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For arguably the first time in the history of the modern North-American mobility marketplace, the overall product trend in rehab technology (high-end power and manual wheelchairs), follows a tenet of the fashion industry: Many trends of the past are new again.

Indeed, after a 40-year span of constant evolution in rehab mobility technology, for the first time, we're seemingly void of a monumental, industry-changing leap in technology as we enter this new decade. Yet, we're not without trends and changes, where among them, what's old is, in many ways, new again. This state of the industry raises intriguing questions: Why don't we see any monumental, industry-changing technologies looming large as we have at the beginning of previous decades; why are some consumers looking “back to the future” when buying new mobility products today; and, what does this present era of mobility trends say as a whole?

Historical Cycles of Technological Evolution and Trends in the Rehab Mobility Market
If we trace the modern North-American rehab mobility market back to its inception, it arguably goes back 40 years, to approximately 1970. Indeed, it was during that era when technologies like the power wheelchair and funding policies began taking hold. Additionally, many veterans were returning from Vietnam with life-changing disabilities, and the civil rights movement was resonating with some within the disability community, rumblings of what would soon become the independent living movement. Therefore, circa 1970, there was a synergy of factors – technology, funding, and social change – that served as the catalyst for the modern rehab mobility market, and the start of monumental evolutions in corresponding technology.

The birth of the modern rehab mobility market laid the groundwork for what ultimately proved as definable, datable technology cycles, ones that cumulatively lead to the amazingly-advanced products of today. Major shifts in mobility technology coincided with each new decade, then followed with a 5-year span for consumers to make the new technology an industry standard. When we look at the time line surrounding monumental, industry-changing leaps in technology, the evolutionary pattern is clearly defined in North America: With the power wheelchair evolving circa 1970, by 1975, it was an industry standard. With the aluminum, ultralight manual wheelchair evolving circa 1980, by 1985, it was an industry standard. With the power base power wheelchair evolving circa 1990, by 1995, it was an industry standard. And, with the 6-wheels-on-the-ground power wheelchair evolving circa 2000, by 2005, it was an industry standard. When pragmatically studied, this evolutionary cycle proves itself strikingly consistent, playing out uncannily close to a formalistic time line of monumental advancements occurring around the turn of each decade, followed by a 5-year market adoption curve.

Where Are We in the Advancement Cycle?
Interestingly, if we simply look at the past 40-year trend of mobility advancement cycles, 2010 should mark the next monumental evolution in at least one of the two major rehab mobility segments – power or manual wheelchairs – where by 2015, a new industry standard of technology should be cemented. However, as we survey the mobility market today as a whole, there is no such up-and-coming, revolutionary technology making ripples industry wide. In 1970, there was the “electric wheelchair.” In 1980, there was the “aluminum wheelchair.” In 1990, there was the “power base power wheelchair.” And, in 2000, there was the “6-wheels-on-the-ground power wheelchair.” Yet, as we sit here in 2010, there is no such “on-the-verge” technology perched to set a new industry-wide standard. Now, I know that there may be wild-card prototypes in shops or garages somewhere, with potentials not yet known; however, that's not what I'm referring to as “on-the-verge” technology. Rather, I'm referring to a known, up-and-coming technology that's being adopted industry-wide as we speak – but, there simply isn't one. That is, 2010 is breaking the historical cycle of evolution in the mobility market with monumental shifts in technology around the turn of each decade – and the question that we should be asking is, Why the divergence this decade?

The answer is found in three specific areas: Previous innovation, funding changes, and conventions in consumer choice – and all three are directly intertwined, creating today's market dynamics that are breaking the 40-year trend of industry-changing technologies occurring at the turn of a decade.

The Perfect Storm
When one looks at the evolution in mobility technology over the past 40 years, then considers the funding cuts by insurers of the past 5 years, and then adds in the increasing conventions of an aging population of those with life-long disabilities, the relationship of why there's no “on-the-verge,” monumental, industry-wide technological change taking hold at present in the rehab mobility market becomes very clear.

