Drongelen AW van; Roszek B; Hilbers-Modderman ESM; Kallewaard M; Wassenaar C; LGM
This RIVM study was performed to gain insight into wheelchair-related incidents with powered and manual wheelchairs reported to the USA FDA, the British MDA and the Dutch Center for Quality and Usability Research of Technical Aids (KBOH). The data in the databases do not indicate that incidents with
Lemaire, E D; Lamontagne, M; Barclay, H W; John, T; Martel, G
A balance platform setup was defined for use in the determination of the center of gravity in the sagittal plane for a wheelchair and patient. Using the center of gravity information, measurements from the wheelchair and patient (weight, tire coefficients of friction), and various assumptions (constant speed, level-concrete surface, patient-wheelchair system is a rigid body), a method for estimating the rolling resistance for a wheelchair was outlined. The center of gravity and rolling resistance techniques were validated against criterion values (center of gravity error = 1 percent, rolling resistance root mean square error = 0.33 N, rolling resistance Pearson correlation coefficient = 0.995). Consistent results were also obtained from a test dummy and five subjects. Once the center of gravity is known, it is possible to evaluate the stability of a wheelchair (in terms of tipping over) and the interaction between the level of stability and rolling resistance. These quantitative measures are expected to be of use in the setup of wheelchairs with a variable seat angle and variable wheelbase length or when making comparisons between different wheelchairs.
Chen, Wan-Yin; Jang, Yuh; Wang, Jung-Der; Huang, Wen-Ni; Chang, Chan-Chia; Mao, Hui-Fen; Wang, Yen-Ho
To report the prevalence, mechanisms, self-perceived causes, consequences, and wheelchair-using behaviors associated with wheelchair-related accidents. A case-control study. Community. A sample of experienced, community-dwelling, active manual and powered wheelchair users (N=95) recruited from a hospital assistive technology service center. Not applicable. Wheelchair-using behaviors, wheelchair-related accidents over a 3-year period, and the mechanisms and consequences of the accidents. Among the 95 participants, 52 (54.7%) reported at least 1 accident and 16 (16.8%) reported 2 or more accidents during the 3 years prior to the interview. A total of 74 accidents, were categorized into tips and falls (87.8%), accidental contact (6.8%), and dangerous operations (5.4%). A logistic regression found individuals who failed to maintain their wheelchairs regularly (odds ratio [OR]=11.28; 95% confidence interval [CI], 2.62-48.61) and used a wheelchair not prescribed by professionals (OR=4.31; 95% CI, 1.10-16.82) had significantly greater risks of accidents. In addition to the risk factor, lack of regular wheelchair maintenance, the Poisson regression corroborated the other risk factor, seat belts not used (incident rate ratio=2.14; 95% CI, 1.08-4.14), for wheelchair-related accidents. Wheelchair-related accidents are closely related to their wheelchair-using behaviors. Services including professional evaluation, repair, maintenance, and an educational program on proper wheelchair use may decrease the risks of wheelchair accidents. Copyright © 2011 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Wang, Hongwu; Liu, Hsin-Yi; Pearlman, Jon; Cooper, Rosemarie; Jefferds, Alexandra; Connor, Sam; Cooper, Rory A
To investigate the relationship between the durability of wheelchairs according to American National Standard for Wheechairs/Rehabilitation Engineering and Assistive Technology Society of North America (ANSI/RESNA) Wheelchair Standards and wheelchair type as well as year of test. A retrospective study design with a sample of 246 wheelchairs that were tested in accordance with the ANSI/RESNA standards from 1992 to 2008 including four types of wheelchairs: manual wheelchair (MWC), electrical powered wheelchair (EPW), scooters and pushrim-activated power-assisted wheelchair (PAPAW). Unconditional binary logic regression analysis was chosen to evaluate the relationship between test results and test year as well as wheelchair type. Rehabilitation Engineering Research Center. Wheelchair durability test result (fatigue test: pass or fail) There was no significant correlation between the year when tested and equivalent cycles. A significant relation was found between test results and wheelchair type (Wald score = 10.845, degree of freedom = 3, p = 0.013) with scooters having a significantly higher pass ratio than MWC (OR = 15.629, 95% CI = 2.026-120.579). EPW also had significantly higher pass ratio than MWC (OR = 1.953, 95% CI = 1.049-3.636). No significant difference on pass ratio was found between PAPAW and MWC. No significant improvements in wheelchair test results during the time frame from 1992 to 2008 were discovered. Wheelchair standard tests should be conducted to assure minimum quality of the wheelchairs and for improving the design of wheelchairs. Although the ANSI/RESNA wheelchair durability test procedures have remained consistent, it does not appear that the introduction of new materials, designs and the availability of test data have improved wheelchair fatigue life.
... a person who uses a wheelchair, do not lean on the wheelchair unless you have permission to ... currently no specific federal requirements regarding ergonomics for office workers. However, there has been some effort to ...
... Paralysis > Health > Staying active > Gardening from a wheelchair Gardening from a wheelchair ☷ ▾ Page contents Tips from community ... round handles) on gate latches, doors, and faucets. Gardening as therapy For Gene Rothert gardening is a ...
Yoshimasa Sagawa Júnior
Full Text Available OBJECTIVES: To analyze aspects related with wheelchair propulsion. MATERIALS AND METHODS: In order to delineate this review the search for information was carried out within electronics databases, using the following descriptors: "wheelchair propulsion", "wheelchair biomechanics" e "wheelchair users". Full papers published in English and French were included in the study. RESULTS: The wheelchair propulsion is a complex movement that requires the execution of repeated bi manual forces applications during a short time period. In this movement high levels of force must be produced due to the bad mechanical performance of the wheelchair. Could be characterized that wheelchair users are not satisfied with their wheelchair, the places are not adapted to their presence and lack of specific criteria for the adjustment of this equipment. The main points to look at are the seat height in relation to elbow flexion (100-120 degrees with his hand in the propulsion rim and tire pressure. The semicircular mode of technique propulsion seems to be more appropriate; in this pattern the wheelchair user returns his hand under the rim after propulsion. Efforts in wheelchairs are high and the incidence of injuries in wheelchair users is high. CONCLUSION: One can conclude that in spite of researchers’ efforts there are still many divergences between topics and methods of evaluation, what makes difficult to apply the experimental results to the wheelchairs users’ daily life.
Mason, Barry S.; Porcellato, Lorna; van der Woude, Lucas H. V.; Goosey-Tolfrey, Victoria L.
Objective: To examine wheelchair athletes' perceptions of wheelchair configuration in relation to aspects of mobility performance. Methods: Nine elite wheelchair athletes from wheelchair basketball, wheelchair rugby and wheelchair tennis were interviewed using a semi-structured format. Interview
Veeger, Thom T.J.; De Witte, Annemarie M H; Berger, Monique A M; van der Slikke, Rienk M A; Veeger, Dirkjan H E J; Hoozemans, Marco J M
OBJECTIVE: This study aimed to investigate which characteristics of athlete, wheelchair and athlete-wheelchair interface are the best predictors of wheelchair basketball mobility performance. DESIGN: Sixty experienced wheelchair basketball players performed a wheelchair mobility performance test to
Morgan, Kerri A; Engsberg, Jack R; Gray, David B
The purpose of this project was to identify wheelchair skills currently being taught to new manual wheelchair users, identify areas of importance for manual wheelchair skills' training during initial rehabilitation, identify similarities and differences between the perspectives of health care professionals and manual wheelchair users and use the ICF to organize themes related to rehabilitation and learning how to use a manual wheelchair. Focus groups were conducted with health care professionals and experienced manual wheelchair users. ICF codes were used to identify focus group themes. The Activities and Participation codes were more frequently used than Structure, Function and Environment codes. Wheelchair skills identified as important for new manual wheelchair users included propulsion techniques, transfers in an out of the wheelchair, providing maintenance to the wheelchair and navigating barriers such as curbs, ramps and rough terrain. Health care professionals and manual wheelchair users identified the need to incorporate the environment (home and community) into the wheelchair training program. Identifying essential components for training the proper propulsion mechanics and wheelchair skills in new manual wheelchair users is an important step in preventing future health and participation restrictions. Implications for Rehabilitation Wheelchair skills are being addressed frequently during rehabilitation at the activity-dependent level. Propulsion techniques, transfers in an out of the wheelchair, providing maintenance to the wheelchair and navigating barriers such as curbs, ramps and rough terrain are important skills to address during wheelchair training. Environment factors (in the home and community) are important to incorporate into wheelchair training to maximize safe and multiple-environmental-setting uses of manual wheelchairs. The ICF has application to understanding manual wheelchair rehabilitation for wheelchair users and therapists for improving
Kirby, R Lee; Rushton, Paula W; Routhier, Francois; Demers, Louise; Titus, Laura; Miller-Polgar, Jan; Smith, Cher; McAllister, Mike; Theriault, Chris; Matheson, Kara; Parker, Kim; Sawatzky, Bonita; Labbé, Delphine; Miller, William C
To test the hypothesis that caregivers enhance the wheelchair skills capacity and confidence of the power wheelchair users to whom they provide assistance, and to describe the nature of that assistance. Multicenter cross-sectional study. Rehabilitation centers and communities. Participants (N=152) included caregivers (n=76) and wheelchair users (n=76). None. Version 4.3 of the Wheelchair Skills Test (WST) and the Wheelchair Skills Test-Questionnaire (WST-Q). For each of the 30 individual skills, we recorded data about the wheelchair user alone and in combination (blended) with the caregiver. The mean total WST capacity scores ± SD for the wheelchair users alone and blended were 78.1%±9.3% and 92.4%±6.1%, respectively, with a mean difference of 14.3%±8.7% (Pskills capacity and confidence of the power wheelchair users to whom they provide assistance, and they do so in a variety of ways. These findings have significance for wheelchair skills assessment and training. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Thirumalai, Mohanraj; Kirkland, William B; Misko, Samuel R; Padalabalanarayanan, Sangeetha; Malone, Laurie A
Active video game (AVG) playing, also known as "exergaming," is increasingly employed to promote physical activity across all age groups. The Wii Fit Balance Board is a popular gaming controller for AVGs and is used in a variety of settings. However, the commercial off-the-shelf (OTS) design poses several limitations. It is inaccessible to wheelchair users, does not support the use of stabilization assistive devices, and requires the ability to shift the center of balance (COB) in all directions to fully engage in game play. The aim of this study was to design an adapted version of the Wii Fit Balance Board to overcome the identified limitations and to evaluate the usability of the newly designed adapted Wii Fit Balance Board in persons with mobility impairments. In a previous study, 16 participants tried the OTS version of the Wii Fit Balance Board. On the basis of observed limitations, a team of engineers developed and adapted the design of the Wii Fit Balance Board, which was then subjected to multiple iterations of user feedback and design tweaks. On design completion, we recruited a new pool of participants with mobility impairments for a larger study. During their first visit, we assessed lower-extremity function using selected mobility tasks from the International Classification of Functioning, Disability and Health. During a subsequent session, participants played 2 sets of games on both the OTS and adapted versions of the Wii Fit Balance Board. Order of controller version played first was randomized. After participants played each version, we administered the System Usability Scale (SUS) to examine the participants' perceived usability. The adapted version of the Wii Fit Balance Board resulting from the user-centered design approach met the needs of a variety of users. The adapted controller (1) allowed manual wheelchair users to engage in game play, which was previously not possible; (2) included Americans with Disabilities Act-compliant handrails as part
Swee Sim Kok
Full Text Available This paper describes the development of a brainwave controlled wheelchair. The main objective of this project is to construct a wheelchair which can be directly controlled by the brain without requires any physical feedback as controlling input from the user. The method employed in this project is the Brain-computer Interface (BCI, which enables direct communication between the brain and the electrical wheelchair. The best method for recording the brain’s activity is electroencephalogram (EEG. EEG signal is also known as brainwaves signal. The device that used for capturing the EEG signal is the Emotiv EPOC headset. This headset is able to transmit the EEG signal wirelessly via Bluetooth to the PC (personal computer. By using the PC software, the EEG signals are processed and converted into mental command. According to the mental command (e.g. forward, left... obtained, the output electrical signal is sent out to the electrical wheelchair to perform the desired movement. Thus, in this project, a computer software is developed for translating the EEG signal into mental commands and transmitting out the controlling signal wirelessly to the electrical wheelchair.
Gil-Agudo, Angel; Solís-Mozos, Marta; del-Ama, Antonio J; Crespo-Ruiz, Beatriz; de la Peña-González, Ana Isabel; Pérez-Nombela, Soraya
The aim of the present study was to describe and test the reliability of a comprehensive product-centered approach to assessing functional performance and wheelchair user perceptions on device ergonomics and satisfaction of performance. A pilot study was implemented using this approach to evaluate differences among four manual wheelchairs. Six wheelchair users with complete spinal cord injury (SCI) at the thoracic level and with no previous upper limbs impairment were recruited for this study. After finishing circuit tasks, subjects were asked to complete a questionnaire about ergonomic wheelchair characteristics (manoeuvrability, stability, comfort and ease of propulsion) and satisfaction about task performance. On the other hand, objective data were recorded during user performance as the time required to complete each test, kinetic wheelchair propulsion data obtained with two SMARTWheels® and physiological parameters (heart rate and physiological index). Kuschall Champion® and Otto Bock Voyage® wheelchairs were ranked best for most ergonomic aspects specially in manoeuvrability (p importance of looking both kinds of information, user perception and user functional performance when evaluating a wheelchair or comparing across devices.
Full Text Available Background: Within a rights-based paradigm, wheelchairs are essential in the promotion of user autonomy, dignity, freedom, inclusion and participation. Objectives: This paper aimed to describe a group of Zimbabwean wheelchair users’ satisfaction with wheelchairs, wheelchair services and wheelchair function. Method: A mixed method, descriptive study was done. Quantitative data was collected from 94 consecutively sampled wheelchair users, who accessed wheelchair services at 16 clinics in five Zimbabwean provinces between October 2013 and February 2014, using the Quebec User Evaluation of Satisfaction with Assistive Technology for adults and children and Functioning Every day with a Wheelchair questionnaire. Qualitative data were collected through two focus group discussions (22 participants and two case studies with participants purposively sampled from those who participated in the quantitative phase. Results: More than 60% of participants were dissatisfied with the following wheelchair features: durability (78.6%, weight (75.6%, ease of adjustment (69.1%, effectiveness (69.0%, safety (66.7%, reliability (66.7%, and meeting user needs (60.6%. Similarly, more than 66% of participants were dissatisfied with various services aspects: professional services (69.0%, follow-up (67.0%, and service delivery (68.3%. Although 60% of participants agreed that the wheelchair contributed to specific functions, more than 50% of participants indicated that the features of the wheelchair did not allow in- (53.2% and outdoor (52.7% mobility. Conclusion: Findings indicate high levels of dissatisfaction with wheelchair features and services, as well as mobility. It is recommended that policy and minimum service standards which incorporate evidence and good practice guidelines for wheelchair services and management of wheelchair donations are developed for Zimbabwe.
Simpson, Richard C
Several studies have shown that both children and adults benefit substantially from access to a means of independent mobility. While the needs of many individuals with disabilities can be satisfied with traditional manual or powered wheelchairs, a segment of the disabled community finds it difficult or impossible to use wheelchairs independently. To accommodate this population, researchers have used technologies originally developed for mobile robots to create "smart wheelchairs." Smart wheelchairs have been the subject of research since the early 1980s and have been developed on four continents. This article presents a summary of the current state of the art and directions for future research.
Full Text Available Electric wheelchairs are designed to aid paraplegics. Unfortunately, these can not be used by persons with higher degree of impairment, such as quadriplegics, i.e. persons that, due to age or illness, can not move any of the body parts, except of the head. Medical devices designed to help them are very complicated, rare and expensive. In this paper a microcontroller system that enables standard electric wheelchair control by head motion is presented. The system comprises electronic and mechanic components. A novel head motion recognition technique based on accelerometer data processing is designed. The wheelchair joystick is controlled by the system’s mechanical actuator. The system can be used with several different types of standard electric wheelchairs. It is tested and verified through an experiment performed within this paper.
van der Woude, L H; Veeger, DirkJan (H. E. J.); Rozendal, R H; Sargeant, A J
To study the effect of different cycle frequencies on cardio-respiratory responses and propulsion technique in hand-rim wheelchair propulsion, experienced wheelchair sportsmen (WS group; n = 6) and non-wheelchair users (NW group; n = 6) performed wheelchair exercise tests on a motor-driven
de Groot, S; Post, M W M; Bongers-Janssen, H M H; Bloemen-Vrencken, J H; van der Woude, L H V
Cross-sectional study. To describe the satisfaction of the manual wheelchair user with hand rim wheelchair-related aspects (for example, dimensions, weight and comfort) and wheelchair service-related aspects and to determine the relationship between wheelchair users' satisfaction, personal and lesion characteristics, and active lifestyle and participation in persons with a spinal cord injury (SCI). Eight Dutch rehabilitation centers with a specialized SCI unit. The Dutch version of the Quebec user evaluation of satisfaction with assistive technology (D-QUEST) was filled out by 109 participants 1 year after discharge from inpatient SCI rehabilitation. Relationships between the D-QUEST scores and personal and lesion characteristics, and active lifestyle and participation (physical activity scale for individuals with physical disabilities (PASIPD), Utrecht activity list (UAL), mobility range and social behavior subscales of the SIP68 (SIPSOC)) were determined. A high level of satisfaction was found with wheelchair-related aspects. The participants were less satisfied with the service-related aspects. Participants with an incomplete lesion were slightly more satisfied regarding both aspects than those with a complete lesion. A higher satisfaction regarding wheelchair dimensions and a higher overall satisfaction were related to a more active lifestyle. Persons who were more satisfied with the simplicity of use of the wheelchair had a better participation score. Dutch persons with SCI are in general quite satisfied with their hand rim wheelchair. Some aspects of the wheelchair (dimensions and simplicity of use) are important to optimize as these are related to an active lifestyle and participation.
Boninger, Michael L; Dicianno, Brad E; Cooper, Rory A; Towers, Jeffrey D; Koontz, Alicia M; Souza, Aaron L
To investigate the relationship between pushrim forces and the progression of shoulder injuries in manual wheelchair users. Longitudinal case series. Biomechanics laboratory and magnetic resonance imaging (MRI) facility at a Veterans Health Administration medical center and university hospital, respectively. Fourteen individuals with spinal cord injury (8 men, 6 women) who used manual wheelchairs. Subjects propelled their own wheelchairs on a dynamometer at 0.9 and 1.8m/s. Bilateral biomechanical data were obtained by using force and moment sensing pushrims at time 1. Bilateral shoulder MR images were also completed on 2 occasions, at time 1 and, approximately 2 years later, at time 2. The peak pushrim forces in a pushrim coordinate system were calculated, weight normalized and averaged over 5 strokes (presented as % body weight). MRI abnormalities were graded by using a summated scale. Differences between scores between times 1 and 2 were calculated. Subjects were divided into 2 groups based on change in MRI score. Seven subjects were in the group with worsening scores (MRI+; mean, 8.14 points; range, 5-16), and 7 were in the group with improving or unchanging scores (MRI-; mean, -1.00 point; range, -5 to 1). There was no significant difference between groups with respect to age, body mass index, or years from injury. There were significantly more women in the MRI+ group (6 women, 1 man) than in the MRI- group (7 men) (P=.001). The MRI+ group used significantly greater weight-normalized radial force, or force directed toward the axle at time 1, to propel their wheelchairs at each speed (Ppay particular attention to women who use wheelchairs. Reducing forces during wheelchair propulsion may minimize the likelihood of developing shoulder injuries.
Karen H. Fung
Conclusion: The majority of the educational institutions teach wheelchair education; however, there is great variability in what and how it is taught and evaluated. The results demonstrate the need for more in-depth investigation regarding the integration process of wheelchair education in educational institutions, with the ultimate goal of improving wheelchair service provision worldwide.
van der Woude, L H; Bakker, W H; Elkhuizen, J W; Veeger, DirkJan (H. E. J.); Gwinn, T
To study the anaerobic work capacity in wheelchair athletes, 67 elite wheelchair athletes (50 male) were studied in a 30-second sprint test on a computer-controlled wheelchair ergometer during the World Championships and Games for the Disabled in Assen (1990). The experimental set-up (ergometer,
Cooper, Rory A; De Luigi, Arthur Jason
Wheelchair sports are an important tool in the rehabilitation of people with severe chronic disabilities and have been a driving force for innovation in technology and practice. In this paper, we will present an overview of the adaptive technology used in Paralympic sports with a special focus on wheeled technology and the impact of design on performance (defined as achieving the greatest level of athletic ability and minimizing the risk of injury). Many advances in manual wheelchairs trace their origins to wheelchair sports. Features of wheelchairs that were used for racing and basketball 25 or more years ago have become integral to the manual wheelchairs that people now use every day; moreover, the current components used on ultralight wheelchairs also have benefitted from technological advances developed for sports wheelchairs. For example, the wheels now used on chairs for daily mobility incorporate many of the components first developed for sports chairs. Also, advances in manufacturing and the availability of aerospace materials have driven current wheelchair design and manufacture. Basic principles of sports wheelchair design are universal across sports and include fit; minimizing weight while maintaining high stiffness; minimizing rolling resistance; and optimizing the sports-specific design of the chair. However, a well-designed and fitted wheelchair is not sufficient for optimal sports performance: the athlete must be well trained, skilled, and use effective biomechanics because wheelchair athletes face some unique biomechanical challenges. Copyright © 2014 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.
Aziz, Fayeem; Arof, Hamzah; Mokhtar, Norrima; Mubin, Marizan
This paper presents a wheelchair navigation system based on a hidden Markov model (HMM), which we developed to assist those with restricted mobility. The semi-autonomous system is equipped with obstacle/collision avoidance sensors and it takes the electrooculography (EOG) signal traces from the user as commands to maneuver the wheelchair. The EOG traces originate from eyeball and eyelid movements and they are embedded in EEG signals collected from the scalp of the user at three different locations. Features extracted from the EOG traces are used to determine whether the eyes are open or closed, and whether the eyes are gazing to the right, center, or left. These features are utilized as inputs to a few support vector machine (SVM) classifiers, whose outputs are regarded as observations to an HMM. The HMM determines the state of the system and generates commands for navigating the wheelchair accordingly. The use of simple features and the implementation of a sliding window that captures important signatures in the EOG traces result in a fast execution time and high classification rates. The wheelchair is equipped with a proximity sensor and it can move forward and backward in three directions. The asynchronous system achieved an average classification rate of 98% when tested with online data while its average execution time was less than 1 s. It was also tested in a navigation experiment where all of the participants managed to complete the tasks successfully without collisions.
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Rashid, Zulqarnain; Pous, Rafael; Norrie, Christopher S
People with physical and mobility impairments continue to struggle to attain independence in the performance of routine activities and tasks. For example, browsing in a store and interacting with products located beyond an arm's length may be impossible without the enabling intervention of a human assistant. This research article describes a study undertaken to design, develop, and evaluate potential interaction methods for motor-impaired individuals, specifically those who use wheelchairs. Our study includes a user-centered approach, and a categorization of wheelchair users based upon the severity of their disability and their individual needs. We designed and developed access solutions that utilize radio frequency identification (RFID), augmented reality (AR), and touchscreen technologies in order to help people who use wheelchairs to carry out certain tasks autonomously. In this way, they have been empowered to go shopping independently, free from reliance upon the assistance of others. A total of 18 wheelchair users participated in the completed study.
Practical Pointers, 1978
The article examines weight lifting training procedures for persons involved in wheelchair sports. Popular myths about weight training are countered, and guidelines for a safe and sound weight or resistance training program are given. Diagrams and descriptions follow for specific weightlifting activities: regular or standing press, military press,…
Mason, Barry S.; van der Woude, Lucas H. V.; Goosey-Tolfrey, Victoria L.
Optimizing mobility performance in wheelchair court sports (basketball, rugby and tennis) is dependent on a combination of factors associated with the user, the wheelchair and the interfacing between the two. Substantial research has been attributed to the wheelchair athlete yet very little has
Veeger, Thom T J; De Witte, Annemarie M H; Berger, Monique A M; Van Der Slikke, Rienk M A; Veeger, Dirkjan H E J; Hoozemans, Marco J M
This study aimed to investigate which characteristics of athlete, wheelchair and athlete-wheelchair interface are the best predictors of wheelchair basketball mobility performance. Sixty experienced wheelchair basketball players performed a wheelchair mobility performance test to assess their mobility performance. To determine which variables were the best predictors of mobility performance, forward stepwise linear regression analyses were performed on a set of 33 characteristics, including ten athlete, nineteen wheelchair and four athlete-wheelchair interface characteristics. Eight of the characteristics turned out to be significant predictors of wheelchair basketball mobility performance. Classification, experience, maximal isometric force, wheel axis height and hand rim diameter - which both interchangeable with each other and wheel diameter - camber angle, and the vertical distance between shoulder and rear wheel axis - which was interchangeable with seat height - were positively associated with mobility performance. The vertical distance between the front seat and the footrest was negatively associated with mobility performance. With this insight, coaches and biomechanical specialists are provided with statistical findings to determine which characteristics they could focus on best to improve mobility performance. Six out of eight predictors are modifiable and can be optimized to improve mobility performance. These adjustments could be carried out both in training (maximal isometric force) and in wheelchair configurations (e.g. camber angle).
Jennifer L Dysterheft
Full Text Available Ten full time adolescent wheelchair users (ages 13-18 completed a total of three propulsion trials on carpet and tile surfaces, at a self-selected velocity, and on a concrete surface, at a controlled velocity. All trials were performed in their personal wheelchair with force and moment sensing wheels attached bilaterally. The first two trials on each surface were used as pre-intervention control trials. The third trial was performed after receiving training on proper propulsion technique. Peak Resultant Force, Contact Angle, Stroke Frequency, and Velocity were recorded during all trials for primary analysis. Carpet and tile trials resulted in significant increases in Contact Angle and Peak Total Force with decreased Stroke Frequency after training. During the velocity controlled trials on concrete, significant increases in Contact Angle occurred, as well as decreases in Stroke Frequency after training. Overall, the use of a training video and verbal feedback may help to improve short term propulsion technique in adolescent wheelchair users and decrease the risk of developing upper limb pain and injury.
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Full Text Available Background: Providing wheelchairs without comprehensive support services might be detrimental to user satisfaction and function. Objectives: This paper compares wheelchair user satisfaction and function before and after implementation of comprehensive wheelchair services, based on the World Health Organization guidelines on wheelchair service provision in less resourced settings, in Zimbabwe. Method: A pre- and post-test study with a qualitative component was done. Quantitative data were collected with the Quebec User Evaluation of Satisfaction with Assistive Technology for adults and children and the ‘Functioning Every day with a Wheelchair Questionnaire’. Data were collected from 55 consecutively sampled wheelchair users, who received a new wheelchair in the study period. Qualitative data were collected through two audio recorded focus groups and two case studies and are presented through narrative examples. Results: The proportion of adult users who were satisfied significantly increased for all wheelchair and service delivery aspects (p = 0.001 - 0.008, except follow-up (p = 0.128. The same was true for children’s post-test ratings on all variables assessed (p = 0.001 - 0.04, except training in the use of the device (p = 0.052. The biggest improvement in satisfaction figures were for comfort needs (44.3%, indoor mobility (43.2%, outdoor mobility (37.2%, safe and efficient, independent operation (33.5% and transport (31.4%. The qualitative data illustrated user satisfaction with wheelchair features and services. Conclusion: The wheelchair service programme resulted in significant positive changes in user satisfaction with the wheelchair, wheelchair services and function. It is recommended that the Zimbabwean government and partner organisations continue to support and develop wheelchair services along these guidelines. Keywords: Wheelchair; service delivery; function; satisfaction
Mason, Barry S; van der Woude, Lucas H V; Goosey-Tolfrey, Victoria L
Optimizing mobility performance in wheelchair court sports (basketball, rugby and tennis) is dependent on a combination of factors associated with the user, the wheelchair and the interfacing between the two. Substantial research has been attributed to the wheelchair athlete yet very little has focused on the role of the wheelchair and the wheelchair-user combination. This article aims to review relevant scientific literature that has investigated the effects of wheelchair configuration on aspects of mobility performance from an ergonomics perspective. Optimizing performance from an ergonomics perspective requires a multidisciplinary approach. This has resulted in laboratory-based investigations incorporating a combination of physiological and biomechanical analyses to assess the efficiency, health/safety and comfort of various wheelchair configurations. To a lesser extent, field-based testing has also been incorporated to determine the effects of wheelchair configuration on aspects of mobility performance specific to the wheelchair court sports. The available literature has demonstrated that areas of seat positioning, rear wheel camber, wheel size and hand-rim configurations can all influence the ergonomics of wheelchair performance. Certain configurations have been found to elevate the physiological demand of wheelchair propulsion, others have been associated with an increased risk of injury and some have demonstrated favourable performance on court. A consideration of all these factors is required to identify optimal wheelchair configurations. Unfortunately, a wide variety of different methodologies have immerged between studies, many of which are accompanied by limitations, thus making the identification of optimal configurations problematic. When investigating an area of wheelchair configuration, many studies have failed to adequately standardize other areas, which has prevented reliable cause and effect relationships being established. In addition, a large
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Wheelchair elevator. 890.3930 Section 890.3930 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... elevator. (a) Identification. A wheelchair elevator is a motorized lift device intended for medical...
van der Slikke, Rienk M A; Berger, Monique; Bregman, Daan; Veeger, Dirkjan
Short sprints are important components of most wheelchair court sports, since being faster than the opponent often determines keeping ball possession or not. Sprinting capacity is best measured during a field test, allowing the athlete to freely choose push strategies adapted to their own wheelchair
Kauzlarich, J J
The characteristics of lead-acid batteries for wheelchairs in terms of a new empirical equation for the capacity, application of the Palmgren-Miner Rule for sizing the battery, and the effect of depth of discharge on the life cycles is presented. A brief section about selecting an economical battery for an electric wheelchair is included.
Veeger, DirkJan (H. E. J.); van der Woude, L H; Rozendal, R H
To study wheelchair propulsion technique at different speeds, five well-trained subjects propelled a wheelchair on a treadmill. Measurements were made at four belt speeds of 0.56-1.39 m/s and against slopes of 2 and 3 degrees. Cardiorespiratory data were collected. Three consecutive strokes were
Toro, Maria Luisa; Bird, Emily; Oyster, Michelle; Worobey, Lynn; Lain, Michael; Bucior, Samuel; Cooper, Rory A; Pearlman, Jonathan
Purpose of state: The aims of this study were to develop a Wheelchair Maintenance Training Programme (WMTP) as a tool for clinicians to teach wheelchair users (and caregivers when applicable) in a group setting to perform basic maintenance at home in the USA and to develop a Wheelchair Maintenance Training Questionnaire (WMT-Q) to evaluate wheelchair maintenance knowledge in clinicians, manual and power wheelchair users. The WMTP and WMT-Q were developed through an iterative process. A convenience sample of clinicians (n = 17), manual wheelchair (n ∞ 5), power wheelchair users (n = 4) and caregivers (n = 4) provided feedback on the training programme. A convenience sample of clinicians (n = 38), manual wheelchair (n = 25), and power wheelchair users (n = 30) answered the WMT-Q throughout different phases of development. The subscores of the WMT-Q achieved a reliability that ranged between ICC(3,1) = 0.48 to ICC(3,1) = 0.89. The WMTP and WMT-Q were implemented with 15 clinicians who received in-person training in the USA using the materials developed and showed a significant increase in all except one of the WMT-Q subscores after the WMTP (p users. This training complements the World Health Organization basic wheelchair service curriculum, which only includes training of the clinicians, but does not include detailed information to train wheelchair users and caregivers. This training program offers a time efficient method for providing education to end users in a group setting that may mitigate adverse consequences resulting from wheelchair breakdown. This training program has significant potential for impact among wheelchair users in areas where access to repair services is limited.
van der Slikke, Rienk M A; de Witte, Annemarie M H; Berger, Monique A M; Bregman, Daan J J; Veeger, Dirk Jan H E J
The purpose of this study was to provide insight in the effect of wheelchair settings on wheelchair mobility performance. Twenty elite wheelchair basketball athletes of low (n=10) and high classification (n=10), were tested in a wheelchair basketball directed field test. Athletes performed the test in their own wheelchair, which was modified for five additional conditions regarding seat height (high - low), mass (central - distributed) and grip. The previously developed, inertial sensor based wheelchair mobility performance monitor 1 was used to extract wheelchair kinematics in all conditions. Adding mass showed most effect on wheelchair mobility performance, with a reduced average acceleration across all activities. Once distributed, additional mass also reduced maximal rotational speed and rotational acceleration. Elevating seat height had effect on several performance aspects in sprinting and turning, whereas lowering seat height influenced performance minimally. Increased rim grip did not alter performance. No differences in response were evident between low and high classified athletes. The wheelchair mobility performance monitor showed sensitive to detect performance differences due to the small changes in wheelchair configuration made. Distributed additional mass had the most effect on wheelchair mobility performance, whereas additional grip had the least effect of conditions tested. Performance effects appear similar for both low and high classified athletes. Athletes, coaches and wheelchair experts are provided with insight in the performance effect of key wheelchair settings, and they are offered a proven sensitive method to apply in sports practice, in their search for the best wheelchair-athlete combination.
Gorce, P; Louis, N
Biomechanical studies have linked the handrim wheelchair propulsion with a prevalence of upper limb musculoskeletal disorders. The purpose of this study was to examine the influence of the wheelchair settings on upper limb kinematics during wheelchair propulsion. Recordings were made under various wheelchair configuration conditions to understand the effect of wheelchair settings on kinematics parameters such shoulder, elbow and wrist angles. Ten experts and ten beginners' subjects propelled an experimental wheelchair on a roller ergometer system at a comfortable speed. Twelve wheelchair configurations were tested. Kinematics were recorded for each configuration. Based on the hand position relatively to the handrim, the main kinematic parameters of wheelchair propulsion were investigated on the whole propulsion cycle and a key event such as handrim contact and release. Compared to the beginner subjects, all the experts' subjects generally present higher joint amplitude and propulsion speeds. Seat height and antero-posterior axle position influence usage of the hand-rim, timing parameters and configurations of upper limb joints. Results seem to confirm that low and backward seat position allow a greater efficiency. Nevertheless, according that proximity of joint limit is a well known factor of musculoskeletal disorders, our results let us think that too low and backward seat position, increasing joints positions and amplitudes, could increase the risk of upper limb injuries in relation with manual wheelchair propulsion. Kinematic differences highlight that future studies on wheelchair propulsion should only be done with impaired experienced subjects. Furthermore, this study provides indications on how wheelchair settings can be used for upper limb injury prevention. Copyright © 2011 Elsevier Ltd. All rights reserved.
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de Groot, Sonja; Vegter, Riemer J. K.; van der Woude, Lucas H. V.
The purpose of this study was to evaluate the effect of wheelchair mass, solid vs. pneumatic tires and tire pressure on physical strain and wheelchair propulsion technique. 11 Able-bodied participants performed 14 submaximal exercise blocks on a treadmill with a fixed speed (1.11 m/s) within 3 weeks
Veeger, DirkJan (H. E. J.); van der Woude, L H; Rozendal, R H
To investigate power output and torque production in wheelchair sprinting, six able-bodied subjects performed nine 20-s sprint tests on a stationary wheelchair ergometer (load 0-8 kg). Ergometer data were analyzed and combined with kinematic data and surface electromyography. Of all power and torque
Hoenig, Helen; Griffiths, Patricia; Ganesh, Shanti; Caves, Kevin; Harris, Frances
This study examined the accuracy of new wheelchair user predictions about their future wheelchair use. This was a prospective cohort study of 84 community-dwelling veterans provided a new manual wheelchair. The association between predicted and actual wheelchair use was strong at 3 mos (ϕ coefficient = 0.56), with 90% of those who anticipated using the wheelchair at 3 mos still using it (i.e., positive predictive value = 0.96) and 60% of those who anticipated not using it indeed no longer using the wheelchair (i.e., negative predictive value = 0.60, overall accuracy = 0.92). Predictive accuracy diminished over time, with overall accuracy declining from 0.92 at 3 mos to 0.66 at 6 mos. At all time points, and for all types of use, patients better predicted use as opposed to disuse, with correspondingly higher positive than negative predictive values. Accuracy of prediction of use in specific indoor and outdoor locations varied according to location. This study demonstrates the importance of better understanding the potential mismatch between the anticipated and actual patterns of wheelchair use. The findings suggest that users can be relied upon to accurately predict their basic wheelchair-related needs in the short-term. Further exploration is needed to identify characteristics that will aid users and their providers in more accurately predicting mobility needs for the long-term.
Okunribido, Olanrewaju O
This article is a report of a study of the effect of the seat cushion on risk of falling from a wheelchair. Two laboratory studies and simulated assistant propelled wheelchair transfers were conducted with four healthy female participants. For the laboratory studies there were three independent variables: trunk posture (upright/flexed forward), seat cushion (flat polyurethane/propad low profile), and feet condition (dangling/supported), and two dependent variables: occupied wheelchair (wheelchair) center of gravity (CG), and stability. For the simulated transfers there was one independent variable: seat cushion (flat polyurethane/propad low profile), and one dependent variable: perception of safety (risk of falling). Results showed that the wheelchair CG was closer to the front wheels, and stability lower for the propad low profile cushion compared to the polyurethane cushion, when the participants sat with their feet dangling. During the simulated transfers, sitting on the propad low profile cushion caused participants to feel more apprehensive (anxious or uneasy) compared to sitting on the polyurethane cushion. The findings can contribute to the assessment of risk and care planning of non-ambulatory wheelchair users.
Shen, Jiajun; Xu, Bin; Pei, Mingtao; Jia, Yunde
This paper presents the architecture and implementation of a tele-presence wheelchair system based on tele-presence robot, intelligent wheelchair, and touch screen technologies. The tele-presence wheelchair system consists of a commercial electric wheelchair, an add-on tele-presence interaction module, and a touchable live video image based user interface (called TIUI). The tele-presence interaction module is used to provide video-chatting for an elderly or disabled person with the family mem...
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van der Woude, L H; Veeger, DirkJan (H. E. J.); de Boer, Y; Rozendal, R H
Lever-propelled wheelchairs have been described as more efficient and less physically demanding than hand-rim-propelled wheelchairs. To evaluate a newly designed lever mechanism (MARC) in both one- and two-arm use, a series of wheelchair exercise tests were performed on a motor-driven treadmill.
van der Slikke, R.M.A.; Berger, MAM; Bregman, DJJ; Veeger, H.E.J.
Increased professionalism in wheelchair sports demand a more precise and quantitative measure of individual wheelchair mobility performance, to allow it to be an evaluation measure of wheelchair setting or training optimization. This research describes the application of an inertial sensor based
Morgan, Kerri A; Tucker, Susan M; Klaesner, Joseph W; Engsberg, Jack R
Developing an evidence-based approach to teaching wheelchair skills and proper propulsion for everyday wheelchair users with a spinal cord injury (SCI) is important to their rehabilitation. The purpose of this project was to pilot test manual wheelchair training based on motor learning and repetition-based approaches for new manual wheelchair users with an SCI. A repeated measures within-subject design was used with participants acting as their own controls. Six persons with an SCI requiring the use of a manual wheelchair participated in wheelchair training. The training included nine 90-minute sessions. The primary focus was on wheelchair propulsion biomechanics with a secondary focus on wheelchair skills. During Pretest 1, Pretest 2, and Posttest, wheelchair propulsion biomechanics were measured using the Wheelchair Propulsion Test and a Video Motion Capture system. During Pretest 2 and Posttest, propulsion forces using the WheelMill System and wheelchair skills using the Wheelchair Skills Test were measured. Significant changes in area of the push loop, hand-to-axle relationship, and slope of push forces were found. Changes in propulsion patterns were identified post-training. No significant differences were found in peak and average push forces and wheelchair skills pre- and post-training. This project identified trends in change related to a repetition-based motor learning approach for propelling a manual wheelchair. The changes found were related to the propulsion patterns used by participants. Despite some challenges associated with implementing interventions for new manual wheelchair users, such as recruitment, the results of this study show that repetition-based training can improve biomechanics and propulsion patterns for new manual wheelchair users.
Kawada, Kyohei; Matsuda, Tadamitsu; Takanashi, Akira; Miyazima, Shigeki; Yamamoto, Sumiko
[Purpose] This study sought to ascertain whether, in hemiplegic patients, the effect of a wheelchair cushion to suppress pelvic posterior tilt when initiating wheelchair propulsion would continue in subsequent propulsions. [Subjects] Eighteen hemiplegic patients who were able to propel a wheelchair in a seated position participated in this study. [Methods] An adjustable wheelchair was fitted with a cushion that had an anchoring function, and a thigh pad on the propulsion side was removed. Pro...
Liu, Hsin-yi; Pearlman, Jonathan; Cooper, Rosemarie; Hong, Eun-kyoung; Wang, Hongwu; Salatin, Benjamin; Cooper, Rory A
Previous studies found that select titanium ultralight rigid wheelchairs (TURWs) had fewer equivalent cycles and less value than select aluminum ultralight folding wheelchairs (AUFWs). The causes of premature failure of TURWs were not clear because the TURWs had different frame material and design than the AUFWs. We tested 12 aluminum ultralight rigid wheelchairs (AURWs) with similar frame designs and dimensions as the TURWs using the American National Standards Institute/Rehabilitation Engineering and Assistive Technology Society of North America and International Organization for Standardization wheelchair standards and hypothesized that the AURWs would be more durable than the TURWs. Across wheelchair models, no significant differences were found in the test results between the AURWs and TURWs, except in their overall length. Tire pressure, tube-wall thickness, and tube manufacturing were proposed to be the factors affecting wheelchair durability through comparison of the failure modes, frames, and components. The frame material did not directly affect the performance of AURWs and TURWs, but proper wheelchair manufacture and design based on mechanical properties are important.
de Witte, AMH; Hoozemans, MJM; Berger, MAM; van der Slikke, R.M.A.; van der Woude, LHV; Veeger, H.E.J.
The aim of this study was to develop and describe a wheelchair mobility performance test in wheelchair basketball and to assess its construct validity and reliability. To mimic mobility performance of wheelchair basketball matches in a standardised manner, a test was designed based on observation
de Witte, Annemarie M. H.; Hoozemans, Marco J. M.; Berger, Monique A. M.; van der Slikke, Rienk M. A.; van der Woude, Lucas H. V.; Veeger, Dirkjan (H. E. J)
The aim of this study was to develop and describe a wheelchair mobility performance test in wheelchair basketball and to assess its construct validity and reliability. To mimic mobility performance of wheelchair basketball matches in a standardised manner, a test was designed based on observation of
de Witte, Annemarie M H; Hoozemans, Marco J M; Berger, Monique A M; van der Slikke, Rienk M A; van der Woude, Lucas H V; Veeger, Dirkjan (H E J)
The aim of this study was to develop and describe a wheelchair mobility performance test in wheelchair basketball and to assess its construct validity and reliability. To mimic mobility performance of wheelchair basketball matches in a standardised manner, a test was designed based on observation of
van der Scheer, Jan W.; de Groot, Sonja; Vegter, Riemer J. K.; Veeger, DirkJan (H. E. J. ); van der Woude, Lucas H. V.
OBJECTIVE: To evaluate whether outcomes based on stopwatch time and power output (PO) over a 15m-overground wheelchair sprint test can be used to assess wheelchair-specific anaerobic work capacity, by studying their relationship with outcomes on a Wingate-based 30s-wheelchair ergometer sprint
van der Scheer, J.W.; De Groot, S.; Vegter, R.J.K.; Veeger, H.E.J.; van der Woude, L.H.V.
Objective: To evaluate whether outcomes based on stopwatch time and power output (PO) over a 15. m-overground wheelchair sprint test can be used to assess wheelchair-specific anaerobic work capacity, by studying their relationship with outcomes on a Wingate-based 30. s-wheelchair ergometer sprint
Evcil, A Nilay
Accessibility to public environment is the human right and basic need of each citizen and is one of the fundamental considerations for urban planning. The aim of this study is to determine the compliance of public buildings in central business districts (CBD) of Istanbul, Turkey, to wheelchair accessibility to the guidelines of the instrument and identify architectural barriers faced by wheelchair users. This is a descriptive study of 26 public buildings in CBD of Istanbul. The instrument used is the adapted Useh, Moyo and Munyonga questionnaire to collect the data from direct observation and measurement. Descriptive statistics of simple percentages and means are used to explain the compliance to the guidelines of the instrument and wheelchair accessibility. The descriptive survey results indicate that wheelchair users experience many accessibility problems in public environment of the most urbanised city (cultural capital of Europe in 2010) in a developing country. It is found that the major architectural barrier is the public transportation items with the lowest mean compliance (25%). Beside this, the most compliant to the instrument is entrance to building items with 79% as mean percentage. It is also found that there is an intention to improve accessibility when building construction period is investigated. This article describes the example of the compliance of public buildings accessibility when the country has legislation, but lacking regulations about accessibility for the wheelchair users.
Xu, Wang; Chen, Naijian; Han, Xiangdong; Sun, Jianbo
The paper describes an intelligent wheelchair control system based on EOG. It can help disabled people improve their living ability. The system can acquire EOG signal from the user, detect the number of blink and the direction of glancing, and then send commands to the wheelchair robot via RS-232 to achieve the control of wheelchair robot. Wheelchair robot control system based on EOG is composed of processing EOG signal and human-computer interactive technology, which achieves a purpose of using conscious eye movement to control wheelchair robot.
Barrett, Steven; Streeter, Robert
An autonomous wheelchair is in development to provide mobility to those with significant physical challenges. The overall goal of the project is to develop a wheelchair that is fully autonomous with the ability to navigate about an environment and negotiate obstacles. As a starting point for the project, we have reversed engineered the joystick control system of an off-the-shelf commercially available wheelchair. The joystick control has been replaced with a microcontroller based system. The microcontroller has the capability to interface with a number of subsystems currently under development including wheel odometers, obstacle avoidance sensors, and ultrasonic-based wall sensors. This paper will discuss the microcontroller based system and provide a detailed system description. Results of this study may be adapted to commercial or military robot control.
Full Text Available In this paper is presented the design and experimental prototype of a wheelchair for disabled people. Design solution proposed to be implemented uses two reduction gears motors and a mechanical transmission with chains. The motion controller developed uses PWM technology (pulse wave modulation. The wheelchair has the ability of forward – backward motion and steering. The design solution is developed in Solid Works, and it’s implemented to a wheelchair prototype model. Wheelchair design and motion makes him suitable especially for indoor use. It is made a study of the wheelchair kinematics, first using a kinematic simulation in Adams. Are presented the wheelchair motion trajectory and kinematics parameters. The experimental prototype is tested with a motion analysis system based on ultra high speed video recording. The obtained results from simulation and experimentally tests, demonstrate the efficiency of wheelchair proposed solution.
This article has no direct link with academics, children, students or those who teach: I severed almost all such connections several years ago. It describes the rewards and challenges of leading a reminiscence group of elderly people, all of whom suffer some level of memory loss and/or severe physical disability; most are wheelchair-bound. It…
Slavens, Brooke A; Schnorenberg, Alyssa J; Aurit, Christine M; Tarima, Sergey; Vogel, Lawrence C; Harris, Gerald F
Currently, there is limited research of the biomechanics of pediatric manual wheelchair mobility. Specifically, the biomechanics of functional tasks and their relationship to joint pain and health is not well understood. To contribute to this knowledge gap, a quantitative rehabilitation approach was applied for characterizing upper extremity biomechanics of manual wheelchair mobility in children and adolescents during propulsion, starting, and stopping tasks. A Vicon motion analysis system captured movement, while a SmartWheel simultaneously collected three-dimensional forces and moments occurring at the handrim. A custom pediatric inverse dynamics model was used to evaluate three-dimensional upper extremity joint motions, forces, and moments of 14 children with spinal cord injury (SCI) during the functional tasks. Additionally, pain and health-related quality of life outcomes were assessed. This research found that joint demands are significantly different amongst functional tasks, with greatest demands placed on the shoulder during the starting task. Propulsion was significantly different from starting and stopping at all joints. We identified multiple stroke patterns used by the children, some of which are not standard in adults. One subject reported average daily pain, which was minimal. Lower than normal physical health and higher than normal mental health was found in this population. It can be concluded that functional tasks should be considered in addition to propulsion for rehabilitation and SCI treatment planning. This research provides wheelchair users and clinicians with a comprehensive, biomechanical, mobility assessment approach for wheelchair prescription, training, and long-term care of children with SCI.
van der Slikke, R.M.A.; Berger, Monique; Bregman, D.J.J.; Veeger, H.E.J.; van der Helm, FCT; Jansen, AJ
Short sprints are important components of most wheelchair court sports, since being faster than the opponent often determines keeping ball possession or not. Sprinting capacity is best measured during a field test, allowing the athlete to freely choose push strategies adapted to their own
Oudejans, R.R.D.; Heubers, S.; Ruitenbeek, J-R.J.A.C.; Janssen, T.W.J.
We examined the effects of visual control training on expert wheelchair basketball shooting, a skill more difficult than in regular basketball, as players shoot from a seated position to the same rim height. The training consisted of shooting with a visual constraint that forced participants to use
van der Voordt, D.J.M.; de Jong, G.E.; Verkroost, S.
To be universally accessible the built environment must be adequately adapted to the needs of the widest possible range of users and to the use of mobility aids such as walking sticks, rollator walkers, manual wheelchairs and electric scooters. Delft University of Technology regularly conducts
Oudejans, Raoul R. D.; Heubers, Sjoerd; Ruitenbeek, Jean-Rene J. A. C.; Janssen, Thomas W. J.
We examined the effects of visual control training on expert wheelchair basketball shooting, a skill more difficult than in regular basketball, as players shoot from a seated position to the same rim height. The training consisted of shooting with a visual constraint that forced participants to use target information as late as possible.…
R Lee Kirby
Full Text Available To test the hypotheses that community-dwelling veterans with spinal cord injury (SCI who receive the Wheelchair Skills Training Program (WSTP in their own environments significantly improve their manual wheelchair-skills capacity, retain those improvements at one year and improve participation in comparison with an Educational Control (EC group.We carried out a randomized controlled trial, studying 106 veterans with SCI from three Veterans Affairs rehabilitation centers. Each participant received either five one-on-one WSTP or EC sessions 30-45 minutes in duration. The main outcome measures were the total and subtotal percentage capacity scores from the Wheelchair Skills Test 4.1 (WST and Craig Handicap Assessment and Reporting Technique (CHART scores.Participants in the WSTP group improved their total and Advanced-level WST scores by 7.1% and 30.1% relative to baseline (p < 0.001 and retained their scores at one year follow-up. The success rates for individual skills were consistent with the total and subtotal WST scores. The CHART Mobility sub-score improved by 3.2% over baseline (p = 0.021.Individualized wheelchair skills training in the home environment substantially improves the advanced and total wheelchair skills capacity of experienced community-dwelling veterans with SCI but has only a small impact on participation.
Charbonneau, Rebecca; Kirby, R Lee; Thompson, Kara
To test the hypotheses that people with hemiplegia using arms and legs to propel their wheelchairs perform better backward than forward and prefer the backward direction. Within-participant cross-sectional design. Manual wheelchair users (N=18) with hemiplegia caused by stroke, a sample of convenience. Rehabilitation center. Participants each performed 9 skills from the Wheelchair Skills Test (WST 4.1)-4 low-rolling-resistance skills (rolls 10m, turns 90° while moving, rolls 2m across 5° side slope, descends 5cm level change) and 5 high-rolling-resistance skills (ascends 5° incline, rolls 2m on soft surface, gets over 15-cm pothole, gets over 2-cm threshold, ascends 5cm level change)-in both the forward and backward directions, in random order. Total percentage capacity scores from the modified WST 4.1, success rates for individual skills, and responses from an orally administered questionnaire regarding direction preferences. The mean ± SD total WST 4.1 capacity scores were 53%±26% in the forward direction and 76%±30% in the backward direction (Pskills, there were no clinically significant differences (≥20%) between forward and backward success rates. For the 5 high-rolling-resistance skills, the success rates were 33% to 50% higher in the backward direction. Participants preferred the forward direction for low-rolling-resistance skills and the backward direction for high-rolling-resistance skills. Wheelchair skills that involve high rolling resistance are performed more successfully in the backward than the forward direction, and participants prefer the backward direction for such skills. These findings have implications for wheelchair selection and skills training. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Tu, Chun-Jing; Liu, Lin; Wang, Wei; Du, He-Ping; Wang, Yu-Ming; Xu, Yan-Bing; Li, Ping
To comprehensively assess the effectiveness and safety of wheelchair skills training program in improving wheelchair skills capacity. PubMed, OVID, EBSCO, ScienceDirect, Web of Science, CINAHL, Cochrane Library, Google Scholar, and China Knowledge Resource Integrated Database were searched up to March 2017. Controlled clinical trials that compared a wheelchair skills training program with a control group that received other interventions and used the wheelchair skills test scores to evaluate wheelchair skills capacity were included. Two authors independently screened articles, extracted data, and assessed the methodological quality using the Cochrane risk-of-bias tool in randomized controlled trial (RCT) and methodological index for non-randomized studies. The data results of wheelchair skills test scores were extracted. Data from 455 individuals in 10 RCTs and from 140 participants in seven non-randomized studies were included for meta-analysis using Stata version 12.0 (Stata Corporation, College Station, TX, USA). In the short term (immediately to one week) post-intervention, relative to a control group, manual wheelchair skills training could increase the total wheelchair skills test scores by 13.26% in RCTs (95% confidence interval (CI), 6.19%-20.34%; P skills training and the long-term (3-12 months) advantage of manual wheelchair skills training ( P = 0.755). The limited evidence suggests that wheelchair skills training program is beneficial in the short term, but its long-term effects remain unclear.
Peretz, Avi; Koiefman, Anna; Dinisman, Eleonora; Brodsky, Diana; Labay, Kozitta
Transmission of nosocomial pathogens has been linked to transient colonization of health care workers, medical devices and other constituents of patients' environment. In this paper we present our findings concerning the presence of pathogenic bacteria on wheelchairs, and the possibility that wheelchairs constitute a reservoir of these bacteria and a means of spreading them. In this work we examined four wheelchairs, each from a different location: the internal medicine ward, the emergency department, the general surgery ward and wheelchair stockpile of the transportation unit of the hospital. The samples were collected and cultured on different media. Bacterial identification and antimicrobial sensitivity testing were carried out using accepted practices in the microbiology laboratory. We found that wheelchairs are contaminated with several pathogenic bacteria, among them antibiotic-resistant strains such as MRSA, Pseudomonas aeruginosa, Acinetobacter baumanni etc. Since there is no specific guideline protocol that deals with disinfection and cleaning frequency of wheelchairs in hospitals, we suggest each hospital to write one.
Medola, Fausto Orsi; Elui, Valeria Meirelles Carril; Santana, Carla da Silva; Fortulan, Carlos Alberto
Many aspects relating to equipment configuration affect users' actions in a manual wheelchair, determining the overall mobility performance. Since the equipment components and configuration determine both stability and mobility efficiency, configuring the wheelchair with the most appropriate set-up for individual users' needs is a difficult task. Several studies have shown the importance of seat/backrest assembly and the relative position of the rear wheels to the user in terms of the kinetics and kinematics of manual propulsion. More recently, new studies have brought to light evidence on the inertial properties of different wheelchair configurations. Further new studies have highlighted the handrim as a key component of wheelchair assembly, since it is the interface through which the user drives the chair. In light of the new evidence on wheelchair mechanics and propulsion kinetics and kinematics, this article presents a review of the most important aspects of wheelchair configuration that affect the users' actions and mobility.
Deepan C. Kamaraj
Conclusion: We believe that adoption of this conceptual framework could have broad applications in wheelchair provision globally to develop evidence-based practices. Such a perspective will help in the comparison of different strategies employed in wheelchair provision and further improve clinical guidelines. Further work is being conducted to test the efficacy of this conceptual framework to evaluate effectiveness of wheelchair service provision in various settings across the globe.
Visagie, Surona; Duffield, Svenje; Unger, Mariaan
Wheelchairs provide mobility that can enhance function and community integration. Function in a wheelchair is influenced by wheelchair design. To explore the impact of wheelchair design on user function and the variables that guided wheelchair prescription in the study setting. A mixed-method, descriptive design using convenience sampling was implemented. Quantitative data were collected from 30 wheelchair users using the functioning every day with a Wheelchair Scale and a Wheelchair Specification Checklist. Qualitative data were collected from ten therapists who prescribed wheelchairs to these users, through interviews. The Kruskal-Wallis test was used to identify relationships, and content analysis was undertaken to identify emerging themes in qualitative data. Wheelchairs with urban designs were issued to 25 (83%) participants. Wheelchair size, fit, support and functional features created challenges concerning transport, operating the wheelchair, performing personal tasks, and indoor and outdoor mobility. Users using wheelchairs designed for use in semi-rural environments achieved significantly better scores regarding the appropriateness of the prescribed wheelchair than those using wheelchairs designed for urban use ( p = <0.01). Therapists prescribed the basic, four-wheel folding frame design most often because of a lack of funding, lack of assessment, lack of skills and user choice. Issuing urban type wheelchairs to users living in rural settings might have a negative effect on users' functional outcomes. Comprehensive assessments, further training and research, on long term cost and quality of life implications, regarding provision of a suitable wheelchair versus a cheaper less suitable option is recommended.
