where “easier” is defined as the ability to move farther and faster, more comfortably navigate rough sidewalks and slide slopes, jump higher curbs, deal with steps and stairs, open doors, and more, all with less effort. The technological advances in motorized electrical devices and assists are slowly filtering down to wheelchairs. But existing devices are costly. The popular SmartDrive costs in excess of $6,000. It, like the other existing wheelchair assist devices, has limited functionality and multiple drawbacks.

But what if an improvement solution already exists? What if this solution doesn’t require adding significant weight to the person’s wheelchair? What if it doesn’t depend upon technology that is subject to malfunction and failure? What if it was cheap to implement and to maintain? What if this solution wouldn’t interfere with (and would enhance) other future wheelchair developments and attachments? Yes, it sounds like the perfect solution. Something that is too good to be true. But it is true. It does exist and the majority of manual wheelchair users are missing out on it.

It’s not their fault. How would wheelchair users, particularly those new to using them, know that there is a way they could make their wheelchair perform better, if nobody tells them about it? They are naturally going to assume that the difficulties and frustrations that they feel using their wheelchairs day to day are the inescapable aspects of wheelchair use. They have nothing better to compare it too. They, like the rest of society, have been told and firmly believe that using a wheelchair is always, and always will be hard, in all situations. That wheelchair use is the least desirable form of mobility bar none. That continual wheelchair use will inevitably result in overuse injuries. That shoulders can “be saved” simply by using them less as opposed to learning how to use them more effectively, engaging in proper conditioning, and knowing the movements to avoid.

Let’s think about bicyclists for a moment. Most bicyclists don’t bike that much, therefore let’s focus on the ones that do. The ones that bike each and every day. They bike to work, for pleasure, for competition. They are constantly using their bicycles and they know bikes. Their bikes are setup perfectly for them.

Over their cycling lives, they have experimented with many different types of bikes. They have tried countless setups and variations. They are constantly investigating and tinkering to optimize their cycling ability and experience. They talk to others like themselves to share and compare notes and ideas. They don’t settle for low performance. The don’t ride bicycles that are too big, too heavy, with the wrong wheel sizes and tires for their use. When something isn’t working right, they know it and fix it. The don’t settle for sub-par equipment and performance.

Now ponder this idea. Wheelchair users have more at stake than cycling enthusiasts when it comes to mobility performance. Cyclists ride bikes because they want to. Wheelchair users ride wheelchairs because they have to use them to get around.  Which one has more to lose in life by engaging in poor performance?

Wait. Did I just imply that some wheelchair users could be described as having “poor performance”? Let me rephrase that – poor performance relative to what they are capable of, assuming that their wheelchair was properly optimized, they had acquired the requisite skills, and they were in reasonably decent physical condition relative to their disability. The fact that I have to clarify my phrasing is indicative of the problem. There are no standards for performance for everyday wheelchair use. There are minimal expectations of competence. How can that be? Well, every wheelchair user is different, so one person can’t be compared to another, right?

Let’s face it. We compare people to each other all the time. In all sorts of ways. Much of getting ahead in life involves establishing your worth and competence so you get selected from the crowd. There is a big difference between comparing people on an absolute basis and comparing them on a relative basis. A small person can be considered to be strong even if he or she can lift less weight than a larger person. But if that same person could only lift less weight than other even smaller people, then he or she would be considered weak. 

Actually, this comparative assessment only happens when the person is able-bodied. Comparing standards for able-bodied people are everywhere. Not so for people with disabilities. Why is this the case? In my opinion, it is because society doesn’t believe that people with disabilities can handle the truth. It could potentially damage their self-esteem. And, it’s not “fair” to assess a person with a disability. There are too many disabilities, too many variations, too much chance of hurting someone feelings. Therefore, the safest course of action is to not have standards and valid assessments.

The lack of comparative standards leads to low expectations of wheelchair users in both their minds and also in the view of society. Competitive sports, such as the Paralympics produce increasing levels of absolute performance. Are the Paralympics fair? In my opinion, they are not. Competitors with the least disability in any given category have a huge advantage over their competition. While the result of who wins a medal in any given race may not be fair, the effect of comparative competition is to raise the level of performance for all involved.

By now it should be obvious that my solution to improving wheelchair performance is not some innovative device that the user can attach to his or her wheelchair. The device already exists. It is the wheelchair user him or herself. Unlike typical cycling enthusiasts who have likely maximized their bicycles’ optimization, riding technique and conditioning, most wheelchair users have lots of room for improvement in the areas of wheelchair setup/optimization, wheelchair skills, and physical conditioning. I call this the Wheelchair Performance Gap (WPG).

I believe, based on my extensive observation and interaction with countless active wheelchair users over decades, that there is a large performance gap between what most active wheelchair users can currently do and what they are ultimately capable of doing. Since this Wheelchair Performance Gap centers around personal mobility, it negatively effects many mobility dependent areas of wheelchair users’ lives.

We are constantly hearing hype about the next new mobility device that will change the lives of wheelchair users for the better. This hypothetical device invariably does more, so the wheelchair user can do less, think less, and control less. After wheelchair users have shrunk the WPG to a minimal amount, then innovation will likely create the greatest improvement. But given the large Wheelchair Performance Gap that currently exists, the most efficient and cost effective method to improve the lives of wheelchair users, as a whole, is by systemically optimizing wheelchairs, training wheelchair skills, and enabling them to be involved in physical conditioning.

The Wheelchair Performance Gap