Individuals who use wheelchairs or who have other mobility challenges often are unable to access modern mobility systems "“ including application-based ride hailing and on-demand microtransit. Even designing a system targeted at these users is challenging, given the limited prior analysis of their travel behavior and activity patterns. Simulation tools are used by cities around the world to understand novel and complex transportation systems, yet few are including the needs of users with disabilities in these simulation studies. This thesis examines the travel patterns of wheelchair users from the 2017 National Household Travel Survey and presents a model of daily activity pattern choice of respondents who self-identify as using a wheelchair. This thesis discusses the application of a wheelchair status variable in the activity-based travel demand model ActivitySim and measures its effect on individual and household daily activity pattern choice. Wheelchair use is estimated to reduce the utility of a work daily activity pattern by 1.9 points relative to a home pattern for full time workers and 3.4 for part time workers. Including the effect of wheelchair use in a regional daily activity pattern model resulted in 21.9 percent of wheelchair users changing to a home activity pattern relative to a base scenario not including wheelchair use. Lastly, the thesis evaluates the performance of an on-demand, accessible mode for users with wheelchairs in the agent-based microsimulation BEAM. This simulation showed that demand for such a service increases linearly with fleet size and wait time remains constant, though further scenario refinement and research is necessary.

Orientador: Fausto Orsi Medola / Banca: Luis Carlos Paschoarelli / Banca: Sandro Caramaschi / Resumo: Os objetos de uso diário comunicam algo sobre quem os utiliza e as pessoas tendem naturalmente a associar esses produtos com a personalidade do usuário. Assim como a maioria das Tecnologias Assistivas, em muitos casos a cadeira de rodas manual não possui aparência agradável e tem sido associada a julgamentos negativos com relação a quem os utiliza. Nesse sentido, este estudo, de caráter transversal, tem como objetivo avaliar o julgamento visual de cadeiras de rodas manuais por sujeitos não usuários, com a finalidade de verificar se existe relação entre características do design deste objeto e percepções negativas (estigma) relacionadas a quem o utiliza. Para isso, foram utilizadas fotografias de 6 modelos diferentes de cadeiras, uma cadeira comum de madeira e 5 cadeiras de rodas diferentes. A pesquisa contou com a participação de 156 estudantes de graduação e pós-graduação das três faculdades do campus de Bauru da UNESP (FAAC, FC e FEB). Para avaliação das imagens foi utilizado um protocolo de Diferencial Semântico composto de 14 pares de adjetivos opostos relacionados a um julgamento da pessoa que utiliza a cadeira. Os sujeitos responderam de forma anônima a um dos seis testes de Diferencial Semântico disponível por meio digital e, em seguida, um questionário a respeito do grau de convivência com usuários de cadeiras de rodas. Os dados foram analisados por meio de estatística descritiva (média e desvio padrão) e os testes estatísticos de Kruskal-Wallis, Mann-Whitney e Teste ... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The everyday objects communicate about who uses it and people naturally tend to associate those products with the user's personality. Most of Assistive Technologies, including manual wheelchairs, do not have pleasant appearance and. In this sense, this cross-sectional study aims to evaluate the visual judgment of manual wheelchairs by non-users in order to verify if there are a relation between characteristics in the design of this object and negative perceptions (stigma) about who uses it. To this study, used photograph 6 different models of chairs, a common wooden chair and 5 different wheelchairs. For the tests, 156 students of undergraduate and graduate levels participated from the three campus of colleges of UNESP/Bauru (FAAC, FC e FEB). The subjects responded anonymously to one of six semantic differential tests available in digital media and, after that, a questionnaire about the degree of interaction with users of wheelchairs. The data were analyzed by descriptive statistics (mean and standard deviation) and the statistical tests of Kruskal-Wallis, Mann-Whitney and Test "T" were used to compare means. The results suggests that the wheelchair implies a negative judgment about who uses it and the judgment about wheelchairs users is influenced by the appearance of the equipment that they use. Furthermore, apparently, the proximity of an individual to wheelchairs users interferes positively in their judgment. The results can contribute to rethinking the design of the wheelchair, especially in its aesthetic and symbolic functions, in order to throw a new look at people with disabilities / Mestre

No description available.