Firstly, it's astounding how far rehab mobility technology has come over the past 40 years. For example, if we consider the evolution of manual wheelchairs – from steel hospital-intended devices to ultralight, minimalistic, custom-fit, prosthetic-like ultralights – one has to wonder, how can high-end manual wheelchairs dramatically evolve from here while still serving the mobility market at large? It' quite plausible that high-end manual wheelchairs are a lot like bicycles in that they are now such an effective, eloquent design that they simply can't be exponentially improved to where it sets a new industry standard of overall technological form. After all, no one has accomplished such a feat in bicycles – the industry standard since the 1860s has remained two wheels, peddles, and handlebars! – so it is possible that products like ultralight, mono-tube manual wheelchairs have reached such advancement status that refinements and variations can still occur, but we may not see a complete industry-wide shift in form. Therefore, it's quite possible that, in some rehab mobility product segments, the technological evolution has been so great that it now, logically, can't make the huge leaps that it once did. Refinements surely can always be made, but sometimes technology evolves to such a high level that there's simply less room for monumental shifts – and some rehab technologies may have reached such evolutionary status.

Secondly, the mobility marketplace has experienced devastating government-originated funding cuts in the last 5 years, not only adversely effecting consumer access to products, but also requiring a refocusing of innovation. In our market economy, manufacturers can only stay in business by innovating and producing products that they can sell – that is, products for which there is demand. While prior to 2005 there was meaningful mobility funding that allowed for vast technological advancements in mobility products, the funding cuts of the past 5 years have required both consumers and manufacturers to focus on more “core” mobility products, not always the most innovative, reducing ultra-high-end research and development projects and the subsequent products that they produce. For example, circa 2000 was a very exciting time in the high-end power wheelchair segment – we saw an industry-wide acceleration toward overall superior performance, from durability, to suspension, to advanced motors, to higher speeds, and on and on. Consumer demand was present, and funding was available, so manufacturers were innovating at a very fast pace. Yet, today, in 2010, Medicare and most insurers won't fund much of the high-end power wheelchair technologies sold during the early 2000s (an 8 mph power wheelchair, for example, is now non-funded “Group-4” technology). As a result, today the industry has to focus more on core products that comply with discouraging funding cutbacks that simply weren't present in the past. No, this new age of mobility funding – or, lack thereof – hasn't stifled mobility product research and development, but it has required that it is focused in areas like funding-compliant models instead of revolutionary advancements in technology for which there's very little, if no, funding.  

Thirdly, many of us are the first generation to live our entire lives as those with disabilities in the age of ever-evolving mobility technology, and have developed strong preferences about what we want for our own mobility. And, it's this fact that hits at the heart of how, in 2010, an undeniable trend for a notable number of rehab consumers is that everything old is new again. Prior to circa 2000, rear-wheel-drive power wheelchairs, for example, were the industry standard, where many consumers had 20 or more years of experience using the technology. As the industry shifted toward 6-wheels-on-the-ground technology in the early to mid 2000s – most notably due to increased maneuverability indoors –  so did most who used rear-wheel-drive power wheelchairs their whole lives. Here we are 5 to 8 years later, and a share of those who switched from rear-wheel-drive to 6-wheels-on-the- ground technology are now due for new power wheelchairs, and are choosing to go back to rear-wheel-drive technology based on personal preference (and some long-time manual wheelchair users are likewise returning to traditional closed-frame manual wheelchairs over mono-tube technology along the same mindset). As a result, there's presently renewed interest in more “traditional” rehab mobility technologies, where consumers are re-embracing the types of products that they've known for much of their lives. And, as the market goes, manufacturers are responding. While 5 years ago, manufacturers were looking to discontinue “older” technologies like rear-wheel-drive power wheelchairs and closed-frame ultralight manual wheelchairs, they've ended up not only continuing to sell them, but are also introducing new models (for example, among the most advertised “new” models released so far this year is a very traditional rehab front-wheel-drive power base wheelchair that could have easily fit in the market circa 1990 [but, with modern electronics and such, of course]).

Doing More With Less
Although 2010 isn't in keeping with the mobility industry's historical trend of each decade ushering in monumental, industry-changing technology, it's not to say that it's an era without trends and advancements. In fact, the dramatic funding cuts, in themselves, have required a trend toward innovations in core mobility products, where consumers and manufacturers alike are striving to do more with less – and this drives innovation, maybe not toward revolutionary technologies, but toward overall product improvement (for example, we're seeing next-generation 6-wheel models in the pipeline). And, consumers and the industry are re-recognizing the merits of technologies once thought on their way to extinction, going as far as introducing new models based on “older” technologies, but with 2010 refinements, as with the aforementioned front-wheel drive power base.

Therefore, while we aren't seeing a monumental, industry-wide technological shift on the immediate horizon at the turn of this decade, there remains tremendous optimism that the products that we've known – some for decades! – continue getting better despite the challenging funding climate. And, maybe that will be the meaningful theme for the present decade: The best just keeps getting better.

Published 6/2010, Copyright 2010,