Wheelchair Research Articles

Adherence to Physical Activity Guidelines in Manual Wheelchair Users With Spinal Cord Injury and the Association With Shoulder Pain.

The aim of the study is to investigate the association between adherence to spinal cord injury-specific physical activity guidelines in manual wheelchair users with spinal cord injury and shoulder pain prevalence. This is a cross-sectional analysis of the SwiSCI Community Survey 2022 data, assessing aerobic activity and muscle strength training adherence in manual wheelchair users with spinal cord injury and shoulder pain prevalence. Logistic regression analysis was used to identify the association between meeting the physical activity guidelines and shoulder pain. Low adherence to aerobic activity and strength training guidelines are observed, with 46% and 64% of the study sample not meeting the respective guidelines. The low adherence to physical activity guidelines contrasts with the general Swiss population from which around 75% is physically active for more than 2.5 hrs a week. Manual wheelchair users present a high prevalence of shoulder pain (40%) and nonadherence to aerobic guidelines in the study sample correlates with 1.55-1.97 higher odds of having shoulder pain. Aerobic activity adherence is associated with lower shoulder pain prevalence, emphasizing its potential for injury prevention. Overall, the presented findings necessitate further longitudinal studies and interventions for a comprehensive understanding and effective management of shoulder pain in manual wheelchair users with spinal cord injury.

Improvement of Safety Standards for Railway Station Platforms

This study compares and analyzes the fire safety standards of both domestic and international railway station platforms by investigating the installation status of fire protection facilities in platforms with a total floor area of over 5,000 m<sup>2</sup> in the Chungcheong region. The existing fire protection facilities require improvement in their standards by taking into account various factors, such as the location of railway stations, openness of platforms, and amount of combustible materials. The installation standards for fire protection facilities on platforms must be clearly defined and reinforced. Additionally, the installation of evacuation elevators is required for wheelchair users on underground station platforms without any open areas, as this would facilitate easy evacuation in the event of a fire.

Accessible Trail Tourism: Trail Accessibility and Difficulty Rating Approach Designed for Individuals, Including With Mobility Impairments

ABSTRACTThis study introduces a novel approach to trail accessibility and difficulty rating tailored specifically for individuals, including those with mobility impairments, aiming to promote accessible trail tourism. Grounded in theoretical frameworks of inclusive outdoor recreation, equality, and complex adaptive systems, the proposed rating system incorporates criteria addressing physical access, terrain challenges, and amenities to accommodate diverse user needs. This study employed a sensor technology, called wheeled instrumentation sensor package (WISP) within the framework of the high‐efficiency trail assessment process (HETAP) to develop a new quantitatively based trail classification scheme. A case study trail and two hypothetical synthetic data trails were used to demonstrate both the trail wheelchair accessibility binary classification approach and the proposed trail difficulty classification approach. This research pioneers trail accessibility and difficulty rating and underscores the importance of integrating accessibility considerations into trail management practices to create truly inclusive outdoor recreational experiences.

Program evaluation and healthcare process improvement focused on complex wheelchair procurement

ABSTRACT The operations of a specialty wheelchair (WC) seating center can influence the evaluation to delivery timeframe in days for a complex rehab technology (CRT) WC. Operations at one facility improved due to departmental process improvement (PI) project with evaluation of the delivery workflow and implementation of changes. A retrospective chart audit gathered baseline data on the evaluation to delivery timeframe in days of a CRT WC for 50 individuals prior to PI changes. Standard departmental workflow collected 745 individuals’ post-PI changes. The interventions took place from March 25, 2017, to April 5, 2018, and included defining and educating stakeholders on their roles and expectations, revisions of the electronic medical record, weekly and quarterly meetings with supplier leadership, paperwork completion goals, and follow-up paperwork centralization. Mean pre- and post-intervention evaluation to delivery timeframes in days was significantly different (162.2 versus 127.4 days, p < 0.0001). Overall, a reduction in the mean evaluation to delivery timeframe in days of CRT WC by 21.5% or 34.8 days occurred. Systematic change takes time as well as the commitment of all key players. PI changes resulted in evaluation to delivery timeframe reduction for patients to receive their CRT WCs.

