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Published before final editing as: Assist Technol. 2025 Jul 23:1–6. doi: 10.1080/10400435.2025.2529921

Distance traveled by people using Permobil power wheelchairs based on large data analytics

Hanju Zhu a, Richard M Schein a, Gede Pramana a, Carla Nooijen b, Karin Leire b, Brad E Dicianno a,c,d, Mark R Schmeler a
PMCID: PMC12422865  NIHMSID: NIHMS2100057  PMID: 40699907

Abstract

Data logging technologies have been implemented in manual and power wheelchairs (PWCs) to measure device performance and user behaviors. Previous studies have investigated mean daily distance traveled in both types of wheelchairs, however, with small sample sizes and limited time frames. Permobil instrumented its PWCs with connectivity to continuously collect usage data. The purpose of this study was to analyze this dataset to calculate the mean daily distance traveled over the entire year of 2022 across a large sample of Permobil PWC users within the United States, compare the mean daily distance traveled and the number of use days among five wheelchair models, and to compare the mean daily distance traveled and the number of use days between PWC classifications (Group 3 and Group 4 PWCs). The study sample consisted of 3,058 Permobil PWCs across 5 models. Further reduced dataset for Group 3 and Group 4 devices comprised 2,615 wheelchairs. The results showed PWC users drove on average 1,365 m per day. Group 4 PWCs had a significantly higher mean daily distance traveled than Group 3 PWCs. PWCs were used on average 301 days in a year. Study results could inform scheduled maintenance, repairs, and replacements based on usage versus current indicator of device age.

Keywords: activities of daily living, assistive technology, rehabilitation, wheelchairs

Introduction

Wheelchairs are frequently prescribed to facilitate independent mobility (Arledge et al., 2011) and promote social participation of individuals with mobility limitations (Ferretti et al., 2022). According to the U.S. Census Bureau, approximately 5.5 million adults have had experience with using a wheelchair in the United States (Taylor, 2018). The utilization of power wheelchairs (PWCs) enables people with disabilities to maintain their independence in mobility (Pettersson et al., 2014; Stenberg et al., 2016) and further reduces burdens to people around them (Frank et al., 2010).

Historically, data logging technologies have been implemented in manual wheelchairs (MWCs). Earlier studies had already validated the feasibility of accelerometers on MWCs to measure arm propulsion, activity level, and wheelchair propulsion (Postma et al., 2005; Tajima et al., 1994; Washburn & Copay, 1999). These studies also discussed future opportunities of data logging technologies across real-world settings and broader types of activities, and to compare interventions and users. A study of 52 MWC users using a data logger (Tolerico et al., 2007) indicated an event that promoted active participation resulted in more travel distance and greater levels of activity as compared to a home environment. Investigators from the study also observed more physical exertion in MWC users who were employed compared to those who were not. The study further reported data logging technologies assisted in recording MWC performance and user activity. A scoping review (Routhier et al., 2018) reported data logging devices on MWCs have demonstrated the capability to measure discrete factors on wheelchairs such as maneuverability, operation time, travel distance, and speed, as well as user variables including heart rate. The review described additional clinical implications and outcomes as logging devices become more advanced, affordable, and routinely applied on wheelchairs.

Similarly, data logging technologies have also been implemented in PWCs. A study of 17 PWC users (Cooper et al., 2002) showed people had higher use of their PWCs when taking part in activity-promoting events versus staying at home. The study also highlighted data loggers supporting more assessment outcomes were needed in PWC performance such as battery consumption, turning time, and direction detection as well as in user behaviors such as differences in use across season/climate conditions. Another study of 25 PWC users (Sonenblum et al., 2008) reported data logging devices were able to measure variation in PWC use among different users, environments, and times. Another scoping review (Routhier et al., 2019) discussed research showing their applications for global positioning systems (GPS) and to measure the use of seat functions (such as tilt, recline, and seat elevation), pressure relieving activities, and time spent in the PWC.

Currently, some PWC manufacturers can provide information regarding wheelchair performance and user behaviors. Some PWCs are now equipped with GPS and remote monitoring whereby data transfer via cellular connections to the cloud servers offers an opportunity to measure device performance and user behaviors (Walls et al., 2022). Permobil (2021, 2024a), a global manufacturer of complex power wheelchairs, launched the “Connected Wheelchair” in 2018 and provided consumers, suppliers, and healthcare providers with cloud-based information on specific features and applications with respect to wheelchair performance and user behaviors. This includes, for example, battery status and distance traveled as well as the frequency, duration, and amount of powered seat usage. These data were also used and shared with researchers in a deidentified aggregate manner to investigate the use and performance of PWCs. A recent study (Gohlke & Kenyon, 2022) probed the data to measure utilization of power standing.