Bloemen, Manon A T; de Groot, Janke F; Backx, Frank J G; Westerveld, Rosalyne A; Takken, Tim
To determine the best test performance and feasibility using a Graded Arm Cranking Test vs a Graded Wheelchair Propulsion Test in young people with spina bifida who use a wheelchair, and to determine the reliability of the best test. Validity and reliability study. Young people with spina bifida who use a wheelchair. Physiological responses were measured during a Graded Arm Cranking Test and a Graded Wheelchair Propulsion Test using a heart rate monitor and calibrated mobile gas analysis system (Cortex Metamax). For validity, peak oxygen uptake (VO2peak) and peak heart rate (HRpeak) were compared using paired t-tests. For reliability, the intra-class correlation coefficients, standard error of measurement, and standard detectable change were calculated. VO2peak and HRpeak were higher during wheelchair propulsion compared with arm cranking (23.1 vs 19.5 ml/kg/min, p = 0.11; 165 vs 150 beats/min, p propulsion showed high intra-class correlation coefficients (ICCs) for both VO2peak (ICC = 0.93) and HRpeak (ICC = 0.90). This pilot study shows higher HRpeak and a tendency to higher VO2peak in young people with spina bifida who are using a wheelchair when tested during wheelchair propulsion compared with arm cranking. Wheelchair propulsion showed good reliability. We recommend performing a wheelchair propulsion test for aerobic fitness testing in this population.
Gassara, H. E.; Almuhamed, S.; Moukadem, A.; Schacher, L.; Dieterlen, A.; Adolphe, D.
The aim of the present work is to develop a smart wheelchair by integrating multiple sensors for measuring user’s physiological signals and subsequently transmitting and monitoring the treated signals to the user, a designated person or institution. Among other sensors, force, accelerometer, and temperature sensors are successfully integrated within both the backrest and the seat cushions of the wheelchair; while a pulse sensor is integrated within the armrest. The pulse sensor is connected to an amplification circuit board that is, in turn, placed within the armrest. The force and temperature sensors are integrated into a textile cover of the cushions by means of embroidery and sewing techniques. The signal from accelerometer is transmitted through Wi-Fi connection. The electrical connections needed for power supplying of sensors are made by embroidered conductive threads.
Full Text Available The purpose of this study was to determine the effect of the sensel window’s location and size when calculating the peak pressure index (PPI of pressure mapping with varying degrees of wheelchair tilt-in-space (tilt and recline in people with spinal cord injury (SCI. Thirteen power wheelchair users were recruited into this study. Six combinations of wheelchair tilt (15°, 25°, and 35° and recline (10° and 30° were used by the participants in random order. Displacements of peak pressure and center of pressure were extracted from the left side of the mapping system. Normalized PPI was computed for three sensel window dimensions (3 sensels × 3 sensels, 5 × 5, and 7 × 7. At least 3.33 cm of Euclidean displacement of peak pressures was observed in the tilt and recline. For every tilt angle, peak pressure displacement was not significantly different between 10° and 30° recline, while center of pressure displacement was significantly different (P<.05. For each recline angle, peak pressure displacement was not significantly different between pairs of 15°, 25°, and 35° tilt, while center of pressure displacement was significantly different between 15° versus 35° and 25° versus 35°. Our study showed that peak pressure displacement occurs in response to wheelchair tilt and recline, suggesting that the selected sensel window locations used to calculate PPI should be adjusted during changes in wheelchair configuration.
Lung, Chi-Wen; Yang, Tim D; Crane, Barbara A; Elliott, Jeannette; Dicianno, Brad E; Jan, Yih-Kuen
The purpose of this study was to determine the effect of the sensel window's location and size when calculating the peak pressure index (PPI) of pressure mapping with varying degrees of wheelchair tilt-in-space (tilt) and recline in people with spinal cord injury (SCI). Thirteen power wheelchair users were recruited into this study. Six combinations of wheelchair tilt (15°, 25°, and 35°) and recline (10° and 30°) were used by the participants in random order. Displacements of peak pressure and center of pressure were extracted from the left side of the mapping system. Normalized PPI was computed for three sensel window dimensions (3 sensels × 3 sensels, 5 × 5, and 7 × 7). At least 3.33 cm of Euclidean displacement of peak pressures was observed in the tilt and recline. For every tilt angle, peak pressure displacement was not significantly different between 10° and 30° recline, while center of pressure displacement was significantly different (P < .05). For each recline angle, peak pressure displacement was not significantly different between pairs of 15°, 25°, and 35° tilt, while center of pressure displacement was significantly different between 15° versus 35° and 25° versus 35°. Our study showed that peak pressure displacement occurs in response to wheelchair tilt and recline, suggesting that the selected sensel window locations used to calculate PPI should be adjusted during changes in wheelchair configuration.
Granados, Cristina; Yanci, Javier; Badiola, Aduna; Iturricastillo, Aitor; Otero, Montse; Olasagasti, Jurgi; Bidaurrazaga-Letona, Iraia; Gil, Susana M
This study investigated whether anthropometric characteristics, generic and specific sprinting, agility, strength, and endurance capacity could differentiate between First-Division and Third-Division wheelchair basketball (WB) players. A First-Division WB team (n = 8; age = 36.05 ± 8.25 years, sitting body height = 91.38 ± 4.24 cm, body mass = 79.80 ± 12.63 kg) and a Third-Division WB team (n = 11; age = 31.10 ± 6.37 years, sitting body height = 85.56 ± 6.48 cm, body mass = 71.18 ± 17.63 kg) participated in the study. Wheelchair sprint, agility, strength, and endurance tests were performed. The First-Division team was faster (8.7%) in 20 m without the ball, more agile (13-22%), stronger (18-33%), covered more distance (20%) in the endurance test, and presented higher values of rate of perceived exertion for the exercise load (48%) than the Third-Division team. Moreover, the individual 20-m sprint time values correlated inversely with the individual strength/power values (from r = -0.54 to -0.77, p ≤ 0.05, n = 19). Wheelchair basketball coaches should structure strength and conditioning training to improve sprint and agility and evaluate players accordingly, so that they can receive appropriate training stimuli to match the physiological demands of their competitive level.
van der Slikke, R.M.A.
Performance in wheelchair court sports is to a large extent determined by the wheelchair mobility performance, the performance measure for the wheelchair-athlete combination. So far, wheelchair mobility performance is mostly utilized as concept, rather than a well quantified measure. However, in
Full Text Available In this paper are presented the authors contributions on designing and evaluation of a mechanical transmission intended to be used to wheelchairs for disabled people. In most cases the wheelchairs propulsion system solution consist of two DC motors, mounted on wheels shafts directly, or by means an intermediary transmission with chains or belts. In this case the wheelchair must be equipped with a controller, generally based on a PWM technology. Proposed solution consists of a mechanical transmission based on differential gears, which uses two motors, for steering and for propulsion. For this design architecture the control solution is much simple and easy cost to design, consisting in one servo controller for two motors. Based on dimensional synthesis of transmission gears, is developed the design solution of the robotic wheelchair. The wheelchair motion simulation is studied in Adams software, for the case of traction, steering and combined motion. From Adams simulations are obtained the wheelchair motion trajectories, kinematic and dynamic parameters. Obtained results are analyzed and compared to other wheelchairs design solution, concluding that proposed design solution of this transmission can be successful used to a wheelchair experimental prototype.
Conclusion: The results of this study show that public buildings in the Kumasi metropolis are not wheelchair accessible. An important observation made during this study was that there is an intention to improve accessibility when buildings are being constructed or renovated, but there are no laid down guidelines as how to make the buildings accessible for wheelchair users.
Brandt, Ase; Iwarsson, Susanne; Ståhle, Agneta
OBJECTIVE: The aims of this study were to investigate outcomes of older people's use of powered wheelchairs and risk factors for negative outcomes. DESIGN: The study was a cross-sectional interview-study including 111 powered wheelchair users over 65 years of age. RESULTS: All participants used t...
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Wheelchair platform scale. 890.3940 Section 890.3940 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... platform scale. (a) Identification. A wheelchair platform scale is a device with a base designed to...
van der Woude, L.H.V.; Veeger, H.E.J.; Dallmeijer, A.J.; Janssen, T.W.J.
An estimated 90% of all wheelchairs are hand-rim propelled, a physically straining form of ambulation that can lead to repetitive strain injuries in the arms and, eventually, to secondary impairments and disability. Further disability in wheelchair-dependent individuals can lead to a sedentary
The aim of this study was to analyze technical drills, warm-up and cool-down exercises used by wheelchair basketball players of the Turkish league in relation to training sessions. 33 male wheelchair basketball players participated in the study (mean age 26.6[plus or minus]5,95 years). All players reported that they used warm-up exercises before…
van der Woude, L.H.V.; de Groot, S.; van Drongelen, S.; Janssen, T.W.J.; Haisma, J.; Valent, L.; Veeger, H.E.J.
Evaluation of wheelchair performance (capacity and skills) is crucial in the investigation of wheeled mobility in people with a spinal cord injury (SCI). Manual wheelchair use is a complex combination of skills, which together determine overall functioning, daily activities, participation, and
Bregman, D.J.J.; van Drongelen, S.V.; Veeger, H.E.J.
Background: Efficiency in manual wheelchair propulsion is low, as is the fraction of the propulsion force that is attributed to the moment of propulsion of the wheelchair. In this study we tested the hypothesis that a tangential propulsion force direction leads to an increase in physiological cost,
Vegter, R.J.K.; De Groot, S.; Lamoth, C.J.C.; Veeger, H.E.J.; van der Woude, L.H.V.
To gain insight into cyclic motor learning processes, hand rim wheelchair propulsion is a suitable cyclic task, to be learned during early rehabilitation and novel to almost every individual. To propel in an energy efficient manner, wheelchair users must learn to control bimanually applied forces
Simpson, Richard C; LoPresti, Edmund F; Cooper, Rory A
Independent mobility is important, but some wheelchair users find operating existing manual or powered wheelchairs difficult or impossible. Challenges to safe, independent wheelchair use can result from various overlapping physical, perceptual, or cognitive symptoms of diagnoses such as spinal cord injury, cerebrovascular accident, multiple sclerosis, amyotrophic lateral sclerosis, and cerebral palsy. Persons with different symptom combinations can benefit from different types of assistance from a smart wheelchair and different wheelchair form factors. The sizes of these user populations have been estimated based on published estimates of the number of individuals with each of several diseases who (1) also need a wheeled mobility device and (2) have specific symptoms that could interfere with mobility device use.
Bloemen, Manon A T; De Groot, Janke F.; Backx, FJG; Westerveld, Rosalyne A.; Takken, Tim
Objective: To determine the best test performance and feasibility using a Graded Arm Cranking Test vs a Graded Wheelchair Propulsion Test in young people with spina bifida who use a wheelchair, and to determine the reliability of the best test. Design: Validity and reliability study. Subjects: Young
Bloemen, M.A.T.; Groot, J.F. de; Backx, F.J.G.; Westerveld, R.A.; Takken, T.
OBJECTIVE: To determine the best test performance and feasibility using a Graded Arm Cranking Test vs a Graded Wheelchair Propulsion Test in young people with spina bifida who use a wheelchair, and to determine the reliability of the best test. DESIGN: Validity and reliability study. SUBJECTS: Young
Intended to aid in the building or purchase of a home suitable for use by a handicapped individual in a wheelchair, the booklet provides detailed design guidelines. Included is information on the decision process, finances, ramps, a car shelter, doors communication devices, electrical needs, windows, elevators and chair lifts, the kitchen, an…
Vanlandewijck, Yves C; Verellen, Joeri; Tweedy, Sean
In most Paralympic wheelchair sports, active trunk range of movement is assessed by observing shoulder girdle excursion during active trunk movements and is a key determinant of an athlete's class. However, to date research evaluating the impact of reduced trunk range of movement on wheelchair sports performance has not been conducted. In the present study, 15 non-disabled male participants performed two 20-s sprints on a wheelchair ergometer in each of three seating positions. Positions were typical of those used to enhance sitting stability in wheelchair sport and each impacted available trunk range of movement differently: condition-90 (seated with thighs horizontal; unrestricted range of movement) condition-45 (seated with thighs in 45°), and condition-0 (seated with hips maximally flexed; minimum range of movement). In condition-90, the trunk only actively contributed to the first push; for the remainder of the sprint, the trunk was held almost isometrically at 48.2° to the horizontal (range 42.1-56.4°). Similar patterns were observed for both condition-45 and condition-0. Compared with condition-90, participants in condition-0 had reduced capacity to accelerate of statistical (P sports performance, including strapping, seating position, and impairments of trunk muscle power and coordination.
de Groot, Sonja; Vegter, Riemer J K; van der Woude, Lucas H V
The purpose of this study was to evaluate the effect of wheelchair mass, solid vs. pneumatic tires and tire pressure on physical strain and wheelchair propulsion technique. 11 Able-bodied participants performed 14 submaximal exercise blocks on a treadmill with a fixed speed (1.11 m/s) within 3 weeks to determine the effect of tire pressure (100%, 75%, 50%, 25% of the recommended value), wheelchair mass (0 kg, 5 kg, or 10 kg extra) and tire type (pneumatic vs. solid). All test conditions (except pneumatic vs. solid) were performed with and without instrumented measurement wheels. Outcome measures were power output (PO), physical strain (heart rate (HR), oxygen uptake (VO2), gross mechanical efficiency (ME)) and propulsion technique (timing, force application). At 25% tire pressure PO and subsequently VO2 were higher compared to 100% tire pressure. Furthermore, a higher tire pressure led to a longer cycle time and contact angle and subsequently lower push frequency. Extra mass did not lead to an increase in PO, physical strain or propulsion technique. Solid tires led to a higher PO and physical strain. The solid tire effect was amplified by increased mass (tire × mass interaction). In contrast to extra mass, tire pressure and tire type have an effect on PO, physical strain or propulsion technique of steady-state wheelchair propulsion. As expected, it is important to optimize tire pressure and tire type. Copyright © 2013 IPEM. Published by Elsevier Ltd. All rights reserved.
Darling, Aurelia McLaughlin
This thesis describes a Microsoft Kinect-based feedback controller for a robot-assisted powered wheelchair trainer for children with a severe motor and/or cognitive disability. In one training mode, "computer gaming" mode, the wheelchair is allowed to rotate left and right while the children use a joystick to play video games shown on a screen in front of them. This enables them to learn the use of the joystick in a motivating environment, while experiencing the sensation and dynamics of turning in a safe setting. During initial pilot testing of the device, it was found that the wheelchair would creep forward while children were playing the games. This thesis presents a mathematical model of the wheelchair dynamics that explains the origin of the creep as a center of gravity offset from the wheel axis or a mismatch of the torques applied to the chair. Given these possible random perturbations, a feedback controller was developed to cancel these effects, correcting the system creep. The controller uses a Microsoft Kinect sensor to detect the distance to the screen displaying the computer game, as well as the left-right position (parallel parking concept) with respect to the screen, and then adjusts the wheel torque commands based on this measurement. We show through experimental testing that this controller effectively stops the creep. An added benefit of the feedback controller is that it approximates a washout filter, such as those used in aircraft simulators, to convey a more realistic sense of forward/backward motion during game play.
Kirby, R Lee; Mitchell, Doug; Sabharwal, Sunil; McCranie, Mark; Nelson, Audrey L
To test the hypotheses that community-dwelling veterans with spinal cord injury (SCI) who receive the Wheelchair Skills Training Program (WSTP) in their own environments significantly improve their manual wheelchair-skills capacity, retain those improvements at one year and improve participation in comparison with an Educational Control (EC) group. We carried out a randomized controlled trial, studying 106 veterans with SCI from three Veterans Affairs rehabilitation centers. Each participant received either five one-on-one WSTP or EC sessions 30-45 minutes in duration. The main outcome measures were the total and subtotal percentage capacity scores from the Wheelchair Skills Test 4.1 (WST) and Craig Handicap Assessment and Reporting Technique (CHART) scores. Participants in the WSTP group improved their total and Advanced-level WST scores by 7.1% and 30.1% relative to baseline (p advanced and total wheelchair skills capacity of experienced community-dwelling veterans with SCI but has only a small impact on participation.
Fu, Jicheng; Hao, Wei; White, Travis; Yan, Yuqing; Jones, Maria; Jan, Yih-Kuen
Power wheelchairs have been widely used to provide independent mobility to people with disabilities. Despite great advancements in power wheelchair technology, research shows that wheelchair related accidents occur frequently. To ensure safe maneuverability, capturing wheelchair maneuvering patterns is fundamental to enable other research, such as safe robotic assistance for wheelchair users. In this study, we propose to record, store, and analyze wheelchair maneuvering data by means of mobile cloud computing. Specifically, the accelerometer and gyroscope sensors in smart phones are used to record wheelchair maneuvering data in real-time. Then, the recorded data are periodically transmitted to the cloud for storage and analysis. The analyzed results are then made available to various types of users, such as mobile phone users, traditional desktop users, etc. The combination of mobile computing and cloud computing leverages the advantages of both techniques and extends the smart phone's capabilities of computing and data storage via the Internet. We performed a case study to implement the mobile cloud computing framework using Android smart phones and Google App Engine, a popular cloud computing platform. Experimental results demonstrated the feasibility of the proposed mobile cloud computing framework.
Full Text Available The shock and vibration of electric wheelchairs undergoing road irregularities is inevitable. The road excitation causes the uneven magnetic gap of the motor, and the harmful vibration decreases the recovery rate of rehabilitation patients. To effectively suppress the shock and vibration, this paper introduces the DA (dynamic absorber to the electric wheelchair. Firstly, a vibration model of the human-wheelchair system with the DA was created. The models of the road excitation for wheelchairs going up a step and going down a step were proposed, respectively. To reasonably evaluate the impact level of the human-wheelchair system undergoing the step–road transition, evaluation indexes were given. Moreover, the created vibration model and the road–step model were validated via tests. Then, to reveal the vibration suppression performance of the DA, the impact responses and the amplitude frequency characteristics were numerically simulated and compared. Finally, a sensitivity analysis of the impact responses to the tire static radius r and the characteristic parameters was carried out. The results show that the DA can effectively suppress the shock and vibration of the human-wheelchair system. Moreover, for the electric wheelchair going up a step and going down a step, there are some differences in the vibration behaviors.
Full Text Available To study how to design different grades of individualized wheelchairs according to users' needs, a personalized wheelchair design method based on AHP and Kano model is proposed. The AHP model determines the relative importance of characteristics of customers' demands. The subfunctions of manual wheelchairs and their attributes are given. The weight coefficients are calculated. 20 experts (10 are the members of the research team, 5 are doctors, and 5 are wheelchair designers are involved in the above two parts of the work. Kano model represents the types of user requirements. 30 participants' (wheelchair users needs are divided into 5 categories: M, O, E, I, and R. According to the types of user needs and the weight of each subfunction, three manual wheelchair models are built. Traditional design method usually cannot satisfy the requirements of users and product structure, so this paper makes a contribution to solve this problem. The method can be used to design individualized wheelchairs which may improve the product quality and customers' satisfaction. Meanwhile it also can reduce the design time, thereby reducing the design cost.
Kamaraj, Deepan C; Bray, Nathan; Rispin, Karen; Kankipati, Padmaja; Pearlman, Jonathan; Borg, Johan
Currently, inadequate wheelchair provision has forced many people with disabilities to be trapped in a cycle of poverty and deprivation, limiting their ability to access education, work and social facilities. This issue is in part because of the lack of collaboration among various stakeholders who need to work together to design, manufacture and deliver such assistive mobility devices. This in turn has led to inadequate evidence about intervention effectiveness, disability prevalence and subsequent costeffectiveness that would help facilitate appropriate provision and support for people with disabilities. In this paper, we describe a novel conceptual framework that can be tested across the globe to study and evaluate the effectiveness of wheelchair provision. The Comparative Effectiveness Research Subcommittee (CER-SC), consisting of the authors of this article, housed within the Evidence-Based Practice Working Group (EBP-WG) of the International Society of Wheelchair Professionals (ISWP), conducted a scoping review of scientific literature and standard practices used during wheelchair service provision. The literature review was followed by a series of discussion groups. The three iterations of the conceptual framework are described in this manuscript. We believe that adoption of this conceptual framework could have broad applications in wheelchair provision globally to develop evidence-based practices. Such a perspective will help in the comparison of different strategies employed in wheelchair provision and further improve clinical guidelines. Further work is being conducted to test the efficacy of this conceptual framework to evaluate effectiveness of wheelchair service provision in various settings across the globe.
Abdullah, Soran Jalal; Shaikh Mohammed, Javeed
Independent mobility is vital to individuals of all ages, and wheelchairs have proven to be great personal mobility devices. The tasks of opening and navigating through a door are trivial for healthy people, while the same tasks could be difficult for some wheelchair users. A wide range of intelligent wheelchair controllers and systems, robotic arms, or manipulator attachments integrated with wheelchairs have been developed for various applications, including manipulating door knobs. Unfortunately, the intelligent wheelchairs and robotic attachments are not widely available as commercial products. Therefore, the current manuscript presents the modeling and simulation of a novel but simple technology in the form of a passive wheelchair accessory (straight, arm-like with a single wheel, and arc-shaped with multiple wheels) for pushing doors open from a wheelchair. From the simulations using different wheel shapes and sizes, it was found that the arc-shaped accessory could push open the doors faster and with almost half the required force as compared to the arm-like accessory. Also, smaller spherical wheels were found to be best in terms of reaction forces on the wheels. Prototypes based on the arc-shaped accessory design will be manufactured and evaluated for pushing doors open and dodging or gliding other obstacles.
Zondervan, Daniel K; Secoli, Riccardo; Darling, Aurelia Mclaughlin; Farris, John; Furumasu, Jan; Reinkensmeyer, David J
Children with severe disabilities are sometimes unable to access powered mobility training. Thus, we developed the Kinect-Wheelchair Interface Controlled (KWIC) smart wheelchair trainer that converts a manual wheelchair into a powered wheelchair. The KWIC Trainer uses computer vision to create a virtual tether with adaptive shared-control between the wheelchair and a therapist during training. It also includes a mixed-reality video game system. We performed a year-long usability study of the KWIC Trainer at a local clinic, soliciting qualitative and quantitative feedback on the device after extended use. Eight therapists used the KWIC Trainer for over 50 hours with 8 different children. Two of the children obtained their own powered wheelchair as a result of the training. The therapists indicated the device allowed them to provide mobility training for more children than would have been possible with a demo wheelchair, and they found use of the device to be as safe as or safer than conventional training. They viewed the shared control algorithm as counter-productive because it made it difficult for the child to discern when he or she was controlling the chair. They were enthusiastic about the video game integration for increasing motivation and engagement during training. They emphasized the need for additional access methods for controlling the device. The therapists confirmed that the KWIC Trainer is a useful tool for increasing access to powered mobility training and for engaging children during training sessions. However, some improvements would enhance its applicability for routine clinical use.
I agree with the authors, that ;there have been very few attempts to develop user-centered medical technologies;  in the field of rehabilitation for persons with disabilities and wheelchair users in particular. The human-environment context in which humans plan and inhabit their actions as wheelchair users has not been extensively studied. The authors' unique work explores how a person embodies an exoskeleton (robotic legs or a wheelchair) in their everyday life and focuses on proprioception and brain's capacity to enlarge one's body schema in order to understand users' perspectives. Ultimately, Pazzaglia and Molinari wish to support persons who use assistive devices adapt and have successful, meaningful lives. The work is neuro-scientifically grounded, but doesn't forget the emotional or affective aspects of the user.
van Koppenhagen, Casper F; de Groot, Sonja; Post, Marcel W; Hoekstra, Trynke; van Asbeck, Floris W; Bongers, Helma; Lindeman, Eline; van der Woude, Luc H
(1) To identify different patterns of changes in wheelchair exercise capacity in the period between the start of active spinal cord injury (SCI) rehabilitation and 5 years after discharge; (2) to examine the pattern determinants of the change in wheelchair exercise capacity. Prospective cohort study. Measurements were recorded at the start of active inpatient rehabilitation, 3 months after the start, at discharge of inpatient rehabilitation, 1 year after discharge, and 5 years after discharge. Eight rehabilitation centers. Persons with SCI (N=130; age range, 18-65y), who were wheelchair-dependent, at least for long distances. Not applicable. Wheelchair exercise capacity: peak power output (W). We found 4 different patterns of the change of peak power output (mean ± SD): (1) a pattern with high and progressive scores (33% of total study group): high progressive scores (start of rehabilitation: 49±15W to 5 years after discharge: 77±17.2W); (2) a pattern of improvement during inpatient rehabilitation and deterioration after inpatient rehabilitation (12%): progressive scores during inpatient rehabilitation with deteriorating scores after discharge (start of rehabilitation: 29±8.7W, to discharge: 60±8.4W, to 5 years after discharge: 39±13.1W); (3) a pattern with low and only slightly progressive scores (52%): low progressive scores (start of rehabilitation: 20±10.1W to 5 years after discharge: 31±15.9W); and (4) a pattern with low scores during inpatient rehabilitation and a sharp rise after discharge (3%): low inpatient scores with strong progressive scores after discharge (start of rehabilitation: 29±15.5W to 5 years after discharge: 82±10.6W). A logistic regression of factors that may distinguish between patterns with high and progressive scores and patterns with low and only slightly progressive scores revealed that older age, being a woman, having a tetraplegic lesion, and low functional status were associated with patterns with low and only slightly
Cowan, Rachel E.; Nash, Mark S.; Collinger, Jennifer L.; Koontz, Alicia M.; Boninger, Michael L.
Objective To examine the impact of surface type, wheelchair weight, and rear axle position on older adult propulsion biomechanics. Design Crossover trial. Setting Biomechanics laboratory. Participants Convenience sample of 53 ambulatory older adults with minimal wheelchair experience (65−87y); men = 20, women = 33. Intervention Participants propelled 4 different wheelchair configurations over 4 surfaces; tile, low carpet, high carpet, and an 8% grade ramp (surface, chair order randomized). Chair configurations included: (1) unweighted chair with an anterior axle position, (2) 9.05kg weighted chair with an anterior axle position, (3) unweighted chair with a posterior axle position (Δ0.08m), and (4) 9.05kg weighted chair with a posterior axle position (Δ0.08m). Weight was added to a titanium folding chair, simulating the weight difference between very light and depot wheelchairs. Instrumented wheels measured propulsion kinetics. Main Outcome Measures Average self-selected velocity, push-frequency, stroke length, peak resultant and tangential force. Results Velocity decreased as surface rolling resistance or chair weight increased. Peak resultant and tangential forces increased as chair weight increased, surface resistance increased, and with a posterior axle position. The effect of a posterior axle position was greater on high carpet and the ramp. The effect of weight was constant, but more easily observed on high carpet and ramp. The effects of axle position and weight were independent of one another. Conclusion Increased surface resistance decreases self-selected velocity and increases peak forces. Increased weight decreases self-selected velocity and increases forces. Anterior axle positions decrease forces, more so on high carpet. Effects of weight and axle position are independent. Greatest reductions in peak forces occur in lighter chairs with anterior axle positions. PMID:19577019
Shea, Kathleen M; Schultz, Dana L; Barrett, Steven F
One device that is receiving a considerable amount of attention in the biomedical community is the smart wheelchair. Smart wheelchairs provide those who are unable to control the traditional joystick of a powered wheelchair with an alternative option. With minimal user input, these wheelchairs are able to autonomously navigate around a persons environment, providing them with a higher level of mobility. The limited competition and extreme complexity of these wheelchairs propels their price outside of the affordable range for the average household. An alternative, cheaper system that could be attached to a typical powered wheelchair would be beneficial to the community.
Pansiot, J.; Zhang, Z.; Lo, B.; Yang, G. Z.
Improved wheelchair design in recent years has significantly increased the mobility of people with disabilities, which has also enhanced the competitive advantage of wheelchair sports. For the latter, detailed assessment of biomechanical factors influencing individual performance and team tactics requires real-time wireless sensing and data modelling. In this paper, we propose the use of a miniaturized wireless wheel-mounted inertial sensor for wheelchair motion monitoring and tracking in an indoor sport environment. Based on a combined use of 3D microelectromechanical system (MEMS) gyroscopes and 2D MEMS accelerometers, the proposed system provides real-time velocity, heading, ground distance covered and motion trajectory of the wheelchair across the sports court. The proposed system offers a number of advantages compared to existing platforms in terms of size, weight and ease of installation. Beyond sport applications, it also has important applications for training and rehabilitation for people with disabilities.
Barfield, J P; Malone, Laurie A
Lack of exercise is a major risk factor for secondary conditions among persons dependent upon motorized wheelchairs. Power wheelchair soccer is a unique exercise opportunity for this population, and understanding factors that influence exercise decision-making is necessary for clinicians to help those in motorized chairs reduce their secondary risk. Therefore, this study examined differences in perceived benefits and barriers to exercise among power wheelchair soccer players using a mixed-methods analysis. The most common perceived benefit to exercise was "Exercising lets me have contact with friends and persons I enjoy." Post hoc comparisons of quantitative data indicated that persons with muscular dystrophy perceived exercise to be significantly less important than did other disability groups (p Exercise is hard work for me," "Exercise tires me," and "There are too few places for me to exercise" were the most common perceived barriers. These findings can assist with development of exercise opportunities for power wheelchair users.
... 2, 2014 Tongue-Driven Wheelchair Out-Maneuvers the Competition Researchers funded by the National Institute of Biomedical ... significant step towards vastly improving the independence and quality of life of individuals with tetraplegia, and is ...
Pansiot, J; Zhang, Z; Lo, B; Yang, G Z
Improved wheelchair design in recent years has significantly increased the mobility of people with disabilities, which has also enhanced the competitive advantage of wheelchair sports. For the latter, detailed assessment of biomechanical factors influencing individual performance and team tactics requires real-time wireless sensing and data modelling. In this paper, we propose the use of a miniaturized wireless wheel-mounted inertial sensor for wheelchair motion monitoring and tracking in an indoor sport environment. Based on a combined use of 3D microelectromechanical system (MEMS) gyroscopes and 2D MEMS accelerometers, the proposed system provides real-time velocity, heading, ground distance covered and motion trajectory of the wheelchair across the sports court. The proposed system offers a number of advantages compared to existing platforms in terms of size, weight and ease of installation. Beyond sport applications, it also has important applications for training and rehabilitation for people with disabilities
Dysterheft, Jennifer L; Rice, Ian M; Rice, Laura A
Ten full-time adolescent wheelchair users (ages 13-18) completed a total of three propulsion trials on carpet and tile surfaces, at a self-selected velocity, and on a concrete surface, at a controlled velocity. All trials were performed in their personal wheelchair with force and moment sensing wheels attached bilaterally. The first two trials on each surface were used as pre-intervention control trials. The third trial was performed after receiving training on proper propulsion technique. Peak resultant force, contact angle, stroke frequency, and velocity were recorded during all trials for primary analysis. Carpet and tile trials resulted in significant increases in contact angle and peak total force with decreased stroke frequency after training. During the velocity controlled trials on concrete, significant increases in contact angle occurred, as well as decreases in stroke frequency after training. Overall, the use of a training video and verbal feedback may help to improve short-term propulsion technique in adolescent wheelchair users and decrease the risk of developing upper limb pain and injury.
ZHAO Cong; WANG Zheng-xing; JIANG Shi-hong; ZHANG Li; LIU Zheng-yu
In order to achieve a wheelchair lift function, this paper designs a tri-scissors mechanism. Through the so-called H-type transmission and L-type swing rod, the three scissors mechanisms lift in the same rate with only one liner motor while ensuring the stability of the lift. Finite element analysis in ANSYS is performed to verify the material strength. The control system with Sunplus SCM achieves the voice control of wheelchair walking and lifting.
Becker, D G; Washington, B V; Devlin, P M; Zook, J E; Edlich, R F
Approximately 750,000 disabled individuals use electrical platform mobility aids (wheelchairs) for adaptive transportation. Because there are no mandatory standards for platform mobility aids and wheelchairs, these adaptive transportation aids are prone to potential design and maintenance problems. An injury caused by uncontrolled acceleration of a platform mobility aid is reported. Examination of the platform mobility aid identified a defect in its speed control regulator that has been subsequently corrected by the manufacturer.
Medola, Fausto Orsi [UNESP; Elui, Valeria Meirelles Carril; Santana, Carla da Silva; Fortulan, Carlos Alberto
Many aspects relating to equipment configuration affect users’ actions in a manual wheelchair, determining the overall mobility performance. Since the equipment components and configuration determine both stability and mobility efficiency, configuring the wheelchair with the most appropriate set-up for individual users’ needs is a difficult task. Several studies have shown the importance of seat/backrest assembly and the relative position of the rear wheels to the user in terms of the kinetic...
Tanohata, Naoki; Seki, Hirokazu
This paper describes a novel drive control scheme of electric power assisted wheelchairs based on neural network learning of human wheelchair operation characteristics. “Electric power assisted wheelchair” which enhances the drive force of the operator by employing electric motors is expected to be widely used as a mobility support system for elderly and disabled people. However, some handicapped people with paralysis of the muscles of one side of the body cannot maneuver the wheelchair as desired because of the difference in the right and left input force. Therefore, this study proposes a neural network learning system of such human wheelchair operation characteristics and a drive control scheme with variable distribution and assistance ratios. Some driving experiments will be performed to confirm the effectiveness of the proposed control system.
Sakakibara, Brodie M; Miller, William C; Souza, Melanie; Nikolova, Viara; Best, Krista L
To examine the effects of wheelchair skills training on confidence in older adults who are inexperienced wheelchair users. Parallel group, single-blind randomized controlled trial. Research laboratory in a rehabilitation hospital. Participants (N=20) who were community-living older adults at least 65 years old (mean age, 70y), 50% women, and who had no experience of using a wheelchair were randomly allocated to an intervention (n=10) or control (n=10) group. The intervention group received two 1-hour training sessions that followed the Wheelchair Skills Training Program (WSTP) protocol. The control group received a single socialization contact. The Wheelchair Use Confidence Scale-Manual (WheelCon-M) was used to evaluate confidence with using a manual wheelchair. The WheelCon-M is a self-report questionnaire that comprises 65 items in 6 conceptual areas. A 1-way between-groups analysis of covariance revealed a significant difference in postintervention WheelCon-M scores between the intervention and control groups (F1,17=10.9, P=.004) after controlling for baseline WheelCon-M scores. A large effect size was also observed (partial η(2)=.39). Secondary analyses revealed that the WSTP had greater effects on confidence in areas related to maneuvering around the physical environment, knowledge and problem solving, advocacy, and managing emotions than in areas related to performing activities and behaving in social situations. Two 1-hour WSTP sessions improve confidence with using a manual wheelchair among older adults who are inexperienced wheelchair users. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Ripat, Jacquie D; Brown, Cara L; Ethans, Karen D
To test the hypothesis that challenges to community participation posed by winter weather are greater for individuals who use scooters, manual and power wheelchairs (wheeled mobility devices [WMDs]) than for the general ambulatory population, and to determine what WMD users identify as the most salient environmental barriers to community participation during the winter. Cross-sectional survey organized around 5 environmental domains: technological, natural, physical, social/attitudinal, and policy. Urban community in Canada. Convenience sample of WMD users or their proxy (N=99). Not applicable. Not applicable. Forty-two percent identified reduced outing frequency in winter months, associated with increased age (χ(3)=6.4, P=.04), lack of access to family/friends for transportation (χ(2)=8.1, P=.04), and primary type of WMD used in the winter (scooter χ(2)=8.8, P=.003). Most reported tires/casters becoming stuck in the snow (95%) or slipping on the ice (91%), difficulty ascending inclines/ramps (92%), and cold hands while using controls or pushing rims (85%); fewer identified frozen wheelchair/scooter batteries, seat cushions/backrests, or electronics. Sidewalks/roads were reported to be problematic by 99%. Eighty percent reported needing additional help in the winter. Limited community access in winter led to a sense of loneliness/isolation, and fear/anxiety related to safety. Respondents identified policies that limited participation during winter. People who use WMDs decrease their community participation in cold weather because of multiple environmental barriers. Clinicians, researchers, and policymakers can take a multidimensional approach to mitigate these barriers in order to enhance community participation by WMD users in winter. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Toro, Maria L; Eke, Chika; Pearlman, Jonathan
For people who have a mobility impairment, access to an appropriate wheelchair is an important step towards social inclusion and participation. The World Health Organization Guidelines for the Provision of Manual Wheelchairs in Less Resourced Settings emphasize the eight critical steps for appropriate wheelchair services, which include: referral, assessment, prescription, funding and ordering, product preparation,fitting and adjusting, user training, and follow-up and maintenance/repairs. The purpose of this study was to investigate how the provision of wheelchairs according to the World Health Organization's service provision process by United Cerebral Palsy Wheels for Humanity in Indonesia affects wheelchair recipients compared to wait-listed controls. This study used a convenience sample (N = 344) of Children, Children with proxies, Adults, and Adults with proxies who were on a waiting list to receive a wheelchair as well as those who received one. Interviews were conducted at baseline and a 6 month follow-up to collect the following data: Demographics and wheelchair use questions, the World Health Organization Quality of Life-BREF, Functional Mobility Assessment, Craig Handicap Assessment Recording Technique Short Form. The Wheelchair Assessment Checklist and Wheelchair Skills Test Questionnaire were administered at follow up only. 167 participants were on the waiting list and 142 received a wheelchair. Physical health domain in the World Health Organization Quality of Life-BREF improved significantly for women who received a wheelchair (p = 0.044) and environmental health improved significantly for women and men who received a wheelchair as compared to those on the waiting list (p received a wheelchair reported being able to perform a "wheelie". The condition of Roughrider wheelchairs was significantly better than the condition of kids wheelchairs for Children with proxies as measured by the Wheelchair Assessment Checklist (p = 0
van der Slikke, R.M.A.; Berger, MAM; Bregman, DJJ; Veeger, H.E.J.
Quantitative assessment of an athlete׳s individual wheelchair mobility performance is one prerequisite needed to evaluate game performance, improve wheelchair settings and optimize training routines. Inertial Measurement Unit (IMU) based methods can be used to perform such quantitative assessment,
Dallmeijer, A.J.; Zentgraaff, I.D.; Zijp, N.I.; van der Woude, L.H.V.
Study design: Experimental study in subjects with paraplegia and nondisabled subjects. Objective: To compare submaximal physical strain and peak performance in handcycling and handrim wheelchair propulsion in wheelchair-dependent and nondisabled control subjects Setting: Amsterdam, The Netherlands.
Saltan, Asuman; Bakar, Yeşim; Ankarali, Handan
The aim of this study was to assess the influence of wheelchair basketball sport on the functional abilities of wheelchair users. This is a randomized controlled study. Wheelchair basketball players (n = 111) and non-player (n = 85) were included in this study. We administered the questionnaire version of the wheelchair skills test questionnaire (WST_Q), recording the participants' capacity and performance scores on each of 32 skills. Player group have the baseline values of WST_Q higher than control group. The mean total percentage score of player group was significantly greater than control group (p skills-sports relationship is reciprocal. With increased wheelchair skills, people may be more inclined to engage in sports; subsequently, with greater sports, wheelchair skills could improve. Wheelchair mobility skills during clinical rehabilitation should reflect the daily activities and needs of each wheelchair user. WST-Q provides advantages in terms of requiring less time and material in using of clinical.
Conclusion: The study findings indicate the need to develop a wide range of tests, with specific tests for measuring corrosion resistance of the entire wheelchair, rolling resistance of castors and rear wheels, and durability of whole wheelchair and castor assemblies.
Zwinkels, M.; Verschuren, O.; Janssen, T.W.J.; Ketelaar, M.; Takken, T.
Objective: An adequate wheelchair propulsion capacity is required to perform daily life activities. Exercise training may be effective to gain or improve wheelchair propulsion capacity. This review investigates whether different types of exercise training programs are effective in improving
Zwinkels, M.G.J.; Verschuren, O.W.; Janssen, T.; Ketelaar, M.; Takken, T.; Backx, F.J.G.; Groot, J.F. de; Smits, D.W.; Volman, MJM
Objective: An adequate wheelchair propulsion capacity is required to perform daily life activities. Exercise training may be effective to gain or improve wheelchair propulsion capacity. This review investigates whether different types of exercise training programs are effective in improving
Tarik Ozmen; Bekir Yuktasir; Necmiye Un Yildirim; Birol Yalcin; Mark ET Willems
INTRODUCTION: Wheelchair basketball is a paralympic sport characterized by intermittent high-intensity activities that require explosive strength and speed. OBJECTIVE: To investigate the effect of explosive strength training on speed and agility performance in wheelchair basketball players. METHODS: Ten male wheelchair basketball players (Mage=31±4 yrs) were divided into two groups [i.e. explosive strength training (ES); control (CN)] based on International Wheelchair Basketball Fede...
Background Currently, inadequate wheelchair provision has forced many people with disabilities to be trapped in a cycle of poverty and deprivation, limiting their ability to access education, work and social facilities. This issue is in part because of the lack of collaboration among various stakeholders who need to work together to design, manufacture and deliver such assistive mobility devices. This in turn has led to inadequate evidence about intervention effectiveness, disability prevalence and subsequent costeffectiveness that would help facilitate appropriate provision and support for people with disabilities. Objectives In this paper, we describe a novel conceptual framework that can be tested across the globe to study and evaluate the effectiveness of wheelchair provision. Method The Comparative Effectiveness Research Subcommittee (CER-SC), consisting of the authors of this article, housed within the Evidence-Based Practice Working Group (EBP-WG) of the International Society of Wheelchair Professionals (ISWP), conducted a scoping review of scientific literature and standard practices used during wheelchair service provision. The literature review was followed by a series of discussion groups. Results The three iterations of the conceptual framework are described in this manuscript. Conclusion We believe that adoption of this conceptual framework could have broad applications in wheelchair provision globally to develop evidence-based practices. Such a perspective will help in the comparison of different strategies employed in wheelchair provision and further improve clinical guidelines. Further work is being conducted to test the efficacy of this conceptual framework to evaluate effectiveness of wheelchair service provision in various settings across the globe. PMID:28936421
Lin, Hwai-Ting; Su, Fong-Chin; Wu, Hong-Wen; An, Kai-Nan
This study combines an ergometric wheelchair, a six-camera video motion capture system and a prototype computer graphics based musculoskeletal model (CGMM) to predict shoulder joint loading, muscle contraction force per muscle and the sequence of muscular actions during wheelchair propulsion, and also to provide an animated computer graphics model of the relative interactions. Five healthy male subjects with no history of upper extremity injury participated. A conventional manual wheelchair was equipped with a six-component load cell to collect three-dimensional forces and moments experienced by the wheel, allowing real-time measurement of hand/rim force applied by subjects during normal wheelchair operation. An ExpertVision six-camera video motion capture system collected trajectory data of markers attached on anatomical positions. The CGMM was used to simulate and animate muscle action by using an optimization technique combining observed muscular motions with physiological constraints to estimate muscle contraction forces during wheelchair propulsion. The CGMM provides results that satisfactorily match the predictions of previous work, disregarding minor differences which presumably result from differing experimental conditions, measurement technologies and subjects. Specifically, the CGMM shows that the supraspinatus, infraspinatus, anterior deltoid, pectoralis major and biceps long head are the prime movers during the propulsion phase. The middle and posterior deltoid and supraspinatus muscles are responsible for arm return during the recovery phase. CGMM modelling shows that the rotator cuff and pectoralis major play an important role during wheelchair propulsion, confirming the known risk of injury for these muscles during wheelchair propulsion. The CGMM successfully transforms six-camera video motion capture data into a technically useful and visually interesting animated video model of the shoulder musculoskeletal system. The CGMM further yields accurate
de Witte, A.M.H.; Hoozemans, M.J.M.; Berger, M.A.; van der Woude, L.H.V.; Veeger, H.E.J.
Improved understanding of mobility performance in wheelchair basketball is required to increase game performance. The aim of this study was to quantify the wheelchair-athlete activities of players in different field positions and of different playing standard during wheelchair basketball matches.
de Groot, S.; Bos, F.; Koopman, J.; Hoekstra, A. E.; Vegter, R. J. K.
The purpose of this study was to determine possible differences in propulsion technique between propelling the wheelchair with and without a racket in the hand. Eight experienced wheelchair tennis players performed three submaximal exercise tests and six sprint tests on a wheelchair ergometer.
Morgulec-Adamowicz, Natalia; Kosmol, Andrzej; Molik, Bartosz; Yilla, Abu B.; Laskin, James J.
The purpose of the study was to examine the sport-specific performance of wheelchair rugby players with regard to their classification. A group of 30 male athletes from the Polish Wheelchair Rugby League participated in the study. The seven International Wheelchair Rugby Federation classes were collapsed into four groups. Standardized measures of…
Van der Slikke, R.M.A.; Berger, M.A.M.; Bregman, D.J.J.; Veeger, H.E.J.
Accurate knowledge of wheelchair kinematics during a match could be a significant factor in performance improvement in wheelchair basketball. To date, most systems for measuring wheelchair kinematics are not suitable for match applications or lack detail in key kinematic outcomes. This study
Discussion: The results of this study are useful in understanding the perspective of Indian wheelchair users’ needs toward evidence-based wheelchair design. The design parameters with high absolute and relative technical importance can be selected to design new wheelchairs for Indian users in order to enhance the quality of life, comfort, and safety of people with disability.
de Groot, S.; Post, M. W. M.; Bongers-Janssen, H. M. H.; Bloemen-Vrencken, J. H.; van der Woude, L. H. V.
Study design: Cross-sectional study. Objectives: To describe the satisfaction of the manual wheelchair user with hand rim wheelchair-related aspects (for example, dimensions, weight and comfort) and wheelchair service-related aspects and to determine the relationship between wheelchair users'
Kwarciak, Andrew M.; Turner, Jeffrey T.; Guo, Liyun; Richter, W. Mark
Study design Cross-sectional study. Objectives To compare handrim biomechanics recorded during overground propulsion to those recorded during propulsion on a motor-driven treadmill. Setting Biomechanics laboratory. Methods Twenty-eight manual wheelchair users propelled their own wheelchairs, at a self-selected speed, on a low-pile carpet and on a wheelchair accessible treadmill. Handrim biomechanics were recorded with an OptiPush instrumented wheelchair wheel. Results Across the two conditions, all handrim biomechanics were found to be similar and highly correlated (r > 0.85). Contact angle, peak force, average force, and peak axle moment differed by 1.6% or less across the two conditions. While not significant, power output and cadence tended to be slightly higher for the treadmill condition (3.5% and 3.6%, respectively), due to limitations in adjusting the treadmill grade. Conclusion Based on the results of this study, a motor-driven treadmill can serve as a valid surrogate for overground studies of wheelchair propulsion. PMID:21042332
Full Text Available To support safe self-movement of the disabled and the aged, we developed an electric wheelchair that realizes the functions of detecting both the potential hazards in a moving environment and the postures and gestures of a user by equipping an electric wheelchair with the stereo omnidirectional system (SOS, which is capable of acquiring omnidirectional color image sequences and range data simultaneously in real time. The first half of this paper introduces the SOS and the basic technology behind it. To use the multicamera system SOS on an electric wheelchair, we developed an image synthesizing method of high speed and high quality and the method of recovering SOS attitude changes by using attitude sensors is also introduced. This method allows the SOS to be used without being affected by the mounting attitude of the SOS. The second half of this paper introduces the prototype electric wheelchair actually manufactured and experiments conducted using the prototype. The usability of the electric wheelchair is also discussed.
Sharon Eve Sonenblum
Full Text Available Background. This study aimed to describe how people move about in manual wheelchairs (MWCs during everyday life by evaluating bouts of mobility or continuous periods of movement. Methods. A convenience sample of 28 MWC users was recruited. Participants' everyday mobility was measured using a wheel-mounted accelerometer and seat occupancy switch for 1-2 weeks. Bouts of mobility were recorded and characterized. Results. Across 29,200 bouts, the median bout lasted 21 seconds and traveled 8.6 m at 0.43 m/s. 85% of recorded bouts lasted less than 1 minute and traveled less than 30 meters. Participants' daily wheelchair activity included 90 bouts and 1.6 km over 54 minutes. Average daily occupancy time was 11 hours during which participants wheeled 10 bouts/hour and spent 10% of their time wheeling. Spearman-Brown Prophecy analysis suggested that 7 days were sufficient to achieve a reliability of 0.8 for all bout variables. Conclusions. Short, slow bouts dominate wheelchair usage in a natural environment. Therefore, clinical evaluations and biomechanical research should reflect this by concentrating on initiating movement, maneuvering wheelchairs, and stopping. Bouts of mobility provide greater depth to our understanding of wheelchair use and are a more stable metric (day-to-day than distance or time wheeled.
Lin, Chien-Ju; Lin, Po-Chou; Guo, Lan-Yuen; Su, Fong-Chin
Researchers of wheelchair propulsion have usually suggested that a wheelchair can be properly designed using anthropometrics to reduce high mechanical load and thus reduce pain and damage to joints. A model based on physiological features and biomechanical principles can be used to determine anthropometric relationships for wheelchair fitting. To improve the understanding of man-machine interaction and the mechanism through which propulsion performance been enhanced, this study develops and validates an energy model for wheelchair propulsion. Kinematic data obtained from ten able-bodied and ten wheelchair-dependent users during level propulsion at an average velocity of 1m/s were used as the input of a planar model with the criteria of increasing efficiency and reducing joint load. Results demonstrate that for both experienced and inexperienced users, predicted handrim contact forces agree with experimental data through an extensive range of the push. Significant deviations that were mostly observed in the early stage of the push phase might result from the lack of consideration of muscle dynamics and wrist joint biomechanics. The proposed model effectively verified the handrim contact force patterns during dynamic propulsion. Users do not aim to generate mechanically most effective forces to avoid high loadings on the joints. Copyright © 2010 Elsevier Ltd. All rights reserved.
Soltau, Shelby L; Slowik, Jonathan S; Requejo, Philip S; Mulroy, Sara J; Neptune, Richard R
Studies of manual wheelchair propulsion often assume bilateral symmetry to simplify data collection, processing, and analysis. However, the validity of this assumption is unclear. Most investigations of wheelchair propulsion symmetry have been limited by a relatively small sample size and a focus on a single propulsion condition (e.g., level propulsion at self-selected speed). The purpose of this study was to evaluate bilateral symmetry during manual wheelchair propulsion in a large group of subjects across different propulsion conditions. Three-dimensional kinematics and handrim kinetics along with spatiotemporal variables were collected and processed from 80 subjects with paraplegia while propelling their wheelchairs on a stationary ergometer during three different conditions: level propulsion at their self-selected speed (free), level propulsion at their fastest comfortable speed (fast), and propulsion on an 8% grade at their level, self-selected speed (graded). All kinematic variables had significant side-to-side differences, primarily in the graded condition. Push angle was the only spatiotemporal variable with a significant side-to-side difference, and only during the graded condition. No kinetic variables had significant side-to-side differences. The magnitudes of the kinematic differences were low, with only one difference exceeding 5°. With differences of such small magnitude, the bilateral symmetry assumption appears to be reasonable during manual wheelchair propulsion in subjects without significant upper-extremity pain or impairment. However, larger asymmetries may exist in individuals with secondary injuries and pain in their upper extremity and different etiologies of their neurological impairment.
Kloosterman, Marieke G. M.; Buurke, Jaap H.; de Vries, Wiebe; Van der Woude, Lucas H. V.; Rietman, Johan S.
This study aims to compare hand-rim and power-assisted hand-rim propulsion on potential risk factors for shoulder overuse injuries: intensity and repetition of shoulder loading and force generation in the extremes of shoulder motion. Eleven experienced hand-rim wheelchair users propelled an
Kloosterman, Marieke; Buurke, Jaap; de Vries, W.; de Vries, W.; van der Woude, L.H.V.; Rietman, Johan Swanik
This study aims to compare hand-rim and power-assisted hand-rim propulsion on potential risk factors for shoulder overuse injuries: intensity and repetition of shoulder loading and force generation in the extremes of shoulder motion. Eleven experienced hand-rim wheelchair users propelled an
Sanders, David A
A shared-control scheme for a powered wheelchair is presented. The wheelchair can be operated by a wheelchair driver using a joystick, or directed by a sensor system, or control can be combined between them. The wheelchair system can modify direction depending on the local environment. Sharing the control allows a disabled wheelchair driver to drive safely and efficiently. The controller automatically establishes the control gains for the sensor system and the human driver by calculating a self-reliance factor for the wheelchair driver. The sensor system can influence the motion of the wheelchair to compensate for some deficiency in a disabled driver. Practical tests validate the proposed techniques and designs.
Booka, Masayuki; Yoneda, Ikuo; Hashizume, Tsutomu; Lee, Hokyoo; Oku, Hidehisa; Fujisawa, Shoichiro
It is often experienced that low tire pressure of the wheelchair not only increases running resistance, but also reduces parking brake performance. In this study, the required driving forces for different tire pressures were experimentally measured and evaluated. It was indicated from the result that the wheelchair with proper tire pressure could be run with less workload of wheelchair-user. Then it was also indicated that the wheelchair with a lower tire pressure needed more workload of wheelchair-user even on hard level surface.
Terry J. Ellapen
Conclusion: Wheelchair users have a high body mass index, body fat percentage and serum lipid, cholesterol and blood glucose concentrations. Empirical investigations illustrate exercise improves their PCMRP and cardiorespiratory fitness levels. Although literature encourages regular exercise, none discusses the need to individualise chair setup in order to eliminate wheelchair pathomechanics and upper limb neuromuscular injuries. Wheelchair users must be encouraged to consult a biokineticist or physiotherapist to review their wheelchair setup so as to eliminate possible incorrect manual wheelchair propulsion biomechanics and consequent overuse injuries.
Moon, Y; Jayaraman, C; Hsu, I M K; Rice, I M; Hsiao-Wecksler, E T; Sosnoff, J J
Manual wheelchair users report a high prevalence of shoulder pain. Growing evidence shows that variability in forces applied to biological tissue is related to musculoskeletal pain. The purpose of this study was to examine the variability of forces acting on the shoulder during wheelchair propulsion as a function of shoulder pain. Twenty-four manual wheelchair users (13 with pain, 11 without pain) participated in the investigation. Kinetic and kinematic data of wheelchair propulsion were recorded for 3 min maintaining a constant speed at three distinct propulsion speeds (fast speed of 1.1 m/s, a self-selected speed, and a slow speed of 0.7 m/s). Peak resultant shoulder forces in the push phase were calculated using inverse dynamics. Within individual variability was quantified as the coefficient of variation of cycle to cycle peak resultant forces. There was no difference in mean peak shoulder resultant force between groups. The pain group had significantly smaller variability of peak resultant force than the no pain group (Ppropulsion variability could be a novel marker of upper limb pain in manual wheelchair users. © 2013.
Kawada, Kyohei; Matsuda, Tadamitsu; Takanashi, Akira; Miyazima, Shigeki; Yamamoto, Sumiko
[Purpose] This study sought to ascertain whether, in hemiplegic patients, the effect of a wheelchair cushion to suppress pelvic posterior tilt when initiating wheelchair propulsion would continue in subsequent propulsions. [Subjects] Eighteen hemiplegic patients who were able to propel a wheelchair in a seated position participated in this study. [Methods] An adjustable wheelchair was fitted with a cushion that had an anchoring function, and a thigh pad on the propulsion side was removed. Propulsion movements from the seated position without moving through three propulsion cycles were measured using a three-dimensional motion analysis system, and electromyography was used to determine the angle of pelvic posterior tilt, muscle activity of the biceps femoris long head, and propulsion speed. [Results] Pelvic posterior tilt could be suppressed through the three propulsion cycles, which served to increase propulsion speed. Muscle activity of the biceps femoris long head was highest when initiating propulsion and decreased thereafter. [Conclusion] The effect of the wheelchair cushion on suppressing pelvic posterior tilt continued through three propulsion cycles.
Guillermo Del Castillo
Full Text Available The paper extends the teach-and-repeat paradigm that has been successful for the control of holonomic robots to nonholonomic wheelchairs which may undergo pivoting action over the course of their taught movement. Due to the nonholonomic nature of the vehicle kinematics, estimation is required -- in the example given herein, based upon video detection of wall-mounted cues -- both in the teaching and the tracking events. In order to accommodate motion that approaches pivoting action as well as motion that approaches straight-line action, the estimation equations of the Extended Kalman Filter and the control equations are formulated using two different definitions of a nontemporal independent variable. The paper motivates the need for pivoting action in real-life settings by reporting extensively on the abilities and limitations of estimation-based teach-and-repeat action where pivoting and near-pivoting action is disallowed. Following formulation of the equations in the near-pivot mode, the paper reports upon experiments where taught trajectories which entail a seamless mix of near-straight and near-pivot action are tracked.
