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Aim: To explore the effect of a 4‐week structured power wheelchair skills training programme (WSTP) intervention on mobility skills and participation in children and young people (CYP) with cerebral palsy (CP). Method: This was a one‐group, repeated‐measures study; baseline, intervention, and retention phases, each lasting 4 weeks, were used. Twelve participants (three females, nine males) with a mean age of 15 years 11 months (SD = 3 years 6 months) classified in Gross Motor Function Classification System levels IV and V participated in the study. To be included in the study, individuals had to be aged 6 to 21 years and currently using a power wheelchair. Participants received 12 WSTP training sessions of 45 minutes, 3 times per week. Power mobility skills were assessed using the Wheelchair Skills Test (WST) before baseline, before the intervention, after the intervention, and at the follow‐up; mobility‐related participation was assessed with the Canadian Occupational Performance Measure (COPM). Generalized mixed models with Bonferroni correction were used to assess the differences between the assessment points (p < 0.05). Results: Statistical analysis showed a 10.4% (12.5) increase in WST total scores (p < 0.001) after the intervention compared to before the intervention, and a 1‐point (0.9) increase in the COPM performance subdomain (p = 0.002). Interpretation: Power mobility skills and mobility‐related participation improved after a 4‐week WSTP intervention in CYP with CP. Thus, task‐based power mobility skills training based on the WSTP, and in line with individualized needs and capabilities, taking place in a natural environment, should be recommended. Power mobility skills training needs to be structured and individualized; the training interventions must consider the individual, the task, and the environment. This original article is commented by Best and Kirby on pages 1540–1541 of this issue. [ABSTRACT FROM AUTHOR]

This review reports on the use of sensors in wheelchair sports to monitor and analyze performance during match and training time. With rapid advancements in electronics and related technologies, understanding performance metrics in wheelchair sports is essential. We reviewed nine studies using various sensor types, including electric motors, inertial measurement units, miniaturized data loggers with magnetic reed switches, and smartphones with inbuilt accelerometers and gyroscopes, operating at frequencies from 8 Hz to 1200 Hz. These studies measured parameters such as angular and translational velocities, distance, number of starts/pushes, and other performance indicators in sports such as basketball, rugby, tennis, and racing. Despite differences in sport types and methodologies, most studies found sensor-derived data effective for assessment of performance. Future developments and research in this field should focus on multi-sensor systems that could provide real-time match analysis and deeper insights into performance metrics. Overall, sensor technologies show significant potential for improving wheelchair sport performance diagnostics, contributing to better athlete training and future wheelchair design, and enhancing competitive outcomes. This review emphasizes the need for continued innovation and standardization in applying sensor technologies in wheelchair sports. [ABSTRACT FROM AUTHOR]

Background: Monitoring player mobility in wheelchair sports is crucial for helping coaches understand activity dynamics and optimize training programs. However, the lack of data from monitoring tools, combined with a lack of standardized processing approaches and ineffective data presentation, limits their usability outside of research teams. To address these issues, this study aimed to propose a simple and efficient algorithm for identifying locomotor tasks (static, forward/backward propulsion, pivot/tight/wide rotation) during wheelchair movements, utilizing kinematic data from standard wheelchair mobility tests. Methods: Each participant's wheelchair was equipped with inertial measurement units—two on the wheel axes and one on the frame. A total of 36 wheelchair tennis and badminton players completed at least one of three proposed tests: the star test, the figure-of-eight test, and the forward/backward test. Locomotor tasks were identified using a five-step procedure involving data reduction, symbolic approximation, and logical pattern searching. Results: This method successfully identified 99% of locomotor tasks for the star test, 95% for the figure-of-eight test, and 100% for the forward/backward test. Conclusion: The proposed method offers a valuable tool for the simple and clear identification and representation of locomotor tasks over extended periods. Future research should focus on applying this method to wheelchair court sports matches and daily life scenarios. [ABSTRACT FROM AUTHOR]

Adaptation to technological advancements and intelligent digital tools can enable healthcare providers to overcome the challenges of their patient-oriented care systems and processes. One such intelligent tool is automated assistive robots, which can improve patient care and safety in the health sector. This paper presents an invariant set of continuous nonlinear control laws for an assistive robot and a rehabilitation wheelchair robot modeled as a new autonomous robotic dog and rehabilitation wheelchair system for navigating a highly constrained environment. The control laws are derived from the Lyapunov-based control scheme classified under the umbrella of artificial potential field (APF) methods, and inherently proved stability of the new heterogeneous system. The robotic dog guides the wheelchair robot during the navigation process in a cluttered environment where the avoidances are from the robotic dog and the integrated dynamic protective polygon. The wheelchair traverses the obstacle-free path traced by the dynamic polygon. The leash is flexible, and its length is bounded, which invariably provides the protective polygon to change its intrinsic dimension. Thus, the dual-robot system has increased mobility for obstacle avoidance and passing through narrow passageways. The solution proffered herein is only feasible in a highly constrained and isolated human environment where nothing else appears to be moving in the direction of the robotic dog and wheelchair. The computer simulations and associated convergence graphs present the efficacy of the unique control laws for the new heterogeneous robotic system. Adoption of such control laws and their suitable variants can make a big impact in the healthcare industry. [ABSTRACT FROM AUTHOR]

Traditional wheelchairs are pushed from behind the occupant, which hinders eye contact and communication. It was proposed that the wheelchair be pushed from the side using a push bar to place the caregiver beside the occupant. However, this method requires the caregiver to exert continuous effort to maintain a straight trajectory because the force at the lateral push location generates a moment. This study explores simple modifications to the front castor wheel of the wheelchair that allow pushing it from the side without additional effort. We used a three-dimensional dynamic model of the castor wheel to predict the effects of altering its dimensions and rake, cant, and bank angle and present a simplified steady-state solution. Experimental results support the model's predictions, and a proof-of-concept experiment with a wheelchair showed that it is possible to push a wheelchair from the side without increasing forces or moments. The results also confirmed that the lateral ground reaction force generated on the castor wheel is proportional to the normal force and the cant angle, which can counter the moment caused by the lateral push location. The implications of this model extend beyond wheelchair design and can be applied to other applications that use castor wheels, such as robotics, trolleys, and walkers. [ABSTRACT FROM AUTHOR]

Intelligent nursing wheelchairs significantly enhance mobility and independence for elderly individuals with disabilities. However, traditional designs often suffer from large turning radii that restrict their functionality in confined spaces. Addressing this critical challenge, this study introduces an innovative design utilizing a Mecanum wheel chassis that allows for omnidirectional movement, significantly improving maneuverability and stability. Our design incorporates independently controlled Mecanum wheels, overcoming traditional constraints and enhancing user autonomy. To address issues such as wheel spacing variations and hub center tilting, which can lead to slipping and inaccurate motion control, we developed a novel suspension system that stabilizes the chassis, minimizes slipping risks, and boosts motion control accuracy. Experimental validations, including shock absorption and positioning tests, demonstrate that our suspension system markedly enhances the wheelchair's control performance and stability, thereby providing users with enhanced precision and potentially improving their quality of life. [ABSTRACT FROM AUTHOR]

