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BCIT Citations Collection

Characterizing the community use of an ultralight wheelchair with "on the fly" adjustable seating functions
An ultralight manual wheelchair that allows users to independently adjust rear seat height and backrest angle during normal everyday usage was recently commercialized. Prior research has been performed on wheelchair tilt, recline, and seat elevation use in the community, however no such research has been done on this new class of manual ultralight wheelchair with "on the fly" adjustments. The objective of this pilot study was to investigate and characterize the use of the two adjustable seating functions available on the Elevation™ ultralight dynamic wheelchair during its use in the community. Eight participants had data loggers installed onto their own wheelchair for seven days to measure rear seat height, backrest angle position, occupied sitting time, and distance traveled. Analysis of rear seat height and backrest adjustment data revealed considerable variability in the frequency of use and positions used by participants. There was a wide spread of mean daily rear seat heights among participants, from 34.1 cm to 46.7 cm. Two sub-groups of users were further identified: those who sat habitually at a single typical rear seat height, and those who varied their rear seat height more continuously. Findings also showed that participants used the rear seat height adjustment feature significantly more often than the backrest adjustment feature. This obvious contrast in feature use may indicate that new users of this class of wheelchair may benefit from specific training. While the small sample size and exploratory nature of this study limit the generalizability of our results, our findings offer a first look at how active wheelchairs users are using a new class of ultralight wheelchair with "on the fly" seating adjustments in their communities. Further studies are recommended to better understand the impact of dynamic seating and positioning on activity, participation and quality of life., Peer-reviewed article, Published. Received: April 28, 2016; Accepted: February 26, 2017; Published: March 9, 2017.
Concept proposal for a detachable exoskeleton-wheelchair to improve mobility and health
Proceedings of 2013 IEEE International Conference on Rehabilitation Robotics, June 24-26, 2013 Seattle, Washington USA. Wheelchair use has consequences to quality of life in at least two areas: 1) health issues such as pressure sores and chronic overuse injury; and 2) access problems due to the inaccessible nature of the built and natural environments that are most amenable to upright postures. Even with these concerns, wheelchairs are still the best form of mobility for many people (e.g. they are relatively easy to transfer into and propel). However, wheelchairs are simply not transformative, i.e. they do not allow a person with a disability to attain a level of mobility performance that approaches that of their non-disabled peers, nor do they typically allow for face to face interactions and full participation in the community. Wheelchairs also do not typically support ongoing therapeutic benefits for the user. To address the inadequacy of existing wheelchairs, we are merging two evolving technologies into a coherent new mobility device. The first is dynamic wheeled mobility, which adds significant functionality to conventional wheelchairs through the use of on-the-fly adjustable positioning. The second is powered walking exoskeletons, which enable highly desired standing and walking functions, as well as therapeutic benefits associated with rehabilitation gait training. Unfortunately, exoskeletons have significant usability concerns such as slow speed, limited range, potential to cause skin issues, and difficult transfers. A new concept of docking a detachable exoskeleton to a wheeled frame has been developed to address these issues. The design goal is a single mobility device that not only optimizes daily activities (i.e. wheelchair seating and propulsion with dynamic positioning), but also serves as an easy-to-use rehabilitation tool for therapeutic benefits (i.e. a detachable powered exoskeleton for walking sojourns). This has significant potential benefits for the lives of people with mobility impairments., Conference paper, Published.
Development and pilot testing of a kneeling ultralight wheelchair design
Proceedings of 2015 37th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC), Milan, Italy, Aug 25-29 2015. "Dynamic wheeled mobility" offers "on the fly" seating adjustments for wheelchair users such that various activities performed throughout the day can be matched by an appropriate seat position. While this has benefits for user participation and health, the added weight in existing dynamic wheelchairs may impact the user's ability to transport the frame, e.g. into cars. Other dynamic features to enable more participation avenues are also desirable. This paper outlines the development of a "kneeling" ultralight wheelchair design that offers dynamic wheeled mobility functionality at a weight that is comparable to many existing ultralight wheelchairs. In addition, the wheelchair's kneeling function allows a lowered seat position to facilitate low-to-the-ground tasks such as floor transfers and other activities where sustained low level reaching may be required (e.g. playing with children, changing a tire, etc.). This paper also describes the development and pilot testing of an end user evaluation protocol designed to validate the wheelchair's functionality and performance. Successful realization and commercialization of the technology would offer a novel product choice for people with mobility disabilities, and that may support daily activities, health, improved quality of life, and greater participation in the community., Conference paper, Published.