Holistic Sensor-Based Approach for Assessing Community Mobility and Participation of Manual Wheelchair Users in the Real World

Holistic Sensor-Based Approach for Assessing Community Mobility and Participation of Manual Wheelchair Users in the Real World

Exploring Indoor Home Environment Factors Influencing Fear of Falling: A Systematic Review.

In-home falls and fear of falling (FOF) are significant concerns among older adults and people with disabilities (PwD), impacting independence in daily lives. The indoor home environment (IHE) plays an important role in influencing FOF, as it is influenced by barriers and facilitators within the home. This systematic review provides an evidence-based list of IHE factors and investigates their association with FOF, especially in older adults, PwD, and wheelchair users. Examining 24 studies, we found associations between IHE factors and FOF, suggesting the importance of home modifications to live in a supportive environment to reduce FOF. Most studies were experimental and intervened for either single or multiple IHE factors, indicating reasonably strong evidence. Our findings highlight the importance of considering psychological factors when evaluating home environments to reduce FOF. The list of barriers and facilitators we provide can help healthcare professionals conduct evidence-based home assessments.

Comparisons and associations of psychological factors and the number of painful sites in wheelchair basketball athletes with and without shoulder pain: A cross-sectional case-control study

Objective To compare psychological factors and the number of painful sites between wheelchair basketball athletes (WBA) with and without shoulder pain and examine their associations with shoulder pain. Design A cross-sectional, case-control study. Methods Forty-three WBA participated. Shoulder pain was assessed with the Wheelchair User's Shoulder Pain Index (WUSPI), pain catastrophizing with the Pain Catastrophizing Scale (PCS), kinesiophobia by the Tampa Kinesiophobia Scale (TKS), self-efficacy with the General Self-Efficacy Scale (GSES), and the number of painful sites using the Nordic Musculoskeletal Questionnaire. Disability and sport-related data were collected. Spearman’s correlation coefficients were calculated. Mann-Whitney U and independent samples t-tests were used for between-group comparisons. Results Athletes with shoulder pain (n = 21) had an increased number of painful sites (P < .050) and higher PCS (P = .003). The WUSPI exhibited moderate associations with the number of painful sites during the last year (rho = .581) and past seven days (rho = .602), and PCS (rho = .470), and a weak association with the TKS (rho = .333)(P < .050). The number of painful sites with disability exhibited moderate associations with PCS (rho = .427) and GSES (rho = –.473)(P < .050). WBA classification levels showed moderate associations with the WUSPI (rho = –.400) and the number of painful sites during the last year (rho = –.437), and a weak association with the number of painful sites during past seven days (rho = –.315)(P < .050). The PCS showed weak associations with the number of painful sites during the last year (rho = .365) and the past seven days (rho = .398)(P < .050). Conclusions Results suggest considering WBA classes, pain catastrophizing, self-efficacy and multisite pain in the pain management of WBA.

Lighting Features Affecting the Well-Being of Able-Bodied People and People with Physical Disabilities in the Park in the Evening: An Integrated and Sustainable Approach to Lighting Urban Green Areas

This study focuses on the analysis of lighting in night conditions to explain what lighting in parks should look like and how parks should be lit from the point of view of people’s perceptions. It addresses the impact of the lighting configuration of urban parks on preference, safety, mystery, legibility, and contact with the environment. The feelings of wheelchair users and able-bodied people were measured. The respondents assessed park landscapes presented in visualisations that varied in terms of lighting features and spatial contexts. This research showed, inter alios, that the participants rated evenly lit spaces more highly than those featuring spot lighting. In unevenly lit spaces, the lighting of the surroundings turned out to be crucial import for able-bodied people, while for the disabled respondents, a combination of lighting of the surroundings and of paths was significant. For evenly lit spaces, path lighting is less important for disabled people than for those without disabilities. These insights can help researchers to look at lighting solutions in a more human-centered way and take into account the environment in which they are used. This allows the design of night lighting in parks to be socially sustainable and promotes access to urban green spaces for all citizens. The study emphasises that the provision of sustainable lighting in parks should take into account different social groups, making light a common good.

