Manual wheelchair (WC) users with spinal cord injury (SCI) experience shoulder pain and fatigue associated with their increased reliance on the upper extremity during activities of daily living (Bayley et al. 1987, “The Weight-Bearing Shoulder. The Impingement Syndrome in Paraplegics,” J. Bone Jt. Surg. Am., 69(5), pp. 676–678). We hypothesized that the mechanical demand imposed on the shoulder, represented as resultant shoulder net joint moment (NJM) impulse, would be greater when initiating manual WC propulsion from a stationary position without momentum than when manually propelling at speed on a level sidewalk. Thirty manual WC users with paraplegia participated. Each individual initiated manual WC propulsion from a stationary position and propelled on a level sidewalk at their self-selected fast speed. Upper extremity kinematics and pushrim reaction forces (RFs) were measured and upper extremity joint kinetics were calculated and compared ( α = 0.05) between cycle 1, initiated without momentum, and cycle 3 with momentum. Results indicate that multiple factors contributing to the mechanical demand imposed on the shoulder were significantly greater when manual WC propulsion was initiated without momentum than with momentum. Significant differences in resultant shoulder NJM impulse, push duration, orientation of RF relative to forearm, and resultant average shoulder NJMs during push were observed between momentum conditions. No significant differences in average resultant RF during push were found. These results indicate that mechanical loading of the shoulder during manual WC propulsion differs between momentum conditions; these differences in resultant shoulder NJM impulse during push need to be considered when assessing shoulder load exposure in stop-and-start activities.

Multibody kinematic optimization is frequently used to assess shoulder kinematics during manual wheelchair (MWC) propulsion, but multiple kinematics chains are available. It is hypothesized that these different kinematic chains affect marker tracking, shoulder kinematics, and resulting musculotendon (MT) lengths. In this study, shoulder kinematics and MT lengths obtained from four shoulder kinematic chains (open-loop thorax-clavicle-scapula-humerus (M 1 ), closed-loop with contact ellipsoid (M 2 ), scapula rhythm from regression equations (M 3 ), and a single ball-and- socket joint between the thorax and the humerus (M 4 ) were compared. Right-side shoulder kinematics from seven subjects were obtained with 34 reflective markers and a scapula locator using an optoelectronic motion capture system while propelling on a MWC simulator. Data were processed based on the four models. The results showed the impact of shoulder kinematic chains on all studied variables. Marker reconstruction errors were found to be similar between M 1 and M 2 and lower than for M 3 and M 4 . Few degrees-of-freedom (DoF) were noticeably different between M 1 and M 2 , but all shoulder DoFs were significantly affected between M 1 and M 4 . As a consequence of differences in joint kinematics, MT lengths were affected by the kinematic chain definition. The contact ellipsoid (M 2 ) was found as a good trade-off between marker tracking and penetration avoidance of the scapula. The regression-based model (M 3 ) was less efficient due to limited humerus elevation during MWC propulsion, as well as the ball-and-socket model (M 4 ) which appeared not suitable for upper limbs activities, including MWC propulsion.

The anthropometries of elite wheelchair racing athletes differ from the generic, able-bodied anthropometries commonly used in computational biomechanical simulations. The impact of using able-bodied parameters on the accuracy of simulations involving wheelchair racing is currently unknown. In this study, athlete-specific mass segment inertial parameters of the head and neck, torso, upper arm, forearm, hand, thigh, shank, and feet for five elite wheelchair athletes were calculated using dual-energy X-ray absorptiometry (DXA) scans. These were compared against commonly used anthropometrics parameters of data presented in the literature. A computational biomechanical simulation of wheelchair propulsion using the upper extremity dynamic model in opensim assessed the sensitivity of athlete-specific mass parameters using Kruskal–Wallis analysis and Spearman correlations. Substantial between-athlete body mass distribution variances (thigh mass between 7.8% and 22.4% total body mass) and between-limb asymmetries (<62.4% segment mass; 3.1 kg) were observed. Compared to nonathletic able-bodied anthropometric data, wheelchair racing athletes demonstrated greater mass in the upper extremities (up to 3.8% total body mass) and less in the lower extremities (up to 9.8% total body mass). Computational simulations were sensitive to individual body mass distribution, with joint torques increasing by up to 31.5% when the scaling of segment masses (measured or generic) differed by up to 2.3% total body mass. These data suggest that nonathletic, able-bodied mass segment inertial parameters are inappropriate for analyzing elite wheelchair racing motion.

