Manual stand-up wheelchair - Rehabilitation Institute of Chicago

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Development of a Manual Stand-Up Wheelchair that Provides Mobility in Both Sitting and Standing Modes

Project Overview

  • Early prototype of Manual Standing Wheelchair (MSW) in sitting mode.
  • Early prototype of Manual Standing Wheelchair (MSW) transitioning from sitting to standing mode.
  • Early prototype of Manual Standing Wheelchair (MSW) in standing mode.

Project D3, R5

Objective: To design a manual standing wheelchair (MSW) that allows users to be mobile in either a seated or standing position. Our objective is to build an innovative wheelchair that meets important user needs.

In order to develop this MSW, we will build upon a preliminary prototype comprising of a standing frame based on a patented design. This prototype was developed at the Rehabilitation Institute of Chicago (US Patent 7,165,778).

Significance

Currently, manual wheelchairs provide the user with mobility in a seated position; however, there are many compelling reasons for enabling wheelchair users to stand.

The functional benefits of standing include:

  • A raised and enlarged workspace.
  • Allowing easy use of kitchen counters and appliances and access to overhead cabinets or grocery store shelves.
  • Being able to stand may thus increase independence and enhance employment and leisure opportunities.

Standing also has physical benefits—reducing the risk of osteoporosis, muscle spasticity, and contractures; improving cardiovascular, digestive, and renal function; and relieving or preventing pressure sores.

Perhaps equally important are the psychological benefits: when standing, wheelchair users can interact with others eye-to-eye; they do not have to always look up at the rest of society, or have everyone literally look down on them.

Current Options

Some electric wheelchairs allow users to stand when stationary, or to move in a standing position, and powered mobile platforms enable people to move around in a standing position, but do not allow the person to sit. However, powered devices tend to be expensive, big, and heavy.

Some manual wheelchairs provide mobility in the conventional sitting posture, and when stationary, allow the user to stand in place to perform a task. However, the user must return to a sitting position in order to move the chair. There are no commercially available manual wheelchairs that provide mobility in both a sitting and a standing position: this constitutes a very apparent and important mobility gap for the more than one million manual wheelchair users.

Target Population

Any individual who uses a wheelchair for mobility, including those with a range of mobility-limiting disabilities.

Resources & Statistics

Statistics

  • Standing can stimulate circulation and tone the cardiovascular system.
  • Renal function can be aided by standing, and standing has been shown to decrease the incidence of urinary tract infections.

Resources & Organizations

Americans with Disabilities: 2005 (U.S. Census report, issued in 2008)

National Spinal Cord Injury Association (NSCIA)

Users First

United Spinal Association

Christopher & Dana Reeve Foundation

Rehabilitation Institute of Chicago Wheelchair Seating and Positioning Center

Articles

Justify It: Standing Frames & Wheelchairs (Mobility Management, June 2014)

RESNA Updates Standing Chair (Mobility Management, June 2014)

The Benefits of Standing: A Clinical View (Mobility Management, June 2014)

RESNA Position on the Application of Wheelchair Standing Devices: 2013 Current State of the Literature

Sitting All Day: Worse for You than You Might Think (NPR, April 2011)

Calorie Burner: How much better is standing up than sitting? (BBC News Magazine, 2013)

Pronk NP, Katz AS, Lowry M, Payfer JR. Reducing Occupational Sitting Time and Improving Worker Health: The Take-a-Stand Project, 2011. Prev Chronic Dis 2012;9:110323.

Kaye HS, et al., "Mobility Device use in the United States. Disability Statistics Report (14) Washington, D.C.: U.S. Department of Education, National Institute on Disability and Rehabilitation Research," 2000.

News

Interview with CBM Intern Emily Seyforth (August 2014)


Emily Seyforth

CBM intern Emily Seyforth

Emily Seyforth, 21, is entering her senior year as a biomedical engineering major and business minor at the University of Illinois at Urbana-Champaign. Emily has spent her summer interning at the Center for Bionic Medicine (CBM), where she assisted in the design of a manual standing wheelchair that can provide mobility in both seated and standing positions. Under the mentorship of Tim Reissman, PhD, Emily has been designing the moving seat and stationary frame of the wheelchair so it can slide and allow the user to be lifted from seated position to standing position. Read more about Emily in the following Q&A.

