Ref 15: Biomechanics of Manual

Wheelchair Propulsion in Elderly

Introduction
[1]
850.000 Of America's population are Disable people who use wheel chair and their age
higher than 65yr[ CITATION Red93 \l 1033 ]
[2], [3]
This number is large with comparison to population and need attention, the standard
dimension of wheel chair cause problem for older people in Nursing home who represent
58% of disable people [ CITATION Sha91 \l 1033 ]
The last research in capability of wheel chair is to apply tilt and back recline angles
system which helps nonambulatory and disable people to prevent sliding so this paper is
to study the effect of this system in wheel chair propulsion cycle
[4]
After two days of follow-up the nursing house and disable people there, the percent of
disable people who have capability to wheel chair propelling is to low (4%)
[5]
The main cause for inability to propel the wheel chair is related to disable people
Weakness muscle such as shoulder joint with range (33% -57%) And wrist joint with
range (49%-73%)
[6]
By resonance imaging the edema and thickening take place in coracoacromial ligament
due to force acting on it
[7], [8][ CITATION Red93 \l 1033 ]
Several research about the force done in coracoacromial ligament recently but still no
enough information about causes of edema
[9], [10]
Physiologic test such as oxygen uptake almost done in specific situation such as after 4
min of propel in constant speed but it’s not available for many older people
[11]
The effective factor of performance with respect to Main wheels is the mass of disable
people which affect in speed control and so on.
[12-15]
In the past, many research’s Consisted the effectiveness of seat position in biomechanics
of wheel chair
[16]
Authors found that the lowest high of seat and backward with respect to the wheel axle
give more advantage for disable people in propel the chair (more forward the axle more
better propulsion)

Methods:
[12]
To investigate the effect of tilt and back recline system, fourteen older people chosen for
this task with age range (64-77), sample must apply specific condition all procedure for
experiment approved by Institute University
Three angle was applied in seat to back rest (95,100,105) and three system tilt angle to
test (0,5,10) also Rare wheel at zero degree radius for rare wheel and hand rim wheel are
repressively( 0.267,0.305)m
The wheel axle is horizontal with respect to acromion which making easy to elbow
movement in angle (110-120) degree
[17]
Tilt and back recline was done at speed between (0.96-1.01)m/s, Using SMART wheel
instrumentation is used just for roller cylinder without motor so the friction force is
(14±4) and power dissipated is (22.4±1.1) W. analysis done in 10 m long and rest period
is 4 min
Pushrim force and any data needed in this test collected using SMART wheel instrument
[18-20]
Using rectangular coordinate system to represent different force which affect in disable
people where X-axis oriented horizontal but Y-axis vertical and Z axis outward so the
resultant force is sum of these component
[19]
The best defining of Mechanical friction of effective force (MEF) represent the relation
between hub torques and radius of hand rim which is normal to resultant force
[21]
Represent factor which is called physical functioning measures (MVF) whish measure
when wheel chair elevated 5cm from the ground to study the relation between hand rim
and rear wheel
[15]
Mechanical use factor is the ratio between resultant force and MVF, Biomechanical
efficiency (BMF) is equal MVF×MU

Result:
This paper is to express new system for disable people which is called tilt and back recline in
order to facilitate the propulsion of wheel chair, to test this system, sample of older people using
in specified condition the best result for system according to elbow angel is 112.5 degrees in all
factor used no interaction between tilt angle and back angle
The result represent in table below depends on parameter use:

Factor Tilt angle Back angle

MEF Significant effect No effect

MU No effect Significant effect

Linear velocity Significant effect No effect

BMF Significant effect No effect

REFRENCES:

[1] Redford JB: Seating and wheeled mobility

In the disabled elderly population.
Arch Phys Med Rehabil 1993; 74:877–85
[2] Shaw G, Taylor S: A survey of wheelchair
seating problems of the institutionalized
elderly. Assist Technol 1991;3:5–10
[3]. Perks BA, Macintosh R, Stewart CPU,
et al: A survey of marginal wheelchair
users. J Rehabil Res Dev 1994;31:297–302
[4]. Simmons SF, Schnelle JF, MacRae PG,
et al: Wheelchairs as mobility restraints:
Predictors of wheelchair activity in
nonambulatory nursing home residents.
J Am Geriatr Soc 1995;43:384–8
[5]. Boninger ML, Cooper RA: Repetitive
strain injuries in manual wheelchair users,
in van der Woude LHV, Hopman MTE, van
Kemenade CH (eds): Biomedical Aspects of
Manual Wheelchair Propulsion: The State
of the ART II. Amsterdam, IOS Press, 1999,
vol 5, pp 115–20
[6]. Koontz AM, Boninger ML, Towers J, et
al: Propulsion Forces and MRI Evidence
of Shoulder Impairment. Proceedings of
the North American Congress on Biomechanics,
Waterloo, Canada, August 14–
18, 1998
[7]. Cooper RA: Engineering manual and
electric powered wheelchairs. Crit Rev
Biomed Eng 1999;27:27–73
[8]. Sawka MN, Glaser RM, Laubach LL, et
al: Wheelchair exercise performance of
the young, middle-aged, and elderly.
J Appl Physiol 1981;50:824–8
[9]. Hunter J: Energy cost of wheelchair
propulsion by elderly and disabled people.
Int J Rehabil Res 1987;10(suppl 5):50–4
[10]. Mattison PG, Hunter J, Spence S: Development
of a realistic method to assess
wheelchair propulsion by disabled people.
Int J Rehabil Research 1989;12:137–45
[11]. Brubaker CE: Wheelchair prescription:
An analysis of factors that affect mobility
and performance. J Rehabil Res Dev 1986;
23:19–26
[12]. van der Woude LHV, Veeger H, Rozendal
RH: Seat height in hand rim
wheelchair propulsion: A follow-up study.
J Rehabil Sci 1990;3:79–83
[13]. Hughes CJ, Weimar WH, Sheth PN,
et al: Biomechanics of wheelchair propulsion
as a function of seat position and
user-to-chair interface. Arch Phys Med
Rehabil 1992;73:263–9
[14]. Maˆsse LC, Lamontagne M, O’Riain
MD: Biomechanical analysis of wheelchair
propulsion for various seating positions.
J Rehabil Res Dev 1992;29:12–8