Mobuis Mobility team members Dawn Hameline and Megan Yeigh sat down with ABILITY’s Sabrina Bertucci and Denise Miller to discuss the improved design of the innovative iBOT. The personal mobility device utilizes advanced electronics, sensors, battery technology, and software so you can go where you want to go. Barriers to accessibility are too common out in the world. So curbs and stairs be aware—iBOT can roll up or down you!
Denise Miller: What are your roles at Mobuis Mobility?
Dawn Hameline: I am an occupational therapist and an Assistive Technology Professional (ATP). I started with Mobius Mobility about four years ago. I’d always worked in a hospital, but I took my clinical skills to the manufacturing service side of things. What I do here is a lot of the education about the iBOT. I work with both users and clinicians. Both groups are required to be trained on the equipment. With the clinicians, I help them understand how the device operates in order to answer questions for their potential clients or patients. Also I explain other things about the device—who it might be appropriate for, who it might not be appropriate for, and what the different ways to use it at home are and in the community.
Megan Yeigh:. I am not as fancy as Dawn. (laughs) I’m an engineer by background, by training, but I’m program manager for Mobius, so I’m running daily operations, getting iBOT out the door. That’s my main role, and also making sure that iBOTs stay in the field and in service—the post-sale side. The other hat I wear is why we’re here with you today: how do we raise awareness? How do we let people know that this is a technology that is available and is ready to be out in the world? How do we make it more affordable for people?
Miller: My husband is mobility limited and I was showing him the website. He said, “I don’t believe it!”
Hameline: (laughs) Believe it!
Sabrina Bertucci: Could you could give us a little background about iBot. What was the idea that launched it?
Yeigh: The inventor of the iBOT is Dean Kamen, as you may know. He was in a grocery store parking lot and he noticed a gentleman in a wheelchair unable to find a curb cut, unable to get up the curb, or maybe it was down the curb, I forget which one.
Bertucci: Either way, it’s hard!
Yeigh: For sure. Dean was walking right by him and saw that the man was unable to get to where he was going. That was the genesis of the iBOT. Dean said, “This is a problem I can solve. There’s no reason that a person shouldn’t have the ability to get to where they need to go in this world.” That’s what kicked off the iBOT program. Funnily enough, people would say that the Segway was the older brother of the iBOT, but it’s actually the reverse.
The FDA regulations for medical devices are so long and stringent that in the process of developing the iBOT, Dean said, “OK, we can use the same balancing technology, take the seat off, take the rehab side out of it, and let’s just put a little go-stick on it and call it a Segway.” He sold that company off while the iBOT was still being developed and going through the FDA process.
Miller: So that is how the Segway came to be. So it validated the engineering of it?
Yeigh: Absolutely. The safety was there, obviously, because to put a people mover product on the market, you still have to show that your safety has met certain ISO standards. The iBOT was launched in the early 2000s under a company called Independence Technology, which is owned by Johnson & Johnson. It was on the market for several years, but ultimately Johnson & Johnson pulled it from the market for a lot of reasons. One reason was that the product was really expensive and it wasn’t a fit for a lot of people. So Dean was able to buy back the technology and the licensing from Johnson & Johnson. The engineering team got to work again and redesigned it, taking into account all of previous customers experiences and input.
What Mobuis sells now is the iBOT Personal Mobility Device—completely redesigned PMD, with the core technology still inherent. It still has all the same operating modes, standard mode for indoor ADA surface-type use, four-wheel mode, which is all-terrain, grass, gravel, sand, rock, snow. We have balance mode, which is the real eye-catcher—where you’re elevating up on two wheels at eye level. The stair mode allows the user to climb stairs with or without the help of an assistant. All that technology is still there, but we’ve redesigned the battery life, the weight, and the transportability. The biggest change is adding the rehab seat to it, so now it is appropriate for a vast majority of the population of people who need a mobility device.
Bertucci: I have a question. It’s about who the product would be appropriate for and not appropriate for.
Hameline: You guys are in this business, so you understand that it’s not cut and dried. We do have some things that definitely we use to direct who might be appropriate and who might not. There are a few things. A person needs to weigh between 50 and 300 pounds. That a rather wide range.
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Bertucci: Right! That’s great!
