title: Measures of energy expenditure and comfort in an ESP wheelchair: a controlled trial using hemiplegic users'.
abstract: OBJECTIVE
  The aim of this pilot study using hemiplegic subjects was to measure energy expenditure, hand position and ride comfort, in a standard dual handrim Sunrise Breezy wheelchair compared to one modified with a novel ergonomic self-propelled steering (ESP) mechanism kit. A previous study by Mandy et al. (Disabil Rehabil Assist Technol 2007;2:255-260) reported that the attachment of the ESP kit to a standard Sunrise Breezy wheelchair provided a more ergonomically efficient mechanism for wheelchair steering and propulsion for non-disabled individuals.
  
  
  METHODS
  Thirteen hemiplegic stroke users participated in a repeated measures trial by driving two manual wheelchairs--a standard manual dual handrim wheelchair and one fitted with the ESP steering conversion kit. Wheelchairs were randomly assigned, to participants who drove each wheelchair around a designated circuit. Oxygen consumption, carbon dioxide and heart rate were measured as indicators of ergonomic efficiency using a Cosmed analyser. Comfort for each wheelchair was measured using a validated questionnaire.
  
  
  RESULTS
  Oxygen consumption (O(2)mls/min) and exhaled carbon dioxide (CO(2)mls/min) were significantly lower in the modified wheelchair (p < 0.004 and p < 0.04, respectively). Time taken to complete the course was significantly faster in the ESP (p < 0.001). There was no significant difference in heart rate readings between the wheelchairs. All comfort ratings were reported to be significantly greater in the ESP (p < 0.01).
  
  
  CONCLUSIONS
  The ESP conversion kit transforms a standard Sunrise Breezy wheelchair into one that is ergonomically more efficient and comfortable for hemiplegic subjects.
authors.affiliation: Clinical Research Centre, University of Brighton, Eastbourne, Sussex, UK. am86@bton.ac.uk
authors.forename: Anne
authors.initials: A
authors.lastname: Mandy
authors.forename: Samuel
authors.initials: S
authors.lastname: Lesley
mesh_terms: D000368:Aged; D002245:Carbon Dioxide / Q000378:metabolism; D004734:Energy Metabolism / Q000502:physiology*; D004867:Equipment Design; D045853:Exhalation; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006429:Hemiplegia / Q000378:metabolism / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008328:Man-Machine Systems; D010101:Oxygen Consumption / Q000502:physiology; D010865:Pilot Projects; D011795:Surveys and Questionnaires; D014910:Wheelchairs / Q000592:standards*
chemical_list: D002245:Carbon Dioxide