Wheelchairs Chapter 8, An introduction to rehabilitation engineering

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and important characteristics Wheelchair propulsion

1 Wheelchairs Chapter 8, An introduction to rehabilitation engineering Agenda Why do we need to know about wheelchairs? Types of wheelchair Manual Wheelchairs Basic components and important characteristics Wheelchair propulsion biomechanics SmartWheel Standards By: Kristy A. Godoy Jaimes Biomedical Engineer EN2313 Engenharia de Reabilitação

Motivation An estimated 1% of the world's population, or just over 74 million people, need a wheelchair. [1] In 2003, 20 million people requiring a wheelchair for mobility did not have one.

[2] Wheelchairs provide mobility, and mobility changes everything; Mobility means independence, the ability to participate in society and earn a living; It means dignity, leaving behind the days of

2 Motivation An estimated 1% of the world's population, or just over 74 million people, need a wheelchair. [1] In 2003, 20 million people requiring a wheelchair for mobility did not have one. [1] Around 14 million Brazilians suffer some kind of motor disability, and 40% of those need a wheelchair (around 5 million people). [2] Wheelchairs provide mobility, and mobility changes everything; Mobility means independence, the ability to participate in society and earn a living; It means dignity, leaving behind the days of living on the ground. [3] [1] [2] COSTA H. Modelagem e simulação da propulsão de cadeiras de rodas manuais. Dissertação São Paulo [3]

Advantages Technological advances of programmability, special seating systems and integrated

3 Wheelchairs Electric power wheelchairs (EPW) Indicated for individuals: With severe sensory motor impairments: High level tetraplegia. Advance multiple sclerosis. Severe cerebral palsy. Advantages Technological advances of programmability, special seating systems and integrated control units = wider potential users Power-assisted wheelchairs SmartDrive Manual wheelchairs

5 Manual wheelchair Principal conditions and abilities Upper body strength. Function. Endurance, resistance. Self-propeled Some pathological conditions: Spinal cord injury at 1 st thoracic level or below and some at 6 th or 7 th cervical level injury Spina bifida Multiple sclerosis, early stages Lower limb amputation Postpolio affecting lower extremity Arthritis Stroke Age Cardiopulmonary disease

6 Basic structural components Wheelchair should be designed specifically. Standard wheelchairs not for long-term use. Heavy duty or bariatric wheelchairs overweight individuals ( kg). Children. Sports (lightweight, maneuverable, adjusting the axle position and camber angles).

7 Manual wheelchair assessment List of Problems and Aims, as identified by the patient Medical Social/Functional/Environmental Transfers Physical Measurements Postural Assessment

8 Manual wheelchair assessment Postural Assessment

10 Basic structural components Frame: chrome, aluminum, steel tubing, titanium, besides stainless steel. Affects the overall weight, durability, transportability and storage. Seat height: leg length, footrest high to avoid obstacles, the right height for tables, counters and sinks height Seat depth: support for thighs Seat width Back height: depends on postural support, affects the range of motion for propulsion.

Basic structural components Seat and back angles Armrest and footrest: Letting the arm lie parallel to the ground. Can affect neck and shoulder. Affects the width of the wheelchair.

11 Basic structural components Seat and back angles Armrest and footrest: Letting the arm lie parallel to the ground. Can affect neck and shoulder. Affects the width of the wheelchair. Footrest can be adjustable or removable. Wheels and tires: Typically 2 large rear wheels and 2 small front wheels (casters). Casters 5 to 20 cm in diameter Rear wheels cm (24 ), spoked

12 Basic structural components

Basic structural components Rear wheel camber: Inclination of the rear wheel, where the upper part is closer, and, thus, the bottom part is further from

13 Basic structural components Rear wheel camber: Inclination of the rear wheel, where the upper part is closer, and, thus, the bottom part is further from the midline. Up to 8 of camber. >8 of camber in sports wheelchairs. Affects wheelchair width.

Basic structural components Rear axle position: Can be adjusted Horizontally and vertically. Weight distribution between rear wheels and casters.

If rear wheels are in a rearward position, the length of the wheelbase is greater and the turning radius is increased. http://www.clinical-corner.

14 Basic structural components Rear axle position: Can be adjusted Horizontally and vertically. Weight distribution between rear wheels and casters. If more weight proportion falls into the caster the greater the rolling resistance. If rear wheels are in a rearward position, the length of the wheelbase is greater and the turning radius is increased. If the rear wheels are in rearward position, is less likely to tip backwards. Lowering the seat height improves stability, but it affects the arms abduction.

15 Basic structural components

16 Stability

17 Wheelchair propulsion Kinematics: Main interest: arms and trunk. Kinetics: Forces and moments applied to the pushrim. Joint forces and moments.

18 ABNT NBR ISO

19 ABNT NBR 9050 Accessibility to buildings, furniture, spaces and urban facilities

20 Obrigado!

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