Mean daily distance traveled in both MWCs and PWCs has been explored and reported by several investigators. A study for one group of MWC users (Tolerico et al., 2007) found mean daily distance traveled was 2,457 m at home and 6,745 m in an activity-promoting environment. A similar study among two groups of PWC users (Cooper et al., 2002) showed those who participated in an activity-promoting event traveled on average 3,433 m per day as compared to on average 1,667 m per day for those who did not. A pilot study for children using wheelchairs (Cooper et al., 2008) reported mean daily distance traveled was 1,602 m for MWCs and 1,752 m for PWCs. Another study in an older population using MWCs (Karmarkar et al., 2010) found users who resided in nursing facilities affiliated with the Veterans Administration traveled on average 1,452 m per day using arm propulsion and on average 807 m per day using leg or combined arm and leg propulsion, while those living in private nursing facilities traveled on average 686 m per day using arm propulsion and on average 709 m per day using leg or combined arm and leg propulsion. A similar study focusing on MWC users ages 50 and older (Sakakibara et al., 2017) showed mean daily distance traveled was in the community. MWC users with a power assist option have been reported to travel on average 2,040 m per day (Levy et al., 2010). Ultra-lightweight MWC users in a study (Sonenblum & Sprigle, 2017) were discussed to travel on average 1,707 m per day. A study for MWC users with spinal cord injury (Oyster et al., 2011) showed mean daily distance traveled was 1,878 m, similar to research (Sonenblum et al., 2012) that showed MWC users traveled on average 1,953 m per day and another study (Sonenblum et al., 2008) that showed PWC users traveled on average 1,906 m per day. Another research investigating users with spinal cord injury who used either an MWC or a PWC (Cooper et al., 2011) discussed mean daily distance traveled was 3,374 m. However, these studies had relatively small sample sizes and collected data over a short-time frame, which coupled with distinct user environments and user profiles across these studies contributed to the variation in found mean daily distances traveled. It is also noted that when combining all findings of these studies PWC users had a slightly higher mean daily distance traveled than MWC users.

Objectives

The purpose of this study was to analyze a large dataset obtained from Permobil connected PWCs being used for an entire year by people in real-world settings within the United States. The primary objective was to compare mean daily distance traveled and number of use days among five wheelchair models. The secondary objective was to compare the mean daily distance traveled and the number of use days between PWC classifications (Group 3 and Group 4 PWCs).

Methods

Permobil connected power wheelchair

Permobil instrumented their PWCs with connectivity to continuously collect usage data, organize data in their fleet management platform, and store the data in cloud servers. Users are able to voluntarily set up an account in the MyPermobil app and consent to sharing their data in a deidentified manner. They can choose to opt in or out of either or both of the two data sharing options: one is sharing data for research, and the other is sharing data for product feedback. Shared data includes distance traveled from an odometer, actuator activity on seat functions, battery metrics, and service codes. GPS can be turned on or off; however, GPS data is not shared with the cloud. The Human Research Protection Office at the University of Pittsburgh determined that the study did not require an institutional review board protocol because the dataset contained no data about the users. Data use agreement made between the University of Pittsburgh and Permobil detailed the specific dataset shared and permitted appropriate collaboration to publish results in accordance with university policies.

Data variables

For each PWC, the following variables were calculated:

  • Total daily distances traveled (m) in 2022: defined as the summation of daily distances over 365 days

  • Mean daily distance traveled (m): defined as the total daily distances traveled divided by 365, which was the mean daily distance traveled at individual level, i.e., outcome variable name representing mean daily distance traveled across individuals; otherwise reported mean daily distance traveled was at group level to describe average daily use, i.e., the mean of mean daily distance traveled across user groups such as PWC models or classifications.

  • Number of use days: defined as the number of days during which the daily distance traveled was greater than 5 m.

Five wheelchair models were included:

  • front-wheel drive: F3 Corpus, F5 Corpus and F5 Corpus VS

  • mid-wheel drive: M3 Corpus and M5 Corpus

Based on product information (Permobil, 2024b) and Healthcare Common Procedure Coding System (HCPCS) codes (Centers for Medicare & Medicaid Services, 2024), models were classified as either Group 3 (F3 Corpus and M3 Corpus) or Group 4 (F5 Corpus and M5 Corpus). The F5 Corpus VS, equipped with a standing feature, has no definite classification. Group 3 and Group 4 share the same seating options; however, Group 4 is distinguished by stronger motors, enhanced suspension, higher speed, and greater obstacle-climbing capabilities to negotiate certain outdoor terrains. Notably, these features are typically not covered by Medicare and other payers in the United States as they are typically not needed for indoor mobility.

