Managing Maneuverability and Rear Stability of Adjustable Manual Wheelchairs: An Update

Tomlinson, James D

doi:10.1093/ptj/80.9.904

Cited by 31 publications

(15 citation statements)

References 7 publications

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“…Changes in wheelchair configuration that affect downhill stability will also affect maneuverability and biomechanical demand during manual wheelchair propulsion [24, 31, 32]. The mobility of a manual wheelchair is a function of both the biomechanics of the user and the dynamics of the wheelchair itself.…”

Section: Discussionmentioning

confidence: 99%

“…most dynamic cases apart from wheeling downhill), reducing rolling resistance and improving push biomechanics are important for minimizing the risk of upper limb overuse injuries [31, 33–35]. Increasing the load on the rear wheels reduces rolling resistance for straight trajectories [32], such as the modelled case of wheeling downhill, but does so at the cost of reducing rear stability [17, 30]. In addition to mechanical advantages due to reduced rolling resistance, shifting the rear axle forward increases the biomechanical push angle and shoulder ROM [24], and decreases needed muscle activity for the triceps, anterior deltoids and biceps [36].…”

Section: Discussionmentioning

confidence: 99%

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Manual wheelchair downhill stability: an analysis of factors affecting tip probability

Thomas

Borisoff

Sparrey

2018

J NeuroEngineering Rehabil

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BackgroundFor people who use manual wheelchairs, tips and falls can result in serious injuries including bone fractures, concussions, and traumatic brain injury. We aimed to characterize how wheelchair configuration changes (including on-the-fly adjustments), user variables, and usage conditions affected dynamic tip probability while rolling down a slope and contacting a small block.MethodsRigid body dynamic models of a manual wheelchair and test dummy were created using multi-body software (Madymo, TASS International, Livonia, MI), and validated with 189 experiments. Dynamic stability was assessed for a range of seat angles (0 to 20° below horizontal), backrest angles (0 to 20°), rear axle positions (0 to 20 cm from base of backrest), ground slopes (0 to 15°), bump heights (0 to 4 cm), wheelchair speeds (0 to 20 km/hr), user masses (50 to 115 kg), and user positions (0 to 10 cm from base of backrest). The tip classifications (forward tip, backward tip, rolled over bump, or stopped by bump) were investigated using a nominal logistic regression analysis.ResultsFaster wheelchair speeds significantly increased the probability of tipping either forward or backward rather than stopping, but also increased the probability of rolling over the bump (p < 0.001). When the rear axle was positioned forward, this increased the risk of a backward tip compared to all other outcomes (p < 0.001), but also reduced the probability of being stopped by the bump (p < 0.001 compared to forward tip, p < 0.02 compared to rolling over). Reclining the backrest reduced the probability of a forward tip compared to all other outcomes (p < 0.001), and lowering the seat increased the probability of either rolling over the bump or tipping backwards rather than tipping forward (p < 0.001). In general, the wheelchair rolled over bumps < 1.5 cm, and forwards tipping was avoided by reducing the speed to 1 km/hr.ConclusionsThe probability of forward tipping, corresponding to the greatest risk of injury, was significantly reduced for decreased speeds, smaller bumps, a reclined backrest, and a lower rear seat height. For wheelchairs with dynamic seating adjustability, when travelling downhill, on-the-fly adjustments to the seat or backrest can increase the likelihood of safely rolling over a bump.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Manual wheelchair downhill stability: an analysis of factors affecting tip probability

Thomas

Borisoff

Sparrey

2018

J NeuroEngineering Rehabil

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“…The turning moment will depend on the distance of the centre of mass from the axis of the rear wheels, the mass of the system and the friction between the wheels and the footway surface. It is facilitated by the presence of free-turning front wheels (casters) (Brubaker, McLaurin, and McClay 1986;Tomlinson 2000). This turning moment must be overcome if the wheelchair is to travel in a straight line.…”

Section: Introductionmentioning

confidence: 99%

A micro-level approach to measuring the accessibility of footways for wheelchair users using the Capability Model

