Kinetic Seating: From the Office to the Wheelchair

Transcription

1 Abstract Number: 50 Kinetic Seating: From the Office to the Wheelchair Farricielli, S Susan Farricielli P.O. Box 935 Branford, CT USA susan.farricielli@yale.edu Summary: Many manual wheelchair users suffer from back pain and pressure sores because they cannot move as much as they should. Few people would tolerate sitting all day long without being able to move. After assessment was made of the ways office seats move, a prototype was made of a dynamic seat for a wheelchair. The seat lets wheelchair users flex their backs and shift their weight without risk of falling over. Clinicians and therapists who evaluated the prototype identified potential wheelchair users as those with upper body strength. The prototype will undergo clinical trial testing. Introduction: A growing number of studies are indicating the beneficial effects of dynamic seating for people in wheelchairs. These studies suggest that dynamic seating maintains spinal health and improves circulation. Method: Dynamic seating for office chairs helps reduce pain for many who sit for long hours in their chairs. An evaluation of office seating helped determine the design of the wheelchair seat prototype. A test seat was devised in order to take measurements from people of varying sizes and shapes to identify their hinging points and range of motion. Results: The result is a design for a wheelchair seat that lets users flex their backs and shift their weight without the risk of falling over. The efficacy of the seat will be determined through clinical trial testing. Discussion: People who use manual wheelchairs generally have upper body strength but lower body weakness. They can suffer greatly from back pain and pressure sores. More than half of today s wheelchair users suffer chronic injuries from long-term wheelchair use, according to Michael Boninger, MD, medical director of the Pittsburgh Human Engineering and Research Laboratories. Researchers at the University of Pittsburgh

2 estimate that more than 400,000 people in manual wheelchairs experience serious secondary injuries to their shoulders, wrists, backs, and other body areas. 1 Preliminary research was conducted to investigate the problems with current wheelchair seating. Nurses from the Geriatrics Special Interest Group and physicians from Gaylord Rehabilitation Hospital, in Connecticut gave their opinion of some of the problems for people using wheelchairs. The Rehabilitation Research Center at the State University of New York conducted a focus study and found that users suffered chronic pain because they cannot move in their seats as much as they should. Wheelchair users complained of the following problems: Chronic back pain Rounded shoulders Spinal alignment problems Pressure sores These users evaluated the prototype of the dynamic seat and found it to be more comfortable. They felt it would: Increase their stability Improve circulation Improve their posture The proposed seat allows for natural tensing and relaxing of muscles that is otherwise restricted in traditional wheelchairs. The seating system permits flexing of the hips, knees and spinal column. Seat BACK flexes Seat BASE springs 1

3 The seat back allows a person in a wheelchair to flex along the spine. The seat base allows the users to shift their weight side to side and up and down. Clinical testing will be used to determine pressure requirements and range of motion for the seat back and the seat base. Medical specialists who evaluated the prototype have identified users of manual wheelchairs with the following conditions or diseases as most likely to benefit from a dynamic wheelchair seat. (note: US demographics).

4 The seat proposes to have the following benefits and features: Better stability The seat fits within the wheelchair frame with an adjustable height and depth. The user s center of gravity remains over the main wheels when stretching back, reducing the chance of tipping over. Better support A rigid surface under a cushion will distribute the users weight better than a standard sling seat. The support has enough flex to permit side-to-side motion. Extra movement Spring suspension allows users to stretch and move in their seats. The springs may alleviate pressure in areas prone to pressure sores. The springs also provide shock absorption, which has been shown to reduce fatigue. Modular Users can incorporate the seat back or the seat base into their wheelchair frame at any time. Users can use it in other wheelchairs. Cost Saving The shock absorbing properties of the seating system may extend wheelchair life by reducing stress, wear and tear. Medical Approval Medical approval will be sought so that the seat back and the seat base can be reimbursed through most [US] insurance plans. Affordable Price Users can improve the comfort of their wheelchairs for less than half the cost of the nearest equivalent product on the market. Users whose conditions may not qualify for insurance reimbursement can still afford to make their wheelchairs more comfortable.

