Assessing the Impact of the Built Environment on the Health and Wellbeing of Manual Wheelchair Users

Abstract

The built environment (BE) fails to meet the accessibility needs of people with mobility impairments (MI), particularly those who have a spinal cord injury and use a manual wheelchair (MWC) for mobility purposes. The urban infrastructure has several invisible barriers to the able-bodied individual; however, for MWC users, it significantly impedes their fulfillment of essential activities like commute, education, work, leisure, etc. In addition, it is poorly understood how these barriers in the BE impact the health and wellbeing of MWC users. This thesis systematically reviews the available datasets that promote the following concepts, walkability, pedestrian safety, and accessibility, by quantifying factors that are known to encourage them and comparing them with the actual conditions of the BE in a particular area. Then, it measures the physiological strain and psychological stress of facing these (in)accessible BE to understand further its impact on individuals with different mobility capabilities via a wearable device. Much literature supports the idea that there is a lack of wheelchair accessibility within the BE. In addition, there is literature that suggests that there are several design guidelines, codes, and accessibility indexes that show us proper wheelchair-accessible design as well as the common barriers that MWC users are likely to encounter within the BE. Nonetheless, there is little to no research on the impact of dealing with these barriers on the health and well-being of MWC users. It is inevitable that, at some point, MWC users will encounter barriers in the BE, whether they are temporary obstacles or immovable physical characteristics. This study aims to look deeper into this relationship to understand how this poorly designed, unpredictable BE impacts wheelchair users' health and well-being. The study gathers data to help wheelchair users understand what happens at a physiological and psychological level when navigating an inaccessible outdoor environment. It also aims to provide solid data-based evidence of which barriers must be avoided to find an optimal route depending on the individual mobility limitations or what he or she considers accessible. Ultimately, it aims to help MWC users in the decision-making process when planning their routes.