Standard Wheelchair Research Articles

Activity Identification, Classification, and Representation of Wheelchair Sport Court Tasks: A Method Proposal.

Monitoring player mobility in wheelchair sports is crucial for helping coaches understand activity dynamics and optimize training programs. However, the lack of data from monitoring tools, combined with a lack of standardized processing approaches and ineffective data presentation, limits their usability outside of research teams. To address these issues, this study aimed to propose a simple and efficient algorithm for identifying locomotor tasks (static, forward/backward propulsion, pivot/tight/wide rotation) during wheelchair movements, utilizing kinematic data from standard wheelchair mobility tests. Each participant's wheelchair was equipped with inertial measurement units-two on the wheel axes and one on the frame. A total of 36 wheelchair tennis and badminton players completed at least one of three proposed tests: the star test, the figure-of-eight test, and the forward/backward test. Locomotor tasks were identified using a five-step procedure involving data reduction, symbolic approximation, and logical pattern searching. This method successfully identified 99% of locomotor tasks for the star test, 95% for the figure-of-eight test, and 100% for the forward/backward test. The proposed method offers a valuable tool for the simple and clear identification and representation of locomotor tasks over extended periods. Future research should focus on applying this method to wheelchair court sports matches and daily life scenarios.

Effectiveness of custom seating and mobility services for individuals with disabilities in Guatemala

The purpose of this study was to evaluate the effectiveness of custom seating and mobility services provided via an international service learning (ISL) model on the occupational performance of individuals with disabilities in Guatemala. A one-group prospective pretest-posttest design was implemented using the standardized Wheelchair Outcome Measure (WhOM – Spanish) administered on the day of wheelchair fitting, and at 3- and 6-month intervals after receiving seating and mobility services. A two-tailed t-test demonstrated a statistically significant (p < 0.001) improvement in satisfaction for in-home and out-of-home occupations for all participants (n = 71) at 3-months with a huge effect size (d > 2) and this improvement was maintained at the 6-month interval. The results were consistent for various areas of occupational performance (e.g. activities of daily living). The provision of customized seating and mobility services by occupational therapists through an ISL model demonstrated effectiveness at improving satisfaction with occupational performance for individuals with disabilities in Guatemala. Cultural humility, customization of equipment based on personal and environmental factors, inclusion of education and training, and collaboration with in-country partners were identified as contributors to positive outcomes.

IoT Based Smart Reclining Wheel Chair

Individuals with disabilities are immobile; smart devices give them access to medical databases. One possible way to make improvements to your scenario would be to create a health-1 monitoring system for a patient. The current project’s objective is to build a low-cost smart wheelchair that uses a microcontroller and to attach a health monitoring device to a standard wheelchair

Rancang Bangun Kursi Roda Bermotor Elektrik Dengan Sistem Pengendalian Gestur Untuk Penyandang Tetraplegic

Improving medical services is continuously prioritized for the sake of achieving the welfare of all people in the world, and by providing good services in the medical field, people's needs will be increasingly fulfilled. Limitations of movement in someone with a disability, such as persons with disabilities tetraplegic in terms of mobility, are often obstacles. Therefore, a media-assisting movement is needed. This study designed an electric wheelchair that can help users with disabilities tetraplegic in moving without the need for too much force as in a standard wheelchair. This electric wheelchair uses automation by utilizing Accelerometer, which can detect vectors or so-called gyroscopes and connect with Arduino as the processor is continued to the DC motor as the driving force. Based on the test data, it was found that the design of this wheelchair moves as desired. This can be seen from the change in speed of the driving motor to changes in the tilt of the accelerometer mounted on the head. In the forward motion test, the maximum motor speed is 35 RPM when the accelerometer angle is at a slope of 64.7o positive axes. Meanwhile, the backward movement of the wheelchair occurs when the accelerometer is at a slope of -21.1o and produces a speed of 11.2 RPM on wheels. The rider's maximum load is designed to be 50 Kg.

