Participatory Action Design and Engineering of Powered Personal Transfer System for Wheelchair Users: Initial Design and Assessment.

Caregivers that assist with wheelchair transfers are susceptible to back pain and occupational injuries. The study describes a prototype of the powered personal transfer system (PPTS) consisting of a novel powered hospital bed and a customized Medicare Group 2 electric powered wheelchair (EPW) working together to provide a no-lift solution for transfers. The study follows a participatory action design and engineering (PADE) process and describes the design, kinematics, and control system of the PPTS and end-users' perception to provide qualitative guidance and feedback about the PPTS. Thirty-six participants (wheelchair users (n = 18) and caregivers (n = 18)) included in the focus groups reported an overall positive impression of the system. Caregivers reported that the PPTS would reduce the risk of injuries and make transfers easier. Feedback revealed limitations and unmet needs of mobility device users, including a lack of power seat functions in the Group-2 wheelchair, a need for no-caregiver assistance/capability for independent transfers, and a need for a more ergonomic touchscreen. These limitations may be mitigated with design modifications in future prototypes. The PPTS is a promising robotic transfer system that may aid in the higher independence of powered wheelchair users and provide a safer solution for transfers.

Mini-review: Robotic wheelchair taxonomy and readiness.

Robotic wheelchair research and development is a growing sector. This article introduces a robotic wheelchair taxonomy, and a readiness model supported by a mini-review. The taxonomy is constructed by power wheelchair and, mobile robot standards, the ICF and, PHAATE models. The mini-review of 2797 articles spanning 7 databases produced 205 articles and 4 review articles that matched inclusion/exclusion criteria. The review and analysis illuminate how innovations in robotic wheelchair research progressed and have been slow to translate into the marketplace.

TECHNOLOGY TRANSFER ASSISTANCE PROJECT BRINGS VA HEALTH CARE IDEAS TO LIFE.

Clinicians and staff of the Department of Veterans Affairs Health Care System (VA), who provide services to veterans, have invented many devices and methods for improving veterans' lives. However, translating those inventions to the market has been a challenge due to limited collaboration between the clinical inventors and the scientists, researchers, and engineers who can produce the prototypes necessary for licensing the technology. The VA Technology Transfer Program office and the Human Engineering Research Laboratories, a research laboratory with experience with developing prototypes and licensing technology, jointly developed a program called the Technology Transfer Assistance Project (TTAP) to bridge the gap between clinical inventors and prototypes ready for licensing. This paper describes TTAP and provides examples of the first inventions that were developed or enhanced through TTAP.

A review of adaptive sport opportunities for power wheelchair users.

PURPOSE: To identify adaptive sports opportunities for individuals who use powered wheelchairs for their primary means of mobility, and to determine barriers and facilitators for new sporting opportunities. MATERIALS AND METHODS: A structured literature review of the peer-reviewed scientific literature and analysis of major adaptive sport competitions information. Pubmed and Scopus were searched for the phrases "Power wheelchair sports" and "complex disability sport" to identify articles discussing competitive sport opportunities for power wheelchair users. Also, the websites and instructional materials were searched to identify what sports exist for power wheelchair users in the Paralympics, the National Veteran Wheelchair Games, the Invictus Games and the Warrior Games. RESULTS: Eleven articles were found from Pubmed and Scopus which met the criteria, most of which were focused on power soccer. The search for sport opportunities from the four major competitions found few events where someone using a power wheelchair could participate, most of which involve a stationary chair during competition (e.g., archery, billiards). CONCLUSIONS: This literature review identified few programs for sports for people who use power wheelchairs. Many challenges such as lack of appropriate technology, lack of programs, and challenging classification categories all interact to contribute to this problem. Opportunities exist for better and more appropriate technology to be developed and for new and innovative sports and rules to be adopted for these athletes to benefit more from sport and recreation.Implications for rehabilitationAthletes with complex disabilities and high support needs are not provided with the same opportunities as other athletes.Challenges such as insufficient technology, lack of programs, and challenging classification categories all interact to contribute to the lack of opportunities.Opportunities exist for better and more appropriate technology to be developed and for new and innovative sports and rules to be adopted for athletes with complex disabilities and high support needs to benefit more from sport and recreation.

Design of an adjustable wheelchair for table tennis participation.

PURPOSE: Physical activity and recreation are very important for people with disabilities and provide benefits for self-esteem, social relationships, employment, rehabilitation, and education. Para Table Tennis is an adaptive sport where participants compete in table tennis while sitting in a wheelchair. However, athletes generally use their everyday wheelchair instead of a device specifically designed for the sport. The specific support, movements, and posture needed to participate in table tennis at the highest level are different than general day-to-day mobility and a device could be optimized for the sport. This research describes the development of a wheelchair specifically designed for para table tennis. MATERIALS AND METHODS: The design followed a participatory action design approach which identified the specific needs for a wheelchair to be used during para table tennis. RESULTS: Three design needs were identified which included 1) locking the casters in the forward direction, 2) ability to raise the seat height as high as possible while allowing the user's knees to fit under the table, and 3) adjustable seat angle which will allow some users to have anterior tilt to get their trunk even higher while other users could have posterior tilt for stability. A new chair meeting these needs was designed and prototyped. CONCLUSIONS: Para table tennis has some specific requirements related to movements and posture which were improved by a new wheelchair design specific for the sport.IMPLICATIONS FOR REHABILITATIONMany adaptive sports are improved with sport specific technology.A model client was used to develop a wheelchair specifically for adaptive table tennis.The height and angle of the seat of the new wheelchair can be adjusted for optimal stability and reach.The casters of the new wheelchair can be locked to allow only forward and backward motion.

