Showing papers in "Disability and Rehabilitation: Assistive Technology in 2009"
TL;DR: The importance of mimicking human ankle–foot biomechanics with prosthetic feet is briefly discussed and prior work in both objective and subjective evaluation of prosthetic gait is reported.
Abstract: Numerous prosthetic feet are currently on the market for individuals with a transtibial amputation, each device aimed at raising the 3C-level (control, comfort and cosmetics) with slightly different characteristics. In general, prosthetic feet can be classified into three categories. These are, following the time line: conventional feet (CF), energy-storing-and-returning (ESR) feet and the recent so-called ‘bionic’ feet. Researchers have shown enhanced performance properties of ESR feet compared with early CF. However, even with the advanced technology, none of the ESR feet is capable of significantly reducing energy cost of walking or enhancing prosthetic gait (Nielsen et al. J Prosthet Orthotics 1989;1:24–31; Waters et al. J Bone Joint Surg Am 1976;58:42–46; Torburn et al. J Rehabil Res Dev 1990;27:369–384). From the 1990s, gradually more attention has been paid to the incorporation of active elements in prosthetic feet as the passive devices are not capable of providing the individual with sufficient a...
165 citations
TL;DR: The LSA-F is a valid measure with regards to its content, stable over a period of 2 weeks and applicable for a population of middle-aged and older French-Canadian speaking adults who use PMDs.
Abstract: Purpose. To examine the measurement properties of the French-Canadian version of the Life-Space Assessment questionnaire (LSA-F) for power mobility device (PMD) users.Methods. Content validity, test–retest reliability of telephone interviews (2-week interval) and applicability were examined with PMD users presenting neurological, orthopedic or medically complex conditions. Translation/back-translation from English to French and cultural adaptation was performed and pretested with five bilingual users. Test–retest reliability was examined with 40 French-speaking users, age 50 and over, who had been using a subsidised PMD for 2–15 months. Audio-taped interviews were coded to judge content validity and applicability.Results. Content validity results confirmed equivalent meaning for most questions. The test–retest reliability was excellent for the composite score (intra-class correlation coefficient = 0.87) and revealed moderate to substantial concordance for 18/20 items (k = 0.47–0.73; Pa > 57.5%). The appli...
61 citations
TL;DR: The strongest correlate of use of electronic memory aids was endorsement of difficulties thinking though younger age, higher education, and report of higher fatigue were also significant, and Fatigue and depression were highly associated with use of memory strategies.
Abstract: Purpose. To investigate the use of assistive technology (AT), unmet needs for AT, and examine correlates of use of memory aids and cognitive strategies among individuals with multiple sclerosis (MS).Method. A cross-sectional study of 1,063 community dwelling adults with MS in Washington State. A self-report survey assessed use of AT as well as depression, fatigue, mobility, and other demographic and disease related variables.Results. Some 70% of respondents reported using memory strategies and 50.7% reported using electronic memory aids. The strongest correlate of use of electronic memory aids was endorsement of difficulties thinking (OR: 2.09, p < 0.001) though younger age, higher education, and report of higher fatigue were also significant. Fatigue (OR: 1.27, p < 0.001) and depression (OR: 0.89, p < 0.001) were highly associated with use of memory strategies. Subjects who were older, unemployed, more depressed, and have more mobility disability were less likely to use memory strategies.Conculsions. Use...
58 citations
TL;DR: The decision-making process during the construction of a new office building housing a disability-rights organization is explored, revealing complex interactions between accessibility, universal design, and sustainability.
Abstract: Purpose. A growing emphasis has been placed on providing equal opportunities for all people, particularly people with disabilities, to support participation. Barriers to participation are represented in part by physical space restrictions. This article explores the decision-making process during the construction of a new office building housing a disability-rights organization. The building project featured in this study was developed on the principles of universal design, maximal accessibility, and sustainability to support access and participation.Method. A qualitative case study approach was used involving collection of data through in-depth interviews with key decision-makers; non-participant observations at design meetings; and on-site tours. Qualitative thematic analysis along with the development of a classification system was used to understand specific building elements and the relevant decision processes from which they resulted.Results. Recording and analyzing the design process revealed severa...
