Mrs. Geigner has osteoarthritis and Parkinson’s disease. The latter is a neurodegenerative disease that affects the right side of her brain. Due to her health issues, Mrs. Geigner has undergone brain surgery, back surgery, and replacements of both her shoulders and knees. Her current health condition makes it difficult for her to carry her groceries from the trunk of her car to her kitchen counter. She needs a way to transport her groceries from the trunk of her car to her kitchen counter given that she has limited mobility. A solution to this problem would not only alleviate her pain but also allow her to be more independent.
Primary Research
We conducted two forms of primary research: an interview with the project partner and an observation study with Judy.
Primary Research Tabs
Introduction:
We conducted the interview with our partner in person at the Ford Motor Company Engineering Design Center Room G-205 on January 15, 2023. The purpose of our interview was to gain a further understanding of Mrs. Geigner’s health conditions and to learn more about the housing conditions she lives in. The class conducted the interview together, even though there are 3 other groups working on the same project.
Methodology:
To prepare for this interview, the class collaborated on questions to ask her. We combined all of our questions into one Google Doc, categorized each question by health and physical conditions, grocery shopping routines, location, car, and housing. We then further deleted redundant questions and assigned each section to one or two people to ask during the interview. During the interview, 3 classmates volunteered to take notes and write a transcript. Below is a summary of our findings from the interview.
Results
Certain actions, such as turning her head, cause Judy to lose her balance. This is a direct consequence of Parkinson’s disease. To help with her balance, Judy relies on a cane everywhere except for inside her condo. As for her osteoarthritis, it mainly affects her shoulders, back, and hands, and causes her a lot of pain, especially when carrying her grocery bags. It is also present in her knees, ankles, and toes.
There are three main facilities involved in the task of Judy transporting items: the trunk, the garage, and the kitchen. The trunk is 24 inches high, and she has no trouble getting shopping bags out of the trunk.
For the garage, Judy had a wooden ramp installed in it. The distance from her car to the ramp is 10 feet. The ramp — which isn’t ADA certified — helps her get from the garage to her door. It isn’t that convenient though, because not only is it fairly steep, but Judy also needs to step onto it since it doesn’t start from the ground. There are also two rugs in her garage, one on the ground and the other on the ramp. Her garage’s floor and the ramp are both compatible with wheels.
After getting up onto the ramp, there are two doors separating the garage from the kitchen. The first one is a screen door that closes quickly — often on Judy — and the second one is a regular door that she can keep open. Judy mentioned adding a latch to the screen door to keep it open would be a feasible solution. Her doorway is between 32 and 36 inches wide and the distance from her door to her kitchen counter is 8 feet. Once she is in her kitchen, she puts her groceries on shelves that are 36 inches above the counter and in cabinets that are 5.5 feet. She said that putting her groceries away wasn’t that big of an issue for her.
Judy has to do multiple trips to and from her car in order to get all of her items in her kitchen. She follows a specific process to carry her groceries: she begins by moving her bags from her trunk to the bottom of the ramp, and then picks them up two at a time to get them into her kitchen. The items she buys are more or less the same every week: meat, frozen vegetables, bread, eggs, butter, milk, and cream. She doesn’t like the fact that the baggers at the supermarket put all the meat in the same bag, and says that carrying the heavy milk jugs really hurts her shoulders. She uses plastic bags for her groceries because according to her, baggers tend to overfill paper bags.
Judy has certain aesthetic preferences she’d like to see applied to the device. Her favorite colors are blue and purple. She expressed a preference for a mechanical design as opposed to an electrical one. She also made it clear that she wants her device to be as light as possible, otherwise, she won’t be able to push it up the ramp.
Introduction:
On Tuesday, January 17, we watched a video of Judy getting groceries out of her car and into her house. We discussed our observations amongst ourselves and with our classmates. This observation summary goes into detail about Judy’s process of transporting her groceries from her car to her kitchen.
Methodology:
We observed that the process of Judy getting her groceries can be divided into three parts: getting them out of her car, going up the ramp and through the door into the house, and walking through the kitchen and putting the groceries on the counter.
The observation took place in Room G.205 in the Ford Design Building on the Northwestern University campus between 12:30-2:30 PM. The video of Judy moving her groceries was played many times with frequent stops for discussion among team members and the class. Two students in the group used the AEIOU method of observation while the others used the POEMS method. Both methods are outlined below:
AEIOU stands for activities, environment, objects, interactions, and users. There is also a section to elaborate on the user experience, which is divided into five sections: physical, cognitive, social, cultural, and emotional. Someone observing an event should fill out each section in intense detail to ensure that there are no missing pieces of information when they use the observations for designing a solution.
