Wheelchair trainer

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.

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

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:
   • 4,233,844
   • 4,911,425
   • 4,966,362
   • 5,476,429
   • 5,643,143
   • 5,649,883
   • 5,704,876
   • 5,709,631
   • 6,113,519
   • 7,604,572
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.

Dynamics: Kwarciak et al. 2009. Koontz et al. 2007. Gil-Agudo et al. 2010. Sasaki et al. 2008. Cooper et al. 1997. Lemaire et al. 1991. Aerobics: Cerny et al. 1980. Beekman, Miller-Porter & Schoneberger 1999. Shivayogi Hiremath Keyser et al. 2003. Morrow et al. 2009. Keyser, Rodgers & Rasch 2001. Cooper, Boninger & Robertson 1998.

Ergonomics: "Global Research Innovation and Technology". GRIT. Retrieved 16 October 2014. Wheeled Mobility 1999. Requejo et al. 2008. McLaurin 2005. "About the Wijit". Innovations Health. Retrieved 17 October 2014. "Pivot™ Dual Lever Drive". RIO Mobility. Retrieved 17 October 2014.

Citations

• Beekman, Claire E.; Miller-Porter, Leslie; Schoneberger, Marion (1999). "Energy Cost of Propulsion in Standard and Ultralight Wheelchairs in People With Spinal Cord Injuries". Phys. Ther. 79: 146–158. Retrieved October 15, 2014.
• Cerny, Kay; Waters, Robert; Hislop, Helen; Perry, Jacquelin (1980). "Walking and Wheelchair Energetics in Persons with Paraplegia". Phys. Ther. 60: 1133–1139. Retrieved October 15, 2014.
• Cooper, Rory A.; Boninger, Michael L.; Robertson, Rick N. (February 1998). "Heavy handed: Repetitive Strain Injury Among Manual Wheelchair Users" (PDF). TeamRehab Reports: 36–36, 38. Retrieved 16 October 2014 – via wheelchairnet.org.
• Cooper, Rory (May 30, 2006). New Exercise Equipment Engineering & Design: GameCycle & GameWheels (PDF). Rectech conference. Retrieved August 23, 2011.
• Cooper, Rory A.; Robertson, Rick N.; VanSickle, David P.; Boninger, Michael L.; Shimada, Sean D. (1997). "Methods for determining three-dimensional wheelchair pushrim forces and moments: A technical note" (PDF). JRRD 34 (2): 162–170. ISSN 0748-7711. Retrieved August 23, 2011.
• Gil-Agudo, A.; Del Ama-Espinosa, A.; Pérez-Rizo, E.; Pérez-Nombela, S.; Crespo-Ruiz, B. (2010). "Shoulder joint kinetics during wheelchair propulsion on a treadmill at two different speeds in spinal cord injury patients". Spinal Cord 48 (4): 290–296. doi:10.1038/sc.2009.126. ISSN 1362-4393. PMID 19773798. Retrieved August 24, 2011. (subscription required (help)).
• Keyser, Randall E.; Rasch, Elizabeth K.; Finley, Margaret; Rodgers, Mary M. (2003). "Improved upper-body endurance following a 12-week home exercise program for manual wheelchair users" (PDF). JRRD 40 (6): 501–510. doi:10.1682/JRRD.2003.11.0501. ISSN 0748-7711. Retrieved August 23, 2011.
• Keyser, Randall E.; Rodgers, Mary M.; Rasch, Elizabeth R. (2001). "Reliability of cardiorespiratory measurements during wheelchair ergometry". JRRD 38 (4). ISSN 0748-7711. Retrieved August 23, 2011.
• Koontz, Alicia M.; Yang, Yusheng; Price, Robert; Tolerico, Michelle L.; DiGiovine, Carmen P.; Sisto, Sue Ann; Cooper, Rory A.; Boninger, Michael L. (2007). "Multisite comparison of wheelchair propulsion kinetics in persons with paraplegia". JRRD 44 (3): 449–458. doi:10.1682/JRRD.2006.05.0048. ISSN 0748-7711. Retrieved August 23, 2011.