Hameline: Right now we are not able to accommodate a ventilator, so a person cannot use a ventilator. Because the iBOT is a multi-modal device, meaning it’s like five devices in one, a person needs to be able to attend to the learning and go through the training process. They also need to be able to demonstrate some good visual-special skills, meaning, the device has the ability to be used to go over a five-inch obstacle. So if you came up to a curb and it was this high, let’s say this is five inches, a person looks at that and they can see that it’s five inches, that’s great. If they look at something that’s 12 inches and think that it’s five inches that’s a problem. Visual-special skills are about a person’s ability to evaluate their environment and be able to make some of those estimates so that they can safely use the equipment to its ability. We look for somebody to have good special awareness. We have folks using the device who have lower extremity or upper extremity amputations. We have people with a lot of different neurologic conditions, like MS or cerebral palsy or spinal cord injuries. It’s a wide range of potential users
The iBOT currently is not able to accept specialty controls, so if somebody uses their head or a sip-and-puff to drive to operate their wheelchair, currently we’re not able to accept those types of controls. We look at all of those abilities. We try to manage those types of expectations in advance of somebody getting too far along in the process. Those are some of the things that we discuss with people.
The one other area where we spend time and make sure that people are on the same page about is when it comes to stair climbing. The iBOT can be used to go up and down stairs. It in and of itself does not climb the stairs, meaning you don’t push the joystick and it doesn’t go up and down the stairs. It takes some physical exertion or support to shift a person up and down the stairs.
Bertucci: Can every iBOT use this feature?
Hameline: First, if a person has no hand movement at all, they still can use the device to go over to go over the curbs, through the grass, go to the beach, and do all of the things the iBOT offers, balance mode, four-wheel mode.
But if they can’t grasp a handrail, it only means that they cannot do stairs by themselves. The alternative is a trained assistant is able to help them go up and down the stairs.
Miller: Is the user pulling themselves and the chair up the steps?
Hameline: The best example I can give is this one. If you are in a standard kitchen chair and you tip backwards on those back two legs, we’ve all tried that, right? You can kind of balance there. If you imagine holding on to something and going back and coming forward and tipping back again, that’s the motion, that’s the movement that you’re doing to help the device to climb up and down the stairs. It’s more tipping backwards. It’s not necessarily pulling yourself up the stairs.
Miller: That’s a good analogy.
Bertucci: Yeah, that’s interesting. May I ask a question?
Hameline: You keep going, Sabrina! (laughs)
Bertucci: (laughs) I was wondering, because I’ve always wanted to go on the sand. I have a wheelchair, I’m sure you guessed that. It seems that the iBOT can go on any surface, right? Sand, rocks, and that’s great. My brother has a cobblestone driveway. It would be really helpful to go down that. In terms of slick surfaces, such as rain, I did see it on the website, but I was wondering if it’s hailing or storming, that would be inconvenient, right?
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Hameline: Sabrinia, I love the questions that come from people who use wheelchairs, because you’ve run into other problems. I know exactly where you’re going when you started talking about where it can go. It’s more about, you’re really wondering where can it not go, you know?
Bertucci: Exactly! (laughs)
Hameline: I think that—we always like to highlight where it can go. The device is designed to go over five-inch obstacles. It’s essentially the full height of the palm of your hand. We’re talking up and down curves, on the trails through the woods, where you’ll have tree roots and rocks and dirt and all of that. All of this you would do with the device in four-wheel mode. Four-wheel is our all-terrain vehicle mode. You’ve got four drive wheels actively working that are able to push you through all these different obstacles.
The other reason it works so well is that when you’re in four-wheel mode, the seat itself is a little bit higher, so your foot plate is higher off the ground. You won’t get that foot plate stuck in anything, and those little casters on the front of the chair are up off the ground. So those don’t get stuck. You have four big drive wheels pushing your through. That’s what allows you to get through things without getting stuck.
You asked about slippery wet surfaces. When the iBOT is in balance mode the wheels need to maintain contact and have some traction with the ground below them. If traversing something slippery like wet grass or ice The device could slip just like you or I. If we slip, we may lower our center of gravity and maybe take a step forward or back, to avoid a fall. The iBOT has a similar built-in safety system. If it senses instability or “slips” when in balance mode the device will automatically transition to put four wheels on the ground seeking stability.
Bertucci: I get it.
