ECRI study reins in iBOT hype
August 30, 2004
PLYMOUTH MEETING, Pa. - Researchers at ECRI, an independent nonprofit health services research agency, have assessed the results of available studies of the iBOT, which is purported to offer increased benefits to power wheelchair users.
ECRI concluded that the iBOT has the potential to increase the quality of life for some physically disabled patients by offering novel capabilities in a powered wheelchair-like transport system. The available evidence on actual improvement attained by users, is, however, very limited.
The iBOT system closely resembles a conventional powered wheelchair, but instead of two main wheels, it has four. Users can control the iBOT as a conventional powered wheelchair or use its features to raise the seat to reach high objects or converse face-to-face with a standing adult. iBOT also affords the potential to scale curbs, travel on uneven terrain, and ascend or descend stairways - activities that are not possible in a traditional wheelchair.
Approximately 2.2 million people in the U.S. use wheelchairs; however, iBOT is only suitable for those wheelchair users who have the use of at least one arm, who weigh less than 250 lbs., who can sit upright, and who do not have any mental impairment that prevents their learning the safe operation of the iBOT system. Users must complete extensive training before purchasing and using an iBOT.
While the system offers special features intended to afford greater mobility, the limited evidence available indicated that using iBOT to maneuver in the home was more difficult than using it to maneuver in a community environment. Study participants also reported more operational and mechanical difficulties with the iBOT than with their own wheelchairs, but the extremely short duration of the study may not have afforded users ample time to become accustomed to using the device in their typical environments.
ECRI notes that one large issue with the iBOT is its high cost, lack of reimbursement by third-party payers, and the fact that users still need to have a traditional wheelchair as well. Developers of the iBOT state that they are seeking ways to make it more affordable.
The manufacturer asserts that the iBOT's versatility may enable some disabled individuals to avoid some of the other costs of modifying / renovating living space to accommodate their needs and offset the impact of its hefty price tag. No published evidence is available at this time to support this assertion.
ECRI concludes that larger and longer-term studies using more objective measures of patient independence - especially studies that examine changes in a user's employability as a result of iBOT - are needed to determine the benefits of the system relative to its cost. Also needed are studies reporting results of objective measures of the user's ability to be involved in his or her community as a result of iBOT use, and the effect of iBOT on improving the user's ability to perform daily living tasks (e.g. eating, toileting, bathing).
This 2004 iBOT mobility system report was published as part of ECRI's Web- based TARGET (Technology Assessment Resource Guide for Emerging Technologies(TM)). TARGET short-term evidence reports, offering clear, unbiased information on new drugs, devices, procedures, and services, are provided to members of ECRI's Health Technology Assessment Information Service (HTAIS) and Emerging Technology Services (ETS). To learn more about ECRI's TARGET database, visit http://www.ecri.org/.