A procedure for modeling wheelchair-users undergoing vibrations was developed. Experimental data acquired with a wheelchair simulator were used to develop a model of a seated wheelchair user. Maximum likelihood estimation procedure was used to determine the model complexity required to characterize wheelchair-user's response. It was determined that a two segment rotational link model is adequate for characterization of vibratory response. The parameters of the proposed model were identified using the experimental data and verified using additional experimental results. The proposed approach can be used to develop subject-specific design criteria for wheelchair seating and suspension.

There exists a need for educational processes in which students gain experience with design and commercialization of medical devices. This manuscript describes the implementation of, and assessment results from, the first year offering of a project course sequence in Master of Engineering (MEng) in Design and Commercialization at our institution. The three-semester course sequence focused on developing and applying hands-on skills that contribute to product development to address medical device needs found within our university hospital and local community. The first semester integrated computer-aided drawing (CAD) as preparation for manufacturing of device-related components (hand machining, computer numeric control (CNC), three-dimensional (3D) printing, and plastics molding), followed by an introduction to microcontrollers (MCUs) and printed circuit boards (PCBs) for associated electronics and control systems. In the second semester, the students applied these skills on a unified project, working together to construct and test multiple weighing scales for wheelchair users. In the final semester, the students applied industrial design concepts to four distinct device designs, including user and context reassessment, human factors (functional and aesthetic) design refinement, and advanced visualization for commercialization. The assessment results are described, along with lessons learned and plans for enhancement of the course sequence.

This paper presents a mechanism for standing and sitting transformation of a wheelchair using a two-wheeled inverted pendulum concept with reduced torque requirement, in simulation studies. The motivation of this work is to design a compact standing mechanism to help an elderly/disabled person with functional limitation in lower extremities to maneuver in small and confined spaces and enable them to perform standard daily life routines independently. The wheelchair system at the upright standing position is tested with different travel distances, and the challenge is to control both sit-to-stand and stand-to-sit operations in a stable manner using flexible-joint humanoid. An additional spring/damping element is incorporated at each wheel to provide a comfortable ride for the user especially during stand-to-sit transformation task. A PD-fuzzy control with modular structure is implemented, and the performance of the system is observed through visual nastran 4 d ( vn4d ) visualization software and simulation in matlab . The stand-to-sit performance tests have shown more than 38% reduction in tilt and back seat angles fluctuation in linear travel motion using a suspension system, while the initial tilt torque needed is 50% less than the amount required in previous designs.

The question of using the nonorthogonal joint coordinate system (JCS) to report joint moments has risen in the literature. However, the expression of joint moments in a nonorthogonal system is still confusing. The purpose of this paper is to present a method to express any 3D vector in a nonorthogonal coordinate system. The interpretation of these expressions in the JCS is clarified and an example for the 3D joint moment vector at the shoulder and the knee is given. A nonorthogonal projection method is proposed based on the mixed product. These nonorthogonal projections represent, for a 3D joint moment vector, the net mechanical action on the JCS axes. Considering the net mechanical action on each axis seems important in order to assess joint resistance in the JCS. The orthogonal projections of the same 3D joint moment vector on the JCS axes can be characterized as “motor torque.” However, this interpretation is dependent on the chosen kinematic model. The nonorthogonal and orthogonal projections of shoulder joint moment during wheelchair propulsion and knee joint moment during walking were compared using root mean squares (rmss). rmss showed differences ranging from 6 N m to 22.3 N m between both projections at the shoulder, while differences ranged from 0.8 N m to 3.0 N m at the knee. Generally, orthogonal projections were of lower amplitudes than nonorthogonal projections at both joints. The orthogonal projection on the proximal or distal coordinates systems represents the net mechanical actions on each axis, which is not the case for the orthogonal projection (i.e., motor torque) on JCS axes. In order to represent the net action at the joint in a JCS, the nonorthogonal projection should be used.