A rotary actuator effectively drives the motion of a power wheelchair, which distinguishes it from manual wheelchairs. For the design and development of a smart robotic power wheelchair (SRPW) prototype, the choice of rotary actuators (RA) is critical. However, the wide range of RA features available commercially make it challenging to choose an appropriate and valuable device for a SRPW prototype. This article employs four multi-criteria decision-making (MCDM) approaches, including (Additive Ratio Assessment) ARAS, (Complex Proportional Assessment) COPRAS, (Evaluation Based on Distance from Solution) EDAS, and (Grey Relation Analysis) GRA, along with the (Criteria Importance through Inter-Criteria Correlation) CRITIC weight assignment technique, to rank 10 alternatives RAs with 7 competing criteria such as cost, weight, voltage, current, power, torque, and speed. Due to the different rankings generated by these methods, Spearman's rank correlation coefficient is used to resolve disagreements and highlight the optimum ranking for the decision matrix. Based on the Copeland voting rule, RA-6 is the most suitable alternative, while RA-10 is found to be the least ideal of the ten alternatives. The rankings have been robustly analyzed with sensitivity analysis on cost parameters and found to be quite helpful in leading future research communities and prototype developers. [ABSTRACT FROM AUTHOR]

Operating a powered wheelchair involves significant risks and requires considerable cognitive effort to maintain effective awareness of the surrounding environment. Therefore, people with significant disabilities are at a higher risk, leading to a decrease in their social interactions, which can impact their overall health and well-being. Thus, we propose an intelligent driving-assistance system that innovatively uses Transformers, typically employed in Natural Language Processing, for navigation and a retrieval mechanism, allowing users to specify their destinations using natural language. The system records the areas visited and enables users to pinpoint these locations through descriptions, which will be considered later in the retrieval phase. Taking a foundational model, the system is fine-tuned with simulated data. The preliminary results demonstrate the system's effectiveness compared to non-assisted solutions and its readiness for deployment on edge devices. [ABSTRACT FROM AUTHOR]

Over the years, intelligent wheelchairs have been developed to fulfill the needs of wheelchair users by gathering information from the environment to make autonomous decisions. This paper proposes an intelligent object manipulation algorithm that leverages users' intentions, past experiences, and preferences. To gather the necessary information for object placement, a human study involving 20 healthy participants was conducted. The study included two situation‐based object placement scenarios and object placement when objects were given in pairs. Building on the authors' previously developed electromyography‐based wheelchair navigation algorithm, a semiautonomous object manipulation algorithm was developed. This new algorithm was tested in the CoppeliaSim simulation environment by replicating the tasks performed in the human study. The object arrangements in the simulation were then compared to the results from the human study. The findings indicate that the implemented object manipulation algorithm successfully replicated the outcomes observed in the human study. The application of this controller is expected to significantly enhance accessibility for individuals with impaired motor functionalities in addition to their ambulatory impairments. This development represents a significant step forward in creating user‐friendly and adaptive assistive technologies for wheelchair users. [ABSTRACT FROM AUTHOR]

Autonomous personal mobility vehicles (PMVs), such as electric wheelchairs, are meant to drive through pedestrian spaces. Cooperative pedestrian avoidance by PMVs is necessary in these spaces to maintain smooth traffic. Previous studies suggested that PMVs can avoid pedestrians on a shorter path without compromising each other's acceptability. This avoidance can be realized by understanding how pedestrians react to the behavior of PMVs and considering those characteristics in the autonomous navigation of PMVs. In this study, the characteristics of pedestrian's avoidance behavior were investigated. Experiments were conducted to understand the influence of the parameters of the PMV's avoidance behavior on pedestrians. Results showed that the angular velocity of the PMV during avoidance affects the pedestrian's avoidance width and tolerance against the PMV's behavior. These results suggest that it is possible to avoid pedestrians in smaller avoidance spaces by controlling the angular velocity of the PMV and maintaining smooth traffic. [ABSTRACT FROM AUTHOR]

In the global context, advancements in technology and science have rendered virtual, augmented, and mixed-reality technologies capable of transforming clinical care and medical environments by offering enhanced features and improved healthcare services. This paper aims to present a mixed reality-based system to control a robotic wheelchair for people with limited mobility. The test group comprised 11 healthy subjects (six male, five female, mean age 35.2 ± 11.7 years). A novel platform that integrates a smart wheelchair and an eye-tracking-enabled head-mounted display was proposed to reduce the cognitive requirements needed for wheelchair movement and control. The approach's effectiveness was demonstrated by evaluating our system in realistic scenarios. The demonstration of the proposed AR head-mounted display user interface for controlling a smart wheelchair and the results provided in this paper could highlight the potential of the HoloLens 2-based innovative solutions and bring focus to emerging research topics, such as remote control, cognitive rehabilitation, the implementation of patient autonomy with severe disabilities, and telemedicine. [ABSTRACT FROM AUTHOR]

As a significant technological innovation in the fields of medicine and geriatric care, smart care wheelchairs offer a novel approach to providing high-quality care services and improving the quality of care. The aim of this review article is to examine the development, applications and prospects of smart nursing wheelchairs, with particular emphasis on their assistive nursing functions, multiple-sensor fusion technology, and human–machine interaction interfaces. First, we describe the assistive functions of nursing wheelchairs, including position changing, transferring, bathing, and toileting, which significantly reduce the workload of nursing staff and improve the quality of care. Second, we summarized the existing multiple-sensor fusion technology for smart nursing wheelchairs, including LiDAR, RGB-D, ultrasonic sensors, etc. These technologies give wheelchairs autonomy and safety, better meeting patients' needs. We also discussed the human–machine interaction interfaces of intelligent care wheelchairs, such as voice recognition, touch screens, and remote controls. These interfaces allow users to operate and control the wheelchair more easily, improving usability and maneuverability. Finally, we emphasized the importance of multifunctional-integrated care wheelchairs that integrate assistive care, navigation, and human–machine interaction functions into a comprehensive care solution for users. We are looking forward to the future and assume that smart nursing wheelchairs will play an increasingly important role in medicine and geriatric care. By integrating advanced technologies such as enhanced artificial intelligence, intelligent sensors, and remote monitoring, we expect to further improve patients' quality of care and quality of life. [ABSTRACT FROM AUTHOR]