Miller: I have two questions. First of all, how do you clean the iBOT if you go into the sand and the mud? My husband’s driven into mud with his power chair, and it’s like, “Oh, man, why did you do that?” (laughs)
Hameline: And then he drives it into the house, right?
Miller: Right, right!
Hameline: I have to say, this is one of my favorite things about the iBOT. I have a lot of friends who use wheelchairs, and if I go to their house, there’s usually a series of towels that they have to roll over before they get into the house so that they can clean the wheels, the base, and whatever got wet or dirty before they go back in the house. The iBOT itself, the power base, is a closed design, meaning all the electronics are totally sealed in there. You can just take a garden hose and just run water over the whole base, rinse it all off, and then drive right into the house.
Miller: Wow! You sold me!
Bertucci: I want one!
Miller: Next question: How do the majority of the users use it? Four wheels on the ground? Two wheels?
Hameline: Gosh, everybody’s different. One of the biggest things is the fact that a lot of people find that this one chair meets many needs. Instead of having an indoor chair, an outdoor chair and a recreation chair, they can do all that and more in one chair. It makes things easier. I am an occupational therapist, so I look at function. What it is that people typically need to do in their day? What is accessibility like? From that standpoint, people who are out in their community, four-wheel drive, four-wheel mode is one of their favorites, because they can get all over town without problems.
The other one is balance mode. People who are so tired of looking at somebody’s belly button all day want to be up at eye level. They want to be received in a different fashion. It’s a feeling that you get and how you feel about yourself, how you feel you’re perceived. That’s something different. Balance mode is another one for people who are again out and about, working in their community, communicating with peers and workers out there. That’s typically the modes we see when people are out in their community.
Then going back into the house, you go into standard mode, and it’s like your typical wheelchair. You can be in your house to do what you need to do there. I think stairs are good, but they’re kind of that little added bonus, but that’s not what the iBOT is totally about. A lot of people can function in a whole new way using balance and four-wheel mode and never use stairs. That’s an added bonus. Some people love it and it works great. Other people find it’s not something they need to have and it doesn’t change their ability to access the community in the way they want to.
Bertucci: What about narrow places like bathrooms or hallways?
Hameline: It’s all about the turning radius. Depending on what mode you’re in, whether it’s standard mode, four-wheel mode, balance mode, they all have a different turning radius. In standard mode you have two wheels on the ground and two casters on the ground. In this point you have your largest turning radius, because we’re using the majority of that space, and the device drives like a rear-wheel drive wheelchair.
If you’re in four-wheel mode, we have four wheels on the ground and the tires are all working at the same time. It’s a lot like scrub turning, so you have a really tight turning radius. From there, if you’re in balance mode, it is like turning on a dime, because you only have those two wheels. Literally, it’s like a little ballet pirouette. You are so tight. It kind of depends what mode you’re in.
Miller: Do you do road shows or anything like that? The pandemic probably stopped any type of marketing effort that way.
Hameline: We’ve barely been to any in-person events. They’re just not happening.
Miller: How do people find out about you?
Yeigh: It’s a great question. It’s part of the reason we’re doing this interview. For the first time, we’ve felt comfortable spending some money on advertising. Our philosophy has been, keep it super-small-scale, and keep that grassroots feeling of letting iBOT users tell other people. Because if we went out blazing with a sales course and huge branding and huge shows, we would just be jacking up the price of the iBOT for the people for whom it’s already expensive. I think the thing to know is that what you’re paying for now is purely the technology. We are not using any distributors for the same reason of not having another mark up tin price for the iBOT. You’re paying for the technology, for the quality of the product as it is. This is the first year where we’ve put aside a small budget for some marketing and advertising, but as you can tell, we’re still doing it all ourselves internally. We haven’t hired marketing or sales. We’re just—Dawn and I are—
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Hameline: You’re lookin’ at it! (laughs)
Yeigh: We’re very sensitive to the affordability piece. We feel that—medical equipment is outrageous for populations that are already strapped in so many ways. We’re working really hard to try to keep that costs down and more manageable. We’ve got this small team. We’re trying to do it all. We do a lot of virtual support for people virtually, as that helps to keep the cost down.
Another example is we have new users who can’t travel to us and they need to have a trainer, like Dawn, go to their home. I spent almost six hours the other week figuring out how to get more affordable rental cars for us to go to their homes, and we’re spending $1,000 on the rental car. Rental car prices are absurd right now.