The purpose of the study was to investigate the effectiveness of universal design kitchen features by people using wheelchairs. The study examined the features of the GE Real Life Design Kitchen in the Center for Real Life Design at Virginia Tech and determined which universal design features were beneficial to users in wheelchairs. The specific objectives were: 1. to evaluate the universal design features of the GE Real Life Design Kitchen by people in wheelchairs, and 2. to examine how the GE Real Life Design Kitchen is used by people in wheelchairs as they prepare a meal in the space. Nine participants, with various disabilities, who use a wheelchair on a daily basis were selected for the study. The sample consisted of 5 male and 4 female participants with ages ranging from 28-58 years old. Each participant had varying levels of grip, strength, and memory as a result of their disability. Data for this study were collected through a variety of observation and interviewing methods. The study was separated into four different sections/activities; the pre-cooking interview, the universal design evaluation, the cooking activity, and the post-cooking interview. Each participant was asked to test specific universal design features located in the GE Real Life Design Kitchen and was given a set menu and asked to prepare a meal. The results of this study determined that people who use a wheelchair while cooking are very efficient and do not require much counter space in order to prepare a meal. Appliances with easy to read and use controls are preferred and should be located within good visual range of a person in a wheelchair to be effective. In addition, it was determined that a pull-out cutting board and some type of roll-out tray feature in a base cabinet is useful to a person in a wheelchair. The results concurred with existing recommendations concerning clear floor and open knee spaces at the sink and cooktop areas, and also discovered that clear floor and open knee space is useful under a countertop microwave because it allows the wheelchair user to get their body closer to the task. Results from this study cannot be generalized to a national population of wheelchair users because of the limitations of the sample. Results, however, are significant in terms of providing consumers, cabinet and appliance manufacturers, policy makers, and designers with valuable insight and information concerning the inclusion of universal design features in kitchens and environments that accommodate the needs of all people, including the person in a wheelchair. In addition, the results of this study imply that not all universal design features recommended in kitchen design are beneficial to people in wheelchairs. Further investigation of some of the universal design features tested is needed. / Ph. D.

A lesão da medula espinhal (LME) é uma das principais causas de modificações na integridade física, psíquica e social, decorrentes das perdas funcionais que afetam a capacidade de andar das pessoas acometidas. A cadeira de rodas é um recurso utilizado para suprir a dificuldade de locomoção das pessoas com deficiência física, que contribui como um instrumento para a promoção de independência funcional, permitindo a continuidade das atividades cotidianas da vida. Sob esta ótica, buscouse compreender a representação social do uso da cadeira de rodas atribuído pelas pessoas com lesão da medula espinhal. Para analisar estas informações optou-se pela pesquisa qualitativa, sob a fundamentação da Teoria das Representações Sociais, desenvolvida com dez pessoas acometidas por LME, atendidas por dois serviços distintos de fisioterapia da cidade de Londrina / PR. A coleta de dados ocorreu através de entrevistas semi-estruturadas, gravadas e transcritas na íntegra. Todas as pessoas aceitaram participar voluntariamente da pesquisa e assinaram o termo de consentimento livre e esclarecido. A Análise de Conteúdo, na modalidade temática, foi a técnica eleita para interpretar as informações coletadas, que permitiram, sob o enfoque das representações sociais, a construção de cinco categorias temáticas: 1) Equipamento indispensável; 2) Símbolo de deficiência; 3) Meio de locomoção e transporte; 4) Extensão dos membros inferiores e do corpo e 5) Expressão de autonomia. O fenômeno vivenciado sobre a utilização da cadeira de rodas possibilitou compreender as suas representações sociais numa trajetória ascendente de significados e simbologias, repassados a este equipamento como indispensável, após as perdas motoras e sensoriais sofridas pela LME. É vista como símbolo de deficiência, quando a pessoa percebe as modificações em sua integridade física e a situação de dependência funcional. Representada como meio de locomoção, transporte e resgate dos valores de seus potenciais funcionais, para a capacidade de locomoção. A cadeira de rodas