Full Text Available Assistant robots like robotic wheelchairs can perform an effective and valuable work in our daily lives. However, they eventually may need external help from humans in the robot environment (particularly, the driver in the case of a wheelchair to accomplish safely and efficiently some tricky tasks for the current technology, i.e. opening a locked door, traversing a crowded area, etc. This article proposes a control architecture for assistant robots designed under a multi-agent perspective that facilitates the participation of humans into the robotic system and improves the overall performance of the robot as well as its dependability. Within our design, agents have their own intentions and beliefs, have different abilities (that include algorithmic behaviours and human skills and also learn autonomously the most convenient method to carry out their actions through reinforcement learning. The proposed architecture is illustrated with a real assistant robot: a robotic wheelchair that provides mobility to impaired or elderly people.
Haydon, David S; Pinder, Ross A; Grimshaw, Paul N; Robertson, William S P
Maximal acceleration from standstill has been identified as a key performance indicator in wheelchair rugby; however, the impact of classification and kinematic variables on performance has received limited attention. This study aimed to investigate kinematic variables during maximal acceleration, with level of activity limitation accounted for using sport-classification scores. Based on their sporting classification scores, which reflect combined trunk, arm, and hand function, 25 elite wheelchair rugby players were analyzed in high-, mid-, and low-point groups before completing five 5-m sprints from a stationary position. Inertial measurement units and video analysis were used to monitor key kinematic variables. Significant differences in kinematic variables were evident across the classification groups, particularly for the first stroke-contact angle (1-way ANOVA F 2,122 = 51.5, P propulsion approaches exist across classification groups, with this information potentially informing individual wheelchair setups and training programs.
Gardner, Paula; Muller, Matthew P; Prior, Betty; So, Ken; Tooze, Jane; Eum, Linda; Kachur, Oksana
Wheelchairs are complex equipment that come in close contact with individuals at increased risk of transmitting and acquiring antibiotic-resistant organisms and health care-associated infection. The purpose of this study was to determine the status of wheelchair cleaning and disinfection in Canadian health care facilities. Acute care hospitals (ACHs), chronic care hospitals (CCHs), and long-term care facilities (LTCFs) were contacted and the individual responsible for oversight of wheelchair cleaning and disinfection was identified. A structured interview was conducted that focused on current practices and concerns, barriers to effective wheelchair cleaning and disinfection, and potential solutions. Interviews were completed at 48 of the 54 facilities contacted (89%), including 18 ACHs, 16 CCHs, and 14 LTCFs. Most (n = 24) facilities had 50-200 in-house wheelchairs. Respondents were very concerned about wheelchair cleaning as an infection control issue. Specific concerns included the lack of reliable systems for tracking and identifying dirty and clean wheelchairs (71%, 34/48), failure to clean and disinfect wheelchairs between patients (52%, 25/48), difficulty cleaning cushions (42%, 20/48), lack of guidelines (35%, 27/48), continued use of visibly soiled wheelchairs (29%, 14/48) and lack of resources (25%, 12/48). Our results suggest that wheelchair cleaning and disinfection is not optimally performed at many Canadian hospitals and LTCFs. Specific guidance on wheelchair cleaning and disinfection is necessary. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
Luciene Chagas de Oliveira
Full Text Available Introduction: Individuals with mobility impairments associated with lower limb disabilities often face enormous challenges to participate in routine activities and to move around various environments. For many, the use of wheelchairs is paramount to provide mobility and social inclusion. Nevertheless, they still face a number of challenges to properly function in our society. Among the many difficulties, one in particular stands out: navigating in complex internal environments (indoors. The main objective of this work is to propose an architecture based on Mobile Augmented Reality to support the development of indoor navigation systems dedicated to wheelchair users, that is also capable of recording CAD drawings of the buildings and dealing with accessibility issues for that population. Methods Overall, five main functional requirements are proposed: the ability to allow for indoor navigation by means of Mobile Augmented Reality techniques; the capacity to register and configure building CAD drawings and the position of fiducial markers, points of interest and obstacles to be avoided by the wheelchair user; the capacity to find the best route for wheelchair indoor navigation, taking stairs and other obstacles into account; allow for the visualization of virtual directional arrows in the smartphone displays; and incorporate touch or voice commands to interact with the application. The architecture is proposed as a combination of four layers: User interface; Control; Service; and Infrastructure. A proof-of-concept application was developed and tests were performed with disable volunteers operating manual and electric wheelchairs. Results The application was implemented in Java for the Android operational system. A local database was used to store the test building CAD drawings and the position of fiducial markers and points of interest. The Android Augmented Reality library was used to implement Augmented Reality and the Blender open source
ZHANG Li; WU Bo; JIN Ai-min; JIANG Shi-hong; ZHENG Yu-fei; ZHANG Shuai
In order to achieve a wheelchair climb stairs function, this paper designs a star-wheel stair-climbing mechanism. Through the effect of the lock coupling, the star-wheel stair-climbing mechanism is formed to be fixed axis gear train or planetary gear train achieving flat-walking and stair-climbing functions. Crossing obstacle analysis obtains the maximum height and minimum width of obstacle which the wheelchair can cross. Stress-strain analysis in Solidworks simulation is performed to verify material strength.
Brandt, Ase; Iwarsson, Susanne; Ståhle, Agneta
research were identified. CONCLUSION: The use of powered wheelchairs is a relevant societal intervention in relation to older people with limited walking ability in order to make activity and participation possible. It is likely that a larger proportion of older people could benefit from this intervention...... not use the wheelchair for visits, and supplementary travel modes are called for. Users who could not walk at all or who could not transfer without assistance were more likely not to be able to carry out prioritized activities. Furthermore, other risk factors for negative outcomes and need for further...
This work explores disability in the cultural context of contemporary Japanese comics. In contrast to Western comics, Japanese manga have permeated the social fabric of Japan to the extent that vast numbers of people read manga on a daily basis. It has, in fact, become such a popular medium for visual communication that the Japanese government and education systems utilize manga as a social acculturation and teaching tool. This multibillion dollar industry is incredibly diverse, and one particularly popular genre is sports manga. However, Inoue Takehiko's award-winning manga series REAL departs from more conventional sports manga, which typically focus on able-bodied characters with sometimes exaggerated superhuman physical abilities, by adopting a more realistic approach to the world of wheelchair basketball and the people who play it. At the same time REAL explores cultural attitudes toward disability in Japanese culture-where disability is at times rendered "invisible" either through accessibility problems or lingering associations of disability and shame. It is therefore extremely significant that manga, a visual medium, is rendering disability visible-the ultimate movement from margin to center. REAL devotes considerable attention to realistically illustrating the lived experiences of its characters both on and off the court. Consequently, the series not only educates readers about wheelchair basketball but also provides compelling insight into Japanese cultural notions about masculinity, family, responsibility, and identity. The basketball players-at first marginalized by their disability-join together in the unity of a sport typically characterized by its "abledness."
Russell, Ian M; Raina, Shashank; Requejo, Philip S; Wilcox, Rand R; Mulroy, Sara; McNitt-Gray, Jill L
Repetitive loading of the upper limb joints during manual wheelchair (WC) propulsion (WCP) has been identified as a factor that contributes to shoulder pain, leading to loss of independence and decreased quality of life. The purpose of this study was to determine how individual manual WC users with paraplegia modify propulsion mechanics to accommodate expected increases in reaction forces (RFs) generated at the pushrim with self-selected increases in WCP speed. Upper extremity kinematics and pushrim RFs were measured for 40 experienced manual WC users with paraplegia while propelling on a stationary ergometer at self-selected free and fast propulsion speeds. Upper extremity kinematics and kinetics were compared within subject between propulsion speeds. Between group and within-subject differences were determined (α = 0.05). Increased propulsion speed was accompanied by increases in RF magnitude (22 of 40, >10 N) and shoulder net joint moment (NJM, 15 of 40, >10 Nm) and decreases in pushrim contact duration. Within-subject comparison indicated that 27% of participants modified their WCP mechanics with increases in speed by regulating RF orientation relative to the upper extremity segments. Reorientation of the RF relative to the upper extremity segments can be used as an effective strategy for mitigating rotational demands (NJM) imposed on the shoulder at increased propulsion speeds. Identification of propulsion strategies that individuals can use to effectively accommodate for increases in RFs is an important step toward preserving musculoskeletal health of the shoulder and improving health-related quality of life.
Passuni, Diego; Dalzotto, Elisa; F Gath, Christian; Buffetti, Eliana; Elizalde, Milagros; Jarmoluk, Verónica; Russo, Maria J; Intruvini, Silvia; Olmos, Lisandro E; Freixes, Orestes
Cross-sectional. The majority of people with a spinal cord injury (SCI) are dependent on wheelchair for their mobility. Approximately, 36% of wheelchair users reported that obstacles such as curbs, uneven terrain, flooring surfaces and thresholds were barriers to mobility. Several studies have shown that assessment and training of wheelchair skills leads to improvements in those skills. The purpose of our study was to translate the Wheelchair Skill Test (4.2) and its report form into Spanish and then determine the inter-rater reliability of the WST 4.2 for manual wheelchairs operated by their users. Rehabilitation Unit, FLENI Institute, Buenos Aires, Argentina. The translation was performed by a physical therapist with advanced English language skills and specialized in the treatment of SCI subjects. We administrated and video-recorded the WST 4.2 manual Spanish version in 11 SCI subjects. Two physical therapists received specific training for administering the test and scoring the record. The reliability of the total percentage WST score were statistically quantified by intraclass correlation coefficient (ICC). ICC values for Interrater were 0.998 (p skills had a 100 percentage of agreement. Percentage of agreement in the three skills that presented less rating agreement was 73%, 81 % and 82 %, respectively. The results show that the Spanish version of WST 4.2 is a reliable assessment tool to evaluate the skills capacity of spinal cord manual wheelchair users. Implications for rehabilitation Wheelchair users require a proficient management of various wheelchair skills to achieve maximum independence in daily life. Determining which wheelchair skills should be addressed during the rehabilitation process is of great importance for their correct training. The WST 4.2 is an appropriate assessment tool to determine the functional capacity of wheelchair users. Making available the WST 4.2 in the Spanish language and demonstrating its reliability in this language
Full Text Available A new control system of a hand gesture-controlled wheelchair (EWC is proposed. This smart control device is suitable for a large number of patients who cannot manipulate a standard joystick wheelchair. The movement control system uses a camera fixed on the wheelchair. The patient’s hand movements are recognized using a visual recognition algorithm and artificial intelligence software; the derived corresponding signals are thus used to control the EWC in real time. One of the main features of this control technique is that it allows the patient to drive the wheelchair with a variable speed similar to that of a standard joystick. The designed device “hand gesture-controlled wheelchair” is performed at low cost and has been tested on real patients and exhibits good results. Before testing the proposed control device, we have created a three-dimensional environment simulator to test its performances with extreme security. These tests were performed on real patients with diverse hand pathologies in Mohamed Kassab National Institute of Orthopedics, Physical and Functional Rehabilitation Hospital of Tunis, and the validity of this intelligent control system had been proved.
Salatino, Claudia; Andrich, Renzo; Converti, R M; Saruggia, M
Powered wheelchairs are complex and expensive assistive devices that must be selected and configured on the basis of individual user needs, lifestyle, motivation, driving ability, and environment. Providing agencies often require evidence that their financial investment will lead to a successful outcome. The authors surveyed a sample of 79 users who had obtained powered wheelchairs from a Regional Health Service in Italy in the period 2008-2013. Follow-up interviews were conducted at the users' homes in order to collect information about wheelchair use, and its effectiveness, usefulness, and economic impact. The instruments used in the interviews included an introductory questionnaire, QUEST (Quebec User Evaluation of Satisfaction with Assistive Technology), PIADS (Psychosocial Impact of Assistive Devices Scale), FABS/M (Facilitators and Barriers Survey/Mobility), and SCAI (Siva Cost Analysis Instrument). The results indicated positive outcomes, especially in relation to user satisfaction and psychosocial impact. A number of barriers were identified in various settings that sometimes restrict user mobility, and suggest corrective actions. The provision of a powered wheelchair generated considerable savings in social costs for most users: an average of about $38,000 per person over a projected 5-year period was estimated by comparing the cost of the intervention with that of non-intervention.
Veeger, DirkJan (H. E. J.); van der Woude, L H; Rozendal, R H
To study the effect of tangential speed of the handrims independent of external power output on gross mechanical efficiency (ME), nine able-bodied subjects performed wheelchair exercise tests on a stationary ergometer. The ergometer allowed for measurement of torque and three-dimensional forces on
Full Text Available Due to lower limb paralysis, individuals with spinal cord injury (SCI rely on their upper limbs for mobility. The prevalence of upper extremity pain and injury is high among this population. We evaluated the performance of three triaxis accelerometers placed on the upper arm, wrist, and under the wheelchair, to estimate temporal parameters of wheelchair propulsion. Twenty-six participants with SCI were asked to push their wheelchair equipped with a SMARTWheel. The estimated stroke number was compared with the criterion from video observations and the estimated push frequency was compared with the criterion from the SMARTWheel. Mean absolute errors (MAE and mean absolute percentage of error (MAPE were calculated. Intraclass correlation coefficients and Bland-Altman plots were used to assess the agreement. Results showed reasonable accuracies especially using the accelerometer placed on the upper arm where the MAPE was 8.0% for stroke number and 12.9% for push frequency. The ICC was 0.994 for stroke number and 0.916 for push frequency. The wrist and seat accelerometer showed lower accuracy with a MAPE for the stroke number of 10.8% and 13.4% and ICC of 0.990 and 0.984, respectively. Results suggested that accelerometers could be an option for monitoring temporal parameters of wheelchair propulsion.
Martin, Jeffrey J.
In the current study, variables grounded in social cognitive theory with athletes with disabilities were examined. Performance, training, resiliency, and thought control self-efficacy, and positive (PA) and negative (NA) affect were examined with wheelchair basketball athletes (N = 79). Consistent with social cognitive theory, weak to strong…
Sundaram, S. Andrea; Wang, Hongwu; Ding, Dan
Background: Power wheelchairs capable of overcoming environmental barriers, such as uneven terrain, curbs, or stairs, have been under development for more than a decade. Method: We conducted a systematic review of the scientific and engineering literature to identify these devices, and we provide brief descriptions of the mechanism and method of operation for each. We also present data comparing their capabilities in terms of step climbing and standard wheelchair functions. Results: We found that all the devices presented allow for traversal of obstacles that cannot be accomplished with traditional power wheelchairs, but the slow speeds and small wheel diameters of some designs make them only moderately effective in the basic area of efficient transport over level ground and the size and configuration of some others limit maneuverability in tight spaces. Conclusion: We propose that safety and performance test methods more comprehensive than the International Organization for Standards (ISO) testing protocols be developed for measuring the capabilities of advanced wheelchairs with step-climbing and other environment-negotiating features to allow comparison of their clinical effectiveness. PMID:29339886
Routhier, François; Lettre, Josiane; Miller, William C.; Borisoff, Jaimie F.; Keetch, Kate; Mitchell, Ian M.
Recent studies have employed data loggers to record a wide range of, sometimes differing, objective outcomes associated with the use of manual wheelchairs. To identify which outcomes are broadly perceived to be the most important to measure when objectively documenting manual wheelchair use, a cross-sectional survey was conducted with groups of researchers and clinicians in the field of wheeled mobility. We also surveyed the challenges these groups experienced when using data loggers. The survey was informed by a previous scoping review of the scientific and gray literature. Seventy-four people, with various academic and professional backgrounds, completed the survey: 57 researchers (77.0%) and 17 clinicians (23.0%). Regarding the importance they attributed to commonly measured outcomes, the most highly rated outcome identified by both groups was “distance traveled.” There were significant differences between the groups’ perspectives in rating and ranking the importance of “pressure-relief activities”, “seat pressure” and “acceleration.” In terms of challenges or barriers associated with the use of data loggers for monitoring manual wheelchair use, it appears that researchers and clinicians have relatively similar needs and preferences. However, only clinicians reported that the time they wanted to, or could, allocate to review recorded information was a potential hardship. Our hope is that these results will help further development and increase the functionality and applicability of data loggers for manual wheelchairs in research and clinical contexts. PMID:28202382
Vegter, Riemer J K; de Groot, Sonja; Lamoth, Claudine J; Veeger, Dirkjan Hej; van der Woude, Lucas H V
To gain insight into cyclic motor learning processes, hand rim wheelchair propulsion is a suitable cyclic task, to be learned during early rehabilitation and novel to almost every individual. To propel in an energy efficient manner, wheelchair users must learn to control bimanually applied forces onto the rims, preserving both speed and direction of locomotion. The purpose of this study was to evaluate mechanical efficiency and propulsion technique during the initial stage of motor learning. Therefore, 70 naive able-bodied men received 12-min uninstructed wheelchair practice, consisting of three 4-min blocks separated by 2 min rest. Practice was performed on a motor-driven treadmill at a fixed belt speed and constant power output relative to body mass. Energy consumption and the kinetics of propulsion technique were continuously measured. Participants significantly increased their mechanical efficiency and changed their propulsion technique from a high frequency mode with a lot of negative work to a longer-slower movement pattern with less power losses. Furthermore a multi-level model showed propulsion technique to relate to mechanical efficiency. Finally improvers and non-improvers were identified. The non-improving group was already more efficient and had a better propulsion technique in the first block of practice (i.e., the fourth minute). These findings link propulsion technique to mechanical efficiency, support the importance of a correct propulsion technique for wheelchair users and show motor learning differences.
Qi, Liping; Wakeling, James; Grange, Simon; Ferguson-Pell, Martin
This study investigated changes in the coordination patterns of shoulder muscles and wheelchair kinetics with different propulsion techniques by comparing wheelchair users' self-selected propulsion patterns with a semicircular pattern adopted after instruction. Wheelchair kinetics data were recorded by Smart(Wheel) on an ergometer, while EMG activity of seven muscles was recorded with surface electrodes on 15 able-bodied inexperienced participants. The performance data in two sessions, first using a self-selected and then the learned semicircular pattern, were compared with a paired t-test. Muscle coordination patterns across seven muscles were analyzed by principal component analysis. The semicircular pattern was characterized by significantly lower push frequency, significantly longer push length, push duration and push distance (p propulsion technique, synergistic muscles were recruited in distinct phases and displayed a clearer separation between activities in the push phase and recovery phase muscles. An instruction session in semicircular propulsion technique is recommended for the initial use of a wheelchair after an injury.
Krista L. Best
Full Text Available Background. Physical and leisure activities are proven health promotion modalities and have not been examined in older wheelchair users. Main Objectives. Examine physical and leisure activity in older wheelchair users and explore associations between wheelchair use and participation in physical and leisure activity, and wheelchair use, physical and leisure activity, and perceived health. Methods. 8301 Canadians ≥60 years of age were selected from the Canadian Community Health Survey. Sociodemographic, health-related, mobility-related, and physical and leisure activity variables were analysed using logistic regression to determine, the likelihood of participation in physical and leisure activity, and whether participation in physical and leisure activities mediates the relationship between wheelchair use and perceived health. Results. 8.3% and 41.3% older wheelchair users were physically and leisurely active. Wheelchair use was a risk factor for reduced participation in physical (OR=44.71 and leisure activity (OR=10.83. Wheelchair use was a risk factor for poor perceived health (OR=10.56 and physical and leisure activity negatively mediated the relationship between wheelchair user and perceived health. Conclusion. There is a need for the development of suitable physical and leisure activity interventions for older wheelchair users. Participation in such interventions may have associations with health benefits.
Best, Krista L; Miller, William C
Background. Physical and leisure activities are proven health promotion modalities and have not been examined in older wheelchair users. Main Objectives. Examine physical and leisure activity in older wheelchair users and explore associations between wheelchair use and participation in physical and leisure activity, and wheelchair use, physical and leisure activity, and perceived health. Methods. 8301 Canadians ≥60 years of age were selected from the Canadian Community Health Survey. Sociodemographic, health-related, mobility-related, and physical and leisure activity variables were analysed using logistic regression to determine, the likelihood of participation in physical and leisure activity, and whether participation in physical and leisure activities mediates the relationship between wheelchair use and perceived health. Results. 8.3% and 41.3% older wheelchair users were physically and leisurely active. Wheelchair use was a risk factor for reduced participation in physical (OR = 44.71) and leisure activity (OR = 10.83). Wheelchair use was a risk factor for poor perceived health (OR = 10.56) and physical and leisure activity negatively mediated the relationship between wheelchair user and perceived health. Conclusion. There is a need for the development of suitable physical and leisure activity interventions for older wheelchair users. Participation in such interventions may have associations with health benefits.
Omar W Heyward
Full Text Available In recent years the popularity of disabled sports and competition among disabled athletes has grown considerably. With this rise in exposure of, and participation in wheelchair sports comes an increase in related stressors, including musculoskeletal load. External mechanical loading may increase the risk of shoulder complaints. The objective of this literature review was to 1 identify and describe the prevalence and/or incidence of shoulder complaints in wheelchair athletes in the literature, to 2 examine the factors and underlying mechanisms that could be potentially involved, and 3 provide some insights into the development of preventative measures.A literature search was conducted using PubMed, Scopus and Embase databases, to identify relevant published articles. All articles in the English language that contained any type of shoulder complaint in relation with a wheelchair sports player, at any level of status (recreational to elite, of any sport, were included. Articles were excluded if they did not include any statistical analysis. Articles that included studies with wheelchair athletes in combination with athletes of other disability sports were excluded in order to be able to differentiate between the two. Narrative, exploratory and case studies were also excluded. Two reviewers independently assessed articles for inclusion. Thirteen articles matched the selection criteria. These were judged on their quality by use of an adapted version of the Webster checklist.Of the included studies the overall quality was low. A relatively high prevalence of complaints was found, ranging from 16% to 76%. Pain was found to be a common complaint in wheelchair athletes. Based on the current literature the cause of shoulder problems is difficult to identify and is likely multifactorial, nevertheless characteristics of the user (i.e. increased years of disability, age and BMI were shown to increase risk. Preventative measures were indistinct. There may be
Terada, Kyoko; Satonaka, Ayako; Terada, Yasuto; Suzuki, Nobuharu
There were few studies about training effects of wheelchair dance on aerobic fitness in the bedridden individuals with severe cerebral palsy for whom the traditional maximal or submaximal exercise tests were not applicable. As the oxygen pulse (O2P), the oxygen uptake divided by the heart rate, is regarded to be a relative measure of stroke volume and the O2P correlates to peak oxygen uptake, we would be able to assess the training effects of wheelchair dance on aerobic fitness in those individuals measuring O2P. To study training effects of wheelchair dance on aerobic fitness in bedridden individuals with severe athetospastic cerebral palsy. Pre-post study design. A laboratory and a community care center. Bedridden individuals with athetospastic cerebral palsy rated to Gross Motor Function Classification System (GMFCS) level V (N.=6). The O2P was compared between during the rest, the waltz, and the jive at the baseline, the 3rd, the 6th, and the 12th month of the intervention of wheelchair dance 6 to 15 minutes at a time, 2 days a week or more. Paired Student's t-test showed that O2P during the waltz and the jive was significantly increased compared with that during the rest at the 6th and the 12th month, and O2P during the jive was also significantly increased compared with that during the rest at the 3rd, the 6th, and the 12th month of the intervention period. This is the first study that shows wheelchair dance may possibly increase aerobic fitness in bedridden individuals with severe athetospastic cerebral palsy rated GMFCS level V. Future studies with a larger sample will be warranted to prove the claim.
Bregman, D J J; van Drongelen, S; Veeger, H E J
Efficiency in manual wheelchair propulsion is low, as is the fraction of the propulsion force that is attributed to the moment of propulsion of the wheelchair. In this study we tested the hypothesis that a tangential propulsion force direction leads to an increase in physiological cost, due to (1) the sub-optimal use of elbow flexors and extensors, and/or (2) the necessity of preventing of glenohumeral subluxation. Five able-bodied and 11 individuals with a spinal cord injury propelled a wheelchair while kinematics and kinetics were collected. The results were used to perform inverse dynamical simulations with input of (1) the experimentally obtained propulsion force, and (2) only the tangential component of that force. In the tangential force condition the physiological cost was over 30% higher, while the tangential propulsion force was only 75% of the total experimental force. According to model estimations, the tangential force condition led to more co-contraction around the elbow, and a higher power production around the shoulder joint. The tangential propulsion force led to a significant, but small 4% increase in necessity for the model to compensate for glenohumeral subluxation, which indicates that this is not a likely cause of the decrease in efficiency. The present findings support the hypothesis that the observed force direction in wheelchair propulsion is a compromise between efficiency and the constraints imposed by the wheelchair-user system. This implies that training should not be aimed at optimization of the propulsion force, because this may be less efficient and more straining for the musculoskeletal system.
Background Experiencing independent mobility is important for children with a severe movement disability, but learning to drive a powered wheelchair can be labor intensive, requiring hand-over-hand assistance from a skilled therapist. Methods To improve accessibility to training, we developed a robotic wheelchair trainer that steers itself along a course marked by a line on the floor using computer vision, haptically guiding the driver's hand in appropriate steering motions using a force feedback joystick, as the driver tries to catch a mobile robot in a game of "robot tag". This paper provides a detailed design description of the computer vision and control system. In addition, we present data from a pilot study in which we used the chair to teach children without motor impairment aged 4-9 (n = 22) to drive the wheelchair in a single training session, in order to verify that the wheelchair could enable learning by the non-impaired motor system, and to establish normative values of learning rates. Results and Discussion Training with haptic guidance from the robotic wheelchair trainer improved the steering ability of children without motor impairment significantly more than training without guidance. We also report the results of a case study with one 8-year-old child with a severe motor impairment due to cerebral palsy, who replicated the single-session training protocol that the non-disabled children participated in. This child also improved steering ability after training with guidance from the joystick by an amount even greater than the children without motor impairment. Conclusions The system not only provided a safe, fun context for automating driver's training, but also enhanced motor learning by the non-impaired motor system, presumably by demonstrating through intuitive movement and force of the joystick itself exemplary control to follow the course. The case study indicates that a child with a motor system impaired by CP can also gain a short-term benefit
Karen L. Rispin
Conclusion: Results support the preliminary reliability and validity of the AWMT 2.0, supporting its effectiveness in comparing the mobility provided by different wheelchair types. This information can be used to enable effective use of limited funds for wheelchair selection at individual and organisational scales.
Hwang, Seonhong; Kim, Seunghyeon; Son, Jongsang; Kim, Youngho
Manual wheelchair users are at a high risk of pain and injuries to the upper extremities due to mechanical inefficiency of wheelchair propulsion motion. The kinetic analysis of the upper extremities during manual wheelchair propulsion in various conditions needed to be investigated. We developed and calibrated a wheelchair dynamometer for measuring kinetic parameters during propulsion. We utilized the dynamometer to investigate and compare the propulsion torque and power values of experienced and novice users under four different conditions. Experienced wheelchair users generated lower torques with more power than novice users and reacted alertly and sensitively to changing conditions. We expect that these basic methods and results may help to quantitatively evaluate the mechanical efficiency of manual wheelchair propulsion.
Ihsan, Izzat Aqmar; Tomari, Razali; Zakaria, Wan Nurshazwani Wan; Othman, Nurmiza
Quadriplegia or tetraplegia patients have restricted four limbs as well as torso movement caused by severe spinal cord injury. Undoubtedly, these patients face difficulties when operating their powered electric wheelchair since they are unable to control the wheelchair by means of a standard joystick. Due to total loss of both sensory and motor function of the four limbs and torso, an alternative input medium for the wheelchair will be developed to assist the user in operating the wheelchair. In this framework, the direction of the wheelchair movement is determined by the user's conscious intent through a brain control interface (BCI) based on Electroencephalogram (EEG) signal. A laser range finder (LFR) is used to perceive environment information for determining a safety distance of the wheelchair's surrounding. Local path planning algorithm will be developed to provide navigation planner along with user's input to prevent collision during control operation.
Caspall, Jayme J; Seligsohn, Erin; Dao, Phuc V; Sprigle, Stephen
When executing turning maneuvers, manual wheelchair users must overcome the rotational inertia of the wheelchair system. Differences in wheelchair rotational inertia can result in increases in torque required to maneuver, resulting in greater propulsion effort and stress on the shoulder joints. The inertias of various configurations of an ultralightweight wheelchair were measured using a rotational inertia-measuring device. Adjustments in axle position, changes in wheel and tire type, and the addition of several accessories had various effects on rotational inertias. The configuration with the highest rotational inertia (solid tires, mag wheels with rearward axle) exceeded the configuration with the lowest (pneumatic tires, spoke wheels with forward axle) by 28%. The greater inertia requires increased torque to accelerate the wheelchair during turning. At a representative maximum acceleration, the reactive torque spanned the range of 11.7 to 15.0 N-m across the wheelchair configurations. At higher accelerations, these torques exceeded that required to overcome caster scrub during turning. These results indicate that a wheelchair's rotational inertia can significantly influence the torque required during turning and that this influence will affect active users who turn at higher speeds. Categorizing wheelchairs using both mass and rotational inertia would better represent differences in effort during wheelchair maneuvers.
Harrand, Jenny; Bannigan, Katrina
A wheelchair can enhance the quality of life of an individual with limited mobility, poor trunk control and stability, by enabling activity and participation and so occupational engagement. High specification wheelchairs which can tilt-in-space enable the position of users to be altered to suit activity and context. Despite tilt-in-space wheelchairs being expensive little is known about their therapeutic value. A critical literature review of the evidence was undertaken to evaluate whether the use of tilt-in-space increases occupational engagement. A wide ranging search strategy identified 170 articles which were screened using inclusion criteria. The eligible literature (n = 6) was analysed thematically using open coding. The majority of the participants used tilt-in-space but the data was too heterogeneous to combine. Measures of occupational engagement were not used so the therapeutic value could not be assessed. There is a lack of high quality evidence about the therapeutic benefits of tilt-in-space wheelchairs. Given the expense associated with providing these wheelchairs, and the increase in their provision, research is needed to justify provision of high specification wheelchairs to meet the occupational needs of users within the limited resources of health and social care. Implications for Rehabilitation Tilt-in-space wheelchairs. Wheelchairs are an important and essential assistive device for promoting independence and function. Suggests there are benefits for tilt-in-space wheelchairs. Identifies the need for additional large scale research.
Chien, Chi-Sheng; Huang, Tung-Yung; Liao, Tze-Yuan; Kuo, Tsung-Yuan; Lee, Tzer-Min
Wheelchairs are an essential assistive device for many individuals with injury or disability. Manual wheelchairs provide a relatively low-cost solution to the mobility needs of such individuals. Furthermore, they provide an effective means of improving the user's cardiopulmonary function and upper-limb muscle strength. However, manual wheelchairs have a loss gross mechanical efficiency, and thus the risk of user fatigue and upper-limb injury is increased. Electric-powered wheelchairs reduce the risk of injury and provide a more convenient means of transportation. However, they have a large physical size and are relatively expensive. Accordingly, the present study utilizes a quality function deployment method to develop a wheelchair with a user-selectable manual/electric propulsion mode and an auxiliary solar power supply system. The auxiliary solar power supply increased the travel range of the wheelchair by approximately 26% compared with that of a wheelchair powered by battery alone. Moreover, the wheelchair has a modular design and can be disassembled and folded for ease of transportation or storage. Overall, the present results suggest that the proposed wheelchair provides an effective and convenient means of meeting the mobility needs of individuals with mobility difficulties.
Frost, Karen; Bertocci, Gina; Smalley, Craig
The purpose of this study was to characterize wheelchair tiedown and occupant restraint system (WTORS) usage in paratransit vehicles based on observations of wheelchair and scooter (wheeled mobility devices, collectively, "WhMD") passenger trips. A retrospective review of on-board video monitoring recordings of WhMD trips was conducted. Four hundred seventy-five video recordings were collected for review and analysis. The use of all four tiedowns to secure the WhMD was observed more frequently for power WhMDs (82%) and manual WhMDs (80%) compared to scooters (39%), and this difference was significant (pinjuries in this study, misuse and nonuse of WTORS potentially place WhMD seated passengers at higher risk of injury during transit. These findings support the need for improved vehicle operator training and passenger education on the proper use of WTORS and development of WTORS with improved usability and/or alternative technologies that can be automated or used independently.
Keyser, R E; Rodgers, M M; Gardner, E R; Russell, P J
To determine if a single-stage, submaximal fatigue test on a wheelchair ergometer would result in higher than expected energy expenditure. An experimental survey design contrasting physiologic responses during peak graded exercise tests and fatigue tests. A rehabilitation science laboratory that included a prototypical wheelchair ergometer, open-circuit spirometry system, and heart rate monitor. Nine able-bodied non-wheelchair users (the NWC group: 6 men and 3 women, mean +/- SD age 30 +/- 7yrs) and 15 manual wheelchair users (the WC group: 12 men and 3 women, age 40 +/- 9yrs, time in wheelchair 16 +/- 9yrs). No subject had any disease, medication regimen, or upper body neurologic, orthopedic, or other condition that would limit wheelchair exercise. Peak oxygen uptake (VO2) for graded exercise testing and during fatigue testing, using a power output corresponding to 75% peak aerobic capacity on graded exercise test. In the WC group, VO2 at 6 minutes of fatigue testing was not significantly different from peak VO2. In the NWC group, VO2 was similar to the expected level throughout fatigue testing. Energy expenditure was higher than expected in the WC group but not in the NWC group. Fatigue testing may provide a useful evaluation of cardiorespiratory status in manual wheelchair users.
Full Text Available This paper deal with a robust sliding-mode trajectory tracking controller, fornonholonomic wheeled mobile robots and its experimental evaluation by theimplementation in an intelligent wheelchair (RobChair. The proposed control structureis based on two nonlinear sliding surfaces ensuring the tracking of the three outputvariables, with respect to the nonholonomic constraint. The performances of theproposed controller for the trajectory planning problem with comfort constraint areverified through the real time acceleration provided by an inertial measurement unit.
Full Text Available The postures of wheelchair users can reveal their sitting habit, mood, and even predict health risks such as pressure ulcers or lower back pain. Mining the hidden information of the postures can reveal their wellness and general health conditions. In this paper, a cushion-based posture recognition system is used to process pressure sensor signals for the detection of user’s posture in the wheelchair. The proposed posture detection method is composed of three main steps: data level classification for posture detection, backward selection of sensor configuration, and recognition results compared with previous literature. Five supervised classification techniques—Decision Tree (J48, Support Vector Machines (SVM, Multilayer Perceptron (MLP, Naive Bayes, and k-Nearest Neighbor (k-NN—are compared in terms of classification accuracy, precision, recall, and F-measure. Results indicate that the J48 classifier provides the highest accuracy compared to other techniques. The backward selection method was used to determine the best sensor deployment configuration of the wheelchair. Several kinds of pressure sensor deployments are compared and our new method of deployment is shown to better detect postures of the wheelchair users. Performance analysis also took into account the Body Mass Index (BMI, useful for evaluating the robustness of the method across individual physical differences. Results show that our proposed sensor deployment is effective, achieving 99.47% posture recognition accuracy. Our proposed method is very competitive for posture recognition and robust in comparison with other former research. Accurate posture detection represents a fundamental basic block to develop several applications, including fatigue estimation and activity level assessment.
Gupta, Ashutosh; Ghosh, Tathagata; Kumar, Pradeep; Bhawna, Shruthi. S.
Several surveys give us the view that both children and adults benefit substantially from access towards independent mobility. With the inventions of technology, no individuals are satisfied with traditional manual operated machines. To accommodate population, researchers are using technology, originally developed for mobile robots to create ‘intelligent wheelchairs’. It’s a major challenge for quadriplegic persons as they really find it difficult to manipulate powered wheelchair during the activities of their daily living. As the Smartphone era has evolved with innovative android based applications, engineers are improving and trying to make such machines simple and cheap to the next level. In this paper, we present a development of android based powered intelligent wheelchair to assist the quadriplegic person by making them self sufficient in controlling the wheelchair. The wheels of the chair can be controlled by the voice or gesture movement or by touching the screen of the android app by the challenged persons. The system uses the Bluetooth communication to interface the microcontroller and the inbuilt sensors in the android Smartphone. According to the commands received from android phone, the kinematics of the wheels are controlled.
Shaari, Muhammad Farid; Rasli, Ibrahim Ismail Mohammad; Jamaludin, M. Z. Z. Wan; Isa, W. A. Mohamad; M., H.; Rashid, A. H. Abdul
Sharia compliant wheelchair wheel cleaner was developed in order to assist the muslim Person with Disabilities (PWD) to pray in the mosque without leaving their wheelchair because of the filthy wheels. Though there are many wheelchair wheel cleaning system in the market, it is very rare to find sharia compliant cleaning system that applies sertu concept which is one of the cleaning and purification technique in Islamic practice. The sertu concept is based on 6:1 ratio that refers to the six times pipe water cleaning and one time soiled water cleaning. The development process consists of design stage, fabrication and system installation stage and followed by testing stage. During the design stage, the proposed prototype underwent design brainstorming, operation programming and structural simulation analysis. Once fabricated, the cleaner prototype underwent was tested. The results showed that the prototype can cater load up to 100kg with 1.31×10-6 mm shaft bending displacement. The water ejection timing varied approximately 3% compared to the program.
Chiwandire, Desire; Vincent, Louise
South Africa's Constitution guarantees everyone, including persons with disabilities, the right to education. A variety of laws are in place obliging higher education institutions to provide appropriate physical access to education sites for all. In practice, however, many buildings remain inaccessible to people with physical disabilities. To describe what measures South African universities are taking to make their built environments more accessible to students with diverse types of disabilities, and to assess the adequacy of such measures. We conducted semi-structured in-depth face-to-face interviews with disability unit staff members (DUSMs) based at 10 different public universities in South Africa. Challenges with promoting higher education accessibility for wheelchair users include the preservation and heritage justification for failing to modify older buildings, ad hoc approaches to creating accessible environments and failure to address access to toilets, libraries and transport facilities for wheelchair users. South African universities are still not places where all students are equally able to integrate socially. DUSMs know what ought to be done to make campuses more accessible and welcoming to students with disabilities and should be empowered to play a leading role in sensitising non-disabled members of universities, to create greater awareness of, and appreciation for, the multiple ways in which wheelchair user students continue to be excluded from full participation in university life. South African universities need to adopt a systemic approach to inclusion, which fosters an understanding of inclusion as a fundamental right rather than as a luxury.
Full Text Available The purpose of this study was to develop the new wheel-chair which had the function to drive straight by one-hand operation. To perform this purpose, the driving force transmission axis (DFTA which had transmitted the driving force from the one side of wheel to another side of that was developed. The wheel-chair could drive straight by one-hand operation by the DFTA. The large torque, however, was generated in the DFTA, because the DFTA transmitted the driving force from the one side of wheel to another side by the axis of small diameter. Furthermore, the shear stress in the DFTA generated by this torque would lead to the DFTA break. The shear stress in the DFTA was calculated to examine the axial strength and durability. On the DETA of the wheelchair, the maximum shear stress calculated from the torque in driving was 39.53 MP and this was defined as the standard of the demand specifications as a strength and durability of the DFTA.
... passengers' wheelchairs, other mobility aids, and other assistive devices must be disassembled for stowage... Stowage of Wheelchairs, Other Mobility Aids, and Other Assistive Devices § 382.129 What other requirements apply when passengers' wheelchairs, other mobility aids, and other assistive devices must be...
Antonelli, Michele Gabrio; Alleva, Stefano; Beomonte Zobel, Pierluigi; Durante, Francesco; Raparelli, Terenziano
For off-road mobility, some manual or power assisted devices were conceived to be self-driven by paraplegics while for tetraplegics non power-assisted devices were conceived. These devices require one or more conductors who are subjected to a high physical demand thus potentially creating: precarious safety condition for the user an elevated physical demand of conductors could reduce the care and the attention to give to the user; the time of the outdoor adventure experience of the user could be limited. To address these issues, an innovative user-centered power assisted off-road wheelchair for the transportation of tetraplegics along mountain trails was developed. The device, structured like a trike, is driven by two healthy conductors; the user is placed in the middle of the frame. A movable seat provides for the transfer from the standard to the off-road wheelchair. An electrical motor, powered by a battery pack, provides for the actuation. All the design and prototype aspects, the control system and experimental tests are detailed. The prototype satisfies mechanical, safety and duration requirements. No physical demand while using the device and for the transfer of the user to the device was identified. Fun and engaging tests were carried out and all the participants were involved. Implications for Rehabilitation The device has the potential to enhance the quality of life of tetraplegics in terms of new life experiences. The device revealed the real possibility of a full recreational experience, an enhanced participation and a better social integration of tetraplegics.
... 49 Transportation 1 2010-10-01 2010-10-01 false Wheelchair locations and food service on intercity rail trains. 37.91 Section 37.91 Transportation Office of the Secretary of Transportation TRANSPORTATION SERVICES FOR INDIVIDUALS WITH DISABILITIES (ADA) Acquisition of Accessible Vehicles By Public Entities § 37.91 Wheelchair locations and food...
Leving, Marika T; Vegter, Riemer J K; de Groot, Sonja; van der Woude, Lucas H V
Handrim wheelchair propulsion is a cyclic skill that needs to be learned during rehabilitation. It has been suggested that a higher intra-individual variability benefits the motor learning process of wheelchair propulsion. PURPOSE: The goal of the current study was to determine the effect of
Prototype of newly developed power-assisted wheelchair wheels were evaluated to determine their potential alleviating value on shoulder load, daily activities and participation compared to hand-rim wheelchair propulsion. Five research questions were answered: 1. What is the current knowledge of
de Groot, Sonja; Balvers, Inge J.M.; Kouwenhoven, Sanne M.; Janssen, Thomas W.J.
The purpose of this study was to investigate the reliability and validity of wheelchair basketball field tests. Nineteen wheelchair basketball players performed 10 test items twice to determine the reliability. The validity of the tests was assessed by relating the scores to the players'
Martorello, Laura; Swanson, Edward
The purpose of this study was to evaluate the effectiveness of an automatic manual wheelchair braking system in the reduction of falls for patients at high risk of falls while transferring to and from a manual wheelchair. The study design was a normative survey carried out through the use of a written questionnaire sent to 60 skilled nursing facilities to collect data from the medical charts, which identified patients at high risk for falls who used an automatic wheelchair braking system. The facilities participating in the study identified a frequency of falls of high-risk patients while transferring to and from the wheelchair ranging from 2 to 10 per year, with a median fall rate per facility of 4 falls. One year after the installation of the automatic wheelchair braking system, participating facilities demonstrated a reduction of zero to three falls during transfers by high-risk patients, with a median fall rate of zero falls. This represents a statistically significant reduction of 78% in the fall rate of high-risk patients while transferring to and from the wheelchair, t (18) = 6.39, p braking system for manual wheelchairs was installed. The application of the automatic braking system allows clients, families/caregivers, and facility personnel an increased safety factor for the reduction of falls from the wheelchair.
Ward, Amber Lea; Hammond, Sara; Holsten, Scott; Bravver, Elena; Brooks, Benjamin Rix
The objectives of this study were to survey persons with Amyotrophic Lateral Sclerosis (ALS) at 1 and 6 months after receiving power wheelchairs to determine long-term use, comfort, and function as well as the power wheelchair's impact on daily tasks and quality of life. A 33-question survey and Psychosocial Impact of Assistive Devices Scale (PIADS) were sent 1 month after getting a new power wheelchair; a follow-up survey was sent at 6 months. Based on satisfaction and feature use survey results, at 1 month, 81% of users found the power wheelchair overall comfort to be high, 88% found their overall mobility to be improved, and 95% found it easy to use. Their quality of life increased and pain decreased at 1 and 6 months. According to the PIADS, the power wheelchair gave users increased ability to participate and sense of competence. This study has important results for the ALS community, as it is the first to assess power wheelchair users at 1 and 6 months after power wheelchair procurement. The results demonstrate the impact the power wheelchair has on mobility, psychosocial issues, functional abilities, and quality of life for a person with ALS.
De Groot, Sonja; Balvers, Inge J. M.; Kouwenhoven, Sanne M.; Janssen, Thomas W. J.
The purpose of this study was to investigate the reliability and validity of wheelchair basketball field tests. Nineteen wheelchair basketball players performed 10 test items twice to determine the reliability. The validity of the tests was assessed by relating the scores to the players'
Jeong, Minseok; Yang, Chuneun; You, Heecheon; Park, Kwangae; Lee, W.
An online suit-customizing system for the special accessibility needs of wheelchair users should be developed because the demand for business suits by wheelchair users involved in economic activities has increased. This study
develops a user interface an online customizing system for men's suits
Blach Rossen, Camilla; Sørensen, Bodil; Würtz Jochumsen, Bente
The aim of this paper is to explore how users of electric wheelchairs experience their everyday life and how their electric wheelchairs influence their daily occupation. Occupation is defined as a personalized dynamic interaction between person, task and environment, and implies the value...
... Elevator AGENCY: Food and Drug Administration, HHS. ACTION: Final order. SUMMARY: The Food and Drug... requirements for wheelchair elevator devices commonly known as inclined platform lifts and vertical platform... wheelchair elevators, class II devices, from premarket notification and establishes conditions for exemption...
...] Medical Devices; Exemption From Premarket Notification: Wheelchair Elevator AGENCY: Food and Drug... elevator devices commonly known as inclined platform lifts and vertical platform lifts. These devices are... behalf of Bruno Independent Living Aids, Inc., for wheelchair elevator devices (commonly known as...
van Koppenhagen, C.F.; de Groot, S.; Post, M.W.; Hoekstra, T.; van Asbeck, F.W.; Bongers, H.; Lindeman, E.; van der Woude, L.H.
Objectives: (1) To identify different patterns of changes in wheelchair exercise capacity in the period between the start of active spinal cord injury (SCI) rehabilitation and 5 years after discharge; (2) to examine the pattern determinants of the change in wheelchair exercise capacity. Design:
van Koppenhagen, Casper F.; de Groot, Sonja; Post, Marcel W.; Hoekstra, Trynke; van Asbeck, Floris W.; Bongers, Helma; Lindeman, Eline; van der Woude, Luc H.
Objectives: (1) To identify different patterns of changes in wheelchair exercise capacity in the period between the start of active spinal cord injury (SCI) rehabilitation and 5 years after discharge; (2) to examine the pattern determinants of the change in wheelchair exercise capacity. Design:
van der Woude, L H; Veeger, DirkJan (H. E. J.); Rozendal, R H; van Ingen Schenau, G J; Rooth, F; van Nierop, P
Effects of different hand rim diameters in wheelchair racing were studied with respect to physiological and technique parameters at five speed levels (N = 8 wheelchair sportsmen). In each of five subsequent 15-min exercise tests on a treadmill, a different sized hand rim was mounted to the rear
van der Slikke, R M A; Berger, M A M; Bregman, D J J; Lagerberg, A H; Veeger, H E J
Knowledge of wheelchair kinematics during a match is prerequisite for performance improvement in wheelchair basketball. Unfortunately, no measurement system providing key kinematic outcomes proved to be reliable in competition. In this study, the reliability of estimated wheelchair kinematics based on a three inertial measurement unit (IMU) configuration was assessed in wheelchair basketball match-like conditions. Twenty participants performed a series of tests reflecting different motion aspects of wheelchair basketball. During the tests wheelchair kinematics were simultaneously measured using IMUs on wheels and frame, and a 24-camera optical motion analysis system serving as gold standard. Results showed only small deviations of the IMU method compared to the gold standard, once a newly developed skid correction algorithm was applied. Calculated Root Mean Square Errors (RMSE) showed good estimates for frame displacement (RMSE≤0.05 m) and speed (RMSE≤0.1m/s), except for three truly vigorous tests. Estimates of frame rotation in the horizontal plane (RMSE0.90), rotational speed (ICC>0.99) and IRC (ICC> 0.90) showed high correlations between IMU data and gold standard. IMU based estimation of wheelchair kinematics provided reliable results, except for brief moments of wheel skidding in truly vigorous tests. The IMU method is believed to enable prospective research in wheelchair basketball match conditions and contribute to individual support of athletes in everyday sports practice. Copyright © 2015 Elsevier Ltd. All rights reserved.
Mason, B.; van der Woude, L.; Lenton, J. P.; Goosey-Tolfrey, V.
The purpose of the current study was to investigate the effects of different wheel sizes, with fixed gear ratios, on maximal effort mobility performance in wheelchair athletes. 13 highly trained wheelchair basketball players, grouped by classification level, performed a battery of 3 field tests in
Mason, Barry S.; van der Woude, L. H. V.; Goosey-Tolfrey, V. L.
Objective: The purpose of this study was to determine the effectiveness of different glove types on mobility performance in a series of field tests specific to wheelchair rugby. Design: Ten international wheelchair rugby players performed three drills in each glove condition: (i) players' current
van der Woude, L.H.V.; de Groot, S.; Janssen, T.W.J.
Aims: Description of the principal characteristics of the wheelchairs and their technological developments. Current knowledge: Those with lower-limb disabilities are often dependent on manually propelled wheelchairs for their mobility, in Europe today some 3.3 million people. This implies a transfer
Mason, B.; van der Woude, L.; Tolfrey, K.; Goosey-Tolfrey, V.
This study examined the effect of rear-wheel camber on maximal effort wheelchair mobility performance. 14 highly trained wheelchair court sport athletes performed a battery of field tests in 4 standardised camber settings (15°, 18°, 20°, 24°) with performance analysed using a velocometer. 20 m
The extent to which individual differences in fine motor abilities affect indoor safety and efficiency of human-wheelchair systems was examined. To reduce the currently large number of indoor wheelchair accidents, assistance systems with a high level of automation were developed. It was proposed to adapt the wheelchair's level of automation to the user's ability to steer the device to avoid drawbacks of highly automated wheelchairs. The state of the art, however, lacks an empirical identification of those abilities. A study with 23 participants is described. The participants drove through various sections of a course with a powered wheelchair. Repeatedly measured criteria were safety (numbers of collisions) and efficiency (times required for reaching goals). As covariates, the participants' fine motor abilities were assessed. A random coefficient modeling approach was conducted to analyze the data,which were available on two levels as course sections were nested within participants.The participants' aiming, precision, and armhand speed contributed significantly to both criteria: Participants with lower fine motor abilities had more collisions and required more time for reaching goals. Adapting the wheelchair's level of automation to these fine motor abilities can improve indoor safety and efficiency. In addition, the results highlight the need to further examine the impact of individual differences on the design of automation features for powered wheelchairs as well as other applications of automation. The results facilitate the improvement of current wheelchair technology.
Sol, M.E.; Vershuren, O.; Groot, L. de; Groot, J.F. de
Background: Wheelchair mobility skills (WMS) training is regarded by children using a manual wheelchair and their parents as an important factor to improve participation and daily physical activity. Currently, there is no outcome measure available for the evaluation of WMS in children. Several
Sol, Marleen Elisabeth; Verschuren, Olaf; de Groot, Laura; de Groot, Janke Frederike
BACKGROUND: Wheelchair mobility skills (WMS) training is regarded by children using a manual wheelchair and their parents as an important factor to improve participation and daily physical activity. Currently, there is no outcome measure available for the evaluation of WMS in children. Several
van der Helm, Frans C T; Veeger, H. E J
During wheelchair propulsion the largest net joint moments and net joint powers are generated around the shoulder. The analysis of the contribution of arm- and shoulder muscles to the joint moments could explain the low efficiency of wheelchair propulsion. Basically, it is assumed that a large
Zwinkels, Maremka; Verschuren, Olaf; Janssen, Thomas Wj; Ketelaar, Marjolijn; Takken, Tim
An adequate wheelchair propulsion capacity is required to perform daily life activities. Exercise training may be effective to gain or improve wheelchair propulsion capacity. This review investigates whether different types of exercise training programs are effective in improving wheelchair propulsion capacity. PubMed and EMBASE databases were searched from their respective inceptions in October 2013. Exercise training studies with at least one outcome measure regarding wheelchair propulsion capacity were included. In this study wheelchair propulsion capacity includes four parameters to reflect functional wheelchair propulsion: cardio-respiratory fitness (aerobic capacity), anaerobic capacity, muscular fitness and mechanical efficiency. Articles were not selected on diagnosis, training type or mode. Studies were divided into four training types: interval, endurance, strength, and mixed training. Methodological quality was rated with the PEDro scale, and the level of evidence was determined. The 21 included studies represented 249 individuals with spinal-cord injury (50%), various diagnoses like spina bifida (4%), cerebral palsy (2%), traumatic injury, (3%) and able-bodied participants (38%). All interval training studies found a significant improvement of 18-64% in wheelchair propulsion capacity. Three out of five endurance training studies reported significant effectiveness. Methodological quality was generally poor and there were only two randomised controlled trials. Exercise training programs seem to be effective in improving wheelchair propulsion capacity. However, there is remarkably little research, particularly for individuals who do not have spinal-cord injury. © The Author(s) 2014.
similar to aluminium wheelchairs. A negative correlation between VT and WN-WPM was found, which means that reducing VT may be at the expense of increasing WN-WPM. Based on our results, use of carbon in wheelchair construction seems promising to reduce VT without increasing WN-WPM.
Kloosterman, Marieke G M; Buurke, Jaap H; de Vries, Wiebe; Van der Woude, Lucas H V; Rietman, Johan S
This study aims to compare hand-rim and power-assisted hand-rim propulsion on potential risk factors for shoulder overuse injuries: intensity and repetition of shoulder loading and force generation in the extremes of shoulder motion. Eleven experienced hand-rim wheelchair users propelled an instrumented wheelchair on a treadmill while upper-extremity kinematic, kinetic and surface electromyographical data was collected during propulsion with and without power-assist. As a result during power-assisted propulsion the peak resultant force exerted at the hand-rim decreased and was performed with significantly less abduction and internal rotation at the shoulder. At shoulder level the anterior directed force and internal rotation and flexion moments decreased significantly. In addition, posterior and the minimal inferior directed forces and the external rotation moment significantly increased. The stroke angle decreased significantly, as did maximum shoulder flexion, extension, abduction and internal rotation. Stroke-frequency significantly increased. Muscle activation in the anterior deltoid and pectoralis major also decreased significantly. In conclusion, compared to hand-rim propulsion power-assisted propulsion seems effective in reducing potential risk factors of overuse injuries with the highest gain on decreased range of motion of the shoulder joint, lower peak propulsion force on the rim and reduced muscle activity. Copyright © 2015 IPEM. Published by Elsevier Ltd. All rights reserved.
Full Text Available INTRODUCTION: Wheelchair basketball is a paralympic sport characterized by intermittent high-intensity activities that require explosive strength and speed. OBJECTIVE: To investigate the effect of explosive strength training on speed and agility performance in wheelchair basketball players. METHODS: Ten male wheelchair basketball players (Mage=31±4 yrs were divided into two groups [i.e. explosive strength training (ES; control (CN] based on International Wheelchair Basketball Federation (IWBF classification scores. The ES group underwent 6-weeks of training, twice weekly, at 50% 1RM, 10-12 repetitions and 3-4 sets in addition to routine training. Effects of training were measured by the 20 m sprint test and Illinois agility test. RESULTS: The ES group, showed significantly higher increases in speed and agility performance (p ≤ .05. CONCLUSION: A short-duration (i.e. 6-week explosive strength training programme in wheelchair basketball athletes results in significant improvements in sprint and agility performance.
Gerling, Kathrin M; Hicks, Kieran C; Kalyn, Michael R
people who have special needs) and 2) three case studies (4 participants) exploring player perspectives on a set of three wheelchair-controlled casual games. Our results show that movement-based playful experiences are engaging for young people using powered wheelchairs. However, the participatory design...... in the development of accessible, empowering movement-based games, which is crucial to the wider participation of young people using powered wheelchairs in play.......Young people using powered wheelchairs have limited access to engaging leisure activities. We address this issue through a two-stage project; 1) the participatory development of a set of wheelchair-controlled, movement-based games (with 9 participants at a school that provides education for young...
Full Text Available We developed a wheelchair robot to support the movement of elderly people and specifically implemented two functions to enhance their intention to use it: speaking behavior to convey place/location related information and speed adjustment based on individual preferences. Our study examines how the evaluations of our wheelchair robot differ when compared with human caregivers and a conventional autonomous wheelchair without the two proposed functions in a moving support context. 28 senior citizens participated in the experiment to evaluate three different conditions. Our measurements consisted of questionnaire items and the coding of free-style interview results. Our experimental results revealed that elderly people evaluated our wheelchair robot higher than the wheelchair without the two functions and the human caregivers for some items.