Miller: Oh, they’ve gone through the roof!
Yeigh: And I’m on the phone with rental car companies saying, “Can you help us out here?”
There are some things we’ve been doing that I’d love to highlight. First of all, we have two national credit unions who have offered financing for iBOTs at rates that are almost as low as car payments right now. That’s been enormous for us. That means that someone even on a fixed income can find, maybe with some nonprofit help as well for a down payment, an affordable rate that they can pay for getting a device that’s better than whatever insurance will cover for them. We also work with non-profits and fundraising organizations. And many VA facilities have covered the iBOT for Veterans—we encourage Vets to go to their local VA and inquire about the iBOT and schedule a seating assessment.
Miller: I’m going to raise my hand here. The elephant in the room: does Medicare or normal insurance cover it?
Yeigh: Some insurances do cover it, private insurances. Medicare and Medicaid to date have not. That’s an issue we would like to work on. It takes almost an act of Congress to make it happen. It’s something we’re committed to, but I don’t see it as a short-term goal, which is why we have these financing options in place and why we work with nonprofits, to help make it affordable. Private insurances are covering it. We are seeing that once one insurance covers it, the others start to follow on. We are seeing that to a certain extent. “OK, Blue Cross/Blue Shield of Massachusetts signed up, and now Blue Cross/Blue Shield of New Hampshire is coming on board.” So we are seeing that to a certain extent.
But even once Medicare and Medicaid are covering it, there will still be a huge cost share. You’re aware that there’s a huge cost-sharing component with Durable Medical Equipment (DME)—that is the ugly truth of public insurances. We will still need affordable options once we have that as well. Because if you have a 20% co-insurance, that’s expensive.
Miller: Please tell us how much it costs.
Yeigh: The base price is around $32,000, and that gets you an entire unit. What drives the cost up from that is if you need a special seating component. That would be special—
Hameline: Like lateral supports or thigh guides. Those would be additional. But we’re talking about a back, a seat, arm rests, leg rests, tie-downs, securement points, all things like that.
Yeigh: Unlike other wheelchair manufacturers, we don’t start the price at $5,000 and then charge for each individual thing on top of that.
Hameline: The other thing to know with that is, the base itself comes with all those different modes we talked about already built in. If you don’t want to do stairs, we can go into the computer and turn it off. But it’s there. So if in a year or so you decide, “I’ve moved, I now lived where there are stairs everywhere, and I want to do that,” we can go back in and turn it on. The same thing with balance. You can turn it on or turn it off, so everything is already there. You don’t have to add a motor or switch to a whole new thing.
We use Motion Concept’s ultra-low-Max seating. With that, you have a lot of customization, meaning that we can make the seat wider or longer, we can put on different styles of arm rests. Some of those things can evolve as they need to, but you can still keep that power base as it.
Miller: I’ll bring Sabrina and my husband in for a fitting! Do you customize it that way?
Hameline: There’s yes and kind of yes. If Sabrina came to visit us here in Manchester or we were in your area, we would try to make some adjustments to make it fit good enough so that you were good and stable in the iBOT for a demonstration. But then we might look it, if you’re going to use this long-term, we should consider a back with more contour. Or maybe you need arm rests that are shorter because you’re always at a desk. We would go into that kind of configurability. There’s that fit in terms of what fits your body well.
The other fit is something we call “center-of-gravity fit” or CG fit. This is a unique thing to the iBOT. The device, as you go through the CG fit process, moves you while you’re sitting in it in about five or six different positions. While it does that, it calculates where your center of gravity. Yours will be different from mine and from the guy across the hall who’s six foot two versus the guy who’s got huge shoulders. Where our center of gravity is is different based on how our bodies are built or configured. The device collaborates specific for you. That is what lets the device operate optimally outside, going over rough terrain, when you’re using it to go up n down the stairs, because it’s a perfect fit for you. Once we have done that fit, somebody else can’t hop in the chair and use it as effectively because it’s won’t fit well.
Miller: That is similar to how cars work today…the computers remember your braking habits, and so on.
Hameline: And it’s uniquely fit for you. There’s no other chair out here that does that. I think that also shows how you can optimize your ability to use it in a lot of different situations because of that.