In Japan, the number of power wheelchair users is increasing as the country becomes an aging society. This trend is expected to continue in the future. Electric wheelchairs currently on the market include (1) bar-handle-type power wheelchairs for older users and (2) joystick-type power wheelchairs that change direction by operating a joystick. When such electric wheelchairs are used outdoors, the problem is curb-climbing at the boundary between the roadway and the sidewalk. It would be difficult for a wheelchair with a small front wheel diameter of 200 mm to overcome a curb height of 50 mm. Therefore, users are forced to take a detour or drive on the street to avoid the curb step. One of the most effective ways to solve this problem is to increase the wheel diameter. However, larger wheels make it more difficult for users to get in and out of the wheelchair. In addition, there are problems such as an increased footprint when turning, which makes the wheelchairs difficult to use on narrow streets. In this paper, using a joystick-type six-wheel electric wheelchair as an example, we examined the mechanism by which an electric wheelchair can overcome curb climbing and consider improvements to the chassis with a method that does not rely on increasing the wheel diameter. As a result, it became possible to overcome a curb of 96 mm in height with a front-wheel diameter of 200 mm. [ABSTRACT FROM AUTHOR]

The project focuses on the design and development of an automatic adjustable ergonomic wheelchair aimed at improving comfort and usability for individuals with disabilities. The wheelchair contains advanced ergonomics features to find out the issues related to posture, pressure points and overall comfort during extended periods of usage. The key components of the wheelchair include adjustable seat height, backrest angle, armrest height and footrest position all are controlled through the latest technology for the user's convenience. The ergonomic design considers the natural alignment of the body used to minimize strain and discomfort. This contains automatic pressure relief mechanisms to reduce the risk pressure ulcers. This system utilizes sensors and a joystick to periodically adjust the seating position and airbag features and promote circulation. To enhance mobility and accessibility this wheelchair obtains smart navigation, obstacle detection systems, enabling users to need care safety in various equipped with connectivity features for remote monitoring and adjustments, facilitating personalized support and maintenance. The proposed automatic adjustable ergonomic wheelchair offers significant improvements in comfort, safety and overall quality of life for individuals with disabilities. Customizable features enhance wheelchair comfort, functionality, and adaptability to meet individual user needs. [ABSTRACT FROM AUTHOR]

A system has been developed to convert manual wheelchairs into electric wheelchairs, providing assistance to users through the implemented algorithm, which ensures safe driving and obstacle avoidance. While manual wheelchairs are typically controlled indoors based on user preferences, they do not guarantee safe driving in areas outside the user's field of vision. The proposed model utilizes the dynamic window approach specifically designed for wheelchair use, allowing for obstacle avoidance. This method evaluates potential movements within a defined velocity space to calculate the optimal path, providing seamless and safe driving assistance in real time. This innovative approach enhances user assistance and safety by integrating state-of-the-art algorithms developed using the dynamic window approach alongside advanced sensor technology. With the assistance of LiDAR sensors, the system perceives the wheelchair's surroundings, generating real-time speed values within the algorithm framework to ensure secure driving. The model's ability to adapt to indoor environments and its robust performance in real-world scenarios underscore its potential for widespread application. This study has undergone various tests, conclusively proving that the system aids users in avoidance obstacles and ensures safe driving. These tests demonstrate significant improvements in maneuverability and user safety, highlighting a noteworthy advancement in assistive technology for individuals with limited mobility. [ABSTRACT FROM AUTHOR]

The global issue of improving the quality of life for individuals with special needs calls for the fashion industry's dedication to offering equal opportunities, preventing discrimination, and raising their living standards as active members of society. The field of adaptive clothing has evolved over the years, showcasing a big progress from the early 20th century's practical solutions to the innovative technology of today. Adaptive clothing is designed to assist people with various physical limitations by incorporating features that make dressing and undressing easier, often without requiring assistance. This research delves into the critical need to enhance the quality of life for individuals with disabilities, particularly through the development of adaptive clothing tailored to the needs of wheelchair users. By thoroughly examining disability classifications and clothing requirements, it underscores the importance of tailored solutions to address comfort and functionality challenges. The study emphasizes the pivotal role of adaptive clothing in fostering independence and reducing reliance on assistance for those with physical disabilities. Through a focused case study, a garment specifically designed for wheelchair users is developed, featuring innovative design modifications aimed at optimizing both comfort and functionality. With a strong emphasis on functionality and comfort, the research prioritizes meeting both consumer preferences and physiological needs. Ultimately, the goal of this research is to raise the standard of adaptive clothing, promoting inclusivity and enhancing the overall well-being of individuals with disabilities. [ABSTRACT FROM AUTHOR]

Seat pressure measurements in wheelchair users have been available for some time; however, repeated measurements from a commercially available pressure mat over 90 min did not differ in the pressure-loaded measurement area or the coordinates of the center of pressure, even in participants who were able to reposition themselves in the wheelchair. The question therefore arises: to what extent are there other parameters that reflect the activity of wheelchair users with the pressure mat? To investigate this, a commercial pressure mat (BodiTrak®) was used to perform the measurements of pressure of 33 adult wheelchair-dependent people with spinal cord injury after 30 and 90 min sitting on the cushion. In addition to the standard output of the pressure mat, graph-based surface analyses (calculation of the area of maximum pressure, calculation of the pressure-loaded measurement area, and pressure–area ratio) was performed retrospectively using Python 3.7. The analysis of the measurements after 30 and 90 min was performed by distinguishing the participants between those who could actively change their position (N = 24) and those who could not (N = 9). The parameters of the pressure mat and the graph-based analyses remained unchanged for active participants. In participants who were unable to actively change their position, the area of maximum pressure and the pressure–area ratio (ratio of maximum pressure area and total pressure-loaded area) increased. Significant differences between minutes 30 and 90 are only found for the pressure–area ratio. Thus, when measuring the seat pressure of wheelchair users, the pressure–area ratio should be taken into account as it reflects the daily relief activities of wheelchair users. [ABSTRACT FROM AUTHOR]

Wheelchair basketball (WB) is a sport modality adapted for people with disabilities who present functional classification (FC) according to their mobility, from 1.0 for players with lesser functional capacity up to 4.5 for great mobility and trunk control players. This study aimed to analyze and compare the external load (EL) and the internal load (IL) of the WB players according to their FC in 5 × 5 simulation game tasks. The main objective of this task was to develop a simulated game in which two teams of five players faced each other to resemble the physical demands of an official match. The development of these tasks allowed for the players to learn the different systems of play, and to improve tactical skills. To conduct the study, 12 (male) national professional WB players (years: 30.7 ± 4.82 and WB experience: 5 ± 1.43) participated in the study and were grouped according to FC. WIMU PROTM devices monitored the EL manufactured by RealTrack Systems in Almería, Spain, and to measure the player's IL, GarminTM Heart Rate (HR) bands were used (GarminTM in Olathe, KS, USA). The EL variables were divided as kinematic (distance, explosive distance, acc, dec, max. acc, max. dec, average speed, max. speed) and neuromuscular (player load, impact). The IL variables were average HR, max. HR and %max. HR. The main results show that players with greater functional capacity (FC = 4.0) developed higher values in the IL and neuromuscular variables analyzed (p < 0.05), as well as in some kinematic variables like distance, dec and average speed (p < 0.05). This information is relevant because it helps to personalize the training load based on competitive demands and create a gradual and adaptable training program. This information helps athletes to develop better performance during training and prevent injuries caused by overexertion. [ABSTRACT FROM AUTHOR]