Full Text Available In wheelchair sports, aerobic performance is commonly assessed with the use of an arm crank ergometer (ACE, a wheelchair ergometer (WCE or a wheelchair treadmill (WCT. There are different protocols to identify peak oxygen uptake in wheelchair sports; however, only a few protocols have been applied to evaluate these conditions in wheelchair basketball players. The purpose of this study was to compare physiological responses during maximal exercise testing with the use of ACE and WCT in wheelchair basketball players. Twelve elite male wheelchair basketball players participated in this study. The research was performed during a training camp of the Polish National Wheelchair Basketball Team. The study participants were divided into two functional categories: A (players with class 1.0 - 2.5 and B (players with class 3.0 - 4.5. Two main maximal exercise tests, i.e. wheelchair treadmill stress test (WCT test and arm crank ergometer stress test (ACE test were used to evaluate aerobic performance of the players. There were no statistically significant differences in aerobic tests between the players from both groups. The comparison of results achieved in two aerobic tests performed on WCT and ACE did not reveal any significant differences between the analyzed variables (peak heart rate (HRpeak, peak oxygen uptake (VO2peak, minute ventilation (VE, anaerobic threshold (AT, lactate concentration (LApeak, and a drop in lactate concentration (%LA. Strong correlations between results achieved in WCT and ACE tests were found for VO2peak, VE and LApeak. The main conclusion of the study is that both WCT and ACE tests may be useful when determining aerobic capacity of wheelchair basketball players. Moreover, both protocols can be used by athletes regardless of their functional capabilities and types of impairment.
Elite-adapted sports performance has considerably improved over the last decades and winning or losing races at Paralympic Games is often a matter of a split second. In other words, every single detail counts, which underlines the necessity of optimizing training interventions and equipment for athletes in order to achieve top-class performance. However, to date, studies which include Paralympic elite athletes are scarce. A comprehensive literature search was performed to identify potential strategies and interventions in order to optimize elite-adapted wheelchair sports performance, whereas the focus lay on respiratory muscle training (RMT), cooling (CI) and nutritional interventions (NI) as well as on individual equipment adaptations (IEA). The total number of studies identified for the final analysis was six for RMT, two for CI, three for NI and seven for IEA, respectively. Results point predominantly towards performance enhancing benefits for CI and IEA, whereas NI and RMT provided inhomogenous findings. In comparison to the able-bodied population, research in the field of Paralympic elite sport is scarce. CI and IEA seem to have significant performance enhancing benefits, whereas NI and RMT revealed controversial findings. However, due to the limited number of elite athletes with a spinal cord injury available to participate in scientific studies, general conclusions are difficult to make at this stage and in daily practice recommendations are still given mainly on an individual basis or based on personal experiences of coaches, athletes and scientists. Implications for Rehabilitaton Based on the knowledge gained in elite sports, wheelchair equipment could be optimized also for daily use. Elite sports performance could inspire wheelchair users to achieve their personal fitness goals.
Conclusion: South African universities are still not places where all students are equally able to integrate socially. DUSMs know what ought to be done to make campuses more accessible and welcoming to students with disabilities and should be empowered to play a leading role in sensitising non-disabled members of universities, to create greater awareness of, and appreciation for, the multiple ways in which wheelchair user students continue to be excluded from full participation in university life. South African universities need to adopt a systemic approach to inclusion, which fosters an understanding of inclusion as a fundamental right rather than as a luxury.
Schultz, Dana L; Shea, Kathleen M; Barrett, Steven F
A smart wheelchair is in development to provide mobility to those unable to control a traditional wheelchair. A smart wheelchair is an autonomous machine with the ability to navigate a mapped environment while avoiding obstacles. The flexibility and complex design of smart wheelchairs have made those currently available expensive. Ongoing research at the University of Wyoming has been aimed at designing a cheaper, alternative control system that could be interfaced with a typical powered wheelchair. The goal of this project is to determine methods for mapping and navigational control for the wheelchair. The control system acquires data from eighteen sensors and uses the data to navigate around a pre-programmed map which is stored on a micro SD card. The control system also provides a user interface in the form of a touchscreen LCD. The designed system will be an easy-to-use and cost effective alternative to current smart wheelchair technology.
Background People with severe disabilities, e.g. due to neurodegenerative disease, depend on technology that allows for accurate wheelchair control. For those who cannot operate a wheelchair with a joystick, brain-computer interfaces (BCI) may offer a valuable option. Technology depending on visual or auditory input may not be feasible as these modalities are dedicated to processing of environmental stimuli (e.g. recognition of obstacles, ambient noise). Herein we thus validated the feasibility of a BCI based on tactually-evoked event-related potentials (ERP) for wheelchair control. Furthermore, we investigated use of a dynamic stopping method to improve speed of the tactile BCI system. Methods Positions of four tactile stimulators represented navigation directions (left thigh: move left; right thigh: move right; abdomen: move forward; lower neck: move backward) and N = 15 participants delivered navigation commands by focusing their attention on the desired tactile stimulus in an oddball-paradigm. Results Participants navigated a virtual wheelchair through a building and eleven participants successfully completed the task of reaching 4 checkpoints in the building. The virtual wheelchair was equipped with simulated shared-control sensors (collision avoidance), yet these sensors were rarely needed. Conclusion We conclude that most participants achieved tactile ERP-BCI control sufficient to reliably operate a wheelchair and dynamic stopping was of high value for tactile ERP classification. Finally, this paper discusses feasibility of tactile ERPs for BCI based wheelchair control. PMID:24428900
Full Text Available This work was included in a wider project oriented to the improvement of residual neuromuscular skills in disabled athletes playing wheelchair rugby: the wheelchair rugby Italian national team was involved and tests allowed to analyse the impact loads on a rugby wheelchair frame. The frame of a rugby wheelchair offensive model, made by OffCarr Company, was instrumented with four strain gauge bridges in four different points. Then, three test types were conducted in laboratory: two static calibrations with the application of known loads, the first with horizontal load and the second with vertical load, and a dynamic horizontal calibration, impacting against a fix load cell in order to validate the results of horizontal static calibration. Finally, a test session took place in the field with the collaboration of two team players. The test consisted in voluntary frontal impacts between the two players, starting from 6 meters distance each other. The opponent of the instrumented wheelchair was a defender. From this test, the value of the horizontal load received by the frame in the impact instant was quantified. Moreover, also the vertical load acting on the wheelchair during the rebound of the player after the hit was evaluated: these informations were useful to the wheelchair frame manufacturer for the proper static, impact and fatigue design.
Full Text Available Abstract Background Powered wheelchairs are essential for many individuals who have mobility impairments. Nevertheless, if operated improperly, the powered wheelchair poses dangers to both the user and to those in its vicinity. Thus, operating a powered wheelchair with some degree of proficiency is important for safety, and measuring driving skills becomes an important issue to address. The objective of this study was to explore the discriminate validity of outcome measures of driving skills based on joystick control strategies and performance recorded using a data logging system. Methods We compared joystick control strategies and performance during standardized driving tasks between a group of 10 expert and 13 novice powered wheelchair users. Driving tasks were drawn from the Wheelchair Skills Test (v. 4.1. Data from the joystick controller were collected on a data logging system. Joystick control strategies and performance outcome measures included the mean number of joystick movements, time required to complete tasks, as well as variability of joystick direction. Results In simpler tasks, the expert group's driving skills were comparable to those of the novice group. Yet, in more difficult and spatially confined tasks, the expert group required fewer joystick movements for task completion. In some cases, experts also completed tasks in approximately half the time with respect to the novice group. Conclusions The analysis of joystick control made it possible to discriminate between novice and expert powered wheelchair users in a variety of driving tasks. These results imply that in spatially confined areas, a greater powered wheelchair driving skill level is required to complete tasks efficiently. Based on these findings, it would appear that the use of joystick signal analysis constitutes an objective tool for the measurement of powered wheelchair driving skills. This tool may be useful for the clinical assessment and training of powered
Galli, Giulia; Lenggenhager, Bigna; Scivoletto, Giorgio; Molinari, Marco; Pazzaglia, Mariella
Scientific research has consistently shown that prejudicial behaviour may contribute to discrimination and disparities in social groups. However, little is known about whether and how implicit assumptions and direct contact modulate the interaction and quality of professional interventions in education and health contexts. This study was designed to examine implicit and explicit attitudes towards wheelchair users. We investigated implicit and explicit attitudes towards wheelchair users in three different groups: patients with traumatic spinal cord injury (SCI); health professionals with intense contact with wheelchair users, and healthy participants without personal contact with wheelchair users. To assess the short-term plasticity of prejudices, we used a valid intervention that aims to change implicit attitudes through brief direct contact with a patient who uses a wheelchair in an ecologically valid real-life interaction. We found that: (i) wheelchair users with SCI held positive explicit but negative implicit attitudes towards their novel in-group; (ii) the amount of experience with wheelchair users affected implicit attitudes among health professionals, and (iii) interacting with a patient with SCI who contradicts prejudices modulated implicit negative bias towards wheelchair users in healthy participants. The use of a wheelchair immediately and profoundly affects how a person is perceived. However, our findings highlight the dynamic nature of perceptions of social identity, which are not only sensitive to personal beliefs, but also highly permeable to intergroup interactions. Having direct contact with people with disabilities might foster positive attitudes in multidisciplinary health care teams. Such interventions could be integrated into medical education programmes to successfully prevent or reduce hidden biases in a new generation of health professionals and to increase the general acceptance of disability in patients. © 2015 John Wiley & Sons Ltd.
Vermillion, Mark; Dodder, Richard A
The purpose was to examine the construct validity of the Rosenberg Self-esteem Scale (RSES). The construct validity of the scale was examined by applying it to collegiate wheelchair basketball student athletes at an NCAA sanctioned wheelchair basketball tournament at a mid-sized university in the south central United States (N=68). In accordance with previous research on the scale, Cronbach alpha was .86; confirmatory factor analysis supported a one-factor structure. The scale is useful for measuring global self-esteem in collegiate wheelchair basketball student athletes.
Giacobbi, Peter R; Levy, Charles E; Dietrich, Frederick D; Winkler, Sandra Hubbard; Tillman, Mark D; Chow, John W
To assess wheelchair users' perceptions of and experiences with power assist wheels using qualitative interview methods. Qualitative evaluations were conducted in a laboratory setting with a focus on users' experiences using power assist wheel in their naturalistic environments. Participants consisted of seven women and 13 men (M(age) = 42.75, SD = 14.68) that included one African American, one Hispanic, 17 whites, and one individual from Zambia. Qualitative interviews were conducted before, during, and after use of a power assist wheel. Main outcome measures included the wheelchair users' evaluations and experiences related to the use of power assist wheels. The primary evaluations included wheeling on challenging terrains, performance of novel activities, social/family aspects, fatigue, and pain. These descriptions indicated that most participants perceived positive experiences with the power assist wheels, including access to new and different activities. Secondary evaluations indicated that the unit was cumbersome and prohibitive for some participants because of difficulties with transport in and out of a vehicle and battery life. Most participants felt that power assist wheels provided more independence and social opportunities. The power assist wheel seems to offer physical and social benefits for most wheelers. Clinicians should consider users' home environment and overall life circumstances before prescribing.
Goosey, V L; Campbell, I G; Fowler, N E
The aim of the study was to examine the effect of varying push frequency on pushing economy (oxygen uptake at a given speed). Eight male wheelchair racers completed a series of exercise bouts on a wheelchair ergometer (Bromking Turbo Trainer, Bromakin, UK) at 6.58 m x s(-1). Initially, subjects self-selected their freely chosen push frequency (FCF); this was followed by 4 random trials pushing at 60, 80, 120, and 140% of this FCF. Steady state VO2 was determined using Douglas bags, and heart rate was recorded by telemetry. After each condition, a small capillary blood sample was obtained and analyzed for blood lactate concentration (BLa) and a rating of perceived exertion (RPE) was recorded. At 6.58 m x s(-1) oxygen uptake, RPE, and gross mechanical efficiency were nonlinearly related to push frequency. Analysis of variance showed a significant effect (P push frequency had little effect on HR although BLa increased linearly and was higher at the 140% FCF condition compared with 60% FCF (P push frequency increased. The start angle and end angle of hand contact were similar for conditions, whereas the range of trunk motion decreased with push frequency (P push frequency had an effect on pushing economy, and that the athletes' FCF was the most economical.
Dehghansai, N; Lemez, S; Wattie, N; Baker, J
Considering the growth in research, examining the development of mainstream sport athletes over the past two decades, studies examining development of athletes with disabilities have been surprisingly limited. While similarities in developmental trajectories between the two cohorts may exist regarding factors such as the value of practice, which tend to be universal regardless of context, disability-related issues (e.g. whether the disability was congenital or acquired) may influence the course of development, affecting variables such as starting age, training and developmental milestones. Fifty-two male and female athletes training with the Wheelchair Basketball Canada National Academy provided detailed training histories. Athletes illustrated similar developmental patterns (e.g. milestones, training adjustments) as they progressed through their sporting career. However, athletes with congenital disabilities started participation in wheelchair basketball and unorganised practice at significantly younger ages (t 49 = -4.35, p training throughout their sporting career. Future work may consider examining developmental trajectories and training histories of athletes in various parasports to extend our understanding of their development and skill acquisition.
Rosângela Elisa de Sousa
Full Text Available This project addresses social inclusion, as a resource to be stimulated by the development of fashion products. Taking into account this market demand research, part of the project, identified aspects of use, accessibility, comfort and perception of parents and therapists with regard to dress, undress and cognitive development in relation to clothing. The audience researched this project were wheelchair children with age range from eight to twelve years, parents and professionals in the health field, such as Physiotherapists, Physical Educator, Occupational Therapist and psychologists, members of institutions CEAEHH - Centro de Atividades Especiais Helena Holanda e FUNAD – Fundação Centro Integrado de Apoio ao Portador de Deficiência, João Pessoa - PB, supporters this project through the sale of infrastructure and public access. The data resulted in the development of a fashion collection with differentiated modeling, versatility of uses combined with an aesthetic framework that prioritized the inclusion of wheelchair-bound child in society through the use of the usual market trends in the children's segment.
Full Text Available The purpose of this study was to characterize wheelchair tiedown and occupant restraint system (WTORS usage in paratransit vehicles based on observations of wheelchair and scooter (wheeled mobility devices, collectively, "WhMD" passenger trips. A retrospective review of on-board video monitoring recordings of WhMD trips was conducted. Four hundred seventy-five video recordings were collected for review and analysis. The use of all four tiedowns to secure the WhMD was observed more frequently for power WhMDs (82% and manual WhMDs (80% compared to scooters (39%, and this difference was significant (p< 0.01. Nonuse or misuse of the occupant restraint system occurred during 88% of WhMD trips, and was most frequently due to vehicle operator neglect in applying the shoulder belt. Despite the absence of incidents or injuries in this study, misuse and nonuse of WTORS potentially place WhMD seated passengers at higher risk of injury during transit. These findings support the need for improved vehicle operator training and passenger education on the proper use of WTORS and development of WTORS with improved usability and/or alternative technologies that can be automated or used independently.
Moon, Hyo-Bin; Park, Seung-Jae; Kim, Al-Chan; Jang, Jee-Hun
The purpose of this study was to identify the characteristics of muscular strength in upper limb and to present the preliminary information for development of sports injury prevention program and exercise rehabilitation program in wheelchair tennis players. Participants were 12 male wheelchair tennis players. Muscular strength was measured in shoulder and elbow joints with isokinetic dynamometer. Ipsilateral (IR) and bilateral (BR) balance ratio were calculated with isokinetic strength at 60°/sec. As a result, extension strength (ES) was significantly higher than flexion strength (FS) (Pelbow joint FS was significantly higher than ES (Pelbow joints and lower IR and BR in elbow joints could be the characteristics in male wheelchair tennis players. It is suggested that flexor strengthening program in nondominant shoulder joint, extensor strengthening program in both elbow joint, and flexor strengthening program in non-dominant elbow joint should be introduced for male wheelchair tennis players. PMID:24278887
Seki, Hirokazu; Takahashi, Kazuki; Tadakuma, Susumu
This paper describes a novel safety driving control scheme for electric power assisted wheelchairs based on the regenerative braking system. “Electric power assisted wheelchair” which assists the driving force by electric motors is expected to be widely used as a mobility support system for elderly people and disabled people, however, the safe and secure driving performance especially on downhill roads must be further improved because electric power assisted wheelchairs have no braking devices. The proposed control system automatically switches the driving mode, from “assisting mode” to “braking mode”, based on the wheelchair's velocity and the declined angle and smoothly suppresses the wheelchair's acceleration based on variable duty ratio control in order to realize the safety driving and to improve the ride quality. Some experiments on the practical roads and subjective evaluation show the effectiveness of the proposed control system.
Eva S. Bazant
Conclusion: Select services that were associated with some better wheelchair use outcomes and should be emphasised in service delivery. Service providers should be aware that increased mobility may lead to serious falls.
Ezeh, Chinemelu; Trautman, Pete; Devigne, Louise; Bureau, Valentin; Babel, Marie; Carlson, Tom
Some people with severe mobility impairments are unable to operate powered wheelchairs reliably and effectively, using commercially available interfaces. This has sparked a body of research into "smart wheelchairs", which assist users to drive safely and create opportunities for them to use alternative interfaces. Various "shared control" techniques have been proposed to provide an appropriate level of assistance that is satisfactory and acceptable to the user. Most shared control techniques employ a traditional strategy called linear blending (LB), where the user's commands and wheelchair's autonomous commands are combined in some proportion. In this paper, however, we implement a more generalised form of shared control called probabilistic shared control (PSC). This probabilistic formulation improves the accuracy of modelling the interaction between the user and the wheelchair by taking into account uncertainty in the interaction. In this paper, we demonstrate the practical success of PSC over LB in terms of safety, particularly for novice users.
Gil, Susana María; Yanci, Javier; Otero, Montserrat; Olasagasti, Jurgi; Badiola, Aduna; Bidaurrazaga-Letona, Iraia; Iturricastillo, Aitor; Granados, Cristina
Wheelchair basketball players are classified in four classes based on the International Wheelchair Basketball Federation (IWBF) system of competition. Thus, the aim of the study was to ascertain if the IWBF classification, the type of injury and the wheelchair experience were related to different performance field-based tests. Thirteen basketball players undertook anthropometric measurements and performance tests (hand dynamometry, 5 m and 20 m sprints, 5 m and 20 m sprints with a ball, a T-test, a Pick-up test, a modified 10 m Yo-Yo intermittent recovery test, a maximal pass and a medicine ball throw). The IWBF class was correlated (pstaff and coaches of the teams when assessing performance of wheelchair basketball players.
Arnet, Ursina; van Drongelen, Stefan; Veeger, D H; van der Woude L, H V
The aim of the study was to evaluate the external applied forces, the effectiveness of force application and the net shoulder moments of handcycling in comparison with handrim wheelchair propulsion at different inclines. Ten able-bodied men performed standardized exercises on a treadmill at inclines of 1%, 2.5% and 4% with an instrumented handbike and wheelchair that measured three-dimensional propulsion forces. The results showed that during handcycling significantly lower mean forces were applied at inclines of 2.5% (P propulsion. The force effectiveness did not differ between the devices (P = .757); however, the effectiveness did increase with higher inclines during handcycling whereas it stayed constant over all inclines for wheelchair propulsion. The resulting peak net shoulder moments were lower for handcycling compared with wheelchair propulsion at all inclines (P < .001). These results confirm the assumption that handcycling is physically less straining.
Full Text Available Interactional characteristics between WT wheelchair robot and stair environment are analyzed, and possible patterns of WT wheelchair robot during the stair-climbing process are summarized, with the criteria of the wheelchair robot for determining the pattern proposed. Aiming at WT wheelchair robot's complicated mechanism with holonomic constraints and combined with the computed torque method, a novel control law that is called active tension control is presented for holonomic or nonholonomic robotic systems, by which the wheelchair robot with a holonomic or nonholonomic mechanism can track the reference input of the constraint forces of holonomic or nonholonomic constraints as well as tracking the reference input of the generalized coordinate of each joint. A stateflow module of Matlab is used to simulate the entire stair-climbing process for WT wheelchair robot. A comparison of output curve with the reference input curve of each joint is made, with the effectiveness of the presented control law verified.
Canoz, V; Gillham, Michael; Oprea, P; Chaumont, P; Bodin, A; Laux, P; Lebigre, M; Howells, Gareth; Sirlantzis, Konstantinos
Literature is abound with smart wheelchair platforms of various developments, yet to date there has been little technology find its way to the market place. Many trials and much research has taken place over the last few decades however the end user has benefited precious little. There exists two fundamental difficulties when developing a smart powered wheelchair assistive system, the first is need for the system to be fully compatible with all of the manufacturers, and the second is to produ...
Ezeh , Chinemelu; Trautman , Pete; Devigne , Louise; Bureau , Valentin; Babel , Marie; Carlson , Tom
International audience; Some people with severe mobility impairments are unable to operate powered wheelchairs reliably and effectively , using commercially available interfaces. This has sparked a body of research into " smart wheelchairs " , which assist users to drive safely and create opportunities for them to use alternative interfaces. Various " shared control " techniques have been proposed to provide an appropriate level of assistance that is satisfactory and acceptable to the user. M...
Gil Susana María
Full Text Available Wheelchair basketball players are classified in four classes based on the International Wheelchair Basketball Federation (IWBF system of competition. Thus, the aim of the study was to ascertain if the IWBF classification, the type of injury and the wheelchair experience were related to different performance field-based tests. Thirteen basketball players undertook anthropometric measurements and performance tests (hand dynamometry, 5 m and 20 m sprints, 5 m and 20 m sprints with a ball, a T-test, a Pick-up test, a modified 10 m Yo-Yo intermittent recovery test, a maximal pass and a medicine ball throw. The IWBF class was correlated (p<0.05 to the hand dynamometry (r= 0.84, the maximal pass (r=0.67 and the medicine ball throw (r= 0.67. Whereas the years of dependence on the wheelchair were correlated to the velocity (p<0.01: 5 m (r= −0.80 and 20 m (r= −0.77 and agility tests (r= −0.77, p<0.01. Also, the 20 m sprint with a ball (r= 0.68 and the T-test (r= −0.57 correlated (p<0.05 with the experience in playing wheelchair basketball. Therefore, in this team the correlations of the performance variables differed when they were related to the disability class, the years of dependence on the wheelchair and the experience in playing wheelchair basketball. These results should be taken into account by the technical staff and coaches of the teams when assessing performance of wheelchair basketball players.
Full Text Available Maintenance of the sporting activity of elite athletes in adapted sports can be difficult if a secondary disorder, such as a pressure ulcer, occurs. Pressure ulcers result from deep tissue injuries by external pressure. The purpose of this study was to use ultrasonography to investigate deep tissue injuries in male wheelchair basketball players of a Japanese national team, and to determine factors associated with the injuries (e.g., body mass index, class of wheelchair basketball, underlying disease, length of athletic career, and whether use of wheelchair is primarily for playing basketball. Twenty male Japanese wheelchair basketball players on the national team for the 2012 London Paralympic Games (12 representative players and eight candidate representative players participated in this study. The sacral region and bilateral ischial regions in each athlete were examined by ultrasonography to detect low-echoic lesions indicative of deep tissue injuries. Nine (45% players had low-echoic lesions, which were detected in 10 of 60 areas. Eight lesions were detected in the sacral region and two lesions were detected in the ischial region. More players with spinal cord injury had low-echoic lesions [9 (69.2% of 13 players], compared to players with skeletal system disease [0 (0% of 7 players, p = 0.002]. Players who used a wheelchair in daily life were more likely to have low-echoic lesions [8 (66.74% of 12 players], compared to players who primarily used a wheelchair for playing basketball [1 (12.5% of 8 players, p = 0.010]. Deep tissue injuries were detected in 45% of male Japanese wheelchair basketball players on the national team. Players with spinal cord injury and players who used a wheelchair in daily life were more likely to have deep tissue injuries, particularly in the sacral region. The lesions were small, but a periodic medical check should be performed to maintain athletes' sporting life.
were mostly naive to wheelchair driving . The overall experiment was divided into four phases, each of which started two meters away from a door (t = t0...effective and efficient navigation assistance. Significantly less attention has been given to the end-user’s preference between different assistance...wheelchairs has traditionally focused heavily on providing effective and efficient navigation assistance. Significantly less attention has been given to
Graham-Paulson, Terri S; Perret, Claudio; Watson, Phil; Goosey-Tolfrey, Victoria L
Caffeine can be beneficial during endurance and repeated-sprint exercise in able-bodied individuals performing leg or whole-body exercise. However, little evidence exists regarding its effects during upper-body exercise. This study therefore aimed to investigate the effects of caffeine on sprint (SPR) and 4-min maximal-push (PUSH) performance in wheelchair sportsmen. Using a double-blind, placebo-controlled, crossover design, 12 male wheelchair rugby players (age 30.0 ± 7.7 y, body mass 69.6 ± 15.3 kg, training 11.1 ± 3.5 h/wk) completed 2 exercise trials, separated by 7-14 d, 70 min after ingestion of 4 mg/kg caffeine (CAF) or dextrose placebo (PLA). Each trial consisted of four 4-min PUSHes and 3 sets of 3 × 20-m SPRs, each separated by 4 min rest. Participants responded to the Felt Arousal (a measure of perceived arousal), Feeling (a measure of the affective dimension of pleasure/displeasure), and rating-of-perceived-exertion (RPE) scales. Salivary caffeine secretion rates were measured. Average SPR times were faster during CAF than PLA during SPR 1 and SPR 2 (P = .037 and .016). There was no influence of supplementation on PUSHes 2-4 (P > .099); however, participants pushed significantly farther during PUSH 1 after CAF than after PLA (mean ± SD 677 ± 107 and 653 ± 118 m, P = .047). There was no influence of CAF on arousal or RPE scores (P > .132). Feeling scores improved over the course of the CAF trial only (P = .017) but did not significantly differ between trials (P > .167). Pre-warm-up (45 min postingestion) salivary CAF secretion rates were 1.05 ± 0.94 and 0.08 ± 0.05 μg/min for CAF and PLA, respectively. Acute CAF supplementation can improve both 20-m-sprint performance and a 1-off bout of short-term endurance performance in wheelchair sportsmen.
Mehmet Fatih Yüksel
Full Text Available This research was conducted to examine the anthropometric and biometric features of the elite wheelchair basketball players in different league levels, and to evaluate them with regards to field tests particular to wheelchair basketball. A sample of 21 male players volunteered to participate in the research with similar classification points, 12 of whom were from Turkey Wheelchair Basketball First League and 9 of whom were from the Second League. Anthropometric measurements, biometric features of the players and their skill test scores particular to wheelchair basketball were detected. The anthropometric measurements were taken over dominant extremity. SPSS 21.0 program was used in the analysis of the data, and minimum, maximum, arithmetic mean, and standard deviation values were determined. Intergroup differences were determined with Mann–Whitney U analysis. Significance level was admitted as p < 0.05. As a conclusion, it was determined that wheelchair basketball players had similar anthropometric features in the First and Second League levels, and that there was no difference based on the league level they were playing, and moreover, that bio-motor features and skills particular to wheelchair basketball were decisive on the levels of the leagues the players were taking part.
Lam, Jean-François; Gosselin, Laurent; Rushton, Paula W
To provide a comprehensive description of the current state of knowledge regarding the use of virtual technology (VT) for wheelchair skills training. The Cochrane Library, MEDLINE, CINAHL, Embase, ACM, IEEE Xplore, Inspec, and Web of Science databases were searched for relevant articles from 1990 to February 2016. We included peer-reviewed studies or long conference proceedings that examined the use of VT as a medium to provide a wheelchair skills training intervention for any population with any diagnosis using any research design. One investigator screened the titles and abstracts, then 2 investigators independently reviewed the full-text articles. Disagreements regarding inclusion were resolved by consensus or a third reviewer. Ten studies were included out of 4994 initially identified. Two investigators extracted data to systematically assess the studies' findings into 5 tables (study design and participant characteristics, equipment and technology used, intervention characteristics, outcome measures, and outcomes). Most studies demonstrated that VT wheelchair skills training showed improved outcomes (eg, simulation score, completion time, number of collisions) in the virtual environment and/or in the real world. However, subject characteristics, equipment, virtual environment, intervention tasks, and outcome measures varied across the studies. There are a variety of studies using VT as an intervention for wheelchair skills training. Given the positive outcomes for most of the studies, it appears as though VT may indeed be a solution that can help to alleviate barriers to wheelchair skills training and subsequently improve wheelchair user skill. Copyright © 2018 American Congress of Rehabilitation Medicine. All rights reserved.
Full Text Available A conventional motorized wheelchair has been fitted with sensors and programmed with an intelligent guidance system to efficiently maneuver itself automatically from one point to another in a facility equipped with a grid of sensors that provide the wheelchair with the basic map of its course. The device described in this paper has been conceptualized such that once the wheelchair is given information regarding the starting and stopping point in a controlled facility, the wheelchair with this pre programmed information can efficiently construct a path towards its destination and automatically drive to that point from its present position while avoiding obstacles in its path and negotiating any turns and bends that it encounters in its course. This is achieved by means of sensors (IR and sonic located at strategic points on the chair, circuits that control the speed of the motors, and a set of microcontrollers programmed to execute the different functions of the wheelchair. The facility in which the wheelchair works has been fitted with a set of sensors that form the basis of the network which is used by the program governing the wheelchair’s automated movement to provide guidance to it by means of a course map.
Schultz, D; Allen, M; Barrett, S F
Assistive technology is a rapidly growing field that provides a degree of freedom and self-sufficiency to people of limited mobility. Smart wheelchairs are a subset of assistive technology, and are designed to be operated by people who are unable to use a traditional control system. Instead, smart wheelchairs are equipped with a combination of automated functionality and steering mechanisms specialized to meet a persons individual needs. One feature common to the automated capabilities of smart wheelchairs is the tracking system. The wheelchairs microcontroller needs to know how far the chair has travelled, its speed, and the rotational direction of its wheels in order to successfully navigate through an environment. The purpose of this research was to develop an odometer to track the motion of a motorized wheelchair. Due to federal regulations that prohibit changing the structure or internal mechanics of a medical device, the odometer had to be designed as a separate, removable part. The final design for the odometer consisted of two infrared sensors that measure edge transitions of a segmented black and white encoder wheel. The sensor output was then run through two comparator op amps and a high pass filter to produce a clean, crisp square wave signal output. The signal was then fed to an Atmel ATmega164P microcontroller. The microcontroller was programmed to compare the sensor signal with its internal clock, sense edge transitions, and thereby extrapolate the speed, travelled distance, and rotational direction of the wheelchair.
The Food and Drug Administration (FDA) is publishing an order granting a petition requesting exemption from premarket notification requirements for wheelchair elevator devices commonly known as inclined platform lifts and vertical platform lifts. These devices are used to provide a means for a person with a mobility impairment caused by injury or other disease to move from one level to another, usually in a wheelchair. This order exempts wheelchair elevators, class II devices, from premarket notification and establishes conditions for exemption for this device that will provide a reasonable assurance of the safety and effectiveness of the device without submission of a premarket notification (510(k)). This exemption from 510(k), subject to these conditions, is immediately in effect for wheelchair elevators. All other devices classified under FDA's wheelchair elevator regulations, including attendant-operated stair climbing devices for wheelchairs and portable platform lifts, continue to require submission of 510(k)s. FDA is publishing this order in accordance with the section of the Food, Drug, and Cosmetic Act (the FD&C Act) permitting the exemption of a device from the requirement to submit a 510(k).
Susmartini, Susy; Pryadhitama, Ilham; Herdiman, Lobes; Wahyufitriani, Cindy
Difficulties in walking is high percentage case in the limitations mobility of the elderly. An assisted technology commonly used to help the elderly who have walking difficulty is a manual wheelchair. However, the elderly frequently experiences difficulties in operating manual wheelchair due to gradually degradation of their physical condition. Preliminary study results showed that the average grip strength of the hands of seven elderly subjects was 13.8 ± 6.96 kg and the value is relatively weak. In addition, the mean maximum speed of 7 elderly subjects when doing to round the wheelchair is 0.6 ± 0.2m / s. This value is only 56.4% compared with an average speed of 20-23-year age group (8 males), which is 1.1 ± 0.1 m / s. This shows that the elderly who have walking difficulty have low grip strength and speed in operating a wheelchair. On the other hand, manual wheelchairs suffer an inadequate technology solution to solve the problem. Therefore, an assistive technology is proposed to create mobility aid to accommodate the elderly needs. One approach used is Universal Design. This paper proposes a system of intervention in the manual wheelchair through the 7 principles of Universal Design approach. The preliminary principle has not been able to accommodate the needs of the elderly will become a reference in the proposed design of this study.
Tsai, Chung-Ying; Boninger, Michael L; Bass, Sarah R; Koontz, Alicia M
Using proper technique is important for minimizing upper limb kinetics during wheelchair transfers. The objective of the study was to 1) evaluate the transfer techniques used during toilet transfers and 2) determine the impact of technique on upper limb joint loading for two different toilet configurations. Twenty-six manual wheelchair users (23 men and 3 women) performed transfers in a side and front wheelchair-toilet orientation while their habitual transfer techniques were evaluated using the Transfer Assessment Instrument. A motion analysis system and force sensors were used to record biomechanical data during the transfers. More than 20% of the participants failed to complete five transfer skills in the side setup compared to three skills in the front setup. Higher quality skills overall were associated with lower peak forces and moments in both toilet configurations (-0.68 perform these skills correctly (p ≤ 0.04). In the front setup, positioning the wheelchair within three inches of the transfer target was associated with reduced peak trailing forces and moments across all three upper limb joints (p = 0.02). Transfer skills training, making toilet seats level with the wheelchair seat, positioning the wheelchair closer to the toilet and mounting grab bars in a more ideal location for persons who do sitting pivot transfers may facilitate better quality toilet transfers. Published by Elsevier Ltd.
Full Text Available In recent years the accessibility of London buses has improved with the introduction of ramps and wheelchair priority areas. These advances are meant to remove physical barriers to entering the bus, but new conflicts have arisen particularly over the physical space aboard. We aimed to research the barriers faced by wheelchair users in public transport using a mixed methods approach to establish the breadth of issues faced by wheelchair users. To this end we quantified the push-force used alight a bus and a study to understand the coping mechanisms used by people to propel up a ramp. This quantitative approach found push forces which resulted in a load of 2 to 3 times body weight being transferred through people’s shoulders, forces which can be directly linked to shoulder injury. This could disable the user further, preventing them from being able to push their wheelchair. Alongside the quantitative study, we conducted qualitative research comprising of a number of in-depth interviews with wheelchair users about the barriers they face in public transport. Our main claim, highlighted through this interdisciplinary collaboration, is that proposed ‘solutions’ to accessibility, such as ramps, often generate problems of their own. These barriers can affect the life of wheelchair users, impacting on their confidence and causing social isolation. These can be long-term in nature or immediate.
Po Er Hsu
Full Text Available A wheelchair user makes direct contact with the wheelchair seat, which serves as the interface between the user and the wheelchair, for much of any given day. Seat adjustment design is of crucial importance in providing proper seating posture and comfort. This paper presents a multiple-DOF (degrees of freedom seat adjustment mechanism, which is intended to increase the independence of the wheelchair user while maintaining a concise structure, light weight, and intuitive control interface. This four-axis Stewart platform is capable of heaving, pitching, and swaying to provide seat elevation, tilt-in-space, and sideways movement functions. The geometry and types of joints of this mechanism are carefully arranged so that only one actuator needs to be controlled, enabling the wheelchair user to adjust the seat by simply pressing a button. The seat is also equipped with soft pressure-sensing pads to provide pressure management by adjusting the seat mechanism once continuous and concentrated pressure is detected. Finally, by comparing with the manual wheelchair, the proposed mechanism demonstrated the easier and more convenient operation with less effort for transfer assistance.
Pavlidou, Efthymia; Kloosterman, Marieke G M; Buurke, Jaap H; Rietman, Johan S; Janssen, Thomas W J
Rolling resistance is one of the main forces resisting wheelchair propulsion and thus affecting stress exerted on the upper limbs. The present study investigates the differences in rolling resistance, propulsion efficiency and energy expenditure required by the user during power-assisted and manual propulsion. Different tire pressures (50%, 75%, 100%) and two different levels of motor assistance were tested. Drag force, energy expenditure and propulsion efficiency were measured in 10 able-bodied individuals under different experimental settings on a treadmill. Results showed that drag force levels were significantly higher in the 50%, compared to the 75% and 100% inflation conditions. In terms of wheelchair type, the manual wheelchair displayed significantly lower drag force values than the power-assisted one. The use of extra-power-assisted wheelchair appeared to be significantly superior to conventional power-assisted and manual wheelchairs concerning both propulsion efficiency and energy expenditure required by the user. Overall, the results of the study suggest that the use of power-assisted wheelchair was more efficient and required less energy input by the user, depending on the motor assistance provided. Copyright © 2015 IPEM. Published by Elsevier Ltd. All rights reserved.
Weston, Eric B; Khan, Safdar N; Marras, William S
The objective of this study was to determine how simulated manual wheelchair pushing influences biomechanical loading to the lumbar spine and shoulders. Sixty-two subjects performed simulated wheelchair pushing and turning in a laboratory. An electromyography-assisted biomechanical model was used to estimate spinal loads. Moments at the shoulder joint, external hand forces and net turning torque were also assessed. Multiple linear regression techniques were employed to develop biomechanically based wheelchair pushing guidelines relating resultant hand force or net torque to spinal load. Male subjects experienced significantly greater spinal loading (p pushing (p pushing and turning can pose biomechanical risk to the lumbar spine and shoulders. Psychophysically determined maximum acceptable push forces do not appear to be protective enough of this biomechanical risk. Practitioner Summary: This laboratory study investigated biomechanical risk to the low back and shoulders during simulated wheelchair pushing. Manual wheelchair pushing posed biomechanical risk to the lumbar spine (in compression and A/P shear) and to the shoulders. Biomechanically determined wheelchair pushing thresholds are presented and are more protective than the closest psychophysically determined equivalents.
Secoli, R; Zondervan, D; Reinkensmeyer, D
For children with a severe disability, such as can arise from cerebral palsy, becoming independent in mobility is a critical goal. Currently, however, driver's training for powered wheelchair use is labor intensive, requiring hand-over-hand assistance from a skilled therapist to keep the trainee safe. This paper describes the design of a mixed reality environment for semi-autonomous training of wheelchair driving skills. In this system, the wheelchair is used as the gaming input device, and users train driving skills by maneuvering through floor-projected games created with a multi-projector system and a multi-camera tracking system. A force feedback joystick assists in steering and enhances safety.
Full Text Available In this paper, an adaptive human-machine interaction (HMI method that is based on surface electromyography (sEMG signals is proposed for the hands-free control of an intelligent wheelchair. sEMG signals generated by the facial movements are obtained by a convenient dry electrodes sensing device. After the signals features are extracted from the autoregressive model, control data samples are updated and trained by an incremental online learning algorithm in real-time. Experimental results show that the proposed method can significantly improve the classification accuracy and training speed. Moreover, this method can effectively reduce the influence of muscle fatigue during a long time operation of sEMG-based HMI.
Pumpa, Kate; Knight, Emma; Miller, Joanna
Objective To investigate the physiological and perceptual effects of three precooling strategies during pre-exercise rest in athletes with a spinal cord injury (SCI). Design Randomized, counterbalanced. Participants were precooled, then rested for 60 minutes (22.7 ± 0.2°C, 64.2 ± 2.6%RH). Setting National Wheelchair Basketball Training Centre, Australia. Participants Sixteen wheelchair basketball athletes with a SCI. Interventions Participants were precooled through; 1) 10 minutes of 15.8°C cold water immersion (CWI), 2) ingestion of 6.8 g/kg−1 of slushie (S) from sports drink; 3) ingestion of 6.8 g/kg−1 of slushie with application of iced towels to the legs, torso and back/arms (ST); or 4) ingestion of 6.8 g/kg−1 of room temperature (22.3°C) sports drink (CON). Outcome measures Core temperature (Tgi), skin temperature (Tsk), heart rate (HR), and thermal and gastrointestinal comfort. Results Following CWI, a significant reduction in Tgi was observed compared to CON, with a greatest reduction of 1.58°C occurring 40 minutes post-cooling (95% CI [1.07, 2.10]). A significant reduction in Tgi following ST compared to CON was also observed at 20 minutes (0.56°C; [0.03, 1.09]) and 30 minutes (0.56°C; [0.04, 1.09]) post-cooling. Additionally, a significant interaction between impairment level and time was observed for Tgi and HR, demonstrating athletes with a higher level of impairment experienced a greater reduction in HR and significant decrease in rate of decline in Tgi, compared to lesser impaired athletes. Conclusion CWI and ST can effectively lower body temperature in athletes with a SCI, and may assist in tolerating warm conditions. PMID:27192132
Background Older adults are the most prevalent wheelchair users in Canada. Yet, cognitive impairments may prevent an older adult from being allowed to use a powered wheelchair due to safety and usability concerns. To address this issue, an add-on Intelligent Wheelchair System (IWS) was developed to help older adults with cognitive impairments drive a powered wheelchair safely and effectively. When attached to a powered wheelchair, the IWS adds a vision-based anti-collision feature that prevents the wheelchair from hitting obstacles and a navigation assistance feature that plays audio prompts to help users manoeuvre around obstacles. Methods A two stage evaluation was conducted to test the efficacy of the IWS. Stage One: Environment of Use – the IWS’s anti-collision and navigation features were evaluated against objects found in a long-term care facility. Six different collision scenarios (wall, walker, cane, no object, moving and stationary person) and three different navigation scenarios (object on left, object on right, and no object) were performed. Signal detection theory was used to categorize the response of the system in each scenario. Stage Two: User Trials – single-subject research design was used to evaluate the impact of the IWS on older adults with cognitive impairment. Participants were asked to drive a powered wheelchair through a structured obstacle course in two phases: 1) with the IWS and 2) without the IWS. Measurements of safety and usability were taken and compared between the two phases. Visual analysis and phase averages were used to analyze the single-subject data. Results Stage One: The IWS performed correctly for all environmental anti-collision and navigation scenarios. Stage Two: Two participants completed the trials. The IWS was able to limit the number of collisions that occurred with a powered wheelchair and lower the perceived workload for driving a powered wheelchair. However, the objective performance (time to complete course
Chénier, Félix; Champagne, Audrey; Desroches, Guillaume; Gagnon, Dany H
Manual wheelchair (MWC) propulsion is increasingly assessed on a motorized treadmill (TM), which is often considered more ecologically valid than stationary rollers. However, no clear consensus on the similarities between overground (OG) and TM propulsion has yet been reached. Furthermore, no study has investigated the participants' perceptions of propelling a MWC on a TM compared to OG. The present study aims to assess the perception of speed when propelling on a TM vs OG, and to relate this perception to measured spatiotemporal variables, kinetics and work. In this repeated-measures study, the propulsion's spatiotemporal variables, kinetics, and work of nineteen experienced wheelchair users with a spinal cord injury were compared between three conditions: 1) OG at a self-selected speed, 2) on a TM at a self-selected speed perceived as being similar to the OG speed (TM perceived ), and 3) on a TM at the same speed as OG (TM matched ). Each variable was compared between conditions using an analysis of variance for repeated measures. All participants selected a lower speed for TM perceived than OG, with a difference of -0.6 m/s (-44%). This adaptation may be due to a combination of two factors: 1) the absence of speed information, and 2) the feeling of urgency to grab the wheels during the recovery phase. The power output, work per cycle, and work per minute were also much lower on TM perceived than OG. However, in contrast to other work on MWC propulsion on a TM, the kinetic variables assessed were all similar between the OG and TM matched conditions. Training on a TM should be performed at a speed that matches the OG speed and not at a self-selected speed on the TM, which would reduce the power output and work and therefore reduce the efficiency of the training. Copyright © 2018 Elsevier B.V. All rights reserved.
van der Woude, Lucas; de Groot, Sonja; van Drongelen, Stefan; Janssen, Thomas W.; Haisma, Janneke A.; Valent, Linda J M; Veeger, DirkJan (H. E. J.)
Evaluation of wheelchair performance (capacity and skills) is crucial in the investigation of wheeled mobility in people with a spinal cord injury (SCI). Manual wheelchair use is a complex combination of skills, which together determine overall functioning, daily activities, participation, and quality of life. The evaluation of wheelchair performance requires a systematic biophysical approach that appreciates the importance of the individual elements of the wheelchair-user combination: the wh...
Leving, Marika T; Horemans, Henricus L D; Vegter, Riemer J K; de Groot, Sonja; Bussmann, Johannes B J; van der Woude, Lucas H V
Hypoactive lifestyle contributes to the development of secondary complications and lower quality of life in wheelchair users. There is a need for objective and user-friendly physical activity monitors for wheelchair-dependent individuals in order to increase physical activity through self-monitoring, goal setting, and feedback provision. To determine the validity of Activ8 Activity Monitors to 1) distinguish two classes of activities: independent wheelchair propulsion from other non-propulsive wheelchair-related activities 2) distinguish five wheelchair-related classes of activities differing by the movement intensity level: sitting in a wheelchair (hands may be moving but wheelchair remains stationary), maneuvering, and normal, high speed or assisted wheelchair propulsion. Sixteen able-bodied individuals performed sixteen various standardized 60s-activities of daily living. Each participant was equipped with a set of two Activ8 Professional Activity Monitors, one at the right forearm and one at the right wheel. Task classification by the Active8 Monitors was validated using video recordings. For the overall agreement, sensitivity and positive predictive value, outcomes above 90% are considered excellent, between 70 and 90% good, and below 70% unsatisfactory. Division in two classes resulted in overall agreement of 82.1%, sensitivity of 77.7% and positive predictive value of 78.2%. 84.5% of total duration of all tasks was classified identically by Activ8 and based on the video material. Division in five classes resulted in overall agreement of 56.6%, sensitivity of 52.8% and positive predictive value of 51.9%. 59.8% of total duration of all tasks was classified identically by Activ8 and based on the video material. Activ8 system proved to be suitable for distinguishing between active wheelchair propulsion and other non-propulsive wheelchair-related activities. The ability of the current system and algorithms to distinguish five various wheelchair-related activities
Hiremath, Shivayogi V; Ding, Dan; Cooper, Rory A
To develop and evaluate a wireless gyroscope-based wheel rotation monitor (G-WRM) that can estimate speeds and distances traveled by wheelchair users during regular wheelchair propulsion as well as wheelchair sports such as handcycling, and provide users with real-time feedback through a smartphone application. The speeds and the distances estimated by the G-WRM were compared with the criterion measures by calculating absolute difference, mean difference, and percentage errors during a series of laboratory-based tests. Intraclass correlations (ICC) and the Bland-Altman plots were also used to assess the agreements between the G-WRM and the criterion measures. In addition, battery life and wireless data transmission tests under a number of usage conditions were performed. The percentage errors for the angular velocities, speeds, and distances obtained from three prototype G-WRMs were less than 3% for all the test trials. The high ICC values (ICC (3,1) > 0.94) and the Bland-Altman plots indicate excellent agreement between the estimated speeds and distances by the G-WRMs and the criterion measures. The battery life tests showed that the device could last for 35 hours in wireless mode and 139 hours in secure digital card mode. The wireless data transmission tests indicated less than 0.3% of data loss. The results indicate that the G-WRM is an appropriate tool for tracking a spectrum of wheelchair-related activities from regular wheelchair propulsion to wheelchair sports such as handcycling. The real-time feedback provided by the G-WRM can help wheelchair users self-monitor their everyday activities.
Kloosterman, Marieke G M; Eising, Hilde; Schaake, Leendert; Buurke, Jaap H; Rietman, Johan S
Repetitive forces and moments are among the work requirements of hand-rim wheelchair propulsion that are related to shoulder injuries. No previous research has been published about the influence of power-assisted wheelchair propulsion on these work requirements. The purpose of our study was therefore to determine the influence of power-assisted propulsion on shoulder biomechanics and muscle activation patterns. We also explored the theoretical framework for the effectiveness of power-assisted propulsion in preventing shoulder injuries by decreasing the work requirements of hand-rim wheelchair propulsion. Nine non-wheelchair users propelled a hand-rim wheelchair on a treadmill at 0.9 m/s. Shoulder biomechanics, and muscle activation patterns, were compared between propulsion with and without power-assist. Propulsion frequency did not differ significantly between the two conditions (Wilcoxon Signed Rank test/significance level/effect size:4/.314/-.34). During power-assisted propulsion we found significantly decreased maximum shoulder flexion and internal rotation angles (1/.015/-.81 and 0/.008/-.89) and decreased peak force on the rim (0/.008/-.89). This resulted in decreased shoulder flexion, adduction and internal rotation moments (2/.021/-.77; 0/.008/-.89 and 1/.011/-.85) and decreased forces at the shoulder in the posterior, superior and lateral directions (2/.021/-.77; 2/.008/-.89 and 2/.024/-.75). Muscle activation in the pectoralis major, posterior deltoid and triceps brachii was also decreased (2/.038/-.69; 1/.015/-.81 and 1/.021/-.77). Power-assist influenced the work requirements of hand-rim wheelchair propulsion by healthy subjects. It was primarily the kinetics at rim and shoulder which were influenced by power-assisted propulsion. Additional research with actual hand-rim wheelchair users is required before extrapolation to routine clinical practice. Copyright © 2011 Elsevier Ltd. All rights reserved.
Faupin, Arnaud; Borel, Benoit; Meyer, Christophe; Gorce, Philippe; Watelain, Eric
This study aimed to first investigate synchronous (SYN) versus asynchronous (ASY) mode of propulsion and, second, investigate the wheel camber effects on sprinting performance as well as temporal parameters. Seven wheelchair basketball players performed four maximal eight-second sprints on a wheelchair ergometer. They repeated the test according to two modes of propulsion (SYN and ASY) and two wheel cambers (9° and 15°). The mean maximal velocity and push power output was greater in the synchronous mode compared to the asynchronous mode for both camber angles. However, the fluctuation in the velocity profile is inferior for ASY versus SYN mode for both camber angles. Greater push time/cycle time (Pt/Ct) and arm frequency (AF) for synchronous mode versus asynchronous mode and inversely, lesser Ct and rest time (Rt) values for the synchronous mode, for which greater velocity were observed. SYN mode leads to better performance than ASY mode in terms of maximal propulsion velocity. However, ASY propulsion allows greater continuity of the hand-rim force application, reducing fluctuations in the velocity profile. The camber angle had no effect on ASY and SYN mean maximal velocity and push power output. The study of wheelchair propulsion strategies is important for better understanding physiological and biomechanical impacts of wheelchair propulsion for individuals with disabilities. From a kinematical point of view, this study highlights synchronous mode of propulsion to be more efficient, with regards to mean maximal velocity reaching during maximal sprinting exercises. Even if this study focuses on well-trained wheelchair athletes, results from this study could complement the knowledge on the physiological and biomechanical adaptations to wheelchair propulsion and therefore, might be interesting for wheelchair modifications for purposes of rehabilitation.
Jayaraman, Chandrasekaran; Beck, Carolyn L; Sosnoff, Jacob J
Repetitive loading of the upper limb due to wheelchair propulsion plays a leading role in the development of shoulder pain in manual wheelchair users (mWCUs). There has been minimal inquiry on understanding wheelchair propulsion kinematics from a human movement ergonomics perspective. This investigation employs an ergonomic metric, jerk, to characterize the recovery phase kinematics of two recommended manual wheelchair propulsion patterns: semi-circular and the double loop. Further it examines if jerk is related to shoulder pain in mWCUs. Data from 22 experienced adult mWCUs was analyzed for this study (semi-circular: n=12 (pain/without-pain:6/6); double-loop: n=10 (pain/without-pain:4/6)). Participants propelled their own wheelchair fitted with SMARTWheels on a roller dynamometer at 1.1 m/s for 3 min. Kinematic and kinetic data of the upper limbs were recorded. Three dimensional absolute jerk experienced at the shoulder, elbow and wrist joint during the recovery phase of wheelchair propulsion were computed. Two-way ANOVAs were conducted with the recovery pattern type and shoulder pain as between group factors. (1) Individuals using a semi-circular pattern experienced lower jerk at their arm joints than those using a double loop pattern (Ppropulsion was able to distinguish between pattern types (semi-circular and double loop) and the presence of shoulder pain. Jerk provides novel insights into wheelchair propulsion kinematics and in the future it may be beneficial to incorporate jerk based metric into rehabilitation practice. Copyright © 2015 Elsevier Ltd. All rights reserved.
Bekker, Michel J; Vegter, Riemer J K; van der Scheer, Jan W; Hartog, Johanneke; de Groot, Sonja; de Vries, Wiebe; Arnet, Ursina; van der Woude, Lucas H V; Veeger, Dirkjan H E J
Altered scapular kinematics have been associated with shoulder pain and functional limitations. To understand kinematics in persons with spinal cord injury during manual handrim wheelchair propulsion, a description of normal scapular behaviour in able-bodied persons during this specific task is a prerequisite for accurate interpretation. The primary aim of this study is to describe scapular kinematics in able-bodied persons during manual wheelchair propulsion. Sixteen able-bodied, novice wheelchair users without shoulder complaints participated in the study. Kinematic and kinetic data were collected during a standardized pose in the anatomic posture, frontal-plane arm elevation and low-intensity steady-state handrim wheelchair propulsion and upper-body Euler angles were calculated. Scapulothoracic joint orientations in a static position were 36.7° (SD 5.4°), 6.4° (SD 9.1°) and 9.1° (SD 5.7°) for respectively protraction, lateral rotation and anterior tilt. At 80° of arm elevation in the frontal plane, the respective values of 33.4° (SD 8.0°), 23.9° (SD 5.4°) and 4.1° (SD 11.3°) were found. During the push phase of manual wheelchair propulsion, the mean scapular rotations were respectively 32.7° (SD 7.1°), 7.1° (SD 9.2°) and 9.8° (SD 8.3°). The orientation of the scapula in a static pose, during arm elevation and in manual wheelchair propulsion in able-bodied participants showed similar patterns to a previous study in persons with para- and tetraplegia. These values provide a reference for the investigation of the scapular movement pattern in wheelchair-dependent persons and its relation to shoulder complex abnormalities. Copyright © 2018. Published by Elsevier Ltd.
York, Sherril L.; Kimura, Iris F.
A photographic analysis of racing wheelchairs used by cerebral palsy class four athletes and amputee athletes at the 1984 International Games for the Disabled was undertaken in order to analyze seven wheelchair construction variables in relation to performance outcome, distance raced, and type of disability of the user. (Author/MT)
... 49 Transportation 1 2010-10-01 2010-10-01 false What wheelchairs and other assistive devices may passengers with a disability bring onto a passenger vessel? 39.93 Section 39.93 Transportation Office of the... and Services to Passengers With Disabilities § 39.93 What wheelchairs and other assistive devices may...
Van Der Woude, L H; Van Koningsbruggen, C M; Kroes, A L; Kingma, I
The aim of this investigation was to analyze the external forces and biomechanical loading on the musculoskeletal system during wheelchair pushing, in relation to different push handle heights. In addition, recommendations for wheelchair pushing in accordance with push handle height are made. Eight
Goosey-Tolfrey, Victoria L; Vegter, Riemer J K; Mason, Barry S; Paulson, Thomas A W; Lenton, John P; van der Scheer, Jan W; van der Woude, Lucas H V
The purpose of this study was to examine the propulsion asymmetries of wheelchair athletes while sprinting on an instrumented, dual-roller ergometer system. Eighteen experienced wheelchair rugby players (8 low point (LP) (class 1.5) and 10 high point (HP) (class 2.0)) performed a 15-second sprint in
Salipur, Zdravko; Bertocci, Gina
It has been shown that ANSI WC19 transit wheelchairs that are crashworthy in frontal impact exhibit catastrophic failures in rear impact and may not be able to provide stable seating support and thus occupant protection for the wheelchair occupant. Thus far only limited sled test and computer simulation data have been available to study rear impact wheelchair safety. Computer modeling can be used as an economic and comprehensive tool to gain critical knowledge regarding wheelchair integrity and occupant safety. This study describes the development and validation of a computer model simulating an adult wheelchair-seated occupant subjected to a rear impact event. The model was developed in MADYMO and validated rigorously using the results of three similar sled tests conducted to specifications provided in the draft ISO/TC 173 standard. Outcomes from the model can provide critical wheelchair loading information to wheelchair and tiedown manufacturers, resulting in safer wheelchair designs for rear impact conditions. (c) 2009 IPEM. Published by Elsevier Ltd. All rights reserved.
Koontz, AM; Cooper, RA; Boninger, ML; Yang, YS; Impink, BG; van der Woude, LHV
The objective of this study was to conduct a kinetic analysis of manual wheelchair propulsion during start-LIP on select indoor and Outdoor surfaces. Eleven manual wheelchairs were fitted with a SMART(Wheel) and their users were asked to Push on a Course consisting of high- and low-pile carpet,
Altalmas, Tareq; Aula, Abqori; Ahmad, Salmiah; Tokhi, M O; Akmeliawati, Rini
Two-wheeled wheelchairs are considered highly nonlinear and complex systems. The systems mimic a double-inverted pendulum scenario and will provide better maneuverability in confined spaces and also to reach higher level of height for pick and place tasks. The challenge resides in modeling and control of the two-wheeled wheelchair to perform comparably to a normal four-wheeled wheelchair. Most common modeling techniques have been accomplished by researchers utilizing the basic Newton's Laws of motion and some have used 3D tools to model the system where the models are much more theoretical and quite far from the practical implementation. This article is aimed at closing the gap between the conventional mathematical modeling approaches where the integrated 3D modeling approach with validation on the actual hardware implementation was conducted. To achieve this, both nonlinear and a linearized model in terms of state space model were obtained from the mathematical model of the system for analysis and, thereafter, a 3D virtual prototype of the wheelchair was developed, simulated, and analyzed. This has increased the confidence level for the proposed platform and facilitated the actual hardware implementation of the two-wheeled wheelchair. Results show that the prototype developed and tested has successfully worked within the specific requirements established.