• Kotajarvi, Brian R.; Sabick, Michelle B.; An, Kai-Nan; Zhao, Kristin D.; Kaufman, Kenton R.; Basford, Jeffrey R. (2004). "The effect of seat position on wheelchair propulsion biomechanics" (PDF). JRRD 41 (3B): 403–414. doi:10.1682/JRRD.2003.01.0008. ISSN 0748-7711. Retrieved August 23, 2011.
• Kwarciak, Andrew M.; Yarossi, Mathew; Ramanujam, Arvind; Dyson-Hudson, Trevor A.; Sisto, Sue Ann (2009). "Evaluation of wheelchair tire rolling resistance using dynamometer-based coast-down tests" (PDF). JRRD 46 (7): 931–938. doi:10.1682/JRRD.2008.10.0137. ISSN 0748-7711. Retrieved August 23, 2011.
• Langbein, W. Edwin; Fehr, Linda (1993). "Research Device to Preproduction Prototype: A Chronology" (PDF). JRRD 30 (4): 436–442. ISSN 0748-7711. Retrieved August 22, 2011.
• Lemaire, Edward D.; Lamontagne, Mario; Barclay, Hugh W.; John, Thomas; Martel, Guy (1991). "A technique for the determination of center of gravity and rolling resistance for tilt-seat wheelchairs" (PDF). JRRD 28 (3): 51–58. doi:10.1682/JRRD.1991.07.0051. ISSN 0748-7711. Retrieved August 23, 2011.
• McLaurin, Colin A. (2005). "Current Directions in Wheelchair Research" (PDF). JRRD. Clinical Supplement #2: 88–99. ISSN 0748-7711. Retrieved August 23, 2011.
• Morrow, Melissa M. B.; Hurd, Wendy J.; Kaufman, Kenton R.; An, Kai-Nan (2009). "Upper-limb joint kinetics expression during wheelchair propulsion". JRRD 46 (7): 939–944. doi:10.1682/JRRD.2008.12.0165. ISSN 0748-7711. Retrieved August 23, 2011.
• O'Connor, Thomas; Fitzgerald, Shirley G.; Cooper, Rory A.; Thorman, Tricia A.; Boninger, Michael L. (2002). "Kinetic and physiological analysis of the GameWheels system". JRRD 39 (6): 627–634. ISSN 0748-7711. Retrieved August 22, 2011.
• Requejo, P. S.; Lee, S. E.; Mulroy, S. J.; Haubert, L. L.; Bontrager, E. L.; Gronley, J. K.; Perry, J. (2008). "Shoulder Muscular Demand During Lever-Activated Vs Pushrim Wheelchair Propulsion in Persons With Spinal Cord Injury". Journal of Spinal Cord Medicine 31 (5): 568–77. PMC 2607130. PMID 19086715.
• Sasaki, Makoto; Kimura, Takumi; Matsuo, Kiyomi; Obinata, Goro; Iwami, Takehiro; Miyawaki, Kazuto; Kiguchi, Kazuo (2008). "Simulator for Optimal Wheelchair Design". J Robot Mechatron 20 (6): 854–862. ISSN 0915-3934. Retrieved August 22, 2011. (subscription required (help)), preview: first two pages.
• Stanford, Christopher (May 30, 2006). Current Strategies for Wheelchair Design (PDF). Rectech conference. Retrieved August 23, 2011.

Conferences

• Conference presentations. RERC Rectech State of the Science Conference on Exercise and Recreational Technologies for People with Disabilities. Denver, Colorado. May 30, 2006. Retrieved August 23, 2011.
• Discussion Preparation for: Manual Wheelchair Propulsion (PDF). The Stakeholders Forum: Wheeled Mobility. Pittsburgh, PA: Rehabilitation Engineering Research Center on Technology Transfer. May 26, 1999. Retrieved October 17, 2014 – via wheelchairnet.org.

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.

External links

• Typical US made ramp and roller wheelchair trainer with frictional resistance and without directionality
• British made low profile ramp & roller trainer with frictional resistance and without directionality
• High end motorized French made research wheelchair trainer/ergometer with directionality and camber adjustment