How power tilt is used in daily life to manage sitting pressure: Perspectives of adults who use power tilt and therapists who prescribe this technology

Recent research studies have identified that use of large amplitudes of power tilt as a pressure management strategy used by adults who use wheelchairs and are at risk of developing pressure ulcers, was low. While the reason for low use was not identified, a lack of fit between using large amplitudes of tilt and daily life function was speculated as a main reason across studies. Using a post-positivist grounded theory approach, this study explored how power tilt was used in daily life particularly for managing sitting pressures, from the perspectives of five people experienced with using power tilt and six therapists who prescribe power tilt. Data were collected from two in-depth semi-structured interviews and a journal that tracked the context of tilt occurrences throughout each of three days. Theoretical saturation was reached at five and six participants respectively. Data were analyzed in separate groups and then combined using a constant comparative approach. The analysis resulted in the generation of a substantive theory from which the process of using power tilt in the context of daily life can be understood. The abstract, cognitive nature of the process specific to using power tilt for pressure management differed from the tacit and tangible nature of the process for all other daily life uses of power tilt. Contextual elements were identified which affected the use of large amplitudes of tilt such as fear of tipping over, social image and lack of functionality. The critical influence of knowledge related to using tilt for pressure management is highlighted including potential implications for clinical practice. The theory scheme offers a preliminary avenue for examining the transactive relationships of person, environment, technology and occupation that comprise daily life, influencing how power tilt is used. The substantive theory and its associated concepts contribute to the wheelchair technology field, addressing the identified knowledge gap specific to advancing the understanding of how power tilts, and potentially other wheelchair technologies, are integrated in daily life occupations. The substantive theory is preliminary, requiring further research however; potential is demonstrated to also inform the understanding of the person-environment-occupation relationship in the discipline of occupational science