McGarry, Sarah; Moir, Lois; Girdler, Sonya
To describe the impact of a mobility training program using the Smart Wheelchair on the driving skills and psychosocial outcomes of children with physical disabilities. A multiple case study design using mixed methods was used. Four children with physical disabilities were recruited through The Centre for Cerebral Palsy in Western Australia. The intervention was a 16 session Smart Wheelchair mobility training program. Data was collected using a quantitative driving skills assessment, field notes and qualitative parent interviews. Three out of four children gained independence in at least three driving skills or more, whilst one child was competent with verbal prompts. Three out of four mothers reported positive changes in their child's confidence, motivation and affect. The Smart Wheelchair has the ability to uncover learning potential and facilitate the recognition of abilities in children previously excluded from access to independent mobility. Given the significant limitation that restrictions in mobility pose to participation for children with physical disabilities, therapists must begin to understand the effectiveness of interventions such as the Smart Wheelchair. The descriptive findings of this study allow for future, more rigorous research, to be conducted on the effectiveness of the Smart Wheelchair as a mobility training tool.
Huang, Wei Pin; Wang, Chia Cheng; Hung, Jo Hua; Chien, Kai Chun; Liu, Wen-Yu; Cheng, Chih-Hsiu; Ng, How-Hing; Lin, Yang-Hua
[Purpose] This study aimed to determine the effectiveness of joystick-controlled video console games in enhancing subjects' ability to control power wheelchairs. [Subjects and Methods] Twenty healthy young adults without prior experience of driving power wheelchairs were recruited. Four commercially available video games were used as training programs to practice joystick control in catching falling objects, crossing a river, tracing the route while floating on a river, and navigating through a garden maze. An indoor power wheelchair driving test, including straight lines, and right and left turns, was completed before and after the video game practice, during which electromyographic signals of the upper limbs were recorded. The paired t-test was used to compare the differences in driving performance and muscle activities before and after the intervention. [Results] Following the video game intervention, participants took significantly less time to complete the course, with less lateral deviation when turning the indoor power wheelchair. However, muscle activation in the upper limbs was not significantly affected. [Conclusion] This study demonstrates the feasibility of using joystick-controlled commercial video games to train individuals in the control of indoor power wheelchairs.
Rankin, Jeffery W; Richter, W Mark; Neptune, Richard R
Manual wheelchair propulsion places considerable physical demand on the upper extremity and is one of the primary activities associated with the high prevalence of upper extremity overuse injuries and pain among wheelchair users. As a result, recent effort has focused on determining how various propulsion techniques influence upper extremity demand during wheelchair propulsion. However, an important prerequisite for identifying the relationships between propulsion techniques and upper extremity demand is to understand how individual muscles contribute to the mechanical energetics of wheelchair propulsion. The purpose of this study was to use a forward dynamics simulation of wheelchair propulsion to quantify how individual muscles deliver, absorb and/or transfer mechanical power during propulsion. The analysis showed that muscles contribute to either push (i.e., deliver mechanical power to the handrim) or recovery (i.e., reposition the arm) subtasks, with the shoulder flexors being the primary contributors to the push and the shoulder extensors being the primary contributors to the recovery. In addition, significant activity from the shoulder muscles was required during the transition between push and recovery, which resulted in increased co-contraction and upper extremity demand. Thus, strengthening the shoulder flexors and promoting propulsion techniques that improve transition mechanics have much potential to reduce upper extremity demand and improve rehabilitation outcomes. Copyright © 2011 Elsevier Ltd. All rights reserved.
Hsieh, Long-Chang; Chen, Tzu-Hsia
Traditionally, the mechanism of wheelchair with lifting and standing functions has 2 degrees of freedom, and used 2 power sources to perform these 2 motion function. The purpose of this paper is to invent new wheelchair with 1 degree of freedom to perform these 2 motion functions. Hence, we can use only 1 power source to drive the mechanism to achieve lifting and standing motion functions. The new design has the advantages of simple operation, more stability, and more safety. For traditional standing wheelchair, its’ centre of gravity moves forward when standing up and it needs 2 auxiliary wheels to prevent dumping. In this paper, by using the checklist method of Osborn, the wheelchair with 1 DOF is invented to perform lifting and standing functions. The centre of gravity of this new wheelchair after standing up still located between the front and rear wheels, no auxiliary wheels needed. Finally, the prototype is manufactured to verify the theoretical results.
Koontz, Alicia M; Lin, Yen-Sheng; Kankipati, Padmaja; Boninger, Michael L; Cooper, Rory A
This study describes a new custom measurement system designed to investigate the biomechanics of sitting-pivot wheelchair transfers and assesses the reliability of selected biomechanical variables. Variables assessed include horizontal and vertical reaction forces underneath both hands and three-dimensional trunk, shoulder, and elbow range of motion. We examined the reliability of these measures between 5 consecutive transfer trials for 5 subjects with spinal cord injury and 12 nondisabled subjects while they performed a self-selected sitting pivot transfer from a wheelchair to a level bench. A majority of the biomechanical variables demonstrated moderate to excellent reliability (r > 0.6). The transfer measurement system recorded reliable and valid biomechanical data for future studies of sitting-pivot wheelchair transfers.We recommend a minimum of five transfer trials to obtain a reliable measure of transfer technique for future studies.
Altalmas, T. M.; Ahmad, S.; Aula, A.; Akmeliawati, R.; Sidek, S. N.
This article is presented a new design of two-wheeled wheelchair that can balance on two wheels to make it suitable in the narrow areas, especially in the domestic environments; it has the ability to extend the height of the chair to help the user to act independently in the life for example, in the library to pick and put books on the shelves. The 3D model has been built up using SolidWorks Software. Nowadays, SolidWorks environment is considered as a powerful tool that is helping designer to design products and attain its performance before physical prototype stage. SolidWorks simulation model has been employed to test the frame of the wheelchair under the weight of the human body and the upper part of the wheelchair. The static analysis has been done on the frame using steel and aluminium; however the aluminium material has been selected due to its light weight
Full Text Available Controlling a robotic device by using human brain signals is an interesting and challenging task. The device may be complicated to control and the nonstationary nature of the brain signals provides for a rather unstable input. With the use of intelligent processing algorithms adapted to the task at hand, however, the performance can be increased. This paper introduces a shared control system that helps the subject in driving an intelligent wheelchair with a noninvasive brain interface. The subject's steering intentions are estimated from electroencephalogram (EEG signals and passed through to the shared control system before being sent to the wheelchair motors. Experimental results show a possibility for significant improvement in the overall driving performance when using the shared control system compared to driving without it. These results have been obtained with 2 healthy subjects during their first day of training with the brain-actuated wheelchair.
Mason, Barry S; Lenton, John P; Goosey-Tolfrey, Victoria L
To explore the physiological and biomechanical differences between forwards (FOR) and reverse (REV) sports wheelchair propulsion. Fourteen able-bodied males with previous wheelchair propulsion experience pushed a sports wheelchair on a single-roller ergometer in a FOR and REV direction at three sub-maximal speeds (4, 6, and 8 km/hour). Each trial lasted 3 minutes, and during the final minute physiological and biomechanical measures was collected. The physiological results revealed that oxygen uptake (1.51 ± 0.29 vs. 1.38 ± 0.26 L/minute, P = 0.005) and heart rate (121 ± 19 vs. 109 ± 14 beats/minute, P 0.05). However, greater mean resultant forces were applied during FOR (P kinematic adaptations in order to maintain constant speeds in REV.
Perreault, Stephane; Vallarand, Robert J
Guided by Self-Determination Theory (SDT), the present study examined the sport motivation and coping skills of male and female wheelchair basketball players with and without disability (N = 72). In line with SDT, results showed that intrinsic and extrinsic motivation as well as amotivation was found to be present in this sample of wheelchair basketball players. Results also demonstrated that the participants surveyed in the present study scored higher on self-determined types of motivation than non self-determined types of motivation, thus replicating past research with athletes without disability. Furthermore, wheelchair basketball players with and without disability did not differ significantly with respect to sport motivation and coping skills, suggesting that they are more alike than dissimilar. Finally, results revealed that self-determined motivation is associated with enhanced psychological functioning.
Brenda N. Onguti
Full Text Available The provision of an appropriate wheelchair, one that provides proper fit and postural support, promotes wheelchair users’ physical health and quality of life. Many wheelchair users have postural difficulties, requiring supplemental postural support devices for added trunk support. However, in many low- and middle-income settings, postural support devices are inaccessible, inappropriate or unaffordable. This article describes the use of the design challenge model, informed by a design thinking approach, to catalyse the development of an affordable, simple and robust postural support device for low- and middle-income countries. The article also illustrates how not-for-profit organisations can utilise design thinking and, in particular, the design challenge model to successfully support the development of innovative solutions to product or process challenges.
Edwin Romeroso Arboleda
Full Text Available A low-cost electronic wheelchair was designed and developed which can perform the similar functions and features as a commercially available wheelchair. It also provides obstacle avoidance capability as added value. The electronic wheelchair was realized by modification of a lightweight manual wheelchair. It uses two electric motors each of 320 W 24 V DC, 5-24 VDC 6 A H-bride drivers, and a 12 V 17 Ah rechargeable lead acid battery. It equipped with switches, joystick, infrared sensors and ultrasonic sensors. A GizduinoAtMega 328 microcontroller is used to read and interpret commands. User’s acceptance evaluation results shows that the developed low-cost wheelchair is able to receive and interpret commands provided by the joystick, detect if a person is seated on it, navigate to avoid obstacles as well as to detect edge and stairs. Technical evaluation result shows that on a flat surface it could move at the speed of around 39.9 m/minute without load and 32 m/minute with 80 kg load. At 10 degrees inclined surface, the maximum weight limit is 30 kg with the speed of 12 m/minute. At 20 degrees inclined surface, the maximum weight limit is 10 kg with the speed of 3 m/minute. Regarding cost, it is just a fraction of a cost compared to the commercially available model. Therefore, the developed wheelchair offers an option for potential users who cannot afford to buy the commercially available one.
Perret, Claudio; Wenger, Martin; Leicht, Christof A; Goosey-Tolfrey, Victoria L
In wheelchair racing, respiratory muscles of the rib cage are concomitantly involved in non-ventilatory functions during wheelchair propulsion. However, the relationship between locomotor-respiratory coupling (LRC: the ratio between push and breathing frequency), respiratory parameters and work efficiency is unknown. Therefore, the aim of the present study was to investigate the LRC in wheelchair racers over different race distances. Eight trained and experienced wheelchair racers completed three time-trials over the distances of 400, 800, and 5000 m on a training roller in randomized order. During the time trials, ventilatory and gas exchange variables as well as push frequency were continuously registered to determine possible LRC strategies. Four different coupling ratios were identified, namely 1:1; 2:1, 3:1 as well as a 1:1/2:1 alternating type, respectively. The 2:1 coupling was the most dominant type. The 1:1/2:1 alternating coupling type was found predominantly during the 400 m time-trial. Longer race distances tended to result in an increased coupling ratio (e.g., from 1:1 toward 2:1), and an increase in coupling ratio toward a more efficient respiration was found over the 5000 m distance. A significant correlation (r = 0.80, p respiratory frequency and the respiratory equivalent for oxygen was found for the 400 m and the 800 m time-trials. These findings suggest that a higher coupling ratio indicates enhanced breathing work efficiency with a concomitant deeper and slower respiration during wheelchair racing. Thus, the selection of an appropriate LRC strategy may help to optimize wheelchair racing performance.
Nguyen, H T; King, L M; Knight, G
Mobility has become very important for our quality of life. A loss of mobility due to an injury is usually accompanied by a loss of self-confidence. For many individuals, independent mobility is an important aspect of self-esteem. Head movement is a natural form of pointing and can be used to directly replace the joystick whilst still allowing for similar control. Through the use of embedded LINUX and artificial intelligence, a hands-free head movement wheelchair controller has been designed and implemented successfully. This system provides for severely disabled users an effective power wheelchair control method with improved posture, ease of use and attractiveness.
Users of walkers and users of different categories of wheelchairs tested doors with different opening force, aiming to reveal the limit that these groups of people could manage on an everyday basis. 94.7% of the wheelchair users reported that a door opening force of 30 N was acceptable, while as 92.1% of this group described 40 N as acceptable. Similarly, 100% of the walker users reported that a door opening force of 30 N was acceptable, while as 87,5% of this group described 40 N as acceptable.
Christensen, Henrik Vie; Garcia, Juan Carlos
This paper presents a new human-machine interface for controlling a wheelchair by head movements. The position of the head is determined by use of infrared sensors, with no parts attached to the head of the user. The placement of the infrared sensors are behind the head of the user, so that the f......This paper presents a new human-machine interface for controlling a wheelchair by head movements. The position of the head is determined by use of infrared sensors, with no parts attached to the head of the user. The placement of the infrared sensors are behind the head of the user, so...
Rice, Ian M; Rice, Laura A; Motl, Robert W
To examine the efficacy and feasibility of a multifactorial intervention to increase lifestyle physical activity in nonambulatory persons with multiple sclerosis (MS) based on wheelchair optimization, propulsion skill/technique training, and behavioral strategies based on social cognitive theory. Randomized controlled trial, 3-month postintervention follow-up. Home and general community, and university research laboratory. Nonambulatory individuals with MS (N=14; mean age ± SD, 53.6±8.7y) were randomly assigned to an intervention group (IG) or a control group (CG). After baseline testing, the IG participants received custom-fit, ultralightweight manual wheelchairs with propulsion/skills training, followed by 3 months of at-home use with the custom ultralightweight wheelchair and weekly phone calls to deliver support through a multifactorial intervention. The CG participants received no training and used their own wheelchairs at home during this time. All subjects were assessed at baseline and 3 months later for fatigue (Fatigue Severity Scale), upper extremity strength (digital handheld dynamometer), and propulsion technique (on a treadmill [0.5m/s] with instrumented wheels). Two 1-week bouts of physical activity were measured in both groups from home with wrist-worn accelerometry at the beginning (IG and CG in own wheelchairs) and end (IG in study wheelchair, CG in own) of the 3-month period of home use. The intervention was well tolerated, and no adverse events were reported. The IG demonstrated increased strength (P=.008) and a trend toward less fatigue (P=.068), both with large effect sizes (d>0.8), as well as reduced application of braking torque during propulsion (P=.003) with a moderate/large effect size (d=.73), compared with the CG. Findings suggest a 3-month physical activity intervention based on manual wheelchair propulsion and training is safe and feasible for some wheelchair users living with MS and may produce secondary benefits in strength
Rushton, Paula W; Kairy, Dahlia; Archambault, Philippe; Pituch, Evelina; Torkia, Caryne; El Fathi, Anas; Stone, Paula; Routhier, François; Forget, Robert; Pineau, Joelle; Gourdeau, Richard; Demers, Louise
To explore power wheelchair users', caregivers' and clinicians' perspectives regarding the potential impact of intelligent power wheelchair use on social participation. Semi-structured interviews were conducted with power wheelchair users (n = 12), caregivers (n = 4) and clinicians (n = 12). An illustrative video was used to facilitate discussion. The transcribed interviews were analyzed using thematic analysis. Three main themes were identified based on the experiences of the power wheelchair users, caregivers and clinicians: (1) increased social participation opportunities, (2) changing how social participation is experienced and (3) decreased risk of accidents during social participation. Findings from this study suggest that an intelligent power wheelchair would enhance social participation in a variety of important ways, thereby providing support for continued design and development of this assistive technology. An intelligent power wheelchair has the potential to: Increase social participation opportunities by overcoming challenges associated with navigating through crowds and small spaces. Change how social participation is experienced through "normalizing" social interactions and decreasing the effort required to drive a power wheelchair. Decrease the risk of accidents during social participation by reducing the need for dangerous compensatory strategies and minimizing the impact of the physical environment.
Hwang, Seonhong; Lin, Yen-Sheng; Hogaboom, Nathan S; Wang, Lin-Hwa; Koontz, Alicia M
Wheelchair propulsion is a major cause of upper limb pain and injuries for manual wheelchair users with spinal cord injuries (SCIs). Few studies have investigated wheelchair turning biomechanics on natural ground surfaces. The purpose of this study was to investigate the relationship between tangential push force and linear velocity of the wheelchair during the turning portions of propulsion. Using an instrumented handrim, velocity and push force data were recorded for 25 subjects while they propel their own wheelchairs on a concrete floor along a figure-eight-shaped course at a maximum velocity. The braking force (1.03 N) of the inside wheel while turning was the largest of all other push forces (p<0.05). Larger changes in squared velocity while turning were significantly correlated with higher propulsive and braking forces used at the pre-turning, turning, and post-turning phases (p<0.05). Subjects with less change of velocity while turning needed less braking force to maneuver themselves successfully and safely around the turns. Considering the magnitude and direction of tangential force applied to the wheel, it seems that there are higher risks of injury and instability for upper limb joints when braking the inside wheel to turn. The results provide insight into wheelchair setup and mobility skills training for wheelchair users.
Samuelsson, Kersti; Björk, Maarit; Erdugan, Ann-Marie; Hansson, Anna-Karin; Rustner, Birgitta
A wheelchair seat and position help clients perform daily activities. The comfort of the wheelchair can encourage clients to participate in daily activities and can help prevent future complications. This study evaluates how a shaped seat-cushion and two different back supports affect under-seat pressure, comfort, and pelvic rotation. Thirty healthy subjects were tested using two differently equipped manual wheelchairs. One wheelchair had a Velcro adjustable back seat and a plane seat-cushion. The other wheelchair had a non-adjustable sling-back seat and a plane cushion. The second wheelchair was also equipped with a shaped cushion and/or a detachable lumbar support. Under-seat pressure, estimated comfort, and pelvic rotation were measured after 10 min in each wheelchair outfit. Peak pressure increased with the shaped cushion compared to the plane cushion. No significant difference in estimated comfort was found. Pelvic posterior-rotation was reduced with the adjustable or detachable back-support irrespective of the shape of the seat cushion. To support a neutral pelvic position and spinal curvature, a combination of a shaped cushion and a marked lumbar support is most effective.
Novak, Charles W.
In this, the International Year of the Disabled, attention is directed among other areas toward rehabilitation and sports participation of wheelchair users. As an application of movement analysis in medicine and rehabilitation and as an application of sports research using biomechanics, this investigation was performed to compare the results of two methods of gathering data on the stress of wheelchair propelling at equivalent work loads and to account for differences in physiological responses with a mechanical analysis of wheelchair propelling. Physiological data collected were heart rate, systolic blood pressure, and rate-pressure product. A biomechanical cinematography analysis was used to determine external work in wheelchair propelling and to determine the extent to which modifications in segment actionsoccurred during increasing magnitude of work. A cycle ergometer was adjusted to replicate external work loads performed during wheelchair propelling. A t-test of equivalent external work loads indicated that heart rate was not different between the two exercise modes at the .05 level of significance. The t-test did indicate a significant difference in systolic blood pressure and rate-pressure product at the .05 level of significance. The biomechanical analysis of wheelchair propelling established that an increase in external work was accomplished by a decrease in the range of motion and an increase in the speed of movement. During cycle ergometry the range and speed of movement remained the same while resistance was increased. Results of the study established that while heart rate for equivalent external work loads was the same for wheelchair propelling and arm cranking cycle ergometry, systolic blood pressure and rate-pressure product were not the same. The suggestion was that some means of propelling a wheelchair other than that which is con-sidered "standard" might be considered which produces less stressful responses in wheelchair users.
Schneider, Lawrence W; Klinich, Kathleen D; Moore, Jamie L; MacWilliams, Joel B
In-depth investigations of motor-vehicle crashes involve detailed inspection, measurement, and photodocumentation of vehicle exterior and interior damage, evidence of belt-restraint use, and evidence of occupant contacts with the vehicle interior. Results of in-depth investigations thereby provide the most objective way to identify current and emerging injury problems and issues in occupant safety and crash protection, and provide important feedback on the real-world performance of the latest restraint-system and vehicle crashworthiness technologies. To provide an objective understanding of real-world transportation safety issues for wheelchair-seated travelers, the University of Michigan Transportation Research Institute (UMTRI) has been conducting and assembling data from in-depth investigations of motor-vehicle crashes and non-crash adverse moving-vehicle incidents, such as emergency vehicle braking, turning, and swerving, in which there was at least one vehicle occupant sitting in a wheelchair. The results of 39 investigations involving 42 wheelchair-seated occupants have been assembled and entered into a wheelchair-occupant crash/injury database. In addition, a biomechanical analysis of each case has been performed to identify key safety issues for wheelchair-seated travelers. The wheelchairs of 34 of the 42 occupants who were seated in wheelchairs while traveling in motor vehicles were effectively secured by either a four-point, strap-type tiedown system or a docking securement device, and all but one of these properly secured wheelchairs remained in place during the crash or non-collision event. However, 30 of the 42 occupants were improperly restrained, either because of non-use or incomplete use of available belt restraints, or because the belt restraints were improperly positioned on the occupant's body. Twenty-six of the 42 occupants sustained significant injuries and 10 of these occupants died as a direct result of injuries sustained, or from
White, G W; Mathews, R M; Fawcett, S B
People who use wheelchairs are at risk for developing pressure sores. Regular pressure relief, in the form of a wheelchair push-up, is one way to reduce the likelihood of pressure sores. We examined the effects of antecedent (i.e., instructions, audible prompts) and consequent (i.e., alarm avoidance) events on wheelchair push-ups, using a multiple baseline analysis with 2 participants with spina bifida. Results suggest that the combined procedure was more effective than either antecedent or consequent events alone, and there is some evidence suggesting maintenance of effects over time. PMID:2793635
Full Text Available The ratio of tangential to total pushrim force, the so-called Fraction Effective Force (FEF, has been used to evaluate wheelchair propulsion efficiency based on the fact that only the tangential component of the force on the pushrim contributes to actual wheelchair propulsion. Experimental studies, however, consistently show low FEF values and recent experimental as well as modelling investigations have conclusively shown that a more tangential pushrim force direction can lead to a decrease and not increase in propulsion efficiency. This study aims at quantifying the contributions of active, inertial and gravitational forces to the normal pushrim component. In order to achieve this goal, an inverse dynamics-based framework is proposed to estimate individual contributions to the pushrim forces using a model of the wheelchair-user system. The results show that the radial pushrim force component arise to a great extent due to purely mechanical effects, including inertial and gravitational forces. These results corroborate previous findings according to which radial pushrim force components are not necessarily a result of inefficient propulsion strategies or hand-rim friction requirements. This study proposes a novel framework to quantify the individual contributions of active, inertial and gravitational forces to pushrim forces during wheelchair propulsion.
Rushton, Paula W; Mortenson, Ben W; Viswanathan, Pooja; Wang, Rosalie H; Miller, William C; Hurd Clarke, Laura
Long-term care (LTC) residents with cognitive impairments frequently experience limited mobility and participation in preferred activities. Although a power wheelchair could mitigate some of these mobility and participation challenges, this technology is often not prescribed for this population due to safety concerns. An intelligent power wheelchair (IPW) system represents a potential intervention that could help to overcome these concerns. The purpose of this study was to explore a) how residents experienced an IPW that used three different modes of control and b) what perceived effect the IPW would have on their daily lives. We interviewed 10 LTC residents with mild or moderate cognitive impairment twice, once before and once after testing the IPW. Interviews were conducted using a semi-structured interview guide, audio recorded and transcribed verbatim for thematic analyses. Our analyses identified three overarching themes: (1) the difference an IPW would make, (2) the potential impact of the IPW on others and (3) IPW-related concerns. Findings from this study confirm the need for and potential benefits of IPW use in LTC. Future studies will involve testing IPW improvements based on feedback and insights from this study. Implications for rehabilitation Intelligent power wheelchairs may enhance participation and improve safety and feelings of well-being for long-term care residents with cognitive impairments. Intelligent power wheelchairs could potentially have an equally positive impact on facility staff, other residents, and family and friends by decreasing workload and increasing safety.
Larsen, Camilla Marie; Hansen, Sabrina S.; Hansen, Line S.
Translation and Cross-Cultural Adaptation of the Danish Version: Wheelchair Users Shoulder Pain Index (WUSPI). Larsen CM1,2; Hansen SS2; Hansen LH2; Bruun P1; Juul-Kristensen B1,3. 1Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark. 2Health Sciences Research...
de Witte, Annemarie M. H.; Berger, Monique A. M.; Hoozemans, Marco J. M.; Veeger, Dirkjan H. E. J.; van der Woude, Lucas H. V.
The aim of this study was to determine to what extent mobility performance is influenced by offensive or defensive situations and ball possession and to what extent these actions are different for the field positions. From video analysis, the relative duration of the various wheelchair movements
Moore, Britta; Fuhrman, Susan; Karg, Patricia
This study quantitatively reviews publicly available state policies as they relate to the transportation of wheelchair-seated students in school buses. Inclusion of best practices in specially equipped school bus and driver training policies was assessed. Key points of interest within state policies were identified based on site visits, common…
Chénier, Félix; Aissaoui, Rachid; Gauthier, Cindy; Gagnon, Dany H
The commercially available SmartWheel TM is largely used in research and increasingly used in clinical practice to measure the forces and moments applied on the wheelchair pushrims by the user. However, in some situations (i.e. cambered wheels or increased pushrim weight), the recorded kinetics may include dynamic offsets that affect the accuracy of the measurements. In this work, an automatic method to identify and cancel these offsets is proposed and tested. First, the method was tested on an experimental bench with different cambers and pushrim weights. Then, the method was generalized to wheelchair propulsion. Nine experienced wheelchair users propelled their own wheelchairs instrumented with two SmartWheels with anti-slip pushrim covers. The dynamic offsets were correctly identified using the propulsion acquisition, without needing a separate baseline acquisition. A kinetic analysis was performed with and without dynamic offset cancellation using the proposed method. The most altered kinetic variables during propulsion were the vertical and total forces, with errors of up to 9N (p<0.001, large effect size of 5). This method is simple to implement, fully automatic and requires no further acquisitions. Therefore, we advise to use it systematically to enhance the accuracy of existing and future kinetic measurements. Copyright © 2016 IPEM. Published by Elsevier Ltd. All rights reserved.
Chugo, Daisuke; Fujita, Kazuya; Sakaida, Yuki; Yokota, Sho; Takase, Kunikatsu
For reducing the risk of pressure sore caused by long period sitting on a wheelchair, we develop a depressurization motion assistance system which is low cost and suitable for practical use. Our developing system consists of a seating cushion which the patient sits on and four air cells which can lift or incline the seating cushion. Each air cell is actuated by small air compressor, which can drive using batteries on the wheelchair respectively, and each compressor has a pressure sensor on its body. In this paper, our key ideas are two topics. One topic is mechanical design for practical use. We realize thin mechanism which enables easy implementation to the general wheelchair. For realizing this thinly design, we develop the tilt mechanism using elasticity of acrylic resin and the controller which uses only pressure sensors for estimating its lifting height and inclination. The other topic is assistance control scheme based on the patient's depressurization operation for increasing a rehabilitation performance. For realizing the proposed control scheme, we analyze the hip depressurization operation by the nursing specialists and use its results for estimating the patient's condition. Using our system, the patient can depressurize by his own will on the general wheelchair easily. The performance of our system is verified by experiments using our prototype. © 2011 IEEE
Lenton, J. P.; Fowler, N.; Nicholson, G.; Tolfrey, K.; Goosey-Tolfrey, V.; van der Woude, Lucas
To compare the force application characteristics at various push frequencies of asynchronous (ASY) and synchronous (SYN) hand-rim propulsion, 8 able-bodied participants performed a separate sub-maximal exercise test on a wheelchair roller ergometer for each propulsion mode. Each test consisted of a
van Koppenhagen, Casper F.; de Groot, Sonja; Post, Marcel W. M.; van Asbeck, Floris W. A.; Spijkerman, Dorien; Faber, Willemijn X. M.; Lindeman, Eline; van der Woude, Lucas H. V.
Objective: To elucidate the course and determinants of wheelchair exercise capacity in spinal cord injury up to 5 years after discharge from inpatient rehabilitation, and to describe loss to follow-up. Design: Prospective cohort study, with measurements at the start and discharge from inpatient
Cláudia Regina Cabral Galvão
Full Text Available The Orthesis and Prosthesis Grant Program from Rio Grande do Norte State was restructured by a team of occupational and physical therapists specialized in Assistive Technology. The sector has a showroom for the equipment, prepares prescriptions, and makes deliveries after individual assessment made by the team. The work is developed in conjunction with orthopedic workshop technicians to adjust and adapt the wheelchairs when necessary. Social workers guide and follow the bureaucratic processes of documentation and purchasing, which allows the handing in of wheelchairs throughout the year. This program is considered distinctive compared to programs from other states. In this work, a study was conducted to characterize the demand for locomotion assistance devices, such as wheelchairs, and describe the delivery and acquisition process of the Orthesis and Prosthesis Grant Program from Rio Grande do Norte State. The study was carried out after analyzing and correlating information on the wheelchair delivery process in the past three years. A discussion on the organizational structure, operation, and acquisition facilities of this program is presented in order to promote the social inclusion of people with special needs.
Cooper, Rory A.; Ferretti, Eliana; Oyster, Michelle; Kelleher, Annmarie; Cooper, Rosemarie
Participation is considered the most meaningful outcome of rehabilitation. The purpose of this study was to investigate whether there were correlations between wheelchair activity recorded with a data logger and community participation as measured by the Participation Survey/Mobility. Data from 16 participants were included in this study. Data…
DeLeon, Iser G.; Kahng, SungWoo; Rodriguez-Catter, Vanessa; Sveinsdottir, Ingibjorg; Sadler, Christine
An adolescent with developmental disabilities who used a wheelchair was anecdotally observed to display little aggressive behavior when being pushed, but higher rates when movement was terminated. A functional analysis confirmed the elevated aggression and the child was taught to request movement through appropriate means. Aggression decreased…
Dallmeijer, A J; Kappe, Y J; Veeger, DirkJan (H. E. J.); Janssen, T W; van der Woude, L H
In order to investigate the influence of the level of the spinal cord injury (SCI) on anaerobic or short-term power production and propulsion technique, 23 male SCI subjects performed a 30-second sprint test on a stationary wheelchair ergometer. Kinematic parameters were studied both inter- and
Mason, Barry S.; Van der Woude, Lucas H. V.; Tolfrey, Keith; Lenton, John P.; Goosey-Tolfrey, Victoria L.
MASON, B. S., L. H. V. VAN DER WOUDE, K. TOLFREY, J. P. LENTON, and V. L. GOOSEY-TOLFREY. Effects of Wheel and Hand-Rim Size on Submaximal Propulsion in Wheelchair Athletes. Med. Sci. Sports Exerc., Vol. 44, No. 1, pp. 126-134, 2012. Purpose: This study aimed to investigate the effects of fixed gear
van der Woude, L.H.V.; de Groot, S.; Janssen, T.W.J.
Those with lower limb disabilities are often dependent on manually propelled wheelchairs for their mobility, in Europe today some 3.3 million people. This implies a transfer from leg to arm work for ambulation and all other activities of daily living (ADL). Compared to the legs, arm work is less
Lundberg, Neil R.; Zabriskie, Ramon B.; Smith, Kevin M.; Barney, Keith W.
The purpose of this study was to examine the effects of a campus-wide intramural wheelchair sports program on attitudes toward people with disabilities. The sample consisted of 126 participants at a large, western university. A quasi-experimental pre-post design was used. Results indicated that there was a significant decrease in discomfort in…
Bekker, Michel J.; Vegter, Riemer J.K.; van der Scheer, Jan W.; Hartog, Johanneke; de Groot, Sonja; de Vries, Wiebe; Arnet, Ursina; van der Woude, Lucas H.V.; Veeger, Dirkjan (.H.E.J)
Background: Altered scapular kinematics have been associated with shoulder pain and functional limitations. To understand kinematics in persons with spinal cord injury during manual handrim wheelchair propulsion, a description of normal scapular behaviour in able-bodied persons during this specific
Harrison, C. S.; Grant, P. M.; Conway, B. A.
The increasing importance of inclusive design and in particular accessibility guidelines established in the U.K. 1996 Disability Discrimination Act (DDA) has been a prime motivation for the work on wheelchair access, a subset of the DDA guidelines, described in this article. The development of these guidelines mirrors the long-standing provisions…
Goosey-Tolfrey, V.; Keil, M.; Brooke-Wavell, K.; de Groot, S.
The purpose of this study was to assess the agreement in body composition measurements of wheelchair athletes using skinfolds, bio-impedance analysis (BIA) and air displacement plethysmography (ADP) relative to dual-energy X-ray absorptiometry (DXA). A secondary objective was to develop new skinfold
van Drongelen, S.; van der Woude, L. H. V.; Veeger, DirkJan (H. E. J.)
Background: This study focuses on the relationship between overuse in association with wheelchair activities of daily living and risks for osteoarthrosis in the acromioclavicular and sternoclavicular joints. The aim is to quantify the joint moments and joint reaction forces in all three joints of
van Drongelen, S.V.; van der Woude, L.H.V.; Veeger, H.E.J.
Background: This study focuses on the relationship between overuse in association with wheelchair activities of daily living and risks for osteoarthrosis in the acromioclavicular and sternoclavicular joints. The aim is to quantify the joint moments and joint reaction forces in all three joints of
Lindemann, Kurt; Cherney, James L.
This article investigates communicative practices surrounding wheelchair rugby, a growing sport played worldwide by people with quadriplegia. Researchers have studied extensively the practice of using sport for rehabilitation, but the role of communication in this process has been overlooked. We argue that participating in this sport is itself a…
Giner-Pascual, Manuel; Alcanyis-Alberola, Modesto; Millan Gonzalez, Luis; Aguilar-Rodriguez, Marta; Querol, Felipe
The objective of this study was to determine the relationship between shoulder pain and the position of the seat of a wheelchair relative to the ground and to determine the relationship between shoulder pain and structural damage. A transversal study of a patient cohort of 140 patients with grade A and B spinal cord injuries below the T1 vertebra,…
De Witte, Annemarie M.H.; Berger, Monique A.M.; Hoozemans, Marco J.M.; Veeger, H.E.J.; van der Woude, Lucas H.V.
The aim of this study was to determine to what extent mobility performance is influenced by offensive or defensive situations and ball possession and to what extent these actions are different for the field positions. From video analysis, the relative duration of the various wheelchair movements
Weissland, Thierry; Faupin, Arnaud; Borel, Benoit; Berthoin, Serge; Leprêtre, Pierre-Marie
A bioenergetical analysis of manoeuvrability and agility performance for wheelchair players is inexistent. It was aimed at comparing the physiological responses and performance obtained from the octagon multistage field test (MFT) and the modified condition in "8 form" (MFT-8). Sixteen trained wheelchair basketball players performed both tests in randomized condition. The levels performed (end-test score), peak values of oxygen uptake (VO2peak), minute ventilation (VEpeak), heart rate (HRpeak), peak and relative blood lactate (Δ[Lact(-)] = peak--rest values), and the perceived rating exertion (RPE) were measured. MFT-8 induced higher VO2peak and VEpeak values compared to MFT (VO2peak: 2.5 ± 0.6 versus 2.3 ± 0.6 L · min(-1) and VEpeak: 96.3 ± 29.1 versus 86.6 ± 23.4 L · min(-1); P < 0.05) with no difference in other parameters. Significant relations between VEpeak and end-test score were correlated for both field tests (P < 0.05). At exhaustion, MFT attained incompletely VO2peak and VEpeak. Among experienced wheelchair players, MFT-8 had no effect on test performance but generates higher physiological responses than MFT. It could be explained by demands of wheelchair skills occurring in 8 form during the modified condition.
Sprigle, Stephen; Huang, Morris
Propulsion effort of manual wheelchairs, a major determinant of user mobility, is a function of human biomechanics and mechanical design. Human studies that investigate both variables simultaneously have resulted in largely inconsistent outcomes, motivating the implementation of a robotic propulsion system that characterizes the inherent mechanical performance of wheelchairs. This study investigates the impacts of mass and mass distribution on manual wheelchair propulsion by configuring an ultra-lightweight chair to two weights (12-kg and 17.6-kg) and two load distributions (70% and 55% on drive wheels). The propulsion torques of these four configurations were measured for a straight maneuver and a fixed-wheel turn, on both tile and carpet. Results indicated that increasing mass to 17.6-kg had the largest effect on straight acceleration, requiring 7.4% and 5.8% more torque on tile and carpet, respectively. Reducing the drive wheel load to 55% had the largest effect on steady-state straight motion and on both turning acceleration and steady-state turning; for tile and carpet, propulsion torque increased by 13.5% and 11.8%, 16.5% and 4.1%, 73% and 5.1%, respectively. These results demonstrate the robot's high sensitivity, and support the clinical importance of evaluating effects of wheelchair mass and axle position on propulsion effort across maneuvers and surfaces.
Wästlund, Erik; Sponseller, Kay; Pettersson, Ola; Bared, Anders
This article describes a novel add-on for powered wheelchairs that is composed of a gaze-driven control system and a navigation support system. The add-on was tested by three users. All of the users were individuals with severe disabilities and no possibility of moving independently. The system is an add-on to a standard power wheelchair and can be customized for different levels of support according to the cognitive level, motor control, perceptual skills, and specific needs of the user. The primary aim of this study was to test the functionality and safety of the system in the user's home environment. The secondary aim was to evaluate whether access to a gaze-driven powered wheelchair with navigation support is perceived as meaningful in terms of independence and participation. The results show that the system has the potential to provide safe, independent indoor mobility and that the users perceive doing so as fun, meaningful, and a way to reduce dependency on others. Independent mobility has numerous benefits in addition to psychological and emotional well-being. By observing users' actions, caregivers and healthcare professionals can assess the individual's capabilities, which was not previously possible. Rehabilitation can be better adapted to the individual's specific needs, and driving a wheelchair independently can be a valuable, motivating training tool.
Bekker, Michel J; Vegter, Riemer J K; van der Scheer, Jan W; Hartog, Johanneke; de Groot, Sonja; de Vries, Wiebe; Arnet, Ursina; van der Woude, Lucas H V; Veeger, Dirkjan H E J
BACKGROUND: Altered scapular kinematics have been associated with shoulder pain and functional limitations. To understand kinematics in persons with spinal cord injury during manual handrim wheelchair propulsion, a description of normal scapular behaviour in able-bodied persons during this specific
Tsai, Chung-Ying; Lin, Chien-Ju; Huang, Yueh-Chu; Lin, Po-Chou; Su, Fong-Chin
The rear-wheel camber, defined as the inclination of the rear wheels, is usually used in wheelchair sports, but it is becoming increasingly employed in daily propulsion. Although the rear-wheel camber can increase stability, it alters physiological performance during propulsion. The purpose of the study is to investigate the effects of rear-wheel cambers on temporal-spatial parameters, joint angles, and propulsion patterns. Twelve inexperienced subjects (22.3±1.6 yr) participated in the study. None had musculoskeletal disorders in their upper extremities. An eight-camera motion capture system was used to collect the three-dimensional trajectory data of markers attached to the wheelchair-user system during propulsion. All participants propelled the same wheelchair, which had an instrumented wheel with cambers of 0°, 9°, and 15°, respectively, at an average velocity of 1 m/s. The results show that the rear-wheel camber significantly affects the average acceleration, maximum end angle, trunk movement, elbow joint movement, wrist joint movement, and propulsion pattern. The effects are especially significant between 0° and 15°. For a 15° camber, the average acceleration and joint peak angles significantly increased (p propulsion patterns and joint range of motion. When choosing a wheelchair with camber adjustment, the increase of joint movements and the base of support should be taken into consideration.
Slowik, Jonathan S; Requejo, Philip S; Mulroy, Sara J; Neptune, Richard R
The hand pattern used during manual wheelchair propulsion (i.e., full-cycle hand path) can provide insight into an individual's propulsion technique. However, previous analyses of hand patterns have been limited by their focus on a single propulsion condition and reliance on subjective qualitative characterization methods. The purpose of this study was to develop a set of objective quantitative parameters to characterize hand patterns and determine the influence of propulsion speed and grade of incline on the patterns preferred by manual wheelchair users. Kinematic and kinetic data were collected from 170 experienced manual wheelchair users on an ergometer during three conditions: level propulsion at their self-selected speed, level propulsion at their fastest comfortable speed and graded propulsion (8%) at their level self-selected speed. Hand patterns were quantified using a set of objective parameters, and differences across conditions were identified. Increased propulsion speed resulted in a shift away from under-rim hand patterns. Increased grade of incline resulted in the hand remaining near the handrim throughout the cycle. Manual wheelchair users change their hand pattern based on task-specific constraints and goals. Further work is needed to investigate how differences between hand patterns influence upper extremity demand and potentially lead to the development of overuse injuries and pain. Copyright © 2015 Elsevier Ltd. All rights reserved.
DeGroot, Keri K; Hollingsworth, Holly H; Morgan, Kerri A; Morris, Carrie L; Gray, David B
To determine if verbal training with visual feedback improved manual wheelchair propulsion; to examine propulsion differences between an individual with paraplegia and an individual with tetraplegia. Quasi-experimental study: Nine manual wheelchair-using adults participated in propulsion assessments and training. Baseline propulsion performance was measured on several tasks on different surfaces. Participants were trained on a wheelchair treadmill with verbal and visual feedback to increase push length, reduce push frequency and to modify propulsion pattern. Handrim biomechanics were measured with an instrumented wheel. Changes in propulsion were assessed. Differences in propulsion characteristics between a participant with paraplegia and a participant with tetraplegia were examined. Push length increased (p propulsion characteristics between a participant with paraplegia and a participant with tetraplegia. Verbal training may produce changes in push biomechanics of manual wheelchair users. Longer training periods may be needed to sustain propulsion changes. Findings from this study support other studies that have shown propulsion differences between people with tetraplegia and paraplegia. Propulsion training for populations with upper-extremity impairments warrants further study.
van Drongelen, Stefan; Arnet, Ursina; Veeger, DirkJan (H E. J); van der Woude, Lucas H. V.
Objective: To investigate the influence of workload setting (speed at constant power, method to impose power) on the propulsion technique (i.e. force and timing characteristics) in handrim wheelchair propulsion. Method: Twelve able-bodied men participated in this study. External forces were measured
Mason, Barry; Lenton, John; Leicht, Christof; Goosey-Tolfrey, Victoria
The purpose of the study was to determine which laboratory-based modality provides the most valid physiological and biomechanical representation of over-ground sports wheelchair propulsion. Fifteen able-bodied participants with previous experience of wheelchair propulsion performed a 3-minute exercise trial at three speeds (4, 6 and 8 km ∙ h(-1)) in three testing modalities over separate sessions: (i) over-ground propulsion on a wooden sprung surface; (ii) wheelchair ergometer propulsion; (iii) treadmill propulsion at four different gradients (0%, 0.7%, 1.0% and 1,3%). A 0.7% treadmill gradient was shown to best reflect the oxygen uptake (7.3 to 9.1% coefficient of variation (CV)) and heart rate responses (4.9 to 6.4% CV) of over-ground propulsion at 4 and 6 km ∙ h(-1). A 1.0% treadmill gradient provided a more valid representation of oxygen uptake during over-ground propulsion at 8 km ∙ h(-1) (8.6% CV). Physiological demand was significantly underestimated in the 0% gradient and overestimated in the 1.3% gradient and wheelchair ergometer trials compared to over-ground trials (Ppropulsion at lower speeds (4 and 6 km ∙ h(-1)) whereas a 1.0% gradient may be more suitable at 8 km ∙ h(-1).
Qi, Liping; Wakeling, James; Grange, Simon; Ferguson-Pell, Martin
The aim of this study was to investigate how the coordination patterns of shoulder muscles change with level-ground and incline wheelchair propulsion. Wheelchair kinetics and electromyography (EMG) activity of seven muscles were recorded with surface electrodes for 15 nondisabled subjects during wheelchair propulsion on a stationary ergometer and wooden ramp (4 degree slope). Kinetic data were measured by a SmartWheel. The kinetics variables and the onset, cessation, and duration of EMG activity from seven muscles were compared with paired t-tests for two sessions. Muscle coordination patterns across seven muscles were analyzed by principal component analysis. Push forces on the push rim and the percentage of push phase in the cycle increased significantly during incline propulsion. Propulsion condition and posture affected muscle coordination patterns. During incline propulsion, there was more intense and longer EMG activity of push muscles in the push phase and less EMG activity of the recovery muscles, which corresponded with the increased kinetic data total force output and longer push phase in the incline condition. This work establishes a framework for developing a performance feedback system for wheelchair users to better coordinate their muscle patterning activity.
Meena, Yogesh Kumar; Cecotti, Hubert; Wong-Lin, KongFatt; Prasad, Girijesh
Human-computer interaction (HCI) research has been playing an essential role in the field of rehabilitation. The usability of the gaze controlled powered wheelchair is limited due to Midas-Touch problem. In this work, we propose a multimodal graphical user interface (GUI) to control a powered wheelchair that aims to help upper-limb mobility impaired people in daily living activities. The GUI was designed to include a portable and low-cost eye-tracker and a soft-switch wherein the wheelchair can be controlled in three different ways: 1) with a touchpad 2) with an eye-tracker only, and 3) eye-tracker with soft-switch. The interface includes nine different commands (eight directions and stop) and integrated within a powered wheelchair system. We evaluated the performance of the multimodal interface in terms of lap-completion time, the number of commands, and the information transfer rate (ITR) with eight healthy participants. The analysis of the results showed that the eye-tracker with soft-switch provides superior performance with an ITR of 37.77 bits/min among the three different conditions (pusers.
Bhatnagar, Tim; Ben Mortensen, W; Mattie, Johanne; Wolff, Jamie; Parker, Claire; Borisoff, Jaimie
Exoskeleton technology has potential benefits for wheelchair users' health and mobility. However, there are practical barriers to their everyday use as a mobility device. In particular, challenges related to travelling longer distances and transitioning between using a wheelchair and exoskeleton walking may present significant deterrents to regular exoskeleton use. In an effort to remove these barriers, a combined exoskeleton-wheelchair concept ('COMBO') has been proposed, which aims to achieve the benefits of both these mobility technologies. Given the inherent importance of including user-stakeholder opinions when designing an assistive technology solution, a study was undertaken to explore the perspectives of wheelchair users and healthcare professionals on the proposed conceptual design of the COMBO. An online survey with quantitative and qualitative components was conducted with wheelchair users and healthcare professionals working directly with individuals with mobility impairments. Respondents rated whether they would use or recommend a COMBO for four potential reasons. Nine design features were rated and compared in terms of their importance. Content analysis was used to analyze data from an open-ended question regarding additional perceptions about using or recommending a COMBO. A total of 481 survey responses were analyzed, 354 from wheelchair users and 127 from healthcare professionals. Potential health benefits was the most highly rated reason for potential use or recommendation of a COMBO. Of the 9 design features, 2 had a median rating of very important: inclusion of a fall-protection mechanism, and the ability for the operator to use their hands while standing. Qualitative findings indicated that health and physical benefits, use for daily life activities, and psychosocial benefits were important considerations in whether to use or recommend the COMBO. This study captures the opinions and perspectives of two stakeholder groups for an exoskeleton-wheelchair
Learmonth, Y C; Kinnett-Hopkins, D; Rice, I M; Dysterheft, J L; Motl, R W
This is an experimental design. This study examined the association between rates of energy expenditure (that is, oxygen consumption (VO2)) and accelerometer counts (that is, vector magnitude (VM)) across a range of speeds during manual wheelchair propulsion on a motor-driven treadmill. Such an association allows for the generation of cutoff points for quantifying the time spent in moderate-to-vigorous physical activity (MVPA) during manual wheelchair propulsion. The study was conducted in the University Laboratory. Twenty-four manual wheelchair users completed a 6-min period of seated rest and three 6-min periods of manual wheelchair propulsion on a motor-driven wheelchair treadmill. The 6-min periods of wheelchair propulsion corresponded with three treadmill speeds (1.5, 3.0 and 4.5 mph) that elicited a range of physical activity intensities. Participants wore a portable metabolic unit and accelerometers on both wrists. Primary outcome measures included steady-state VO2 and VM, and the strength of association between VO2 and VM was based on the multiple correlation and squared multiple correlation coefficients from linear regression analyses. Strong linear associations were established between VO2 and VM for the left (R=0.93±0.44; R2=0.87±0.19), right (R=0.95±0.37; R2=0.90±0.14) and combined (R=0.94±0.38; R2=0.88±0.15) accelerometers. The linear relationship between VO2 and VM for the left, right and combined wrists yielded cutoff points for MVPA of 3659 ±1302, 3630±1403 and 3644±1339 counts min(-1), respectively. We provide cutoff points based on the linear association between energy expenditure and accelerometer counts for estimating time spent in MVPA during manual wheelchair propulsion using wrist-worn accelerometry. The similarity across wrist location permits flexibility in selecting a location for wrist accelerometry placement.
Borisoff, Jaimie F; Ripat, Jacquie; Chan, Franco
To describe how people who use wheelchairs participate and move at home and in the community over an entire yearlong period, including during times of inclement weather conditions. Longitudinal mixed-methods research study. Urban community in Canada. People who use a wheelchair for home and community mobility (N=11). Not applicable. Use of a global positioning system (GPS) tracker for movement in community (number of trips per day), use of accelerometer for bouts of wheeling mobility (number of bouts per day, speed, distance, and duration), prompted recall interviews to identify supports and barriers to mobility and participation. More trips per day were taken during the summer (P= .03) and on days with no snow and temperatures above 0°C. Participants reliant on public transportation demonstrated more weather-specific changes in their trip patterns. The number of daily bouts of mobility remained similar across seasons; total daily distance wheeled, duration, and speed were higher on summer days, days with no snow, and days with temperatures above 0°C. A higher proportion of outdoor wheeling bouts occurred in summer (P=.02) and with temperatures above 0°C (P=.03). Inaccessible public environments were the primary barrier to community mobility and participation; access to social supports and private transportation were the primary supports. Objective support is provided for the influence of various seasonal weather conditions on community mobility and participation for people who use a wheelchair. Longitudinal data collection provided a detailed understanding of the patterns of, and influences on, wheelchair mobility and participation within wheelchair users' own homes and communities. Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Nightingale, T E; Walhin, J P; Thompson, D; Bilzon, J L J
To assess the error in predicting physical activity energy expenditure (PAEE), using a multisensor device in wheelchair users, and to examine the efficacy of using an individual heart rate calibration (IC) method. 15 manual wheelchair users (36±10 years, 72±11 kg) completed 10 activities: resting, folding clothes, wheelchair propulsion on a 1% gradient (3456 and 7 km/h) and propulsion at 4 km/h (with an additional 8% of body mass, 2% and 3% gradient) on a motorised wheelchair treadmill. Criterion PAEE was measured using a computerised indirect calorimetry system. Participants wore a combined accelerometer and heart rate monitor (Actiheart). They also performed an incremental arm crank ergometry test to exhaustion which permitted retrospective individual calibration of the Actiheart for the activity protocol. Linear regression analysis was conducted between criterion (indirect calorimetry) and estimated PAEE from the Actiheart using the manufacturer's proprietary algorithms (group calibration, GC) or IC. Bland-Altman plots were used and mean absolute error was calculated to assess the agreement between criterion values and estimated PAEE. Predicted PAEE was significantly (p<0.01) correlated with criterion PAEE (GC, r=0.76 and IC, r=0.95). The absolute bias ±95% limits of agreement were 0.51±3.75 and -0.22±0.96 kcal/min for GC and IC, respectively. Mean absolute errors across the activity protocol were 51.4±38.9% using GC and 16.8±15.8% using IC. PAEE can be accurately and precisely estimated using a combined accelerometer and heart rate monitor device, with integration of an IC. Interindividual variance in cardiovascular function and response to exercise is high in this population. Therefore, in manual wheelchair users, we advocate the use of an IC when using the Actiheart to predict PAEE.
Full Text Available Wheelchairs for children with impaired mobility provide health, developmental and psychosocial benefits, however there is limited understanding of how mobility aids affect the health-related quality of life of children with impaired mobility. Preference-based health-related quality of life outcome measures are used to calculate quality-adjusted life years; an important concept in health economics. The aim of this research was to understand how young wheelchair users and their parents define health-related quality of life in relation to mobility impairment and wheelchair use.The sampling frame was children with impaired mobility (≤18 years who use a wheelchair and their parents. Data were collected through semi-structured face-to-face interviews conducted in participants' homes. Qualitative framework analysis was used to analyse the interview transcripts. An a priori thematic coding framework was developed. Emerging codes were grouped into categories, and refined into analytical themes. The data were used to build an understanding of how children with impaired mobility define health-related quality of life in relation to mobility impairment, and to assess the applicability of two standard measures of health-related quality of life.Eleven children with impaired mobility and 24 parents were interviewed across 27 interviews. Participants defined mobility-related quality of life through three distinct but interrelated concepts: 1 participation and positive experiences; 2 self-worth and feeling fulfilled; 3 health and functioning. A good degree of consensus was found between child and parent responses, although there was some evidence to suggest a shift in perception of mobility-related quality of life with child age.Young wheelchair users define health-related quality of life in a distinct way as a result of their mobility impairment and adaptation use. Generic, preference-based measures of health-related quality of life lack sensitivity in this
Full Text Available The relationships among physical characteristics, performance, and functional ability classification of younger wheelchair basketball players have been barely investigated to date. The purpose of this work was to assess anthropometry, body composition, and performance in sport-specific field tests in a national sample of Italian younger wheelchair basketball players as well as to evaluate the association of these variables with the players' functional ability classification and game-related statistics. Several anthropometric measurements were obtained for 52 out of 91 eligible players nationwide. Performance was assessed in seven sport-specific field tests (5m sprint, 20m sprint with ball, suicide, maximal pass, pass for accuracy, spot shot and lay-ups and game-related statistics (free-throw points scored per match, two- and three-point field-goals scored per match, and their sum. Association between variables, and predictivity was assessed by correlation and regression analysis, respectively. Players were grouped into four Classes of increasing functional ability (A-D. One-way ANOVA with Bonferroni's correction for multiple comparisons was used to assess differences between Classes. Sitting height and functional ability Class especially correlated with performance outcomes, but wheelchair basketball experience and skinfolds did not. Game-related statistics and sport-specific field-test scores all showed significant correlation with each other. Upper arm circumference and/or maximal pass and lay-ups test scores were able to explain 42 to 59% of variance in game-related statistics (P<0.001. A clear difference in performance was only found for functional ability Class A and D.In younger wheelchair basketball players, sitting height positively contributes to performance. The maximal pass and lay-ups test should be carefully considered in younger wheelchair basketball training plans. Functional ability Class reflects to a limited extent the actual
Dicianno, Brad E; Morgan, Amy; Lieberman, Jenny; Rosen, Lauren
This article, approved by the Rehabilitation Engineering & Assistive Technology Society of North America Board of Directors on December 23, 2013, shares typical clinical applications and provides evidence from the literature supporting the use of wheelchair standers.
Micaele Kedma Ribeiro de Moraes
Full Text Available Seating and positioning are an assistive technology resource that aims to improve functional performance in the wheelchair. The aim of this paper was to find in the literature studies that addressed the benefits of seating and positioning in a wheelchair and factors that interfere with the prescription and use of this technology. Articles found that discuss the benefits addressed: the functionality and respiratory function; the pressure ulcer prevention; and user satisfaction and the family with assistive technology. Articles discussing the factors linked to prescription and use of adapting wheelchairs are those that address the environmental factors, components and wheelchair accessories. There are factors involved in the prescription process to achieve its benefits through its use, the prescribed process must have an interdisciplinary and biopsychosocial approach applied individually to each patient.
Weissland, Thierry; Faupin, Arnaud; Borel, Benoit; Leprêtre, Pierre-Marie
The intermittent nature of wheelchair court sports suggests using a similar protocol to assess repeated shuttles and recovery abilities. This study aimed to compare performances, physiological responses and perceived rating exertion obtained from the continuous multistage field test (MFT) and the 30-15 intermittent field test (30-15IFT). Eighteen trained wheelchair basketball players (WBP) (WBP: 32.0 ? 5.7 y, IWBF classification: 2.9 ? 1.1 points) performed both incremental field tests in ran...
Skucas, Kestutis; Pokvytyte, Vaida
The aim of this paper was to investigate the effect of short-term period, moderate intensity and high volume endurance training on physiological variables in elite wheelchair basketball players. Eight wheelchair basketball players were examined. The subjects participated in a two-week intervention program of mainly two training types: wheelchair basketball and wheelchair driving endurance training. The subjects performed the continuously increasing cycling exercise (CCE) at the constant 60 rpm arm cranking speed at the beginning of the program and after two weeks of the program. The initial workload was 20 W, then the workload was increased by 2 W every 5 seconds until fatigue. The post training of the wheelchair basketball group in the study showed a significant improvement in the peak oxygen uptake (VO2peak) and the peak power output (POpeak). VO2peak increased by 9% from 2.32±0.16 L/min to 2.53±0.2 L/min (Pbasketball squad had relatively high levels of aerobic fitness prior to participating in the endurance training program. Nevertheless, the high-volume, moderate-intensity, short-term training program, which evolved over the two-weeks period, resulted in the improvement of the athlete's aerobic endurance. The ventilatory threshold (VT) and the second ventilatory threshold (VT2) are good markers for aerobic capacity of wheelchair athletes.