Bertucci: I have a really bad tremor. Is there a different type of mode for that? Is it customized so that I—could you explain that?
Hameline: Is your tremor mostly in your hands?
Bertucci: Yes.
Hameline: One of the things we can do is through the joystick control. We have something called a dead band or like a tremor dampening—the joystick is proportional, so we can adjust it so that if you have a little bit of a shake, we can have it do nothing, it will be unresponsive. You have to get outside, you have to do a bigger movement for it to react. That is something we can do to control from a driving perspective. In terms of the center-of-gravity fit, when it tries to customize to your body, you would just be sitting there, and as long as your legs aren’t kicking out, your arms aren’t doing giant movements, it will be able to collaborate to you. Some of your small movements within that zone will end up integrating just fine.
Think about somebody having a seizure, where they have really big movements that would change their center of gravity that could be something that could influence how the device operates, particularly when it is in balance mode. That would be something we would have to look at and talk about how your body might respond. If you’re going over the grass to watch your friends at a soccer game or something like that and you’re bouncing around, if that tends to trigger a lot of spasticity, we might look to see what your response is and how that works for you.
Bertucci: It’s pretty impressive! It looks pretty large, but given the things it can do, that would only be appropriate. Is there any way it can be put in a car? It’s a hard question.
Hameline: It’s not hard! It’s a good one!
Yeigh: It looks big, but the footprint is actually smaller than most power wheelchairs. Power positioning wheelchairs have a much bigger base of support because you have that whole tilting action happening. The iBOT doesn’t have that length and it doesn’t need the stability of that base of support. It has a very small base of support because it’s dynamically stabilized. It’s much smaller footprint-wise than the average power wheelchair. And yes, it can go in a car. It fits in my Subaru Outback.
Bertucci: I love it! I want to have one! (laughter)
Yeigh: And it sits in the Subaru by the backrest is on a single post and it folds right down, and I then lower the arm rests all the way down into their little joints. I fold the back rest down, take the cushion off and it folds down even further. We have what’s called a remote mode, which we haven’t talked about. When the device is unoccupied, you can use remote mode and drive from the joystick away from the device. There’s a little extension cable that goes to the device, and it goes to a 20-degree slope, which is pretty steep. I use small four-foot ramps to go up into my Outback and it just drives right on up there like a little crab.
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Bertucci: (laughs) That’s great!
Hameline: It works great, because you do not need a modified vehicle, and if you travel, you don’t have to deal with waiting for that one adaptive rental vehicle that somebody else might have out. It allows you to access a lot more vehicles. You do need somebody else to set up the ramps and drive it in, in most cases. The device has got to be unoccupied. But it drives up and it’s more stored like cargo. Then you drive it back down to get it out. If we go to clients or clinicians in our area, that’s what we do. We’ve been loading in it all of our different vehicles to take it places.
Yeigh: In August 2021, we received approval from the U.S. Food & Drug Administration to use the iBOT as secured Occupied Transport device in a vehicle. We have two methods for people to drive from their iBOT if they do want to have an adaptive vehicle or already have one. You can use either a four- tie-down system, just using tie-down hooks you’re probably familiar with, or we have an easy-lock system that is customized for the iBOT. You can have that installed in your van or truck, your vehicle.
Bertucci: I just want to make sure I have all the points here. You can take the parts apart? I’m just wondering. I live in New York, and it’s such a pain if I go in an Uber. Are you saying you take these different parts and then you go up the ramp into your car?
Yeigh: If you’re going to take it like cargo in the trunk of your car, all you have to do is fold the back rest down and then it will use remote load to drive up. Remote mode is just like any other modes, you access it through the joystick and you can have whoever, the Uber driver, drive it up like in a video game into the back of their ride, if they have ramps. It also only takes two medium-sized people to be able to lift it, so if you don’t have ramps, someone can lift it into your trunk. Dawn and I can lift it. It’s not a heavy device.
Hameline: The average weight is 250, 260 pounds. I use a ramp to load the device in my Jeep. The back needs to be folded down, and that’s the only thing needed to do to get it up into the back of the Jeep.
Bertucci: That’s great!
Hameline: The other thing I love about travel is for people who travel on planes, I think we all know that that’s a big area of interest right now for the disabled community, because equipment gets damaged so readily.
Bertucci: Exactly!