Impact of Seating and Mobility Services for Individuals With Disabilities in El Salvador.

Outcomes research on the impact of seating and mobility services delivered using a short-term medical mission (STMM) model is limited. To evaluate the impact of seating and mobility services on the occupational performance of individuals with disabilities in El Salvador. One-group retrospective pretest-posttest. Clinical (El Salvador). Individuals with disabilities in El Salvador. Survey and the standardized Wheelchair Outcome Measure (WhOM) for those who received a wheelchair as their mobility device. Participants rated satisfaction with performance of preferred in-home and out-of-home occupations on the WhOM before and after receiving seating and mobility services. For most survey questions assessing the impact on activities of daily living, more than 86% of the respondents selected agree or strongly agree. Nearly half of the respondents reported that questions regarding work and education were not applicable. Participants' WhOM scores (n = 86) demonstrated a statistically significant improvement in performance satisfaction for both in-home (p < .001; d > 1) and out-of-home (p < .001; d > 1) occupations after they received services, with a huge effect size (d > 2). The findings suggest that seating and mobility services provided by rehabilitation professionals in El Salvador improved occupational performance for people with disabilities. Compared with STMMs that solely provide equipment, the findings emphasize the importance of professional service provision with education and training as best practice. What This Article Adds: Seating and mobility services delivered through a STMM model may improve occupational performance for individuals with disabilities. However, STMMs should be carefully planned in collaboration with in-country partners, provide customized seating systems, and include education and training from licensed rehabilitation professionals.

Biomechanics of wheelchair turning manoeuvres: novel insights into wheelchair propulsion.

Wheelchair turning biomechanics is an under researched area despite its obvious relevance to functional mobility of wheelchair users. Wheelchair turns might be linked to a higher risk of upper limb injuries due to the increased forces and torques potentially associated with asymmetric movement. Our aim was to obtain a better theoretical understanding of wheelchair turning by biomechanically analyzing turns compared to steady-state straightforward propulsion (SSSFP). Ten able-bodied men received 12-min familiarization and 10 trials (in a random order) of SSSFP and multiple left and right turns around a rectangular course. A Smartwheel was mounted at the right wheel of a standard wheelchair to measure kinetic parameters during SSSFP and of the inner hand during right turns and the outer hand during left turns. A repeated measures ANOVA was used to detect differences across tasks. Two strategies were identified: 3% demonstrated roll turns and 97% spin turns. Spin turns consisted of three phases: approach, turning and depart phase. The turning phase was accomplished by increasing peak force (72.9 ± 25.1 N vs. 43.38 ± 15.9 N in SSSFP) of the inner hand, while maintaining high push frequency of the outer hand (1.09 ± 0.20 push/s vs. 0.95 ± 0.13 push/s in SSSFP). Peak negative force and force impulse during the turning phase were much higher than SSSFP, 15.3 ± 15.7 and 4.5 ± 1.7 times higher, respectively. The spin turn strategy might carry an increased risk of upper limb injuries due to higher braking force and requires particular attention by rehabilitation professionals to preserve upper limb function of long-term wheelchair users.

A new system to measure the trunk angle and pelvis angle during wheelchair propulsion.

The number of wheelchair users is increasing as the population ages. However, there is still lack of tools to objectively assess posture during wheelchair propulsion. The purpose of this study was to develop a system to measure trunk and pelvis ROM (range of motion) while driving a wheelchair and to assess the reproducibility of the measured posture changes and cyclic fluctuations during propulsion. Motion recorders were attached to the sternum and pelvis of fifteen healthy adults, and a pressure sensor was attached to the right heel. Subjects drove a standard wheelchair using their right leg and trunk and pelvis ROM was measured in two separate sessions. To detect the trend of postural changes during propulsion, a trend curve was computed from the measured ROM using a low-pass filter and then subtracted from the measured ROM waveforms. The resulting curves were normalized and averaged, and the maximum, minimum, and amplitude of the cyclic variation during propulsion were assessed for reproducibility. Intraclass correlation coefficients of the maximum, minimum, and amplitude ranged from 0.65 to 0.84. The proposed method can estimate the posture change and the periodic fluctuation during wheelchair propulsion with high reproducibility.