Paula W. Rushton PhD
Full Text Available Objective: In this study, we aimed to describe the burden of family caregivers providing powered wheelchair-related and overall assistance and test the hypotheses that caregiver burden correlates with participation, wheelchair skills capacity, anxiety, depression, and social support. Methods: Cross-sectional study. Participants included 35 family caregivers of powered wheelchair users. Caregivers were assessed using the Power Mobility Caregiver Assistive Technology Outcome Measure, Late Life Disability Instrument, Wheelchair Skills Test Questionnaire for caregivers, Hospital Anxiety and Depression Scale, and Interpersonal Support Evaluation List–12. Results: The most burdensome powered wheelchair assistance items were providing verbal hints/directions, needing to be nearby, anxiety, and fear that user may be harmed. The most burdensome overall assistance item was feeling limited in recreational/leisure activities. Caregiver burden was significantly correlated with participation limitations, anxiety, depression, and social support. Discussion: Caregivers experience burden for wheelchair-related and overall help, especially psychological burden. Such results have implications for the type of resources required to support family caregivers.
Lee, Joo-Hyun; Yoo, In-Gyu
[Purpose] The purpose of this study was to investigate the effects of the thickness of a wheelchair backrest provided for support and comfort on upper arm and trunk muscle load during wheelchair propulsion by using accelerometers. [Subjects and Methods] The Fourteen healthy participants were enrolled in this study. The study compared effects of three backrest conditions including no pad, a 3-cm-thick lumbar pad, and a 6-cm-thick lumbar pad. The instruments used for measurement were used two accelerometers. The participants were asked to propel their wheelchairs, which had been equipped with two accelerometers, 30 times. [Results] The intensity of muscle movement with the 3-cm-thick lumbar pad was significantly lower than the intensities with no lumbar pad and the 6-cm-thick lumbar pad. The muscle intensity did not differ significantly between the no pad and 6-cm-thick lumbar pad conditions. [Conclusion] An appropriately thick backrest has good effects on upper arm and trunk muscles during wheelchair propulsion. In the future, we must consider the appropriate backrest thickness for providing wheelchair users with a comfortable wheelchair.
Sol, Marleen Elisabeth; Verschuren, Olaf; de Groot, Laura; de Groot, Janke Frederike
Wheelchair mobility skills (WMS) training is regarded by children using a manual wheelchair and their parents as an important factor to improve participation and daily physical activity. Currently, there is no outcome measure available for the evaluation of WMS in children. Several wheelchair mobility outcome measures have been developed for adults, but none of these have been validated in children. Therefore the objective of this study is to develop a WMS outcome measure for children using the current knowledge from literature in combination with the clinical expertise of health care professionals, children and their parents. Mixed methods approach. Phase 1: Item identification of WMS items through a systematic review using the 'COnsensus-based Standards for the selection of health Measurement Instruments' (COSMIN) recommendations. Phase 2: Item selection and validation of relevant WMS items for children, using a focus group and interviews with children using a manual wheelchair, their parents and health care professionals. Phase 3: Feasibility of the newly developed Utrecht Pediatric Wheelchair Mobility Skills Test (UP-WMST) through pilot testing. Phase 1: Data analysis and synthesis of nine WMS related outcome measures showed there is no widely used outcome measure with levels of evidence across all measurement properties. However, four outcome measures showed some levels of evidence on reliability and validity for adults. Twenty-two WMS items with the best clinimetric properties were selected for further analysis in phase 2. Phase 2: Fifteen items were deemed as relevant for children, one item needed adaptation and six items were considered not relevant for assessing WMS in children. Phase 3: Two health care professionals administered the UP-WMST in eight children. The instructions of the UP-WMST were clear, but the scoring method of the height difference items needed adaptation. The outdoor items for rolling over soft surface and the side slope item were
Dysterheft, Jennifer; Rice, Ian; Learmonth, Yvonne; Kinnett-Hopkins, Dominque; Motl, Robert
To examine whether differences in propulsion technique as a function of intraindividual variability occur as a result of shoulder pain and physical activity (PA) level in full-time manual wheelchair users (MWUs). Observational study. Research laboratory. Adults (N=14) with spinal cord injury (mean age: 30.64±11.08) who used a wheelchair for >80% of daily ambulation and were free of any condition that could be worsened by PA. Not applicable. PA level was measured using the Physical Activity Scale for Individuals with Physical Disabilities (PASIPD), and shoulder pain was measured using the Wheelchair User's Shoulder Pain Index (WUSPI) survey. Mean and intraindividual variability propulsion metrics were measured for propulsion analysis. WUSPI scores indicated participants experienced low levels of shoulder pain. The results of the Spearman rank-order correlation revealed that PASIPD scores were significantly related to mean contact angle (r s =-.57) and stroke frequency (r s =.60) as well as to coefficient of variation of peak force (r s =.63), peak torque (r s =.59), contact angle (r s =.73), and stroke frequency (r s =.60). WUSPI scores were significantly correlated with only mean peak force (P=.02). No significant correlations were observed between PASIPD, WUSPI, and body mass index scores. Differences in propulsion technique were observed on the basis of PA levels. Participants with higher PASIPD scores used a more injurious stroke technique when propelling at higher speeds. This may indicate that active individuals who use injurious stroke mechanics may be at higher risk of injury. A strong relation was found between peak propulsion forces and shoulder pain. Rehabilitation professionals should emphasize the use of a protective stroke technique in both inactive and active MWUs during exercise and faster propulsion. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Full Text Available In wheelchair racing, the optimal pair of gloves, as well as knowledge of conditioning of glove-rim contact surfaces can have a significant impact on race performance. Extreme temperatures, humidity, wet or dry conditions can considerably influence not only the hand-rim friction coupling (effectiveness of the athlete’s push cycle but also the risk of injuries, blisters or sore areas which in turn, can influence the endurance of the athlete across long distance events. This paper reports an experimental study of the effect of bio-mimicry surface textures as a supplement for heightening glove-rim coupling for dry and wet weather conditions. The paper also provides recommendations for the practical implementation of the study findings through a proposal for the design and development of a pair of bespoke gloves for a wheelchair racing athlete for initial prototyping and performance trials.
Takahashi, Yoshiaki; Seki, Hirokazu
This paper proposes a novel regenerative braking control system of electric wheelchairs for senior citizen. "Electric powered wheelchair", which generates the driving force by electric motors according to the human operation, is expected to be widely used as a mobility support system for elderly people. This study focuses on the braking control to realize the safety and smooth stopping motion using the regenerative braking control technique based on fuzzy algorithm. The ride quality improvement and energy recycling can be expected by the proposed control system with stopping distance estimation and variable frequency control on the step-up/down chopper type of capacitor regenerative circuit. Some driving experiments confirm the effectiveness of the proposed control system.
Jonathan Bruce Shepherd
Full Text Available With the increasing rise of professionalism in sport, athletes, teams, and coaches are looking to technology to monitor performance in both games and training in order to find a competitive advantage. The use of inertial sensors has been proposed as a cost effective and adaptable measurement device for monitoring wheelchair kinematics; however, the outcomes are dependent on the reliability of the processing algorithms. Though there are a variety of algorithms that have been proposed to monitor wheelchair propulsion in court sports, they all have limitations. Through experimental testing, we have shown the Attitude and Heading Reference System (AHRS-based algorithm to be a suitable and reliable candidate algorithm for estimating velocity, distance, and approximating trajectory. The proposed algorithm is computationally inexpensive, agnostic of wheel camber, not sensitive to sensor placement, and can be embedded for real-time implementations. The research is conducted under Griffith University Ethics (GU Ref No: 2016/294.
Seki, Hirokazu; Tadakuma, Susumu
This paper describes a novel straight and circular road driving control scheme for electric power assisted wheelchairs. “Electric power assisted wheelchair” which assists the driving force by electric motors is expected to be widely used as a mobility support system for elderly people and disabled people, however, the performance of the straight and circular road driving must be further improved because the two wheels drive independently. This paper proposes a novel driving control scheme based on fuzzy algorithm to realize the stable and reliable driving on straight and circular roads. The suitable assisted torque of the right and left wheels is determined by fuzzy algorithm based on the posture angular velocity of the wheelchair and the human input torque proportion of the right and left wheels. Some experiments on the practical roads show the effectiveness of the proposed control system.
Murakami, Hiroki; Seki, Hirokazu; Minakata, Hideaki; Tadakuma, Susumu
This paper describes a novel operationality improvement control for electric power assisted wheelchairs. “Electric power assisted wheelchair” which assists the driving force by electric motors is expected to be widely used as a mobility support system for elderly people and disabled people, however, the performance of the straight and circular road driving must be further improved because the two wheels drive independently. This paper proposes a novel operationality improvement control by fuzzy algorithm to realize the stable driving on straight and circular roads. The suitable assisted torque of the right and left wheels is determined by fuzzy algorithm based on the posture angular velocity, the posture angle of the wheelchair, the human input torque proportion and the total human torque of the right and left wheels. Some experiments on the practical roads show the effectiveness of the proposed control system.
Full Text Available Introduction: Locomotion efficiency levels in individuals with spinal cord injury deal cord injury depend upon the level of spinal cord injury. Rehabilitation of people with spinal cord injury aims to prepare them to function in society in the best possible manner. One of the significant tasks of rehabilitation is to develop the skill of moving in a wheelchair, which becomes the only means of locomotion for most people. The aim of the study was to assess the influence of selected factors such as age, sex, time from the occurrence of the injury, the level of spinal cord injury, participation in Active Rehabilitation camps and the level of physical activity on the efficiency of locomotion in a wheelchair in individuals with spinal cord injury.
Headleand, Christopher J; Day, Thomas; Pop, Serban R; Ritsos, Panagiotis D; John, Nigel W
Control of a powered wheelchair is often not intuitive, making training of new users a challenging and sometimes hazardous task. Collisions, due to a lack of experience can result in injury for the user and other individuals. By conducting training activities in virtual reality (VR), we can potentially improve driving skills whilst avoiding the risks inherent to the real world. However, until recently VR technology has been expensive and limited the commercial feasibility of a general training solution. We describe Wheelchair-Rift, a cost effective prototype simulator that makes use of the Oculus Rift head mounted display and the Leap Motion hand tracking device. It has been assessed for face validity by a panel of experts from a local Posture and Mobility Service. Initial results augur well for our cost-effective training solution.
Seki, Hirokazu; Takahashi, Yoshiaki
This paper describes a novel capacitor regenerative braking control scheme of electric powered wheelchairs for efficient driving on downward slopes. An electric powered wheelchair, which generates the driving force by electric motors, is expected to be widely used as a mobility support system for elderly people and disabled people; however the energy efficiency has to be further improved because it is driven only by battery energy. This study proposes a capacitor regenerative braking circuit and two types of velocity control schemes with variable duty ratio. The proposed regenerative braking circuit is based on the step-up/down circuit with additional resistance and connects right and left motors in series in order to obtain a larger braking power. Some driving experiments on a practical downward slope show the effectiveness of the proposed control system.
van Drongelen, Stefan; Arnet, Ursina; Veeger, Dirkjan H E J; van der Woude, Lucas H V
To investigate the influence of workload setting (speed at constant power, method to impose power) on the propulsion technique (i.e. force and timing characteristics) in handrim wheelchair propulsion. Twelve able-bodied men participated in this study. External forces were measured during handrim wheelchair propulsion on a motor driven treadmill at different velocities and constant power output (to test the forced effect of speed) and at power outputs imposed by incline vs. pulley system (to test the effect of method to impose power). Outcome measures were the force and timing variables of the propulsion technique. FEF and timing variables showed significant differences between the speed conditions when propelling at the same power output (p propulsion technique parameters despite an overall constant power output. Copyright © 2012 IPEM. Published by Elsevier Ltd. All rights reserved.
Jonathan Bruce Shepherd; Tomohito Wada; David Rowlands; Daniel Arthur James
With the increasing rise of professionalism in sport, athletes, teams, and coaches are looking to technology to monitor performance in both games and training in order to find a competitive advantage. The use of inertial sensors has been proposed as a cost effective and adaptable measurement device for monitoring wheelchair kinematics; however, the outcomes are dependent on the reliability of the processing algorithms. Though there are a variety of algorithms that have been proposed to monito...
Giesbrecht, Edward Mark; Miller, William C; Jin, Boyang Tom; Mitchell, Ian M; Eng, Janice J
Background Alternative and innovative strategies such as mHealth and eLearning are becoming a necessity for delivery of rehabilitation services. For example, older adults who require a wheelchair receive little, if any, training for proficiency with mobility skills. This substantive service gap is due in part to restricted availability of clinicians and challenges for consumers to attend appointments. A research team of occupational therapists and computer scientists engaged clinicians, consu...
Torkia, Caryne; Ryan, Stephen E; Reid, Denise; Boissy, Patrick; Lemay, Martin; Routhier, François; Contardo, Resi; Woodhouse, Janet; Archambault, Phillipe S
To: 1) characterize the overall experience in using the McGill immersive wheelchair - community centre (miWe-CC) simulator; and 2) investigate the experience of presence (i.e., sense of being in the virtual rather than in the real, physical environment) while driving a PW in the miWe-CC. A qualitative research design with structured interviews was used. Fifteen clinicians and 11 children were interviewed after driving a power wheelchair (PW) in the miWe-CC simulator. Data were analyzed using the conventional and directed content analysis approaches. Overall, participants enjoyed using the simulator and experienced a sense of presence in the virtual space. They felt a sense of being in the virtual environment, involved and focused on driving the virtual PW rather than on the surroundings of the actual room where they were. Participants reported several similarities between the virtual community centre layout and activities of the miWe-CC and the day-to-day reality of paediatric PW users. The simulator replicated participants' expectations of real-life PW use and promises to have an effect on improving the driving skills of new PW users. Implications for rehabilitation Among young users, the McGill immersive wheelchair (miWe) simulator provides an experience of presence within the virtual environment. This experience of presence is generated by a sense of being in the virtual scene, a sense of being involved, engaged, and focused on interacting within the virtual environment, and by the perception that the virtual environment is consistent with the real world. The miWe is a relevant and accessible approach, complementary to real world power wheelchair training for young users.
Rankin, Jeffery W; Kwarciak, Andrew M; Richter, W Mark; Neptune, Richard R
The majority of manual wheelchair users will experience upper extremity injuries or pain, in part due to the high force requirements, repetitive motion and extreme joint postures associated with wheelchair propulsion. Recent studies have identified cadence, contact angle and peak force as important factors for reducing upper extremity demand during propulsion. However, studies often make comparisons between populations (e.g., able-bodied vs. paraplegic) or do not investigate specific measures of upper extremity demand. The purpose of this study was to use a musculoskeletal model and forward dynamics simulations of wheelchair propulsion to investigate how altering cadence, peak force and contact angle influence individual muscle demand. Forward dynamics simulations of wheelchair propulsion were generated to emulate group-averaged experimental data during four conditions: 1) self-selected propulsion technique, and while 2) minimizing cadence, 3) maximizing contact angle, and 4) minimizing peak force using biofeedback. Simulations were used to determine individual muscle mechanical power and stress as measures of muscle demand. Minimizing peak force and cadence had the lowest muscle power requirements. However, minimizing peak force increased cadence and recovery power, while minimizing cadence increased average muscle stress. Maximizing contact angle increased muscle stress and had the highest muscle power requirements. Minimizing cadence appears to have the most potential for reducing muscle demand and fatigue, which could decrease upper extremity injuries and pain. However, altering any of these variables to extreme values appears to be less effective; instead small to moderate changes may better reduce overall muscle demand. Copyright © 2012 Elsevier Ltd. All rights reserved.
Fitzsimmons, Suzanne; Schoenfelder, Deborah Perry
Depression is a problem that will continue to burden older adults and challenge health care providers. Failing to recognize and effectively treat depression in institutionalized older adults is sanctioning these members of society to live their final years in despair and emotional suffering. The wheelchair biking program described in this evidence-based practice guideline provides a refreshing, safe, innovative tool to address depression and improve quality of life in older adults.
MOUSSAOUI, Abdelhak; PRUSKI, Alain; MAAOUI, Choubeila
The aging world population requires more attention to the autonomy of individuals. The impaired physical abilities need changes in the built environment for an optimal use. Due to physical limitations, aged persons frequently become users of a wheelchair which also leads to limitations in accessing their homes. This paper describes a tool for evaluating mobility and grasping, thus allowing housing professionals to assess the needed changes in terms of accessibility. This tool, which uses the ...
Benzidane, Houcine; Mokrani, Djamel; Zerf, Mohammed
The research aims to determine the effect of a weighted basketball balls training program on some physical performance via wheelchair basketball players. The sample was selected in an intended manner including 20 players’. Divided into two equal groups (experimental 10 players, control 10 players) for the sports season 2016/2017. As protocol experimental, our training program for the experimental group was applied under researchers’ supervision, using Weighted basketball balls in the opposite...
Archambault, Philippe S; Blackburn, Émilie; Reid, Denise; Routhier, François; Miller, William C
Mobility is important for participation in daily activities and a power wheelchair (PW) can improve quality of life of individuals with mobility impairments. A virtual reality simulator may be helpful in complementing PW skills training, which is generally seen as insufficient by both clinicians and PW users. To this end, specific, ecologically valid activities, such as entering an elevator and navigating through a shopping mall crowd, have been added to the McGill wheelchair (miWe) simulator through a user-centred approach. The objective of this study was to validate the choice of simulated activities in a group of newly trained PW users. We recruited 17 new PW users, who practiced with the miWe simulator at home for two weeks. They then related their experience through the Short Feedback Questionnaire, the perceived Ease of Use Questionnaire, and semi-structured interviews. Participants in general greatly appreciated their experience with the simulator. During the interviews, this group made similar comments about the activities as our previous group of expert PW users had done. They also insisted on the importance of realism in the miWe activities, for their use in training. A PW simulator may be helpful if it supports the practice of activities in specific contexts (such as a bathroom or supermarket), to complement the basic skills training received in the clinic (such as driving forward, backward, turning, and avoiding obstacles). Implications for Rehabilitation New power wheelchair users appreciate practicing on a virtual reality simulator and find the experience useful when the simulated diving activities are realistic and ecologically valid. User-centred development can lead to simulated power wheelchair activities that adequately capture everyday driving challenges experienced in various environmental contexts.
Chaikhot, Dhissanuvach; Taylor, Matthew J D; Hettinga, Florentina J
An awareness of sex differences in gait can be beneficial for detecting the early stages of gait abnormalities that may lead to pathology. The same may be true for wheelchair propulsion. The aim of this study was to determine the effect of sex on wheelchair biomechanics and mechanical efficiency in novice young able-bodied wheelchair propulsion. Thirty men and 30 women received 12 min of familiarisation training. Subsequently, they performed two 10-m propulsion tests to evaluate comfortable speed (CS). Additionally, they performed a 4-min submaximal propulsion test on a treadmill at CS, 125% and 145% of CS. Propulsion kinetics (via Smart wheel ) and oxygen uptake were continuously measured in all tests and were used to determine gross mechanical efficiency (GE), net efficiency (NE) and fraction of effective force (FEF). Ratings of perceived exertion (RPE) were assessed directly after each trial. Results indicated that CS for men was faster (0.98 ± 0.24 m/s) compared to women (0.71 ± 0.18 m/s). A lower GE was found in women compared to men. Push percentage, push angle and local RPE were different across the three speeds and between men and women. NE and FEF were not different between groups. Thus, even though their CS was lower, women demonstrated a higher locally perceived exertion than men. The results suggest sex differences in propulsion characteristics and GE. These insights may aid in optimising wheelchair propulsion through proper training and advice to prevent injuries and improve performance. This is relevant in stimulating an active lifestyle for those with a disability.
Ron-Angevin, Ricardo; Velasco-Álvarez, Francisco; Fernández-Rodríguez, Álvaro; Díaz-Estrella, Antonio; Blanca-Mena, María José; Vizcaíno-Martín, Francisco Javier
Certain diseases affect brain areas that control the movements of the patients' body, thereby limiting their autonomy and communication capacity. Research in the field of Brain-Computer Interfaces aims to provide patients with an alternative communication channel not based on muscular activity, but on the processing of brain signals. Through these systems, subjects can control external devices such as spellers to communicate, robotic prostheses to restore limb movements, or domotic systems. The present work focus on the non-muscular control of a robotic wheelchair. A proposal to control a wheelchair through a Brain-Computer Interface based on the discrimination of only two mental tasks is presented in this study. The wheelchair displacement is performed with discrete movements. The control signals used are sensorimotor rhythms modulated through a right-hand motor imagery task or mental idle state. The peculiarity of the control system is that it is based on a serial auditory interface that provides the user with four navigation commands. The use of two mental tasks to select commands may facilitate control and reduce error rates compared to other endogenous control systems for wheelchairs. Seventeen subjects initially participated in the study; nine of them completed the three sessions of the proposed protocol. After the first calibration session, seven subjects were discarded due to a low control of their electroencephalographic signals; nine out of ten subjects controlled a virtual wheelchair during the second session; these same nine subjects achieved a medium accuracy level above 0.83 on the real wheelchair control session. The results suggest that more extensive training with the proposed control system can be an effective and safe option that will allow the displacement of a wheelchair in a controlled environment for potential users suffering from some types of motor neuron diseases.
Connick, Mark J; Beckman, Emma; Vanlandewijck, Yves; Malone, Laurie A; Blomqvist, Sven; Tweedy, Sean M
The Para athletics wheelchair-racing classification system employs best practice to ensure that classes comprise athletes whose impairments cause a comparable degree of activity limitation. However, decision-making is largely subjective and scientific evidence which reduces this subjectivity is required. To evaluate whether isometric strength tests were valid for the purposes of classifying wheelchair racers and whether cluster analysis of the strength measures produced a valid classification structure. Thirty-two international level, male wheelchair racers from classes T51-54 completed six isometric strength tests evaluating elbow extensors, shoulder flexors, trunk flexors and forearm pronators and two wheelchair performance tests-Top-Speed (0-15 m) and Top-Speed (absolute). Strength tests significantly correlated with wheelchair performance were included in a cluster analysis and the validity of the resulting clusters was assessed. All six strength tests correlated with performance (r=0.54-0.88). Cluster analysis yielded four clusters with reasonable overall structure (mean silhouette coefficient=0.58) and large intercluster strength differences. Six athletes (19%) were allocated to clusters that did not align with their current class. While the mean wheelchair racing performance of the resulting clusters was unequivocally hierarchical, the mean performance of current classes was not, with no difference between current classes T53 and T54. Cluster analysis of isometric strength tests produced classes comprising athletes who experienced a similar degree of activity limitation. The strength tests reported can provide the basis for a new, more transparent, less subjective wheelchair racing classification system, pending replication of these findings in a larger, representative sample. This paper also provides guidance for development of evidence-based systems in other Para sports. © Article author(s) (or their employer(s) unless otherwise stated in the text of
Rice, Ian; Gagnon, Dany; Gallagher, Jere; Boninger, Michael
As considerable progress has been made in laboratory-based assessment of manual wheelchair propulsion biomechanics, the necessity to translate this knowledge into new clinical tools and treatment programs becomes imperative. The objective of this study was to describe the development of a manual wheelchair propulsion training program aimed to promote the development of an efficient propulsion technique among long-term manual wheelchair users. Motor learning theory principles were applied to the design of biomechanical feedback-based learning software, which allows for random discontinuous real-time visual presentation of key spatiotemporal and kinetic parameters. This software was used to train a long-term wheelchair user on a dynamometer during 3 low-intensity wheelchair propulsion training sessions over a 3-week period. Biomechanical measures were recorded with a SmartWheel during over ground propulsion on a 50-m level tile surface at baseline and 3 months after baseline. Training software was refined and administered to a participant who was able to improve his propulsion technique by increasing contact angle while simultaneously reducing stroke cadence, mean resultant force, peak and mean moment out of plane, and peak rate of rise of force applied to the pushrim after training. The proposed propulsion training protocol may lead to favorable changes in manual wheelchair propulsion technique. These changes could limit or prevent upper limb injuries among manual wheelchair users. In addition, many of the motor learning theory-based techniques examined in this study could be applied to training individuals in various stages of rehabilitation to optimize propulsion early on.
Mills, Tamara L; Holm, Margo B; Schmeler, Mark
The purpose of this study was to establish the test-retest reliability and content validity of an outcomes tool designed to measure the effectiveness of seating-mobility interventions on the functional performance of individuals who use wheelchairs or scooters as their primary seating-mobility device. The instrument, Functioning Everyday With a Wheelchair (FEW), is a questionnaire designed to measure perceived user function related to wheelchair/scooter use. Using consumer-generated items, FEW Beta Version 1.0 was developed and test-retest reliability was established. Cross-validation of FEW Beta Version 1.0 was then carried out with five samples of seating-mobility users to establish content validity. Based on the content validity study, FEW Version 2.0 was developed and administered to seating-mobility consumers to examine its test-retest reliability. FEW Beta Version 1.0 yielded an intraclass correlation coefficient (ICC) Model (3,k) of .92, p content validity results revealed that FEW Beta Version 1.0 captured 55% of seating-mobility goals reported by consumers across five samples. FEW Version 2.0 yielded ICC(3,k) = .86, p content validity of FEW Version 2.0 was confirmed. FEW Beta Version 1.0 and FEW Version 2.0 were highly stable in their measurement of participants' seating-mobility goals over a 1-week interval.
Rice, I; Dysterheft, J; Bleakney, A W; Cooper, R A
Our purpose was to examine the influence of glove type on kinetic and spatiotemporal parameters at the handrim in elite wheelchair racers. Elite wheelchair racers (n=9) propelled on a dynamometer in their own racing chairs with a force and moment sensing wheel attached. Racers propelled at 3 steady state speeds (5.36, 6.26 & 7.60 m/s) and performed one maximal effort sprint with 2 different glove types (soft & solid). Peak resultant force, peak torque, impulse, contact angle, braking torque, push time, velocity, and stroke frequency were recorded for steady state and sprint conditions. Multiple nonparametric Wilcoxon matched pair's tests were used to detect differences between glove types, while effect sizes were calculated based on Cohen's d. During steady state trials, racers propelled faster, using more strokes and larger contact angle, while applying less impulse with solid gloves compared to soft gloves. During the sprint condition, racers achieved greater top end velocities, applying larger peak force, with less braking torque with solid gloves compared to soft gloves. Use of solid gloves may provide some performance benefits to wheelchair racers during steady state and top end velocity conditions. © Georg Thieme Verlag KG Stuttgart · New York.
Weissland, Thierry; Faupin, Arnaud; Borel, Benoit; Berthoin, Serge; Leprêtre, Pierre-Marie
A bioenergetical analysis of manoeuvrability and agility performance for wheelchair players is inexistent. It was aimed at comparing the physiological responses and performance obtained from the octagon multistage field test (MFT) and the modified condition in “8 form” (MFT-8). Sixteen trained wheelchair basketball players performed both tests in randomized condition. The levels performed (end-test score), peak values of oxygen uptake (VO2peak), minute ventilation (VEpeak), heart rate (HRpeak), peak and relative blood lactate (Δ[Lact−] = peak – rest values), and the perceived rating exertion (RPE) were measured. MFT-8 induced higher VO2peak and VEpeak values compared to MFT (VO2peak: 2.5 ± 0.6 versus 2.3 ± 0.6 L·min−1 and VEpeak: 96.3 ± 29.1 versus 86.6 ± 23.4 L·min−1; P physiological responses than MFT. It could be explained by demands of wheelchair skills occurring in 8 form during the modified condition. PMID:25802841
Goosey-Tolfrey, V L; West, M; Lenton, J P; Tolfrey, K
The purpose of this study was to analyse adaptations in propulsion technique and gross efficiency in novice able-bodied subjects during the initial phase of learning hand-rim wheelchair propulsion to music. 22 able bodied participants performed wheelchair propulsion (1.1 m·s(-1)) followed by a VO(2) peak test on a wheelchair ergometer. Push frequency, gross efficiency (GE), heart rate, rating of perceived exertion and propulsion technique variables (force application and temporal characteristics) were recorded. Participants were then assigned to a 3-wk practice period listening to i) 125 beats·min(-1) tempo music (LOW); ii) 170 beats·min(-1) tempo music (HIGH); or iii) a control group (CON). Following practice, all participants repeated the pre-testing protocol whilst force application data was collected in practice trials 1 and 9. After accounting for the pre-practice differences in GE (using ANCOVA), GE was higher in LOW compared with CON (P=0.038; 6.6 vs. 6.1% respectively). The differences between CON vs. HIGH and LOW vs. HIGH (P=0.830; P=0.188) were trivial suggesting that only LOW experienced an increase in GE. Practice had a favourable effect on the perceptions of effort, work per cycle, push and cycle time in contrast to the CON group. The use of music in a rehabilitation setting warrants further investigation. © Georg Thieme Verlag KG Stuttgart · New York.
Goosey-Tolfrey, V; Foden, E; Perret, C; Degens, H
There is considerable evidence that respiratory muscle training improves pulmonary function, quality of life and exercise performance in healthy athletic populations. The benefits for wheelchair athletes are less well understood. Therefore, in the present study, influence of inspiratory muscle training (IMT) on respiratory function and repetitive propulsive sprint performance in wheelchair basketball players was examined. Using a placebo-controlled design, 16 wheelchair athletes were divided to an experimental (IMT; n=8) or placebo (sham-IMT; n=8) group based on selective grouping criteria. 30 dynamic breaths were performed by the IMT group twice daily at a resistance equivalent to 50% maximum inspiratory pressure (MIP), and 60 slow breaths were performed by the sham-IMT group once a day at 15% MIP for a period of 6 weeks. In the IMT group, both MIP and maximum expiratory pressure (17% and 23%, respectively; ptraining device suggested "less breathlessness" and "less tightness in the chest during the training". Although there was no improvement in sprint performance, an improved respiratory muscle function and quality of life were reported by participants in both the IMT and sham-IMT groups.
Koontz, Alicia M; Roche, Bailey M; Collinger, Jennifer L; Cooper, Rory A; Boninger, Michael L
To classify propulsion patterns over surfaces encountered in the natural environment during start-up and compare selected biomechanical variables between pattern types. Case series. National Veterans Wheelchair Games, Minneapolis, MN, 2005. Manual wheelchair users (N=29). Subjects pushed their wheelchairs from a resting position over high-pile carpet, over linoleum, and up a ramp with a 5 degrees incline while propulsion kinematics and kinetics were recorded with a motion capture system and an instrumented wheel. Three raters classified the first 3 strokes as 1 of 4 types on each surface: arc, semicircular (SC), single looping over propulsion (SL), and double looping over propulsion (DL). The Fisher exact test was used to assess pattern changes between strokes and surface type. A multiple analysis of variance test was used to compare peak and average resultant force and moment about the hub, average wheel velocity, stroke frequency, contact angle, and distance traveled between stroke patterns. SL was the most common pattern used during start-up propulsion (44.9%), followed by arc (35.9%), DL (14.1%), and SC (5.1%). Subjects who dropped their hands below the rim during recovery achieved faster velocities and covered greater distances (.016propulsion patterns is a difficult task that should use multiple raters. In addition, propulsion patterns change during start-up, with an arc pattern most prevalent initially. The biomechanical findings in this study agree with current clinical guidelines that recommend training users to drop the hand below the pushrim during recovery.
Lui, Jordon; MacGillivray, Megan K; Sheel, A William; Jeyasurya, Jeswin; Sadeghi, Mahsa; Sawatzky, Bonita Jean
The purpose of this study was to (1) evaluate the mechanical efficiency (ME) of two commercially available lever-propulsion mechanisms for wheelchairs and (2) compare the ME of lever propulsion with hand rim propulsion within the same wheelchair. Of the two mechanisms, one contained a torsion spring while the other used a roller clutch design. We hypothesized that the torsion spring mechanism would increase the ME of propulsion due to a passive recovery stroke enabled by the mechanism. Ten nondisabled male participants with no prior manual wheeling experience performed submaximal exercise tests using both lever-propulsion mechanisms and hand rim propulsion on two different wheelchairs. Cardiopulmonary parameters including oxygen uptake (VO2), heart rate (HR), and energy expenditure (En) were determined. Total external power (Pext) was measured using a drag test protocol. ME was determined by the ratio of Pext to En. Results indicated no significant effect of lever-propulsion mechanism for all physiological measures tested. This suggests that the torsion spring did not result in a physiological benefit compared with the roller clutch mechanism. However, both lever-propulsion mechanisms showed decreased VO2 and HR and increased ME (as a function of slope) compared with hand rim propulsion (p propulsion mechanisms tested are more mechanically efficient than conventional hand rim propulsion, especially when slopes are encountered.
Masson, G; Bégin, M-A; Lopez Poncelas, M; Pelletier, S-K; Lessard, J-L; Laroche, J; Berrigan, F; Langelier, E; Smeesters, C; Rancourt, D
Pushing capacity is a key parameter in athletic racing wheelchair performance. This study estimated the potential contribution of upper limb momentum to pushing. The question is relevant since it may affect the training strategy adopted by an athlete. A muscle-free Lagrangian dynamic model of the upper limb segments was developed and theoretical predictions of power transfer to the wheelchair were computed during the push phase. Results show that limb momentum capacity for pushing can be in the order of 40J per push cycle at 10m/s, but it varies with the specific pushing range chosen by the athlete. Although use of momentum could certainly help an athlete improve performance, quantifying the actual contribution of limb momentum to pushing is not trivial. A preliminary experimental investigation on an ergometer, along with a simplified model of the upper limb, suggests that momentum is not the sole contributor to power transfer to a wheelchair. Muscles substantially contribute to pushing, even at high speeds. Moreover, an optimal pushing range is challenging to find since it most likely differs if an athlete chooses a limb momentum pushing strategy versus a muscular exertion pushing strategy, or both at the same time. The study emphasizes the importance of controlling pushing range, although one should optimize it while also taking the dynamics of the recovery period into account. Copyright © 2016 Elsevier Ltd. All rights reserved.
Huang, Qiyun; He, Shenghong; Wang, Qihong; Gu, Zhenghui; Peng, Nengneng; Li, Kai; Zhang, Yuandong; Shao, Ming; Li, Yuanqing
Non-manual human-machine interfaces (HMIs) have been studied for wheelchair control with the aim of helping severely paralyzed individuals regain some mobility. The challenge is to rapidly, accurately and sufficiently produce control commands, such as left and right turns, forward and backward motions, acceleration, deceleration, and stopping. In this paper, a novel electrooculogram (EOG)-based HMI is proposed for wheelchair control. Thirteen flashing buttons are presented in the graphical user interface (GUI), and each of the buttons corresponds to a command. These buttons flash on a one-by-one manner in a pre-defined sequence. The user can select a button by blinking in sync with its flashes. The algorithm detects the eye blinks from a channel of vertical EOG data and determines the user's target button based on the synchronization between the detected blinks and the button's flashes. For healthy subjects/patients with spinal cord injuries (SCIs), the proposed HMI achieved an average accuracy of 96.7%/91.7% and a response time of 3.53 s/3.67 s with 0 false positive rates (FPRs). Using only one channel of vertical EOG signals associated with eye blinks, the proposed HMI can accurately provide sufficient commands with a satisfactory response time. The proposed HMI provides a novel non-manual approach for severely paralyzed individuals to control a wheelchair. Compared with a newly established EOG-based HMI, the proposed HMI can generate more commands with higher accuracy, lower FPR and fewer electrodes.
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Full Text Available Abstract Background Due to the shift of the age structure in today's populations, the necessities for developing the devices or technologies to support them have been increasing. Traditionally, the wheelchair, including powered and manual ones, is the most popular and important rehabilitation/assistive device for the disabled and the elderly. However, it is still highly restricted especially for severely disabled. As a solution to this, the Intelligent Wheelchairs (IWs have received considerable attention as mobility aids. The purpose of this work is to develop the IW interface for providing more convenient and efficient interface to the people the disability in their limbs. Methods This paper proposes an intelligent wheelchair (IW control system for the people with various disabilities. To facilitate a wide variety of user abilities, the proposed system involves the use of face-inclination and mouth-shape information, where the direction of an IW is determined by the inclination of the user's face, while proceeding and stopping are determined by the shapes of the user's mouth. Our system is composed of electric powered wheelchair, data acquisition board, ultrasonic/infra-red sensors, a PC camera, and vision system. Then the vision system to analyze user's gestures is performed by three stages: detector, recognizer, and converter. In the detector, the facial region of the intended user is first obtained using Adaboost, thereafter the mouth region is detected based on edge information. The extracted features are sent to the recognizer, which recognizes the face inclination and mouth shape using statistical analysis and K-means clustering, respectively. These recognition results are then delivered to the converter to control the wheelchair. Result & conclusion The advantages of the proposed system include 1 accurate recognition of user's intention with minimal user motion and 2 robustness to a cluttered background and the time-varying illumination
Frey, Jochen; Stahl, Christoph; Röfer, Thomas; Krieg-Brückner, Bernd; Alexandersson, Jan
The DFKI Competence Center for Ambient Assisted Living (CCAAL) is a cross-project and cross-department virtual organization within the German Research Center for Artificial Intelligence coordinating and conducting research and development in the area of Ambient Assisted Living (AAL). Our demonstrators range from multimodal speech dialog systems to fully instrumented environments allowing the development of intelligent assistant systems, for instance an autonomous wheelchair, or the recognition and processing of everyday activities in a smart home. These innovative technologies are then tested, evaluated and demonstrated in DFKI's living labs.
Vincent, Claude; Gagnon, Dany H; Dumont, Frédéric
To assess the effects of a mobility service dog (MSD) on pain, fatigue, wheelchair-related functional tasks, participation and satisfaction among manual wheelchair users over a nine-month period. A longitudinal study with repeated assessment times before and three, six and nine months after intervention was achieved. Intervention consisted in partnering each participant with a MSD. The setting is a well-established provincial service dog training school and participants homes. A convenience sample of 24 long-term manual wheelchair users with a spinal cord injury was involved. Outcome measures were: Wheelchair User's Shoulder Pain Index (WUSPI), Rate of Perceived Exertion (RPE), vitality scale from the SF-36, grip strength, Wheelchair Skills Test (WST), Canadian Occupational Performance Measure (COPM), Reintegration to Normal Living Index (RNLI), Life Space Assessment, Psychosocial Impact of Assistive Devices Scale (PIADS) and Quebec User Evaluation of Satisfaction with assistive Technology (QUEST 2.0). Shoulder and wrist pain as well as fatigue decreased significantly over time with the use of a MSD as evidenced by scores from WUSPI, RPE and SF-36 (feeling less worn out). Manual wheelchair propulsion skills (steep slopes, soft surfaces and thresholds) improved significantly over time as confirmed by the WST. Participation increased significantly over time as revealed by the COPM (for five occupations) and the RNLI (for five items). Satisfaction with the MSD was high over time (QUEST: nine items) and with a high positive psychosocial impact (PIADS: 10 items). MSD represents a valuable mobility assistive technology option for manual wheelchair users. IMPLICATIONS FOR REHABILITATION For manual wheelchair users partenered with mobility service dog • Shoulder pain and fatigue significantly decreased and continued to decrease between the third and sixth month and the ninth month. • Performance with propelling the wheelchair up steep slopes
van der Woude, Lucas; de Groot, Sonja; van Drongelen, Stefan; Janssen, Thomas W.; Haisma, Janneke A.; Valent, Linda J M; Veeger, DirkJan (H. E. J.)
Evaluation of wheelchair performance (capacity and skills) is crucial in the investigation of wheeled mobility in people with a spinal cord injury (SCI). Manual wheelchair use is a complex combination of skills, which together determine overall functioning, daily activities, participation, and
Sasaki, Kotaro; Rispin, Karen
In under-resourced settings where motorized wheelchairs are rarely available, manual wheelchair users with limited upper-body strength and functionalities need to rely on assisting pushers for their mobility. Because traveling surfaces in under-resourced settings are often unpaved and rough, wheelchair pushers could experience high physiological loading. In order to evaluate pushers' physiological loading and to improve wheelchair designs, we built indoor modular units that simulate rough surface conditions, and tested a hypothesis that pushing different wheelchairs would result in different physiological performances and pushers' perception of difficulty on the simulated rough surface. Eighteen healthy subjects pushed two different types of pediatric wheelchairs (Moti-Go manufactured by Motivation, and KidChair by Hope Haven) fitted with a 50-kg dummy on the rough and smooth surfaces at self-selected speeds. Oxygen uptake, traveling distance for 6 minutes, and the rating of difficulty were obtained. The results supported our hypothesis, showing that pushing Moti-Go on the rough surface was physiologically less loading than KidChair, but on the smooth surface, the two wheelchairs did not differ significantly. These results indicate wheelchair designs to improve pushers' performance in under-resourced settings should be evaluated on rough surfaces.
Full Text Available The current study assessed the validity and reliability of a miniaturised data logger (MDL against a radio-frequency-based indoor tracking system (ITS for quantifying key aspects of mobility performance during wheelchair rugby. Eleven international wheelchair rugby players were monitored by both devices during four wheelchair rugby matches. MDL data were averaged over both 1-second (MDL-1 and 5-second (MDL-5 intervals to calculate distance, mean, and peak speeds. The results revealed no significant differences between devices for the distance covered or mean speeds, although random errors of 10% and 12%, respectively, were identified in relation to the mean values. No significant differences in peak speed were revealed between ITS (3.91±0.32 m·s−1 and MDL-1 (3.85±0.45 m·s−1. Whereas peak speeds in MDL-5 (2.75±0.29 m·s−1 were significantly lower than ITS. Errors in peak speed led to large random errors in time and distance spent in speed zones relative to peak speed, especially in MDL-5. The current study revealed that MDL provide a reasonable representation of the distance and mean speed reported during wheelchair rugby. However, inaccuracy in the detection of peak speeds limits its use for monitoring performance and prescribing wheelchair rugby training programmes.
Bergamini, Elena; Morelli, Francesca; Marchetti, Flavia; Vannozzi, Giuseppe; Polidori, Lorenzo; Paradisi, Francesco; Traballesi, Marco; Cappozzo, Aurelio
As participation in wheelchair sports increases, the need of quantitative assessment of biomechanical performance indicators and of sports- and population-specific training protocols has become central. The present study focuses on junior wheelchair basketball and aims at (i) proposing a method to identify biomechanical performance indicators of wheelchair propulsion using an instrumented in-field test and (ii) developing a training program specific for the considered population and assessing its efficacy using the proposed method. Twelve athletes (10 M, 2 F, age = 17.1 ± 2.7 years, years of practice = 4.5 ± 1.8) equipped with wheelchair- and wrist-mounted inertial sensors performed a 20-metre sprint test. Biomechanical parameters related to propulsion timing, progression force, and coordination were estimated from the measured accelerations and used in a regression model where the time to complete the test was set as dependent variable. Force- and coordination-related parameters accounted for 80% of the dependent variable variance. Based on these results, a training program was designed and administered for three months to six of the athletes (the others acting as control group). The biomechanical indicators proved to be effective in providing additional information about the wheelchair propulsion technique with respect to the final test outcome and demonstrated the efficacy of the developed program. PMID:26543852
Arthanat, Sajay; Desmarais, Joanne M; Eikelberg, Pam
The iBOT(®) is an advanced power wheelchair introduced in 2003 for people with mobility impairments to enhance their independence and community access. Although this innovation soon gained popularity, the production of this wheelchair was recently stopped owing to the lower-than-expected sale figures. In this scenario, this study examines the impact of this wheelchair on current consumers by highlighting its usability in multiple contexts and verifying the value associated with its ownership. Seven active consumers of the iBOT(®) were interviewed using a mixed method approach. Participants discussed and rated the iBOT's usability in relation to their standard power wheelchair and shared their perceived value for it. A content analysis was used to elucidate the qualitative data, whereas the quantitative data was analyzed using descriptive and non-parametric comparisons to compute differences in consumer ratings for the two wheelchairs. Results, although statistically non-significant (α valued its capability to expand their mobility in otherwise inaccessible environments and to enhance their social participation through eye level communication. The iBOT(®) serves as an exemplar to promote interest and funding for advanced AT devices for people with disabilities. [Box: see text].
Bergamini, Elena; Morelli, Francesca; Marchetti, Flavia; Vannozzi, Giuseppe; Polidori, Lorenzo; Paradisi, Francesco; Traballesi, Marco; Cappozzo, Aurelio; Delussu, Anna Sofia
As participation in wheelchair sports increases, the need of quantitative assessment of biomechanical performance indicators and of sports- and population-specific training protocols has become central. The present study focuses on junior wheelchair basketball and aims at (i) proposing a method to identify biomechanical performance indicators of wheelchair propulsion using an instrumented in-field test and (ii) developing a training program specific for the considered population and assessing its efficacy using the proposed method. Twelve athletes (10 M, 2 F, age = 17.1 ± 2.7 years, years of practice = 4.5 ± 1.8) equipped with wheelchair- and wrist-mounted inertial sensors performed a 20-metre sprint test. Biomechanical parameters related to propulsion timing, progression force, and coordination were estimated from the measured accelerations and used in a regression model where the time to complete the test was set as dependent variable. Force- and coordination-related parameters accounted for 80% of the dependent variable variance. Based on these results, a training program was designed and administered for three months to six of the athletes (the others acting as control group). The biomechanical indicators proved to be effective in providing additional information about the wheelchair propulsion technique with respect to the final test outcome and demonstrated the efficacy of the developed program.
Full Text Available As participation in wheelchair sports increases, the need of quantitative assessment of biomechanical performance indicators and of sports- and population-specific training protocols has become central. The present study focuses on junior wheelchair basketball and aims at (i proposing a method to identify biomechanical performance indicators of wheelchair propulsion using an instrumented in-field test and (ii developing a training program specific for the considered population and assessing its efficacy using the proposed method. Twelve athletes (10 M, 2 F, age = 17.1 ± 2.7 years, years of practice = 4.5 ± 1.8 equipped with wheelchair- and wrist-mounted inertial sensors performed a 20-metre sprint test. Biomechanical parameters related to propulsion timing, progression force, and coordination were estimated from the measured accelerations and used in a regression model where the time to complete the test was set as dependent variable. Force- and coordination-related parameters accounted for 80% of the dependent variable variance. Based on these results, a training program was designed and administered for three months to six of the athletes (the others acting as control group. The biomechanical indicators proved to be effective in providing additional information about the wheelchair propulsion technique with respect to the final test outcome and demonstrated the efficacy of the developed program.
Gagnon, Dany H; Jouval, Camille; Chénier, Félix
Using ground reaction forces recorded while propelling a manual wheelchair on an instrumented treadmill may represent a valuable alternative to using an instrumented pushrim to calculate temporal and kinetic parameters during propulsion. Sixteen manual wheelchair users propelled their wheelchair equipped with instrumented pushrims (i.e., SMARTWheel) on an instrumented dual-belt treadmill set a 1m/s during a 1-minute period. Spatio-temporal (i.e., duration of the push and recovery phase) and kinetic measures (i.e. propulsive moments) were calculated for 20 consecutive strokes for each participant. Strong associations were confirmed between the treadmill and the instrumented pushrim for the mean duration of the push phase (r=0.98) and of the recovery phase (r=0.99). Good agreement between these two measurement instruments was also confirmed with mean differences of only 0.028s for the push phase and 0.012s for the recovery phase. Strong associations were confirmed between the instrumented wheelchair pushrim and treadmill for mean (r=0.97) and peak (r=0.96) propulsive moments. Good agreement between these two measurement instruments was also confirmed with mean differences of 0.50Nm (mean moment) and 0.71Nm (peak moment). The use of a dual-belt instrumented treadmill represents an alternative to characterizing temporal parameters and propulsive moments during manual wheelchair propulsion. Copyright © 2016 Elsevier Ltd. All rights reserved.
Slowik, Jonathan S; McNitt-Gray, Jill L; Requejo, Philip S; Mulroy, Sara J; Neptune, Richard R
The considerable physical demand placed on the upper extremity during manual wheelchair propulsion is distributed among individual muscles. The strategy used to distribute the workload is likely influenced by the relative force-generating capacities of individual muscles, and some strategies may be associated with a higher injury risk than others. The objective of this study was to use forward dynamics simulations of manual wheelchair propulsion to identify compensatory strategies that can be used to overcome weakness in individual muscle groups and identify specific strategies that may increase injury risk. Identifying these strategies can provide rationale for the design of targeted rehabilitation programs aimed at preventing the development of pain and injury in manual wheelchair users. Muscle-actuated forward dynamics simulations of manual wheelchair propulsion were analyzed to identify compensatory strategies in response to individual muscle group weakness using individual muscle mechanical power and stress as measures of upper extremity demand. The simulation analyses found the upper extremity to be robust to weakness in any single muscle group as the remaining groups were able to compensate and restore normal propulsion mechanics. The rotator cuff muscles experienced relatively high muscle stress levels and exhibited compensatory relationships with the deltoid muscles. These results underline the importance of strengthening the rotator cuff muscles and supporting muscles whose contributions do not increase the potential for impingement (i.e., the thoracohumeral depressors) and minimize the risk of upper extremity injury in manual wheelchair users. Copyright © 2016 Elsevier Ltd. All rights reserved.
Cloud, Beth A; Zhao, Kristin D; Ellingson, Arin M; Nassr, Ahmad; Windebank, Anthony J; An, Kai-Nan
To quantify and compare spinal curvature and shoulder kinematics throughout the manual wheelchair (MWC) propulsion cycle for individuals with spinal cord injury (SCI) who were seated at 2 different seat dump angles. Single-group, repeated-measures study. Academic medical center. Individuals (N=28) with SCI or spinal cord disease who used MWCs completed a telephone screening, and 21 of them were eligible and completed the study. Participants' personal MWCs were modified to have seat dump angles of 0° or 14°, with a vertical backrest. Participants completed at least 3 propulsion cycles in each condition, during which spine and shoulder motion data were collected with fiberoptic and electromagnetic sensors, respectively. Thoracolumbar spinal curvature, glenohumeral kinematics, and scapulothoracic kinematics at the start of push (SP), mid-push (MP), end of push (EP), and mid-recovery. Participants had significantly less lordosis in the 14° condition for all propulsion events. Median differences ranged from 2.0° to 4.6°. Lordosis differences were more pronounced in those with low SCI. Scapulothoracic internal rotation was increased in the 14° condition at SP and MP (mean differences, 2.5° and 2.7°, respectively). Relative downward rotation increased in the 14° condition at SP and MP (mean differences, 2.4° and 2.1°, respectively). Scapulothoracic differences were more pronounced in those with high SCI. No glenohumeral rotations were significantly different between the conditions. Scapulothoracic kinematics and spinal curvature differences during propulsion may be associated with the position of other body segments or postural stability. Because no differences were observed at the glenohumeral joint, the risk of subacromial impingement may not be affected by this seat angle change. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Full Text Available Abstract Background Reclining wheelchairs are commonly used to transport elderly stroke patients in Taiwan. However, there is concern that the patient's body in the wheelchair often slides forward when they return to a seated position, increasing the sitting pressure. Therefore, a novel reclining wheelchair with an ergonomic "V-Seat" was designed to prevent forward sliding and pressure sores. The use of these reclining chairs by stroke patients has not yet been studied. Thus, we investigated the effects of V-shaped and conventional seats in reclining wheelchairs on the extent of forward sliding and on the sitting pressure of stroke patients with flaccid hemiplegia and of able-bodied elders. Methods We recruited 13 able-bodied elders and 11 stroke patients with flaccid hemiplegia and performed 5 reclining cycles in both types of wheelchair. The amount of sliding along the backrest (BS plane and the seat (SS plane, the mean sitting pressure (MP, and the sacral peak pressure (SPP of the subjects were recorded. We used the Wilcoxon signed-rank test to compare the BS, SS, MP, and SPP in wheelchairs with conventional and V-shaped seats, and we used the Wilcoxon rank sum test to compare the differences in BS and SS between stroke patients and able-bodied elders in both types of reclining wheelchair. Results The BS, SS, and SPP of stroke patients were significantly lower in the wheelchairs with V-shaped seats than in conventional wheelchairs in most comparisons; however, the BS of able-bodied elders was higher in V-shaped seats than in conventional seats. The SS and SPP of stroke patients were significantly higher than those of able-bodied elders in both types of reclining wheelchair, and the BS of stroke patients was significantly higher than that of able-bodied elders only in conventional reclining wheelchairs. Conclusions The use of V-shaped seats in reclining wheelchairs can help reduce the forward sliding and sacral peak pressure of stroke patients
Kaida, Yukiko; Murakami, Toshiyuki
A wheelchair is an important apparatus of mobility for people with disability. Power-assist motion in an electric wheelchair is to expand the operator's field of activities. This paper describes force sensorless detection of human input torque. Reaction torque estimation observer calculates the total disturbance torque first. Then, the human input torque is extracted from the estimated disturbance. In power-assist motion, assist torque is synthesized according to the product of assist gain and the average torque of the right and left input torque. Finally, the proposed method is verified through the experiments of power-assist motion.
Akbar, Michael; Brunner, Manuela; Ewerbeck, Volker; Wiedenhöfer, Bernd; Grieser, Thomas; Bruckner, Thomas; Loew, Markus; Raiss, Patric
To analyze whether frequent overhead-sports activity increases the risk for rotator cuff disease in patients with spinal cord injuries (SCIs) who are wheelchair dependent. Cross-sectional study, risk analysis. Department of Orthopaedic Surgery, Trauma Surgery and Spinal Cord Injury. Patients (N=296) with SCI requiring the full-time use of a manual wheelchair were recruited for this study. The total population was divided into 2 groups (sports vs no sports), among them 103 patients playing overhead sports on a regular basis (at least 1-2 times/wk) and 193 patients involved in overhead sports less than once a week or in no sports activity at all. The mean age of the sports group was 49.1 years. The mean duration of wheelchair dependence was 26.5 years. The mean age of the no-sports group was 48 years. The mean duration of wheelchair dependence was 25.2 years. Each individual completed a questionnaire designed to identify overhead-sports activity on a regular basis and was asked about shoulder problems. Magnetic resonance imaging scans of both shoulders were performed in each patient and analyzed in a standardized fashion. None. Possible differences in continuous data between patients with and without rotator cuff tear were evaluated. The relative risk of suffering from a rotator cuff tear between patients playing overhead sports and those not playing overhead sports was calculated. One hundred three patients played overhead sports regularly and 193 did not. There was no difference between groups regarding age, sex, level of SCI, and duration of wheelchair dependence. The body mass index was significantly lower in the sports group than in the no-sports group (Psports group and in 36.3% of the patients in the no-sports group (Psports group to develop rotator cuff tears was twice as high as for the no-sports group (95% confidence interval, 1.7-2.6; Psports activities have been identified as an additional risk factor, along with age and duration of wheelchair dependence
Noyes, Jane; Spencer, Llinos Haf; Bray, Nathan; Kubis, Hans-Peter; Hastings, Richard P; Jackson, Matthew; O'Brien, Thomas D
To gain a better understanding of how children aged 6-18 years who use wheelchairs and their families conceptualized physical exercise and keeping fit. Disabled children with reduced mobility are commonly overweight and unfit. Nurse-led health screening programmes in schools commonly exclude disabled children if they cannot use standard weighing scales or stand against height measuring sticks. Qualitative interview study at two time points over 6 months with children who use wheelchairs and their families. Framework analysis using the theory of planned behaviour. Mainly physically active participants were recruited (24 children and 23 parents) 2013-2014. Despite engaging in high levels of physical exercise, children were assessed as fit but had elevated body fat and did not realize how fit they were or that they were slightly overweight and nor did their parents. Children enjoyed the social benefits of exercise. Unlike their parents, children confused the purpose and outcomes of physical exercise with therapy (e.g. physiotherapy) and incorrectly understood the effects of physical exercise on body function and strength, preventing stiffness, increasing stamina and reducing fatigue. A new model was developed to show children's misconceptions. Proactive parents can overcome barriers to enable their children to benefit from physical exercise. Professionals need to increase communication clarity to improve children's understanding of therapy compared with physical exercise outcomes. Inclusion of children who use wheelchairs in health education policy; routine health screening; physical education classes and teacher training requires improvement. Body composition measurement is recommended, for which nurses will need training. © 2016 The Authors. Journal of Advanced Nursing Published by John Wiley & Sons Ltd.
