Structures promoting research, training, and technology transfer in mobility: lessons learned from a visit to European centers

Over 40 million Americans live with a disability. According to the 2007 IOM report on disability, disability in the form of limited activities and restricted participation in social life is not an unavoidable result of injury and chronic disease [1]. It results, in part, from choices society makes about working conditions, health care, transportation, housing, and other aspects of our environment. This is a powerful statement that places the cause of disability on society. According to the ICF model [2], disability results form an interaction between an individual and their environment. Technology for mobility can be a very important mediator of this interaction. A simple example is the well accepted assistive technology for mobility, the wheelchair. In its simplest form, the wheelchair enables an individual who cannot walk to travel from point A to point B. For the task of going from point A to B in an airport, this technology is nearly perfect. However, for getting on the airplane, it fails. The chair will not fit down the aisle and a transfer is needed to get out of the chair and into an airplane seat.Could additional technology solve this problem in a way that is seamless to the wheelchair user? The answer is undoubtedly yes; however, the technology that enables an individual with lower limb paralysis to transfer into an airplane seat does not exist. One could easily argue that with existing materials a device could easily be fabricated, so why don't we have such a device? One answer is that society has not chosen to invest the money needed to provide true accessibility. While this answer is true, the other truth is that groups are needed that have the will and expertise to focus on fixing this and the myriad of problems faced by individuals with mobility impairment. At present there is a shortage of well trained researchers working on these problems [3]. This shortage has been recognized by major research funding agencies in the United States who have set up va