Influence of a Hybrid Manual–Electric Wheelchair Propulsion System on the User’s Muscular Effort

Abstract Self-propelled wheelchairs favour the rehabilitation process, forcing the user to be physically active. Unfortunately, in most cases, the manual propulsion is not adapted to the individual needs and physical capabilities of the user. This paper presents the results of operational tests of a wheelchair equipped with a hybrid propulsion system in which the muscle strength generated by the user is assisted by two independent electric motors. The research aimed to investigate the influence of the applied control algorithm and the assistance factor (W) on the value of the muscular effort (MA) while propelling the wheelchair with the use of push rims. A modified ARmedical AR-405 wheelchair equipped with two MagicPie 5 electric motors built into the wheelchair’s hubs with a power of 500 W was used in this research. The tests were carried out on a wheelchair test bench simulating the moment of resistance within the range of 8–11 Nm. Surface electromyography was employed for the measurement of MA, specifically, a four-channel Noraxon Mini DTS apparatus. The research was carried out on five patients from the group of C50 anthropometric dimensions. The effort was measured for four muscles: deltoid–anterior part, deltoid–posteriori part, and triceps brachii and extensor carpi radialis longus. The effectiveness of the hybrid propulsion system was observed based on the extensor carpi radialis longus muscle. In this case, for the standard wheelchair, the MA ranged from 93% to 123%. In contrast, for a wheelchair equipped with the hybrid propulsion system, at W = 70%, the MA was within the range of 43%–75%.

Evaluation of anti-rollback systems in manual wheelchairs: muscular activity and upper limb kinematics during propulsion

Self-propelling a wheelchair up a hill requires intense muscular effort and introduces the risk of the wheelchair rolling down. The purpose of this paper was to assess the user's muscular activity during ramp climbing. Tests were carried out on a group of 10 subjects who had to propel a wheelchair up a standardized wheelchair ramp. Basic parameters of upper limb kinematics were measured to determine the total push-rim rotation angle. This was 105.91° for a wheelchair with a stiff anti-rollback system, 99.39° for a wheelchair without an anti-rollback system and 98.18° for a wheelchair with a flexible anti-rollback system. The upper limb muscle effort was measured at 55 ± 19% for the wheelchair without an anti-rollback system, 59 ± 19% for the wheelchair with a stiff anti-rollback system and 70 ± 46% for the wheelchair with a flexible anti-rollback system. The conducted research showed an increase in muscle effort while using anti-rollback systems. In the case of push-rim rotation angle, no significant differences in the value of the rotation angle were found.

Implementation of Brain Computer Interface (BCI) as a Smart Wheelchair Motion Commands

A wheelchair is a tool used to assist people with physical limitations in their legs. The most widely used are standard wheelchairs with a manual operating system by being pushed by hand. However, people with disabilities who have paralysis or suffer from neuromuscular and neurological conditions cannot use this wheelchair. Because of this, in this study focuses on implementing the Brain Computer Interface system to generate five commands to move a wheelchair. There are five important stages in the BCI system, that is signal acquisition, pre-processing, feature extraction, classification, and applications interface. Fast Fourier Transform (FFT) method used to extract brainwave features. The results of FFT are alpha (8-12Hz) and beta (12-30 Hz) waves in the frequency domain. For classifying brain waves into six classes as input commands to drive a DC motor used Support Vector Machine (SVM) method. Based on the test results, the average accuracy of the classification for the whole class reached 93,1%, the accuracy of class 0 (77,3%), class 1 (95,7%), class 2 (97,8%), class 3 (98,0%), and class 4 (97,5%).

Impact of Sprinting and Dribbling on Shoulder Joint and Pushrim Kinetics in Wheelchair Basketball Athletes.