Full Text Available This paper focuses on how to provide mobility to people with motor impairments with the integration of robotics and wearable computing systems. The burden of learning to control powered mobility devices should not fall entirely on the people with disabilities. Instead, the system should be able to learn the user's movements. This requires learning the degrees of freedom of user movement, and mapping these degrees of freedom onto electric-powered wheelchair (EPW controls. Such mapping cannot be static because in some cases users will eventually improve with practice. Our goal in this paper is to present a hands-free interface (HFI that can be customized to the varying needs of EPW users with appropriate mapping between the users' degrees of freedom and EPW controls. EPW users with different impairment types must learn how to operate a wheelchair with their residual body motions. EPW interfaces are often customized to fit their needs. An HFI utilizes the signals generated by the user's voluntary shoulder and elbow movements and translates them into an EPW control scheme. We examine the correlation of kinematics that occur during moderately paced repetitive elbow and shoulder movements for a range of motion. The output of upper-limb movements (shoulder and elbows was tested on six participants, and compared with an output of a precision position tracking (PPT optical system for validation. We find strong correlations between the HFI signal counts and PPT optical system during different upper-limb movements (ranged from r = 0.86 to 0.94. We also tested the HFI performance in driving the EPW in a virtual reality environment on a spinal-cord-injured (SCI patient. The results showed that the HFI was able to adapt and translate the residual mobility of the SCI patient into efficient control commands within a week's training. The results are encouraging for the development of more efficient HFIs, especially for wheelchair users.
Rice, Laura A; Sung, JongHun; Peters, Joseph; Bartlo, Wendy D; Sosnoff, Jacob J
To understand the circumstances surrounding the worst fall experienced by power wheelchair users in the past year and to examine injuries sustained and recovery methods. A qualitative study using a semi-structured interview. Community. A self-selected volunteer sample of 19 power wheelchair users who utilize their device for at least 75% of mobility. The most common disability represented was cerebral palsy ( n = 8). The mean (SD) age of participants was 41.9 (7.6) years, who lived with their disability for a mean (SD) of 20.5 (8.62) years and used their current device for a mean (SD) of 3.9 (1.9) years. None. A semi-structured interview examined the circumstances surrounding the worst fall experienced in the past year, injuries sustained and recovery techniques used. Upon examination of the circumstances of the worst fall, four main themes emerged: (1) action-related fall contributors, (2) location of falls, (3) fall attributions and (4) time of fall. Each fall described was found to involve multiple factors. As a result of the fall, participants also reported the occurrence of physical injuries and a fear of falling. Physical injuries ranged from skin abrasion and bruises to fractures and head injuries. Participants also reported that fear of falling diminished their desire to participation in activities they enjoyed doing. Finally, most participants reported the need for physical assistance to recover from a fall. Participant descriptions provide an in-depth description of the circumstances and aftermath of falls experienced by power wheelchair users.
Full Text Available The implementation of Artificial Neural Network in prediction the direction of electric wheelchair from brain signal input for physical mobility impairment.. The control of the wheelchair as an effort in improving disabled person life quality. The interaction from disabled person is helping in relation to social life with others. Because of the mobility impairment, the wheelchair with brain signal input is made. This wheel chair is purposed to help the disabled person and elderly for their daily activity. ANN helps to develop the mapping from input to target. ANN is developed in 3 level: input level, one hidden level, and output level (6-2-1. There are 6 signal from Neurosky Mindset sensor output, Alpha1, Alpha2, Raw signal, Total time signal, Attention Signal, and Meditation signal. The purpose of this research is to find out the output value from ANN: value in turning right, turning left, and forward. From those outputs, we can prove the relevance to the target. One of the main problem that interfering with success is the problem of proper neural network training. Arduino uno is chosen to implement the learning program algorithm because it is a popular microcontroller that is economic and efficient. The training of artificial neural network in this research uses 21 data package from raw data, Alpha1, Aplha2, Meditation data, Attention data, total time data. At the time of the test there is a value of Mean square Error(MSE at the end of training amounted to 0.92495 at epoch 9958, value a correlation coefficient of 0.92804 shows that accuracy the results of the training process good. Keywords: Navigation, Neural network, Real-time training, Arduino
Enomoto, A; Yokomori, M; Yamaguchi, S [Meijo University, Aichi (Japan)
We analyzed about the motion of motorized wheelchairs and the driver`s behavior when passing over the small obstacles in place of the rough surface road or the gateway of house and road by experiment. The tested two type wheelchairs are the front wheel drive and the rear wheel drive. The lean angle of head and the pulse rate of driver, the feeling for stability and the yaw angle and the roll angle of the wheelchair bodies, and the deflection angle of front wheels of rear drive. 4 refs., 11 figs., 1 tab.
Giesbrecht, Edward M; Miller, William C; Eng, Janice J; Mitchell, Ian M; Woodgate, Roberta L; Goldsmith, Charles H
Many older adults rely on a manual wheelchair for mobility but typically receive little, if any, training on how to use their wheelchair effectively and independently. Standardized skill training is an effective intervention, but limited access to clinician trainers is a substantive barrier. Enhancing Participation in the Community by Improving Wheelchair Skills (EPIC Wheels) is a 1-month monitored home training program for improving mobility skills in older novice manual wheelchair users, integrating principles from andragogy and social cognitive theory. The purpose of this study is to determine whether feasibility indicators and primary clinical outcome measures of the EPIC Wheels program are sufficiently robust to justify conducting a subsequent multi-site randomized controlled trial. A 2 × 2 factorial randomized controlled trial at two sites will compare improvement in wheelchair mobility skills between an EPIC Wheels treatment group and a computer-game control group, with additional wheelchair use introduced as a second factor. A total of 40 community-dwelling manual wheelchair users at least 55 years old and living in two Canadian metropolitan cities (n = 20 × 2) will be recruited. Feasibility indicators related to study process, resources, management, and treatment issues will be collected during data collection and at the end of the study period, and evaluated against proposed criteria. Clinical outcome measures will be collected at baseline (pre-randomization) and post-intervention. The primary clinical outcome measure is wheelchair skill capacity, as determined by the Wheelchair Skills Test, version 4.1. Secondary clinical outcome measures include wheelchair skill safety, satisfaction with performance, wheelchair confidence, life-space mobility, divided-attention, and health-related quality of life. The EPIC Wheels training program offers several innovative features. The convenient, portable, economical, and adaptable tablet-based, home program model
Bloemen, M.A.; Takken, T.; Backx, F.J.; Vos, M.; Kruitwagen, C.L.; Groot, J.F. de
Objectives: To determine content validity of the Muscle Power Sprint Test (MPST), and construct validity and reliability of the MPST, 10x5 Meter Sprint Test (10x5MST), slalom test, and One Stroke Push Test (1SPT) in wheelchair-using youth with spina bifida (SB). Design: Clinimetric study. Setting:
Kloosterman, Marieke; Snoek, G.J.; van der Woude, L.H.V.; Buurke, Jaap; Rietman, Johan Swanik
Objective: To determine the (dis)advantages of transition to a power-assisted wheelchair, and derive the clinical implications for its use or prescription. Data sources: Relevant articles published prior to May 2012 were identified using PubMed, Cochrane Library, REHABDATA, CIRRIE and CINAHL
Mohebbi, Ali; Engelsholm, Signe K.D.; Puthusserypady, Sadasivan
In this pilot study, a novel and minimalistic Brain Computer Interface (BCI) based wheelchair control application was developed. The system was based on pseudorandom code modulated Visual Evoked Potentials (c-VEPs). The visual stimuli in the scheme were generated based on the Gold code...
Full Text Available AbstractManual wheelchair users with spinal cord injury have a high prevalence of shoulder pain, due to the use of the upper extremity for independent mobility, transfers and other activities of daily living. Indeed, shoulder pain dramatically affects quality of life of these individuals. There is limited evidence obtained through radiographic techniques of a relationship between the forces acting on the shoulder during different propulsion conditions and shoulder pathologies. Today, ultrasound is widely accepted as a precise tool in diagnosis, displaying particularly effectiveness in screening the shoulder rotator cuff. Thus, we set out to perform an ultrasound-based study of the acute changes to the shoulder soft tissues after propelling a manual wheelchair in two workload settings. Shoulder joint kinetics was recorded from 14 manual wheelchair users with spinal cord injury while they performed high and low intensity wheelchair propulsion tests (constant and incremental. Shoulder joint forces and moments were obtained from inverse dynamic methods, and ultrasound screening of the shoulder was performed before and immediately after the test. Kinetic changes were more relevant after the most intensive task, showing the significance of high intensity activity, yet no differences were found in ultrasound-related parameters before and after each propulsion task. It therefore appears that further studies will be needed to collect clinical data and correlate data regarding shoulder pain with both ultrasound images and data from shoulder kinetics.
Haisma, J.A.; van der Woude, L.H.V.; Stam, H.J.; Bergen, M.P.; Sluis, T.A.; Bussmann, J.B.J.
Study design: Review of publications. Objective: To assess the level of physical capacity (peak oxygen uptake, peak power output, muscle strength of the upper extremity and respiratory function) in wheelchair-dependent persons with a spinal cord injury (SCI). Setting: Erasmus MC, University Medical
Haisma, J. A.; van der Woude, L. H. V.; Stam, H. J.; Bergen, M. P.; Sluis, T. A. R.; Bussmann, J. B. J.
Study design: Review of publications. Objective: To assess the level of physical capacity ( peak oxygen uptake, peak power output, muscle strength of the upper extremity and respiratory function) in wheelchair-dependent persons with a spinal cord injury (SCI). Setting: Erasmus MC, University
van der Slikke, Rienk M A; Bregman, Daan J J; Berger, Monique A M; de Witte, Annemarie M H
PURPOSE: Classification is a defining factor for competition in wheelchair sports, but it is a delicate and time-consuming process with often questionable validity.1 New inertial sensor based measurement methods applied in match play and field tests, allow for more precise and objective estimates of
Qi, Liping; Wakeling, James; Grange, Simon; Ferguson-Pell, Martin
The purpose of this study was to determine whether muscle balance is influenced by fatigue in a recordable way, toward creating novel defensive activity strategies for manual wheelchair users (MWUs). Wheelchair propulsion to a point of mild fatigue, level 15 on the Rating of Perceived Exertion scale, was investigated at two different speeds. Surface electromyographic (EMG) activity of 7 muscles was recorded on 14 nondisabled participants. Kinetic variables were measured using a SmartWheel. No significant effect was found of percentage endurance time on kinetic variables for the two propulsion speeds. Fatigue-related changes in the EMG spectra were identified as an increase of EMG intensity and a decrease of mean power frequency as a function of percent endurance time for the tested muscles under both fast and slow speed conditions. The greater increases in activity for propulsive muscles compared with recovery muscles during fast speed wheelchair propulsion indicated muscle imbalance associated with fatiguing wheelchair propulsion. This study shows how kinetic and EMG information might be used as feedback to MWUs to ensure that they conduct activity in ways that do not precipitate injury.
van Velzen, Judith M.; de Groot, Sonja; Post, Marcel W. M.; Slootman, Johannes Hans R.; van Bennekom, Coen A. M.; van der Woude, Lucas H. V.
To describe the number of people with spinal cord injury who returned to work (RTW) 1 yr after discharge from inpatient rehabilitation and to investigate whether RTW can be predicted from wheelchair capacity at discharge from inpatient rehabilitation, after correction for confounders. Prospective
Gil-Agudo, Ángel; Solís-Mozos, Marta; Crespo-Ruiz, Beatriz; del-Ama Eng, Antonio J.; Pérez-Rizo, Enrique; Segura-Fragoso, Antonio; Jiménez-Díaz, Fernando
Manual wheelchair users with spinal cord injury (SCI) have a high prevalence of shoulder pain due to the use of the upper extremity for independent mobility, transfers, and other activities of daily living. Indeed, shoulder pain dramatically affects quality of life of these individuals. There is limited evidence obtained through radiographic techniques of a relationship between the forces acting on the shoulder during different propulsion conditions and shoulder pathologies. Today, ultrasound is widely accepted as a precise tool in diagnosis, displaying particularly effectiveness in screening the shoulder rotator cuff. Thus, we set out to perform an ultrasound-based study of the acute changes to the shoulder soft tissues after propelling a manual wheelchair in two workload settings. Shoulder joint kinetics was recorded from 14 manual wheelchair users with SCI while they performed high- and low-intensity wheelchair propulsion tests (constant and incremental). Shoulder joint forces and moments were obtained from inverse dynamic methods, and ultrasound screening of the shoulder was performed before and immediately after the test. Kinetic changes were more relevant after the most intensive task, showing the significance of high-intensity activity, yet no differences were found in ultrasound-related parameters before and after each propulsion task. It therefore appears that further studies will be needed to collect clinical data and correlate data regarding shoulder pain with both ultrasound images and data from shoulder kinetics. PMID:25566539
Fliess-Douer, Osnat; Vanlandewijck, Yves C.; Van der Woude, Lucas H. V.
Fliess-Douer O, Vanlandewijck YC, Van Der Woude LHV. Most essential wheeled mobility skills for daily life: an international survey among paralympic wheelchair athletes with spinal cord injury. Arch Phys Med Rehabil 2012;93:629-35. Objectives: To create a hierarchical list of the most essential
Silveira, S L; Ledoux, T; Cottingham, M; Hernandez, D C
Cross-sectional. To determine whether frequency of training is related to self-reported lower psychological distress, defined as depressive symptomology and perceived stress, among the US male wheelchair rugby athletes with tetraplegia. United States. Survey data were collected on a convenience sample at wheelchair rugby tournaments from January-April 2016. Participants self-reported depressive symptomology (CES-D-10), perceived stress scale (PSS), and frequency of rugby practice. Covariate-adjusted regression models were conducted among the full sample and a subsample of individuals who reported spinal cord injury (SCI) as the nature of their disability. Participants included 150 males with tetraplegia, and 87% identified the nature of their disability as SCI. Participants were primarily Caucasian with an average age of ~35 years. Participants scored low on measures of depressive symptomology (mean=5.63; s.d.=4.35) and perceived stress (mean=4.63; s.d.=2.73). Sixty-seven percent of the participants practiced two or more times per week. Results of the main analyses indicated that practicing wheelchair rugby two times or more (compared to once a week or less) was significantly associated with lower depressive symptomology and perceived stress among the full sample and subsample of individuals with SCI. Greater frequency of wheelchair rugby participation was associated with lower levels of psychological distress. Future research should examine the directional and mechanistic relationship between frequency of sports participation and psychological distress to inform the benefits of adaptive sport.
Bloemen, Manon A.; Takken, Tim; Backx, Frank J.; Vos, Marleen; Kruitwagen, Cas L.; de Groot, Janke F.
OBJECTIVE: To determine content validity of the Muscle Power Sprint Test (MPST) and construct validity and reliability of the MPST, 10x5 Meter Sprint Test (10x5MST), slalom test and one stroke push test (1SPT) in wheelchair-using youth with spina bifida (SB). DESIGN: Clinimetric study SETTING:
Cas L.J.J. Kruitwagen; Frank J.G. Backx; Tim Takken; Janke de Groot; Marleen Vos; Manon A.T. Bloemen
Objective: To determine content validity of the Muscle Power Sprint Test (MPST) and construct validity and reliability of the MPST, 10x5 Meter Sprint Test (10x5MST), slalom test and one stroke push test (1SPT) in wheelchair-using youth with spina bifida (SB). Design: Clinimetric study Setting:
ELISA M. BERETTA
Full Text Available Thermal comfort of wheelchairs still requires improvements, since users remain on the chair for as long as 12 h a day. Increased sweating makes the skin more susceptible to colonization by fungi and bacteria, and may cause pressure ulcers. In this sense, the microencapsulation of Phase-Change Materials (PCMs may help to enhance wheelchair cushion comfort by regulating heat exchange. This study describes the production of PCM microcapsules and their application in flexible polyurethane foams after expansion, and assesses improvements in heat exchange. Microcapsules with eicosane core coated with melamine-formaldehyde were produced. Eicosane is a thermoregulation agent whose phase-change temperature is near that of the human body’s. Microcapsules were characterized by thermogravimetric analysis, differential scanning calorimetry, scanning electron microscopy, and Fourier transform infrared spectroscopy. Then, microcapsules were applied on polyurethane foams by vacuum filtration and high-pressure air gun. Samples were exposed to a heat source and analysed by infrared thermography. The results indicate that thermal load increased in samples treated with microcapsules, especially by pressure air gun, and show that it is possible to enhance thermal comfort in wheelchair seats. Thereby, this study contributes to enhance quality of life for wheelchair users, focusing on thermal comfort provided by cushion seats made from PU foam.
Full Text Available This paper introduces a novel device based on a tactile interface to replace the attendant joystick in electric wheelchairs. It can also be used in other vehicles such as shopping trolleys. Its use allows intuitive driving that requires little or no training, so its usability is high. This is achieved by a tactile sensor located on the handlebar of the chair or trolley and the processing of the information provided by it. When the user interacts with the handle of the chair or trolley, he or she exerts a pressure pattern that depends on the intention to accelerate, brake or turn to the left or right. The electronics within the device then perform the signal conditioning and processing of the information received, identifying the intention of the user on the basis of this pattern using an algorithm, and translating it into control signals for the control module of the wheelchair. These signals are equivalent to those provided by a joystick. This proposal aims to help disabled people and their attendees and prolong the personal autonomy in a context of aging populations.
Full Text Available Transfers are one of the most physically demanding wheelchair activities. The purpose of this study was to determine if using proper transfer skills as measured by the Transfer Assessment Instrument (TAI is associated with reduced loading on the upper extremities. Twenty-three wheelchair users performed transfers to a level-height bench while a series of forces plates, load cells, and a motion capture system recorded the biomechanics of their natural transferring techniques. Their transfer skills were simultaneously evaluated by two study clinicians using the TAI. Logistic regression and multiple linear regression models were used to determine the relationships between TAI scores and the kinetic variables on both arms across all joints. The results showed that the TAI measured transfer skills were closely associated with the magnitude and timing of joint moments (P<.02, model R2 values ranged from 0.27 to 0.79. Proper completion of the skills which targeted the trailing arm was associated with lower average resultant moments and rates of rise of resultant moments at the trailing shoulder and/or elbow. Some skills involving the leading side had the effect of increasing the magnitude or rate loading on the leading side. Knowledge of the kinetic outcomes associated with each skill may help users to achieve the best load-relieving effects for their upper extremities.
Wang, Hongwu; Candiotti, Jorge; Shino, Motoki; Chung, Cheng-Shiu; Grindle, Garrett G; Ding, Dan; Cooper, Rory A
This paper describes the development of a mobile base for the Personal Mobility and Manipulation Appliance Generation II (PerMMA Gen II robotic wheelchair), an obstacle-climbing wheelchair able to move in structured and unstructured environments, and to climb over curbs as high as 8 inches. The mechanical, electrical, and software systems of the mobile base are presented in detail, and similar devices such as the iBOT mobility system, TopChair, and 6X6 Explorer are described. The mobile base of PerMMA Gen II has two operating modes: "advanced driving mode" on flat and uneven terrain, and "automatic climbing mode" during stair climbing. The different operating modes are triggered either by local and dynamic conditions or by external commands from users. A step-climbing sequence, up to 0.2 m, is under development and to be evaluated via simulation. The mathematical model of the mobile base is introduced. A feedback and a feed-forward controller have been developed to maintain the posture of the passenger when driving over uneven surfaces or slopes. The effectiveness of the controller has been evaluated by simulation using the open dynamics engine tool. Future work for PerMMA Gen II mobile base is implementation of the simulation and control on a real system and evaluation of the system via further experimental tests.
Sharma, Vinod; Simpson, Richard C; LoPresti, Edmund F; Schmeler, Mark
Nonambulatory, visually impaired individuals mostly rely on caregivers for their day-to-day mobility needs. The Drive-Safe System (DSS) is a modular, semiautonomous smart wheelchair system aimed at providing independent mobility to people with visual and mobility impairments. In this project, clinical evaluation of the DSS was performed in a controlled laboratory setting with individuals who have visual impairment but no mobility impairment. Their performance using DSS was compared with their performance using a standard cane for navigation assistance. Participants rated their subjective appraisal of the DSS by using the National Aeronautics and Space Administration-Task Load Index inventory. DSS significantly reduced the number and severity of collisions compared with using a cane alone and without increasing the time required to complete the task. Users rated DSS favorably; they experienced less physical demand when using the DSS, but did not feel any difference in perceived effort, mental demand, and level of frustration when using the DSS alone or along with a cane in comparison with using a cane alone. These findings suggest that the DSS can be a safe, reliable, and easy-to-learn and operate independent mobility solution for visually impaired wheelchair users.
Ingrid G Barlow
Full Text Available This study compared outcomes of wheelchair seating and positioning interventions provided by telerehabilitation (n=10 and face-to-face (n=20; 10 in each of two comparison groups, one urban and one rural. Comparison clients were matched to the telerehabilitation clients in age, diagnosis, and type of seating components received. Clients and referring therapists rated their satisfaction and identified if seating intervention goals were met. Clients recorded travel expenses incurred or saved, and all therapists recorded time spent providing service. Wait times and completion times were tracked. Clients seen by telerehabilitation had similar satisfaction ratings and were as likely to have their goals met as clients seen face-to-face; telerehabilitation clients saved travel costs. Rural referring therapists who used telerehabilitation spent more time in preparation and follow-up than the other groups. Clients assessed by telerehabilitation had shorter wait times for assessment than rural face-to-face clients, but their interventions took as long to complete. Keywords: Telerehabilitation, Telehealth, Videoconferencing, Wheelchair Seating, Outcomes, Rehabilitation
van der Linden, Marietta L; Bulley, Catherine; Geneen, Louise J; Hooper, Julie E; Cowan, Paula; Mercer, Thomas H
This mixed methods study aimed to explore the feasibility, efficacy and the participants' experiences of a Pilates programme for people with Multiple Sclerosis (pwMS) who use a wheelchair. Fifteen pwMS took part in the 12-week Pilates programme. At baseline and after 6 and 12 weeks of the programme, sitting stability, measured as maximum progression of the Centre of Pressure when leaning sideways (COPmax), posture, pain on a Visual Analogue Scale, function, fatigue and the impact of MS (MSIS29) were assessed. Ten participants took part in two focus groups within six weeks of the completion of the programme. Significant improvements at the 12-week assessment were found in COPmax (p = 0.046), sitting posture (p = 0.004), pain in the shoulders (p = 0.005) and back (p = 0.005) and MSIS29 (p = 0.006). The majority of participants described various physical, functional, psychological and social benefits from participation that reflected increased confidence in activities of daily living. Enjoyment of the classes was expressed by all, and most wished to continue participation. Pilates appears to be efficacious in improving sitting stability and posture and decreasing pain and was also well tolerated by wheelchair users with MS. Further mixed methods studies are warranted.
David S. Haydon
Full Text Available Optimisation of wheelchairs for court sports is currently a difficult and time-consuming process due to the broad range of impairments across athletes, difficulties in monitoring on-court performance, and the trade-off set-up that parameters have on key performance variables. A robust design approach to this problem can potentially reduce the amount of testing required, and therefore allow for individual on-court assessments. This study used orthogonal design with four set-up factors (seat height, depth, and angle, as well as tyre pressure at three levels (current, decreased, and increased for three elite wheelchair rugby players. Each player performed two maximal effort sprints from a stationary position in nine different set-ups, with this allowing for detailed analysis of each factor and level. Whilst statistical significance is difficult to obtain due to the small sample size, meaningful difference results aligning with previous research findings were identified and provide support for the use of this approach.
Vaile, Joanna; Stefanovic, Brad; Askew, Christopher D
To investigate the effects of compression socks worn during exercise on performance and physiological responses in elite wheelchair rugby athletes. In a non-blinded randomized crossover design, participants completed two exercise trials (4 × 8 min bouts of submaximal exercise, each finishing with a timed maximal sprint) separated by 24 hr, with or without compression socks. National Sports Training Centre, Queensland, Australia. Ten national representative male wheelchair rugby athletes with cervical spinal cord injuries volunteered to participate. Participants wore medical grade compression socks on both legs during the exercise task (COMP), and during the control trial no compression was worn (CON). The efficacy of the compression socks was determined by assessments of limb blood flow, core body temperature, heart rate, and ratings of perceived exertion, perceived thermal strain, and physical performance. While no significant differences between conditions were observed for maximal sprint time, average lap time was better maintained in COMP compared to CON (Pbenefit may be associated with an augmentation of upper limb blood flow.
Sporner, Michelle L; Fitzgerald, Shirley G; Dicianno, Brad E; Collins, Diane; Teodorski, Emily; Pasquina, Paul F; Cooper, Rory A
The purpose of this study was to determine the characteristics of individuals who participate in the National Veterans Wheelchair Games (NVWG) and the Winter Sports Clinic (WSC) for veterans with disabilities. In addition, it was of interest to determine how these events had impacted their lives. Participants were recruited at the 20th Winter Sports Clinic, held in Snowmass Colorado and the 26th National Veterans Wheelchair Games held in Anchorage, Alaska. Data of interest included demographic, sport participation information, community integration, self-esteem, and quality of life. A secondary data analysis was completed to determine how comparable individuals who attended the NVWG/WSC were to individuals who did not participate in these events. The 132 participants were a mean age of 47.4 + 13.4 and lived with a disability for an average of 13.4 + 12.1. Participants felt that the NVWG/WSC increased their knowledge of sports equipment (92%), learning sports (89%), mobility skills (84%), and acceptance of disability (84%). The majority of participants stated that the NVWG/WSC improved their life. Of those who participated at the NVWG/WSC, they tended to be more mobile, but have increased physical and cognitive limitations as measured by the CHART when compared to the non-attendees. Recommending veterans participate in events such as the NVWG and WSC can provide psychosocial benefits to veterans with disabilities.
Full Text Available Sport and exercise psychology research in disability sport seldom engages with social models of disability. As a result, the socio-historical landscape of disability is underrepresented in sport psychology research. The aim of this study is to interpret influences on participation in disability sport through the conceptual lens of the social relational model (SRM of disability (Thomas, 1999, 2004, 2007. Ten Irish adult male athletes with physical disabilities participated in semi-structured interviews exploring the barriers and facilitators that influence participation in Wheelchair Rugby. Deductive thematic analysis produced four themes influenced by the social relational model: impairment effects; societal attitudes and discourse; opportunities and access; and psychological well-being. Links were made to the experience of embodied impairment, classification, oppression, inequality, media, independence, and self-efficacy. The analysis illustrates how cultural constructions of disability are inextricably linked to individual influences on participation in Wheelchair Rugby. The results indicate that in disability sport participation, the experience of social oppression, inequality and cultural stereotypes of disability can be synonymous with the personal experience of physical impairment. The implication of this research is that there is a value in sport and exercise psychology practitioners utilising the social relational model as a tool to conceptualise the lived experience of physical disability.
Iturricastillo, Aitor; Granados, Cristina; Los Arcos, Asier; Yanci, Javier
The aim of the present study was to analyse the training load in wheelchair basketball small-sided games and determine the relationship between heart rate (HR)-based training load and perceived exertion (RPE)-based training load methods among small-sided games bouts. HR-based measurements of training load included Edwards' training load and Stagno's training impulses (TRIMP MOD ) while RPE-based training load measurements included cardiopulmonary (session RPEres) and muscular (session RPEmus) values. Data were collected from 12 wheelchair basketball players during five consecutive weeks. The total load for the small-sided games sessions was 67.5 ± 6.7 and 55.3 ± 12.5 AU in HR-based training load (Edwards' training load and TRIMP MOD ), while the RPE-based training loads were 99.3 ± 26.9 (session RPEres) and 100.8 ± 31.2 AU (session RPEmus). Bout-to-bout analysis identified greater session RPEmus in the third [P training loads. It is suggested that HR-based and RPE-based training loads provide different information, but these two methods could be complementary because one method could help us to understand the limitations of the other.
Murata, Tomoyuki; Asami, Toyoko; Matsuo, Kiyomi; Kubo, Atsuko; Okigawa, Etsumi
This study investigated the effects of seat-height settings of wheelchairs with alternating propulsion with both legs. Seven healthy individuals with no orthopedic disease participated. Flexion angles at initial contact (FA-IC) of each joint, range of motion during propulsion period (ROM-PP), and ground reaction force (GRF) were measured using a three dimensional motion capture system and force plates, and compared with different seat-height settings. Statistically significant relationships were found between seat-height and speed, stride length, knee FA-IC, ankle FA-IC, hip ROM-PP, vertical ground reaction force (VGRF), and anterior posterior ground reaction force (APGRF). Speed, hip ROM-PP, VGRF and APGRF increased as the seat-height was lowered. This effect diminished when the seat-height was set below -40 mm. VGRF increased as the seat-height was lowered. The results suggest that the seat-height effect can be attributed to hip ROM-PP; therefore, optimal foot propulsion cannot be achieved when the seat height is set either too high or too low. Efficient foot propulsion of the wheelchair can be achieved by setting the seat height to lower leg length according to a combination of physical characteristics, such as the user's physical functions, leg muscles, and range of motion.
Puanhvuan, Dilok; Khemmachotikun, Sarawin; Wechakarn, Pongsakorn; Wijarn, Boonyanuch; Wongsawat, Yodchanan
Currently, electric wheelchairs are commonly used to improve mobility in disabled people. In severe cases, the user is unable to control the wheelchair by themselves because his/her motor functions are disabled. To restore mobility function, a brain-controlled wheelchair (BCW) would be a promising system that would allow the patient to control the wheelchair by their thoughts. P300 is a reliable brain electrical signal, a component of visual event-related potentials (ERPs), that could be used for interpreting user commands. This research aimed to propose a prototype BCW to allowed severe motor disabled patients to practically control a wheelchair for use in their home environment. The users were able to select from 9 possible destination commands in the automatic mode and from 4 directional commands (forward, backward, turn left and right) in the shared-control mode. These commands were selected via the designed P300 processing system. The wheelchair was steered to the desired location by the implemented navigation system. Safety of the user was ensured during wheelchair navigation due to the included obstacle detection and avoidance features. A combination of P300 and EOG was used as a hybrid BCW system. The user could fully operate the system such as enabling P300 detection system, mode shifting and stop/cancelation command by performing a different consecutive blinks to generate eye blinking patterns. The results revealed that the prototype BCW could be operated in either of the proposed modes. With the new design of the LED-based P300 stimulator, the average accuracies of the P300 detection algorithm in the shared-control and automatic modes were 95.31 and 83.42% with 3.09 and 3.79 bits/min, respectively. The P300 classification error was acceptable, as the user could cancel an incorrect command by blinking 2 times. Moreover, the proposed navigation system had a flexible design that could be interfaced with other assistive technologies. This research developed
van der Slikke, Rienk M A; Bregman, Daan J J; Berger, Monique A M; de Witte, Annemarie M H; Veeger, Dirk-Jan H E J
Classification is a defining factor for competition in wheelchair sports, but it is a delicate and time-consuming process with often questionable validity. 1 New inertial sensor based measurement methods applied in match play and field tests, allow for more precise and objective estimates of the impairment effect on wheelchair mobility performance. It was evaluated if these measures could offer an alternative point of view for classification. Six standard wheelchair mobility performance outcomes of different classification groups were measured in match play (n=29), as well as best possible performance in a field test (n=47). In match-results a clear relationship between classification and performance level is shown, with increased performance outcomes in each adjacent higher classification group. Three outcomes differed significantly between the low and mid-class groups, and one between the mid and high-class groups. In best performance (field test), a split between the low and mid-class groups shows (5 out of 6 outcomes differed significantly) but hardly any difference between the mid and high-class groups. This observed split was confirmed by cluster analysis, revealing the existence of only two performance based clusters. The use of inertial sensor technology to get objective measures of wheelchair mobility performance, combined with a standardized field-test, brought alternative views for evidence based classification. The results of this approach provided arguments for a reduced number of classes in wheelchair basketball. Future use of inertial sensors in match play and in field testing could enhance evaluation of classification guidelines as well as individual athlete performance.
Sakakibara, Brodie M; Routhier, François; Miller, William C
To characterize the life-space mobility and social participation of manual wheelchair users using objective measures of wheeled mobility. Individuals (n = 49) were included in this cross-sectional study if they were aged 50 or older, community-dwelling and used their wheelchair on a daily basis for the past 6 months. Life-space mobility and social participation were measured using the life-space assessment and late-life disability instrument. The wheeled mobility variables (distance travelled, occupancy time, number of bouts) were captured using a custom-built data logger. After controlling for age and sex, multivariate regression analyses revealed that the wheeled mobility variables accounted for 24% of the life-space variance. The number of bouts variable, however, did not account for any appreciable variance above and beyond the occupancy time and distance travelled. Occupancy time and number of bouts were significant predictors of social participation and accounted for 23% of the variance after controlling for age and sex. Occupancy time and distance travelled are statistically significant predictors of life-space mobility. Lower occupancy time may be an indicative of travel to more distant life-spaces, whereas the distance travelled is likely a better reflection of mobility within each life-space. Occupancy time and number of bouts are significant predictors of participation frequency. Implications for rehabilitation Component measures of wheelchair mobility, such as distance travelled, occupancy time and number of bouts, are important predictors of life-space mobility and social participation in adult manual wheelchair users. Lower occupancy time is an indication of travel to more distant life-spaces, whereas distance travelled is likely a better reflection of mobility within each life-space. That lower occupancy time and greater number of bouts are associated with more frequent participation raises accessibility and safety issues for manual wheelchair
Tørhaug, T; Brurok, B; Hoff, J; Helgerud, J; Leivseth, G
To assess the effect from maximal bench press strength training (MST) on wheelchair propulsion work economy (WE). Pretest-posttest case-control group design. St Olavs Hospital, Trondheim, Norway. Seventeen male individuals with spinal cord injury (SCI) paraplegia were allocated to either MST bench press (n=11) or the control group (CG) (n=7). The MST group trained bench press three times per week, for 6 weeks, starting at 85-95% of their pretest bench press one-repetition maximum (1RM). For calculation of WE during wheelchair propulsion, oxygen uptake (VO 2 ) measurements were collected during wheelchair ergometry (WCE) at submaximal workload of 50 W. Similarly, peak oxygen uptake (VO 2peak ) and peak power output (W) were measured during WCE. Individuals in the MST regimen significantly improved WE compared with the CG by 17.3 % (mean between-group differences: 95% confidence interval) of 2.63 ml kg -1 min -1 : (-4.34, -0.91) (P=0.007). Between pretest and posttest, the increase in bench press 1RM was by 17% higher in the MST group compared with the CG. At peak testing, the MST group generated significantly higher peak power compared with the CG. All other physiological variables were comparable within and between groups. A 6-week MST bench press regimen significantly improved WE during wheelchair propulsion at 50 W workload. These preliminary data support a possible beneficial role for MST to reduce the energy cost of wheelchair propulsion for SCI individuals.
Full Text Available Background/Objective: Shoulder overuse due weight-bearing loads – wheelchair propulsion and transfers – are supposed to cause shoulder pain in active wheelchair users. Consequently, shoulder pain has been found to have a high prevalence in the spinal cord-injured population. Severity of pain levels in individuals with spinal cord injury has been shown to impact quality of life. Aim of this study was to describe the consequences of shoulder pain intensity on quality of life, physical activity, and community activities in spinal cord-injured paraplegic wheelchair users. Materials and Methods: It was a qualitative, analytical one moment study where was involved persons after spinal cord injury below Th1 with lower paraplegia, who used manually operated wheelchairs for mobility at least 50% of the time. Main outcomes measure: SF-36textregistered Health Survey, Physical Activity Scale for Individuals With Physical Disabilities, Community Activities Checklist, Wheelchair User’s Shoulder Pain Index, Functional Independence Measure, Goniometry for shoulder joint. Results and analysis: 40 participants (9 female, 31 male after spinal cord injury (SCI, mean age – 30,8 years, one to twenty years after spinal cord injury. 20 participants had pain in shoulder, 20 participants without pain in shoulder. The intensity of shoulder pain was not related to duration of SCI or the duration of shoulder pain. Shoulder pain intensity scores were inversely related to quality of life. There was a moderate, inverse relationship between shoulder pain intensity and physical activity. There was no relationship, however, between shoulder pain intensity and community activities. The level of community activity was positively related to quality of life. Conclusions: Persons with spinal cord injury who reported lower subjective quality of life and physical activity scores experienced significantly higher levels of shoulder pain. Shoulder pain intensity did not relate to
Conclusion: Passive limb activation by FES improved wheelchair driving and cognitive performance for patients with USN. It can be used with instruction from occupational therapists to enhance the performance on ADL.
Conclusion: While overall health status, and distance travelled into the community fluctuated over time, receipt of one of two models of a wheelchair in less-resourced settings of the world appears to have a positive sustained impact on employment and income. Further investigations should be carried out to confirm these results and explore the factors responsible for fluctuating variables. This study affirms the importance of long-term follow-up of outcomes associated with wheelchair distribution in less-resourced environments.
Rice, Ian M; Wong, Alex W K; Salentine, Benjamin A; Rice, Laura A
To examine the relationship of self-esteem and wheelchair type with participation of young adult manual and power wheelchair users with diverse physical disabilities. Cross-sectional survey study. Large University Campus. A convenience sample of college students (N = 39) with self-reported physical disabilities who are full time wheelchair users (>40 per week) and are two or more years post illness or injury. Not applicable. The Rosenberg Self-Esteem Scale was used to measure self-esteem, and the Craig Handicap Assessment and Reporting Technique was used to measure participation. Self-esteem correlated highly with cognitive independence (CI) (r = 0.58), mobility (r = 0.67) and social integration (SI) (r = 0.52). Use of manual wheelchair was significantly related to higher levels of CI and mobility while longer use of any wheelchair (power or manual) was significantly associated with higher levels of mobility and SI. In addition higher self-esteem independently predicted a significant proportion of the variance in CI, mobility and SI, while type of wheelchair predicted a significant proportion of the variance in CI (p self-esteem was found to be the strongest predictor of participation in a population of young adults with mobility limitations. Better understanding of the factors influencing participation may help to facilitate new interventions to minimize the disparities between persons with disabilities and their able bodied peers. Implication for Rehabilitation A total of 46.8% of wheelchair users report the desire for increased community participant but face significant barriers. The type of wheelchair has been identified as having a large impact on participation. This study found self-esteem to be the strongest predictor of participation, which is notable because self-esteem is a characteristic that is potentially modifiable with treatment.
Raphael José Perrier Melo
Full Text Available Aimed:This study aimed to analyze the hemodynamic responses during an active game session (VGA with the use of a wheelchair. Method: Twelve subjects (6 men and 6 women (24 ± 3.98 years; 22.6 ± 2.17 kg / m2 , apparently healthy (PAR-Q, not wheelchair users. Rest measures for heart rate (HR: bpm, blood pressure (BP;mmHg and calculation of double product (DP; mmHg/bpm were taken following the anthropometric assessment. Subsequently, they performed a session of Kinect Sports Boxing game for 15 minutes. The variables HR, BP and DP were measured at rest, during and after the session. Data was analyzed using the Friedman’s test with Dunn’s post hoc test for no parametric data to compare pre, during and post session. Values of p<0.05 were accepted as significant. Results: Immediately post session data showed significant increases in HR, SBP and DP for both men (HR: 68.00 ± 8.99 vs 105.17 ± 22.55; PAS: 123.67 ± 68 vs 134.17 ± 8.23; DP = 8446.00 ± 1453.54 vs 3628.76 ± 14217.50 and women (HR: 68.00 ± 8.00 vs 126.00 ± 20.44; PAS: 100.33 ± 8.82 vs 113.17 ± 9.15; DP: 6.843 ± 1160.36 vs 3597.45 ± 14 405. Similarly, after the experimental session were observed significant decreases in HR, SBP and DP compared to the immediately post session, for both boys and for girls. (HR: 74.67 ± 9.46 vs 105.17 ± 22.55; SBP: 121 ± 5.62 vs 134.17 ± 8.23; SD: 9066.50 ± 1449.98 vs 14217.50 ± 3628.76 and for women (HR: 76.83 ± 9.02 vs 126.00 ± 20.44; PAS: 100.67 ± 3.01 vs 113.17 ± 9.15; DP= 7745.33 ± 1025.34 vs 3597.45 ± 14.405. Conclusion: The practice of VGAs contributes to increased hemodynamic demands, being a safe alternative in the period of rehabilitation and training for athletes using wheelchair.
Full Text Available This study unites researchers from the fields of psychology, occupational therapy, and engineering to improve the holistic physical and psychological well-being of persons with spinal cord injury (SCI by using assistive devices (i.e., wheelchairs and mobile technology (i.e., cell phone and network. These technologies are used to bring persons with SCI through the difficult period of rehabilitation and to return them to their daily life in school or the working environment. First, a SpinoAid Application (APP is developed to motivate persons with SCI to participate in the community after their injury. Second, we integrate mobile technology with a mobility assistive device to design a smart wheelchair, which is innovated by transforming the pushrim of a manually driven wheelchair into a rim motor. After the rim motor is combined with a battery, a brake, and a controller to become a power wheel, two power wheels are installed on both sides of the wheelchair to become a powered wheelchair. Third, a SmartChair APP is developed with the main functions of reminding persons with SCI to perform exercises, recording the physical condition and the wheelchair using status, and building up a social network for information sharing to increase their exercise habit, prevent cumulative injuries or discomfort of the upper extremities, and enhance their health and quality of life.
Bertolaccini, Guilherme da Silva; Carvalho Filho, Idinei Francisco Pires de; Christofoletti, Gustavo; Paschoarelli, Luis Carlos; Medola, Fausto Orsi
Wheelchair configuration is an important factor influencing the ergonomics of the user-device interface and, from a biomechanical point of view, small changes in chair setup may have a positive influence on the demand on the upper limbs during manual propulsion. This study aimed to investigate the influence of the position of the rear wheels' axle and the use of accessories on the activity of upper limb muscles during manual wheelchair propulsion. Electromyography signals of the biceps, triceps, anterior deltoids and pectoralis major were collected for 11 able-bodied subjects in a wheelchair propulsion protocol with four different wheelchair configurations (differing in axle position and the use of accessories) on a straightforward sprint and a slalom course. With accessories, moving the axle forward led to a decrease in the activity of all muscles in both the straightforward sprint (significant differences in triceps, anterior deltoids and biceps) and the slalom course (significant difference in anterior deltoids and biceps). However, when propelling the chair without accessories, no difference was found related to axle position. Changes in wheelchair configuration can influence the ergonomics of manual wheelchair propulsion. Reducing the biomechanical loads may benefit users' mobility, independence and social participation.
Impink, Bradley G; Collinger, Jennifer L; Boninger, Michael L
To quantify median nerve characteristics before and after strenuous wheelchair propulsion and relate them to symptoms of carpal tunnel syndrome (CTS). We hypothesized that persons with and without symptoms of CTS would have significantly different nerve characteristics at baseline and after propulsion. A repeated-measures design was used to obtain ultrasound images of the median nerve at 3 levels of the wrist (radius, pisiform, and hamate) before and after wheelchair propulsion. Investigators were blinded to subject history related to CTS. The 2007 and 2008 National Veterans Wheelchair Games and the Human Engineering Research Laboratories. Fifty-four participants between the ages of 18 and 65 years with a nonprogressive disability who used a manual wheelchair as their primary means of mobility completed this study. Participants completed questionnaires regarding demographics and the presence and severity of symptoms of CTS. Ultrasound images of the median nerve were obtained before and after a 15-minute strenuous wheelchair-propulsion task. Baseline values and post-propulsion changes were determined for median nerve cross-sectional area, flattening ratio, and swelling ratio. Differences in median nerve variables between symptomatic and asymptomatic groups were assessed. No significant differences between symptom groups were identified at baseline; however, persons with symptoms of CTS showed a significantly different percent change from baseline compared with the asymptomatic participants for cross-sectional area at pisiform (P = .014) and flattening ratio at hamate (P = .022), and they showed a strong trend toward a difference in swelling ratio (P = .0502). For each of these variables, the change in the symptomatic group was in the opposite direction of the change in the asymptomatic group. We found several median nerve responses to wheelchair propulsion associated with symptoms of CTS. These responses occurred even though no baseline ultrasound difference was
Giesbrecht, Edward Mark; Miller, William C; Jin, Boyang Tom; Mitchell, Ian M; Eng, Janice J
Alternative and innovative strategies such as mHealth and eLearning are becoming a necessity for delivery of rehabilitation services. For example, older adults who require a wheelchair receive little, if any, training for proficiency with mobility skills. This substantive service gap is due in part to restricted availability of clinicians and challenges for consumers to attend appointments. A research team of occupational therapists and computer scientists engaged clinicians, consumers, and care providers using a participatory action design approach. A tablet-based application, Enhancing Participation In the Community by improving Wheelchair Skills (EPIC Wheels), was developed to enable in-chair home training, online expert trainer monitoring, and trainee-trainer communication via secure voice messaging. Prior to undertaking a randomized controlled trial (RCT), a pilot study was conducted to determine the acceptability and feasibility of administering an mHealth wheelchair skills training program safely and effectively with two participants of different skill levels. The findings were used to determine whether further enhancements to the program were indicated. The program included two in-person sessions with an expert trainer and four weeks of independent home training. The EPIC Wheels application included video instruction and demonstration, self-paced training activities, and interactive training games. Participants were provided with a 10-inch Android tablet, mounting apparatus, and mobile Wi-Fi device. Frequency and duration of tablet interactions were monitored and uploaded daily to an online trainer interface. Participants completed a structured evaluation survey and provided feedback post-study. The trainer provided feedback on the training protocol and trainer interface. Both participants perceived the program to be comprehensive, useful, and easily navigated. The trainer indicated usage data was comprehensive and informative for monitoring participant
Barlow, Ingrid G; Liu, Lili; Sekulic, Angela
This study compared outcomes of wheelchair seating and positioning interventions provided by telerehabilitation (n=10) and face-to-face (n=20; 10 in each of two comparison groups, one urban and one rural). Comparison clients were matched to the telerehabilitation clients in age, diagnosis, and type of seating components received. Clients and referring therapists rated their satisfaction and identified if seating intervention goals were met. Clients recorded travel expenses incurred or saved, and all therapists recorded time spent providing service. Wait times and completion times were tracked. Clients seen by telerehabilitation had similar satisfaction ratings and were as likely to have their goals met as clients seen face-to-face; telerehabilitation clients saved travel costs. Rural referring therapists who used telerehabilitation spent more time in preparation and follow-up than the other groups. Clients assessed by telerehabilitation had shorter wait times for assessment than rural face-to-face clients, but their interventions took as long to complete. PMID:25945159
Full Text Available The International Symbol of Access (ISA produces, capacitates, and debilitates disability in particular ways and is grounded by a happy affective economy that is embedded within neoliberal capitalism. This production of disability runs counter to the dismantling of ableism and compulsory able-bodiedness. In charting the development of the modern wheelchair, the rise of disability rights in North America, and the emergence of the ISA as a universally acceptable representation of access for disabled people, I argue that this production of disability serves a capacitating function for particular forms of impairment. These capacitated forms are celebrated through a neoliberal economy of inclusion. I conclude by critically approaching the happy affects of the ISA, including the way in which the symbol creates a sense of cruel optimism for disabled people.
Depression is a common condition among long-term care residents with limited treatment options available. There are few nonpharmacological interventions available to this population. This study examined the use of a prescribed, therapeutic recreation-nursing intervention, wheelchair biking, for treatment of symptoms of depression in older adults in a long-term care setting. A classical experimental design was used and was guided by the Roy Adaptation Model. Forty residents were pretested for depression and randomly assigned to two groups. A 2-week trial of biking therapy was provided to the treatment group. All participants were posttested. Findings indicated there was a statistically significant improvement in depression scores for the treatment group and no significant change for the control group. This study contributes to the body of knowledge of nursing regarding options for the treatment of depression in older adults, and is an encouraging indicator that psychosocial interventions may be effective in reducing depression.
Spencer-Cavaliere, Nancy; Peers, Danielle
The inclusion of able-bodied athletes within disability sport, a phenomenon known as reverse integration, has sparked significant debate within adapted physical activity. Although researchers and practitioners have taken up positions for or against reverse integration, there is a lack of supporting research on the experiences of athletes who already play in such settings. In this study, we explore how competitive female athletes who have a disability experience reverse integration in Canadian wheelchair basketball. Athletic identity was used as the initial conceptual framework to guide semistructured interviews with nine participants. The results suggest that participation in this context contributed to positive athletic identities. Interviews also pointed to the unexpected theme of "what's the difference?" that this sporting context provided a space for the questioning and creative negotiation of the categories of disability and able-bodiedness. Methodologically, this paper also explores the possibilities and challenges of inter- worldview and insider-outsider research collaboration.
Full Text Available The research aims to determine the effect of a weighted basketball balls training program on some physical performance via wheelchair basketball players. The sample was selected in an intended manner including 20 players’. Divided into two equal groups (experimental 10 players, control 10 players for the sports season 2016/2017. As protocol experimental, our training program for the experimental group was applied under researchers’ supervision, using Weighted basketball balls in the opposite of control group which used the same program with real weight basketball. All the tests practised (pre or post test were conducted with the same team and in the same condition based on endurance test (1000 m, speed test (30 m, push the medical ball and dribbling to test the agility. After statistically processing, it was clear that weighted basketball balls as ingrate tool led to the increase of physical performance intended to study. In the opposite of traditional method.
Ferreira, A; Silva, R L; Celeste, W C; Filho, T F Bastos; Filho, M Sarcinelli
This paper presents a Human-Machine Interface (HMI) based on the signals generated by eye blinks or brain activity. The system structure and the signal acquisition and processing are shown. The signals used in this work are either the signal associated to the muscular movement corresponding to an eye blink or the brain signal corresponding to visual information processing. The variance is the feature extracted from such signals in order to detect the intention of the user. The classification is performed by a variance threshold which is experimentally determined for each user during the training stage. The command options, which are going to be sent to the commanded device, are presented to the user in the screen of a PDA (Personal Digital Assistant). In the experiments here reported, a robotic wheelchair is used as the device being commanded
Ferreira, A; Silva, R L; Celeste, W C; Filho, T F Bastos; Filho, M Sarcinelli [Electrical Engineering Department, Federal University of Espirito Santo (UFES), Av. Fernando Ferrari, 514, Vitoria, 29075-910 (Brazil)
This paper presents a Human-Machine Interface (HMI) based on the signals generated by eye blinks or brain activity. The system structure and the signal acquisition and processing are shown. The signals used in this work are either the signal associated to the muscular movement corresponding to an eye blink or the brain signal corresponding to visual information processing. The variance is the feature extracted from such signals in order to detect the intention of the user. The classification is performed by a variance threshold which is experimentally determined for each user during the training stage. The command options, which are going to be sent to the commanded device, are presented to the user in the screen of a PDA (Personal Digital Assistant). In the experiments here reported, a robotic wheelchair is used as the device being commanded.
In nowadays aging society, many people require mobility assistance. Sometimes, assistive devices need a certain degree of autonomy when users' disabilities difficult manual control. However, clinicians report that excessive assistance may lead to loss of residual skills and frustration. Shared control focuses on deciding when users need help and providing it. Collaborative control aims at giving just the right amount of help in a transparent, seamless way. This book presents the collaborative control paradigm. User performance may be indicative of physical/cognitive condition, so it is used to decide how much help is needed. Besides, collaborative control integrates machine and user commands so that people contribute to self-motion at all times. Collaborative control was extensively tested for 3 years using a robotized wheelchair at a rehabilitation hospital in Rome with volunteer inpatients presenting different disabilities, ranging from mild to severe. We also present a taxonomy of common metrics for wheelc...
Arpaia, G; Bavera, P M; Caputo, D; Mendozzi, L; Cavarretta, R; Agus, G B; Milani, M; Ippolito, E; Cimminiello, C
Multiple sclerosis (MS) often causes progressive loss of mobility, leading to limb paralysis. Venous and lymphatic stasis is a risk condition for venous thromboembolism (VTE). There is, however, no data on the frequency of VTE complicating the progression of MS. The aim of this study was to assess the frequency of deep vein thrombosis (DVT) in patients with late-stage MS attending a neurology center for rehabilitation. A total of 132 patients with MS were enrolled, 87 women and 45 men, mean age 58+/-11 years. The disease had started on average 18.7 years before; patients reported 9.6 hours bedridden per day or 14.3 hours wheelchair-bound. Only 25 patients reported a residual ability to walk alone or with help. Lower limb edema was present in 113 patients, bilateral in 41 cases. At admission all patients underwent extended compression ultrasonography. Their plasma D-dimer levels were measured. No antithrombotic prophylaxis was given. DVT was found in 58 patients (43.9%); 32 had a history of VTE. Forty of these patients (69%) had chronic lower limb edema, in 19 cases bilateral. D-dimer levels in the DVT patients were significantly higher than in patients without DVT (553+/-678 vs. 261+/-152 ng/mL, p=0.0112, Mann-Whitney Test). Nearly half the DVT patients (26, 45%) had high D-dimer levels (701+/-684 ng/mL). Of the 74 patients without DVT, 48 had normal D-dimer (193.37+/-67.28 ng/mL) and 26 high (387.61+/-187.42 ng/mL). The frequency of DVT in late-stage MS may be over 40%. The long history of the disease means the onset of each episode cannot be established with certainty. A number of patients with positive CUS findings had negative D-dimer values, suggesting a VTE event in the past. However, the level of DVT risk in this series should lead physicians to consider the systematic application of long-term preventive measures. (c) 2009 Elsevier Ltd. All rights reserved.
Nightingale, Tom Edward; Walhin, Jean-Philippe; Thompson, Dylan; Bilzon, James Lee John
To assess the validity of two accelerometer devices, at two different anatomical locations, for the prediction of physical activity energy expenditure (PAEE) in manual wheelchair users (MWUs). Seventeen MWUs (36 ± 10 yrs, 72 ± 11 kg) completed ten activities; resting, folding clothes, propulsion on a 1% gradient (3,4,5,6 and 7 km·hr-1) and propulsion at 4km·hr-1 (with an additional 8% body mass, 2% and 3% gradient) on a motorised wheelchair treadmill. GT3X+ and GENEActiv accelerometers were worn on the right wrist (W) and upper arm (UA). Linear regression analysis was conducted between outputs from each accelerometer and criterion PAEE, measured using indirect calorimetry. Subsequent error statistics were calculated for the derived regression equations for all four device/location combinations, using a leave-one-out cross-validation analysis. Accelerometer outputs at each anatomical location were significantly (p < .01) associated with PAEE (GT3X+-UA; r = 0.68 and GT3X+-W; r = 0.82. GENEActiv-UA; r = 0.87 and GENEActiv-W; r = 0.88). Mean ± SD PAEE estimation errors for all activities combined were 15 ± 45%, 14 ± 50%, 3 ± 25% and 4 ± 26% for GT3X+-UA, GT3X+-W, GENEActiv-UA and GENEActiv-W, respectively. Absolute PAEE estimation errors for devices varied, 19 to 66% for GT3X+-UA, 17 to 122% for GT3X+-W, 15 to 26% for GENEActiv-UA and from 17.0 to 32% for the GENEActiv-W. The results indicate that the GENEActiv device worn on either the upper arm or wrist provides the most valid prediction of PAEE in MWUs. Variation in error statistics between the two devices is a result of inherent differences in internal components, on-board filtering processes and outputs of each device.
Leving, Marika T; Vegter, Riemer J K; Hartog, Johanneke; Lamoth, Claudine J C; de Groot, Sonja; van der Woude, Lucas H V
It has been suggested that a higher intra-individual variability benefits the motor learning of wheelchair propulsion. The present study evaluated whether feedback-induced variability on wheelchair propulsion technique variables would also enhance the motor learning process. Learning was operationalized as an improvement in mechanical efficiency and propulsion technique, which are thought to be closely related during the learning process. 17 Participants received visual feedback-based practice (feedback group) and 15 participants received regular practice (natural learning group). Both groups received equal practice dose of 80 min, over 3 weeks, at 0.24 W/kg at a treadmill speed of 1.11 m/s. To compare both groups the pre- and post-test were performed without feedback. The feedback group received real-time visual feedback on seven propulsion variables with instruction to manipulate the presented variable to achieve the highest possible variability (1st 4-min block) and optimize it in the prescribed direction (2nd 4-min block). To increase motor exploration the participants were unaware of the exact variable they received feedback on. Energy consumption and the propulsion technique variables with their respective coefficient of variation were calculated to evaluate the amount of intra-individual variability. The feedback group, which practiced with higher intra-individual variability, improved the propulsion technique between pre- and post-test to the same extent as the natural learning group. Mechanical efficiency improved between pre- and post-test in the natural learning group but remained unchanged in the feedback group. These results suggest that feedback-induced variability inhibited the improvement in mechanical efficiency. Moreover, since both groups improved propulsion technique but only the natural learning group improved mechanical efficiency, it can be concluded that the improvement in mechanical efficiency and propulsion technique do not always appear
Diaper, Nicholas J.; Goosey-Tolfrey, Victoria L.