The effect of building bottlenecks on crowd dynamics involving individuals with simulated disabilities

With the development of urbanization and the growth of population, there is a growing demand for safety in public building facilities. As one of the essential building components of urban architecture, bottlenecks have a significant impact on the evacuation efficiency of crowds. Furthermore, the heterogeneity of crowds also contributes to the complexity of crowd movement through bottlenecks, while aggravating the magnitude of congestion induced by bottlenecks. The objective of this paper is to explore the movement characteristics of heterogeneous crowds passing through a corridor with a bottleneck by conducting a controlled experiment. There were three variables in this experiment, namely the individual categories (i.e., able-bodied individuals, simulated individuals on crutches and simulated wheelchair users), bottleneck width (i.e., 1.2, 1.6 and 2.0 m) and proportion of simulated disabilities in crowds (i.e., 0 %, 5 % and 10 %). Then offset angle, passing efficiency, fundamental diagram, etc., were analyzed. In trials involving simulated individuals on crutches, a higher detouring degree is observed compared to trials involving simulated wheelchair users or mixed groups of two types of simulated disabilities. There is an increase in flow rate induced by increasing the bottleneck width and decreasing the proportion of simulated disabilities. The passing efficiency at the upstream of the bottleneck in all tests is primarily influenced by the bottleneck width, while by the type and proportion of simulated disabilities at the downstream or inside the bottleneck. The findings are intended to complement the dynamic theory of heterogeneous crowds at building bottlenecks, while providing a reference for congestion control of crowds at bottlenecks.

Determinants of low satisfaction with life among wheelchair users with spinal cord injury in Egypt: a cross-sectional study

BackgroundSpinal cord injury (SCI) is one of the most catastrophic injuries that might lead to permanent use of a wheelchair and severely affects the quality of life, hence SCI patients report lower satisfaction with life (SWL) than the general population. Therefore, it is important to identify factors that determine SWL among wheelchair users with SCI. Our study aimed to assess the prevalence of low SWL and to identify its determinants among wheelchair users with SCI in Egypt.MethodsA cross-sectional study included 105 wheelchair users with SCI from the Al Hassan Foundation for wheelchair users in Egypt. The main outcome measure was low SWL, while the independent variables included sociodemographic characteristics, injury-related characteristics, anxiety, depression, neuropathic pain, functional independence, and environmental barriers.ResultsThe prevalence of low SWL among study participants was 57.1%. We found significant associations between SWL and age, area of living, and age at injury. Additionally, SWL correlated negatively with anxiety, depression, neuropathic pain, and environmental barriers, and positively with functional independence. Finally, the binary multiple logistic regression revealed that living in Upper Egypt (p = 0.017, OR = 13.7), depression (p = 0.034, OR = 6.08), older age (p = 0.002, OR = 1.21), and work and school environmental barriers (p = 0.022, OR = 0.46) were the predictors of low SWL.ConclusionTo improve the SWL for wheelchair users with SCI we need to effectively manage neuropathic pain, depression, and anxiety, and promote functional independence. There is an urgent need to reinforce legislation to improve the living conditions for wheelchair users with SCI in Egypt, especially in Upper Egypt.