BackgroundWhile wheelchair basketball is one of the most popular Paralympic sports, it eventually causes shoulder problems and pain in many athletes. However, shoulder kinetics has never been assessed during propulsion in wheelchair basketball. This study analyzes the impact of sprinting and dribbling on pushrim and shoulder kinetics in terms of external forces and net muscular moments.MethodsA group of 10 experienced wheelchair basketball athletes with various classifications performed four, 9-m sprints on a basketball court using classic synchronous propulsion, and four sprints while dribbling forward. Pushrim and shoulder kinetics were calculated by inverse dynamics, using a motion capture device and instrumented wheels.FindingsSprinting was associated to peak shoulder load from 13 to 346% higher than in previous studies on standard wheelchair propulsion in most force/moment components. Compared to sprinting without a ball, dribbling reduced the speed, the peak external forces in the anterior and medial direction at the shoulder, and the peak net shoulder moment of internal rotation.InterpretationThe high shoulder load calculated during both sprinting and dribbling should be considered during training sessions to avoid overloading the shoulder. Dribbling generally reduced the shoulder load, which suggests that propelling while dribbling does not put the shoulder at more risk of musculoskeletal disorders than sprinting.

Folding Mechanism for Wheelchair

Lots of people across the globe are suffering from disabilities either temporary or permanent, and many of them are having difficulty in walking. That is why the role of the wheelchair is important for all having physical disabilities where they cannot walk by self. To address this issue wheelchairs are available in market with following benefits (i) easy transportation, (ii) compact storage space. This study is to propose a design of detachable folding mechanism that can mount on the frame of standard size wheelchair and can be dismounted to replace if any break down or maintenance. The mechanism can be mounted on standard wheelchairs and safe up to 150 kg weight of the subject.

Association between individual wheelchair skills and fitness in community-dwelling manual wheelchair users with spinal cord injuries

Purpose Wheelchair skills are a key component to promotion of community participation among persons with spinal cord injury (SCI). The objective of this secondary analysis was to examine the association between individual wheelchair skills from the Wheelchair Skills Test Questionnaire (WST-Q) and fitness among community-dwelling adults with SCI. Materials and methods Twenty-six adults were recruited to complete the WST-Q and a standard graded aerobic wheelchair exercise test on a motorized treadmill for assessing peak power output (POpeak). Results Spearman Rho rank-order correlation (ρ) analyses indicated statistically significant correlations between POpeak and six basic (ρ = 0.41–0.57), eight intermediate (ρ = 0.44–0.59), and nine advanced (ρ = 0.42–0.80) WST-Q skill scores. After controlling for sex and injury level (Partial Spearman Rho rank order) significant correlations persisted for four advanced skills (i.e., descends high curb, turns in place in wheelie position, descends steep incline in wheelie position, descends high curb in wheelie position; ρ = 0.46–0.59) and one additional skill (i.e., ascends high curb ρ = 0.51). Conclusions More advanced wheelchair skills are significantly associated with fitness in persons with SCI. The directionality of the skills-fitness relationship, specifically whether wheelchair skills facilitate greater fitness or fitness is a prerequisite for certain wheelchair skills needs to be determined in future, larger studies. However, results from this study provide a comprehensive list of wheelchair skills that are associated with fitness that can be directly applied to guide further research and practice promoting community participation among persons with SCI. Implications for Rehabilitation Significant positive associations exist between advanced wheelchair skills (i.e., descends high curb, turns in place in wheelie position, descends steep incline in wheelie position, descends high curb in wheelie position and ascends high curb) and fitness in manual wheelchair users with spinal cord injury (SCI). This study provides a list of skills associated with fitness to guide clinical practice and areas for further rehabilitation research assessing the directionality of the relationship between fitness and wheelchair skills.