Study and reformulation of the technical aid device HomeHoist

Dissertação de mestrado integrado em Engenharia BiomédicaCerebral palsy manifests itself in the first years of a child's life and may be caused by brain injuries, or abnormal brain development, reflecting in disorders in the child's motor capacity, each case varying in terms of severity and type of motor disorders. The average life expectancy of these children has been increasing, which means that it is relevant to find alternatives to improve the quality of life of those affected by this condition. Thus, the HomeHoist project emerged, which aimed to function as a single device for transferring patients with cerebral palsy without burdening the caregiver. The HomeHoist device consisted of an electric wheelchair, with a built-in hoist, removable seat, and free interior space, which allowed the patient to be transferred between various surfaces, such as beds and toilets. Following an internship at the company Orthos XXI, the interest arose to revive this project, which had been concluded in 2014. The aspects identified for improving the device were to incorporate verticalization; include leg raising, which despite being a goal in the original project, was not achieved; split the seat and backrest to customize the operation of the device; free up the lateral space on the seat to facilitate patient handling; and change the structure and components to meet the company's production, reducing production time and cost. Using project methodologies such as the goal tree, analysis of functions, and the method of weighted goals, it was possible, among several solutions, to understand which ones best fit the intended goals, followed by the determination of dimensional constraints and the selection and placement of mechanical components, to obtain a 3D model of the final device. With the model it was possible to obtain 65º verticalization; 155º reclination; the dimensions of the device were as intended; and the foot elevation was incorporated, although it did not allow to completely stretch the legs. Then, a brief analysis of the electrical components to be incorporated was made, followed by the simulation of two components, and with the simulation of one of them, the arch, it was realised that it would have to be redesigned to withstand the load that was applied to it, by increasing the diameter of the tube and the positioning of the rings. Finally, with the production of the prototype, it was possible to understand what should be improved to facilitate the production of the device, both in terms of production and assembly. The functioning of the device was also tested, to confirm the information obtained with the 3D model.A paralisia cerebral manifesta-se nos primeiros anos de vida de uma criança e pode ser provocada por lesões cerebrais, ou desenvolvimento cerebral anormal, refletindo-se em distúrbios na capacidade motora da mesma, cada caso variando em termos de severidade e de tipo de disfunções motoras. A esperança média de vida destas crianças tem vindo a aumentar, o que significa que é relevante encontrar alternativas para melhorar a qualidade de vida daqueles afetados por esta condição. Assim, surgiu o projeto HomeHoist, que tinha como objetivo funcionar como dispositivo único para a transferência de pacientes com paralisia cerebral, sem sobrecarregar o prestador de cuidados. O dispositivo HomeHoist consistia numa cadeira de rodas elétrica, com uma grua incorporada, assento removível e o espaço interior livre, o que permitia transferir o paciente entre várias superfícies, como a cama e vasos sanitários. No seguimento de um estágio na empresa Orthos XXI, surgiu o interesse em reavivar este projeto, que tinha sido concluído em 2014. Os aspetos identificados para a melhoria do dispositivo foram incorporar a função de verticalização; adicionar a elevação de pernas, que apesar de ser um objetivo no projeto original, não foi alcançado; dividir o assento e o encosto de costas, para personalizar o funcionamento do dispositivo; libertar o espaço lateral no assento, para facilitar o manuseamento do paciente; e alterar a estrutura e componentes para irem de encontro à produção da empresa, reduzindo o tempo e custo de produção. Usando metodologias de projeto, como a árvore de objetivos, análise de funções e o método dos objetivos ponderados, foi possível de entre várias soluções, compreender quais as que melhor se enquadravam nos objetivos pretendidos, seguindo-se então a determinação das restrições dimensionais e de seleção e colocação de componentes mecânicos, para obter um modelo 3D do dispositivo final. Com o modelo foi possível obter verticalização de 65º; reclinação de 155º; as dimensões do dispositivo foram ao encontro do pretendido; e a elevação de pés foi incorporada, apesar de não permitir esticar completamente as pernas. De seguida, foi feita uma breve análise dos componentes elétricos a ser incorporados, seguida da simulação FEM de dois componentes, sendo que, com a simulação de um deles, o arco, percebeu-se que o mesmo teria de ser alterado de modo a aguentar a carga que lhe era aplicada, aumentando-se o diâmetro do tubo e o posicionamento das argolas. Por fim, com a produção do protótipo foi possível perceber o que deveria ser melhorado para facilitar a produção do dispositivo, tanto em termos de produção como de montagem. Foi também testado o funcionamento do dispositivo, para confirmar a informação obtida com o modelo 3D

DEVELOPMENT AND EVALUATION OF AN ADVANCED REAL-TIME ELECTRICAL POWERED WHEELCHAIR CONTROLLER

Advances in Electric Powered Wheelchairs (EPW) have improved mobility for people with disabilities as well as older adults, and have enhanced their integration into society. Some of the issues still present in EPW lie in the difficulties when encountering different types of terrain, and access to higher or low surfaces. To this end, an advanced real-time electrical powered wheelchair controller was developed. The controller was comprised of a hardware platform with sensors measuring the speed of the driving, caster wheels and the acceleration, with a single board computer for implementing the control algorithms in real-time, a multi-layer software architecture, and modular design. A model based real-time speed and traction controller was developed and validated by simulation. The controller was then evaluated via driving over four different surfaces at three specified speeds. Experimental results showed that model based control performed best on all surfaces across the speeds compared to PID (proportional-integral-derivative) and Open Loop control. A real-time slip detection and traction control algorithm was further developed and evaluated by driving the EPW over five different surfaces at three speeds. Results showed that the performance of anti-slip control was consistent on the varying surfaces at different speeds. The controller was also tested on a front wheel drive EPW to evaluate a forwarding tipping detection and prevention algorithm. Experimental results showed that the tipping could be accurately detected as it was happening and the performance of the tipping prevention strategy was consistent on the slope across different speeds. A terrain-dependent EPW user assistance system was developed based on the controller. Driving rules for wet tile, gravel, slopes and grass were developed and validated by 10 people without physical disabilities. The controller was also adapted to the Personal Mobility and Manipulation Appliance (PerMMA) Generation II, which is an advanced power wheelchair with a flexible mobile base, allowing it to adjust the positions of each of the four casters and two driving wheels. Simulations of the PerMMA Gen II system showed that the mobile base controller was able to climb up to 8” curb and maintain passenger’s posture in a comfort position