57 citations
TL;DR: Social participation improved significantly following wheelchair acquisition although confounding variables may have contributed to this improvement.
Abstract: Purpose. Efficient mobility could be a prerequisite to carrying out many daily activities and social roles (social participation). The aim of this study was to assess the impact of wheelchair acqui...
55 citations
TL;DR: The results indicate that children's views about their assistive devices may be different from those of adult users due to their different developmental stages and unique personal experiences and suggest the importance of children's active participation in the field of assistive device research.
Abstract: Purpose. The study aimed to explore how children with cerebral palsy (CP) perceived their disability and assistive devices and to consider the factors influencing their device use in home and school settings. Method. Semi-structured interviews were adopted as the main data collection instrument. There were 44 participants, which comprised of 15 Taiwanese children with CP as well as their mothers and teachers. Results. Most children associated their perceptions of disability with their experiences of lower physical performance. Consequently, they generally perceived assistive devices as having a positive effect on their disability. Their enthusiasm for using their devices in the home and school contexts, however, was markedly different. Four factors leading to such a difference were identified, namely the nature of the two environments, physical environmental factors, the children’s desired level of independence and the mothers’ attitudes. Conclusions. The results demonstrate the significance of child-environment interaction. The children’s attitudes towards device usage are influenced by their perceptions of the contextual feature of both settings. Additionally, the results indicate that children’s views about their assistive devices may be different from those of adult users due to their different developmental stages and unique personal experiences. The findings suggest the importance of children’s active participation in the field of assistive device research.
53 citations
TL;DR: Although curb ramps were usually present at intersections, only a small proportion of them met all of the accessibility criteria evaluated, which has implications for those responsible for installing and maintaining curb ramps and suggests that wheelchair users and their caregivers should learn the wheelchair skills needed to overcome such accessibility barriers.
Abstract: Purpose. To determine the extent to which curb ramps in an urban area met a set of wheelchair accessibility guidelines.Method. For each of 79 intersections in an urban area, we collected data about eight accessibility characteristics, based on existing guidelines. A total score (0–8) was calculated for each intersection, based on the number of criteria met.Results. Of the 79 intersections assessed, 98.7% had curb ramps. Of the curb ramps, 53.8% provided direct lines of travel from the sidewalks to the crosswalks, 93.6% were ≥915 mm in width, 43.6% had ramp slopes ≤4.8° (1:12), 57.7% had gutter counter-slopes of ≤2.9° (1:20), 26.9% had smooth transitions (≤13 mm) from the curb ramps to the gutters, 85.9% were free from irregularities and 100% were free from drainage grates. The mean (±SD) total score was 5.6 (±1.1). Only 2.6% of the intersections met all eight criteria.Conclusions. Although curb ramps were usually present at intersections, only a small proportion of them met all of the accessibility criter...
49 citations
TL;DR: Evaluating pushrim-activated, power-assisted wheelchair performance among dual-users in their natural environment to determine whether the PPW would serve as a satisfactory alternative to a power wheelchair for community-based activities found it to provide an alternative to the power wheelchair.
Abstract: Purpose. The purpose of this study was to evaluate pushrim-activated, power-assisted wheelchair (PPW) performance among dual-users in their natural environment to determine whether the PPW would serve as a satisfactory alternative to a power wheelchair for community-based activities.Methods. A concurrent mixed methods research design using a cross-over trial was used. The outcome measures used were number of hours reported using the different wheelchairs, Quebec User Evaluation of Satisfaction with assistive Technology (QUEST), Functioning Everyday with a Wheelchair (FEW), Psychosocial Impact of Assistive Devices Scale (PIADS) and Canadian Occupational Performance Measure (COPM).Results. The number of hours spent participating in self-identified activities was not significantly different. Only the Self-Esteem subscale of the PIADS identified a statistically significant difference between the PPW and power wheelchair conditions (p = 0.016). A clinically important difference for Performance and Satisfaction...
