Does the setting matter? Observing wheelchair transfers across different environmental conditions

The setting in which wheelchair transfers are performed can affect difficulty and the risks associated with completion. This article presents results from an observational study involving 13 wheelchair users performing independent transfers across four settings. The aim is to understand how the environment affects how different types of independent transfers are performed. Descriptive analysis was performed alongside an objective assessment using the Transfer Assessment Instrument (TAI). The perceived difficulty reported after each transfer was also collected. Two participants exhibited radically different transferring techniques in different scenarios. Additionally, the transferring scenario was found to significantly affect the perceived difficulty of sitting transfers (toilet 2.17 ± .88; bed 1.47 ± .65, p = .001; car 1.63 ± .82, p = .012) and standing transfers (car 3.5 ± .71; bed 1 ± 0, p = .03; toilet 1 ± 0, p = .03), and the TAI score attributed to sitting pivot with use of a transfer board (couch 4.3 ± .88; bed 6.93 ± 1.29, p = .022; car 7.13 ± 1.32, p = .018) . Overall, environmental constraints, can lead to major technique changes and, more often, to different positioning of hands and feet which could impact the transfer’s biomechanics

Wheelchair in-seat monitoring design considerations

Wheelchair in-seat activity trackers are developed to monitor and provide feedback about the pressure redistributing movements of wheelchair users, including weight shifts and other postural shifts that redistribute buttocks pressures. From a design perspective, in-seat activity trackers reflect myriad design decisions that impact performance, function, and usability. Many, if not all, of these decisions involve interconnections across system components, and can have significant impact on tracker operation and user-experience. Technology developers will have to manage many benefits and trade-offs that accompany design of each subsystem. Two documents were created based upon real-world use of in-seat trackers to briefly identify design criteria and constraints that should be considered.U.S. Army Medical Research and Materiel Command Spinal Cord Injury Research Program, Translational Research Award W81XWH-17-1-022

Measuring Activity and Participation in Outcomes Research

Presented at the RESNA Annual Meeting. 2006. Atlanta, GA

Monitoring Power Upright and Tilt-In-Space Wheelchair Use

Presented at the RESNA Annual Meeting. 2006. Atlanta, GA.This study examines the use of power upright and power tilt-in-space (TIS) wheelchairs. An occupancy detector, wheel revolution counter, and position sensor comprise the Wheelchair Activity Monitoring Instrument as used in this study. On average, subjects sat in their wheelchairs for 10 hours per day, spent 50 (±24) minutes wheeling with an average daily distance traveled of 0.84 miles. The majority of mobility bouts were less than 30 seconds and shorter than 25 feet. Subjects with TIS used their tilt feature (at least a 15° change in position) 16±10 times and spent between 0 and 108 minutes at a fully tilted (>40°) position daily.occupancy detector, wheel revolution counter, and position sensor comprise the Wheelchair Activity Monitoring Instrument as used in this study. On average, subjects sat in their wheelchairs for 10 hours per day, spent 50 (±24) minutes wheeling with an average daily distance traveled of 0.84 miles. The majority of mobility bouts were less than 30 seconds and shorter than 25 feet. Subjects with TIS used their tilt feature (at least a 15° change in position) 16±10 times and spent between 0 and 108 minutes at a fully tilted (>40°) position daily

A Case Study Comparing Activity and Participation Measurement in Two Subjects

Presented at the RESNA Annual Meeting. 2007. Phoenix, AZ.This case study compares the differences between complementary methodologies that measure activity and participation in two subjects who use wheeled mobility devices. Data collection consisted of 1) a self-report participation measure for people with mobility disabilities - the Community Participation and Perceived Receptivity Survey (CPPRS) - and 2) a passive instrumentation data-gathering methodology that includes a global positioning system (GPS) data logger, followed by a prompted recall interview (PRI) to confirm GPS data location and query activity purpose. Many of the destination types (e.g., grocery stores) named in the CPPRS were confirmed by GPS/PRI data. Issues affecting subject responses in both methods included ambiguous categories and researcher assumptions about the nature of activity. Differences between self-report and instrumentation data are discussed as they impact understanding activity and community participation among wheeled mobility users and the development of self-report participation instruments

