Debilitating shoulder pain is prevalent among wheelchair users, however the causes remain unknown. Shoulder pain is reported to be greater among those who began wheeling after skeletal maturity (adulthood-onset, AO) than among those who began wheeling prior to skeletal maturity (childhood-onset, CO). It is unclear whether functional load-bearing from manual wheelchair use affects glenohumeral bone and cartilage morphology. Bone is known to adapt to loading, however the literature is conflicting regarding cartilage’s capacity to adapt to loading. We performed a pilot study to quantify bone and cartilage morphology at the glenohumeral joint of manual wheelchair users (nCO=3, nAO=5) and age- and gender-matched able-bodied controls (nC=8). Bone morphology (volumetric bone mineral density (vBMD) and normalized cross-sectional area (nCSA)) was evaluated using quantitative computed tomography. Bone density distribution was assessed across the glenoid and, for the first time, across the humeral head using a novel quantitative CT-Osteoabsorptiometry method. Cartilage morphology (thickness, volume, and surface area) was evaluated using quantitative magnetic resonance imaging, in the first assessment at 3T MRI. This novel combination of methods provides complementary quantitative data of glenohumeral bone and cartilage morphology. Compared to the AO, the CO in our study had significantly higher (p<0.05) glenoid subchondral nCSA, non-significantly lower glenoid subchondral vBMD, and non-significantly higher humeral head and glenoid trabecular vBMD. A reasonable cross-sectional study (n=22) would likely show higher humeral head and glenoid trabecular vBMD and glenoid subchondral nCSA in CO subjects but would not find differences in nCSA of humeral head total, trabecular, and cortical bone, or glenoid trabecular bone. Surprisingly, vBMD was (non-significantly) lower in the wheelchair users than in the able-bodied controls, however activity levels varied considerably. Significant correlations were found between humeral head and glenoid trabecular vBMD (r=0.94), and between humeral head trabecular vBMD and physical activity scores (r=0.84). Given the small effect sizes and the large variance in humeral head and glenoid cartilage thickness, volume, and surface area, it is not likely that further study of these parameters would provide insight into wheelchair users’ shoulder pain. Gaining a better understanding of how glenohumeral bone and cartilage respond to wheelchair use would allow for rehabilitation programs and wheelchair-design to be tailored to childhood-onset and adulthood-onset wheelchair users.

Debilitating shoulder pain is prevalent among wheelchair users, however the causes remain unknown. Shoulder pain is reported to be greater among those who began wheeling after skeletal maturity (adulthood-onset, AO) than among those who began wheeling prior to skeletal maturity (childhood-onset, CO). It is unclear whether functional load-bearing from manual wheelchair use affects glenohumeral bone and cartilage morphology. Bone is known to adapt to loading, however the literature is conflicting regarding cartilages capacity to adapt to loading. We performed a pilot study to quantify bone and cartilage morphology at the glenohumeral joint of manual wheelchair users (nCO=3, nAO=5) and age- and gender-matched able-bodied controls (nC=8). Bone morphology (volumetric bone mineral density (vBMD) and normalized cross-sectional area (nCSA)) was evaluated using quantitative computed tomography. Bone density distribution was assessed across the glenoid and, for the first time, across the humeral head using a novel quantitative CT-Osteoabsorptiometry method. Cartilage morphology (thickness, volume, and surface area) was evaluated using quantitative magnetic resonance imaging, in the first assessment at 3T MRI. This novel combination of methods provides complementary quantitative data of glenohumeral bone and cartilage morphology. Compared to the AO, the CO in our study had significantly higher (p<0.05) glenoid subchondral nCSA, non-significantly lower glenoid subchondral vBMD, and non-significantly higher humeral head and glenoid trabecular vBMD. A reasonable cross-sectional study (n=22) would likely show higher humeral head and glenoid trabecular vBMD and glenoid subchondral nCSA in CO subjects but would not find differences in nCSA of humeral head total, trabecular, and cortical bone, or glenoid trabecular bone. Surprisingly, vBMD was (non-significantly) lower in the wheelchair users than in the able-bodied controls, however activity levels varied considerably. Significant correlations were found between humeral head and glenoid trabecular vBMD (r=0.94), and between humeral head trabecular vBMD and physical activity scores (r=0.84). Given the small effect sizes and the large variance in humeral head and glenoid cartilage thickness, volume, and surface area, it is not likely that further study of these parameters would provide insight into wheelchair users shoulder pain. Gaining a better understanding of how glenohumeral bone and cartilage respond to wheelchair use would allow for rehabilitation programs and wheelchair-design to be tailored to childhood-onset and adulthood-onset wheelchair users.

