Pediatric Wheelchair Transportation Safety: Transit Manual Wheelchair Design Guidelines and Injury Risk of 6-year-old Children in a Frontal Motor Vehicle Impact

Children with disabilities often cannot be seated in standard child seats or automobile seats because of physical deformities or poor trunk and head control. Therefore, when children with disabilities are transported to schools and developmental facilities, they often remain seated in their wheelchairs in vehicles such as school buses and family vans. Children who must travel seated in their wheelchairs are excluded from the protections dictated by the federal and state laws related to child protection in motor vehicle crashes. This dissertation investigated the safety of children in wheelchairs in transit, mainly using computer simulation software. Three pediatric manual wheelchairs were tested with a Hybrid III 6-year-old ATD in accordance with the ANSI/RESNA WC-19 standard. Using sled test data, a computer model representing a Zippie wheelchair seated with a Hybrid III 6-year-old ATD subjected to a 20g/48kph frontal crash was developed and validated in MADYMO. The injury risks of 6-year-old wheelchair occupants in a frontal impact motor vehicle crash was investigated by analyzing sled test data and by using the pediatric wheelchair computer model. The loads imposed on the wheelchair and occupant restraint system under 20g/48kph frontal impact conditions with varying wheelchair setup conditions was also investigated using the computer model. The study results showed that a 6-year-old wheelchair seated occupant may be subjected to a risk of neck and chest injuries in a frontal impact motor vehicle crash. Results also showed that altering wheelchair settings does have impact on kinematics and injury risk of a 6-year-old wheelchair occupant in a frontal motor vehicle crash. Changing wheelchair settings also had impact on wheelchair kinematics and loads imposed on the wheelchair and occupant restraint system. The study results presented in this dissertation will provide guidelines for manufacturers designing pediatric transit wheelchairs, seating, and occupant restraint system. The pediatric wheelchair model developed in this study will provide a foundation for studying the response of a manual pediatric wheelchair and a child occupant in crashes. Moreover, the model will promote the study of associated injury risks for pediatric wheelchair users in motor vehicle crashes

Wheelchair-based game design for older adults

Few leisure activities are accessible to institutionalized older adults using wheelchairs; in consequence, they experience lower levels of perceived health than able-bodied peers. Video games have been shown to be an engaging leisure activity for older adults. In our work, we address the design of wheelchair-accessible motion-based games. We present KINECTWheels, a toolkit designed to integrate wheelchair movements into motion-based games, and Cupcake Heaven, a wheelchair-based video game designed for older adults using wheelchairs. Results of two studies show that KINECTWheels can be applied to make motion-based games wheelchair-accessible, and that wheelchair-based games engage older adults. Through the application of the wheelchair as an enabling technology in play, our work has the potential of encouraging older adults to develop a positive relationship with their wheelchair. Copyright 2013 ACM

Upper Extremity Biomechanics of Children with Spinal Cord Injury during Wheelchair Mobility

While much work is being done evaluating the upper extremity joint dynamics of adult manual wheelchair propulsion, limited work has examined the pediatric population of manual wheelchair users. Our group used a custom pediatric biomechanical model to characterize the upper extremity joint dynamics of 12 children and adolescents with spinal cord injury (SCI) during wheelchair propulsion. Results show that loading appears to agree with that of adult manual wheelchair users, with the highest loading primarily seen at the glenohumeral joint. This is concerning due to the increased time of wheelchair use in the pediatric population and the impact of this loading during developmental years. This research may assist clinicians with improved mobility assessment methods, wheelchair prescription, training, and long-term care of children with orthopaedic disabilities

Designing wheelchair-based movement games

People using wheelchairs have access to fewer sports and other physically stimulating leisure activities than nondisabled persons, and often lead sedentary lifestyles that negatively influence their health. While motion- based video games have demonstrated great potential of encouraging physical activity among nondisabled players, the accessibility of motion-based games is limited for persons with mobility disabilities, thus also limiting access to the potential health benefits of playing these games. In our work, we address this issue through the design of wheelchair-accessible motion-based game controls. We present KINECTWheels, a toolkit designed to integrate wheelchair movements into motion-based games. Building on the toolkit, we developed Cupcake Heaven, a wheelchair-based video game designed for older adults using wheelchairs, and we created Wheelchair Revolution, a motion-based dance game that is accessible to both persons using wheelchairs and nondisabled players. Evaluation results show that KINECTWheels can be applied to make motion-based games wheelchair-accessible, and that wheelchair-based games engage broad audiences in physically stimulating play. Through the application of the wheelchair as an enabling technology in games, our work has the potential of encouraging players of all ages to develop a positive relationship with their wheelchair

A Portable, Low-Cost Wheelchair Ergometer Design Based on a Mathematical Model of Pediatric Wheelchair Dynamics

Evaluation and training of wheelchair propulsion improves efficiency and prevents orthopaedic injury in pediatric manual wheelchair users. Ergometers allow static propulsion and emulate typical conditions. Currently available ergometers have deficiencies that limit their use in motion analysis. A new ergometer is developed and evaluated based on a model of wheelchair inertial dynamics that eliminates these deficiencies. This makes integrated motion analysis of wheelchair propulsion in current community, home, and international outreach efforts possible

Biomechanical Model for Evaluation of Pediatric Upper Extremity Joint Dynamics During Wheelchair Mobility

