Abstract
BackgroundPowered wheelchairs are an essential technology to support mobility, yet their use is associated with a high level of sedentarism that can have negative health effects for their users. People with Duchenne muscular dystrophy (DMD) start using a powered wheelchair in their early teens due to the loss of strength in their legs and arms. There is evidence that low-intensity exercise can help preserve the functional abilities of people with DMD, but options for exercise when sitting in a powered wheelchair are limited.MethodsIn this paper, we present the design and the feasibility study of a new version of the MOVit device that allows powered-wheelchair users to exercise while driving the chair. Instead of using a joystick to drive the wheelchair, users move their arms through a cyclical motion using two powered, mobile arm supports that provide controller inputs to the chair. The feasibility study was carried out with a group of five individuals with DMD and five unimpaired individuals. Participants performed a series of driving tasks in a wheelchair simulator and on a real driving course with a standard joystick and with the MOVit 2.0 device.ResultsWe found that driving speed and accuracy were significantly lowered for both groups when driving with MOVit compared to the joystick, but the decreases were small (speed was 0.26 m/s less and maximum path error was 0.1 m greater). Driving with MOVit produced a significant increase in heart rate (7.5 bpm) compared to the joystick condition. Individuals with DMD reported a high level of satisfaction with their performance and comfort in using MOVit.ConclusionsThese results show for the first time that individuals with DMD can easily transition to driving a powered wheelchair using cyclical arm motions, achieving a reasonable driving performance with a short period of training. Driving in this way elicits cardiopulmonary exercise at an intensity found previously to produce health-related benefits in DMD.
Highlights
Powered wheelchairs are an essential technology to support mobility, yet their use is associated with a high level of sedentarism that can have negative health effects for their users
The five Duchenne muscular dystrophy (DMD) participants were aged 13–17 years and had a Brooke scale ranging from 2–4, where a Brooke score of 2 indicates moderate reduction in the ability to raise the hands over the head, and a score of 4 indicates an inability to raise an 8 oz (227 g) of water to the mouth
This study shows for the first time that individuals with DMD can quickly learn to drive a powered wheelchair using cyclical arm motions, achieving a reasonable driving performance with which they felt subjectively satisfied and comfortable
Summary
Powered wheelchairs are an essential technology to support mobility, yet their use is associated with a high level of sedentarism that can have negative health effects for their users. People with Duchenne muscular dystrophy (DMD) start using a powered wheelchair in their early teens due to the loss of strength in their legs and arms. While powered wheelchairs are an essential technology to support mobility, their continuous use results in an increased level of sedentarism, which leads to secondary functional deterioration of the musculoskeletal and cardiorespiratory systems [2], as well as to an accelerated loss of arm function [3]. An appropriate, long-term dose of dynamic physical training can help preserve the functional abilities of boys with DMD
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