Current survey has showed that people with disability need equal work opportunity. Meanwhile, labor shortage is becoming more and more serious in existing manufacturing industry and there is less physical work involved in CNC machine operation. Thus it is a good opportunity for people with disability to work in manufacturing industry as CNC operators. In the preliminary research, observation, interview and domain research were conducted to understand activates of FVMC (Fadal Vertical Machining Center is a type of CNC machine) operators. Researchers found the existing FVMC are very inconvenient to use, because most of them were designed for the general public. Operator's performance was restricted by the poor design of the machines and the work area. As a result, many people, especially wheel chair users have found limited employment opportunities in the manufacturing industry. To address this problem, on one hand, we presented a study on the current FVMC. A Full size FVMC was mocked up and 9 wheelchair users and 6 able-body users participated in this study. They were asked to mimic to finish the tasks relate to FVMC operation. This study also aims at collecting data for universal FVMC design. On the other hand, based on the preliminary research two concept of FVMC design scenarios are also developed and evaluated by two groups of subjects. This study addressed limitations of wheelchair users with respect to CNC operation, especially reaching issues, and collected data about the preferred FVMC settings and design from wheelchair users and able-bodied people. At the end, design guidelines were developed for machine engineers or designers in two aspects: 1) improve currently available FVMC; 2) redesign FVMC that is safer and easier to use. These guidelines will increase the potential of employing wheelchair users alongside able-bodied people in the manufacturing industry.

Diploma thesis deals with design of electric wheelchair. Final product is standing on the bases from the designer and technical analysis. The main goal is to create electric wheelchair with a charakteristic appearance, that will respect user health condition and ergonomic and technical parameters as well.

Title: Bodyweight training in individuals with spinal cord injuries and the possibilities in usage of outdoor gyms in Prague Objectives: The aim of this diploma thesis was to compile a methodical series of bodyweight exercises suitable for people after spinal cord injury. It was also found out which of the Prague outdoor gyms are suitable for performing exercises from this methodical series and thus also for people using a wheelchair. Methods: The method of theoretical-critical analysis was used to compile the methodical series. Theoretical knowledge was applied in the selection and description of exercises. The methodical series is divided into groups of pulling and pushing exercises. Each of them contains descriptions of exercises, their modifications and photographs. Outdoor gyms was deliberately selected for research and quantitatively evaluated in the table. Selected outdoor gyms evaluated as suitable were qualitatively commented and supplemented with photographs. Results: The methodical series contains 12 exercises and photographs. In the description of the exercises, attention is paid to the key points in the implementation, the possibility of regression and progression of the exercise and the goal of the exercise. After the analysis of 39 Prague outdoor gyms, 12 suitable outdoor gyms were...

Master's thesis topic: Effects of the training with the krankcycle on wheelchair users Author: Bc. Ondřej Doubrava Branch of study: Physiotherapy Disertation Tutor: Mgr. Rostislav Čichoň, Ph.D. Year of Defense: 2014 This work was focused on training and strengthening of wheelchair users as a prevention of their health problems, a regulation of wrong physical and physiological mechanisms and an increase their fitness and motional skills. In this training the new instrument designed to strengthen the upper extremity and to improve the function of the cardiorespiratory system was used. This device is called krankcycle and its popularity has increased dramatically especially in the recent years. Therefore it became the main purpose of this work to determine whether completing a 12-week continuous training with krankcycle will lead to changes in monitored parameters evaluating physiological, physical and motional skills of subjects and thus identify the true value of its use. At the same time, we wanted to verify previously confirmed advantages and effectiveness of this exercise especifically for wheelchair users and reveal the krankcycle to them and the wider public as well. Values of body composition were measured in the biomedical laboratory of the UK FTVS by caliperation of four skinfolds method on...

To measure physical activity in a wheelchair user is important. Disabled people have been found to be less active and it has negative health implications. By relating to ones own physical activity in concrete form it is easier to reinforce a positive attitude towards being physically active. The aim of this thesis is to show how a system can be built, that is able to collect measurements from sensors, with usability in mind. The system consists of software that integrates an iPhone, Apple Watch and a Tacx rotation sensor mounted on a wheelchair. With the help of a physics model these measurements can estimate energy expenditure of a wheelchair user. The system was tested with four participants performing subjectively decided low, moderate and vigorous physical activity while the system collected data. In terms of absolute energy expenditure the system was inaccurate. On the other hand, correlations were found between the calculated energy expenditures and physical activity. Using measurements from the rotations sensor a correlation of 0.7315 was found between the calculated energy expenditure and physical activity, a correlation of 0.5385 using measurements from the GPS and a correlation of 0.6452 using measurements from Apples own proprietary algorithm. The created system is a promising prototype towards objective measurement of physical activity in wheelchair users.