47 citations
TL;DR: The descriptive survey results indicate that wheelchair users experience many accessibility problems in public environment of the most urbanised city (cultural capital of Europe in 2010) in a developing country.
Abstract: Background. Accessibility to public environment is the human right and basic need of each citizen and is one of the fundamental considerations for urban planning.Purpose. The aim of this study is to determine the compliance of public buildings in central business districts (CBD) of Istanbul, Turkey, to wheelchair accessibility to the guidelines of the instrument and identify architectural barriers faced by wheelchair users.Methods. This is a descriptive study of 26 public buildings in CBD of Istanbul. The instrument used is the adapted Useh, Moyo and Munyonga questionnaire to collect the data from direct observation and measurement. Descriptive statistics of simple percentages and means are used to explain the compliance to the guidelines of the instrument and wheelchair accessibility.Results. The descriptive survey results indicate that wheelchair users experience many accessibility problems in public environment of the most urbanised city (cultural capital of Europe in 2010) in a developing country.Conc...
44 citations
TL;DR: Monitor and describe the use of power tilt systems in everyday life illustrated the variability in function and activity among users, as well as the diverse benefits of a tilt system for different users.
Abstract: Purpose. The goal of this study was to monitor and describe the use of power tilt systems in everyday life. Additionally, tilt measurements were used to determine if participants performed regular pressure reliefs.Methods. Wheelchair occupancy and seat position of 16 fulltime power wheelchair users were monitored regularly for 1–2 weeks. Daily wheelchair occupancy, typical position, time spent at different tilt angles, tilt frequency and pressure relieving tilt (PRT) frequency were described.Results. Participants used their tilt systems in many different ways, including subjects who typically sat at small (0–14°) tilt angles and subjects who typically sat at medium (15–29°) tilt angles. Few subjects tilted past 45°. Almost all subjects tilted throughout the day, with the median subject performing >3 tilts per hour of wheelchair occupancy. Despite the regular use, few subjects performed regular PRTs (median = 0.13/h)Conclusion. Differences in tilt-use illustrated the variability in function and activity am...
42 citations
TL;DR: Two instruments evaluating subjective comfort or discomfort were identified that have been carefully developed and psychometrically tested and have potential for use in clinical practice and research – one developed for wheelchair seating and one for wearable computers.
Abstract: Purpose. This review aims to identify measures suitable for evaluation of physical comfort in a range of clinical settings or specialised areas.Method. A review of literature included articles that evaluated an intervention, position, equipment or surface for comfort or discomfort. Electronic databases, hand searches and internet sources were used.Results. In addition to several theoretical papers on comfort, 29 studies were identified that used ‘comfort’ or ‘discomfort’ as outcomes. There was a lack of consistency in measurement of comfort and researchers used a wide range of different scales and tools. Objective and subjective measures are described. The impact of symptoms, environmental variables and emotional factors was generally not considered. Two instruments evaluating subjective comfort or discomfort were identified that have been carefully developed and psychometrically tested. Both have potential for use in clinical practice and research – one developed for wheelchair seating and one for wearab...
TL;DR: The findings of this study clearly indicate the potential clinical utility of tuning using wedges to correct knee hyperextension during the stance phase in children with cerebral palsy, however, observations support the need for an adequately powered study to assess the long-term effects of tuning on gait parameters, activity level and quality of life.
Abstract: Purpose. This pilot study investigated the feasibility of reducing stance phase knee hyperextension in children with cerebral palsy by tuning the ankle foot orthoses-footwear combination (AFO-FC) using different sizes of wedges.Methods. Five children with cerebral palsy underwent three dimensional gait analysis and tuning of their AFO-FC using wedges. Data analysis was carried out by comparing relevant gait parameters between the non-tuned and tuned prescription.Results. Knee hyperextension during stance significantly decreased, and the shank to vertical angle was closer to normal after tuning. Although none of the other parameters showed statistically significant changes, the wide confidence intervals and lack of power indicated the likelihood of a type II error. Further, it was noted that the influence of tuning on temporal-spatial parameters was different between children with diplegia and those with hemiplegia. It was estimated that a sample size of 15 is required to detect significant changes at p = ...
