Temporal Parameters Estimation for Wheelchair Propulsion Using Wearable Sensors

Due to lower limb paralysis, individuals with spinal cord injury (SCI) rely on their upper limbs for mobility. The prevalence of upper extremity pain and injury is high among this population. We evaluated the performance of three triaxis accelerometers placed on the upper arm, wrist, and under the wheelchair, to estimate temporal parameters of wheelchair propulsion. Twenty-six participants with SCI were asked to push their wheelchair equipped with a SMARTWheel. The estimated stroke number was compared with the criterion from video observations and the estimated push frequency was compared with the criterion from the SMARTWheel. Mean absolute errors (MAE) and mean absolute percentage of error (MAPE) were calculated. Intraclass correlation coefficients and Bland-Altman plots were used to assess the agreement. Results showed reasonable accuracies especially using the accelerometer placed on the upper arm where the MAPE was 8.0% for stroke number and 12.9% for push frequency. The ICC was 0.994 for stroke number and 0.916 for push frequency. The wrist and seat accelerometer showed lower accuracy with a MAPE for the stroke number of 10.8% and 13.4% and ICC of 0.990 and 0.984, respectively. Results suggested that accelerometers could be an option for monitoring temporal parameters of wheelchair propulsion.

[1]  R. Burnham,et al.  Upper extremity peripheral nerve entrapments among wheelchair athletes: prevalence, location, and risk factors. , 1994, Archives of physical medicine and rehabilitation.

[2]  Rory A Cooper,et al.  Quantifying Wheelchair Activity of Children: A Pilot Study , 2008, American journal of physical medicine & rehabilitation.

[3]  E. Bergstrom,et al.  Long-term spinal cord injury: functional changes over time. , 1993, Archives of physical medicine and rehabilitation.

[4]  M. Granat,et al.  Development and validation of a physical activity monitor for use on a wheelchair , 2011, Spinal Cord.

[5]  M. Boninger,et al.  Shoulder joint kinetics and pathology in manual wheelchair users. , 2006, Clinical biomechanics.

[6]  E. Garshick,et al.  Association of Shoulder Pain With the Use of Mobility Devices in Persons With Chronic Spinal Cord Injury , 2010, PM & R : the journal of injury, function, and rehabilitation.

[7]  Anita Silvers,et al.  Americans with Disabilities , 2015 .

[8]  Tae-Gyung Kang,et al.  Mobility Device Use in the United States , 2003 .

[9]  M. Laplante,et al.  MOBILITY DEVICE USE IN THE UNITED STATES: DISABILITY STATISTICS REPORT , 2000 .

[10]  R. Adkins,et al.  Effects of reduction in shoulder pain on quality of life and community activities among people living long-term with SCI paraplegia: a randomized control trial , 2011, The journal of spinal cord medicine.

[11]  R. Waters,et al.  Preservation of Upper Limb Function Following Spinal Cord Injury: A Clinical Practice Guideline for Health-Care Professionals , 2005, The journal of spinal cord medicine.

[12]  Alicia M Koontz,et al.  Filter frequency selection for manual wheelchair biomechanics. , 2002, Journal of rehabilitation research and development.

[13]  Dan Ding,et al.  Detection of Wheelchair User Activities Using Wearable Sensors , 2011, HCI.

[14]  Aaron L. Souza,et al.  Shoulder kinematics and kinetics during two speeds of wheelchair propulsion. , 2002, Journal of rehabilitation research and development.

[15]  C. Blomstrand,et al.  Spinal Cord Injuries: Clinical, Functional, and Emotional Status , 1991 .

[16]  P. London Injury , 1969, Definitions.

[17]  D. Cardenas,et al.  Upper extremity pain after spinal cord injury , 1999, Spinal Cord.

[18]  Dan Ding,et al.  Estimating Temporal Parameters of Wheelchair Propulsion based on Hand Acceleration , 2008 .

[19]  K. Roach,et al.  Development of the Wheelchair User's Shoulder Pain Index (WUSPI) , 1995, Paraplegia.

[20]  Phillip A Bishop,et al.  Wheelchair-mounted accelerometers for measurement of physical activity , 2012, Disability and rehabilitation. Assistive technology.

[21]  M. Boninger,et al.  Assessing mobility characteristics and activity levels of manual wheelchair users. , 2007, Journal of rehabilitation research and development.

[22]  J. Collinger,et al.  The Effect of Symptoms of Carpal Tunnel Syndrome on Ultrasonographic Median Nerve Measures Before and After Wheelchair Propulsion , 2011, PM & R : the journal of injury, function, and rehabilitation.

[23]  Michael L Boninger,et al.  Handrim wheelchair propulsion training effect on overground propulsion using biomechanical real-time visual feedback. , 2013, Archives of physical medicine and rehabilitation.

[24]  James Gordon,et al.  Strengthening and Optimal Movements for Painful Shoulders (STOMPS) in Chronic Spinal Cord Injury: A Randomized Controlled Trial , 2011, Physical Therapy.

[25]  R. Waters,et al.  Upper extremity pain in the postrehabilitation spinal cord injured patient. , 1992, Archives of physical medicine and rehabilitation.

[26]  R A Cooper,et al.  Manual wheelchair pushrim biomechanics and axle position. , 2000, Archives of physical medicine and rehabilitation.

[27]  R. Sorrentino,et al.  Electronic Filter Simulation & Design , 2007 .

[28]  D. Altman,et al.  STATISTICAL METHODS FOR ASSESSING AGREEMENT BETWEEN TWO METHODS OF CLINICAL MEASUREMENT , 1986, The Lancet.

[29]  Rory A Cooper,et al.  A kinetic analysis of manual wheelchair propulsion during start-up on select indoor and outdoor surfaces. , 2005, Journal of rehabilitation research and development.

[30]  Alicia M Koontz,et al.  Relation between median and ulnar nerve function and wrist kinematics during wheelchair propulsion. , 2004, Archives of physical medicine and rehabilitation.

[31]  Shirley G Fitzgerald,et al.  Carpal Tunnel Syndrome in Manual Wheelchair Users with Spinal Cord Injury: A Cross-Sectional Multicenter Study , 2009, American Journal of Physical Medicine & Rehabilitation.

[32]  A. Ilyas Upper extremity. , 2014, The Orthopedic clinics of North America.

[33]  H J Stam,et al.  Validity of the detection of wheelchair propulsion as measured with an Activity Monitor in patients with spinal cord injury , 2005, Spinal Cord.

[34]  L. Twomey,et al.  The weight-bearing upper extremity in women with long term paraplegia , 1991, Paraplegia.

[35]  Shirley G Fitzgerald,et al.  A Preliminary Study on the Impact of Pushrim-Activated Power-Assist Wheelchairs Among Individuals with Tetraplegia , 2008, American journal of physical medicine & rehabilitation.

[36]  Alicia M Koontz,et al.  Biomechanics and Strength of Manual Wheelchair Users , 2005, The journal of spinal cord medicine.

[37]  Ana Souza,et al.  Pilot study for quantifying driving characteristics during power wheelchair soccer. , 2012, Journal of rehabilitation research and development.

[38]  Stephen Sprigle,et al.  Validation of an accelerometer-based method to measure the use of manual wheelchairs. , 2012, Medical engineering & physics.

[39]  Laurent Degos,et al.  HISTOCOMPATIBILITY DETERMINANTS IN MULTIPLE SCLEROSIS , 1974 .

[40]  Á. Gil-Agudo,et al.  Shoulder joint kinetics during wheelchair propulsion on a treadmill at two different speeds in spinal cord injury patients , 2010, Spinal Cord.