For individuals who rely on wheeled mobility devices (WMD), performing transfers is essential to independence with activities of daily living at home and participation in the community. Transfers are required for getting to and from the device to bed, bath tub, car seat, among others. The United States Access Board develops guidelines and maintains design criteria for the built environment to maximize accessibility to public places. The objective of this study was to analyze the impact of transfer setup on performance of independent transfers. The first aim of the study was to perform an expert review of the current knowledge regarding transfers and the impact of setup. Results showed a consensus among studies that transferring to a higher surface implies greater exertion of the upper limb. Yet, there is no evidence concerning height differences, horizontal distance, and space needed next to the target surface so it can be accessible by a majority of WMD users. The second aim was to compare the current guidelines for amusement park rides with the results obtained by evaluating the impact of setup on transfer performance using a custom-built transfer station. We evaluated community-dwelling WMD users who were able to transfer independently and who represented a broad spectrum of disabilities. We evaluated the impact of height differential, gap, placement of a non removable armrest, and the effect of a grab bar. Results showed that height differentials above and below WMD height, gaps and obstacles pose serious transfer-related accessibility problems for WMD users. Current guidelines for amusement park rides fall short in terms of height recommendations and space available for the WMD and could exclude up to 72% of our sample. The third aim was to evaluate the relationship between functional performance (i.e. upper limb strength and trunk control) and transfer ability in people with spinal cord injury. Results found that trunk stability and gender are significant predictors of transfer ability. Rehabilitation plans should include balance training and core strengthening in addition to upper limb conditioning when teaching transfer skills. Improving transfer ability has the potential to increase community participation and independence among WMD users.

This thesis is composed of two studies related to wheelchair propulsion biomechanics. The first study investigated the impact of cross-slope and surface roughness on wheelchair propulsion. Fifteen manual wheelchair users propelled across a five-meter platform which were set to level, 1°, or 2° cross slope, and attached with one of three surfaces including Teflon (slippery), wood (normal), and blind guide (rough). The study found main effects of both cross slope and surface roughness on stroke number and sum of work, and a main effect of cross slope on velocity. Subjects travelled slower, used more strokes, and expended more work with increasing cross slope. Subjects also used more strokes when propelling on the slippery and rough surfaces than on the level surface. They expended more work when propelling on the rough surface than on the level surface. When looking into bilateral propulsion parameters, we found that peak resultant force, peak wheel torque, and sum of work became significantly asymmetrical with the increase of cross slopes. Exposure to biomechanics loading can be reduced by avoiding slippery, rough, and cross slopes when possible. The second study consisted of a preliminary analysis on the validity of a wheelchair propulsion monitor (WPM) in estimating wheelchair propulsion biomechanics. The WPM integrates three devices including a wheel rotation datalogger, and an accelerometry-based device on the upper arm and underneath the wheelchair seat, respectively. Five wheelchair users were asked to push their own wheelchairs fitted with a SMARTWheel over level and sloped surfaces on two separate visits. The estimated stroke number and cadence by the WPM were consistent with the criterion measures by the SMARTWheel (ICC= 0.99 for stroke number, ICC=0.97 for cadence) with less than 5% absolute percentage errors for stroke number and 9% for cadence. The peak resultant force and wheel torque could be predicted to some extent by acceleration features on an individual subject basis. The study demonstrated the potential of the WPM in tracking wheelchair propulsion characteristics in the natural environment of wheelchair users.

This thesis describes the history of the Endeavor folding wheelchair. In its current incarnation, it is an adjustable folding manual wheelchair conceptually based on a diamond shaped truss (similar to a bicycle). By disconnecting this truss at two points, the chair is able to fold flat enough to fit in the overhead bin of an airplane. It also features "airplane wheels" for maneuvering down the aisle of an airplane, taking the place of a boarding chair. The main part of the study was a clinical trial to gain feedback on the current chair design. The first phase of the study involved users performing obstacles encountered on a daily basis using the Endeavor and their personal chair. In the second phase, users took the chair home to see how the chair would function in their everyday lives. Because participants were comparing the Endeavor to their personal chairs, much of the feedback received was based primarily on the differences between the geometry and options of the Endeavor and their personal chairs. Based on the clinical results, the most important features that the Endeavor is lacking are: a more forgiving seatpan, and a more effective range of adjustability. In the future, a more organized approach based on product development methods should be used to develop better design criteria. The results of this study showed that in its current form, the Endeavor folding wheelchair may best be a special-purpose chair. By addressing all of the safety concerns, improving the ranges of adjustability to match the dimensions of the users in our focus group, and adding usability related options the chair may be able to function as an everyday wheelchair for many users. When our take-home participants were asked if they would like their chair better if they had "airplane wheels" five of the nine agreed. With some redesign to increase ease of use and decrease weight they could be marketed as their own product.

Previous literature has shown that depression is the most common major emotional result following a stroke. Although the prevalence and severity of this issue have been well documented, limited research has been done to identify the evolution of post-stroke depressive symptoms in the acute phase following a stroke. During this period of time, the patient is faced with a number of significant changes from his / her previous level of functioning. These issues can include loss of physical functioning, loss of independence, changes in living arrangements, and an increased reliance on the support and care of others. The purpose of the current study was to examine fluctuations in depressive symptoms as each participant progressed through rehabilitation and discharge, and to gather qualitative information pertaining to the contributing factors that could play a role in this issue. A sample of nine participants between the ages of 50 and 85 was obtained from a regional rehabilitation unit. Data and clinical information were collected using an intensive case study design. Participants were asked to complete the Geriatric Depression Scale (GDS) at three-day intervals while on the rehabilitation unit and following discharge. This information was interpreted in the context of qualitative information gathered through reports from the participant, his or her significant other / family member, nursing and professional staff members on the rehabilitation unit, and patient records. Other analyses performed included an examination of the interactions between performance and motivation during the rehabilitation process and role of discharge site in the development and course of depressive symptoms. When examined as a whole, the information collected across all nine participants would suggest that following discharge there was a statistically significant increase in the level of post-stroke depressive symptoms. While the individuals were on the rehabilitation unit, the depressive symptoms decreased significantly and this trend continued following discharge, but the slope was not as significant as that which was observed on the rehabilitation unit. The results also suggested that there is a significant difference between the progression of depressive symptoms between groups separated based on discharge site.

Thesis (D.P.T.Sc.)--University of California, San Francisco, 2009. / Source: Dissertation Abstracts International, Volume: 70-06, Section: B, page: 3470. Adviser: Sandra Radtka.

Thesis (M.A. in Security Studies (Middle East, South Asia, Sub-Saharan Africa))--Naval Postgraduate School, December 2009. / Thesis Advisor(s): Hafez, Mohammad ; Russell, James. "December 2009." Description based on title screen as viewed on January 27, 2010. Author(s) subject terms: Deradicalization, Indonesia, Rehabilitation, Saudi Arabia, Singapore, Yemen. Includes bibliographical references (p. 65-68). Also available in print.

Thesis (doctoral)--Universität, Oldenburg, 2001.

Thesis (doctoral)--Universität, Heidelberg, 2002.

Thesis--PlanB (M.S.)--University of Wisconsin--Stout, 2000. / Includes bibliographical references.

Thesis (Ph.D.)--New York University, 1998. / Source: Dissertation Abstracts International, Volume: 00-00, Section: B, page: 0000. Chairperson: Jim Hinojosa.