VA TECHNOLOGY TRANSFER PROGRAM RESPONDS TO COVID-19 PANDEMIC.

The COVID-19 pandemic stressed healthcare systems all over the world. Two primary challenges that healthcare systems faced were a shortage of personal protective equipment and the need for new technologies to handle infection prevention for staff and patients. The Department of Veteran's Affairs (VA) Technology Transfer Program responded by prioritizing the development of innovations in the Technology Transfer Assistance Project which addressed the pandemic. This paper describes several innovations that addressed the needs of the VA healthcare system during the pandemic and how they were rapidly developed.

Detection and classification methodology for movements in the bed that supports continuous pressure injury risk assessment and repositioning compliance.

Pressure injuries are costly to the healthcare system and mostly preventable, yet incidence rates remain high. Recommendations for improved care and prevention of pressure injuries from the Joint Commission revolve around continuous monitoring of prevention protocols and prompts for the care team. The E-scale is a bed weight monitoring system with load cells placed under the legs of a bed. This study investigated the feasibility of the E-scale system for detecting and classifying movements in bed which are relevant for pressure injury risk assessment using a threshold-based detection algorithm and a K-nearest neighbor classification approach. The E-scale was able to detect and classify four types of movements (rolls, turns in place, extremity movements and assisted turns) with >94% accuracy. This analysis showed that the E-scale could be used to monitor movements in bed, which could be used to prompt the care team when interventions are needed and support research investigating the effectiveness of care plans.

Proposed pedestrian pathway roughness thresholds to ensure safety and comfort for wheelchair users.

In the United States, over three million people use a wheelchair for their primary means of mobility and they rely on functional and accessible pathways to participate in their communities. The Americans with Disabilities Act Accessibility Guidelines related to pathway roughness are currently ambiguous, subjective and therefore unable to be measured. Consequently, many public pathways are sufficiently rough to result in harmful vibrations and discomfort for wheelchair users. In previous research, subjective ratings and root-mean-square accelerations were reported from subjects traveling over surfaces with various roughnesses in their own wheelchairs. The purpose of the current study is to use previous data to propose roughness thresholds by correlating the roughness of surfaces to vibration data and subjective ratings from wheelchair users. The results suggest a pathway roughness index threshold of ≤50 mm/m (1.2 in./ft) for a surface segment of 100 m (328 ft) in length, and ≤100 mm/m (1.2 in./ft) for a surface segment of 3 m (9.8 ft) in length would protect wheelchair users against discomfort and possible health risks due to vibration exposure. For surfaces of different lengths, a 3 m (9.8 ft) and 100 m (328 ft) moving window should be used.

Design and focus group evaluation of a bed-integrated weight measurement system for wheelchair users.

Regular weight monitoring is known to help with weight management, which is an important part of maintaining a healthy, active lifestyle. Unfortunately, weight monitoring is challenging for wheelchair users because the few scales that are available are expensive and very large. Consequently, wheelchair users typically learn their weight at infrequent visits to their healthcare providers, which likely contributes to higher prevalence of obesity-related health risks among this population. In this article, we describe the design and development of the Embedded Scale, or E-Scale, which is a bed-integrated bodyweight measuring system that allows a user to measure and track their weight. The E-Scale team followed a standard product development approach to build the E-Scale prototype. Bench testing results indicate that the performance of the prototype is on par with commercially available wheelchair scales (capacity = 1,200 lbs, accuracy = 1.73 lbs, and precision = ± 0.35 lbs over one-fourth rated capacity). Institutional Review Board (IRB)-approved focus groups with 20 Veterans who use wheelchairs for mobility were conducted to gather feedback about the design, which was very positive. Development and testing results suggests the E-Scale technology is feasible and may provide a valuable tool to help wheelchair users manage their weight.

Pedestrian pathway characteristics and their implications on wheelchair users.

Individuals who use wheelchairs (WCs) frequently navigate over pathways with obstacles (e.g., bumps or curb descents) or terrain that is extremely rough. Surface characteristics such as roughness can have an effect on comfort and variables associated with bodily injury. Understanding these relationships can be helpful to ensure safe and comfortable access to all public and private pathways. This article reviews existing research related to the topics of surface roughness effects on WC user's bodies, surface roughness measurement techniques, and design guidelines and exposure limits that attempt to ensure pathways are safe and passable. These findings are discussed along with opportunities to improve them. Using a broad literature search, it was found that several measurement and analysis techniques exist to characterize surface roughness related to automobile roadways, but they have not been systematically applied to WC use over pedestrian pathways. The roughness measurement approach that appears most relevant and adaptable for sidewalks are rolling profilers. Commercially available devices could be recalibrated or adapted to measure pedestrian pathways. IRI and ride-quality analysis techniques appear most relevant and could also be adapted. Any analysis technique that uses profiles of surfaces should focus on frequencies and wavelengths that are most applicable to WC riders.