Design and Fabrication of Low Cost Modified Maneuverable Standing Stretcher Wheelchair Transport System

Wheel Chairs are one of the convenient man made structure which are highly useful for person with disability. The major problem of this wheelchair is the architectural obstacles such as stairs etc. Many researchers around the globe have worked on wheel chair design so as to make the user independent. The question of overcoming these obstacles by a wheelchair always is the most discussed topics in recent days.&#x0D; This paper involves in fabricating a wheel chair which is motor operated. It is stair climbing wheelchair design which concept which overcomes the structural obstacles. The fabrication of an ergonomically designed battery operated wheel chair for multi usage is done. Concept of stairs climbing function is embedded in the design by adopting new design and mechanism. The design considerations of the wheelchair are based on the standard design of the stairs which are constructed in India. The work deals with design and fabrication of wheelchair convertible to bed. It is also equipped with a standing aid which helps the disabled individual to stand up and perform certain work.&#x0D; The design involves the use of electrical linear actuators which consists of an assembly of motor driven power screw to make the transformation from sitting to a bed by using a hand held remote, overcoming the need of a another person to shift the patient from wheelchair to bed. This project offers multiple features over a standard wheelchair and is very economical in comparison to commercially available wheelchairs.

Structural analysis of three-dimensional finite element model to design multifunction wheelchair for patients

The disabled and patients, especially hemiplegia and paraplegia cases and elder need to use a wheelchair for movement and admitted to the hospital or stay at home. The problem of using wheelchairs for patients and the elder is due to their different shapes. There is only a standard type of wheelchair in a hospital, therefore could not respond to differences in shape and usability. The ability of a wheelchair that does not provide enough facilities will result in the service as being ineffective in achieving and will make patients feel uncomfortable. The basis of the strength analysis, as well as stress distribution of the device structure design, is still minimal due to computer program limitations. A comprehensive understanding of the fundamentals of strength analysis will support the recommendation to design of wheelchair to handle patient for appropriate use in each situation. This research aim provides strength analysis to design the multifunction wheelchair. The multifunction wheelchair is designed to be turned into a bed, height-adjustable to use in a situation where a standard wheelchair could not be achieved due to the height is not enough and arm rest’s width adjustable for the convenience of patients with different body shapes. The detail regarding concept design and strength analysis of main components are solved by the finite element method (FEM) with a three-dimensional model. The results obtained from the simulation solution are examined and compared with the analytical solution. It is found that the highest maximum stress value does not exceed the yield strength of the material. The obtained results can be helpful in determining the basis for the guideline of wheelchair design and develop medical instruments situation by using principles of engineering.

Efficiency and perceived exertion of manual wheelchair propulsion: a physiological comparison of push vs pull wheeling

Manual wheelchair users face a high prevalence of upper extremity pain and injuries associated with poor biomechanics and the relatively low mechanical efficiency of conventional push wheeling. Recently developed geared wheels, which permit the wheelchair user to propel forwards by pulling at the handrims using a ‘rowing’ motion, have been speculated to improve ergonomics and reduce operational energy costs. This study compared the gross mechanical efficiency (GME) and perceived exertion (RPE) of these geared wheels to standard wheelchair wheels after a motor skill-based training session was conducted to familiarise participants with using both wheels. Fourteen able-bodied males were enrolled in the study. A within-participants, repeated-measures design was used to assess oxygen uptake (VO2), respiratory exchange ratio (RER), energy expenditure (En) and RPE during 5-minute, steady-state wheeling trials. Total external power output (Pext) was obtained using a drag test protocol for comparison over En to determine GME ratio. Stroke frequency and movement pattern were assessed through video tracking and propulsion testing. Although geared wheels required fewer strokes, standard wheels resulted in significantly lower VO2, RPE and En (p ≤ 0.001). These findings suggest overall that standard wheels were more mechanically efficient, likely due to internal energy loss of the geared wheel system.