1. Why were you interested in an internship at RIC/CBM?

As a lifelong Chicagoan, I always had an idea of the reputable work being done at RIC. The more my interest grew in rehabilitative devices, the more I researched RIC’s work and realized just how stellar and ground-breaking of an institution it is. I think the biggest eye opener to how much CBM’s work aligned with my own interests was seeing a local news story on an amputee (Zac Vawter) kick a soccer ball with TMR and the bionic leg. I remember saying aloud after I watched the news clip, “that’s what I want to do with the rest of my life!”  It has truly been an honor to work here.

2. What has been the most challenging part of the project thus far?

The most challenging part was trying to design the most optimal system that was sturdy enough to hold a person while trying to minimize the chair's weight and make the design machinable. When you draw a theoretical design on the computer, there are so many different ways to mechanically manipulate objects that it is not too difficult to come up with a design that accomplishes your goal on screen. The real challenge is determining what real-world parts can accomplish what you have in mind and if it is the most practical solution. As mind boggling as some days could be, I am very grateful that I was exposed to these real-world challenges. The staff here has been so incredibly supportive and helpful along the way that I cannot thank them enough for how much they helped me learn and grow as an engineer in just the past 12 weeks.

3. What skills do you think you have learned as a result of working on this project?

One of the many things I have loved most about this experience is having the chance to learn how to thoroughly go through the design process. When I heard the word “design” before I came to CBM, I thought of sketching an idea on graph paper and then building it once others on the team agreed. After working on the wheelchair project, I have learned how a good design first starts with thorough background research into what is currently on the market, what are the pros and cons of these current designs, and what the user wants. From there you brainstorm ideas with other members of your team and gradually these ideas grow from words on a white board to a computer-aided drawing. Once you have the drawing, you then need to make sure it is possible to make (either the parts exist or they are practical for the machine shop to invest time in to fabricate). This is best done by either doing further research, or even better, asking others who are experts or who have prior experience in the field.

Another vital skill you learn is how to be flexible with tolerances in your material. The real world is not perfect so you have to expect that poles will not be perfectly straight or the cut size will be half a millimeter too big or too small. The best thing you can do is make room so your design can accommodate these small errors so that they do not completely destroy your whole work. I think this is a great life lesson in general, too.

As a bioengineer, I also love how much mechanical knowledge and fabrication skills I have gained working on this project. I feel much more well-rounded and realize just how much more there is to know about design and fabrication. Most importantly though, engineering is not just about building devices, but accepting new challenges and problems every day and appreciating the opportunity to continue learning even outside of a classroom.

4. What is your educational background and why did you choose to focus on biomedical engineering?

I will be entering my senior year at the University of Illinois at Urbana-Champaign in bioengineering with a concentration in biomechanics. I am also pursuing a business minor in order to better understand the financial point-of-view of a design and manufacturing company.

Throughout junior high and high school I was interested in a medical-based profession. After taking physics in high school, I realized how much I enjoyed engineering principles. I decided to combine the two for my undergraduate major and quickly grew to love how to mechanically model the body’s movements, especially areas specializing in prosthetics and orthotics.

5. What are your future career goals?

I would love to work in an industry specializing in prosthetic and/or orthotic design and manufacturing. Although, after working at CBM this summer, I would also be thrilled to continue working in a wheelchair or other rehabilitative device industry.

6. Is there anything else you want to add about your time spent on the wheelchair project?

One of the best aspects of working here is being able to meet so many extraordinary and intelligent people. Everyone is super passionate about their work and is always willing to share some of their knowledge (whether it’s on their work or life after undergrad). CBM is not just a place full of extreme talent, but also is full of many wonderful mentors and role models that are leading the next generation of rehabilitative medicine.

Dr. Rory Cooper Visits RIC (July 2014)

Dr. Rory Cooper of the University of Pittsburgh visited the Rehabilitation Institute of Chicago on Wednesday to discuss recent technical advances in wheelchair design and his experience in participatory design. The Center for Bionic Medicine hosted his Grand Rounds discussion, "Advances in Wheelchairs and Related Technologies."