TL;DR: There is a need for high-quality research to verify current findings and highlight AT issues specific to this generation, as the baby boomer generation represent a new era for aged health care.
Abstract: Purpose. The objective of this article is to review published studies to describe issues and quality of evidence surrounding assistive technology (AT) use by the baby boomer generation. As the baby boomer generation are ageing, they represent a new era for aged health care. In terms of helping this generation maintain independence, it is expected that there will be an increased demand for AT.
Method. A systematic literature search of Medline, CINAHL and Cochrane was undertaken. Selected studies were critically appraised using a previously validated tool. Inclusion criteria were: research related to AT use by a population which includes baby boomers; published in peer-reviewed journals and full-text English language articles. Studies were based in acute rehabilitation units in the USA and Australia. Frequency of use and patient satisfaction surveys were the main outcome measures.
Results. A total of 11 eligible studies were reviewed. All were cross-sectional. Many studies indicated a significant rate of AT non-use; use rates ranged from 35% to 86.5%. Numerous factors influencing use were proposed. Study quality was upper-mid range.
Conclusions. Baby boomers will place more demand on AT in the future. There is a need for high-quality research to verify current findings and highlight AT issues specific to this generation.
TL;DR: A framework for Web adaptability is introduced, which encourages the development of Web-based services that can be resilient to the diversity of uses of such services, the target audience, available resources, technical innovations, organisational policies and relevant definitions of ‘accessibility’.
Abstract: Purpose. This article asserts that current approaches to enhance the accessibility of Web resources fail to provide a solid foundation for the development of a robust and future-proofed framework. ...
TL;DR: Speech was considered a useful method of operating environmental controls by the participants interviewed; however, their perceptions regarding reliability often influenced their decision to have backup or alternative systems for certain functions and there was a perception of increased independence from the use of speech-driven environmental control.
Abstract: Purpose. To explore users' experiences and perceptions of speech-driven environmental control systems (SPECS) as part of a larger project aiming to develop a new SPECS. The motivation for this part of the project was to add to the evidence base for the use of SPECS and to determine the key design specifications for a new speech-driven system from a user's perspective.Method. Semi-structured interviews were conducted with 12 users of SPECS from around the United Kingdom. These interviews were transcribed and analysed using a qualitative method based on framework analysis.Results. Reliability is the main influence on the use of SPECS. All the participants gave examples of occasions when their speech-driven system was unreliable; in some instances, this unreliability was reported as not being a problem (e.g., for changing television channels); however, it was perceived as a problem for more safety critical functions (e.g., opening a door). Reliability was cited by participants as the reason for using a switc...
TL;DR: This study supports the establishment of a re-evaluation process of wheelchair fit as the users' age, to aide in provision of the best quality wheelchairs and service delivery programs.
Abstract: Purpose. Older adults commonly use wheelchairs for mobility impairments regardless of their living situations. However, limited outcomes data are available to determine quality of the wheelchairs that older Americans are receiving, as well as their satisfaction with wheelchair service delivery programs. The purpose of this article was to analyze satisfaction data collected from three cohorts of older individuals living at nursing homes and in community settings. Ninety participants were residents in VA (n = 60).Methods. One hundred thirty two older adults completed the standardized Quebec User Evaluation of Satisfaction with Assistive Technology. Ninety participants were residents in VA (n = 30) or private nursing homes (n = 30), and 42 were community dwelling participants. Those enrolled were either independent manual or power wheelchairs users.Results. The community dwelling group reported significantly higher levels of satisfaction with their manual wheelchairs and service delivery when compared with t...
TL;DR: This study assessed a program based on the use of learning principles and assistive technology with two persons with a diagnosis of severe post-coma motor impairment and minimally conscious state to help the persons bring about brief periods of environmental stimulation through a microswitch and request contact with the caregiver through a voice output communication aid.