Statistical analysis

All statistical analyses were performed using R version 4.4.1 (R Core Team, 2024). Alpha level was set at 0.05 a priori. The Anderson–Darling normality test was conducted on outcome variables of mean daily distance and number of use days. A Kruskal–Wallis test was performed to find the difference in mean daily distance traveled and number of use days among wheelchair models. Post hoc pairwise group comparisons using Dunn’s test with Bonferroni adjustment were performed to find different patterns. A Mann-Whitney U test was conducted to compare the mean daily distance traveled and the number of use days between Group 3 and Group 4 PWCs.

Results

Study sample

The total number of activated wheelchairs with consent was 7,798. Of these wheelchairs, 233 were excluded as they were demo wheelchairs, 634 wheelchairs were removed as they did not send any data in 2022, one was eliminated as the data were abnormal (likely due to a technical error), 2,002 wheelchairs that were not provided in the United States were removed, and 1,870 wheelchairs that had 60-day or longer data loss were also excluded. Thus, the study sample was 3,058 wheelchairs comprised 32.4% F3 Corpus (n = 992), 3.3% F5 Corpus (n = 100), 14.5% F5 Corpus VS (n = 443), 48.1% M3 Corpus (n = 1,471), and 1.7% M5 Corpus (n = 52).

The sample was then further reduced to 2,615 PWCs for analyses between Group 3 and Group 4 PWCs after removing the F5 Corpus VS model that had no definite classification. Of these wheelchairs, 94.2% were Group 3 (n = 2,463).

Mean daily distance traveled and number of use days in 2022

The mean daily distance traveled regardless of wheelchair model was 1,365 m (SD = 1,433); the mean number of use days regardless of wheelchair model was 301 days (SD = 91). See details in Table 1.

Table 1.

Mean daily distance traveled and mean number of use days across the five models in the United States in 2022 (n = 3,058).

Mean Daily Distance Traveled (SD) (m) Mean Number of Use Days (SD)†
F3 Corpus 1,393 (1,449) 304 (89)
F5 Corpus 1,676 (1,441) 316 (81)
F5 Corpus 1,416 (1,580) 301 (87)
VS
M3 Corpus 1,287 (1,355) 298 (94)
M5 Corpus 1,988 (1,712) 314 (90)
All models 1,365 (1,433) 301 (91)
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†

Number of use days were defined as days with daily distance traveled more than 5 m.

Mean daily distance traveled among the five PWC models

There was a significant difference in mean daily distance traveled among the five models, H(4) = 26.811, p < 0.001. See the distribution of mean daily distance across the five models in Figure 1. F5 Corpus (M = 1,676, SD = 1,441) had a significantly higher mean daily distance traveled than the M3 Corpus (M = 1,287, SD = 1,355), p = 0.004. F3 Corpus (M = 1,393, SD = 1,449) had a significantly lower mean daily distance traveled than M5 Corpus (M = 1,988, SD = 1,712), p = 0.029. F5 Corpus VS (M = 1,416, SD = 1,580) had a significantly lower mean daily distance traveled than M5 Corpus, p = 0.043. M3 Corpus had a significantly lower mean daily distance traveled than M5 Corpus, p = 0.003. Four PWC users in the sample maintained a mean daily distance traveled above 10,000 m, indicating approximately 1 out of 1,000 Permobil PWC users in the United States would drive on average more than 10,000 m per day, while the whole user population drove an average of 1,365 m per day in 2022. See details in Tables 1 and 2.

Figure 1.

Figure 1.

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Median and IQR of mean daily distance traveled across the five models in the United States in 2022.

Table 2.

Pairwise group comparisons on mean daily distance traveled across the five models.

p Value F3 Corpus F5 Corpus F5 Corpus VS M3 Corpus M5 Corpus
F3 Corpus .084 1.000 .288 .029*
F5 Corpus .144 .004* 1.000
F5 Corpus VS .783 .043*
M3 Corpus .003*
M5 Corpus
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†

p value with an asterisk means difference between the two groups was statistically significant.

Mean daily distance traveled between Group 3 and Group 4 PWCs

Group 3 PWCs (M = 1,330, SD = 1,394) had a significantly lower mean daily distance traveled than Group 4 PWCs (M = 1,783, SD = 1,541), U = 146249, p < 0.001.

Number of use days among the five PWC models

There was no significant difference in the number of use days among the five models in the US, H(4) = 5.971, p = 0.201. See the distribution of the number of use days across the five models in Figure 2.

Figure 2.

Figure 2.

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Median and IQR of number of use days across the five models in the United States in 2022.

Number of use days between Group 3 and Group 4 PWCs

There was no significant difference in the number of use days between Group 3 (M = 301, SD = 92) and Group 4 PWCs (M = 315, SD = 84), U = 175183, p = 0.182.

