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Barbara Meyers’ life changed overnight when she suffered a spinal stroke in October 2006.

Less than 24 hours after feeling a sharp pain in her back while working on a routine redecorating project in her Maitland home, the athletic 47-year-old wife, mother and household taskmaster lay immobile in a hospital bed, paralyzed below the chest. A week at home, she was resigned to coping with the limitations and frustrations of using a wheelchair.

Then, following six months of physical therapy, rehabilitation and support group counseling at several healthcare facilities, another event changed her life overnight: Meyers left Orlando Regional Healthcare’s Rehabilitation Institute in a computerized wheelchair that gives her the mobility and self-sufficiency longed for by those paralyzed by spinal cord injuries.

The ORHC Rehabilitation Institute recently was selected as the third evaluation site in Florida to train wheelchair users on the iBOT® 4000, a second-generation mobility system that enables users to climb or descend stairs without assistance, rise to eye-level with standing adults, and traverse rough terrain, including grass, gravel and even sand, without losing balance or becoming over-exerted. The other evaluation centers in Florida are in Tampa and Miami.

There are only 58 such sites in the United States and 17 of those are Veterans Administration facilities, according to Gregg Howard, vice president of sales and reimbursement with Independence Technology. IT is a subsidiary of Johnson & Johnson, which developed the iBOT® with Dean Kamen, founder of DEKA Research and Development and pioneer of the Segway stand-up urban transport.

According to the manufacturer, iBOT® technology is based on “an integrated combination of sensor and software components that work together to mimic the principles of human balance. (It) is custom-programmed and calibrated to the user’s center of gravity, allowing the device to stabilize the user by realigning and adjusting the wheel position and seat orientation.’’

Think computerized gyroscopes guided by electronic sensors.

By all accounts, the device, first marketed in 2003 and upgraded twice since then, has transformed the mobility equipment industry. That assessment is substantiated by Dr. David Portee, medical director of ORHC’s Rehabilitation Institute since 1996.

“It’s just amazing,’’ said Portee. “It’s incredible for people in wheelchairs to be able to go up and down stairs, or rise up to eye level. It is quite revolutionary,’’ he said.

Portee said he saw the iBOT® “at a demonstration and then made contact with (Independence Technology) to see what I could do to bring it to Orlando. We provided them the therapists who are trained to evaluate the patients for appropriateness, and the space to actually do the testing at one of our outpatient clinics.”

That facility is at ORHC’s Lucerne hospital, where outpatient rehabilitation manager and physical therapist Rob Olsen oversees the assessment process, known as pre-qualification screening, for potential iBOT® owners.

The training “takes about two hours, and once their chair is delivered, it takes about eight hours more training,’’ Olsen said.

“PTs figure out what is best for the patients and have ultimate say about who qualifies to use an iBOT®,’’ Olsen said. However, not everyone who qualifies on the iBOT, or even most who do, winds up driving one, he said.

As of late August, Olsen said his staff of four PTs has “tested 32 potential iBOT® users and only three have bought the chair.’’

That is partly because some simply can’t afford it.

The second generation iBOT® costs $23,900, according to Howard. That price is down from $29,000 in 2004, but still is less than some manufacturers’ mobility systems, which Howard said are upward of $35,000.

“The iBOT® is at the premium end, but not the high end, of the market,’’ he said.

Insurance plans vary widely among those who purchase the iBOT®, but Howard said nearly half of their consumers had gotten some type of reimbursement. That exceeds projections made by the company four years ago of 25 percent insurance coverage, he said, adding “and we’re pretty happy with that.’’

Still, most consumers are paying cash. For example, Meyers’ insurance coverage topped out at $2,500 per calendar year, which wasn’t even enough to cover the $5,600 cost of her push wheelchair. She was fortunate that her husband’s business partner and close friend, Tom Oyler, made the iBOT® a very generous gift for her.

But cost is not the only limitation for potential iBOT® users.

Patients must demonstrate that they “have the mental agility’’ to operate the chair, Portee said. After referral from a physician and confirming the appropriate diagnosis, “they have to do a cognitive screening as well,’’ he said. “You have to have certain ability to reason and respond and retain. You just don’t put anyone in (a powered wheelchair) and tell them ‘Have at it.’ They could hurt themselves or somebody else.’’

Portee said operating the iBOT® requires “eye-hand coordination and judgment, and knowing when it is safe to use the chair in its various modes. For example, they must be able to manipulate a joystick and push a number of buttons in the right sequence to get it to do what it is supposed to do. They have to have a certain amount of strength, and the ability to reason, retain and make sound decisions.’’

Meyers exceeded that profile, Portee said.

“She was a very viable, active, engaged woman,’’ he said, admiring her resilience. “For her, (the iBOT®) has really opened up a lot of doors and restored a lot of abilities,’’ he said.

After three months in the iBOT®, Meyers said one of the best features is her ability to rise up and look people in the eye. “The best thing you can do for a person in a wheelchair is to come down to their level,’’ she said. “Looking up at everybody is a pain in the neck, literally and figuratively. But being able to see eye-to-eye is so much more comfortable and natural.’’

Meyers said she is helping to spread the word about the iBOT® because “I want people to know that if they know someone who needs it they should try to start a fundraiser’’ to help them pay for it.

“It is expensive, but it’s special,’’ she said.

“It really has changed my life.’’



October 2007

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