Dr. Cooper is considered a leading rehabilitation engineer and expert on wheelchair design, development, and testing.

A wheelchair user since he suffered a severe spinal cord injury nearly 35 years ago in a bicycle collision, Dr. Cooper is also a Paralympian and former Paralympic coach. He won a bronze medal in the 1988 Paralympic Games, held in Seoul, South Korea.

He is currently director of the Human Engineering Research Laboratories at the University of Pittsburgh, where he specializes in assistive technology research. 

RESNA Conference (June 2014)

TEAMM members presented at the annual Rehabilitation Engineering and Assistive Technology Society of North America (RESNA) conference, held this year in Indianapolis from June 11-15. You can view TEAMM's presentation about in-home mobility and measures here.

High School Students Help Design Wireless System for Monitoring Mobility (May 2014)

IMSA high school students work on an engineering project at RIC.

Tim Reissman, PhD (center), works with Illinois Math and Science
Academy students Vimal Bellamkonda (left) and Timothy Akintilo
(right) on a wireless communications device that tracks when a
person is trying to stand.

Every Wednesday morning for six months, Vimal Bellamkonda and Timothy Akintilo boarded a bus at 7 a.m. to travel from Aurora to the Rehabilitation Institute of Chicago (RIC). The journey took up to two hours depending on traffic, but the two teenagers usually didn’t mind—as high school juniors, they were simply excited to put the knowledge they are learning in school to practical use.

From September to April, Bellamkonda, 16, and Akintilo, 15, both juniors at the Illinois Math and Science Academy (IMSA), worked at RIC’s Center for Bionic Medicine (CBM) as part of a unique student research program coordinated by their high school. The Student Inquiry and Research (SIR) program, formally established in 1989, is a collaborative academic research program available for IMSA juniors and seniors. Students who participate in the program gain real-world experience by working one day a week in laboratories, companies, educational institutions, and museums around the Chicago area.

“It’s like a graduate school experience because they’re doing research in laboratories or businesses,” says Judith Scheppler, PhD, coordinator of SIR and director of IMSA’s Grainger Center for Imagination and Inquiry. “Most of these students have never been in a work environment before, so we want them to figure out how to do data collection and statistical analysis. How do you think critically? How do you present your results? How do you work with a professional?”

Detecting mobility.

Detecting mobility: Red arrow shows receiver/recording
unit worn on wrist. Purple arrow indicates cabinet-mounted
transmitter.

At CBM, Bellamkonda and Akintilo helped researchers develop a wireless communications network that will track when and where people with mobility-limiting disabilities (for example, after a stroke or a leg amputation) try to stand while at home. Researchers hope the network - comprising several transmitters that can be placed inconspicuously within a home, and a single recording unit, or “receiver,” that can be worn like a wristwatch – will help occupational and physical therapists learn more about the needs of their patients. This network works in similar ways to a person’s home wireless Internet set-up - the receiver records the strength of the transmitted signal. The closer a person is to a transmitter, the stronger the signal becomes. Because all of the transmitters are placed in high places within a home (such as a cabinet or shelf), a strong signal indicates a person is standing.

“Using this system, we can monitor how much patients are trying to use the therapies they learn in the hospital in order to stand,” says Tim Reissman, PhD, a post-doctoral fellow at CBM who is supervising the students. “In the meantime, we need to prove to the community that this is a valid assessment tool.”

Reissman explains that current technologies, including smart phones and fitness watches, can assess when people are highly active, such as when a person is exercising or walking. But many individuals with mobility-limiting disabilities are less active and may stay within their homes. The challenge then is to effectively record smaller everyday movements, such as standing up to make a sandwich or do laundry. As more is learned about how patients behave within their homes and use (or don’t use) the therapies they practice in their clinical sessions, therapists can design more effective rehabilitation techniques.

“If a person has limited mobility, then we must think about where they do most of their primary activities, and it might be in the kitchen, the living room, or another room,” Reissman explains. “So being able to assess whether they are standing when they’re doing activities in the kitchen would show whether or not the therapies a patient receives are effective in the home, or whether or not therapists really need to build a patient’s confidence in using cabinets, cooking at the stove, or using higher shelves, for example.”


