Article

Description of the principal characteristics of the wheelchairs and their technological developments
Current knowledge
Those with lower-limb disabilities are often dependent on manually propelled wheelchairs for their mobility, in Europe today some 3.3 million people. This implies a transfer from leg to arm work for ambulation and all other activities of daily living (ADL). Compared to the legs, arm work is less efficient and more straining, and leads to a lower physical capacity. Also, there is a major risk of mechanical overuse. Problems of long-term wheelchair use are not only pain or discomfort, but also a risk of a physically inactive lifestyle. Subsequently, serious secondary impairments (obesity, diabetes, cardiovascular problems) may eventually emerge. Wheelchair quality, including the ergonomic fitting to the individual may play a preventive role here, but also other modes of physical activity, and the understanding of training, rehabilitation, active lifestyle and sports on health and well being. The 'International Classification of Functioning, Health and Disability' (ICF) model, a stress­strain­work capacity model, as well as the ergonomics model that relates Human-Activity-Assistive-Technology (HAAT) are instrumental to the concepts, structure and aims of research in this field of assistive technology for mobility. Over the last decades manual wheelchairs have evolved from the chromium plated heavy foldable wheelchairs into task specific and individually optimized assistive tools. Apart from empirical developments and innovations from within wheelchair sports, systematic research has played a role in wheelchair development and design in three important areas: (1) the vehicle mechanics, (2) the human movement system, and (3) the wheelchair­user interface. Today manually propelled wheelchairs are primarily hand rim propelled. Many different issues of this propulsion mode were studied over the past, especially addressing performance, technique, vehicle mechanics and the wheelchair­user interaction. This has led to hand rim wheelchairs today that preferably have a box frame, are lightweight, task specific, are tuned to the individual physiognomy and have a contemporary 'fresh' look. Over the years both in sports practice and research, focus has shifted towards alternative modes of manual wheelchair propulsion. Especially crank propulsion has become popular among athletes as well as in daily life in some western countries, but is imperative in many non-western countries. For longer distances outdoors, under non-optimal environmental conditions, in sports and recreation, this propulsion mode is highly beneficial in terms of speed, distance and endurance, as well as in terms of physical strain. Gears allow propulsion at high speeds, but also in difficult terrain, both in highly trained as well as marginal users. Crank propulsion stimulates self-propulsion, mobility and an increased social range of action, i.e. a more active (and healthy) life style. The latter is stimulated through research into and the development of new forms of technology-supported modes of mobility for lower-limb impaired people (FES cycling, body weight support walking) and of training and an active lifestyle early in the rehabilitation program.

Langue : ANGLAIS