The wheelchair is an auxiliary tool for people who have defective legs. In comparison with the power wheelchair, the manual wheelchair has the advantage of low price and easy carrying. The regular, standard manual wheelchair is only suitable for residential environment and short-distance movement, and it¡¦s unsuitable for outdoor recreation and long-distance movement. The purpose of this study is to develop the manual wheelchair for outdoor recreation and long-distance movement, so that the users can expand their living space beyond the residential areas. In order to enhance the efficiency of propulsion for manual wheelchairs, a systematic designing method for propulsive mechanisms is proposed in this study in which the propulsive way of the traditional manual wheelchair is replaced by propelling the propulsive mechanism. In order to let the wheelchair be adapted to all kinds of environments, the multi-speed drive hub is applied to the manual wheelchair to enhance the users¡¦ force with more flexibility. In addition, this study also designs and manufactures a wheelchair to test the functions. The results of the test are then recorded and examined to provide the references for the future design.

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Manual wheelchair users who live in cold climates are faced with daily difficulties related to personal independence and societal inclusion, as their assistive devices are unable to overcome the physical barriers created by snow. Packed snow on sidewalks creates a barrier for wheelchair users as the small caster wheels become embedded in the snow-pack, this leads to upper body fatigue as well as wheelchair tipping, and falling. The purpose of this thesis was to develop a method by which the best design could be determined of a group of four commercially available manual wheelchair casters. This method was developed based on the HAAT model of assistive technology design. It was confirmed that snow-packed surfaces, as well as increased inclines, had a significant detrimental effect on the recorded human factors determinants, as well as conventional engineering determinants. / October 2016

Dans les domaines de la réhabilitation, des sciences du sport et de l'ergonomie, l'évaluation des capacités de génération de force (CGF) peut aider à mieux comprendre les capacités motrices humaines. Le but de cette thèse a été d'évaluer les CGF du membre supérieur prédites au moyen de deux types de formalismes. Le premier provient du domaine de la robotique et a été utilisé pour déterminer l'ellipsoïde de force normalisé (EFN) et biomécanique (EFB), le polytope de force normalisé (PFN) et biomécanique (PFB). Pour une posture, ils sont calculés à partir d’un modèle polyarticulé du membre supérieur et de données sur les couples articulaires isométriques maximaux. Le second type fait appel à un modèle musculosquelettique afin de modéliser les CGF sous la forme d’un polytope de forces (PFMS). Tous ces modèles ont été comparés à un polytope de forces mesurées (PFM). Pour le construire, les forces maximales isométriques exercées par le membre supérieur au niveau de la main ont été évaluées dans vingt-six directions différentes. Enfin, le PFMS a été appliqué dans le cadre de la propulsion en fauteuil roulant afin de caractériser l'application des forces lors de cette tâche et un nouvel indice d’évaluation de la performance postural (IPP) a été proposé. / In fields like rehabilitation, sports sciences and ergonomics, the evaluation of the force feasible set (FFS) of the human limbs may help to better understand the human motor abilities. The aim of this thesis was to compare the upper-limb force capacity at the hand predicted by two different kinds of FFS formalism. The first one originating from the robotics field was used to compute the force ellipsoid (FE), scaled force ellipsoid (SFE), force polytope (FP) and scaled force polytope (SFP). For one posture, they are computed from the upper-limb model and hypotheses and data on maximum isometric joint torques. The second one permitted to compute the FFS modeled as a force polytope from a musculoskeletal model (MSFP). All the previously mentioned models were compared with a measured force polytope (MFP). To construct it, the maximum isometric forces exerted at the hand were assessed in twenty-six directions of the Cartesian space. Then, the MSFP was applied to the manual wheelchair propulsion in order to characterize the forces applied on the handrim during this task and a new evaluation index of postural performance (IPP) was also introduced.