Holloway

Tyler

2013

Transportation Planning and Technology

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There are a growing number of people with mobility impairments who use wheelchairs to get around the built environment. This number is likely to increase in the future due to an increasingly ageing population combined with advances in medical technology which help to overcome some of the barriers to access that have hitherto prevented people from leading as full a life as they would have liked. Footways form an integral part of the transport network and therefore it is essential they can be accessed by all people. Currently, however, there is no well-defined method to measure the accessibility of footways for wheelchair users. One aspect of a footway is the crossfallthe transverse gradient designed to facilitate surface water drainagewhich adds to a wheelchair user's difficulty when progressing along the footway. This paper first reviews previous research on measuring the effect of crossfalls on wheelchair accessibility, highlighting the need for a new approach. It then proposes the Capability Model as a starting point for this new approach. The model is updated and populated with an initial capability set chosen to measure footway accessibility across footways with three different crossfall gradients (0%, 2.5% and 4%). The focus is on the physical work provided by the user to the wheelchair in order to keep it travelling in a straight line. It is shown that in order to travel in a straight line when a footway is flat only a single principal capability is required: the ability to produce sufficient force over the required distance to overcome the inertia and rolling resistance and keep the wheelchair moving at the chosen velocity. When a positive crossfall gradient is introduced a second capability is required: the ability to apply different levels of force to the left and right sides of the wheelchair. It is concluded that it is possible to measure these two capabilities and these provide a good insight into the effect of crossfalls on footway accessibility for wheelchair users.

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“…Em um estudo de revisão sobre a padronização de medidas antropométricas e normas utilizadas na pesquisa e prescrição de cadeira de rodas, Steinfeld et al 1981;YOUNG et al, 1982;SALZBERG et al, 1996). O mau posicionamento sentado tem sido indicado como fator de risco associado à formação de úlceras de pressão (ZACHARKOW, 1988 (TOMLINSON, 2000;VEEGER et al, 1989;PERDIOS et al, 2007;TRUDEL et al, 1997 Tradicionalmente, as rodas têm sido produzidas tanto com material plástico com 6, 8 ou até 12 raios, quanto em aço. Nos últimos anos, têm surgido projetos de rodas feitas em fibra de carbono, oriundos do mercado de bicicletas.…”

Section: Problemas Relacionados Ao Uso De Cadeira De Rodas Manualunclassified

“…As rodas traseiras foram desenvolvidas a partir de um projeto original, tendo (TOMLINSON, 2000;VEEGER et al, 1989;PERDIOS et al, 2007;TRUDEL et al, 1997). Estudos apontam que a cambagem ideal para uma cadeira de rodas para uso diário deve ser menor que 9º (FAUPIN et al, 2004), e próxima de 6º (Perdios et al, 2007…”

Section: Projeto Das Rodas Traseirasunclassified

Projeto conceitual e protótipo de uma cadeira de rodas servo-assistida

Médola¹

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A Deus, pela saúde, esperança, coragem e felicidade na realização deste trabalho. A meus irmãos, Bruno e Henrique, pela amizade, companheirismo, apoio e incentivo. A Fernanda Martins Sarzi, pelo apoio, confiança e companheirismo durante todas estas etapas. A meus orientadores, Profa. Dra. Valéria Meirelles Carril Elui e Prof. Dr. Carlos Alberto Fortulan, pela orientação na condução dos estudos, conhecimento e experiência transmitidos, pelo agradável convívio, paciência, confiança, incentivo, amizade e suporte durante todas as fases de doutoramento.

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Managing Maneuverability and Rear Stability of Adjustable Manual Wheelchairs: An Update

Cited by 31 publications

References 7 publications

Manual wheelchair downhill stability: an analysis of factors affecting tip probability

Manual wheelchair downhill stability: an analysis of factors affecting tip probability

A micro-level approach to measuring the accessibility of footways for wheelchair users using the Capability Model

Projeto conceitual e protótipo de uma cadeira de rodas servo-assistida

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