Rio Mobility Firefly Manuale Utente Pagina 1

Dynamic Wheeled MobilityThe Future of Ultralight Wheelchairs for Active UsersJaimie Borisoff, PhDCanada Research Chair in Rehabilitation Engineering D

AREC 2014DWM 101Dynamic Wheeled MobilityThe Future of Ultralight Wheelchairs for Active Users

Seat Forward With Long Wheelbase on 3 1/2" Platform

AREC 2014"Perform Level Transfers When Possible ""Avoid Positions of Impingement When Possible"DWM Applications: TransfersDynamic

Dynamic ReconfigurationDYNAMIC REPOSITIONING TO FACILITATE TRANSFERSTRANSFER ONE SETUP

Dynamic ReconfigurationDYNAMIC REPOSITIONING TO FACILITATE TRANSFERSTRANSFER TWO SETUP

DYNAMIC REPOSITIONING TO FACILITATE TRANSFERSDynamic Wheeled MobilityDynamic Reconfiguration

DYNAMIC REPOSITIONING TO FACILITATE TRANSFERSDynamic Wheeled MobilityDynamic Reconfiguration

DYNAMIC REPOSITIONING TO FACILITATE TRANSFERSDynamic Wheeled MobilityDynamic Reconfiguration

DYNAMIC REPOSITIONING TO FACILITATE TRANSFERS

AREC 2014CPGs that apply to DWM(even if they don’t know it)DWM has GREATER BENEFITS than with FIXED CONFIGURATIONS 4. Minimize the force required to

AREC 2014Some other benefits of changing seat position? (non – CPG)• Comfort• Functional positioning (other ADL’s)• Pressure re-distribution• Joint mo

AREC 2014DWM 101: RulesDynamic Wheeled Mobility Rule 1: DWM adjustments must be easy to use - “On the fly”. Rule 2: Add-ons must be easily installed

Subject 1Subject 4*Subject 3Subject 2-15

Subject 1Subject 4*Subject 3Subject 20

Subject 1Subject 4*Subject 3Subject 2+15

020406080100120140SAP mmHg DAP mmHg MAP mmHg HR bpm SV mlSEATED ELEVATED LOWEREDCARDIOVASCULAR FUNCTION

AREC 2014- Other Activities- ParticipationDWM Applications: ADL’sDynamic Wheeled Mobility

AREC 2014How do people use Elevation?

Dynamic Repositioning For Function ~ socialization

Dynamic Repositioning For Function ~ socialization

Employment

Children (Pediatrics)

AREC 2014DWM 101: ApplicationsDynamic Wheeled Mobility Propulsion Inclines Soft surfaces Transfers Functional Reach Ergonomics, shoulder pain A

Recreation

High reaching

Self care

AREC 2014Different Users, Different UsesDynamic Wheeled Mobility

AREC 2014“Low” setupDynamic Wheeled Mobility19 degrees Dump - 13 Elevated(6 inches down) (4 inches up)

AREC 2014“High” setupDynamic Wheeled Mobility7 degrees Dump - 26 Elevated(2 inches down) (8 inches up)

Different users, different usesCP <48 cm>SCI <41 cm>

AREC 2014Daily height chart – 2 people<48 cm><41 cm>CPSCIDynamic Wheeled Mobility

AREC 2014Elevation + Function / ActivitiesFunctioning Everyday with a Wheelchair (FEW) Questionnaire MEAN score = 54(Range 47 – 60)Perceived usefulnes

Elevation + Freewheel

AREC 2014DWM 101: TheoryDynamic Wheeled Mobility Guiding Framework: Clinical Practice Guidelines (CPGs) for Preservation of Upper Limb Function Follo

AREC 2014Future DWM?Dynamic Wheeled Mobility Power wheels? Sliding seat + seat height + back recline The floor! Floor to seat transfers Activitie

Merci!Atlantic Rehab and Education Conference 2014Atlantica Halifax Hotel, Halifax, Nova Scotia

2015 International Seating SymposiumHosted by the University of PittsburghNashville, TNDynamic Wheeled Mobility--The Next Chapter in the Ultralight Ev

AREC 2014DWM 101: TheoryDynamic Wheeled Mobility

Clinical Practice GuidelinesParalyzed Veterans of America (PVA) Consortium for Spinal Cord Medicine (2005)

Minimize the Frequency of Repetitive Upper Limb Tasks.Minimize the Forces Needed to Complete Upper Limb Tasks.Minimize Extreme or Potentially Injuriou

Provide Manual Wheelchair Users with SCI a High Strength, Fully Customizable, Wheelchair Made of the Lightest Possible Material.C l i n i c a l P r

The Wheelchair Should be Configured so That:- The Rear Axle Is Located as Far Forward as Possible Without Compromising the Stability of the User.- the

Instruct Manual Wheelchair Users With SCI to:- Use Long, Smooth Strokes that Limit High Impacts on the Pushrim.- Use a Semicircular pushing pattern.C

