The objective of this study was to conduct a kinetic analysis of manual wheelchair propulsion during start-up on select indoor and outdoor surfaces.

Objective: Novel developments in the robotics field have produced systems that can support person wheelchair transfers, maximize safety and reduce caregiver burden. The purpose of this study was to identify and describe these systems, their usability (or satisfaction), the context for which they have been or can be used and how they have been evaluated to determine evidence for their effectiveness. Method: Available research on Person Transfer Assist Systems (PTAS) was systematically gathered using similar standards to the PRISMA guidelines. The search terms were derived from common terms and via exploring similar review articles. Initial search terms displayed 1330 articles and by using the inclusion/exclusion criteria 96 articles were selected for abstract review. After full- text reviewing 48 articles were included. Results: 29 articles concerned research in robotic transfer systems, 10 articles used both ceiling and floor-mounted lifts and 9 articles used only floor-mounted lifts as an intervention/control group. The results of this analysis identified a few usability evaluations for robotic transfer prototypes, especially ones comparing prototypes to existing marketed devices. Conclusion: Robotic device research is a recent development within assistive technology. Whilst usability evaluations provided evidence that a robotic device will provide better service to the user, the sample number of subjects used are minimal in comparison to any of the intervention/control group articles. Experimental studies between PTASs are required to support technological advancements. Caregiver injury risk has been the focus for most of the comparison articles; however, few articles focus on the implications to the person.

Background. The objective of this study was to examine how surface electrical stimulation of trunk musculature influences the kinematic, kinetic, and metabolic characteristics, as well as shoulder muscle activity, during wheelchair propulsion. Methods. Eleven participants with spinal cord injury propelled their own wheelchairs on a dynamometer at a speed of 1.3 m/s for three 5-minute trials. During a propulsion trial, 1 of 3 stimulation levels (HIGH, LOW, and OFF) was randomly applied to the participant’s abdominal and back muscle groups with a surface functional electrical stimulation device. Propulsion kinetics, trunk kinematics, metabolic responses, and surface electromyographic (EMG) activity of 6 shoulder muscles were collected synchronously. Kinetic, kinematic, and EMG variables were recorded during 3 time intervals (30 seconds each) within a 5-minute trial. Metabolic variables were recorded through the entire 5-minute trial. Results. Participants with HIGH stimulation increased their gross mechanical efficiency (P = .05) during wheelchair propulsion. No differences were found in shoulder EMG activity, energy expenditure, and trunk motion between stimulation levels. Conclusion. Functional electrical stimulation on the trunk musculature has potential advantages in helping manual wheelchair users with spinal cord injury improve propulsion efficiency without placing additional demands on shoulder musculature.