A specialized inclusive road dataset with elevation profiles for realistic pedestrian navigation using open geospatial data and deep learning

Built environment characteristics can greatly influence pedestrians' route choices with factors beyond distance, such as accessibility, convenience, safety, and aesthetics, playing crucial roles. Although current navigation apps, such as Google Maps and Waze, have successfully provided driving directions, their navigation services are insufficient and sometimes unrealistic for addressing pedestrians' needs, largely due to the lack of dedicated pedestrian networks and the associated navigation algorithms. To address the research gaps, this paper proposes a novel approach that integrates freely available geospatial data and computer vision technology to create a specialized inclusive network dataset for outdoor pedestrian navigation. Moreover, a pedestrian navigation algorithm is developed to generate more practical “shortest” and “alternative” paths by incorporating various sidewalk attributes. We applied the method to create a pedestrian navigation network in Las Vegas. SpaceNet's open imagery dataset was used to extract Las Vegas's road networks. A virtual audit process assessed the visual and operational properties of the sidewalk networks using Google street-level images, evaluating factors including sidewalk presence, widths, surface types and conditions, missing curb ramps, greenery, protection from weather conditions, and lighting. Google Earth's open elevation data were used to analyze road elevation profiles as meaningful 3D indicators of sidewalk accessibility for wheelchair users. Further, additional geometric properties of the network, including road curviness, proximity to road intersections, and directional changes, were detected and analyzed. A navigation experiment conducted with individuals having varying mobility abilities, including regular pedestrians, older adults, and wheelchair users demonstrated the effectiveness of the newly developed network and algorithm in meeting the diverse needs of pedestrians.

Redesain Kursi Roda Portable untuk Lansia dengan Pendekatan Participatory Ergonomic

This study aims to redesign portable wheelchairs for the elderly at RS Charitas KM 7 Palembang using a participatory ergonomic approach. At the age of 60 and above, the elderly are vulnerable to diseases affecting mobility, requiring ergonomic assistive devices such as wheelchairs. The research was conducted from May to June 2024 using primary data collection through questionnaires given to elderly wheelchair users at RS Charitas and secondary data from relevant literature. Validity and reliability tests of the questionnaire were conducted using SPSS version 25. The results showed that the functional characteristics of the wheelchair (standard shape, adjustable and foldable, additional activity functions, footrests, flat surfaces, metal handles, and easy to clean) significantly affect the comfort and ease of use of the wheelchair. The regression model used is quite good at explaining variations in the dependent variable, although there are other factors outside the model that also influence the comfort and ease of use of the wheelchair.

Manual wheelchair training approaches and intended training outcomes for adults who are new to wheelchair use: A scoping review.

Wheelchair training is pivotal for safety, independence, and occupational engagement in the community, yet adults coming into wheelchair use often receive insufficient or untailored training. This research aimed to understand the range and type of manual wheelchair training approaches that exist for adults commencing wheelchair use. A systematic scoping review involved searching eight electronic databases and grey literature up to September 2023. Papers relating to manual wheelchair training for adults and their caregivers were included for data extraction. Eighty-seven articles were included in this review. The International Classification of Functioning (ICF) was used to organise and analyse data related to intended training outcomes. Consumer consultation was not included in this review; however, the outcomes suggest that involving consumers in future wheelchair training research is critical to assure community participation outcomes. Data were extracted from 87 papers. Manual wheelchair training was delivered across diverse contexts encompassing varied support structures, trainer backgrounds, and technology and was commonly directed towards wheelchair users with spinal cord injury. Intended training outcomes most frequently mapped to the activity and participation component of the ICF (n= 39), followed by personal factors (n= 27), body structures and functions (n= 18), and environmental factors (n= 3), with limited focus on longer term occupational engagement outcomes. Most existing manual wheelchair training focussed on the acquisition of individual wheelchair skill and may not facilitate generalised and long-term occupational participation outcomes. Further exploration into the contexts that support occupational engagement, particularly for older adults with progressive conditions, is required to support service provision. We looked at what manual wheelchair training approaches exist for adults who need to use a manual wheelchair and what training helps people to do/achieve. We did a scoping review that looked at literature about manual wheelchair training programs for adult wheelchair users. We found 87 research papers and training programs that we included in our review. We recorded and analysed information from all the papers about the wheelchair training programs and outcomes for people who do these programs. We found that manual wheelchair training can be done in structured or ad hoc ways, can have different amounts of training, can be provided face-to-face or online, and can be given by different allied health professionals and other wheelchair users. Most training programs had short-term outcomes like learning manual wheelchair skills, being able to use the wheelchair properly, and feeling confident about using a wheelchair. Some had longer term outcomes about being able to use the manual wheelchair in everyday activities. Most people who did the training programs that we looked at in this review were manual wheelchair users with spinal cord injury. Because not many wheelchair programs have been tried with people who do not have a spinal cord injury, it is hard for occupational therapists to make recommendations about training for other people who use a manual wheelchair. Manual wheelchair training that is done in the community and made to meet the needs of individuals may help people with using their wheelchair for their everyday activities and participate in their community.