Individuals who cannot functionally reposition themselves often need dynamic seating interventions that change body posture from automatic chair adjustments. Pelvis alignment directly affects sitting posture, and systems that adjust and monitor pelvis angle simultaneously might be applicable to control body posture in sitting. The present study explores whether it is feasible to monitor pelvis angle from seat support forces. Pelvis angle estimation was based on equivalent “two-force member” loading for which pelvis orientation equals the orientation of the equivalent contact force. Theoretical evaluation was done to derive important conditions for practical application. An instrumented wheelchair was developed for experimental validation in healthy subjects. Seat support forces were measured, and mechanical analysis was done to derive the equivalent contact force from which we estimated the pelvis angle. Model analysis showed a significant influence of pelvis mass, hip force, and lumbar torque on the relation between the actual pelvis angle and the predicted pelvis angle. Proper force compensation and minimal lumbar torque seemed important for accurate pelvis angle estimations. Experimental evaluation showed no body postures that involved a clear relation between the pelvis angle and the orientation of the equivalent contact force. Findings suggest that pelvis angle could not be estimated in healthy individuals under the described experimental seating conditions. Validation experiments with impaired individuals must be performed under different seating conditions to provide a better understanding whether the principle is of interest for clinical application.

A systematic integrated data collection and analysis of kinematic, kinetic, and electromyography (EMG) data allow for the comparison of differences in wheelchair propulsion between able-bodied individuals and persons with paraplegia. Kinematic data from a motion analysis system, kinetic data from force-sensing push rims, and electromyography data from four upper-limb muscles were collected for ten push strokes. Results are as follows: Individuals with paraplegia use a greater percentage of their posterior deltoids, biceps, and triceps in relation to maximal voluntary contraction. These persons also reached peak anterior deltoid firing nearly 10 deg earlier on the push rim, while reaching peak posterior deltoid nearly 10 deg later on the push rim. Able-bodied individuals had no triceps activity in the initial stages of propulsion while their paraplegic groups had activity throughout. Able-bodied participants also had, on average, peak resultant, tangential, and radial forces occurring later on the push rim (in degrees). There are two main conclusions that can be drawn from this integrative investigation: (1) A greater “muscle energy,” as measured by the area under the curve of the percentage of EMG throughout propulsion, results in a greater resultant joint force in the shoulder and elbow, thus potentially resulting in shoulder pathology. (2) Similarly, a greater muscle energy may result in fatigue and play a factor in the development of shoulder pain and pathology over time; fatigue may compromise an effective propulsive stroke placing undue stresses on the joint capsule. Muscle activity differences may be responsible for the observed kinematic and kinetic differences between the two groups. The high incidence of shoulder pain in manual wheelchair users as compared to the general population may be the result of such differences, although the results from this biomedical investigation should be examined with caution. Future research into joint forces may shed light on this. Further investigation needs to focus on whether the pattern of kinematics, kinetics, and muscle activity during wheelchair propulsion is compensatory or evolutionary by tracking individuals longitudinally.

An instrumented wheel system for three-dimensional kinetic analysis of upper extremity during wheelchair propulsion has been designed and validated. This system allows the direct measurements of three-dimensional dynamic forces and moments on the handrim during wheelchair propulsion in a laboratory setting as well as in the field. Static loading tests showed a high linearity and little drift (coefficient of determination, r 2 > 0.999). Under dynamic loading, the instrumented wheel provided the well-matched measurement forces and moments with the predicted values from the inverse dynamic method using video-based kinematic data (correlation coefficient, ρ > 0.97). The three-dimensional handrim forces and moments during wheelchair propulsion by a non-disabled subject were demonstrated.

This paper investigates the deformations and stresses in the buttocks of a person when he sits on a cushion. The study is motivated by the need for a better understanding of the design of wheelchair cushions and the prevention of decubitus ulcers. The finite element method is used on an axisymmetric model. Surface pressure distribution, surface friction, hydrostatic pressures and von Mises stresses are obtained. The finite element model reveals the three-dimensional state of stress at all internal locations for a typical human body. Thus the study complements the experimental measurements performed by many physicians and bioengineers.