Despite advancements in creating barrier-free environments, many buildings still have stairs, making accessibility a significant concern for wheelchair users, the majority of whom check for accessibility information before venturing out. This paper focuses on developing a transformable quadruped wheelchair to address the mobility challenges posed by stairs and steps for wheelchair users. The wheelchair, inspired by the Unitree B2 quadruped robot, combines wheels for flat surfaces and robotic legs for navigating stairs and is equipped with advanced sensors and force detectors to interact with its surroundings effectively. This research utilized reinforcement learning, specifically curriculum learning, to teach the wheelchair stair-climbing skills, with progressively increasing complexity in a simulated environment crafted in the Unity game engine. The experiments demonstrated high success rates in both stair ascent and descent, showcasing the wheelchair's potential in overcoming mobility barriers. However, the current model faces limitations in tackling various stair types, like spiral staircases, and requires further enhancements in safety and stability, particularly in the descending phase. The project illustrates a significant step towards enhancing mobility for wheelchair users, aiming to broaden their access to diverse environments. Continued improvements and testing are essential to ensure the wheelchair's adaptability and safety across different terrains and situations, underlining the ongoing commitment to technological innovation in aiding individuals with mobility impairments. [ABSTRACT FROM AUTHOR]

The traditional wheelchair focuses on the "human-chair" motor function interaction to ensure the elderly and people with disabilities' basic travel. For people with visual, hearing, physical disabilities, etc., the current wheelchairs show shortcomings in terms of accessibility and independent travel for this group. Therefore, this paper develops an intelligent wheelchair with multimodal human–computer interaction and autonomous navigation technology. Firstly, it researches the multimodal human–computer interaction technology of occupant gesture recognition, speech recognition, and head posture recognition and proposes a wheelchair control method of three-dimensional head posture mapping the two-dimensional plane. After testing, the average accuracy of the gesture, head posture and voice control modes of the motorized wheelchair proposed in this study reaches more than 95 percent. Secondly, the LiDAR-based smart wheelchair indoor autonomous navigation technology is investigated to realize the autonomous navigation of the wheelchair by constructing an environment map, using A* and DWA algorithms for global and local path planning, and adaptive Monte Carlo simulation algorithms for real-time localization. Experiments show that the position error of the wheelchair is within 10 cm, and the heading angle error is less than 5° during the autonomous navigation. The multimode human–computer interaction and assisted driving technology proposed in this study can partially compensate and replace the functional deficiencies of the disabled population and improve the quality of life of the elderly and disabled population. [ABSTRACT FROM AUTHOR]

Recently, due to physical aging, diseases, accidents, and other factors, the population with lower limb disabilities has been increasing, and there is consequently a growing demand for wheelchair products. Modern product design tends to be more intelligent and multi-functional than in the past, with the popularization of intelligent concepts. This supports the design of a new, fully functional, intelligent wheelchair that can assist people with lower limb disabilities in their day-to-day life. Based on the UCD (user-centered design) concept, this study focused on the needs of people with lower limb disabilities. Accordingly, the demand for different functions of intelligent wheelchair products was studied through a questionnaire survey, interview survey, literature review, expert consultation, etc., and the function and appearance of the intelligent wheelchair were then defined. A brain–machine interface system was developed for controlling the motion of the intelligent wheelchair, catering to the needs of disabled individuals. Furthermore, ergonomics theory was used as a guide to determine the size of the intelligent wheelchair seat, and eventually, a new intelligent wheelchair with the features of climbing stairs, posture adjustment, seat elevation, easy interaction, etc., was developed. This paper provides a reference for the design upgrade of the subsequently developed intelligent wheelchair products. [ABSTRACT FROM AUTHOR]

Even though Electric Powered Wheelchairs (EPWs) are a useful tool for meeting the needs of people with disabilities, some disabled people find it difficult to use regular EPWs that are joystick-controlled. Smart wheelchairs that use Brain–Computer Interface (BCI) technology present an efficient solution to this problem. This article presents a cutting-edge intelligent control wheelchair that is intended to improve user involvement and security. The suggested method combines facial expression analysis via a camera with EEG signal processing using the EMOTIV Insight EEG dataset. The system generates control commands by identifying specific EEG patterns linked to facial expressions such as eye blinking, winking left and right, and smiling. Simultaneously, the system uses computer vision algorithms and inertial measurements to analyze gaze direction in order to establish the user's intended steering. The outcomes of the experiments prove that the proposed system is reliable and efficient in meeting the various requirements of people, presenting a positive development in the field of smart wheelchair technology. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to evaluate users' driving performances with a Power Wheelchair (PWC) driving simulator in comparison to the same driving task in real conditions with a standard power wheelchair. Methods: Three driving circuits of progressive difficulty levels (C1, C2, C3) that were elaborated to assess the driving performances with PWC in indoor situations, were used in this study. These circuits have been modeled in a 3D Virtual Environment to replicate the three driving task scenarios in Virtual Reality (VR). Users were asked to complete the three circuits with respect to two testing conditions during three successive sessions, i.e. in VR and on a real circuit (R). During each session, users completed the two conditions. Driving performances were evaluated using the number of collisions and time to complete the circuit. In addition, driving ability by Wheelchair Skill Test (WST) and mental load were assessed in both conditions. Cybersickness, user satisfaction and sense of presence were measured in VR. The conditions R and VR were randomized. Results: Thirty-one participants with neurological disorders and expert wheelchair drivers were included in the study. The driving performances between VR and R conditions were statistically different for the C3 circuit but were not statistically different for the two easiest circuits C1 and C2. The results of the WST was not statistically different in C1, C2 and C3. The mental load was higher in VR than in R condition. The general sense of presence was reported as acceptable (mean value of 4.6 out of 6) for all the participants, and the cybersickness was reported as acceptable (SSQ mean value of 4.25 on the three circuits in VR condition). Conclusion: Driving performances were statistically different in the most complicated circuit C3 with an increased number of collisions in VR, but were not statistically different for the two easiest circuits C1 and C2 in R and VR conditions. In addition, there were no significant adverse effects such as cybersickness. The results show the value of the simulator for driving training applications. Still, the mental load was higher in VR than in R condition, thus mitigating the potential for use with people with cognitive disorders. Further studies should be conducted to assess the quality of skill transfer for novice drivers from the simulator to the real world. Trial registration Ethical approval n ∘ 2019-A001306-51 from Comité de Protection des Personnes Sud Mediterranée IV. Trial registered the 19/11/2019 on ClinicalTrials.gov in ID: NCT04171973. [ABSTRACT FROM AUTHOR]