The Shift of the Ischial Region during Maneuvering the Standard Wheelchair and the Electric Wheelchair in Healthy Adults

Pressure injuries are frequent secondary complications that occur in patients with Spinal Cord Injury (SCI), and the recurrence rate of ischial pressure injury is highest in SCI patients. Most SCI patients use wheelchairs, and some studies have shown a relationship between buttock pressure and sitting posture. However, the pressure distribution during wheelchair maneuvering is unclear. We measured and compared the shift of the ischial region when maneuvering a standard wheelchair or electric wheelchair in healthy adults. The subjects drove wheelchairs on a flat ground of 10 m and the shift of ischial region was measured with a pressure distribution-measuring device. The ischial region shifted forward or backward while maneuvering both the standard wheelchair and the electric wheelchair, and the shift rate of the ischial region was not significantly different between the standard wheelchair and the electric wheelchair. The ischial region shift occurred when the forward head moved by the video while maneuvering both a standard wheelchair and an electric wheelchair. Therefore, the shift might occurred because the pelvis shifted forward in conjunction with head movement during maneuvering of both the standard wheelchair and the electric wheelchair. This result showed that it is important to reduce head and trunk movements when maneuvering a wheelchair to reduce the shear force on the buttocks and prevent pressure injuries.

Therapeutic Management of a Patient with Necrotizing Fasciitis Resulting in Quadrilateral Amputation and Critical Illness Myopathy in the Intensive Care Setting: A Case Report.

Purpose: The purpose of this case is to illustrate the best available evidence to provide early therapeutic intervention for a critically ill patient presenting with cardiovascular and pulmonary complications due to multi-system compromise. Case Description: A 19-year-old male was admitted to the hospital with the diagnosis of necrotizing fasciitis and necrotizing pneumonia. He experienced numerous additional medical complications ultimately leading to tracheostomy, delirium, critical illness myopathy, and quadrilateral amputation secondary to necrotizing fasciitis and critical limb ischemia following prolonged veno-venous extracorporeal membrane oxygenation (VV-ECMO). Outcomes: Patient was discharged to an outside rehabilitation hospital after 103 days in the acute setting (56 days in the ICU) and was able to tolerate 40 minutes sitting edge of bed with supervision, perform bed mobility with supervision, and propel a standard wheelchair up to 50 feet independently. At 10 months’ post-discharge from the acute setting, the patient was ambulating independently up to 150 feet without assistive device using bilateral lower extremity prosthetics, able to propel a lightweight wheelchair community distances, independent in all transfers, and returned to school and work. Discussion: These findings suggest that clinicians may want to consider examining and combining the best available evidence of multiple medical conditions to provide a well-rounded therapeutic approach including but not limited to, close monitoring of vitals and early mobilization, to managing complex patients in the intensive care setting.

Experimental modal analysis of a standard wheelchair: a preliminary study

Vibration could affect the health and the comfort of manual wheelchairs (MWC) users (Garcia-Mendez et al. 2013). Literature already showed that during the daily use of a MWC, users are exposed to h...

Assessment of wheeled mobility devices provided to a commercially insured population in 2017

ABSTRACT In the United States, wheeled mobility devices (WMD) are classified as durable medical equipment (DME). Consistent with the definition of DME, wheeled mobility devices are typically covered by health insurance when deemed medically necessary. Despite the number of persons using wheelchairs, little knowledge is available about the types of wheelchairs provided, user’s specific diagnoses and the costs associated with WMD provision. The objective of this analysis was to define the number and types of wheelchairs and associated seating and mobility (S&M) accessories provided in the calendar year 2017. The analysis focused on user demographics, categories of WMDs and associated S&M equipment as well as cost accounting according to the type of insurance and contributions by beneficiaries. Analysis of over 81,000 wheelchair acquisitions found that manual wheelchairs accounted for nearly 90% with standard manual wheelchairs accounting for 86% of all wheelchairs provided. Wheelchair recipients tended to be older with the majority being female. Based upon ICD-10 diagnostic categories over 50% of captured ICD-10 codes came from three classifications, musculoskeletal (M), circulatory (I) and a general category of not otherwise classified disorders (R). Costs associated with seating and mobility equipment were fairly large, exceeding $79 million over a single calendar year.