passa a integralizar, sem distinção, parte ou todo o seu corpo, e, por fim, emerge como expressão de autonomia, atingindo a representação social com a caracterização máxima de seu papel, no desenvolvimento funcional para uma pessoa que teve sua capacidade de andar interrompida subitamente pela incidência da LME. Neste aspecto a cadeira de rodas, como extensão do corpo modificado pela lesão da medula espinhal, ao devolver-lhe o direito de locomoção, presenteia-o não só com a autonomia para vários atos da vida, como também lhe devolve a dignidade, tão essencial à vida humana. / Spinal injury (SI) is one of the major causes of physical integrity, psychological and social changes due to functional losses that affect the ability to walk. The wheelchair is a resource used to manage the locomotion difficulty of people with physical handicaps providing functional independence and allowing them to continue with their daily activities. Under this optic we tried to understand the social representation of the use of the wheelchair for people with spinal injuries. To analyze these data we decided to use the qualitative research, applying the Social Representation Theory approach to ten people with SI that underwent physical therapy care in two different clinics in Londrina-PR. Data was collected by semi-structured interviews that were recorded and fully transcripted. All individuals voluntarily accepted to take part in this study and signed the Informed Consent Form. The Content Analysis was the technique chosen to interpret the data collected, using the thematic approach and under the view of the social representations spawning five thematic categories: 1) Indispensable equipment; 2) Symbol of handicap; 3) Mean of locomotion and transport; 4) Extension of the body and lower limbs and 5) Autonomy expression. The experienced phenomena of using a wheelchair allowed to comprehend its social representations in an ascending trajectory of meanings and symbologies that were attributed to this equipment as indispensable after motor and sensorial losses due to the SI. It is seen as a symbol of handicap when the person realizes the changes in their physical integrity and the situation of functional dependence. It is represented as a mean of locomotion and transport and the regaining of the praise for their functional potentialities for locomotion ability. The wheelchair becomes part of their body without distinction of parts or whole, and, eventually, there is the idea of the wheelchair as autonomy expression reaching the social representation as the highest characterization of its role in functional development to a person that had their walking ability taken suddenly from them due to SI. Considering this aspect, the wheelchair is a extension of their bodies that were modified by the SI, giving back to them their locomotion and right, gifting them not only with the autonomy for many aspects of daily life, but also reassuring their dignity which is so essential to human life.

Este trabalho propõe um novo conceito de cadeira de rodas manual ergonômica com assistência motorizada servo controlada. A mobilidade em cadeira propulsionada manualmente é uma das formas mais utilizadas de locomoção entre pessoas com deficiências, porém expõe o usuário ao risco de lesão nos membros superiores e não propicia independência em todas as situações de locomoção diária. A primeira alternativa tecnológica aplicada pelo homem foi a motorização. No entanto, o uso desta não implica em melhora da mobilidade, pois leva o usuário ao sedentarismo. Neste sentido, fazendo a integração do histórico, ergonomia, biomecânica e engenharia mecatrônica, este projeto tem como objetivo o desenvolvimento do projeto conceitual ao protótipo - de uma cadeira de rodas manual com assistência motorizada complementar e proporcional à força propulsora aplicada pelo usuário. O delineamento do projeto envolveu o levantamento das evidências científicas relacionadas aos aspectos da configuração de cadeiras manuais determinantes para a melhoria do desempenho na mobilidade e conforto. A criação do conceito envolveu ainda a realização de estudos complementares dos aspectos mecânicos, ergonômicos e cinemáticos da locomoção em cadeiras manuais. O conceito do protótipo tem seus pilares na: propulsão, através de um servo-motor centralizado que atua nas duas rodas traseiras através de um diferencial mecânico, simplificando o controle da assistência motorizada; no projeto do aro propulsor ortogonal com acoplamento assimétrico com a roda em cambagem, proporcionando melhor acesso das mãos ao aro; projeto do aro propulsor, baseado em aspectos dactilo-anatômicos; projeto e configuração da cadeira, estruturada nas evoluções tecnológicas das cadeiras manuais e adaptada às características antropométricas da população brasileira; assistência motorizada controlada por um sistema de