Voice-activated wheelchair: An affordable solution for individuals with physical disabilities

The Low-Cost Voice Controlled Wheelchair with Raspberry Pi is an innovative assistive technology designed to improve the mobility and independence of people with disabilities. This research aims to develop a wheelchair system that can be operated using voice commands at an affordable price, making it accessible to a wider range of individuals with limited mobility. The device is built on the Raspberry Pi, a reasonably priced, credit-card-sized computer, and uses an easy-to-use yet efficient voice recognition technique to let users control the wheelchair with their vocal commands. A Raspberry Pi, a microphone, and motor controllers are some of the system's hardware components. The software uses Python programming language and open-source voice recognition technology to recognize voice commands, making it easy for users to navigate their environment independently. The system has been tested on a prototype and has shown promising results in terms of accuracy and reliability. The Low-Cost Voice Controlled Wheelchair with Raspberry Pi can give disabled persons new levels of mobility and independence, enhancing their quality of life and enhancing their capacity to carry out daily tasks

2015 Oklahoma Research Day Full Program

This document contains all abstracts from the 2015 Oklahoma Research Day held at Northeastern State University

Autonomous wheelchair with a smart driving mode and a Wi-Fi positioning system

Wheelchairs are an important aid that enhances the mobility of people with several types of disabilities. Therefore, there has been considerable research and development on wheelchairs to meet the needs of the disabled. Since the early manual wheelchairs to their more recent electric powered counterparts, advancements have focused on improving autonomy in mobility. Other developments, such as Internet advancements, have developed the concept of the Internet of Things (IoT). This is a promising area that has been studied to enhance the independent operation of the electrical wheelchairs by enabling autonomous navigation and obstacle avoidance. This dissertation describes shortly the design of an autonomous wheelchair of the IPL/IT (Instituto Politécnico de Leiria/Instituto de Telecomunicações) with smart driving features for persons with visual impairments. The objective is to improve the prototype of an intelligent wheelchair. The first prototype of the wheelchair was built to control it by voice, ocular movements, and GPS (Global Positioning System). Furthermore, the IPL/IT wheelchair acquired a remote control feature which could prove useful for persons with low levels of visual impairment. This tele-assistance mode will be helpful to the family of the wheelchair user or, simply, to a health care assistant. Indoor and outdoor positioning systems, with printed directional Wi-Fi antennas, have been deployed to enable a precise location of our wheelchair. The underlying framework for the wheelchair system is the IPL/IT low cost autonomous wheelchair prototype that is based on IoT technology for improved affordability

2013 Oklahoma Research Day Full Program

This document contains all abstracts from the 2013 Oklahoma Research Day held at the University of Central Oklahoma

A new perspective on the design of pressure relief cushions for those with spinal injuries

The aim of this study is to develop new insights which pressure relief (PR) cushion designers can use to guide the design of new cushions with greater efficacy at preventing pressure ulcers than contemporary cushions. A methodological framework was formulated which incorporated a number of research techniques from the user-centred methodology USERfit, and included methodological triangulation. Exploratory interviews and observational work were conducted in a specialist unit for spinal cord injury (SCI). This involved ten patients, four physiotherapists, two nurses and an outpatient technician. Additionally, two questionnaires were designed and circulated amongst SCI patients and staff with completed responses from 41 patients and 31 staff. From the analyses of the data gathered from the literature, observational work, interviews and questionnaire responses, 28 recommendations for cushion design were formulated. These recommendations covered the principles which underpin cushion design, cushion usability and the future direction of cushion design