Abstract: Arranging and testing environmental/behavioral (i.e., non-medical) intervention programs for persons with severe post-coma motor impairment and minimally conscious state can be very challenging, an...
TL;DR: Through IPDD, people with disabilities can choose a suitable combination of commercial pointing devices to achieve full cursor control and optimise operational performance through the benefits of flexibility, low cost and high-device compatibility.
Abstract: Purpose. To help people with disabilities such as those with spinal cord injury (SCI) to effectively utilise commercial pointing devices to operate computers. This study proposes a novel method to integrate the functions of commercial pointing devices.Method. Utilising software technology to develop an integrated pointing device driver (IPDD) for a computer operating system.Results. The proposed IPDD has the following benefits: (1) it does not require additional hardware cost or circuit preservations, (2) it supports all standard interfaces of commercial pointing devices, including PS/2, USB and wireless interfaces and (3) it can integrate any number of devices. The IPDD can be selected and combined according to their physical restriction.Conclusions. The IPDD is a novel method of integrating commercial pointing devices. Through IPDD, people with disabilities can choose a suitable combination of commercial pointing devices to achieve full cursor control and optimise operational performance. In contrast wi...
TL;DR: Almost 80% of users needed clinical review within 2 years, mostly due to a scoliosis, and Planned reviews within 1 year appear essential for teenagers with MD with the dual issues of rapid maturation and progressive disease.
Abstract: Purpose. To identify areas of difficulty encountered by a regional wheelchair service in providing Electric Powered Indoor/outdoor wheelchairs (EPIOCs) to those with muscular dystrophy (MD) in the early years of their provision – particularly posture, pain and deformity.Method. Wheelchair service records of all users between April 1997 and March 2000 were reviewed retrospectively and issues relating to weakness, pain/discomfort, deformities, other medical issues, weight change, function, posture and driving were documented on a purpose-designed proforma. Adjustments and modifications were documented over the 2-year period following chair delivery.Results. Of 325 EPIOC users on the departmental database, 29 had MD (15 Duchenne's), whose users charts were reviewed. Almost 80% of users needed clinical review within 2 years, mostly due to a scoliosis. Other problems were postural (66%), medical (48%), pain (31%), functional (24%) and weight change (14%). The commonest prescriptions were for specialised seatin...
TL;DR: A clinical portrait of children with cerebral palsy in relation to their postural stability in the sitting position is drawn up by means of questionnaires addressed to their parents and clinicians and the parameters related to body geometry, activities of daily living (ADL) and the period of the day that are linked with their postures are identified.
Abstract: Purpose. To draw up a clinical portrait of children with cerebral palsy (CP) in relation to their postural stability in the sitting position, by means of questionnaires addressed to their parents and clinicians and to identify the parameters related to body geometry, activities of daily living (ADL) and the period of the day that are linked with their postural instability.Method. Parents and therapists of 31 children with CP (17 boys, 14 girls; mean age, 12.7 years; age range, 8–18 years) took part in the study. As a first step, four questionnaires were developed by the research team. Nine clinicians were then involved in a focus group to validate their content. They were thereafter sent to the parents and therapists of the children. Descriptive analyses (percentage) were performed on the results of the questionnaires.Results. A high percentage of instability was reported by both children's clinicians and parents (81% and 70%, respectively). This instability mainly occurred after less than half an hour in...
TL;DR: The SIMPL-EPW demonstrated a useful and successful multi-phase design approach for developing assistive technology for developing regions.
Abstract: Purpose. To design and develop an appropriate, low-cost electric powered wheelchair (EPW) for the Indian subcontinent.Method. We performed the following multi-phase design process: (1) Conceptual design; (2) System design, Prototype I fabrication, focus group testing with Indian stakeholders (n = 29); (3) System re-design, Prototype II fabrication and user trials with US (n = 5) and Indian (n = 25) subjects.Results. (1) Preliminary investigations revealed that a conventional EPW design was infeasible due to the high component cost. Instead, we constrained our design to incorporate a single drive motor and manual steering, with the option of upgrading to power steering where economically feasible. (2) The first prototype was fabricated out of easily available, low-cost materials. Focus group testing demonstrated feasibility of the design and revealed differences between stakeholder groups. (3) Prototype II incorporated feedback from the first focus group and a needs assessment. US subjects provided valuabl...