POEMS stands for people, objects, environment, messages, and services. Similar to the AEIOU format, this format also has a section to elaborate on the observations and write general comments about the situation. POEMS also needs to be filled out in incredible detail to ensure every piece of information has been extracted from the event.
Results:
Part 1: Getting groceries out of the car.
In this particular scenario, Judy only had one grocery bag to carry. She opens the trunk and then leans back slightly before leaning forward to grab the grocery bag. Using her right hand, she picks up the groceries and then switches the bag to the left hand and uses her right hand to close the trunk. Using the environment portion of AEIOU, the height of the trunk door appears to be too high for Judy to easily reach as she struggles to lift her arm and press the button. She then switches the grocery bag back into her right hand.
Part 2: Going onto the ramp.
After grabbing one bag of groceries, Judy takes 8 steps onto the ramp. The ramp has a step which she climbs with some difficulty on her right foot. She uses her left hand to hold the left rail and slowly walks up the ramp. She switched groceries to her left hand again so she could use her right hand to open the screen door. Here, Judy stumbles as the action of opening the screen door disrupts her balance. This is because she holds the door open with her entire body as she opens the other door and goes into the house. The services part of POEMS is the primary focus of this part because the ramp is intended to be a service to help Judy get into her house, but with the step and steep angle of the ramp, it appears to still cause Judy some difficulty.
Part 3: Putting the groceries on the counter.
After getting into the kitchen, Judy carries her groceries to the counter, lifts her arms and places the items onto the counter. Judy uses the counter by the door to steady herself with her right hand. The AEIOU method works well for this part because it allows the team to further observe that the height of the kitchen counter makes Judy strain her shoulder to lift the bag. The weight of the bag is also a factor in her difficulty to lift the bag onto the counter because it, too, puts strain on her shoulder.
After observing Judy move her grocery bags from the trunk of her car to the kitchen counter, our group discussed each step thoroughly. We realized that each part of Judy’s grocery-getting process presents its own unique problems.
In part one, the act of moving the grocery bag out of the trunk seemed to cause her difficulties with balance and reaching, as can be inferred from her leaning back to reach forward to grab the bag. Judy had to orient herself in such a way that she would not fall from grabbing a bag of decent weight.
Part two also presented balance issues in the way Judy opened the screen door; having to put her entire body into keeping the door open while carrying extra weight (the grocery bag) seemed hard for her to do. Balance is a key issue in people with Parkinson’s and osteoarthritis so carrying anything that offsets a person’s center of mass is not easy to do. Also in part two, the five-inch step onto the ramp appears to hurt her more than it helps her because it again challenges her balance. A ramp is supposed to help people who cannot go upstairs, so having a step up to a ramp is not a good solution to Judy’s problems.
Finally, the act of lifting the grocery bags and putting them on the kitchen counter showed how Parkinson’s and osteoarthritis can weaken muscles and place strain on joints. From secondary research, the team knows that these conditions are the result of eroded cartilage around joints that make it painful to move. Judy mentioned earlier in an interview that her conditions specifically affected her shoulders which is clearly seen in part three.
A solution to these problems needs to account for Judy’s difficulty balancing and the strain getting groceries puts on her joints.
Secondary Research
In the early stages of our design process, our team carried out extensive research about our topic prior to and after our interview with our project partner to further gain a better understanding of our project. Below is a summary of our findings.
Osteoarthritis is a condition in which the cartilage on the ends of the bones breaks down, causing the rough surfaces of the bones to rub together. When this happens, people with osteoarthritis often experience pain and discomfort in their joints [1]. Osteoarthritis mainly affects three parts of the hand: the use of the thumb, the middle joint of a finger, and the joint closest to the fingertip [1]. A visual representation of osteoarthritis can be seen in Figure 14 below. Over 32 million people have osteoarthritis, and it mainly affects people over the age of 60. Other factors such as constant injury and obesity play a factor in a higher chance of having osteoarthritis [2].
Figure 14: Visualization of Osteoarthritis
As of January 26, 2023, there is no permanent cure for osteoarthritis. However,
treatments to help alleviate some of the pain include physical therapy, consistent exercise routines, weight loss, and medication such as pain relievers [2]. If these treatments do not work, surgery is an option but is a last resort. Self-management skills have also been shown to boost confidence and manage arthritis. Self-management is becoming educated about the effects of osteoarthritis and ways to manage the symptoms individually. It involves developing relaxation and coping skills along with exploring lifestyle changes that may reduce pain. [3]
Parkinson’s disease is a brain condition that primarily affects people above age 60. The disease is caused by nerve cells in the brain’s basal ganglia dying, which then decreases the amount of dopamine that part of the brain produces. Refer to Figure 15 for a visual representation of the brain and the location of the basal ganglia.