Uppskattningsvis 2000 personer lever med diagnosen tetraplegia i Sverige idag. Orsaken till skadan är trauma mot halskotpelaren som resulterar i total förlamning i bålen och de nedre extremiteterna. Ju högre upp skadan är placerad, desto större blir även förlamningen i de övre extremiteterna. Det traditionella sättet, att driva en manuell rullstol framåt med hjälp av drivringen, är med dessa funktionsbortfall, inte optimalt för att ta sig framåt eller över hinder. Ett prototyphjälpmedel, som förändrar rörelsemönstret till att större delen av kraften riktas i tangentiell riktigning framåt, med hjälp av de starkaste kvarvarande musklerna, utvecklades i projektet. Projektet har tillämpat dynamisk produktutveckling, med användarna i fokus, för att få fram en prototyp som uppfyller användarnas krav och som framförallt är användarvänlig. Detta har gjorts genom insamling av data under bland annat studiebesök, marknadsundersökningar och användarträffar. Prototypframtagningen skedde genom kontakt med näringslivet. Resultaten som kom fram vid användartesterna visade att prototypen kunde hjälpa till att öka maxkraften, för en av de två testpersonerna, som krävdes för att ta sig upp över en tröskel. Prototypen gav dock en upplevd försämring av manövreringsförmågan, då inte alla prototypens komponenter fungerad optimalt. Det krävs ytterligare tester och utvecklingsarbete innan produkten kan fungera i större utsträckning och för en större målgrupp. / An estimated 2000 people are today living in Sweden with a diagnosis of tetraplegi. The cause of the injury is trauma towards the cervical spine resulting in paralysis of the trunk as well as the lower limbs. The higher the positioning (i.e. the lower numbering of the vertebrae) of the cervical vertebrae damaged by the trauma, the more functions are lost in the upper extremities. When this happens, the traditional way of wheelchair propulsion with the push rim becomes less convenient. During the project, a prototype aid was developed. With the help of the aid, the users are able to change their pattern of movement when using the wheelchair. The new pattern allows the tetraplegi users to use their power in a tangential direction to the wheel. In addition they will be using mainly their strongest muscles in their arms, optimising their ability to move forward. In the project, dynamic product development was applied, focusing on the users in order to develop a user-friendly prototype which meets their requirements. To achieve this goal the project group collected data from people working with the rehabilitation of tetraplegics as well as people involved in the supply and distribution of rehabilitation aids. This benchmarking as well as meetings with intended users was helpful when gathering information. The prototype was developed with in close cooperation with various companies. User tests showed that the prototype could help increase maximum propulsive force required to climb over a threshold, for one of the two test persons. The prototype gave, however, a decrease in experienced maneuverability, as all of the components of the prototype were not working optimally. Further tests and development are needed before the product can operate for an extended use and for a wider target group.

Abstract Purpose: To characterize physical activity of people using manual wheelchairs with spinal cord injury in Manitoba. Methods: An observational study of manual wheelchairs users with spinal cord injury. Participants completed surveys related to self-efficacy for exercise, physical activity participation, and shoulder pain. Accelerometers were worn for 7 days on the wrist and trunk (GT3X, 100 Hz, 5 s epochs) and completed an activity log concurrently. Individual specific thresholds were determined for moderate intensity during a pace graded wheeling trial. Physical activity and sedentary time were characterized using various derived variables. Results: Twenty five participants (12 tetra:13 para, 21M:4F) demonstrated excellent accelerometer adherence achieving an average of 6.2 days worn for over 13 hours per day. A total of 74.6 min (all activity) and 115 min (contiguous bouts of activity) were achieved over time worn (6.2 days), corresponding to 11.8 and 18.5 min/day respectively. The participants substantially exceeded the published SCI guidelines (40 min/week, P<0.01) but were under the able bodied threshold of 150 min/week (P<0.01). No relationships were observed between surveys and objectively measured PA. Characterization of PA bouts revealed few participants (n=7) exhibiting single bout durations greater than 10 minutes, with an average contiguous bout duration of 30 s. A new functional classification scheme revealed positive correlations to PA variables and wheeling performance. Sedentary times ranged from 6.25 to 8.4 hours per day depending upon accelerometer placement. Conclusion: Arm based accelerometry can be used to determine PA and sedentary characteristics of manual wheelchair users with individual specific moderate intensity thresholds. Participants exceeded the SCI specific activity guidelines in terms of time per week, and failed to reach bout durations of 20 min. This study supports the use of able-bodied PA guidelines as a target. A new functional classification scheme was derived based upon wheeling dependent muscle innervation that had enhanced prediction of PA relative to standard anatomical classification / October 2015

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.