Real-Time Posture Identification System for Wheelchair Users Preventing the Generation of Pressure Ulcers

Real-Time Posture Identification System for Wheelchair Users Preventing the Generation of Pressure Ulcers

Redefining Hospital Accessibility: A Service Design Framework for Inclusive Healthcare

Abstract In the framework of becoming a carbon neutral city by 2030, Bologna faces challenges related to enhancing the quality and accessibility of its built environment to improve the quality of life and well-being of its residents. The IRCCS Azienda Ospedaliero-Universitaria Sant’Orsola Polyclinic is a key agent of change within this initiative. The hospital has initiated a comprehensive renovation project aligned with its commitment to the United Nations Sustainable Development Goals (SDGs), particularly SDG 3, which addresses Good Health and Well-being, and SDG 10, which addresses Reduce Inequalities. To address these goals, the hospital has engaged a research team from the University of Bologna to apply Service Design methodologies. The research aims to reshape accessibility and user experience systematically and sustainably, adhering to the principles of Design for All. The study maps diverse user groups, analyses circulation paths, and identifies physical and procedural barriers affecting vulnerable individuals, especially those with disabilities. The research introduces a novel approach by developing a comprehensive strategy rather than isolated solutions, focusing on interconnected accessibility services across pavilions. Dedicated hubs within each pavilion facilitate resource and support device exchange, improving users’ experiences. A pilot project, initially targeting wheelchair accessibility hubs, employs innovative technologies to enhance independent tool usage and monitor distribution and maintenance efficiently. The project is now entering a testing phase, during which the solution will be refined based on user feedback.

CONSTRUÇÃO DE UM INSTRUMENTO PARA ESTUDAR ACADEMIAS AO AR LIVRE: RESULTADOS DA APLICAÇÃO EM QUATRO CIDADES

Outdoor gyms are a democratic space to promote the health and social inclusion of their users. Thus, motor activities can be extended to people with disabilities. The question that guided this study is: do these gyms have equipment adapted for people with disabilities to perform motor activities? Therefore, the objective was to identify and classify the equipment present in outdoor gyms in four cities. It is framed as an exploratory and descriptive study, with qualitative and quantitative analysis. To begin the collection, outdoor gyms were visited in four cities, in three different states and all available equipment was photographed for later analysis. At the same time, an internet search was conducted to find the companies that sell this equipment and to identify which of them had the seal for use by people with disabilities. The results indicated the existence of 28 equipment intended for wheelchair users. The variables chosen for the collection were: 1) access to the gyms; 2) equipment present; 3) equipment intended for people with disabilities; 4) condition of the equipment; 5) written instructions for using the equipment. The data collection took place in 29 outdoor gyms and 198 pieces of equipment were analyzed, making it possible to adequately measure the variables assessed. The results of the applications indicated the need for maintenance of access points and equipment and, mainly, the installation of signs indicating how the population should use them. Received: 2024/09/03 Reformulated: 2024/09/25 Accepted: 2024/09/27

Attribute annotation and bias evaluation in visual datasets for autonomous driving