Hameline: It’s terrible. One of the things we’ve done to try to manage that is, we have a pretty quick release so that you can remove the joystick and put it in your carry-on luggage. Is there is chance that the arm rest will get ripped? Yes, there is. Will you get some scratches and dents? There’s a chance. But the thing that will let you drive when you get to Disney World or wherever you’re going, that piece will be all good and ready to go because you’ve removed it and you’ve taken that risk away, which is huge. Huge.
Bertucci: Huge! That’s the part that would get damaged. And the airlines definitely don’t make any effort to give you any money back.
Miller: I want to jump back. You had said the FDA approved it as a seat in a vehicle. Like, I could take out the back passenger seat and make space for the iBOT?
Yeigh: Yes.
Hameline: It’s called occupied transport. That means that the wheelchair can be transported with a person sitting in it. It has to go through many levels of crash testing to be approved to be utilized in that fashion. Unless something says that it is approved for occupied transport, the intent is that the device can be transported but nobody’s allowed to sit in it while it’s in a moving vehicle.
Miller: Are any of iBOT users children or teenagers?
Yeigh: We have a couple of young kids, 14 or 15, two with cerebral palsy. We have a nine-year-old coming in for a demo next week. I don’t know if he’ll be too young, we’ll see.
Our labeling basically says that if your doctor is prescribing it for you and you’re under the age of 18, that’s fine, we can totally give you a device. But we need that prescription to work with a prescription medical device. Currently we don’t recommend to younger than 14, young adult age.
Hameline: And they need to be at least 50 pounds. We say 50 pounds because that’s what the device has been tested to, and the seating components that we use, I think the narrowest width right now is 15 inches. Again, that’s why we’re not into pediatrics, but we’re using young people, for sure.
Miller: I know we’re getting near our time to close, but what about training?
Hameline: Again, this is five devices in one. We’re not just teaching a person how to use a regular wheelchair and just drive in and out of the bathroom. This is about, can you drive in and out of the bathroom, up to the sink, to the table, can you do balance mode and open a door and recognize what obstacle and slope is approved in balance mode? What about four-wheel mode? Let’s teach you how to go over curbs. Let’s teach you how to go through the sand, through the rocks. We do all of that type of training. And we also do stair training for one person, if they’re able, by themselves, or we might train an assistant, a family member or a friend, to do that assisting if there’s no handrail or if a person’s not able to do it. It’s a lot of training.
I think we are the only company, if I’m correct, that requires a driver’s test at the end. There are two parts to that. There is a practical part that says, is the individual able to navigate obstacles? Are they able to manage slopes and select the right mode? Look at how they can use the device. And then there’s a piece that’s more oral questions. What would you do if you got stuck, if you lost power in such-and-such a situation? To make sure that a person is able to process and make good decisions around how to use the equipment and use it properly.
When we have people come here for training, the entire training takes about a day and a half, maybe a little bit more or less, depending on stairs. If someone wants to learn how to do stairs or if an assistant will be trained, it takes a little time to get a feel for that. Some people get it easily, and other people don’t. We try to allow for enough time for that to happen.
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Bertucci: Has everyone passed their driver’s test?
Yeigh: Except for stair climbing, because it’s such an advanced skill. We’ve had people who say they’ll try it and they say, “This isn’t for me. I don’t need this.” Or they might need an extra day of practice or some time with our clinicians before they get signed off. Stair climbing isn’t for everyone.
Miller: And where is it manufactured?
Yeigh: Right here in Manchester, New Hampshire.
Hameline: We’re pretty proud of that. Made in the USA.
I want to mention the Abilities Expos, we try to have some representation at expos so that people have the opportunity to do a demo and see it in person and get in it. It makes a difference to feel it. There is a facility out there called Casa Colina in Pomona, California. I’ve trained their staff there. We have a demo device in their hospital that they use for demo and evaluation purposes, and I do know that they’re going to be present at the Abilities Expo out there.
We update our social media often, letting people know if we’ll be in their area, and try to always tack on extra time to get an opportunity to get in and see the device. And clearly we need to try to get both of you in an iBOT to feel it. So keep an eye on our social media—we might be able to meet up sooner than you think.
Denise Miller: Definitely put Sabrina in that iBOT!
Bertucci: Definitely! I can model for you!
