Wheelchair-mounted robotic arms: a systematic review of technical design and activities of daily living outcomes

This paper focuses on kinematic analysis and evaluation of wheelchair mounted robotic arms (WMRA). It addresses the kinematics of the WMRA with respect to its ability to reach common positions while performing activities of daily living (ADL). A procedure is developed for the kinematic analysis and evaluation of a WMRA. In an effort to evaluate two commercial WMRAs, the procedure for kinematic analysis is applied to each manipulator. Design recommendations and insights with regard to each device are obtained and used to design a new WMRA to overcome the limitations of these devices. This method benefits the researchers by providing a standardized procedure for kinematic analysis of WMRAs that is capable of evaluating independent designs.

Purpose The increasing prevalence of upper limb dysfunctions due to stroke, spinal cord injuries, and multiple sclerosis presents a critical challenge in assistive technology: designing robotic arms that are both energy‑efficient and capable of effectively performing activities of daily living (ADLs). This challenge is exacerbated by the need to ensure these devices are accessible for non‑expert users and can operate within the spatial constraints typical of everyday environments. Despite advancements in wheelchair‑mounted robotic arms (WMRAs), existing designs do not achieve an optimal balance—minimizing energy consumption and space while maximizing kinematic performance and workspace. Most robotic arms can perform a range of ADLs, but they do not account for outdoor environments where energy conservation is crucial. Furthermore, the need for WMRAs to be compact in idle configurations—essential for navigating through doors or between aisles—adds another layer of complexity to their design. This paper addresses these multifaceted design challenges by proposing a novel objective function to optimize the link lengths of WMRAs, aiming to reduce energy consumption without compromising the robots’ operational capabilities. Materials and Methods To achieve this optimization, the scatter search method was employed, incorporating considerations of collision and singularity avoidance while ensuring the arm remains compact when not in use. The proposed design was evaluated through simulations and experimental validation with both healthy subjects and individuals with lower limb dysfunctions. Results and Conclusions The optimized WMRA demonstrated significant improvements in energy efficiency and spatial adaptability while maintaining the required kinematic performance for ADLs. The validation process confirmed the practical applicability of the proposed design, highlighting its potential to enhance mobility and independence for individuals with upper limb impairments. This study contributes to the field of disability and rehabilitation by providing a structured approach to designing assistive robotic arms that better align with real‑world constraints and user needs.

This paper focuses on kinematic analysis, evaluation and design of wheelchair mounted robotic arms (WMRA). It addresses the kinematics of the WMRA with respect to its ability to reach common positions while performing activities of daily living (ADL). A procedure is developed for the kinematic analysis and evaluation of WMRAs. In an effort to evaluate two commercial WMRAs, the procedure for kinematic analysis is applied to each manipulator. Design recommendations and insights with regard to each device are obtained and used to design a new WMRA to overcome the limitations of these devices. This method benefits the researchers by providing a standardized procedure for kinematic analysis of WMRAs that is capable of evaluating independent designs

BACKGROUND Tetraplegia, often resulting from cervical spinal cord injury (SCI), may lead to significant motor and sensory loss, severely impacting independence and quality of life. Assistive technologies (ATs), such as wheelchair-mounted robotic arms (WMRAs), offer potential to enhance autonomy in daily living. However, adoption remains limited due to high costs, complex controls, and insufficient end-user involvement. Robust evidence on their real-world effectiveness, particularly post-hospitalisation, is still lacking. OBJECTIVE This study explores the real-life use of a WMRA for individuals with tetraplegia. It aims to evaluate its support in activities of daily living (ADLs), assess usability and satisfaction, and conduct a preliminary health economic analysis comparing cost-effectiveness and quality of life outcomes with standard care. METHODS This study will be conducted in post-hospitalisation settings in Switzerland. Up to 15 participants with upper limb impairments (SCI C0–Th1, AIS A–D) using powered wheelchairs will be recruited. They will use the robotic arm for six consecutive days. An equal number of participants will be recruited for the economic analysis group. A mixed methods approach will combine quantitative data collected via standardised questionnaires (PSSUQ, NASA-TLX, EQ-5D-5L, VAS, aCOMP, CSSRI-EU) at baseline and post-intervention, along with qualitative feedback gathered through an informal questionnaire and semi-structured interviews. Feasibility will be assessed through task performance and health economic analysis. The latter will include quality-adjusted life years (QALY), which quantify quality and length of life, and modelling the Incremental Cost-Effectiveness Ratio (ICER), which compares the cost-effectiveness of the intervention based on cost per QALY gained. RESULTS We expect the robotic system to reduce caregiver time and associated costs, while enhancing autonomy, quality of life, and mental well-being. Potential technical and recruitment challenges have been identified and mitigation strategies planned. By evaluating real-life use of a WMRAs, this study may support the broader adoption of assistive robotic technologies. CONCLUSIONS This research offers key insights into the feasibility, usability, and economic value of robotic assistance for individuals with tetraplegia and will help inform future development and scale-up studies.