TL;DR: Results indicated that when family members and educational teams work together, it is possible to achieve important progress in early language skills using relevant software, systematic teaching and an accessible speech generating device (SGD).
Abstract: Young children with complex communication needs require the best possible start to their educational lives, and for some, this will involve the use of communication technology supports and collaborative teams. This case study describes the outcomes of a pilot investigation that utilised MINSPEAK as a means of enhancing emergent language and literacy skills in a young girl with a range of participatory challenges. Results indicated that when family members and educational teams work together, it is possible to achieve important progress in early language skills using relevant software, systematic teaching and an accessible speech generating device (SGD). The implications of this modest case study are discussed in terms of innovative practice amongst collaborative alternative and augmentative communication teams.
TL;DR: The design, manufacture and evaluation of a custom hand-cycle with a Delta-style frame and fork steering with large amounts of frame flexion can indicate eventual plastic deformation and failure is described.
Abstract: Purpose. This paper describes the design, manufacture and evaluation of a custom hand-cycle with a Delta-style frame and fork steering. The state of hand-cycle design and future design directions are also examined.Method. The design of the custom hand-cycle was based on these criteria: Light weight, aerodynamics, climbing ability, ergonomic fit and the user's specific needs. We designed and built a custom hand-cycle for one expert user, therefore, the user's personal needs were key design drivers. The hand-cycle was evaluated by the user over three years of use.Results. During three years of evaluation and over 8000 km of use there were two frame failures: (i) A crack propagated around one of the tubes connecting the mainframe tube to the headset tube; and (ii) a crack propagated around the circumference of the curved part of the main frame tube directly behind the seat. The first failure was repaired and after the second, the device was retired. The evaluation of this design serves as a basis for a new s...
TL;DR: The results suggest that the K-3000 software program improves academic self-perception and functional task performance of high school students with learning difficulties.
Abstract: Purpose. This study was designed to investigate the effects of computer-based instruction (CBI) on the academic self-perception and functional ability of high school students with learning difficulties.Method. Fifty high school students were assigned to one of two groups: (1) CBI or (2) a regular English language arts classroom, the comparison group. Students in the CBI group used the assistive reading software, Kurzweil 3000 (K-3000), intensively for 10 weeks. This specific CBI tool provides reading and auditory presentation of text and study-skills tools. Before and after the intervention period, standardised measurements such as self-perception profile for learning disabled students (SPPLD), the self-perception profile for adolescents and self-developed questionnaires such as a job application form were used to probe students' academic self-perception and functional task performance.Results. Repeated measure analyses of SPPLD revealed that the CBI group made more progress than comparison group on the r...
TL;DR: A new orthosis in rehabilitation of PD patients was introduced to enhance balance and decrease risk of fall and the results suggest that in PD patients, body trajectories on the platform of Biodex balance system follow a random-like chaotic behaviour.
Abstract: Purpose. It was hypothesised that lumbar vibration stimulation applied by a vibratory orthosis improves balance in people with Parkinson's disease (PD).Methods. The overall stability index and the percent of elapsed time in different zones and quadrants on the platform of Biodex balance system were evaluated. General conditions of eyes-open and eyes-close, each with two situations of motors On and motors Off of vibratory orthosis were considered.Results. Balance in PD patients improved in eyes-open condition rather than eyes-close. The balance also improved in eyes-open condition with motors On rather than that in motors Off. In eyes-close condition, balance was lesser in motors On than that in motors Off situation. The results also suggest that in PD patients, body trajectories on the platform of Biodex balance system follow a random-like chaotic behaviour.Conclusions. A new orthosis in rehabilitation of PD patients was introduced to enhance balance and decrease risk of fall. It promotes new ideas for re...