avaliação contínua da inclinação do terreno, forças aplicadas ao aro e o deslocamento angular das rodas medidos por acelerômetro, células de carga e encoder ótico, respectivamente. A efetivação do presente conceito favorece a mobilidade independente do cadeirante, podendo reduzir o custo referente ao uso prolongado de cadeiras manuais: lesão dos membros superiores e incapacidade funcional. Aprimorar a mobilidade de usuários de cadeira de rodas favorece sua independência e participação social, aspectos essenciais para a melhora da qualidade de vida. / This study proposes a new concept of ergonomic manual wheelchair with servo-controlled motor assistance. The mobility in manually propelled wheelchairs is one of the most used means of locomotion among people with disabilities, but it exposes the users to the risk of upper limb injuries and does not provide independence in all the situations of daily locomotion. The first solution applied was the use of a electric-powered motors. However, its usage does not lead to an improvement in mobility and imposes the sedentary condition to the users. Thus, by integrating of the equipment history, ergonomics, biomechanics and mechatronics engineering, this project aims to develop - from the conceptual design to the prototype - a manual wheelchair with complementary motorized assistance that is proportional to the pushing force applied by the user. The project design involved the search for scientific evidences related to the aspects of the wheelchair configuration determinants for the improvement on mobility performance and comfort. The concept creation also involved complementary studies of the mechanics, ergonomics and kinematics of manual wheelchair mobility. The fundamentals of the equipment conception are: propulsion by a servo-motor centrally located that operates the rear wheels by differential transmission. thus simplifying the motor assistance control; the design of an orthogonal handrim coupled to the a cambered wheel, that provides better access of the hands to the rim; the dactyl-anatomical design of the handrim; the wheelchair configuration designed based on the technological evolution of the manual wheelchairs and anthropometric features of the Brazilian population; motor assistance controlled by a system with real-time assessment of the ground slope, handrim forces and angular displacement of the wheels measured, respectively, by accelerometer, load cells and optical encoder. This concept favors the independent mobility of the users and may reduce the cost related to the long term use of manual wheelchairs: upper limb injuries and functional impairment. Improving the mobility of wheelchair users favors their independence and social participation, two essential aspects for the improvement in quality of life.

Pediatric powered mobility training teaches a child useful skills to become effectively mobile with the aid of their powered wheelchair. The staff at the Massachusetts Hospital School (MHS) desired a powered mobility training protocol that could be used for training children who were considered to be marginal wheelchair drivers with respect to basic maneuvering skills. The primary objective of the protocol was to reduce the subject's reliance on verbal cuing and replace this dependence by external cues provided by the environment. The specific aim of this pilot study was to investigate the use of a ranging device mounted on a powered wheelchair to provide an auditory feedback to the subject when an obstacle within its range was detected. The first goal of this study was to verify that the ranging device was capable of providing useful auditory feedback to the MHS patients that had met criteria to be candidates for the study. The second goal was to determine to what extent the device was beneficial in improving the subject's everyday mobility skills. The final goal was to observe if there was an internalization of the ranging device cues such that the subject's mobility skills improved upon removal of the device. Three subjects participated in this study. Each subject participated in pre-training, training and post-training evaluations through which the improvement of their mobility skills was measured. The results of this pilot study demonstrated that the use of a ranging device, with auditory feedback, can potentially be used effectively in the powered mobility training of children with disabilities. Further, it appeared that marginal wheelchair drivers were able to internalize some of the ranging device's auditory cues such that their performance improved when the sensing device was removed from their wheelchair. Recommendations for improving this study include using a more appropriate ranging device, redefining criteria for qualified candidates participating in the study, and eliminating variations in data between different evaluators.