Purpose: Chemotherapy-induced nausea and vomiting (CINV) is a common adverse events in cancer patients and can negatively affect their quality of life (QoL). This study aimed to evaluate the clinical efficacy of an electric massage chair (EMC) for the treatment of CINV. Methods: A randomized phase II cross-over trial was conducted on solid cancer patients who received moderate (MEC) to high emetogenic chemotherapy (HEC). The participants were randomly assigned to receive their first chemotherapy either on a standard bed (Group A) or in an EMC (Group B) during the infusion. The patients were then crossed over to the next cycle. CINV and QoL questionnaires were collected from the participants. Results: A total of 59 patients completed the trial protocol and were included in the analysis, with 29 and 30 patients in Groups A and B, respectively. The mean INVR (Index of Nausea, Vomiting, and Retching) score in the 2nd day of the first cycle was higher in Group B (3.63 ± 5.35) than Group A (2.76 ± 4.78), but the difference was not statistically significant (p = 0.5367). The complete response rate showed little difference between the groups. Among the high-emetic risk subgroups, patients who received HEC (p = 0.04595), younger patients (p = 0.0108), and non-colorectal cancer patients (p = 0.0495) presented significantly lower CINV scores when EMC was applied. Conclusion: Overall, there was no significant difference in INVR scores between standard care and EMC. Applying EMC at the first chemotherapy infusion may help preserve QoL and reduce CINV in high-risk patients. Trial registration: KCT0008200, 17/02/2023, Retrospectively registered. [ABSTRACT FROM AUTHOR]

Monitoring joystick operations in power wheelchairs (PWCs) is promising for investigating user-wheelchair interaction and providing quantitative measures to assess the user's driving performance. In this paper, an add-on measurement system, Power Wheelchair Maneuvering Logger (PWhML), is developed to provide an easy-to-implement and cost-effective solution for monitoring the user's joystick operations in PWCs. The proposed system uses two compact inertial measurement units (IMUs), which are respectively attached to the joystick and wheelchair armrest for movement sensing. A coordinate transformation-based method is proposed to estimate the joystick operating angles using the acceleration data measured by the attached IMUs. The accuracy of the proposed method was thoroughly evaluated under different conditions. The evaluation trials in a stationary PWC reported a mean absolute error (MAE) of 0.59° in the forward/backward direction and 0.64° in the leftward/rightward direction, validating the established geometry model for coordinate transformation. The subsequent driving experiments on outdoor test courses demonstrated the effectiveness and robustness of the proposed method in various terrain conditions (MAE of less than 3°). A clustering analysis based on the t-distributed stochastic neighborhood embedding method correctly categorized different driving activities using the joystick operating angles measured by PWhML. These results indicate that integrating the developed PWhML into PWCs can facilitate a quantitative measurement of the user's driving behavior, providing valuable insights to identify careless operation patterns and help PWC users to improve driving performance. [ABSTRACT FROM AUTHOR]

People with upper limb disabilities or high quadriplegia have extremely high requirements for the maneuverability and functionality of power wheelchairs. Normal wheelchairs cannot meet travel tasks, while smart customized wheelchairs are expensive and cannot be popularized. Therefore, a novel extension control instrument for power wheelchairs with low cost, strong scalability, and convenient usage is proposed, which can realize the control of the wheelchair by sensing a change of head posture. The device is divided into a head motion sensing unit (HMSU) and a wheelchair assistance control unit (WACU). The mapping relationship between the head attitude and the subject's motion intention is established. The inertial measurement module in the HMSU collects the head attitude data and uses the Kalman filtering method to obtain the accurate Euler angle. The WACU is fixed on the original controller of the wheelchair. The joystick is inserted into the extended control mechanism and controlled, instead of the hand, through a 2-degree-of-freedom servo system combined with the pinion and rack push rod structure, thus controlling the movement of the wheelchair. In proceeding, the system can also detect the distance of objects in the environment in real time through the three-direction (front, left, right) ultrasonic ranging sensors installed on the WACU, with a certain obstacle avoidance function. The prototype experiments prove that the extension control instrument developed in this paper based on the Kalman filter can quickly and accurately identify head motion and accurately control the movement of the wheelchair. It is easy to operate and has strong universality, which presents a new low-cost solution for the travel of patients with disabilities. [ABSTRACT FROM AUTHOR]

The existing air pollution monitoring network in the Attica basin, overseen by the Ministry of the Environment (MEEN) consists of certified and high-cost sensors, and consequently is not dense enough. At the same time, it offers no easily accessible information to the citizens or representative data on population exposure. Low cost IoT sensors present a solution to the density issue, even though Quality Assurance/Quality Control (QA/QC) is required to ensure accuracy of their measurements, but face challenges related to their deployment. Within that frame, the Smart Stations were developed by the FAIRCITY (ATTP4-0360457) project aiming to bridge Smart City Services (e.g., free internet, information, wheelchair/devices charging) with continuous air quality monitoring and exposure assessment. The smart info-kiosk benches powered by sunlight (manufactured by a Greek Innovation Company) were thus employed where low cost IoT sensors were embedded, offering a unique opportunity to monitor air quality at the level where citizens live. This endeavor faced several challenges related to the design of smart stations, the network, the information to be conveyed to the public and the scientific value of the data collected. [ABSTRACT FROM AUTHOR]

With the gradual maturity of the Internet of Things environment, the collection and analysis technology of production data is continuously improved, and the improvement of product process quality and safety performance can not only increase product value but also prolong product life, in order to achieve the goal of energy-saving and waste-reducing green production. Therefore, this study used process capability indicators of important quality characteristics as evaluation tools for the manual wheelchair products and proposed a smart quality decision-making model for production data. First, we constructed an evaluation index for the important quality characteristics of the carbon fiber wheel rims to verify that each important quality characteristic can meet the required quality level. Next, based on the upper confidence limit of the evaluation index, the fuzzy decision index and fuzzy testing rules were established. In addition, the decision-making index was converted into the index observation value, and an intuitive fuzzy evaluation rule more convenient for practical application was established. Finally, we employed an easy-to-use radar evaluation chart to assess whether the index fell into the improvement range and decide whether to improve. In conclusion, this study considers the need of businesses for quick their responses to decision-making. The fuzzy testing design built on upper confidence limits can incorporate past data experience. It can still maintain the testing accuracy for small-sized samples. At the same time, it can also help enterprises pursue smart manufacturing and management and realize the business philosophy of sustainable development. [ABSTRACT FROM AUTHOR]