Discussion

This study is perhaps the first utilizing a large dataset to investigate how far PWCs in the United States on average travel per day in an entire year. The average of 1,365 m per day is, in most cases, below the 1,400 to 2,000-m range reported in earlier studies related to either MWCs or PWCs (Cooper et al., 2002, 2008, 2011; Karmarkar et al., 2010; Levy et al., 2010; Oyster et al., 2011; Sakakibara et al., 2017; Sonenblum & Sprigle, 2017; Sonenblum et al., 2008, 2012; Tolerico et al., 2007). The difference could be attributed to those studies having small sample sizes and shorter observation timeframes as compared to this study having a large sample and continuous year-long observation. It also could be attributable to some of those studies investigating specific wheelchair user profile such as children, old adults, or users with spinal cord injury. There could also have been a Hawthorne effect; study participants might change their behaviors owing to awareness in participation, originality and individual curiosity toward participation, motivation by the research, or perceived social appeal of the research (Chen et al., 2015). This study applied a retrospective analysis of deidentified data over an entire year whereby the users might be less motivated to over-perform. Further, the deidentified nature of the data used in this study provided no information on characterization of the user or contextual use of the equipment to determine similarity or difference to parameters of the other studies.

The devices in this study were all Permobil products, which could limit generalization of the findings to Group 3 and Group 4 PWCs across all other manufacturers. Nonetheless, the study found almost half the sample was an M3 Corpus (mid-wheel drive) model and a third was an F3 Corpus (front-wheel drive) model, which were both Group 3 PWCs. This finding was likely due to Group 4 PWCs not being covered by Centers for Medicare & Medicaid Services (CMS). Permobil Group 4 PWCs had a significantly higher mean daily distance traveled as compared to Group 3 PWCs. Although there is no scientific evidence to support this, this could be attributed to users who are more active and have the funding resources, pursue Group 4 PWCs to meet their outdoor mobility needs over longer distances. Group 4 wheelchairs are similar to Group 3 but have features such as more powerful motors and more suspension. A previous study (James et al., 2022) showed Group 4 PWCs were less likely to need repairs compared to Group 3 PWCs. Thus, Group 4 PWCs may be more durable, have greater value, and support activities and participation outside of one’s home. Other factors may also have an impact on the higher mean daily distance traveled of Group 4 PWCs such as varied use environments or employment status. In addition, the dataset in this study did not contain information to calculate bouts of mobility, which was perceived as a critical metric and predictor for wheelchair use (Sakakibara et al., 2017; Sonenblum & Sprigle, 2017; Sonenblum et al., 2008, 2012).

The results also have some implications for consideration of the overall Reasonable Useful Lifetime (RUL) of PWCs. According to CMS (Centers for Medicare & Medicaid Services, 2023), devices are expected to last 5 years, which is somewhat arbitrary and does not consider how a device is used. Knowing distance traveled and a person’s average daily use could better inform routine maintenance and repair schedules and justify earlier device replacements for known active users.

Although this dataset was large, it did not provide any characteristics of the users such as age, gender, diagnosis, employment, living situation, or geographic region to investigate other potential factors associated with use. Future studies could compare or pair the Connected Wheelchair data with other data registries such as the Functional Mobility Assessment and Uniform Dataset (FMA/UDS) (Schmeler et al., 2019) and the Wheelchair Repair Registry (WRR) (James et al., 2021) that include more information about users and context of use to more completely understand how PWCs are used and benefits of different models and features across different types of users and situations.

Conclusion

The purpose of this study was to leverage the Permobil Connected Wheelchair dataset to calculate the mean daily distance traveled by power wheelchair users in the United States. The study analyzed one year of distance data from more than 3,000 users. The results showed PWC users drove on average 1,365 m per day in 2022. Group 4 PWCs had a significantly higher mean daily distance traveled than Group 3 PWCs. PWCs were used on average 301 days in a year. The findings have an array of implications to inform stakeholders, practice, and policy related to value-based purchasing, more accurate estimates of reasonable useful lifetime, routine maintenance, and repairs of PWCs based on use versus age. Practical applications of this type of study results may encourage further development of data loggers and their use across a wide variety of wheelchairs.

Acknowledgements

The contents of this publication were developed under a grant from the National Institute on Disability, Independent Living, and Rehabilitation Research [NIDILRR grant number 90DPGE0014–01-00]. NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). This material is the result of work supported with resources and the use of facilities at the VA Pittsburgh Healthcare System. The contents of this publication do not necessarily represent the policy of NIDILRR, ACL, or HHS, and you should not assume endorsement by the U.S. Department of Veterans Affairs or Federal Government. In addition, the data analyzed were from a Data Use Agreement (DUA00003396) between the University of Pittsburgh and Permobil Inc.

Funding

This work was supported by the National Institute on Disability, Independent Living, and Rehabilitation Research [90DPGE0014–01-00].

Footnotes

Disclosure statement

No potential conflict of interest was reported by the author(s).

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