AREC 2014ACKNOWLEDGEMENTAcademy of Spinal Cord Injury Professionals2014 Educational Conference and ExpoSt. Louis, MissouriDynamic Wheeled MobilityGate

Instruct Individuals with SCI who Complete Independent Transfers to:- Perform Level Transfers When Possible.- Avoid Positions of Impingement When Poss

AREC 2014CPG’s and ultralights – what are missing? The role of an ultralight's configuration and setup in minimizing Frequency, Forces, & Ex

FORM FITFUNCTIONFOOTPRINTC O N T E X TO F U S EOverallUsability "The extent to which a product can be used by specified users to achieve specif

While most conventional ultralight designs provide sufficient adjustability to be customized for an individual user, the configuration itself is inher

These concessions & trade-off's frequently result in a base configuration to be less than optimal for any single context of use…"My chai

Designing Wheelchairs for Functions Other Than Propulsion…WHY?

AREC 2014How do people use wheelchairs?TimeDistance Bouts“Bouts of Mobility”Sonenblum and Sprigle, Georgia Tech1.5 km 58 min 96Propulsion during the d

Daily Activitieshttp://www.bbc.co.uk/news/technology-11012356 via Gary Moulton

Chairs for everyone else are “dynamic”

DWM - Is It Worth the Weight?For Propulsion?- Wheelchairs for sports are often significantly heavier than an athlete's everyday wheelchair- Wheel

AREC 2014DISCLOSURESJaimie Borisoff, PhD is the Canada Research Chair in Rehabilitation Engineering Design at the BC Institute of Technology and ICORD

DWM - Is It Worth the Weight?How important is 3 lbs. on 200 lbs. system?Arch Phys Med Rehabil. 2010 Aug;91(8):1248-54. doi: 10.1016/j.apmr.2010.05.011

AREC 2014Where is weight important? Lifting the chair into a car

AREC 2014DWM 101: Concepts & ApplicationsDynamic Wheeled Mobility

AREC 2014DWM: ConceptsDynamic Wheeled Mobility MODULAR DESIGNS ADD-ON COMPONENTS Products That Reduce Rolling Resistance  Mechanical Alternatives

DWM – Modular Designs Lasher BT-X  Icon A1

MODULAR DESIGNS – Lasher BT-X

AREC 2014DWM – Add-On ComponentsDynamic Wheeled Mobility Power Add On SystemsIn contrast to PAPAWs, these add-on components do not change the base co

ADD-ON COMPONENTS - Power Add-On Systems SmartDrive  Rio Mobility Firefly

ADD-ON COMPONENTS - SmartDrive Weight – 8lb battery, 11lb motor

ADD-ON COMPONENTS - Mechanical Alternatives Lever Drives  Manual geared wheels

AREC 2014DEFINITIONDynamic Wheeled MobilityDynamic Wheeled Mobility (DWM) An alternative approach to ultralight wheelchair configuration that involves

 Clip-on handcyclesADD-ON COMPONENTS - Mechanical Alternatives

ADD-ON COMPONENTS - Reduce Rolling Resistance Freewheel

ADD-ON COMPONENTS - Reduce Rolling Resistance Wheelblades

AREC 2014DWM – DYNAMIC RECONFIGURATIONDynamic Wheeled Mobility Dynamic Repositioning For Function & ADL’sReal time adjustments which change the u

AREC 2014DWM Chair ExamplesDynamic Wheeled Mobility Modified Icon A1  Elevation by PDG

2.5" of Fore/Aft Seat Adjustability2.5" of Dynamic Wheelbase AdjustabilityModified Icon A1

2.5" of Dynamic Fore / Aft Seat AdjustabilityModified Icon A1

2.5" of Fore/Aft Seat AdjustabilityModified Icon A1

Modified Icon A12.5" of Dynamic Wheelbase Adjustability

AREC 2014What are we NOT talking about?Tilt & Recline(conventional dynamic seating)e.g. from PDG MobilityStandinge.g. from LEVO AGPower(convention

A Commercially Available DWM Wheelchair

AREC 2014Dynamic Seat HeightDynamic Wheeled Mobility(10” or > 30) of On-The-Fly Seat Height Adjustment

AREC 2014Dynamic Recline30° of On-The-Fly Back Angle Adjustment

K n e e H i n g eE L E V A T I O N(PDG Mobility Technologies)DWM rule: easy to use“On the fly” adjustability

Elevated seating stability“lifting” side guards

E L E V A T I O N(PDG Mobility Technologies)Dynamic Wheeled Mobility

AREC 2014The last bit, I promise…DWM 101: TheoryDynamic Wheeled Mobility

The Law of Mutually Exclusive ConfigurationsDynamic Wheeled Mobility

The Law of Mutually Exclusive ConfigurationsThere Is an Inverse Relationship Between the Optimal Configuration for Smooth Level Propulsion and Most Ot

DWM is for “Active” manual wheelchair users Dynamic Wheeled Mobility

The Law of Mutually Exclusive ConfigurationsOptimal Propulsion on Smooth Level Surfaces Requires The User To Sit Lower & Further Back In The Chair