Wheelchair Mounted Robotic Arms: Occupational Therapy Perceptions and Practices

Electric wheelchair-mounted robotic arms can help patients with disabilities to perform their activities in daily living (ADL). Joysticks or keypads are commonly used as the operating interface of Wheelchair-mounted robotic arms. Under different scenarios, some patients with upper limb disabilities such as finger contracture cannot operate such interfaces smoothly. Recently, manual interfaces for different symptoms to operate the wheelchair-mounted robotic arms are being developed. However, the stop the wheelchairs in an appropriate position for the robotic arm grasping task is still not easy. To reduce the individual’s burden in operating wheelchair in narrow spaces and to ensure that the chair always stops within the working range of a robotic arm, we propose here an operating system for an electric wheelchair that can automatically drive itself to within the working range of a robotic arm by capturing the position of an AR marker via a chair-mounted camera. Meanwhile, the system includes an error correction model to correct the wheelchair’s moving error. Finally, we demonstrate the effectiveness of the proposed system by running the wheelchair and simulating the robotic arm through several courses.

Background: Cerebral palsy (CP) is a prevalent motor disability, characterized by permanent disorders affecting movement and posture development, resulting in activity limitations. The prevalence of CP is higher in low- and middle-income countries compared to high-income countries. Purpose or Objectives: The research aims to explore the impact of assistive technology (AT) on improving the quality of life for individuals with CP, focusing on their ability to perform Activities of Daily Living. Methods: The study employs a descriptive design and surveys registered occupational therapists in Saudi Arabia. The survey includes questions about the types of AT used, their perceived impact on the patients’ daily lives and quality of life, and any challenges or barriers encountered in their use. Results: The majority of therapists (92.7%) are engaged in the treatment of patients diagnosed with CP, with 71.1% utilizing AT in their treatment approach. The most commonly used types of AT are for self-care (85.2%), mobility (74.1%), and cognition (48.1%). The perceived impact of AT results in a medium to high level of improvement in the patient’s ability to manage daily activities and overall quality of life. However, common barriers encountered by therapists include a lack of availability (70.4%) and insufficient financial support (70.4%). Conclusion: The study concludes that AT plays a crucial role in improving the quality of life for individuals with CP. However, there is a need to address the prevalent barriers to its use, such as availability and financial support.

A wheelchair-mounted robotic arm (WMRA) was designed and built to meet the needs of mobility-impaired persons with limitations of upper extremities, and to exceed the capabilities of current devices of this type. The mechanical design incorporates DC servo drive, with actuator hardware at each individual joint, allowing reconfigurable link lengths. It has seven degrees of freedom and uses a side mount on a power wheelchair. The control system allows coordinated Cartesian control, and offers expandability for future research, such as coordinated motion with the wheelchair itself. This paper discusses the current state of the art in WMRAs; describes the design goals and user requirements for this device; explains the component selection process; discusses details of the mechanical design, electrical system and low-level controller; covers manufacturing concerns; and describes the testing of the completed arm. Further improvements are also suggested

