title: Energy expenditure, and comfort in a modified wheelchair for people with hemiplegia: a controlled trial.
abstract: OBJECTIVE
  The aim of this pilot study using non-disabled 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. The clinical reasoning underpinning the engineering design of the ESP kit was to develop a more ergonomically efficient mechanism for wheelchair steering and propulsion for individuals who had sustained cerebral vascular accidents.
  
  
  METHODS
  Ten non-disabled males participated in a repeated measures trial by driving two manual wheelchairs - a standard manual dual handrim wheelchair and one fitted with the 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
  Heart rate (bpm), oxygen consumption (O2 ml/min) and exhaled carbon dioxide (CO2 ml/min) were significantly lower in the modified wheelchair (P < 0.001, P < 0.006 and P < 0.014, respectively). All comfort ratings were reported to be significantly greater in the ESP (P < 0.05).
  
  
  CONCLUSIONS
  The ESP conversion kit transforms a standard Sunrise Breezy Wheelchair into one that is ergonomically more efficient and comfortable for non-disabled subjects.
authors.affiliation: Clinical Research Centre, University of Brighton, Aldro, 49 Darley Road, Eastbourne, Sussex BN20 7UR, UK. Am86@bton.ac.uk
authors.forename: Anne
authors.initials: A
authors.lastname: Mandy
authors.forename: Samuel
authors.initials: S
authors.lastname: Lesley
authors.forename: Kevin
authors.initials: K
authors.lastname: Lucas
mesh_terms: D000328:Adult; D002245:Carbon Dioxide; D004734:Energy Metabolism; D004867:Equipment Design; D006225:Hand; D006339:Heart Rate; D006429:Hemiplegia / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008328:Man-Machine Systems; D010101:Oxygen Consumption; D010865:Pilot Projects; D011187:Posture; D000071939:Stroke Rehabilitation; D011795:Surveys and Questionnaires; D014910:Wheelchairs
chemical_list: D002245:Carbon Dioxide