University of Pittsburgh Model Center on Spinal Cord Injury
Projects:
Impact of Pushrim Activated Power Assist Wheelchairs on Mobility Among People with Tetraplegia
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Principal Investigator(s): Michael L. Boninger, M.D.; David Gray, Ph.D.; Holly Hollingsworth, Ph.D.
Co-Investigator(s): Mark Schmeler, M.S., OTR/L,; Rosemarie Cooper, MPT; Kerri Morgan, MS OTR/L; Annmarie Kelleher, MS, OTR/L; Ian Rice, MS., OT; Michael D. Scheller, PTA/L; Eliana Chaves, OT
Funding Source: UPMC-SCI/NIDRR
Objectives
This study will use a new dynamic measurement outcomes tool to detect changes in participation in society of individuals with SCI who use assistive technology (AT). It is anticipated that this study has great potential for demonstrating the role that AT can have in affecting disability.
This study will use a prospective, longitudinal, repeated measures group design to compare the influence of current and newly acquired wheelchairs on the participation of people with spinal cord injuries in 25 major life activities in three settings -- home, community, and work or school. There will be four groups: participants who purchase new manual wheelchairs (NMWC); participants who purchase new power wheelchairs (NPWC); manual wheelchair users (CMWC) and power wheelchair users (CPWC) who will act as controls.
Methodology
All study participants will complete surveys at the initial visit to a clinic prior to getting a new wheelchair and seating system, when they come in to get the wheelchair and at the one and two year anniversary visits. For each activity, questions are asked about time spent preparing for the activity; frequency of engaging in the activity; importance, choice and satisfaction of activity; attribution of reason(s) for the limitation in activity; and personal assistance or assistive technology needed to engage in the activity.
Clinical Relationship
An outcome measure that can show changes in participation in the community with AT can be critical to demonstrating to payers the effects of AT. This same tool could also be used to determine the effectiveness of various types of AT and various types of service delivery models for delivering AT.
Impact of a Pushrim Activated Power Assist Wheelchairs on Mobility Among People with Tetraplegia
Principal Investigator: Rory A. Cooper, Ph.D.
Co-Investigator(s): Shirley Fitzgerald, Ph.D.; Annmarie Kelleher, MS, OTR/L; Rosemarie Cooper, MPT; Toru Furui, Ph.D.; Erica Authier, BS
Funding Source: UPMC-SCI/NIDRR
Objectives
The purpose of this study is to evaluate the Pushrim Activated Power Assist Wheelchair (PAPAW). The first phase will examine whether the energy efficiency for propelling a manual wheelchair with and without the device will be significantly different. In the second phase, wheelchair users will evaluate the PAPAW over an activities of daily living course to determine its usability and acceptability and to identify areas for future development. Finally in the third phase, comparison of activities of daily living in the community will be made between the subjects when using their personal wheelchair and a PAPAW.
Research Design
PAPAWs have been successfully tested to current ANSI/RESNA standards. Fifteen wheelchair users with tetraplegia will propel a manual wheelchair with and without a powered add-on unit over an activities of daily living course. Finally, ten subjects will take home a PAPAW. Subjects will act as their own controls, and data will be recorded over a two-week period. Each subject will be randomly selected to have their average speed, time in wheelchair, and distance traveled recorded in either their personal wheelchair or a PAPAW.
Methodology
Fifteen subjects with tetraplegia will be asked to propel a manual wheelchair attached to a computer-controlled wheelchair dynamometer through three resistance conditions. During propulsion, metabolic data will be acquired using metabolic measurement devices attached to the subject with a mouthpiece and tube, and heart-rate monitor similar to a common watch and chest strap. In the second phase, fifteen experienced wheelchair users with tetraplegia will be asked to propel a manual wheelchair first without and then with the device through an activities of daily living course. Each trial will be repeated three times with a rest period after three trials. Finally, comparison of activities of daily living in the community will be made by ten subjects with tetraplegia when using their personal wheelchair and a PAPAW. The subjects will then be asked to rate the chair on a number of subjective scales.
Clinical Relationship
The PAPAW is designed to reduce user-applied force needed to propel the chair by supplying additional torque proportional to the user-applied force. The potential long-term significance will be to reduce the incidence of upper extremity injury and resulting pain, loss of function and dependency in manual wheelchair users.