Wheelchair trainer

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A wheelchair trainer or wheelchair treadmill is an apparatus that allows a manual wheelchair user to simulate linear (translational) travel while remaining stationary in a manner similar to an ambulatory person walking or running on a treadmill or a cyclist pedaling a bicycle on a bicycle trainer. The rear wheelchair wheels are placed in contact with vertical or horizontal rollers which may also be attached to flywheels, mechanical resistance or braking mechanisms, motors and various speed and force sensors. [1] Flywheels may be sized to provide a user of a certain mass with a rotational inertia equivalent to their translational (linear) inertia in order to more realistically approximate actual wheelchair propulsion.

Contents

Wheelchair trainers having independent contact rollers permit simulated directional travel (omnidirectional treadmill). Trainers may also incorporate rotary encoders, accelerometers and torque sensors to enable interface with computer data acquisition systems (DAQ) for analysis of propulsion kinematics. A quadrature rotary encoder or hall effect sensor can be implemented to provide sufficient speed and direction information to enable virtual navigation interface with video games in a manner similar to using a joystick or gaming console. Calculation of rolling resistance between the tire & contact roller interface, axle friction, and inertial characteristics of wheelchair wheels and flywheels may be used in determination of stationary propulsion dynamics. [dynamics]

History

The United States Department of Veterans Affairs (VA) has substantially invested in decades long research and development for two wheelchair trainer devices: the Wheelchair Aerobic Fitness Trainer (WAFT), [2] [3] and GameWheels. [4] The history of wheelchair trainer development may be summarized from the 10 patents issued by the United States Patent and Trademark Office for stationary wheelchair trainers/treadmills/ergometers/dynamometer/simulators issued from 1980 to 2009. [5]

US Patent NumberIssue DateKey Features
4,233,844November 18, 1980introduces variable inertial flywheels to approximate user mass with speed & torque sensors
4,911,425March 27, 1990WAFT (early model) implements independent adjustable wheel resistance
4,966,362October 30, 1990incorporates forward or reverse unidirectional wheel rotation
5,476,429December 19, 1995WAFT (later model) introduces cardio exercise with active electrical controls, DAQ and video gaming interface
5,643,143July 1, 1997implements positioning over two rollers
5,649,883July 22, 1997minimizes rolling resistance for 3 wheeled wheelchair race chairs
5,704,876January 6, 1998implements bicycle trainer eddy current braking resistance and active computer control interface
5,709,631January 20, 1998implements lateral wheel guides to prevent side sway
6,113,519September 5, 2000utilizes electrically controlled resistance and camber adjustment for clinical applications
7,604,572October 20, 2009implements horizontal rollers with passive variable inertia & resistance, clinical DAQ and video gaming interface

Development

The last patent is being commercialized under the trademark Trekease, designed to serve as an acronym for Translational & Rotational Equivalent Kinetic Energy Aerobic Stationary Exertainment and as a homonym for Trekkies  – fans of Star Trek. [6] [7] [8] None of the other cited patents, including the experimental prototypes developed by the VA, are currently being commercialized; however simple unidirectional ramp and roller systems similar in design to patent #4,966,362 are being marketed by others. [9] (See also External links).

Arcade game software and clinical data acquisition use were first introduced by the Veterans Administration's WAFT as a means of promoting stationary wheelchair propulsion as a beneficial aerobic exercise. Clinical professionals are not currently in agreement regarding the cardiovascular health benefits associated with manual wheelchair propulsion and the possible long term repetitive use injuries attributed to manual wheelchair operation. [aerobics] These debates have encouraged developments to enhance wheelchair seating, [10] back support, frame, wheel, and hand-rim designs. Innovative lever styled mechanisms add a new level to improve the overall efficiency, posture and ergonomics of manual wheelchair propulsion. [ergonomics] Utilizing lever propulsion technologies on a wheelchair trainer equipped with flywheel and resistance enables one to engage in an activity similar to rowing with all its associated health benefits and risks. [11] [12]

Related Research Articles

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Treadmill Exercise machine

A treadmill is a device generally used for walking, running, or climbing while staying in the same place. Treadmills were introduced before the development of powered machines to harness the power of animals or humans to do work, often a type of mill operated by a person or animal treading the steps of a treadwheel to grind grain. In later times, treadmills were used as punishment devices for people sentenced to hard labor in prisons. The terms treadmill and treadwheel were used interchangeably for the power and punishment mechanisms.

Functional electrical stimulation Technique that uses low-energy electrical pulses

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Stationary bicycle

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Elliptical trainer Stationary exercise machine

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A disability robot is a robot designed to help people who have physical disabilities with daily tasks. The field of expertise that creates such robots is called disabled robotics.

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Mobility assistance dog

A mobility assistance dog or mobility service dog is a dog trained to assist a physically disabled person who has mobility issues, such as poor balance or being a non-ambulatory wheelchair user. Roles include "providing balance and stability" picking up and carrying objects, pulling wheelchairs, opening and closing doors, and operating light switches. Mobility assistance dogs can have significant positive impacts on the lives of their handlers.