5 P50 Kinetic Seating: From the Office to the Wheelchair S. Farricielli 1, owner, KiSS for Wheelchairs, adjunct professor Yale School of Architecture, 1 st place winning entry: Yale Venture Challenge, May 1, 2010, New Haven, Connecticut, USA Aim Few people would tolerate sitting all day long without being able to move. Motion assists circulation and allows nutrients to flow throughout the body. Sitting in the same position for hours puts tremendous amounts of pressure on the spinal column and ischial tuberosities. Many wheelchair users suffer from back pain and pressure sores because they cannot move as much as they should. The aim of this investigation was to determine a way to provide motion to a wheelchair seat to make it more comfortable without compromise to stability or propulsion. Results Methods Dynamic seating is a common solution to increase comfort for many who sit for long hours in the office environment. A growing number of studies indicate that dynamic seating might also be beneficial to people using wheelchairs. An analysis of office seating helped determine the design of the dynamic wheelchair seat. Chairs examined include: Vertebra (1974), Equa (1984), Aeron (1994), Leap (1994) and Freedom (1999). A test seat was devised and measurements were taken from human subjects to determine critical motions (Fig. 1). A prototype was built to fit into an existing wheelchair frame (Figs. 2 & 3). Figure 1: spring action Figure 4: propelling easier Figure 2: flex back Figure 5: next generation prototype Figure 3: spring seat Results and conclusion The prototype of the dynamic seat has demonstrated that stability is not only maintained but also increased. The seat base spring platform aids the user into and out of the wheelchair. Propulsion is not compromised but increased by a greater range of upper thoracic motion (Fig 4). These results suggest that dynamic motion in a wheelchair seat can increase user functionality as well as comfort. Test prototypes (Fig. 5) will be made for clinical evaluation. For inquiries: info@kissforwheelchairs.com

6 Seating Innovation Timeline Kinetic Seating: From the Office to the Wheelchair Everest & Jennings 1933 Susan Farricielli KiSS for Wheelchairs Aim Few people would tolerate sitting all day long without being able to move. Motion assists circulation and allows nutrients to flow throughout the body. Sitting in the same position for hours puts tremendous amounts of pressure on the spinal column and ischial tuberosities. Many wheelchair users suffer from back pain and pressure sores because they cannot move as much as they should. The aim of this investigation was to determine a way to provide motion to a wheelchair seat to make it more comfortable without compromise to stability or propulsion. Methods Dynamic seating is a common solution to increase comfort for many who sit for long hours in the office environment. A growing number of studies indicate that dynamic seating might also be beneficial to people using wheelchairs. An analysis of office seating helped determine the design of the dynamic wheelchair seat. Chairs examined include: Vertebra (1974), Equa (1984), Aeron (1994), Leap (1994) and Freedom (1999). A test seat was devised and measurements were taken from human subjects to determine critical motions. A prototype was built to fit into an existing wheelchair frame. Vertebra 1974 Quickie 1978 Equa 1984 Colours Boing 1990 Results and conclusion The prototype of the dynamic seat has demonstrated that stability is not only maintained but also increased. Seat base and seat back can be used separately or together. The seat base spring platform aids the user into and out of the wheelchair. Propulsion is not compromised but increased by a greater range of upper thoracic motion. These results suggest that dynamic motion in a wheelchair seat can increase user functionality as well as comfort. Test prototypes will be made for clinical evaluation. If you are interested in testing this device, info@kissforwheelchairs.com Leap 1994 Freedom Kuschall 1999 KiSS for Wheelchairs 2010 Kinetic Innovative Seating System

7 References: The Human Factors of Seating: The Significance of Anthropometrics, A. Kaplan, ID Magazine, 1962 The Human Body in Equipment Design, A. Damon, MIT Press, 1966 Vertebra vs. The Backache Syndrome, Center for Research & Development, Krueger International 1978 Common Fallacies of Posture Seating Design Furniture Design & Manufacturing, D. Krakauer 1978 The Agony and the Ecstasy of the Driving Position, L. Setright, Car & Driver Magazine, June 1987 Automobile Seating: A Kinetic Approach, S. Farricielli, thesis, Rhode Island School of Design 1989 Investigation of Dynamic Seating for Comfort, D. Hobson, PhD, RERC Research 1998 Wheelchair Seating Comfort, D. Hobson, B. Crane, RERC University of Pittsburg 2001 Dynamic Force Distribution at Body-Seat Interface During Propulsion, VA Medical Center 2004 Preventing pressure ulcers using a new sitting concept, Medical Technology Systems, 2005 Development of Dynamic Seating System for High-Tone Extensor Thrust, V. Patrangenaru, thesis Georgia Institute of Technolog A Dynamic Seating Intervention for Wheelchair Seating Discomfort, B. Crane, PhD, et al. American Journal of Physical Medicine & Rehabilitation, 2007 Susan Farricielli is a product designer and owner of KiSS for Wheelchairs and a.k.a. prototype. She is adjunct professor at Yale University School of Architecture and at Quinnipiac University. TRY ME! KiSS for Wheelchairs P.O. Box 935 Branford, CT USA attn: Susan Farricielli Kinetic Innovative Seating System P50