Dynamic wheelchair seating positions impact cardiovascular function after spinal cord injury
Innovative wheelchairs allow individuals to change position easily for comfort and social situations. While these wheelchairs are beneficial in multiple ways, the effects of position changes on blood pressure might exacerbate hypotension and cerebral hypoperfusion, particularly in those with spinal cord injury (SCI) who can have injury to autonomic nerves that regulate cardiovascular control. Conversely, cardiovascular benefits may be obtained with lowered seating. Here we investigate the effect of moderate changes in wheelchair position on orthostatic cardiovascular and cerebrovascular reflex control.Nineteen individuals with SCI and ten neurologically-intact controls were tested in supine and seated positions (neutral, lowered, and elevated) in the Elevation™ wheelchair. Participants with SCI were stratified into two groups by the severity of injury to cardiovascular autonomic pathways. Beat-to-beat blood pressure, heart rate and middle cerebral artery blood flow velocity (MCAv) were recorded non-invasively.Supine blood pressure and MCAv were reduced in individuals with lesions to autonomic pathways, and declined further with standard seating compared to those with preserved autonomic control. Movement to the elevated position triggered pronounced blood pressure and MCAv falls in those with autonomic lesions, with minimum values significantly reduced compared to the seated and lowered positions. The cumulative duration spent below supine blood pressure was greatest in this group. Lowered seating bolstered blood pressure in those with lesions to autonomic pathways.Integrity of the autonomic nervous system is an important variable that affects cardiovascular responses to orthostatic stress and should be considered when individuals with SCI or autonomic dysfunction are selecting wheelchairs.This work was supported in part by the Heart and Stroke Foundation of British Columbia and the Yukon (V.E.C)., Peer-reviewed article, Published. Received: December 14, 2016 ; Accepted: June 12, 2017 ; Published: June 30, 2017
Quantifying the effects of on-the-fly changes of seating configuration on the stability of a manual wheelchair
Proceedings of the 39th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC), in Seogwipo, South Korea, 11-15 July 2017. In general, manual wheelchairs are designed with a fixed frame, which is not optimal for every situation. Adjustable on the fly seating allow users to rapidly adapt their wheelchair configuration to suit different tasks. These changes move the center of gravity (CoG) of the system, altering the wheelchair stability and maneuverability. To assess these changes, a computer simulation of a manual wheelchair was created with adjustable seat, backrest, rear axle position and user position, and validated with experimental testing. The stability of the wheelchair was most affected by the position of the rear axle, but adjustments to the backrest and seat angles also result in stability improvements that could be used when wheeling in the community. These findings describe the most influential parameters for wheelchair stability and maneuverability, as well as provide quantitative guidelines for the use of manual wheelchairs with on the fly adjustable seats., Conference paper, Published.
A scoping review of data logger technologies used with manual wheelchairs
Proceedings of 2015 RESNA Annual Conference. In recent years, more and more studies are using data logger technologies to document driving and physiological characteristics of manual wheelchair users. However, the technologies used offer marked differences in characteristics such as measured outcomes, ease of use, burden, etc. The objective of this study is to examine the extent of research activity that relied on data logger technologies for manual wheelchair users. We undertook a scoping review of the scientific and gray literature. Five databases were searched from January 1979 to November 2014: Medline, Compendex, CINAHL, EMBASE and Google Scholar. This review retained 104 papers. The selected papers document a wide variety of systems and technologies, measuring a whole range of outcomes. Of all technologies combined, 16.8% were accelerometers installed on the user, 14.8% were magnetic odometers or odometers installed on the wheelchair, 10.2% were accelerometers installed on the wheelchair and 8.67% were heart monitors. So, it is not surprising that the most reported outcomes were distance, speed and acceleration of the wheelchair, and heart rate. In the future, it may be necessary to reach a consensus on what outcomes are important to measure and how. Technological improvements and access to less expensive devices will probably make it possible to easily measure many important outcomes at relatively low cost., Conference paper, Published.