Outline of exercise Overview of and topical guide to exercise

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Gait training or gait rehabilitation is the act of learning how to walk, either as a child, or, more frequently, after sustaining an injury or disability. Normal human gait is a complex process, which happens due to co-ordinated movements of the whole of the body, requiring the whole of Central Nervous System - the brain and spinal cord, to function properly. Any disease process affecting the brain, spinal cord, peripheral nerves emerging from them supplying the muscles, or the muscles itself can cause deviations of gait. The process of relearning how to walk is generally facilitated by Physiatrists or Rehabilitation medicine (PM&R) consultants, physical therapists or physiotherapists, along with occupational therapists and other allied specialists. The most common cause for gait impairment is due to an injury of one or both legs. Gait training is not simply re-educating a patient on how to walk, but also includes an initial assessment of their gait cycle - Gait analysis, creation of a plan to address the problem, as well as teaching the patient on how to walk on different surfaces. Assistive devices and splints (orthosis) are often used in gait training, especially with those who have had surgery or an injury on their legs, but also with those who have balance or strength impairments as well.

Wheelchair racing

Wheelchair racing is the racing of wheelchairs in track and road races. Wheelchair racing is open to athletes with any qualifying type of disability, amputees, spinal cord injuries, cerebral palsy and partially sighted. Athletes are classified in accordance with the nature and severity of their disability or combinations of disabilities. Like running, it can take place on a track or as a road race. The main competitions take place at the Summer Paralympics which wheelchair racing and athletics has been a part of since 1960. Competitors compete in specialized wheelchairs which allow the athletes to reach speeds of 30 km/h (18.6 mph) or more. It is one of the most prominent forms of Paralympic athletics.

Wheelchair Chair with wheels used by people with mobility deficiencies

A wheelchair is a chair with wheels, used when walking is difficult or impossible due to illness, injury, problems related to old age, or disability. These can include spinal cord injuries, cerebral palsy, brain injury, osteogenesis imperfecta, motor neurone disease, multiple sclerosis, muscular dystrophy, spina bifida, and more.

A gait trainer is a wheeled device that assists a person who is unable to walk independently to learn or relearn to walk safely and efficiently as part of gait training. Gait trainers are intended for children or adults with physical disabilities, to provide the opportunity to improve walking ability. A gait trainer offers both unweighting support and postural alignment to enable gait practice. It functions as a support walker and provides more assistance for balance and weight-bearing, than does a traditional rollator walker, or a walker with platform attachments. It also provides opportunities to stand and to bear weight in a safe, supported position.

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The Functional Independence Measure (FIM) is an assessment tool that aims to evaluate the functional status of patients throughout the rehabilitation process following a stroke, traumatic brain injury, spinal cord injury or cancer. Its area of use can include skilled nursing facilities and hospitals aimed at acute, sub-acute and rehabilitation care. Performed on admission to and departure from a rehabilitation hospital, it serves as a consistent data collection tool for the comparison of rehabilitation outcomes across the health care continuum. Furthermore, it aims to allow clinicians to track changes in the functional status of patients from the onset of rehab care through discharge and follow-up. The FIM's assessment of degree of disability depends on the patient's score in 18 categories, focusing on motor and cognitive function. Each category or item is rated on a 7-point scale. As such, FIM scores may be interpreted to indicate level of independence or level of burden of care. The scale is used to assess how well a person can carry out basic activities of daily living and thus how dependent he or she will be on help from others. Other areas assessed include the physical like how well patients move and walk, and the cognitive, how well they interact with others, communicate, and process information. FIM was originally made for people who had had strokes, but is used to assess disability in other cases as well.

The Box and Blocks Test is a functional test used in upper limb rehabilitation. The test is used to measure the gross manual dexterity of a patient, or of a person using an upper limb prosthetic device.

Spinal Cord Independence Measure

Outcome measures in rehabilitation medicine are tools used to evaluate the level of disability. They can be beneficial for physicians to judge the path of patient's recovery, for researchers to compare different management protocols and for politicians in order to find the cost-effectiveness of their decisions.

Flywheel training

Flywheel training is a type of strength training where the resistance required for muscle activation is generated by the inertia of a flywheel instead of gravity from weights as in traditional weight training.

References

  1. ↑ Stanford 2006.
  2. ↑ Langbein & Fehr 1993.
  3. ↑ "WAFT – Wheelchair Aerobic Fitness Trainer". Janus Development. Retrieved August 22, 2011.
  4. ↑ O'Connor et al. 2002.
  5. ↑ Patents issued by the United States Patent and Trademark Office:
  6. ↑ "Aerobic Exercise For The Wheelchair-Bound". Science Daily. September 15, 2008. Retrieved August 22, 2011.
  7. ↑ The Daily Texan.
  8. ↑ "Research and theory". Trekease. Retrieved August 22, 2011.
  9. ↑ Cooper 2006.
  10. ↑ Kotajarvi et al. 2004.
  11. ↑ McLaurin 2005.
  12. ↑ "Benefits of Rowing". Tacoma, Washington: Foss Rowing. Retrieved August 23, 2011.

Citations

Conferences

Web pages

"University of Texas-Austin adds wheelchair-accessible equipment to gym". The Daily Texan. Retrieved August 22, 2011– via Media dis&dat. Blog entry posted by the University of Texas student newspaper.{{cite web}}: CS1 maint: postscript (link)

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