A lesão da medula espinhal (LME) é uma das principais causas de modificações na integridade física, psíquica e social, decorrentes das perdas funcionais que afetam a capacidade de andar das pessoas acometidas. A cadeira de rodas é um recurso utilizado para suprir a dificuldade de locomoção das pessoas com deficiência física, que contribui como um instrumento para a promoção de independência funcional, permitindo a continuidade das atividades cotidianas da vida. Sob esta ótica, buscouse compreender a representação social do uso da cadeira de rodas atribuído pelas pessoas com lesão da medula espinhal. Para analisar estas informações optou-se pela pesquisa qualitativa, sob a fundamentação da Teoria das Representações Sociais, desenvolvida com dez pessoas acometidas por LME, atendidas por dois serviços distintos de fisioterapia da cidade de Londrina / PR. A coleta de dados ocorreu através de entrevistas semi-estruturadas, gravadas e transcritas na íntegra. Todas as pessoas aceitaram participar voluntariamente da pesquisa e assinaram o termo de consentimento livre e esclarecido. A Análise de Conteúdo, na modalidade temática, foi a técnica eleita para interpretar as informações coletadas, que permitiram, sob o enfoque das representações sociais, a construção de cinco categorias temáticas: 1) Equipamento indispensável; 2) Símbolo de deficiência; 3) Meio de locomoção e transporte; 4) Extensão dos membros inferiores e do corpo e 5) Expressão de autonomia. O fenômeno vivenciado sobre a utilização da cadeira de rodas possibilitou compreender as suas representações sociais numa trajetória ascendente de significados e simbologias, repassados a este equipamento como indispensável, após as perdas motoras e sensoriais sofridas pela LME. É vista como símbolo de deficiência, quando a pessoa percebe as modificações em sua integridade física e a situação de dependência funcional. Representada como meio de locomoção, transporte e resgate dos valores de seus potenciais funcionais, para a capacidade de locomoção. A cadeira de rodas passa a integralizar, sem distinção, parte ou todo o seu corpo, e, por fim, emerge como expressão de autonomia, atingindo a representação social com a caracterização máxima de seu papel, no desenvolvimento funcional para uma pessoa que teve sua capacidade de andar interrompida subitamente pela incidência da LME. Neste aspecto a cadeira de rodas, como extensão do corpo modificado pela lesão da medula espinhal, ao devolver-lhe o direito de locomoção, presenteia-o não só com a autonomia para vários atos da vida, como também lhe devolve a dignidade, tão essencial à vida humana. / Spinal injury (SI) is one of the major causes of physical integrity, psychological and social changes due to functional losses that affect the ability to walk. The wheelchair is a resource used to manage the locomotion difficulty of people with physical handicaps providing functional independence and allowing them to continue with their daily activities. Under this optic we tried to understand the social representation of the use of the wheelchair for people with spinal injuries. To analyze these data we decided to use the qualitative research, applying the Social Representation Theory approach to ten people with SI that underwent physical therapy care in two different clinics in Londrina-PR. Data was collected by semi-structured interviews that were recorded and fully transcripted. All individuals voluntarily accepted to take part in this study and signed the Informed Consent Form. The Content Analysis was the technique chosen to interpret the data collected, using the thematic approach and under the view of the social representations spawning five thematic categories: 1) Indispensable equipment; 2) Symbol of handicap; 3) Mean of locomotion and transport; 4) Extension of the body and lower limbs and 5) Autonomy expression. The experienced phenomena of using a wheelchair allowed to comprehend its social representations in an ascending trajectory of meanings and symbologies that were attributed to this equipment as indispensable after motor and sensorial losses due to the SI. It is seen as a symbol of handicap when the person realizes the changes in their physical integrity and the situation of functional dependence. It is represented as a mean of locomotion and transport and the regaining of the praise for their functional potentialities for locomotion ability. The wheelchair becomes part of their body without distinction of parts or whole, and, eventually, there is the idea of the wheelchair as autonomy expression reaching the social representation as the highest characterization of its role in functional development to a person that had their walking ability taken suddenly from them due to SI. Considering this aspect, the wheelchair is a extension of their bodies that were modified by the SI, giving back to them their locomotion and right, gifting them not only with the autonomy for many aspects of daily life, but also reassuring their dignity which is so essential to human life.