The article, titled "Michelle Hewitt," discusses the issue of disabled individuals living in poverty and the implications it has on their access to medical assistance in dying (MAiD). The author, Michelle Hewitt, who is a disabled woman with multiple sclerosis, highlights the overrepresentation of disabled people among those living in poverty in Canada. The article presents two examples of individuals who have considered MAiD due to the unbearable suffering caused by their poverty-induced conditions. Hewitt argues that the current safeguards for MAiD are failing and calls for support of the Canada Disability Benefit bill and wide reform in care systems to address the needs of disabled individuals. [Extracted from the article]

Background: The wheelchair is a widely used rehabilitation device, which is indispensable for people with limited mobility. In the process of using a wheelchair, they often face the situation of sitting for a long time, which is easy to cause fatigue of the waist muscles of the user. Therefore, this paper hopes to provide more scientific guidance and suggestions for the daily use of wheelchairs by studying the relationship between the development of muscle fatigue and sitting posture. Methods: First, we collected surface Electromyography (sEMG) of human vertical spine muscle and analyzed it in the frequency domain. The obtained Mean Power Frequency (MPF) was used as the dependent variable. Then, the pose information of the human body, including the percentage of pressure points, span, and center of mass as independent variables, was collected by the array of thin film pressure sensors, and analyzed by a multivariate nonlinear regression model. Results: When the centroid row coordinate of the cushion pressure point is about 16(range, 7.7-16.9), the cushion pressure area percentage is about 80%(range, 70.8%-89.7%), and the cushion pressure span range is about 27(range, 25-31), the backrest pressure point centroid row coordinate is about 15(range, 9.1-18.2), the backrest pressure area percentage is about 35%(range, 11.8%-38.7%), and the backrest pressure span range is about 16(range, 9-22). At this time, the MPF value of the subjects decreased by a small percentage, and the fatigue development of the muscles was slower. In addition, the pressure area percentage at the seat cushion is a more sensitive independent variable, too large or too small pressure area percentage will easily cause lumbar muscle fatigue. Conclusion: The results show that people should sit in the middle and back of the seat cushion when riding the wheelchair, so that the Angle of the hip joint can be in a natural state, and the thigh should fully contact the seat cushion to avoid the weight of the body concentrated on the buttocks; The back should be fully in contact with the back of the wheelchair to reduce the burden on the waist, and the spine posture can be adjusted appropriately according to personal habits, but it is necessary to avoid maintaining a chest sitting position for a long time, which will cause the lumbar spine to be in an unnatural physiological Angle and easily lead to fatigue of the waist muscles. [ABSTRACT FROM AUTHOR]

The current technological revolution driven by advances in machine learning has motivated a wide range of applications aiming to improve our quality of life. Representative of such applications are autonomous and semiautonomous Powered Wheelchairs (PWs), where the focus is on providing a degree of autonomy to the wheelchair user as a matter of guidance and interaction with the environment. Based on these perspectives, the focus of the current research has been on the design of lightweight systems that provide the necessary accuracy in the navigation system while enabling an embedded implementation. This motivated us to develop a real-time measurement methodology that relies on a monocular RGB camera to detect the caregiver's feet based on a deep learning method, followed by the distance measurement of the caregiver from the PW. An important contribution of this article is the metrological characterization of the proposed methodology in comparison with measurements made with dedicated depth cameras. Our results show that despite shifting from 3D imaging to 2D imaging, we can still obtain comparable metrological performances in distance estimation as compared with Light Detection and Ranging (LiDAR) or even improved compared with stereo cameras. In particular, we obtained comparable instrument classes with LiDAR and stereo cameras, with measurement uncertainties within a magnitude of 10 cm. This is further complemented by the significant reduction in data volume and object detection complexity, thus facilitating its deployment, primarily due to the reduced complexity of initial calibration, positioning, and deployment compared with three-dimensional segmentation algorithms. [ABSTRACT FROM AUTHOR]

Here, we present an effective application of adaptive cooperative networks, namely assisting disables in navigating in a crowd in a pandemic or emergency situation. To achieve this, we model crowd movement and introduce a cooperative learning approach to enable cooperation and self-organization of the crowd members with impaired health or on wheelchairs to ensure their safe movement in the crowd. Here, it is assumed that the movement path and the varying locations of the other crowd members can be estimated by each agent. Therefore, the network nodes (agents) should continuously reorganize themselves by varying their speeds and distances from each other, from the surrounding walls, and from obstacles within a predefined limit. It is also demonstrated how the available wireless trackers such as AirTags can be used for this purpose. The model effectiveness is examined with respect to the real-time changes in environmental parameters and its efficacy is verified. [ABSTRACT FROM AUTHOR]

Aim: To estimate the probability of independent walking and wheeled mobility in individuals with cerebral palsy (CP) at home and in the community in relation to age and gross motor function. Method: This was a longitudinal cohort study using data reported into the combined Swedish CP follow‐up programme and national quality registry from October 2000 to October 2022. Walking, walking with aids, wheeled mobility, and assisted mobility defined independent or assisted mobility at home and in the community, based on the Functional Mobility Scale with additional data on wheelchair performance, were assessed. Results: There were 52 858 examinations reported for 6647 individuals with CP (age range 0–32 years, follow‐up period 0–22 years). Most children and adults in Gross Motor Function Classification System (GMFCS) levels I or II walked without assistive devices. The probability of dependence on others for mobility in the community was high for both children and adults in GMFCS levels III to V. Interpretation: Although independent mobility is vital for participation and social inclusion, many children and adults with CP are dependent on others for mobility. We recommend clinicians, together with families and individuals with CP, explore how to increase access to independent mobility from an early age and continuously throughout the life course. What this paper adds: •There is a high probability of independent walking in Gross Motor Function Classification System (GMFCS) levels I to II.•Mobility options vary most at home and in the community in GMFCS level III.•Being dependent on others for mobility is likely in GMFCS levels III to V. [ABSTRACT FROM AUTHOR]

Aim: To describe caregiver experiences, perceptions, and device preferences between a modified ride‐on car (MROC) and an Explorer Mini, including perceived changes in participation, barriers, and benefits for young children with cerebral palsy (CP) classified in Gross Motor Function Classification System (GMFCS) level V. Method: A subset of data were analyzed from a larger multisite study. Semi‐structured interviews were conducted with 10 caregivers of children with CP in GMFCS level V across a 16‐week trial with two mobility devices. Each interview was audio‐recorded, transcribed verbatim, and analysed using constant comparison methods. Results: Seven of 10 caregivers preferred the Explorer Mini over the MROC. Four themes emerged. One related to the perceived benefits and barriers of each device (ease and convenience is essential) and three related to perceived changes in participation: (1) autonomy enacted through mobility; (2) belonging and being present; and (3) participation recognized as an area of growth. Interpretation: Despite limited consideration of powered mobility for this population, caregivers of children in GMFCS level V reported similar benefits and barriers compared to children in other GMFCS levels shown in the literature. Particularly, caregivers perceived positive changes in their child's participation and recognized the ability for continued improvements in participation when using powered mobility. What this paper adds: Children with cerebral palsy classified in Gross Motor Function Classification System level V are often excluded from powered mobility use and research.Despite this, caregivers reported positive experiences for their children.Caregivers felt that participation in powered mobility led to increased autonomy and overall sense of inclusion and belonging for their children.Most caregivers preferred the Explorer Mini over the modified ride‐on car but recognized that both devices had benefits and barriers to use. What this paper adds: Children with cerebral palsy classified in Gross Motor Function Classification System level V are often excluded from powered mobility use and research.Despite this, caregivers reported positive experiences for their children.Caregivers felt that participation in powered mobility led to increased autonomy and overall sense of inclusion and belonging for their children.Most caregivers preferred the Explorer Mini over the modified ride‐on car but recognized that both devices had benefits and barriers to use. This original article is commented on by Jahan and Islam on pages 276–277 of this issue. [ABSTRACT FROM AUTHOR]