IMSAloquium.

CBM post-doctoral fellows Tim Reissman and Luca Lonini with Illinois
Math and Science Academy students Vimal Bellamkonda and
Timothy Akintilo at IMSAloquium on April 17.

When helping build the prototype, Bellamkonda and Akintilo analyzed data and performed basic experiments. They started by testing current wireless communication technologies, including Bluetooth and RFID, but found XBee to be the most effective technology for this project. As a result of research produced by the students and other CBM engineers, the system they helped create may soon be tested in clinical trials with patients. In addition to helping therapists better understand patients’ habits, the wireless system may also serve as an important assessment tool in future projects, including an endeavor aimed at developing an innovative manual standing wheelchair. That specific project is part of RIC’s newly-formed Technologies to Evaluate and Advance Manipulation and Mobility (TEAMM) research center.

Both teenagers say their experience at RIC has helped them hone necessary analytical skills, and understand how much dedication is needed in scientific research.

“For me, I’m getting used to the whole research environment,” says Bellamkonda, who is from Peoria, Illinois. “I’ve never worked in a professional setting like this. Apart from doing the research itself, I have to learn how to meet deadlines, how to work with the team.”

Akintilo, of Bourbonnais, Illinois, agrees, adding that he’s learned how to persevere through trial and error. “We’ll find a potential solution, and then immediately we’ll find something wrong with [trying to implement the device] -- the range of it is too short or it’s too expensive,” he explains. “Or we’ll buy a product, test it, and find it doesn’t work to our liking, so we have to try another one, and another one.”

In April, Bellamkonda and Akintilo presented their research at IMSAloquium, a scientific conference hosted at the high school. After graduating from high school, both teenagers hope to continue similar research at the university level --Bellamkonda as a pre-med student and Akintilo as a biomedical engineering or neuroscience student.

“It just is fascinating to me.  Now, we are able to apply engineering to ourselves. Being able to see man and machine come together is fascinating,” Akintilo says. “Hopefully I’ll become a neuroscientist or neurosurgeon and then move to prosthetic devices.”

Bellamkonda is still deciding on what area of medicine he wants to study, but he believes the skills he learned at RIC have better prepared him for any scientific career. “It’s been a really rewarding experience. I’m really glad I came,” he says. “It’s something I feel like I couldn’t have gotten anywhere else, so I’m grateful to RIC for taking me on.”

– Sheila Burt

Project Staff

RIC's Todd KuikenTodd A. Kuiken, MD, PhD, Principal  Investigator. Dr. Kuiken is director of the Center for Bionic Medicine (CBM) within the Rehabilitation Institute of Chicago. At CBM, Dr. Kuiken leads an interdisciplinary team that includes physicians, prosthetists, therapists, neuroscientists, engineers, software developers, graduate students, and post-doctoral researchers. He received his BS in biomedical engineering from Duke University, and his MD and PhD degrees from Northwestern University.

Arun Jayaraman, PT PhD

Arun Jayaraman, PT, PhD, Co-Investigator (Mobility/ADL Sensing). Dr. Jayaraman is Director of the Max Nader Center for Rehabilitation Technologies and Outcomes Research within the Center for Bionic Medicine at the RIC. He received his doctorate in rehabilitation sciences from the University of Florida and completed his post-doctoral training at the RIC. The overarching goal of his research is to inform clinical practice through rigorous investigator-initiated and industry-sponsored outcomes research.

Tim ReissmanTim Reissman, PhD, Engineering Project Manager. Dr. Reissman is a National Institutes of Health post-doctoral fellow within the Center for Bionic Medicine and the department of biomedical engineering at Northwestern University. His interests are aimed at applying core engineering principles to advance the technology used within rehabilitation research. He earned his BS, MS, and PhD degrees in mechanical engineering from Cornell University.

Additional collaborators: Manuel Amaro, Jim Lipsey,
Luca Lonini, PhD, CK Mummidisetty, Jose Ochoa, Emily Seyforth.

This research is supported by the U.S. Department of Education, National Institute on Disability and Rehabilitation Research, grant number H133E130020.