<p>This thesis evaluates surgical correction in patients with paralytic scoliosis with emphasis on function and activity. The thesis includes four studies of 100 consecutive patients preoperatively evaluated and surgically corrected between 1992 and 1996 at Linköping University Hospital. Eighteen different diagnoses were represented. The postoperative follow-ups were at one year and in average seven years. Six patients dropped out during the first year and twelve during the long-term follow-up period. The assessments included general information, lung function, and measurements of radiographs, function and activity - seating posture, ADL, pain, care and need for rest. The patients or relatives view on the effects of surgery were evaluated in follow-up questionnaires.</p><p>The preoperative results of the 100 patients described a heterogeneous group in terms of function and activity. Even when the patients were grouped into subgroups according to the Scoliosis Research Society classification, they remained heterogeneous. In patients who could understand verbal instructions assessments that needed co-operation could be used and in those who could not understand verbal instructions, assessments relied more heavily on measures of function and level of dependence. Preoperative results of weight distribution on the seating surface were explained by thoracolumbar/lumbar spinal imbalance and pelvic obliquity R²=0.45 (n=45).</p><p>The one-year follow-up of 94 patients showed improvements in angle of scoliosis, sitting balance, weight distribution to the seating surface, seating supports in the wheelchair, time needed for rest. The results in subgroups were almost the same as in the whole group. The subjective results for patients or relatives in the follow-up questionnaire showed a positive outcome of surgery. In the comparison between the one-year follow-up and the long-term follow-up there were further improvements in sitting balance, ADL, and care given, but the angle of scoliosis was increased. These results were in line with patients’ and relatives’ assessments in the follow-up questionnaire and in the open-ended questions.</p><p>Due to the heterogeneity of patients with paralytic scoliosis, irrespective of disorder, it is important to focus on different subgroups with regards to the patients’ total situation. The surgically corrected and stabilised spine resulted in the strength to keep the body upright with improvements in function, activity and possibilities to belong in social activities. Further improvements were shown between the one-year follow-up and the long-term follow-up. It is recommended that patients who have been surgically corrected for paralytic scoliosis are followed for more than one year.</p>

This thesis evaluates surgical correction in patients with paralytic scoliosis with emphasis on function and activity. The thesis includes four studies of 100 consecutive patients preoperatively evaluated and surgically corrected between 1992 and 1996 at Linköping University Hospital. Eighteen different diagnoses were represented. The postoperative follow-ups were at one year and in average seven years. Six patients dropped out during the first year and twelve during the long-term follow-up period. The assessments included general information, lung function, and measurements of radiographs, function and activity - seating posture, ADL, pain, care and need for rest. The patients or relatives view on the effects of surgery were evaluated in follow-up questionnaires. The preoperative results of the 100 patients described a heterogeneous group in terms of function and activity. Even when the patients were grouped into subgroups according to the Scoliosis Research Society classification, they remained heterogeneous. In patients who could understand verbal instructions assessments that needed co-operation could be used and in those who could not understand verbal instructions, assessments relied more heavily on measures of function and level of dependence. Preoperative results of weight distribution on the seating surface were explained by thoracolumbar/lumbar spinal imbalance and pelvic obliquity R2=0.45 (n=45). The one-year follow-up of 94 patients showed improvements in angle of scoliosis, sitting balance, weight distribution to the seating surface, seating supports in the wheelchair, time needed for rest. The results in subgroups were almost the same as in the whole group. The subjective results for patients or relatives in the follow-up questionnaire showed a positive outcome of surgery. In the comparison between the one-year follow-up and the long-term follow-up there were further improvements in sitting balance, ADL, and care given, but the angle of scoliosis was increased. These results were in line with patients’ and relatives’ assessments in the follow-up questionnaire and in the open-ended questions. Due to the heterogeneity of patients with paralytic scoliosis, irrespective of disorder, it is important to focus on different subgroups with regards to the patients’ total situation. The surgically corrected and stabilised spine resulted in the strength to keep the body upright with improvements in function, activity and possibilities to belong in social activities. Further improvements were shown between the one-year follow-up and the long-term follow-up. It is recommended that patients who have been surgically corrected for paralytic scoliosis are followed for more than one year.