Pediatric manual wheelchair users (MWU) require high joint demands on their upper extremity (UE) during wheelchair mobility, leading them to be at risk of developing pain and pathology. Studies have examined UE biomechanics during wheelchair mobility in the adult population; however, current methods for evaluating UE joint dynamics of pediatric MWU are limited. An inverse dynamics model is proposed to characterize three-dimensional UE joint kinematics and kinetics during pediatric wheelchair mobility using a SmartWheel instrumented handrim system. The bilateral model comprises thorax, clavicle, scapula, upper arm, forearm, and hand segments and includes the sternoclavicular, acromioclavicular, glenohumeral, elbow and wrist joints. A single 17 year-old male with a C7 spinal cord injury (SCI) was evaluated while propelling his wheelchair across a 15-meter walkway. The subject exhibited wrist extension angles up to 60°, large elbow ranges of motion and peak glenohumeral joint forces up to 10% body weight. Statistically significant asymmetry of the wrist, elbow, glenohumeral and acromioclavicular joints was detected by the model. As demonstrated, the custom bilateral UE pediatric model may provide considerable quantitative insight into UE joint dynamics to improve wheelchair prescription, training, rehabilitation and long-term care of children with orthopedic disabilities. Further research is warranted to evaluate pediatric wheelchair mobility in a larger population of children with SCI to investigate correlations to pain, function and transitional changes to adulthood

Powered Wheelchair Platform for Assistive Technology Development

Literature shows that numerous wheelchair platforms, of various complexities, have been developed and evaluated for Assistive Technology purposes. However there has been little consideration to providing researchers with an embedded system which is fully compatible, and communicates seamlessly with current manufacturer's wheelchair systems. We present our powered wheelchair platform which allows researchers to mount various inertial and environment sensors, and run guidance and navigation algorithms which can modify the human desired joystick trajectory, so as to assist users with negotiating obstacles, and moving from room to room. We are also able to directly access other currently manufactured human input devices and integrate new and novel input devices into the powered wheelchair platform for clinical and research assessment

Evaluation of Pediatric Manual Wheelchair Mobility Using Advanced Biomechanical Methods

There is minimal research of upper extremity joint dynamics during pediatric wheelchair mobility despite the large number of children using manual wheelchairs. Special concern arises with the pediatric population, particularly in regard to the longer duration of wheelchair use, joint integrity, participation and community integration, and transitional care into adulthood. This study seeks to provide evaluation methods for characterizing the biomechanics of wheelchair use by children with spinal cord injury (SCI). Twelve subjects with SCI underwent motion analysis while they propelled their wheelchair at a self-selected speed and propulsion pattern. Upper extremity joint kinematics, forces, and moments were computed using inverse dynamics methods with our custom model. The glenohumeral joint displayed the largest average range of motion (ROM) at 47.1° in the sagittal plane and the largest average superiorly and anteriorly directed joint forces of 6.1% BW and 6.5% BW, respectively. The largest joint moments were 1.4% body weight times height (BW × H) of elbow flexion and 1.2% BW × H of glenohumeral joint extension. Pediatric manual wheelchair users demonstrating these high joint demands may be at risk for pain and upper limb injuries. These evaluation methods may be a useful tool for clinicians and therapists for pediatric wheelchair prescription and training

A Low-Cost Tele-Presence Wheelchair System

This paper presents the architecture and implementation of a tele-presence wheelchair system based on tele-presence robot, intelligent wheelchair, and touch screen technologies. The tele-presence wheelchair system consists of a commercial electric wheelchair, an add-on tele-presence interaction module, and a touchable live video image based user interface (called TIUI). The tele-presence interaction module is used to provide video-chatting for an elderly or disabled person with the family members or caregivers, and also captures the live video of an environment for tele-operation and semi-autonomous navigation. The user interface developed in our lab allows an operator to access the system anywhere and directly touch the live video image of the wheelchair to push it as if he/she did it in the presence. This paper also discusses the evaluation of the user experience

USING THE ABSORBED POWER METHOD TO EVALUATE EFFECTIVENES OF SELECTED SEAT CUSHIONS DURING MANUAL WHEELCHAIR PROPULSION

Although wheelchair users are constantly subjected to oscillatory and shock vibrations not much research has been conducted to assess the whole-body vibrations experienced by wheelchair users. Studies that have been published have only involved the testing of manual wheelchairs not interventions such as suspension or seating systems.The purpose of this study was to determine if selected wheelchair cushions reduce the amount of harmful whole-body vibrations transferred to wheelchair users and, if the absorbed power method a good measure of evaluating the whole-body vibrations.Thirty-two participants, who use a wheelchair as their primary mode of mobility, partook in this study. Four of the most commonly prescribed wheelchair cushions were selected. Participants were asked to propel their wheelchair over a simulated activities of daily living (ADL) obstacle course while acceleration and force data was collected.A repeated measures ANOVA showed no significant differences between the different cushions for the total averaged absorbed power (p = .190), the 50 mm curb drop (p = .234), or the rumble strip (p = .143). A repeated measures ANOVA for the peak curb drop absorbed power revealed a significant difference in the cushions (p = .043).The cushions that appeared to perform the best in this testing appear to be the Invacare Pindot and the Varilite Solo. Not only did those cushions appear to have the lowest values much of the time but did not display the highest values. Absorbed power appears to be just as effective at determining the effects of vibrations in the time domain as the prescribed methods of the ISO 2631 standard