The Law of Mutually Exclusive ConfigurationsThere Is an Inverse Relationship Between the Optimal Configuration for Smooth Level Propulsion and Most Ot

Conservation of Contextual AnglesDynamic Wheeled Mobility

++Conservation of Contextual Angles=Changing key angles of the ultralight, its user, or the environment will result in changes to other angles in orde

90°Conservation of Contextual Angles

10°Conservation of Contextual Angles

90°Conservation of Contextual Angles

100°Conservation of Contextual Angles

AREC 2014"Avoid positioning the hand above the shoulder"DWM Applications: ReachDynamic Wheeled Mobility

90°"Avoid positioning the hand above the shoulder"

History of wheelchairs

How?"Avoid positioning the hand above the shoulder"

"Avoid positioning the hand above the shoulder"That’s How!

A NEW WAY THAT THE ULTRALIGHT CANEFFECTIVELY IMPLEMENT A CPG!!

DYNAMIC REPOSITIONING FOR FUNCTIONFUNCTIONAL REACHWhat about the Ground? Reaching Down?- Reaching to grab objects- Tasks “on your lap”

AREC 2014"Minimize the Forces Needed to Complete Upper Limb Tasks“"Minimize Extreme or Potentially Injurious Positions“…SLOPES!DWM Applicati

DYNAMIC REPOSITIONING TO IMPROVE PROPULSIONSLOPESADA Standard for a for a New Construction is 4.8° (12:1).ADA Maximum for an Existing Building is 7° (

CASE STUDYWhy Is Steve Anxious About Going Up Minivan Ramps If His Chair Has Really Been "Optimally Configured"?Conservation of Contextual A

17x16+0 85 Degree TiLite ZRc

17x16+0 85 Degree TiLite ZRc

17x16+0 85 Degree TiLite ZRcAn Optimal Configuration for Smooth Level Surfaces

The cantilevered frame: introduced over 25 years ago!

Back Angle = 95°Seat Slope = 14°Occupied Frame Length = 23"COM 117x16+0 85 Degree TiLite ZRcAn Optimal Configuration for Smooth Level Surfaces

17x16+0 85 Degree TiLite ZRcThe Same Configuration on a 10° SlopeGrade = 10°

EffectiveSeat Slope = 24°Grade = 10°EffectiveBack Angle = 105°17x16+0 85 Degree TiLite ZRcConfiguration on a 10° SlopeCOM 2

U∆ anglesUSER =H∆ anglesH I L L=∑ ∆ a n g l e sC O M B I N E D= ∑ ΔD=∆ anglesDEVIC E D U H!Analysis

Now how can we fix the problem?

We Can Change the Angles of the Seating...We Can Change The Center of Mass or Pushrim Orientation by Moving the Seat Forwardand / or

Effect of Dynamic Reconfiguration14 SEAT slope (4” seat dump)95 BACK recline“Optimal” Configuration for Steve

Dynamic Repositioning For Function:PROPULSION – LEVEL WHEELING14 SEAT slope (4” seat dump)95 BACK reclineDynamic Wheeled Mobility

Dynamic Repositioning For Function:PROPULSION – UP HILL (10 degrees)EffectiveBack Angle = 105°EffectiveSeat Slope = 24°14 SEAT slope95 BACK declineD

Dynamic Repositioning For Function:PROPULSION – UP HILL (10 degrees)0 SEAT slope (flat seat)80 BACK declineEffectiveBack Angle = 0°EffectiveSeat Slo

AREC 2014Can the ultralight wheelchair evolve beyond the lightweight static chair it is now?And why would this be a good thing?Dynamic Wheeled Mobilit

Dynamic Repositioning For Function:PROPULSION – DOWN HILL

Dynamic Repositioning For Function:PROPULSION – LEVEL WHEELINGDynamic Wheeled Mobility14 SEAT slope95 BACK recline

Dynamic Repositioning For Function:PROPULSION – DOWN HILL (10 degrees)EffectiveSeat Slope = 4°EffectiveBack Angle = 85°14 SEAT slope95 BACK recline

Dynamic Repositioning For Function:PROPULSION – DOWN HILL (10 degrees)18 SEAT slope (5” seat dump)110 BACK reclineEffectiveSeat Slope = 8°EffectiveB

Dynamic Repositioning For Function:PROPULSION – COG changes (relative in mm)Seat BackCoGUp hill080-25Level ground10950Down hill1811021

Shoulder vs Elbow Angle

2.5" of Fore/Aft Seat Adjustability2.5" of Dynamic Wheelbase AdjustabilityModified Icon A1

EFFECT OF DYNAMIC RECONFIGURATIONUse of a Sliding Seat On a 7° Incline

COMHOW IT WORKSCOM

Which Configurations Will Enable The User To Ascend A3 1/2" Platform With Less Upper Extremity Strain?(and with less skills needed than possessed