This paper uses mixed methods to explore the preliminary design of control authority preferences for an Assistive Robotic Manipulator (ARM). To familiarize users with an intelligent robotic arm, we perform two kitchen task iterations: one with user-initiated software autonomy (predefined autonomous actions) and one with manual control. Then, we introduce a third scenario, enabling users to choose between manual control and system delegation throughout the task. Results showed that, while manually switching modes and controlling the arm via joystick had a higher mental workload, participants still preferred full joystick control. Thematic analysis indicates manual control offered greater freedom and sense of accomplishment. Participants reacted positively to the idea of an interactive assistive system. Users did not want to ask the system to only assist, by taking over for certain actions, but also asked for situational feedback (e.g., 'How close am I (the gripper)?', 'Is the lid centered over the jug?'). This speaks to a future assistive system that ensures the user feels like they drive the system for the entirety of the task and provides action collaboration in addition to more granular situational awareness feedback. [ABSTRACT FROM AUTHOR]

The number of people who need to use wheelchair for proper mobility is increasing. The integration of technology into these devices enables the simultaneous and objective assessment of posture, while also facilitating the concurrent monitoring of the functional status of wheelchair users. In this way, both the health personnel and the user can be provided with relevant information for the recovery process. This information can be used to carry out an early adaptation of the rehabilitation of patients, thus allowing to prevent further musculoskeletal problems, as well as risk situations such as ulcers or falls. Thus, a higher quality of life is promoted in affected individuals. As a result, this paper presents an orderly and organized analysis of the existing postural diagnosis systems for detecting sitting anomalies in the literature. This analysis can be divided into two parts that compose such postural diagnosis: on the one hand, the monitoring devices necessary for the collection of postural data and, on the other hand, the techniques used for anomaly detection. These anomaly detection techniques will be explained under two different approaches: the traditional generalized approach followed to date by most works, where anomalies are treated as incorrect postures, and a new individualized approach treating anomalies as changes with respect to the normal sitting pattern. In this way, the advantages, limitations and opportunities of the different techniques are analyzed. The main contribution of this overview paper is to synthesize and organize information, identify trends, and provide a comprehensive understanding of sitting posture diagnosis systems, offering researchers an accessible resource for navigating the current state of knowledge of this particular field. [ABSTRACT FROM AUTHOR]

Wheelchairs are widely used globally and are essential for providing autonomy and mobility to elderly and disabled people who have movement restrictions. Manual wheelchairs require operation through turning the wheels or pushing the wheelchair directly, thus posing mobility limitations for the user and caregiver. In contrast, electric wheelchairs, when used by the user, allow for improved flexibility by operating the wheelchair through a single control mechanism. However, the use of electric wheelchairs poses challenges in accessing areas with stairs and curbs, limiting the range of activity and thereby diminishing the quality of life for users and those reliant on electric wheelchairs. The electric wheelchair developed in this research incorporates a single motor for lightweight design. It uses a wheel travel variation actuator, eliminating the need for synchronization and allowing for low-power operation. This design reduces power loss from the caterpillar's idling during wheel movement and includes the implementation of a pulley system. The optimal pulley belt length was calculated, and a deceleration device was installed inside the caterpillar, enabling a design that is compact, lightweight, and capable of high deceleration. On paved roads and flat terrain, the electric wheelchair is designed for high-speed travel using two pairs of front omni wheels and drive wheels. For terrains with stairs, speed bumps, unpaved roads, and unavoidable obstacles, the wheelchair is powered by caterpillars. The electric wheelchair developed through the research presented in this paper has verified the reliability of its transmission system through gear stress and deformation analysis. Additionally, an electric wheelchair based on the proposed concept was constructed to validate the drivability, safety, operability, and convenience of its driving unit. Furthermore, a user rode the constructed electric wheelchair to confirm that there were no issues with its drivability. [ABSTRACT FROM AUTHOR]

Disinfection in the hospital environment remains challenging, especially for wide and structurally complex objects such as beds or wheelchairs. Indeed, the regular disinfection of these objects with chemicals is manually carried out by healthcare workers and is fastidious and time-consuming. Alternative antibacterial techniques were thus proposed in the past decades, including the use of naturally antimicrobial UVC. Here, the antibacterial efficiency of a large UVC box built to accommodate wheelchairs was investigated through testing bacterial burden reductions on various parts of a wheelchair, with various support types and with several treatment durations. The results demonstrate a time-dependent antibacterial effect, with a strong burden reduction at only five minutes of treatment (>3-log median reduction in Escherichia coli and Staphylococcus epidermidis). The UVC flux and residual bacterial burden both significantly varied depending on the spatial location on the wheelchair. However, the nature of the support impacted the antibacterial efficiency even more, with residual bacterial burdens being the lowest on rigid materials (steel, plastics) and being the highest on tissue. On metallic samples, the nature of the alloy and surface treatment had various impacts on the antibacterial efficiency of the UVC. This study highlights the efficiency of the tested UVC box to efficiently and quickly decontaminate complex objects such as wheelchairs, but also gives rise to the warning to focus on rigid materials and avoid porous materials in the conception of objects, so as to ensure the efficiency of UVC decontamination. [ABSTRACT FROM AUTHOR]

According to the World Health Organization, hundreds of individuals commence wheelchair use daily, often due to an injury such as spinal cord injury or through a condition such as a stroke. However, manual wheelchair users typically experience reductions in individual community mobility and participation. In this review, articles from 2017 to 2023 were reviewed to identify means of measuring community mobility and participation of manual wheelchair users, factors that can impact these aspects, and current rehabilitation techniques for improving them. The selected articles document current best practices utilizing self-surveys, in-clinic assessments, and remote tracking through GPS and accelerometer data, which rehabilitation specialists can apply to track their patients' community mobility and participation accurately. Furthermore, rehabilitation methods such as wheelchair training programs, brain-computer interface triggered functional electric stimulation therapy, and community-based rehabilitation programs show potential to improve the community mobility and participation of manual wheelchair users. Recommendations were made to highlight potential avenues for future research. [ABSTRACT FROM AUTHOR]