The Design of Compliant Seating for Children with Severe Whole Body Extensor Spasms

Children with cerebral palsy and powerful whole body extensor spasms find sitting in a rigid seat uncomfortable and sometimes painful due to the large forces they apply to their constraints. They are usually unable to speak and communication is difficult. The spasms affect every aspect of their lives. This thesis describes the genesis of a new functional dynamic seat for children with severe whole body extensor spasms, and the novel method used to design it. This novel seat technology is known as 'Whole Body Dynamic Seating'. The thesis describes the clinical need this seat addresses, and the design and technology context in which this research takes place. The user evaluation, observation, measurement, analysis and reasoning that led to a successful seat design are described in detail. Children with cerebral palsy sometimes have whole body spasms that mean they cannot be seated in conventional static seating that positions a child in a fixed posture. For this research the children were classified as functioning at Chailey Sitting Ability Level 1 and Gross Motor Functional Classification System Level V. Such children spend much of their time being held by a person, or lying on a mat, bed or pad. This results in difficulty with social engagement and physical functioning, particularly in school. This research created a seat that such children could sit in, providing a comfortable and functional seat for use in a home or school classroom environment. This seat was designed with the direct and essential involvement of disabled children, their parents, therapists, teachers and carers. The work is part of a larger programme of research into seating and support technology that will enhance a child's ability to gain functional movement and communication skills that can be employed to enable the child's free self expression and social participation. The research investigated means of supporting children with whole body extensor spasms through a progressive iterative method utilizing direct user evaluation of a series of prototypes incrementing in complexity and fidelity towards a fully functional physical seat. An iterative method was used to design, build and evaluate three dynamic seats. This method incorporated two new approaches to prototyping developed for the research programme in response to difficulties encountered in designing dynamic systems for children with highly complex neuromotor disability. Soft and Semi-soft prototyping and evaluation methods provided essential feedback on dynamic seating concepts that guided proposed solutions, without requiring costly and time-consuming manufacture. Video was used to create a record of the children's movements and responses for subsequent analysis. Instrumentation was built into the seats to enable direct objective measurement of the reaction forces and seat movement caused by extensor spasms. This thesis presents several unique features created through this research programme: 1. Independent and virtually hinged anatomical dynamic thigh supports; 2. Independent anatomical dynamic foot supports; 3. A virtually hinged dynamic back support; 4. An anatomical dynamic head support concept. 4 III The final Whole Body Dynamic Seat was child-centred in its functionality and aesthetic design, and was favourably commented upon by parents, children and school staff. Use of the new dynamic seating by three children (including one from a previous work programme) showed that children with severe whole body extensor spasms can be seated comfortably. The children also demonstrated gains in physical and social function as a result of using the dynamic seats. The two fully independent dynamic seats made advances in comfort over static seating for children with whole body extensor spasms. One of the children especially liked the seat and resisted being put back into his usual seating. An adult with severe cerebral palsy and extensor spasms evaluated a dynamic foot support concept and reported very significant reductions in spasticity and pain, and gains in physical function. The Whole Body Dynamic Seats showed gains in postural symmetry and in hand and head function over the usual static seats when used by the children with spasms. These gains were reported by staff during long term evaluations and measured specifically during the final evaluation. Two children learned to control the movement of seats in which they were sat, and were able to control their posture and use that control to carry out functions such as switch pressing. Such learning through the use of dynamic seating by children with severe dystonic cerebral palsy and whole body extensor spasms has not previously been documented. The seats did not just affect the children - school staff were affected too. School staff working around the children in the dynamic seats were observed to be more inclusive towards the children, and to expect more interaction from them. The ability of the children to move altered staff expectations of their ability to participate and communicate. This new seating has improved the quality of life of the children that use it. Future implementation of this technology in commercially produced seating offers the possibility of similar gains to many more severely disabled children who are currently less comfortable and less functional than they need to be. 5EThOS - Electronic Theses Online ServiceGBUnited Kingdo