This study was designed to examine the physiological changes caused by long-term training in a world class female tennis player in preparation for a major championship. Additionally, we aim to describe the training interventions and determine a suitable cooling strategy that was to be used at the 2004 Paralympic Games. The athlete underwent regular physiological assessment during 2003-2004. Physiological measures involved body composition, submaximal and peak oxygen uptake and key variables associated with maximal sprinting. In addition, a suitable match-play cooling intervention and hydration strategy was also explored. Body composition improved over the course of the study. Aerobic capacity fell by 21%, yet the submaximal physiological variables such as lactate profile and pushing economy improved. The trade off of aerobic capacity was perhaps noticeably counter-balanced with the maintenance of the peak sprinting speed and improvement found in the fatigue profile across ten repeated sprints. The extensive training programme was responsible for these changes and these adaptations resulted in a more confident athlete, in peak physical condition leading into the Paralympic Games. It is difficult to appreciate the extent to which this work had an impact on tennis performance given the skill requirements of wheelchair tennis and this warrants future attention. Key points Physiological adaptations were apparent over the two-year training period. The training emphasis resulted in a reduction in aerobic capacity, yet an improvement in repetitive sprint performance was seen leading into the Major competition. An effective cooling technique was identified that could be used during wheelchair tennis performance. The athlete and coaches were complimentary to the physiological support provided, which resulted in a more confident athlete at the Paralympic Games. PMID:24149542
Wilson Kindlein Junior
Full Text Available BackgroundThe design of custom contoured cushions manufactured inflexible polyurethane foams is an option to improvepositioning and comfort for people with disabilities thatspend most of the day seated in the same position. Thesesurfaces increase the contact area between the seat and theuser. This fact contributes to minimise the local pressuresthat can generate problems like decubitus ulcers. Thepresent research aims at establishing development routesfor custom cushion production to wheelchair users. Thisstudy also contributes to the investigation of ComputerNumerical Control (CNC machining of flexible polyurethanefoams.MethodThe proposed route to obtain the customised seat beganwith acquiring the user’s contour in adequate posturethrough plaster cast. To collect the surface geometry, thecast was three-dimensionally scanned and manipulated inCAD/CAM software. CNC milling parameters such as tools,spindle speeds and feed rates to machine flexiblepolyurethane foams were tested. These parameters wereanalysed regarding the surface quality. The best parameterswere then tested in a customised seat. The possibledimensional changes generated during foam cutting wereanalysed through 3D scanning. Also, the customised seatpressure and temperature distribution was tested.ResultsThe best parameters found for foams with a density of50kg/cm3 were high spindle speeds (24000 rpm and feedrates between 2400–4000mm/min. Those parameters didnot generate significant deformities in the machinedcushions. The custom contoured cushion satisfactorilyincreased the contact area between wheelchair and user, asit distributed pressure and heat evenly.ConclusionThrough this study it was possible to define routes for thedevelopment and manufacturing of customised seats usingdirect CNC milling in flexible polyurethane foams. It alsoshowed that custom contoured cushions efficientlydistribute pressure and temperature, which is believed tominimise tissue lesions such as pressure
da Silva, Fabio Pinto; Beretta, Elisa Marangon; Prestes, Rafael Cavalli; Kindlein Junior, Wilson
The design of custom contoured cushions manufactured in flexible polyurethane foams is an option to improve positioning and comfort for people with disabilities that spend most of the day seated in the same position. These surfaces increase the contact area between the seat and the user. This fact contributes to minimise the local pressures that can generate problems like decubitus ulcers. The present research aims at establishing development routes for custom cushion production to wheelchair users. This study also contributes to the investigation of Computer Numerical Control (CNC) machining of flexible polyurethane foams. The proposed route to obtain the customised seat began with acquiring the user's contour in adequate posture through plaster cast. To collect the surface geometry, the cast was three-dimensionally scanned and manipulated in CAD/CAM software. CNC milling parameters such as tools, spindle speeds and feed rates to machine flexible polyurethane foams were tested. These parameters were analysed regarding the surface quality. The best parameters were then tested in a customised seat. The possible dimensional changes generated during foam cutting were analysed through 3D scanning. Also, the customised seat pressure and temperature distribution was tested. The best parameters found for foams with a density of 50kg/cm(3) were high spindle speeds (24000 rpm) and feed rates between 2400-4000mm/min. Those parameters did not generate significant deformities in the machined cushions. The custom contoured cushion satisfactorily increased the contact area between wheelchair and user, as it distributed pressure and heat evenly. Through this study it was possible to define routes for the development and manufacturing of customised seats using direct CNC milling in flexible polyurethane foams. It also showed that custom contoured cushions efficiently distribute pressure and temperature, which is believed to minimise tissue lesions such as pressure ulcers.
Rhodes, James M; Mason, Barry S; Paulson, Thomas A W; Goosey-Tolfrey, Victoria L
To investigate the speed profiles of individual training modes in comparison with wheelchair rugby (WCR) competition across player classifications. Speed profiles of 15 international WCR players were determined using a radio-frequency-based indoor tracking system. Mean and peak speed (m/s), work:rest ratios, and the relative time spent in (%) and number of high-speed activities performed were measured across training sessions (n = 464) and international competition (n = 34). Training was classified into 1 of 4 modes: conditioning (n = 71), skill-based (n = 133), game-related (n = 151), and game-simulation drills (n = 109). Game-simulation drills were further categorized by the structured duration, which were 3-min game clock (n = 44), 8-min game clock (n = 39), and 10-min running clock (n = 26). Players were grouped by their International Wheelchair Rugby Federation classification as either low-point (≤1.5; n = 8) or high-point players (≥2.0; n = 7). Conditioning drills were shown to exceed the demands of competition, irrespective of classification (P ≤ .005; effect size [ES] = 0.6-2.0). Skill-based and game-related drills underrepresented the speed profiles of competition (P ≤ .005; ES = 0.5-1.1). Mean speed and work:rest ratios were significantly lower during 3- and 8-min game-simulation drills in relation to competition (P ≤ .039; ES = 0.5-0.7). However, no significant differences were identified between the 10-min running clock and competition. Although game-simulation drills provided the closest representation of competition, the structured duration appeared important since the 10-min running clock increased training specificity. Coaches can therefore modify the desired training response by making subtle changes to the format of game-simulation drills.
Full Text Available The objectives of the present study were twofold: to determine differences between groups by means of chosen coefficients and to create significant predictors using regression models for athletes in wheelchair rugby who had the same spinal cord injury (tetraplegia and were classified as low point and high point players. The study sample consisted of 24 subjects, who had sustained cervical spinal cord injury (CSCI. They were divided into low point (n=15 and high point (n=9 groups according to the IWRF Classification System. A one-way ANOVA revealed statistically significant differences in the following coefficients differentiating the groups: AC (η2=0.778, LC (η2=0.687, IC (η2=0.565, SC (η2=0.580. The Tukey’s HSD post-hoc test indicated statistically significant higher values of coefficients in the HP compared to the LP group: AC=0.958 (p=0.022, LC=0.989 (p=0.031, IC=0.971 (p=0.044, SC=0.938 (p=0.039. In the HP group, the most significant predictor was the sum of visceral and trunk fat which was negatively correlated with the SC (what constituted a positive adaptive change in response to training. With regard to the LP group, body height and circumference of the chest appeared to be most significant predictors and were positively correlated with the SC. In the LP group no predictor with respect to the SC was significantly correlated to sports training. Therefore, the functional classification system confirmed lower status of the LP players. The results of the present study indicate that both metabolic and somatic profiles which highly determine potential of wheelchair rugby athletes are significantly different in LP and HP players, what confirms the reliability of the functional classification system.
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Spyridonis, Fotios; Gronli, Tor-Morten; Hansen, Jarle; Ghinea, Gheorghita
Pain constitutes an important medical concern that can have severe implications to a wheelchair user's quality of life. Results from studies indicate that pain is a common problem in this group of individuals, having a reported frequency of always (12%) and everyday (33%). This incidence signifies the need for more applicable and effective pain management clinical tools. As a result, in this paper we present an Android application (PainDroid) that has been enhanced with Virtual Reality (VR) technology for the purpose of improving the management of pain. Our evaluation with a group of wheelchair users revealed that PainDroid demonstrated high usability among this population, and is foreseen that it can make an important contribution in research on the assessment and management of pain.
Full Text Available The purpose of the study was to examine how wheelchair basketball players’ self-esteem and motivation levels impact on their state and trait anxiety levels. The Coopersmith Self-Esteem Inventory, Sport Motivation Scale and STAI (State Trait Anxiety Inventory were applied to the athletes before a competition. Data were collected from 124 athletes with disabilities. In this study, descriptive statistical techniques, Pearson product moment correlation and multiple regression analysis (enter method were used. Multiple regression analyses indicated that self-esteem, intrinsic motivation, extrinsic motivation and amotivation, all of which function as predicting variables, predicted 42% variance in state anxiety and 50% variance in trait anxiety. Motivation and self-esteem are the best predictors of trait and state anxiety among the premier league wheelchair basketball players. Finally, a review of factors that impact on anxiety and quality of performance such as motivation and self-esteem is provided.
Best, Krista L; Routhier, François; Sweet, Shane N; Arbour-Nicitopoulos, Kelly P; Borisoff, Jaimie F; Noreau, Luc; Martin Ginis, Kathleen A
Physical activity (PA) must be performed regularly to accrue health benefits. However, the majority of manual wheelchair users do not meet PA recommendations. Existing community-based PA programs for manual wheelchair users appear to work, but effect sizes are small and retention is low. Existing PA programs may not fully implement some psychosocial factors that are strongly linked with PA (eg, autonomy). The use of peers and mobile phone technology in the Smartphone Peer PA Counseling (SPPAC) program represents a novel approach to cultivating a PA-supportive environment for manual wheelchair users. The primary objective is to compare change in objective PA between the experimental (SPPAC) and control groups from baseline to postintervention (10 weeks) and follow-up (3 months). Changes in and relationships between subjective PA, wheelchair skills, motivation, self-efficacy (for overcoming barriers to PA for manual wheelchair use), satisfaction of psychological needs for PA, and satisfaction with PA participation will be explored (secondary outcome). Program implementation will be explored (tertiary objective). A total of 38 community-living manual wheelchair users (≥18 years) will be recruited in a randomized controlled trial (RCT). Participants in both the control and experimental groups will receive existing PA guidelines. Participants in the experimental group will also receive the SPPAC program: 14 sessions (~30 min) over a 10-week period delivered by a peer trainer using a mobile phone. PA activities will be based on individuals' preferences and goals. Implementation of important theoretical variables will be enforced through a peer-trainer checklist. Outcomes for objective PA (primary) and subjective PA, wheelchair skills, motivation, self-efficacy, satisfaction of psychological needs, and satisfaction with participation will be collected at three time points (baseline, postintervention, follow-up). Multiple imputations will be used to treat missing data. A
Full Text Available Objectives. The aim of this study was to compare the musculoskeletal and physical strain on healthcare workers, by measuring range of motion (ROM, muscle activity, and heart rate (HR, during transfer of a simulated patient using either a robotic wheelchair (RWC or a conventional wheelchair (CWC. Methods. The subjects were 10 females who had work experience in transferring patients and another female adult as the simulated patient to be transferred from bed to a RWC or a CWC. In both experimental conditions, ROM, muscle activity, and HR were assessed in the subjects using motion sensors, electromyography, and electrocardiograms. Results. Peak ROM of shoulder flexion during assistive transfer with the RWC was significantly lower than that with the CWC. Values for back muscle activity during transfer were lower with the RWC than with the CWC. Conclusions. The findings suggest that the RWC may decrease workplace injuries and lower back pain in healthcare workers.
Full Text Available The enforced sedentary lifestyle and muscle paresis below the level of injury are associated with adipose tissue accumulation in the trunk. The value of anthropometric indicators of obesity in patients with spinal cord injuries has also been called into question. We hypothesized that the Body Mass Index recommended by the WHO to diagnose obesity in general population has too low sensitivity in case of wheelchair rugby players.
Hoekstra, Sven; Valent, Linda; Gobets, David; van der Woude, Lucas; de Groot, Sonja
Recognizing the encouraging effect of challenging events, the HandbikeBattle (HBB) was created to promote exercise among wheelchair users. The purpose of this study was to reveal the effects on physical fitness and health outcomes of four-month handbike training under free-living conditions in preparation for the event. In this prospective cohort study, 59 relatively inexperienced handyclists participated in the HBB of 2013 or 2014. Incremental exercise tests were conducted, respiratory function was tested and anthropometrics were measured before and after the preparation period. Main outcome measures were peak power output (POpeak), peak oxygen uptake (VO2peak) and waist circumference, of which the changes were tested using repeated measures ANOVA. To detect possible determinants of changes in physical fitness, a linear regression analysis was conducted with personal characteristics, executed training volume and upper-extremity complaints during the training period as independent variables. POpeak, VO2peak and waist circumference improved significantly with 17%, 7% and 4.1%, respectively. None of the included variables were significant determinants for the changes in POpeak found as a result of the training. A challenging event such as the HBB provokes training regimes among participants of sufficient load to realize substantial improvements in physical fitness and health outcomes. Implications for Rehabilitation Due to the often impaired muscle function in the lower-limbs and an inactive lifestyle, wheelchair users generally show considerably lower levels of fitness compared to able-bodied individuals. This prospective cohort study showed that four months of handbike training under free-living conditions in preparation for this event resulted in substantial improvements in physical fitness and health outcomes in wheelchair users. The creation of a challenging event such as the HandbikeBattle as part of a follow-up rehabilitation practice can therefore be a useful
Uzun, S; Pourmoghaddam, A; Hieronymus, M; Thrasher, T A
Wheelchair basketball is the most popular exercise activity among individuals with spinal cord injury (SCI). The purpose of this study was to investigate muscular endurance and fatigue in wheelchair basketball athletes with SCI using surface electromyography (SEMG) and maximal torque values. SEMG characteristics of 10 wheelchair basketball players (WBP) were compared to 13 able-bodied basketball players and 12 sedentary able-bodied subjects. Participants performed sustained isometric elbow flexion at 50% maximal voluntary contraction until exhaustion. Elbow flexion torque and SEMG signals were recorded from three elbow flexor muscles: biceps brachii longus, biceps brachii brevis and brachioradialis. SEMG signals were clustered into 0.5-s epochs with 50% overlap. Root mean square (RMS) and median frequency (MDF) of SEMG signals were calculated for each muscle and epoch as traditional fatigue monitoring. Recurrence quantification analysis was used to extract the percentage of determinism (%DET) of SEMG signals. The slope of the %DET for basketball players and WBP showed slower increase with time than the sedentary able-bodied control group for three different elbow flexor muscles, while no difference was observed for the slope of the %DET between basketball and WBP. This result indicated that the athletes are less fatigable during the task effort than the nonathletes. Normalized MDF slope decay exhibited similar results between the groups as %DET, while the slope of the normalized RMS failed to show any significant differences among the groups (p > 0.05). MDF and %DET could be useful for the evaluation of muscle fatigue in wheelchair basketball training. No conclusions about special training for WBP could be determined.
Full Text Available Background: Many powered wheelchair users find their medical condition and their ability to drive the wheelchair will change over time. In order to maintain their independent mobility, the powered chair will require adjustment over time to suit the user's needs, thus regular input from healthcare professionals is required. These limited resources can result in the user having to wait weeks for appointments, resulting in the user losing independent mobility, consequently affecting their quality of life and that of their family and carers. In order to provide an adaptive assistive driving system, a range of features need to be identified which are suitable for initial system setup and can automatically provide data for re-calibration over the long term. Methods: A questionnaire was designed to collect information from powered wheelchair users with regard to their symptoms and how they changed over time. Another group of volunteer participants were asked to drive a test platform and complete a course which represented manoeuvring in a very confined space as quickly as possible. Two of those participants were also monitored over a longer period in their normal home daily environment. Features, thought to be suitable, were examined using pattern recognition classifiers to determine their suitability for identifying the changing user input over time. Results: The results are not designed to provide absolute insight into the individual user behaviour, as no ground truth of their ability has been determined, they do nevertheless demonstrate the utility of the measured features to provide evidence of the users’ changing ability over time whilst driving a powered wheelchair. Conclusions: Determining the driving features and adjustable elements provides the initial step towards developing an adaptable assistive technology for the user when the ground truths of the individual and their machine have been learned by a smart pattern recognition system.
Liu, Juanxiu; Wu, Yifei; Guo, Jian; Chen, Qingwei
For the attitude control of a novel stair-climbing wheelchair with inertial uncertainties and external disturbance torques, a new synchronous control method is proposed via combing high-order sliding mode control techniques with cross-coupling techniques. For this purpose, a proper controller is designed, which can improve the performance of the system under conditions of uncertainties and torque perturbations and also can guarantee the synchronization of the system. Firstly, a robust high-or...
van Drongelen AW; Roszek B; Hilbers-Modderman ESM; Kallewaard M; Wassenaar C; LGM
Het RIVM heeft een onderzoek uitgevoerd naar rolstoelgerelateerde incidenten. Ongelukken met elektrische en handmatige rolstoelen, welke waren gerapporteerd aan de Amerikaanse FDA, de Britse MDA en het Nederlandse centrum voor Kwaliteits- en Bruikbaarheidsonderzoek van Hulpmiddelen (KBOH) zijn
Kovacs, Francisco M; Seco, Jesús; Royuela, Ana; Barriga, Andrés; Zamora, Javier
Cross-sectional study. To determine the prevalence of, and factors associated with, spinal pain among wheelchair users. Four Spanish hospitals specialized in providing care for wheelchair users. Persons who had used a wheelchair for a median (IRQ) of 10 (5;19) years, 27% of them due to reasons other than spinal cord injury, were recruited consecutively (n = 750). Data on 43 demographic, psychosocial, ergonomic, and clinical variables were collected, and analyzed. Main outcome measures were: point prevalence of neck (NP), thoracic (TP), low back pain (LBP), and pain at any spinal level (PASL); and factors associated with them. Point prevalence was 56% for NP, 54% for TP, 45% for LBP, and 76% for PSAL. PASL was associated with a lower quality of life (OR (95% CI) 0.91 (0.86; 0.97)). Multivariable regression models showed that the main factors associated with significant pain (≥1.5 VAS points) were: (a) For NP: cervical spinal injury and wheelchair seat cushion thickness, (b) For TP: thoracic spinal injury and sagittal index, (c) For LBP: thoracic or lumbar spinal injury, with some sensitivity remaining, (d) For PASL: being female, living alone, and using a non-power wheelchair. Discrimination (AUC) of these models ranged between 0.638 and 0.818. p-values in the Hosmer-Lemeshow test ranged between 0.420 and 0.701. Prevalence of spinal pain among wheelchair users is high. It is associated with a lower quality of life. Future studies should assess whether using a power wheelchair affects PASL, and if the thickness of seat cushion affects NP. Spanish Back Pain Research Network.
Kinoshita, T; Nakamura, T; Umemoto, Y; Kojima, D; Moriki, T; Mitsui, T; Goto, M; Ishida, Y; Tajima, F
Case series. To investigate the effects of wheelchair basketball game on plasma interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), C-reactive protein (CRP) and blood cell counts in persons with spinal cord injury (SCI). The 2009 Mei-shin League of Wheelchair Basketball Games held at Wakayama, Japan. Five wheelchair basketball players with SCI voluntarily participated in this study. Blood samples were taken approximately 1 h before the player warm-up for the game and immediately after the game. IL-6, TNF-α, CRP and blood cell count were measured. Plasma IL-6 level and number of monocytes were significantly increased after the game, compared with pre-game measurements (P<0.05). No changes were observed in other measurements. There was a significant relationship between increased IL-6 levels and accumulated play duration. The lack of change in TNF-α and CRP levels suggested that the exercise-induced rise in IL-6 was not related to exercise-induced inflammatory response. Furthermore, the associated increase in the number of monocytes did not correlate with exercise-induced IL-6 changes, negating monocytes as the source of IL-6.
Moreno, Marlene Aparecida; Zamunér, Antonio Roberto; Paris, Juliana Viana; Teodori, Rosana Macher; Barros, Ricardo M L
The aim of this study was to evaluate the effects of wheelchair sports on respiratory muscle strength and the thoracic mobility of individuals with spinal cord injury. Thirty male subjects with chronic spinal cord injury (American Spinal Injury Association Impairment Scale grade A) took part in the study and were divided into four groups: sedentary subjects with quadriplegia (S-QUAD, n = 7), wheelchair rugby athletes with quadriplegia (A-QUAD, n = 8), sedentary subjects with paraplegia (S-PARA, n = 6), and wheelchair basketball athletes with paraplegia (A-PARA, n = 9). The main outcome measures were maximal inspiratory and expiratory pressure and the respiratory coefficients at the axillary and xiphoid levels. A-QUAD group presented values significantly higher for all respiratory variables studied compared with the S-QUAD group. No significant differences in any of the respiratory variables were observed between S-PARA and A-PARA groups. There was a negative correlation between spinal cord injury level and respiratory variables for the S-QUAD and S-PARA groups. There were positive correlations in the A-QUAD group between time of training and maximal inspiratory pressure (adjusted R = 0.84; P = 0.001) and respiratory coefficients at the axillary level (adjusted R = 0.80; P = 0.002). Physical training seems to have a positive influence on respiratory muscle strength and thoracic mobility, especially in subjects with quadriplegia.
Kratz, G; Söderback, I; Guidetti, S; Hultling, C; Rykatkin, T; Söderström, M
The purpose of the present quasi-experimental post-test-design study was to compare 32 wheelchair users' (mostly para/tetraplegics) experience of wearing specially adapted clothes and non-adapted clothes for sailing, quad rugby or wheel-walking. Four existing assessment instruments were used: the Klein-Bell Activities of Daily Living Scale; a two-part Basic Information Questionnaire eliciting experience of effort, comfort and feeling of physical condition; the Experience Sampling Form for investigating the individuals' attitudes in terms of involvement and affective and activity mood states, and the Occupational Therapy Assessment of Leisure Time interview framework for collecting data about experience of leisure time. The wheelchair users all associated significantly greater comfort with use of the adapted clothes and, particularly the 'sailors', better physical condition. Overall, significantly greater involvement and more positive affect states were associated with the adapted clothes than with conventional garments, and mood state changed for the better. The wheelchair users set a higher priority upon work or leisure activities than upon independence in activities of daily living, and for this reason the Klein-Bell ratings showed great variation between the 'sailors' and the 'quad rugby players' (range 57%-93%), though these groups demonstrated more independence than the 'wheel-walkers'. The results of the study confirm the value of adapting sportswear for handicapped people. Such adaptations should also be of benefit for other activities than those studied.
Bakkum, A J T; de Groot, S; Stolwijk-Swüste, J M; van Kuppevelt, D J; van der Woude, L H V; Janssen, T W J
This is an open randomized controlled trial. The objective of this study was to investigate the effects of a 16-week hybrid cycle versus handcycle exercise program on fitness and physical activity in inactive people with long-term spinal cord injury (SCI). The study was conducted in two rehabilitation centers with a specialized SCI unit. Twenty individuals (SCI⩾8 years) were randomly assigned to a hybrid cycle (voluntary arm exercise combined with functional electrical stimulation (FES)-induced leg exercise) or a handcycle group. During 16 weeks, both groups trained twice a week for 30 min at 65-75% heart rate reserve. Outcome measures obtained before, during and after the program were fitness (peak power output, peak oxygen consumption), submaximal VO2 and heart rate (HR), resting HR, wheelchair skill performance time score) and physical activity (distance travelled in wheelchair and Physical Activity Scale for Individuals with Physical Disabilities (PASIPD) score). Changes were examined using a two-factor mixed-measures analysis of variance. For all fitness parameters, except for submaximal VO2, no interaction effects were found. The hybrid cycle group showed a decrease in VO2 over time in contrast to the handcycle group (P=0.045). An overall reduction in HRrest (5±2 b.p.m.; P=0.03) and overall increase in PASIPD score (6.5±2.1; P=0.002) were found after 16 weeks of training. No overall training effects were found for the other fitness and activity outcome measures. In the current study, hybrid cycling and handcycling showed similar effects on fitness and physical activity, indicating that there seem to be no additional benefits of the FES-induced leg exercise over handcycle training alone.
Vegter, Riemer J K; Hartog, Johanneke; de Groot, Sonja; Lamoth, Claudine J; Bekker, Michel J; van der Scheer, Jan W; van der Woude, Lucas H V; Veeger, Dirkjan H E J
To propel in an energy-efficient manner, handrim wheelchair users must learn to control the bimanually applied forces onto the rims, preserving both speed and direction of locomotion. Previous studies have found an increase in mechanical efficiency due to motor learning associated with changes in propulsion technique, but it is unclear in what way the propulsion technique impacts the load on the shoulder complex. The purpose of this study was to evaluate mechanical efficiency, propulsion technique and load on the shoulder complex during the initial stage of motor learning. 15 naive able-bodied participants received 12-minutes uninstructed wheelchair practice on a motor driven treadmill, consisting of three 4-minute blocks separated by two minutes rest. Practice was performed at a fixed belt speed (v = 1.1 m/s) and constant low-intensity power output (0.2 W/kg). Energy consumption, kinematics and kinetics of propulsion technique were continuously measured. The Delft Shoulder Model was used to calculate net joint moments, muscle activity and glenohumeral reaction force. With practice mechanical efficiency increased and propulsion technique changed, reflected by a reduced push frequency and increased work per push, performed over a larger contact angle, with more tangentially applied force and reduced power losses before and after each push. Contrary to our expectations, the above mentioned propulsion technique changes were found together with an increased load on the shoulder complex reflected by higher net moments, a higher total muscle power and higher peak and mean glenohumeral reaction forces. It appears that the early stages of motor learning in handrim wheelchair propulsion are indeed associated with improved technique and efficiency due to optimization of the kinematics and dynamics of the upper extremity. This process goes at the cost of an increased muscular effort and mechanical loading of the shoulder complex. This seems to be associated with an
Rushton, Paula W; Smith, Emma M; Miller, William C; Kirby, R Lee; Daoust, Geneviève
The aim of this study was to evaluate the internal consistency, test-retest reliability and responsiveness of the Self-Efficacy in Assessing, Training and Spotting manual wheelchair skills (SEATS-M) and Self-Efficacy in Assessing, Training and Spotting power wheelchair skills (SEATS-P). A 2-week test-retest design was used with a convenience sample of occupational and physical therapists who worked at a provincial rehabilitation centre (inpatient and outpatient services). Sixteen participants completed the SEATS-M and 18 participants completed the SEATS-P. For the SEATS-M assessment, training, spotting and documentation sections, Cronbach's alpha coefficients ranged from 0.90 to 0.97, the 2-week intraclass correlation coefficients (ICC 1,1 ) ranged from 0.81 to 0.95, the standard error of measurements (SEM) ranged from 5.06 to 8.70 and the smallest real differences (SRD) ranged from 6.24 to 8.18. For the SEATS-P assessment, training, spotting and documentation sections, Cronbach's alpha coefficients ranged from 0.83 to 0.92, the ICCs ranged from 0.72 to 0.86, the SEMs ranged from 4.54 to 8.91 and the SRDs ranged from 5.90 to 8.27. There is preliminary evidence that both the SEATS-M and the SEATS-P have high internal consistency, good test-retest reliability and support for responsiveness. These tools can be used in evaluating clinician self-efficacy with assessing, training, spotting and documenting wheelchair skills included on the Wheelchair Skills Test. Implications for Rehabilitation There is preliminary evidence that the SEATS-M and SEATS-P are reliable and responsive outcome measures that can be used to evaluate the self-efficacy of clinicians to administer the Wheelchair Skills Program. Measurement of clinicians' self-efficacy in this area of practice may enable an enhanced understanding of the areas in which clinicians lack self-efficacy, thereby informing the development of improved knowledge translation interventions.
Vinet, A; Le Gallais, D; Bernard, P L; Poulain, M; Varray, A; Mercier, J; Micallef, J P
The aims of the present study were: (1) to assess aerobic metabolism in paraplegic (P) athletes (spinal lesion level, T4-L3) by means of peak oxygen uptake (VO2peak) and ventilatory threshold (VT), and (2) to determine the nature of exercise limitation in these athletes by means of cardioventilatory responses at peak exercise. Eight P athletes underwent conventional spirographic measurements and then performed an incremental wheelchair exercise on an adapted treadmill. Ventilatory data were collected every minute using an automated metabolic system: ventilation (l x min[-1]), oxygen uptake (VO2, l x min[-1], ml x min[-1] x kg[-1]), carbon dioxide production (VCO2, ml x min[-1]), respiratory exchange ratio, breathing frequency and tidal volume. Heart rate (HR, beats x min[-1]) was collected with the aid of a standard electrocardiogram. VO2peak was determined using conventional criteria. VT was determined by the breakpoint in the VCO2 - VO2 relationship, and is expressed as the absolute VT (VO2, ml x min[-1] x kg[-1]) and relative VT (percentage of VO2peak). Spirometric values and cardioventilatory responses at rest and at peak exercise allowed the measurement of ventilatory reserve (VR), heart rate reserve (HRr), heart rate response (HRR), and O2 pulse (O2 P). Results showed a VO2peak value of 40.6 (2.5) ml x min(-1) x kg(-1), an absolute VT detected at 23.1 (1.5) ml x min(-1) x kg(-1) VO2 and a relative VT at 56.4 (2.2)% VO2peak. HRr [15.8 (3.2) beats min(-1)], HRR [48.6 (4.3) beat x l(-1)], and O2 P [0.23 (0.02) ml x kg(-1) x beat(-1)] were normal, whereas VR at peak exercise [42.7 (2.4)%] was increased. As wheelchair exercise excluded the use of an able-bodied (AB) control group, we compared our VO2peak and VT results with those for other P subjects and AB controls reported in the literature, and we compared our cardioventilatory responses with those for respiratory and cardiac patients. The low VO2peak values obtained compared with subject values obtained during
van der Scheer, Jan W; de Groot, Sonja; Vegter, Riemer J K; Hartog, Johanneke; Tepper, Marga; Slootman, Hans; Veeger, DirkJan H E J; van der Woude, Lucas H V
The objective of this study was to investigate the effects of a low-intensity wheelchair training on propulsion technique in inactive people with long-term spinal cord injury. Participants in this multicenter nonblinded randomized controlled trial were inactive manual wheelchair users with spinal cord injury for at least 10 yrs (N = 29), allocated to exercise (n = 14) or no exercise. The 16-wk training consisted of wheelchair treadmill propulsion at 30%-40% heart rate reserve or equivalent in rate of perceived exertion, twice a week, 30 mins per session. Propulsion technique was assessed at baseline as well as after 8, 16, and 42 wks during two submaximal treadmill-exercise blocks using a measurement wheel attached to a participant's own wheelchair. Changes over time between the groups were analyzed using Mann-Whitney U tests on difference scores (P propulsion technique were not found in this group. Perhaps, substantial effects require a higher intensity or frequency. Investigating whether more effective and feasible interventions exist might help reduce the population's risk of upper-body joint damage during daily wheelchair propulsion.
Tom Edward Nightingale
Full Text Available To assess the validity of two accelerometer devices, at two different anatomical locations, for the prediction of physical activity energy expenditure (PAEE in manual wheelchair users (MWUs.Seventeen MWUs (36 ± 10 yrs, 72 ± 11 kg completed ten activities; resting, folding clothes, propulsion on a 1% gradient (3,4,5,6 and 7 km·hr-1 and propulsion at 4km·hr-1 (with an additional 8% body mass, 2% and 3% gradient on a motorised wheelchair treadmill. GT3X+ and GENEActiv accelerometers were worn on the right wrist (W and upper arm (UA. Linear regression analysis was conducted between outputs from each accelerometer and criterion PAEE, measured using indirect calorimetry. Subsequent error statistics were calculated for the derived regression equations for all four device/location combinations, using a leave-one-out cross-validation analysis.Accelerometer outputs at each anatomical location were significantly (p < .01 associated with PAEE (GT3X+-UA; r = 0.68 and GT3X+-W; r = 0.82. GENEActiv-UA; r = 0.87 and GENEActiv-W; r = 0.88. Mean ± SD PAEE estimation errors for all activities combined were 15 ± 45%, 14 ± 50%, 3 ± 25% and 4 ± 26% for GT3X+-UA, GT3X+-W, GENEActiv-UA and GENEActiv-W, respectively. Absolute PAEE estimation errors for devices varied, 19 to 66% for GT3X+-UA, 17 to 122% for GT3X+-W, 15 to 26% for GENEActiv-UA and from 17.0 to 32% for the GENEActiv-W.The results indicate that the GENEActiv device worn on either the upper arm or wrist provides the most valid prediction of PAEE in MWUs. Variation in error statistics between the two devices is a result of inherent differences in internal components, on-board filtering processes and outputs of each device.
Marika T Leving
Full Text Available It has been suggested that a higher intra-individual variability benefits the motor learning of wheelchair propulsion. The present study evaluated whether feedback-induced variability on wheelchair propulsion technique variables would also enhance the motor learning process. Learning was operationalized as an improvement in mechanical efficiency and propulsion technique, which are thought to be closely related during the learning process.17 Participants received visual feedback-based practice (feedback group and 15 participants received regular practice (natural learning group. Both groups received equal practice dose of 80 min, over 3 weeks, at 0.24 W/kg at a treadmill speed of 1.11 m/s. To compare both groups the pre- and post-test were performed without feedback. The feedback group received real-time visual feedback on seven propulsion variables with instruction to manipulate the presented variable to achieve the highest possible variability (1st 4-min block and optimize it in the prescribed direction (2nd 4-min block. To increase motor exploration the participants were unaware of the exact variable they received feedback on. Energy consumption and the propulsion technique variables with their respective coefficient of variation were calculated to evaluate the amount of intra-individual variability.The feedback group, which practiced with higher intra-individual variability, improved the propulsion technique between pre- and post-test to the same extent as the natural learning group. Mechanical efficiency improved between pre- and post-test in the natural learning group but remained unchanged in the feedback group.These results suggest that feedback-induced variability inhibited the improvement in mechanical efficiency. Moreover, since both groups improved propulsion technique but only the natural learning group improved mechanical efficiency, it can be concluded that the improvement in mechanical efficiency and propulsion technique do not
Samuel T. Nemanich
Full Text Available Freezing of gait (FOG is a common, disabling gait disturbance in Parkinson’s disease (PD and other Parkinsonian syndromes. Freezing also occurs during non-gait movements involving the upper limbs. The mechanisms underlying freezing are complex, likely involving motor, cognitive, and sensory systems that contribute to the episodes. Here, we reported a 60-year-old female with a 24-year history of parkinsonism who experienced significant FOG when ambulatory. Disease progression resulted in her permanent use of a powered wheelchair. While using the power chair, the patient experiences apparent paroxysmal freezing in the hand and arm used to steer and propel the chair. These episodes, some lasting up to several minutes, occur only in circumstances (e.g., entering and leaving an elevator that are similar to environments known to elicit and exacerbate FOG. Episodes are transient and can be volitionally interrupted by the patient but sometimes require external assistance. Therapeutic intervention for this type of potential freezing has yet to be determined. This case may provide insight into the complex nature of freezing behavior and suggests a need for new approaches to treating non-traditional freezing behavior.
Barros, Helda Oliveira; Soares, Marcelomárcio
This study deals with using digital photogrammetry to make an anthropometric analysis of wheelchair users. To analyse the data, Digita software was used, which was made available by means of the agreement of the Design Department of the Federal University of Pernambuco--Brazil--with the Department of Ergonomics of the Technical University of Lisbon--Portugal. Data collection involved a random sample of 18 subjects and occurred in the Biomechanics Laboratory of the Maurice of Nassau Faculty, located in Recife, Pernambuco. The methodology applied comprises the steps of Ergonomic Assessment, Configuration of the Data Base, Taking Digital Photographs, Digitalising the Coordinates and Presentation of Results. 15 structural variables related to static anthropometry were analysed, and 4 functional range variables relating to dynamic anthropometry. The results were presented by analysing personal data, classified by gender, ethnicity and age; by functional analysis of the sample, classified by clinical diagnosis, results of assessing the joints, results of the evaluation through motion and postural evaluation; and of the analysis of the anthropometric sample, which indicated for each variable the number of people, the mean, the standard deviation, and the minimum, median and maximum values.
Full Text Available This study investigated (1 the effect of repetitive weight-relief raises (WR and shoulder external rotation (ER on the acromiohumeral distance (AHD among manual wheelchair users (MWUs and (2 the relationship between shoulder pain, subject characteristics, and AHD changes. Twenty-three MWUs underwent ultrasound imaging of the nondominant shoulder in an unloaded baseline position and while holding a WR position before and after the WR/ER tasks. Paired t-tests and Spearman correlational analysis were used to assess differences in the AHD before and after each task and the relationships between pain, subject characteristics, and the AHD measures. A significant reduction in the subacromial space (P<0.01 occurred when subjects performed a WR position compared to baseline. Individuals with increased years of disability had greater AHD percentage narrowing after WR (P=0.008. Increased shoulder pain was associated with AHD percentage narrowing after ER (P≤0.007. The results support clinical practice guidelines that recommend MWUs limit WR to preserve shoulder function. The isolated repetitive shoulder activity did not contribute to the changes of subacromial space in MWUs. The ultrasonographic measurement of the AHD may be a target for identifying future interventions that prevent pain.
Hansen, J D; Barrett, S F; Wright, C H G; Wilcox, M
Three different positioning techniques were investigated to create an autonomous vehicle that could accurately navigate towards a goal: Global Positioning System (GPS), compass dead reckoning, and Ackerman steering. Each technique utilized a fuzzy logic controller that maneuvered a four-wheel car towards a target. The reliability and the accuracy of the navigation methods were investigated by modeling the algorithms in software and implementing them in hardware. To implement the techniques in hardware, positioning sensors were interfaced to a remote control car and a microprocessor. The microprocessor utilized the sensor measurements to orient the car with respect to the target. Next, a fuzzy logic control algorithm adjusted the front wheel steering angle to minimize the difference between the heading and bearing. After minimizing the heading error, the car maintained a straight steering angle along its path to the final destination. The results of this research can be used to develop applications that require precise navigation. The design techniques can also be implemented on alternate platforms such as a wheelchair to assist with autonomous navigation.
Hubert, Geoffroy; Tousignant, Michel; Routhier, François; Corriveau, Hélène; Champagne, Noël
Service dogs help people with mobility impairments. They are trained to perform a variety of tasks, such as opening doors, retrieving the telephone, picking up objects, and pulling manual wheelchairs (MWCs). More specifically, using the traction provided by the service dog has physical benefits because MWC users can operate their MWCs with less effort. The objective of this study was to document the effect of a service dog on MWC mobility and user shoulder pain, social participation, and quality of life. Eleven MWC users with spinal cord injury were assessed before and after training with a service dog and 7 mo later. Based on a standardized protocol, all study participants learned how to use the service dog safely and how to move around efficiently in different environments and under different conditions. Results showed that using a service dog increased the distance covered by the MWC users and also significantly decreased shoulder pain and intensity of effort. Using the service dog also produced slight but significant improvements in MWC user skills and social participation and may indicate a trend for improvement in quality of life. More extensive research is needed to precisely identify the effect of service dogs on the long-term management of MWC use.
Koch, I; Schlegel, M; Pirrwitz, A; Jaschke, B; Schlegel, K
The effects of an additional six-weeks training program were investigated ergometrically and in practice in 10 paraplegics. In order to develop stamina, strength and coordinative abilities, the load components were varied by increasing training frequency, expanding load range and increasing stimuli density. It was possible to show a significant increase in the general physical capacity. The performance parameters of paraplegics were compared with those of wheelchair-bound sports competitors and able-bodied persons. It was possible to improve the capacity of skeletal muscles and bring it closer to that of competitive athletes and able-bodied persons. Trained paraplegics as well as competitive athletes both display to the same extent a conspicuously poorer cardiovascular capacity in relation to able-bodied persons. The reason for this is believed to lie in the extensive muscular and vascular deficiency due to the particular disablement and the poorer venous return resulting from the latter. It points to a reduced overall blood volume and a relatively small heart volume. These investigations are being continued. The findings of sports medicine necessarily require that continuous training take place with relatively high intensity for the purpose of producing a circulatory effect. On the other hand, a basic stamina training must ensure that the indicated capacity reserves of skeletal muscles are developed. The multifaceted possibilities for training within the framework of sport for the disabled are presented.
Etienne, Stephanie; Guthrie, Martin; Goillandeau, Michel; Nguyen, Tho Hai; Orignac, Hugues; Gross, Christian; Boraud, Thomas
The neurological bases of spatial navigation are mainly investigated in rodents and seldom in primates. The few studies led on spatial navigation in both human and non-human primates are performed in virtual, not in real environments. This is mostly because of methodological difficulties inherent in conducting research on freely-moving monkeys in real world environments. There is some incertitude, however, regarding the extrapolation of rodent spatial navigation strategies to primates. Here we present an entirely new platform for investigating real spatial navigation in rhesus monkeys. We showed that monkeys can learn a pathway by using different strategies. In these experiments three monkeys learned to drive the wheelchair and to follow a specified route through a real maze. After learning the route, probe tests revealed that animals successively use three distinct navigation strategies based on i) the place of the reward, ii) the direction taken to obtain reward or iii) a cue indicating reward location. The strategy used depended of the options proposed and the duration of learning. This study reveals that monkeys, like rodents and humans, switch between different spatial navigation strategies with extended practice, implying well-conserved brain learning systems across different species. This new task with freely driving monkeys provides a good support for the electrophysiological and pharmacological investigation of spatial navigation in the real world by making possible electrophysiological and pharmacological investigations.
Nicholas J. Diaper
Full Text Available This study was designed to examine the physiological changes caused by long-term training in a world class female tennis player in preparation for a major championship. Additionally, we aim to describe the training interventions and determine a suitable cooling strategy that was to be used at the 2004 Paralympic Games. The athlete underwent regular physiological assessment during 2003-2004. Physiological measures involved body composition, submaximal and peak oxygen uptake and key variables associated with maximal sprinting. In addition, a suitable match-play cooling intervention and hydration strategy was also explored. Body composition improved over the course of the study. Aerobic capacity fell by 21%, yet the submaximal physiological variables such as lactate profile and pushing economy improved. The trade off of aerobic capacity was perhaps noticeably counter-balanced with the maintenance of the peak sprinting speed and improvement found in the fatigue profile across ten repeated sprints. The extensive training programme was responsible for these changes and these adaptations resulted in a more confident athlete, in peak physical condition leading into the Paralympic Games. It is difficult to appreciate the extent to which this work had an impact on tennis performance given the skill requirements of wheelchair tennis and this warrants future attention
Wang, Yong Tai; Li, Zhanghua; Yang, Yi; Zhong, Yaping; Lee, Shih-Yu; Chen, Shihui; Chen, Yu-Ping
A 12-week Wheelchair Tai Chi 10 Form (WTC10) intervention was conducted among elderly with disability to examine the effect of this WTC10 intervention on selected physical and mental health variables. Thirteen (age 87.23 ± 6.71) in the WTC10 intervention group and 15 (age 89.73 ± 6.31) in the control group completed the study. Independent t-tests and paired t-tests were employed to examine the differences between groups and within groups, respectively, at pretest and post-test. The WTC10 intervention group showed significant improvements in systolic and diastolic blood pressure, shoulder external rotation, left trunk rotation and total trunk rotation after the intervention. A 12-week WTC10 intervention had positive effects on blood pressure, range of motion at the shoulder and trunk, physical activity, and mental health among the elderly with disability. WTC10 is a feasible and safe exercise for the elderly with disability.
Mallakzadeh, Mohammadreza; Akbari, Hossein
The repetitious nature of propelling a wheelchair has been associated with the high incidence of injury among manual wheelchair users (MWUs), mainly in the shoulder, elbow and wrist. Recent literature has found a link between handrim biomechanics and risk of injury to the upper extremity. The valid measurement of three-dimensional net joint forces and torques, however, can lead to a better understanding of the mechanisms of injury, the development of prevention techniques, and the reduction of serious injuries to the joints. In this project, an instrumented wheel system was developed to measure the applied loads dynamically by the hand of the user and the angular position of the wheelchair user's hand on the handrim during the propulsion phase. The system is composed of an experimental six-axis load cell, and a wireless eight channel data logger mounted on a wheel hub. The angular position of the wheel is measured by an absolute magnetic encoder. The angular position of the wheelchair user's hand on the handrim during the propulsion phase (ɸ) or point of force application (PFA) is calculated by means of a new-experimental method using 36 pairs of infrared emitter/receiver diodes mounted around the handrim. In this regard, the observed data extracted from an inexperienced able-bodied subject pushed a wheelchair with the instrumented handrim are presented to show the output behavior of the instrumented handrim. The recorded forces and torques were in agreement with previously reported magnitudes. However, this paper can provide readers with some technical insights into possible solutions for measuring the manual wheelchair propulsion biomechanical data. PMID:25426429
Full Text Available Field-based assessments provide a cost–effective and accessible alternative to dual-energy X-ray absorptiometry (DXA for practitioners determining body composition in athletic populations. It remains unclear how the range of physical impairments classifiable in wheelchair sports may affect the utility of field-based body composition techniques. The present study assessed body composition using DXA in 14 wheelchair games players who were either wheelchair dependent (non-walkers; n =7 or relied on a wheelchair for sports participation only (walkers; n =7. Anthropometric measurements were used to predict body fat percentage with existing regression equations established for able-bodied persons by Sloan & Weir, Durnin & Womersley, Lean et al, Gallagher et al and Pongchaiyakul et al. In addition, linear regression analysis was performed to calculate the association between body fat percentage and BMI, waist circumference, sum of 6 skinfold thicknesses and sum of 8 skinfold thicknesses. Results showed that non-walkers had significantly lower total lean tissue mass (46.2±=6.6 kg vs. 59.4±8.2 kg, P =.006 and total body mass (65.8 ±4.2 kg vs. 79.4 ±14.9 kg; P =0.05 than walkers. Body fat percentage calculated from most existing regression equations was significantly lower than that from DXA, by 2 to 9% in walkers and 8 to14% in non-walkers. Of the anthropometric measurements, the sum of 8 skinfold thicknesses had the lowest standard error of estimation in predicting body fat content. In conclusion, existing anthropometric equations developed in able-bodied populations substantially underestimated body fat content in wheelchair athletes, particularly non-walkers. Impairment specific equations may be needed in wheelchair athletes.
Mallakzadeh, Mohammadreza; Akbari, Hossein
The repetitious nature of propelling a wheelchair has been associated with the high incidence of injury among manual wheelchair users (MWUs), mainly in the shoulder, elbow and wrist. Recent literature has found a link between handrim biomechanics and risk of injury to the upper extremity. The valid measurement of three-dimensional net joint forces and torques, however, can lead to a better understanding of the mechanisms of injury, the development of prevention techniques, and the reduction of serious injuries to the joints. In this project, an instrumented wheel system was developed to measure the applied loads dynamically by the hand of the user and the angular position of the wheelchair user's hand on the handrim during the propulsion phase. The system is composed of an experimental six-axis load cell, and a wireless eight channel data logger mounted on a wheel hub. The angular position of the wheel is measured by an absolute magnetic encoder. The angular position of the wheelchair user's hand on the handrim during the propulsion phase (ɸ) or point of force application (PFA) is calculated by means of a new-experimental method using 36 pairs of infrared emitter/receiver diodes mounted around the handrim. In this regard, the observed data extracted from an inexperienced able-bodied subject pushed a wheelchair with the instrumented handrim are presented to show the output behavior of the instrumented handrim. The recorded forces and torques were in agreement with previously reported magnitudes. However, this paper can provide readers with some technical insights into possible solutions for measuring the manual wheelchair propulsion biomechanical data.
Deshpande, Ruchi R.; Li, Han; Requejo, Philip; McNitt-Gray, Sarah; Ruparel, Puja; Liu, Brent J.
Wheelchair users are at an increased risk of developing shoulder pain. The key to formulating correct wheelchair operating practices is to analyze the movement patterns of a sample set of subjects. Data collected for movement analysis includes videos and force/ motion readings. Our goal is to combine the kinetic/ kinematic data with the trial video by overlaying force vector graphics on the raw video. Furthermore, conversion of the video to a DICOM multiframe object annotated with the force vector could provide a standardized way of encoding and analyzing data across multiple studies and provide a useful tool for data mining.
Sung, JongHun; Trace, Yarden; Peterson, Elizabeth W; Sosnoff, Jacob J; Rice, Laura A
The purpose of this study is to (1) explore and (2) compare circumstances of falls among full-time wheelchair users with spinal cord injury (SCI) and multiple sclerosis (MS). A mixed method approach was used to explore and compare the circumstances of falls of 41 full-time wheelchair users with SCI (n = 23) and MS (n = 18). In addition to collecting participants' demographic information (age, gender, type of wheelchair used, duration of wheelchair use, and duration of disability), self-reported fall frequency in the past 6 months, self-reported restriction in activity due to fear of falling and the Spinal Cord Injury-Fall Concerns Scale (SCI-FCS) was collected. Qualitative data in the form of participants' responses to an open-ended question yielding information regarding the circumstances of the most recent fall were also collected. To examine differences in survey outcomes and demographic characteristics between participants with SCI and MS, independent t-tests and Pearson's Chi-square tests were used. Qualitative data were analyzed with a thematic analysis. Statistical analysis revealed that individuals with MS (mean =3.3) had significantly higher average SCI-FCS than individuals with SCI (mean =2.4). The analysis of the participants' descriptions of the circumstances of their most recent falls resulted in three main categories: action-related fall contributors (e.g., transfer), (2) location of falls (e.g., bathroom), and (3) fall attributions (e.g., surface condition). The results from this study helped to understand fall circumstances among full-time wheelchair users with MS and SCI. Findings from this study can inform the development of evidenced-based interventions to improve the effectiveness of clinically based treatment protocols. Implications for rehabilitation Falls are a common health concern in full-time wheelchair users living with multiple sclerosis and spinal cord injury. The circumstances surrounding falls reported by full
Pan, Ruihuan; Zhou, Mingchao; Cai, Hao; Guo, Youhua; Zhan, Lechang; Li, Mei; Yang, Zhijing; Zhu, Leying; Zhan, Jie; Chen, Hongxia
To evaluate the effect of modified wheelchair arm-support to mitigate hemiplegic shoulder pain and reduce pain frequency in stroke patients. A single-blind randomized controlled trial using computer-generated simple randomization. Participants recruited from inpatients at the Guangdong Provincial Hospital of Chinese Medicine. A total of 120 patients with stroke were divided into two groups. All subjects underwent basic rehabilitation training and wheelchair assistance with eight weeks follow-up period. Patients in the treatment group additionally received modified wheelchair arm-support for at least 60 minutes a day, six days a week, for four weeks. Primary outcome was measured by the Visual Analogue Pain Scale or Numeric Pain Rating Scale. Secondary outcome was measured using the Upper Extremity Fugl-Meyer Assessment scale, Modified Barthel Index and Quality of Life Index. Measurements were made at 4 weeks and 12 weeks, following the intervention. Patients age from 21 to 83 years (mean ± SD = 62.41 ± 12.26). The average duration of disease was 1.9 ± 1.3 months. At four weeks, the median of pain intensity was higher in the control group (median, interquartile range = 3, 5.75 vs. 2, 3.75; P = 0.059). At 12 weeks, the median of pain intensity was higher in the control group (median, interquartile range = 3, 5.00 vs. 0, 1.00; P vs. 1; P stroke patients. It may also improve the patients' quality of life.
Full Text Available Background: The positive effects of caffeine supplementation on strength-power and endurance performance in healthy athletes have been demonstrated in many studies. A possible mechanism for its ergogenic effect relates to its influence on the central nervous system. Post-traumatic complications in cervical spinal cord injury affect almost all body systems including the nervous system. For this reason, we expect that caffeine will have a different effect of performance in the group of athletes with spinal cord injuries. Objective: To examine the effects of caffeine supplementation on maximal aerobic power in elite wheelchair rugby players. Methods: Seven elite male wheelchair rugby players with complete cervical-level SCI (C4-Th1 were recruited (mean age: 28 ± 5.42 years; mean body mass index: 26 ± 2.84 kg/m2. The effect of caffeine was assessed by an incremental arm ergometer test until volitional exhaustion. The maximal oxygen uptake (VO2max/kg, maximum power (W max/kg, peak heart rate (HR peak, and intensity of perceived exertion (RPE were measured. Participants performed the test twice with a two-week washout period. One hour before each exercise test subjects ingested a capsule of placebo or caffeine (3 mg per kg of body weight. The tests were applied in a double-blind, randomized, repeated-measures, and cross-over design. Wheelchair rugby players were chosen because of the expected high homogeneity of participants - in terms of the type and degree of disability, gender, and age of the players. Results: The monitored parameters were not significantly influenced by caffeine intervention as compared to placebo: VO2max/kg (p = .40, W max/kg (p = .34, HR peak (p = .50 and RPE (p = .50. Conclusions: The current findings suggest that a caffeine dose of 3 mg/kg body mass does not improve oxygen uptake and maximal power in elite wheelchair rugby players.
Goosey-Tolfrey, V L; Vegter, R J K; Mason, B S; Paulson, T A W; Lenton, J P; van der Scheer, J W; van der Woude, L H V
The purpose of this study was to examine the propulsion asymmetries of wheelchair athletes while sprinting on an instrumented, dual-roller ergometer system. Eighteen experienced wheelchair rugby players (8 low point (LP) (class ≤1.5) and 10 high point (HP) (class ≥2.0)) performed a 15-second sprint in their sports wheelchair on the instrumented ergometer. Asymmetry was defined as the difference in distance and power output (PO) between left and right sides when the best side reached 28 m. Propulsion techniques were quantified based on torque and velocity data. HP players covered an average 3 m further than the LP players (P = .002) and achieved faster sprint times than LP players (6.95 ± 0.89 vs 8.03 ± 0.68 seconds, P = .005) and at the time the best player finished (5.96 seconds). Higher peak POs (667 ± 108 vs 357 ± 78 W, P = .0001) and greater peak speeds that were also evident were for HP players (4.80 ± 0.71 vs 4.09 ± 0.45 m/s, P = .011). Greater asymmetries were found in HP players for distance (1.86 ± 1.43 vs 0.70 ± 0.65 m, P = .016), absolute peak PO (P = .049), and speed (0.35 ± 0.25 vs 0.11 ± 0.10 m/s, P = .009). Although HP players had faster sprint times over 28 m (achieved by a higher PO), high standard deviations show the heterogeneity within the two groups (eg, some LP players were better than HP players). Quantification of asymmetries is important not only for classifiers but also for sports practitioners wishing to improve performance as they could be addressed through training and/or wheelchair configuration. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Requejo, Philip Santos; Mulroy, Sara J; Ruparel, Puja; Hatchett, Patricia E; Haubert, Lisa Lighthall; Eberly, Valerie J; Gronley, JoAnne K
Shoulder loading during manual wheelchair propulsion (WCP) contributes to the development of shoulder pain in individuals with spinal cord injury (SCI). To use regression analysis to investigate the relationships between the hand contact angle (location of the hand on the pushrim at initial contact and release during the push phase of the WCP cycle) with propulsion characteristics, pushrim forces, and shoulder kinetics during WCP in individuals with paraplegia. Biomechanical data were collected from 222 individuals (198 men and 24 women) with paraplegia from SCI during WCP on a stationary ergometer at a self-selected speed. The average age of participants was 34.7 years (±9.3), mean time since SCI was 9.3 years (±6.1), and average body weight was 74.4 kg (±15.9). The majority (n = 127; 56%) of participants had lower level paraplegia (T8 to L5) and 95 (42%) had high paraplegia (T2 to T7). Increased push arc (mean = 75.3°) was associated with greater velocity (R = 0.384, P contact angle and hand release angles were equally associated with cycle distance and cadence, whereas a more anterior release angle was associated with greater velocity (R = 0.372, P contact angle was associated with greater posterior shoulder net joint force (R = 0.229, P = .001) and greater flexor net joint moment (R = 0.204, P = .002), whereas a more anterior hand release angle was significantly associated with increased vertical (R = 0.270, P contact and hand release must be considered in WCP training. It is recommended that participants should reach back to initiate contact with the pushrim to maximize push arc but avoid a more anterior hand position at release, because this could increase shoulder load during the push phase of WCP.
Gillham, Michael; Pepper, Matthew; Kelly, Steve; Howells, Gareth
The objective of this research is to identify stakeholder views with regard to the development of effective powered wheelchair assistive technologies more suited to the user and carer needs, whilst also meeting the requirements for other stakeholders, such that developers can be better guided towards producing solutions which have a better chance of getting to the market place and hence to the end user. A questionnaire was designed to collect the views of all stakeholders and circulated to a statistically representative number of them. The question rating data were then checked for correlation between groups, and within groups, to establish validity. The 74 stakeholders across the eight classes who responded had a good correlation between each other, with a cross class "Pearson's correlation" ranging between 0.7 and 0.95, and the "Fleiss's Kappa reliability of agreement" within each class ranging between 0.07 and 0.36. This research has identified that all stakeholders should be involved in the development of the technology and that some may benefit in 'role-reversal' to help understand user problems and stakeholder concerns more clearly. Cost was a significant barrier to the uptake of appropriate technology, and training of users and carers was a major issue. Furthermore, development should not increase user isolation and the impact on the user must be monitored for 'quality of life'. Technical support and training should be given to the user and their carers, and equipment must be adaptive to meet the changing needs of the user. Implications for Rehabilitation Improved acceptance and use of technology by the user and their carers. Reduced rejection of appropriate provision. Improved mobility and interaction with others. Improved quality of life for users and carers.