Assistive technology (AT) refers to assistive products (AP) and associated systems and services that are relevant for function, independence, well-being, and quality of life for individuals with disabilities. There is a high unmet need for AT for persons with disabilities and this is worse for persons with cognitive and mental or psychosocial disabilities (PDs). Further, information and knowledge on AT for PDs is limited. The aim of this review was to explore the pattern of AT use among persons with PDs and its associated socioeconomic and health benefits. The review was reported according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), and we conducted systematic searches in the 4 databases: PubMed, Embase.com, APA PsycInfo (Ebsco), and Web of Science (Core Collection) with the following index terms: "Assistive Technology," "Self-Help Devices," "Quality of Life," "Activities of Daily Living," "Mental Disorders." We included only AT individuals with PDs can independently use without reliance on a provider. Identified papers were exported to EndNote (Clarivate) and we undertook a narrative synthesis of the included studies. In total, 5 studies were included in the review which reported use of different AT for schizophrenia, bipolar disorder, depression and anxiety disorders. The APs described in the included studies are Palm tungsten T3 handheld computer, MOBUS, personal digital assistant, automated pill cap, weighted chain blankets, and smartphone function. All the AT products identified in the studies were found to be easily usable by individuals with PDs. The APs reported in the included studies have broad impact and influence on social function, productivity, and treatment or management. The studies were heterogeneous and were all conducted in high-income countries. Our study contributes to and strengthens existing evidence on the relevance of AT for PDs and its potential to support socioeconomic participation and health. Although AT has the potential to improve function and participation for individuals with PDs; this review highlights that research on the subject is limited. Further research and health policy changes are needed to improve research and AT service provision for individuals with PDs especially in low-income settings. PROSPERO CRD42022343735; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=343735.

There has been significant progress in bringing commercially-viable wheelchair mounted robotic arms (WMRA) into the marketplace in the past 30 years. This paper focuses on kinematic analysis and evaluation of such robotic arms. It addresses the kinematics of the WMRA with respect to its ability to reach common positions while performing activities of daily living (ADL). A procedure is developed for the kinematic analysis and evaluation of a wheelchair mounted robotic arm. In addition to developing the analytical procedure, the manipulator is evaluated, and design recommendations and insights are obtained. Current commercially-available wheelchair mountable robotic manipulators have been designed specifically for use in rehabilitation robotics. In an effort to evaluate two commercial manipulators, the procedure for kinematic analysis is applied to each manipulator. Design recommendations with regard to each device are obtained. This method will benefit the researchers by providing a standardized procedure for kinematic analysis of WMRAs that is capable of evaluating independent designs.

Wheelchair-mounted robotic arms support people with upper extremity disabilities with various activities of daily living (ADL). However, the associated cost and the power consumption of responsive and adaptive assistive robotic arms contribute to the fact that such systems are in limited use. Neuromorphic spiking neural networks can be used for a real-time machine learning-driven control of robots, providing an energy efficient framework for adaptive control. In this work, we demonstrate a neuromorphic adaptive control of a wheelchair-mounted robotic arm deployed on Intel’s Loihi chip. Our algorithm design uses neuromorphically represented and integrated velocity readings to derive the arm’s current state. The proposed controller provides the robotic arm with adaptive signals, guiding its motion while accounting for kinematic changes in real-time. We pilot-tested the device with an able-bodied participant to evaluate its accuracy while performing ADL-related trajectories. We further demonstrated the capacity of the controller to compensate for unexpected inertia-generating payloads using online learning. Videotaped recordings of ADL tasks performed by the robot were viewed by caregivers; data summarizing their feedback on the user experience and the potential benefit of the system is reported.

AAPM&R Presentation to IOM Committee on Disability in America 2005

BackgroundChronic ankle conditions affect approximately 20% of Australian adults. Although there is a plethora of research on chronic hip and knee conditions, there is limited understanding of the impact of ankle problems. Thus, the significance of chronic ankle conditions is not clear. The aim of this study was to compare self-reported function, disability, instability, physical activity and quality of life (QoL) between adults with and without ankle symptoms. A secondary aim was to explore factors associated with QoL.MethodIndividuals with symptoms of ankle pain and stiffness (symptomatic individuals) and controls with no ankle pain or stiffness (asymptomatic individuals) completed a cross-sectional online survey. The survey included the Ankle Osteoarthritis Scale (AOS), Foot and Ankle Ability Measure (FAAM), Cumberland Ankle Instability Tool (CAIT), International Physical Activity Questionnaire (IPAQ), Assessment of QoL (AQoL-6D), and questions about ankle injury history.ResultsA total of 394 individuals (270 symptomatic and 124 asymptomatic) with mean age of 48.8 (standard deviation (SD): 12.1) years and body mass index of 28.7 (7.7) kgm− 2 completed the survey. Standardized mean differences (SMD) were large to very large (1.45 to 3.20) for greater disability (AOS) and instability (CAIT), and poorer function (FAAM) in symptomatic compared to asymptomatic individuals. Individuals with ankle symptoms had higher body mass index and lower QoL (medium effect: SMD > 1). There were no differences in self-report physical activity between groups. Lower activities of daily living (ADL) function (FAAM-ADL) best explained QoL in a multiple regression model (R2 = 0.66, p = 0.001).ConclusionIndividuals with ankle symptoms reported ankle instability, greater disability, compromised function and worse QoL compared to asymptomatic individuals. There was a strong relationship between ankle function and QoL. Ankle-specific ability during ADL best explained the reduced QoL in individuals with ankle symptoms. Clinicians and researchers should consider ankle function as an antecedent to poorer QoL in patients who have ankle symptoms.