Introduction. Les capacités et les possibilités de déplacement en fauteuil roulant manuel (FRM) sont déterminantes pour l'intégration sociale et professionnelle des usagers. Objectifs. Approfondir la connaissance des contraintes de déplacement en FRM à travers 2 études. La 1ère pour identifier les habitudes et préciser les difficultés des usagers ; la 2nde, induite par les résultats de la 1ère, pour évaluer les effets du dévers, encore méconnus, sur les astreintes cardiaques, énergétiques, musculaires et subjectives. Méthodes. La 1ère étude a été menée par questionnaire complété par 118 sujets paraplégiques en FRM. La 2nde étude, en laboratoire avec 25 hommes paraplégiques, comporte 2 tests : un test d?effort sur ergocycle à bras et un test de propulsion de 300 m et 8 conditions combinant 4 dévers (0, 2, 8 et 12 %) et 2 vitesses (0,97 m.s-1 et une vitesse choisie "de confort"). Résultats. La 1ère étude révèle un environnement peu adapté, avec des moyens de transport et des bâtiments souvent inaccessibles sans aide, et des gènes limitant les sorties des usagers parmi lesquelles figure le dévers. La 2nde étude indique des astreintes cardiaques, énergétiques et musculaires significativement modifiées par le dévers et par la vitesse (p < 0,01). L'astreinte subjective n'est pas modifiée par la vitesse. Des différences entre 0 et 2 % sont faibles mais existent. Un dévers de 12 % est difficilement réalisable. Les équilibres des activités musculaires changent dès 2 % de dévers. Le niveau lésionnel modifie de façon très importante les stratégies de déplacements et les niveaux d'astreintes mesurées ou perçues. Discussion-Conclusion. Les effets du dévers sont perceptibles dès 2 % et sont nets et délétères à 8 %. Ce travail permet de proposer de façon plus argumentée un modèle d'astreintes qui conforte le seuil de dévers fixé réglementairement à 2 % permettant à la grande majorité des usagers de FRM de se déplacer de façon autonome et de rester actifs / Introduction. Displacement capacities and possibilities in manual wheelchair (MWC) are strong determinants of social and occupational integration of MWC users. Objectives. Improve the knowledge of the strains involved by displacement in MWC through 2 studies; the first one to identify habits and difficulties of MWC users. The second one, induced by the results of the first one, has assessed the poorly known cardiac, energetic, muscular and subjective strains of the displacement of MWC users on a cross slope. Methods. The first study was a survey answered by 118 paraplegics habitual MWC users. The second one, a laboratory study conducted with 25 paraplegic men, includes 2 tests: a sub maximal arm-cranking test and a 300 m propulsion test with 8 conditions combining 4 cross slopes (0, 2, 8 et 12%) and 2 velocities (0,97 m.s-1 and a "comfortable" chosen one). Results. The first study shows an adverse environment, with many places unreachable without help and disturbances, like cross slope, which hinders users' displacements. The second study demonstrates the increases of cardiac, energetic, muscular and subjective strains with cross slope. Differencies between 0 and 2% cross slopes are low but quantified. Displacement on a 12% cross slope is very difficult. The balance of muscles activities is changing at 2% cross slope. The injury level makes deep changes in the displacements strategies and in as well perceived as measured strain levels. Discussion-Conclusion. Effects of cross slope are perceived for as low as 2% and onwards values. They are high and deleterious at 8%. This work allows to construct a model of cross slope strains which confirms that the regulatory 2% cross slope limit is well chosen because it allows most MWC users to move without help and remain active

The aim of this project is to provide a manual wheelchair simulator for advanced wheelchair research within Toronto Rehabilitation Institute‘s Challenging Environment Assessment Laboratory (CEAL). To achieve this, a comprehensive mathematical model of the wheelchair/user system and a fully adjustable physical interface (which mimics various wheelchair configurations) have been developed. The mathematical model is unique in its ability to predict complex motions such as wheelies, and is able to update the wheelchair‘s position in a virtual environment, and calculate the force-feedback required for simulating various slopes and surfaces. The physical interface is used to measure the inputs required by the mathematical model (hand-rim input torques, hand and torso positions, and user centre-of-mass position), and utilizes servo motors to provide force-feedback at the wheelchair‘s hand-rims. Preliminary results comparing real-world wheelchair motion data to the mathematical model‘s predictions are presented, along with the physical interface design and mathematical model development.

The aim of this project is to provide a manual wheelchair simulator for advanced wheelchair research within Toronto Rehabilitation Institute‘s Challenging Environment Assessment Laboratory (CEAL). To achieve this, a comprehensive mathematical model of the wheelchair/user system and a fully adjustable physical interface (which mimics various wheelchair configurations) have been developed. The mathematical model is unique in its ability to predict complex motions such as wheelies, and is able to update the wheelchair‘s position in a virtual environment, and calculate the force-feedback required for simulating various slopes and surfaces. The physical interface is used to measure the inputs required by the mathematical model (hand-rim input torques, hand and torso positions, and user centre-of-mass position), and utilizes servo motors to provide force-feedback at the wheelchair‘s hand-rims. Preliminary results comparing real-world wheelchair motion data to the mathematical model‘s predictions are presented, along with the physical interface design and mathematical model development.