TL;DR: This study develops a novel method to realize transferring single-direction physical movement into complete mouse functions that is low-cost, flexible, easy to maintain, and compatible with all standard interfaces of commercial input devices.
Abstract: Purpose. To help people with physical disabilities to effectively utilize commercial pointing devices to operate computers. This study develops a novel method to realize transferring single-direction physical movement into complete mouse functions.Method. The proposed system adopts a redesigned software mouse driver that adopts special switches to change the functionality of the mouse.Results. Three people with disabilities were recruited to test the feasibility of this system. Experimental results demonstrate that this method effectively enables people with disabilities to operate computers.Conclusions. In summary, the use of software technology makes this system low-cost, flexible, easy to maintain, and compatible with all standard interfaces of commercial input devices. The proposed system allows people with disabilities to use their remaining functional abilities to operate a computer.
TL;DR: The procedures used in this study appear to provide a useful tool for better understanding how the concept of a dynamic back in a seat system may affect and influence position and stability of individuals with dystonia on the seat system.
Abstract: To improve postural stability in individuals with dystonic cerebral palsy, the concept of a dynamic seat has been suggested as a potential solution. An experimental set-up for the acquisition of movement during extensor thrusts while sitting on a seating system was defined and applied on a group of dystonic individuals, to compare a dynamic versus a rigid seat system, using quantitative movement analysis. The seating system in dynamic configuration is able to reduce the extensor thrust experienced by the consumers, as well as to increase range of motion in the anterior-posterior direction, limiting the sliding down of trunk and showing better upper limb smoothness during extensor thrusts. The procedures used in this study appear to provide a useful tool for better understanding how the concept of a dynamic back in a seat system may affect and influence position and stability of individuals with dystonia on the seat system.
TL;DR: To support a neutral pelvic position and spinal curvature, a combination of a shaped cushion and a marked lumbar support is most effective.
Abstract: AIM: A wheelchair seat and position help clients perform daily activities. The comfort of the wheelchair can encourage clients to participate in daily activities and can help prevent future complic ...
TL;DR: Verbal training with visual feedback may produce changes in push biomechanics of manual wheelchair users, and longer training periods may be needed to sustain propulsion changes.
Abstract: Purpose. To determine if verbal training with visual feedback improved manual wheelchair propulsion; to examine propulsion differences between an individual with paraplegia and an individual with tetraplegia.Method. Quasi-experimental study: Nine manual wheelchair-using adults participated in propulsion assessments and training. Baseline propulsion performance was measured on several tasks on different surfaces. Participants were trained on a wheelchair treadmill with verbal and visual feedback to increase push length, reduce push frequency and to modify propulsion pattern. Handrim biomechanics were measured with an instrumented wheel. Changes in propulsion were assessed. Differences in propulsion characteristics between a participant with paraplegia and a participant with tetraplegia were examined.Results. Push length increased (p < 0.05), push frequency decreased (p < 0.01) and peak (p < 0.05) and average (p < 0.01) forces increased immediately after training. These changes were not sustained over time....
TL;DR: The findings show that policy changes are required regarding the allocation of funding to ensure accessible on reserve housing for First Nations persons with a SCI and the need for health professionals to liaison more closely with Aboriginal health care workers.
Abstract: Purpose. The purpose of this study was to gain an understanding of the post-rehabilitation experiences of First Nations persons with spinal cord injury who returned to live on reserve using a wheelchair.Method. A phenomenological approach with purposive sampling was employed to recruit participants with spinal cord injuries who used a wheelchair and lived in a First Nations community. Data were collected using a short demographic questionnaire and a semi-structured interview.Results. Most participants returned to live on reserve in homes that were not wheelchair accessible and only two had home assessments completed. Nearly all either moved to modified homes or had homes purpose built for them after waiting considerable periods of time to relocate. However, only one of these homes was considered completely accessible. Participants identified other challenges they coped with including the effects of other medical conditions, negotiating reserve terrain and accessing cultural activities.Conclusions. The fin...