Figure 15: Basal ganglia
Dopamine is a chemical that regulates the fluidity and control of movements, so when there is less dopamine in the brain, movements can become slow and uncoordinated [4]. The four major symptoms of Parkinson’s are tremors in the extremities and the head, muscle stiffness and prolonged muscle contraction, slowness of movement, and impaired balance and coordination which can lead to falls [5]. There are also some less common symptoms, such as depression, difficulty swallowing and speaking, urinary problems, and skin problems [5].
As of January 26, 2023, the primary treatment method is a drug called levodopa which increases dopamine levels in the brain and allows patients to return to their normal lifestyle. [5] Other treatment methods work to reduce the symptoms of Parkinson’s that aren’t movement-based, such as occupational and speech therapies that help patients speak as they did before Parkinson’s.
Section 3 includes research regarding existing ideas that we can possibly implement into our own design. This subsection discusses the use of scissor lifts.
The scissor mechanism gets its name because the components made of steel under the work platform are hinged with pivot points to produce a system that looks like several sets of connected scissor blades. To operate the system, the power source would retract or extend the scissor lift mechanism to raise or lower the load-bearing platform up and down. The power source can either be mechanical as in Figure 11 or electrical as in Figure 12. Mechanical scissor lifts require energy input from a person, which could be an issue when designing a solution for someone with disabilities.
The whole system is geometrically stable. The configuration consists of a set of connected parallelograms with pivot connections that enable the operator to extend or retract the system without causing shape changes. [6]
Figure 16: The configuration of the scissor lift system
Platform
The platform on the top of the scissor system can be of various sizes, shapes, and material. It is the working space to bear the loads. In the case of a liftable shopping cart, the platform’s size depends on the amount of items Judy takes each time.
Scissor Legs
The scissor legs are the crisscross array or parallelogram-like configuration made of fabricated metal. They bridge the gap between the base and the platform and are the most important part of the whole system. The maximum working height of the scissor lift mechanism depends on the length of each scissor leg, the number of scissor legs, and the general strength of the system.
Base
This foundational part of the scissor lift mechanism is a sturdy footing made up of strong, rigid brackets. Commonly, the base is engineered with tracks to guide the rollers at the bottom of the scissor legs. In this case, there would be wheels attached to the bottom of the base just as the normal shopping cart. The size and configuration of the scissor lift base will depend on the model and its application. [6]
Figure 17: An electric scissor lift cart
Section 3 includes research regarding existing ideas that we can possibly implement into our own design. This subsection discusses the use of foldable shopping carts.
Given the cost and complexity of the traditional scissor lift, a lightweight, foldable shopping cart also came into our scope. Instead of using a scissor lift system to change the height of the basket, the top of the cart would be able to rotate for easy placement into a car or counter. This makes for a simple design that is easy to use but could potentially be unreliable in its ability to stay in place both because of the moving wheels and rotating basket. The specifics of how the foldable shopping cart works is shown in Figures 18 and 19.
Figure 18: The upright position of the foldable shopping cart.
Figure 19: The foldable shopping cart rotated so the basket goes into the car trunk
One issue associated with the foldable shopping cart can be clearly seen in Figure 14 where only the basket fits into the trunk of the car, not the entire cart. This would require the user to attach and detach the basket from the cart base every time they want to use it, which could be difficult for someone with Parkinson’s disease and osteoarthritis due to their issues gripping objects. [7]
The American Disabilities Act of 1990, also known as ADA, is a federal civil rights law that prohibits discrimination against people with disabilities in everyday activities. In order to comply with these rules, most areas need ramps or a gradually elevated surface to prevent avoidable injuries. Stairs and curbs can be a hazard to those with disabilities because they have a higher chance of falling or injuring themselves. Section §405 of the ADA curb ramp requirements for 2021 covers the following ADA curb ramp design standards:
- Clear Width: A ramp run must be at least 36 inches wide between the ramp’s handrails.
- Rise: A maximum of 30 inches per run, with no limit on the number of runs.
- Running Slope: 1:12 maximum slope, or one foot in elevation change for every 12 feet.
- Cross Slope: The ADA permits a maximum ratio of 1:48.
- Alterations: Are permitted on running slopes with limited space, such as:
- 1:10 maximum with 6 inches maximum rise
- 1:8 maximum with 3 inches maximum rise
- A slope of no greater than 1:12 [8]
All of these specifications are shown in Figure 20.
Figure 20: ADA Ramp Guidelines
Alternatives for a curb ramp that adheres to ADA standards include having an elevator or platform chair lift. These rules apply to multifamily housing and the majority of public and private facilities [9]. Penalties for non-compliance to ADA standards for ramps can cost millions of tax dollars, as seen in a $1.3 billion Los Angeles lawsuit and $15 million Cedar Rapids, IO lawsuit [10].