Background: Piriformis Syndrome is a neuromuscular disorder characterised by pain and/or numbness in the buttock area caused by the compression or irritation of the sciatic nerve by piriformis muscle tightness. Early diagnosis and treatment of piriformis tightness are crucial to preventing long-term complications and improving the quality of life for individuals. Objective: to determine the prevalence of piriformis tightness and to determine the impact of piriformis tightness on physical activity and quality of life among undergraduate City University students. Methodology: The study was a cross-sectional design conducted at City University, Peshawar, Pakistan, with a sample size of 329 participants selected through non-probability convenient sampling. Ethical approval was obtained from the Research Committee of City University of Science and Information Technology. Inclusion criteria included undergraduate students aged 18-26 and those who are willing to participate, while exclusion criteria covered recent trauma, surgery in low back and lower limbs, psychological issues, lower limb disability, and lumbar radiculopathy. Tools used in the study were piriformis stretch test, numeric pain rating scale, and international physical activity questionnaire. Data was analyzed using SPSS version 26. Qualitative variables were calculated as frequency and percentages. Chi-square test was used to analyze the correlation between variables. The p-value ≤0.05 was considered statistically significant. Results: In a sample size of 329, 165 (50.2%) were males and 164 (49.8%) were females. The pain intensity among these participants was also distributed into different categories such as no pain, mild pain, moderate pain, and severe pain. The mild pain category had the highest frequency with 123 participants representing 37.4%% of the total sample. According to IPAQ score of the participants, the participants who are performing moderate physical activity had the highest frequency accounts for (54.4%). The mean sitting hours of the participants is 10.79±3.12. Conclusion: In conclusion, the prevalence of piriformis tightness and its impact on physical activity and quality of life are high among undergraduate university students, as a significant association was found between piriformis tightness and physical activity.

Background: A stroke commonly leads to permanent dysfunctions such as hemiplegia/hemiparesis. These functional alterations significantly compromise the quality of life (QoL), potentially causing social and emotional impairment for affected patients. With the lesion, the motor incapacity of synergistic trunk muscles interferes with the execution of activities of daily living (ADLs), weakening the patient‘s subjective well-being. Literature results have shown that interventions aimed at improving trunk movement functionality favor an improvement in QoL, but it is still unclear whether trunk control is directly correlated with QoL in post-stroke individuals. Objective: To analyze the correlation between trunk control and aspects of QoL in individuals with post-stroke hemiplegia. Methods: This is a cross-sectional study with a quantitative approach, with a convenience and intentional sample composed of 16 individuals. The evaluation of trunk control and QoL variables was performed using the following questionnaires: Trunk Impairment Scale (TIS) and Stroke Impact Scale (SIS). Pearson and Spearman correlation analyses were used, according to data normality, considering a significance level of 5%. This study was approved by the Research Ethics Committee (CAAE: 67926323.2.0000.5217). Results: Participants had a mean age of 57±12.7 years. The final scores of the questionnaires were: TIS total 16.5±2.9 and SIS total 64.2±8.9. Statistically significant correlations were found in the following variables: with a moderate effect between the total scores of SIS and TIS (p=0.018 and r=0.582), in the ADLs domain and physical problems (p=0.004; r=0.674), and total TIS with the ADLs domain (p=0.003; r=0.685). For the SIS total and the ADLs domain variables, there was a strong correlation (p=0.00001; r=0.867). Conclusion: The lack of motor control in trunk movement adversely impacts the quality of life (QoL) in post-stroke individuals, with a statistically significant correlation observed between these factors in this study‘s sample. Understanding these results underscores the importance of early clinical focus on addressing trunk control issues to enhance the subjective well-being prognosis for these individuals. Further research with larger sample sizes and objective measures of trunk control outcomes is necessary to validate the data presented.