Technology: cardboard revolution

Physiotherapist and academic Tracey Howe is convinced that cardboard could revolutionise how assistive products are made around the world. Catherine Turnbull reports.

Tracey Howe is on a mission to change lives around the world by upcycling cardboard after co-founding the pioneering project, Adaptive Design Global. The CSP member and professor of rehabilitation sciences at Glasgow Caledonian University – which self-describes as ‘the university for the common good’ – is enlisting students in subjects ranging from physiotherapy to engineering, business, marketing, art, architecture and fashion to the cause.
It may sound far-fetched, but hundreds of disabled children have already been helped by thousands of custom-assisted products made in the US. What are these products made from? Simple corrugated cardboard.
Professor Howe, who is also director of Cochrane Global Ageing, explains: ‘Imagine being the parent of a child with a disability, or being an adult with a long-term condition, or having functional decline due to ageing or a progressive disease and being unable to access the things you need to make life fulfilling. Assistive products, such as supported seating, standing frames and spinal supports, enable people to participate in education, the economy and leisure and to live healthy, productive, independent and dignified lives. 
‘However, the current often fragmented service delivery systems in health and social care lead to inefficient resource allocation and sub-optimal outcomes. This results in many missed opportunities for people to participate in society.’ 

Emphasis on the individual

She says the World Health Organization estimates there are about one billion disabled people who need some form of assistance. In many low-income and middle-income countries, just five to 15 per cent of people have access to assistive products. ‘We also know that mass-produced high-tech assistive products are expensive and are typically one-size-fits-all solutions. That often results in reduced utility and their abandonment as they are not suitable for people’s individual needs.’
The solution, Professor Howe says, can be a matter of thinking outside the cardboard box. This everyday product is strong, readily available and offers a simple material for construction. ‘We can make products such as comfortable seating, spinal supports, standing frames to enable people to interact and live comfortable lives, and really quick customised products, such as lap trays for eating meals or easels for reading books.’
On a visit to New York City last summer as a Winston Churchill fellow, Professor Howe met Alex Truesdell, a MacArthur Fellow, and her adaptive design team. She was stunned to discover that for more than 15 years the team has designed and built thousands of customised assistive products for children with disabilities using corrugated cardboard. 
So impressed was Professor Howe that she decided to use her expertise and networks to help them spread the adaptive design message as widely as possible. After all, access to customised assistive products potentially offers an appropriate, timely and economically efficient public health solution to people’s individual needs.
‘The emphasis is on the individual,’ says Professor Howe. ‘Instead of buying a product off-the-shelf and waiting weeks for funding or for it to arrive, the solution can be custom-designed by a trained maker with the individual, who can also be involved in deciding how it will be decorated and become engaged in the process.’ 

Working together

Professor Howe imagines a future for Adaptive Design Global in which professionals and amateurs link up across the world to collaborate and co-create solutions to meet specific needs using locally-sourced materials. 
She says open-source templates and toolkits with high-quality designs meeting local standards and able to be built anywhere will be uploaded by the Adaptive Design Global community. 
By drawing on the expertise of individuals and organisations with the skills to assess need, design and build, Adaptive Design Global will help create ‘sustainable pipelines’ of therapists, local labour forces and empowered communities to co-create customised assistive products with users to meet their specific needs. 
The long-term aim is to create specialist Adaptive Design disaster relief teams, in partnership with other agencies, to provide pop-up Adaptive Design and fabrication facilities. Aid typically arrives in corrugated cardboard. The project is working with The World Confederation for Physical Therapy and other international professional bodies such as the World Health Organization’s Global Cooperation on Assistive Technology.
Professor Howe says that although designing aids in disaster and war zones is welcome, it is important to ensure that EU and UK health and safety regulations are met. 
One example would be a standing frame that can be made in this country and steps are being taken to meet the regulations.  
The school of health and life sciences at Glasgow Caledonian University is integrating adaptive design into its programmes. This aims to promote the concept with students from a range of disciplines and get them interacting to problem solve using real-life situations. The students have also created an Adaptive Design Global Students Society with an active volunteering programme.
Projects about to get under way in Glasgow include a link-up with the charity Yogability using adapted products to get disabled people into appropriate positions for yoga sessions. Meanwhile, at Erskine Care Homes for veterans in Glasgow, the introduction of book and iPad holders are already having an impact on residents’ lives. 

Collaboration is key

Professor Howe urged delegates attending February’s CSP student representatives’ development weekend to get involved with Adaptive Design Global. Helping her present the message was Dereck Frost, a first-year physiotherapy student at Glasgow Caledonian University. He told the event: ‘One aspect of this which I really admire is the collaboration between students from different disciplines. 
‘As a first year I am still learning my role, but I feel if I am helping people engage,be innovative and I am useful, isn’t that what we are all looking for?This isn’t a flash in a pan.This is the future and I am very happy to be involved.’ fl 

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Winning ways

Adaptive Design Global won the inaugural TEDxGlasgow award last month, beating 37 other entrants at the finals, which sought ‘innovative ideas that dare to make positive change’. Professor Howe said: ‘This award gives us an amazing opportunity as a springboard to the next level for Adaptive Design Global and increases our reach by connecting with the wider TED community.’ 
To view Professor Howe’s pitch, along with that of her co-finalist, see here.
Catherine Turnbull

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