Design refinement and evaluation of a mobile manual standing wheelchair.

PURPOSE: There are no manually propelled wheelchairs on the market that are mobile in both seated and standing positions. In response to this product gap, our group formerly designed a mobile manual standing wheelchair (MMSW) and gathered stakeholder feedback. The purpose of this study was to refine the MMSW based on feedback, including weight and width reduction, and evaluate its performance. MATERIALS AND METHODS: The MMSW was subjected to ANSI/RESNA stability testing, and three male participants completed a subset of the wheelchair skills test, including a 100-m roll test in the MMSW (seated and standing) and in their ultralight wheelchair. RESULTS: The MMSW met ANSI/RESNA stability safety standards. During the 100-m roll test, participants reached speeds with the MMSW in both the standing and sitting postures similar or greater than those typical of moving in the home environment (1.11 m/s seated; 0.79 m/s standing). Mobility speeds in the MMSW in the standing position were about three times faster than average walking speeds in exoskeletons (0.26 m/s exoskeletons). With the addition of chain drive bracing to the MMSW, one user was able to reach speeds in the standing position similar to average neurotypical walking speeds indicating the possibility for wheelchair users to be able to move in pace with family and friends. CONCLUSION: All participants expressed interest in the MMSW to facilitate improved quality of life. Further work is needed to test the utility of the MMSW in home and community settings, and its potential effects on standing time and health outcomes.Implications for rehabilitationManual standing wheelchairs with standing mobility may increase functional utility and length of standing time for manual wheelchair usersIncreased standing time may lead to several health benefits for manual wheelchair users.

Microclimate evaluation of strap-based wheelchair seating systems for persons with spinal cord injury: A pilot study.

STUDY PURPOSE: The purpose of this pilot study was to assess microclimate characteristics of two versions of a strap-based wheelchair seating system (perforated and solid straps) and to conduct preliminary microclimate comparisons of subjects' current wheelchair seating systems. MATERIALS AND METHODS: In this pilot study, the microclimate properties of two variations (solid and perforated) of a strap-based seating system were compared with two commonly used seating systems. Six subjects sat on three different seating systems each for 100-min test periods, while temperature and relative humidity were measured with a single sensor adjacent to the skin-seat interface. Additionally, thermal images of the seat interface were collected before and after each test period. RESULTS: The thermal images revealed that the maximum surface temperature of the solid-strap-based seating system was significantly lower than the other seating systems, -1.21 °C. (95% CI -2.11 to -0.30, p = 0.02), immediately following transfer out of the seat. Five minutes after transferring out of the seat, the perforated-strap seat was significantly cooler than the other seats -0.94 °C. (95% CI -1.59 to -0.30), p = 0.01, as was the solid-strap-based seat, -1.66 °C. (95% CI -2.69 to -0.63), p = 0.01. There were no significant differences in interface temperature or relative humidity measured with the single sensor near the skin-seat interface. CONCLUSION: This pilot study offers preliminary evidence regarding the microclimate of the strap-based seating systems compared with other common seating systems. Clinically, the strap-based seating system may offer another option for those who struggle with microclimate management.

Elastic head support for persons with amyotrophic lateral sclerosis.

This article describes an inexpensive elastic head support for persons with amyotrophic lateral sclerosis (ALS) and neck muscle weakness and also presents a case series to examine its effectiveness. The device offers support to the head while the user is seated, standing, and walking, providing support for persons in various stages of ALS. The head support system was tested in seven male patients with ALS. Before and after the 2 wk trial, the subjects answered questions related to their communication efficacy, difficulty swallowing, level of neck discomfort, number of hours being upright before neck discomfort, comfort in social settings, and rating of perceived dyspnea. Subjects also answered specific questions related to the elastic head support after the 2 wk trial. The results suggested that the elastic head support is useful for some, but not all, patients.