Introduction : Bien que les bienfaits de l’Activité Physique (AP) soient largement reconnus, les Utilisateurs de Fauteuil roulant Manuel Pédiatriques (UFMP) ne respectent pas les recommandations canadiennes en matière d’AP quotidienne. Les cours d’Éducation Physique (ÉP) offrent une opportunité d’accroître leur niveau d’AP. Cependant, de nombreux enseignants d’ÉP au Québec ne sont pas familiers avec les habiletés en fauteuil roulant manuel et ne se sentent pas suffisamment préparés pour adapter leurs cours d’ÉP aux besoins des UFMP. Afin de combler cette lacune, ce mémoire de maîtrise vise à identifier les habiletés en fauteuil roulant manuel qui sont utiles à la participation des UFMP aux cours d'ÉP, ainsi que les facteurs contextuels influençant leur participation à ces cours. Méthodes : Une approche qualitative descriptive a été utilisée. Les méthodes d’échantillonnage par convenance et par boule de neige ont été utilisées pour recruter 7 enseignants d’ÉP et 5 UFMP. Des entretiens individuels semi-structurés et un groupe de discussion en ligne ont été menés respectivement avec les 7 enseignants d’ÉP et les 5 UFMP. Les données ont été analysées à l’aide de statistiques descriptives et d’une analyse thématique déductive basée sur le cadre conceptuel de la Classification Internationale, du Fonctionnement, du handicap et de la Santé (CIF). L'accent a été mis spécifiquement sur les composantes : "Activités", "facteurs liés à l’environnement social", et "facteurs liés à l’environnement physique et instrumental". Résultats : Plusieurs habiletés (activités selon la CIF) permettant de se déplacer à l’intérieur et quelques habiletés permettant de se déplacer dans la communauté ont été identifiées comme utiles pour favoriser la participation des UFMP aux cours d'ÉP. Plusieurs stratégies d'adaptation ont été mises en place par les enseignants d'ÉP pour promouvoir l'inclusion et la participation des UFMP aux cours d'ÉP. Cependant, la faible acquisition de ces habiletés par les UFMP et leur faible intégration par les enseignants dans les cours d'ÉP constituent des obstacles à la participation des UFMP aux AP. Conclusion : Il est essentiel de développer un programme d’entraînement basé sur les habiletés en fauteuil roulant manuel identifiées comme étant utiles afin de doter les enseignants des compétences nécessaires pour l'intégration efficace des UFMP dans les cours d'ÉP. / Introduction: Despite the benefits of physical activity (PA) being widely recognized, Pediatric Manual Wheelchair Users (PMWUs) do not adhere to Canadian recommendations for daily PA. Physical Education (PE) classes provide opportunities for developing skills and knowledge required for PA participation in children. However, many PE teachers in Quebec do not have the knowledge about the wheelchair skills necessary to facilitate participation of PMWUs in PE. To address this gap, this master's thesis aimed to identify manual wheelchair skills that are useful for the participation of PMWUs in PE classes, while also examining the contextual factors that influence their participation in these classes. Methods: A qualitative descriptive approach was used. Convenience and snowball sampling methods were used to recruit seven PE teachers and five PMWUs. Online individual semi-structured interviews and an online focus group were conducted with seven PE teachers and five PMWUs, respectively. Data were analyzed using descriptive statistics and a deductive thematic analysis based on the International Classification of Functioning, Disability and Health (ICF) framework. The focus was specifically on the components: "activities", "social environmental factors», and "physical and instrumental environmental factors". Results: Several manual skills for moving indoors and some skills for moving within the community were identified as useful to promote the participation of PMWUs in PE classes. Various adaptation strategies were implemented by PE teachers to enhance the inclusion and participation of PMWUs in PE classes. However, the limited acquisition of these skills by PMWUs and their inadequate integration by teachers into PE classes represent significant barriers to the participation of PMWUs in PE classes. Conclusion: It is essential to develop a training program for PE teachers, based on the manual wheelchair skills identified as useful in order to equip them with the necessary competencies for effective integration of PMWUs into PE classes.