Use of a Low Cost, Chest-Mounted Accelerometer to Evaluate Transfer Skills of Wheelchair Users During Everyday Activities

BACKGROUND: Transfers are an important skill for many wheelchair users. However, they have also been related to the risk of falling or developing upper limb injuries. Transfer abilities are usually evaluated in clinical settings or biomechanics laboratories and these methods of assessment are poorly suited to evaluation in real and unconstrained world settings where transfers take place. OBJECTIVE: The objective of this paper is to develop a strategy to enable transfer quality evaluation and improve the predictive accuracy of transfer detection using a single wearable low cost accelerometer. METHODS: We collected data from nine wheelchair users wearing tri-axial accelerometer on their chest while performing transfers to and from car seats and home furniture. We then extracted significant features from accelerometer data based on biomechanical considerations and previous relevant literature and used machine learning algorithms to evaluate the performance of wheelchair transfers and detect their occurrence from a continuous time series of data. RESULTS: Results show that the best predictive accuracy for Automatic Transfer Quality Evaluation was obtained with Support Vector Machine (SVM) classifiers when determining use of head-hip relationship (75.93%) and smoothness of landing (79.62%), when the start and end of the transfer are known. Automatic Transfer Detection reaches an accuracy of 87.8% using Multinomial Logistic Regression (MLR) classifiers, which is in line with the state of the art in this context. However, we achieve these results using only a single sensor and collecting data in a more ecological manner. CONCLUSIONS: The use of a single chest-placed accelerometer shows a predictive accuracy of over 75% for algorithms applied independently to both transfer evaluation and monitoring. This points to the opportunity for designing ubiquitous technology for personalized skill development interventions targeting wheelchair users. However, monitoring transfers still requires the use of external inputs or extra sensors to identify start and end of the transfer, which are needed to perform an accurate evaluation

Recipients of electric-powered indoor/outdoor wheelchairs provided by a National Health Service: A cross-sectional study

This is the post-print version of the final paper published in Archives of Physical Medicine and Rehabilitation. The published article is available from the link below. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. Copyright @ 2013 by the American Congress of Rehabilitation Medicine.OBJECTIVE: To describe the characteristics, across all ages, of powered wheelchair users and the assistive technology prescribed by a regional specialist wheelchair service DESIGN: Cross-sectional study SETTING: Regional wheelchair service provided to those fulfilling strict eligibility criteria by a National Health Service serving a population of 3 million. PARTICIPANTS: 544 Electric Powered Indoor/outdoor wheelchair (EPIOC) users. INTERVENTIONS: Not applicable MAIN OUTCOME MEASURES: Demographic, clinical/diagnostic details of EPIOC recipients including pain, (kypho)scoliosis and ventilators. Technical features including specialised (adaptive) seating (SS), tilt in space (TIS), and modified control systems. Factors were related to age groups: 1 (0-15), 2 (16-24), 3 (25-54), 4 (55-74) and 5 (75+). RESULTS: 262 men mean age 41.7 (range 8-82, sd 20.7) and 282 women mean age 47.2 (range 7-92, sd 19.7) years were studied. Neurological/neuromuscular conditions predominated (81%) with cerebral palsy (CP) (18.9%) and multiple sclerosis (16.4%). Conditions presenting at birth or during childhood constituted 39%. 99 had problematic pain, 83 a (kypho)scoliosis and 11 used ventilators. SS was provided to 169 users (31%), the majority had CP or muscular dystrophy. TIS was used by 258 (53%). Younger people were more likely to receive TIS than older ones. Only 92 had SS and TIS, mean age 29 (range 8-72, sd 17.8) years. 52 used modified control systems. CONCLUSIONS: The diversity of EPIOC users across age and diagnostic groups is shown. Their complex interrelationships with these technical features of EPIOC prescription are explored. Younger users were more complex due to age-related changes. This study provides outcomes of the EPIOC prescription for this heterogeneous group of very severely disabled people