Yasuhiko Nakamura
Japan Abilities Association, NPO

Introduction

From 20 April 2021, a new shinkansen (“bullet train”) carriage equipped with six spaces for wheelchair use (N700S) went into operation. In October 2020, the Standards for Promoting Easily Accessible Public Transportation, which are based on the Barrier-free Act, were amended, introducing a duty to provide wheelchair spaces according to the number of seats on the train. In addition, from April 2018, the regulations concerning the use of electric wheelchairs with handlebars known as mobility scooters (“senior cars” in Japanese) were substantially loosened, leading to hopes that opportunities will grow for people with physical disabilities to go anywhere safely and comfortably. In this article, I will introduce the latest devices supporting the mobility of people with physical disabilities. 

1. Turning “manual wheelchairs” into “electric wheelchairs”

Electric wheelchairs with handlebars are often seen around the town. For people who previously had driving licenses, it is easy to operate them with a lever, and they are used mainly by the elderly. However, the electric wheelchairs with handlebars which are on the market cannot be adapted to the user’s physical condition. The seat, backrest, and so are installed in a set configuration, which is not necessarily comfortable for people with physical disabilities. Moving around in a seat which does not fit one’s body is painful, and leads to deterioration of posture and the appearance of pressure sores. Given this, I will introduce mobility devices which can move the wheelchairs which people are accustomed to using with a small amount of power.

(1) Modification to electric wheelchairs with handlebars

Devices which attach a set of electric wheels together with a handlebar (hereinafter, “a hand bike”) to a regular manual wheelchair, converting it into an electric wheelchair with a handlebar, are widely used overseas. They can be put on easily depending on the environment in which the wheelchair is used, such as indoors, around town, roads with sudden ups and downs, and so on. In this way, the range of mobility in a wheelchair suited to the user’s body can be extended.

Sunrise Medical International’s “Empulse F55” can be clipped onto a manual wheelchair in a one-touch operation, allowing it to be used as an electric wheelchair with handlebars. Fixed-position or swing-out foot supports can also be attached. It can go for about 25 km before needing to recharge the battery, and is extremely powerful, with a maximum user weight of 110 kg. The apparatus, including the battery, weighs around 13 kg, and it can be detached from the wheelchair in order to load them separately into a car. It is also possible to set the maximum speed, for example to conform to the maximum under Japanese regulations, 6 km/ hour. The biggest problem for such equipment has been the overall length of the wheelchair, but by using 8.5-inch (roughly 21.6-cm) wheels, the overall length has been reduced. At present, it is only on sale overseas, but Sunrise Medical Japan are moving ahead with studies with a view to putting it on sale in Japan.

(2) Modification to electric wheelchairs with joysticks

North Medico’s “Rin” is one of the devices which can turn a wheelchair into an electric wheelchair with a joystick. The wheels of the user’s manual wheelchair are replaced with wheels which have a built-in drive motor and battery (patent pending). By also retrofitting it with the accompanying joystick-type controller, it becomes an electric wheelchair. It is equipped with unique spring wheels (patent pending), which reduce the vibrations reaching the user from the road surface. Moreover, it can be connected to a smartphone using Bluetooth, allowing a carer to control it. It can go for about 15 km before needing to recharge the battery, and can climb inclines of a maximum of 10 degrees. The combined weight of the main unit, battery, control unit, and anti-tip bar is around 24 kg, and so the total weight with a wheelchair is around 30kg, depending on the chair to which it is attached. North Medico are moving ahead with preparations for mass production and sales.     

2. Making manual wheelchairs more active

Turning the wheels of a manual wheelchair needs greater arm strength than you would imagine. The wheels can be turned using little force on level ground, but once you go outside, there are inclines everywhere, such as between the pavement and the road, or the slopes which bypass steps at the entrances of buildings. In areas with a lot of ups and downs, this can be a major hurdle for users of manual wheelchairs. However, if they switch to an electric wheelchair for this reason, maneuvering indoors becomes difficult, and it may become impossible to load the wheelchair when travelling by car.

The “NuDrive” from Denmark’s Langhoej can be attached to the wheels of a manual wheelchair in a one-touch operation, enabling the user to turn the wheels using less force by operating a lever. Gripping the lever and pushing it in an arc requires around 50% of the force needed to grip the hand rims and turn the wheels. It uses a ratchet structure in which the drive force is transmitted to the wheels only when the lever is pushed forwards, and squeezing it inward puts on the brakes. Once the user has pushed the lever outwards, the device goes into neutral mode, used when reversing, for instance. Since the lever and fittings used to secure it can be attached in a one-touch operation, it can be disassembled and loaded into a car. It is available for 22-inch and 24-inch wheels.  

3. Enabling people to get to the places they want to go

Public transport is becoming more and more accessible, and opportunities for people with physical disabilities to go anywhere are increasing. Wheelchair-accessible taxis and a system for the provision of paid transportation services for people with diverse needs have become established in Japan, and the introduction to regular taxi fleets of vehicles accessible to all is also moving ahead. However, even now, many vehicles with a slope cannot carry large electric wheelchairs due to the problem of load limits.

The Caddy Maxi from Italy’s Focaccia Group, a vehicle customisation company, is a lowered-floor model which is equipped with a sturdy ramp with a maximum load of 300 kg. This allows even a large electric wheelchair to be loaded safely. The interior of the car is very roomy, and it is fitted with an extremely safe locking device for wheelchairs which has obtained an ISO Standard, and can be used to fix wheelchairs of various shapes. The car is a customised Volkswagen Caddy (parallel import only. Not carried by authorised dealers). Such vehicles are used overseas as taxis, hotel shuttle cars, and even by private owners as a matter of course, ensuring the right to freedom of movement.   

Conclusion

Many mobility support devices like these are being developed around the world. However, the legislation and standards in Japan impact the situation here, making it hard for them to become common. In many cases, affixing a support device makes a wheelchair exceed the limits on dimensions or speed, meaning that it is no longer possible to ride on the pavement. In order for these support devices to become widespread, a revision of the legislation and standards is needed alongside safety tests.