This paper addresses the often overlooked issue of fairness in the autonomous driving domain, particularly in vision-based perception and prediction systems, which play a pivotal role in the overall functioning of Autonomous Vehicles (AVs). We focus our analysis on biases present in some of the most commonly used visual datasets for training person and vehicle detection systems. We introduce an annotation methodology and a specialised annotation tool, both designed to annotate protected attributes of agents in visual datasets. We validate our methodology through an inter-rater agreement analysis and provide the distribution of attributes across all datasets. These include annotations for the attributes age, sex, skin tone, group, and means of transport for more than 90K people, as well as vehicle type, colour, and car type for over 50K vehicles. Generally, diversity is very low for most attributes, with some groups, such as children, wheelchair users, or personal mobility vehicle users, being extremely underrepresented in the analysed datasets. The study contributes significantly to efforts to consider fairness in the evaluation of perception and prediction systems for AVs. This paper follows reproducibility principles. The annotation tool, scripts and the annotated attributes can be accessed publicly at https://github.com/ec-jrc/humaint_annotator.

Storytelling with disability and broken narratives

This Current Issues piece is a primarily creative piece of writing that takes as its starting point the concept of broken narratives. In writing with her own disability, the author, a wheelchair user, offers a series of broken narratives through which she actively seeks to create her own narrative coherence. In so doing, she expresses some of her thoughts and feelings about disability that she struggles to articulate verbally and directly.

Validity of a wrist-worn consumer-grade wearable for estimating energy expenditure, sedentary behaviour, and physical activity in manual wheelchair users with spinal cord injury

Purpose To evaluate the validity of a consumer-grade wearable for estimating energy expenditure, sedentary behaviour, and physical activity in manual wheelchair users with spinal cord injury (SCI). Materials and methods Fifteen manual wheelchair users with SCI (C5-L1, four female) completed activities of daily living and wheelchair propulsion (2–8 km·h−1). Wrist-worn accelerometry data were collected using consumer-grade (z-Track) and research-grade (ActiGraph GT9X) devices. Energy expenditure was measured via indirect calorimetry. Linear regression was used to evaluate the prediction of criterion metabolic equivalent of task (MET) by each accelerometer’s vector magnitude (VM). Area under the receiver operating characteristic curve (ROC-AUC) evaluated the accuracy of VM for discriminating between physical activity intensities and for identifying accelerometer cut-points. Results Standardised β-coefficients for the association between z-Track and ActiGraph VM for criterion MET were 0.791 (p < 0.001) and 0.774 (p < 0.001), respectively. The z-Track had excellent accuracy for classifying time in sedentary behaviour (ROC-AUC = 0.95) and moderate-to-vigorous physical activity (ROC-AUC = 0.93); similar values to the ActiGraph (ROC-AUC = 0.96 and 0.88, respectively). Cut-points for the z-Track were ≤37 g·min−1 for sedentary behaviour and ≥222 g·min−1 for moderate-to-vigorous physical activity. Conclusions This study supports the validity of a consumer-grade wearable to measure sedentary time and physical activity in manual wheelchair users with SCI.

Implementation of smart wheelchair with obstacle avoidance

The primary goal of this work is to develop a dependable and efficient solution for maintaining optimal mobility in wheelchair systems. The aim is to enhance functionality and reduce the user’s physical effort required to move the wheelchair wheels. The proposed system integrates advanced sensing technology, intelligent control algorithms, and robust hardware components to manage the wheelchair, detect obstacles, and eliminate the need for external assistance. This wheelchair employs joystick control and halts when the system senses an obstacle. The system enhances user autonomy by providing ease of control and ensures safety by detecting and avoiding obstacles. Motor speeds are adjusted based on joystick input, and the motor direction (forward, backward, left, right) is determined accordingly. An ultrasonic sensor measures obstacle distance, and if an obstacle is detected (distance &lt;= 20cm), both motors stop, and a warning buzzer activates for 1 second. If no obstacle is detected, the warning buzzer turns off, and motor speeds are adjusted based on joystick input. The system effectively demonstrated obstacle avoidance by changing direction when a command was issued away from the obstacle. The outcomes of this study contribute valuable insights to the field of wheelchairs, specifically in the realm of obstacle avoidance.