Within rehabilitation, there is a great need for a simple method to monitor wheelchair use, especially whether it is active or passive. For this purpose, an existing measurement technique was extended with a method for detecting self- or attendant-pushed wheelchair propulsion. The aim of this study was to validate this new detection method by comparison with manual annotation of wheelchair use. Twenty-four amputation and stroke patients completed a semi-structured course of active and passive wheelchair use. Based on a machine learning approach, a method was developed that detected the type of movement. The machine learning method was trained based on the data of a single-wheel sensor as well as a setup using an additional sensor on the frame. The method showed high accuracy (F1 = 0.886, frame and wheel sensor) even if only a single wheel sensor was used (F1 = 0.827). The developed and validated measurement method is ideally suited to easily determine wheelchair use and the corresponding activity level of patients in rehabilitation. [ABSTRACT FROM AUTHOR]

As the world enters an aging and super-aged society, the application of advanced technology in assistive devices to support the daily life of the elderly is becoming a hot issue. Among them, electric wheelchairs are representative assistive devices for the walking support of the elderly, and their structural form is similar to AGV and AMR. For this reason, research is being introduced and underway to guarantee the right to voluntarily move or improve the convenience of movement for the elderly and severely disabled people who have difficulties in operating a joystick for operating an electric wheelchair. Autonomous driving of mobile robots is a technology that configures prior information on the driving environment as a map DB and operates based on it. However, active driving assistance technology is needed because wheelchairs do not move in a limited space, but can move to a place without a prior map DB or vehicle boarding depending on the passenger's intention to move. Therefore, a system for estimating the moving position and direction of the wheelchair is needed to develop a driving assistance technology in the relevant driving environment. In order to solve the above problem, this study proposes a position and direction estimation algorithm suitable for active driving of a wheelchair based on a UWB sensor. This proposal is an algorithm for estimating the position and direction of the wheelchair through the fusion of UWB, IMU, and encoder sensors. In this proposal, it is difficult to design an active driving assistance system for wheelchairs due to low accuracy, obstacles, and errors due to signal strength in the position and direction estimation with UWB sensors alone. Therefore, this study proposes a wheelchair driving position and direction estimation system that fuses the dead recording information of a wheelchair and the UWB-based position estimation technique based on sensors applied in IMU and encoders. Applying quantitative verification to the proposed technique, the direction estimation accuracy of the wheelchair of about 15.3° and the position estimation error average of ±15 cm were confirmed, and it was verified that a driving guide for active driving was possible when the sensor system proposed in a mapless environment of the wheelchair was installed at a specific destination. [ABSTRACT FROM AUTHOR]

Periprosthetic femoral fracture (PFF) after total hip arthroplasty (THA) or bipolar hip arthroplasty (BHA) represents a challenging situation and the treatment is associated with high rates of complications and mortality. The aims of this multicenter retrospective study were to determine 1-year mortality and to identify predictors associated with mortality, including patient characteristics and surgical factors, in patients undergoing surgery for PFF after THA or BHA. We collected 249 cases of PPF after THA or BHA that were treated in our 11 hospitals (named the TRON group) between January 2010 and December 2019. We excluded patients who were conservatively treated, cases in which the 1-year postoperative outcome was unknown, and Vancouver type A cases. Finally, we analyzed 161 patients. Univariate and multivariate Cox regression analyses were performed to identify factors affecting 1-year mortality. Patient-side factors such as age, BMI, fracture type, and preoperative mobility, and surgical factors such as surgical procedure, time to surgery, and operation time were analyzed respectively. Eighteen of 161 patients (11.2%) died one year after surgery. The multivariate Cox regression analysis identified older age, wheelchair status before injury, and operation time as independent predictors of 1-year mortality (older age: hazard ratio [HR] 1.07, 95% CI 1.01–1.15, P = 0.048; wheelchair status: HR 5.82, 95% CI 1.01–33.47, P = 0.049; operation time: [HR] 1.01, 95% CI 1.00–1.01, P = 0.00929). Meanwhile, fracture type according to the Vancouver classification, body mass index, presence of previous fragility fractures, type of fixation, blood loss during operation, and time to surgery were not independent predictors of 1-year mortality in this analysis. ConclusionThe 1-year mortality rate after surgery for PPFs patients was 11.2%. Factors associated with older and poor activity of daily living (ADL) performance (e.g., wheelchair status before injury), and longer operative time were associated with 1-year mortality after surgery for PPF. Surgeons should carefully plan treatment according to each patient's condition. [ABSTRACT FROM AUTHOR]

Background: Heterotopic ossification of large joints, such as knees and hips, has been reported after spinal cord injury, possibly leading to decreased activity of daily living due to a limited range of motion of the affected joint. Therefore, heterotopic ossification resection is performed to improve the range of motion, but it might cause massive bleeding as a complication.Methods: In this case, the patient had a history of spinal cord injury and developed heterotopic ossification after the left hip injury. He had left hip ankylosis and could not transfer to a wheelchair by himself; therefore, heterotopic ossification resection was planned. On conducting contrast-enhanced computed tomography, the supplying arteries extending to the heterotopic ossification could be identified. A day before the surgery, embolization of the branches by interventional radiology was performed.Results: Heterotopic ossification resection was performed with an 820-ml blood loss. Postoperative rehabilitation was continued, and range of motion continued to improve without heterotopic ossification recurrence 2 years post-surgery.Conclusions: The combination of preoperative contrast-enhanced computed tomography and embolization was useful in treating heterotopic ossification. [ABSTRACT FROM AUTHOR]

This paper presents a study that focuses on sidewalk following problem of an autonomous wheelchair. The main goal is to propose a solution to the urban mobility problem of people with walking disabilities. The study offers an efficient control system design for this task. A linearized wheelchair model is constructed and image-based visual servoing is introduced to evaluate the performance of tracking yellow tactile pavement on sidewalk with optimal control. Reference trajectory sets are created using robust vanishing point for sidewalk following by employing the Hough Lines method. These reference paths are tested with two control methods of Linear Quadratic Regulator (LQR) control and Pole Placement (PP) control. Both control methods are applied through simulation on the autonomous wheelchair model, and efficacy of sidewalk following under these control methods is discussed comparatively. Disturbance attenuation results of the given optimal control methods and simulation outputs prove the efficacy of the model and the designed control systems. LQR control method proves to have better performance in system response in comparison to PP control method. [ABSTRACT FROM AUTHOR]

As automated driving system (ADS) technology is adopted in wheelchairs, clarity on the vehicle's imminent path becomes essential for both users and pedestrians. For users, understanding the imminent path helps mitigate anxiety and facilitates real-time adjustments. For pedestrians, this insight aids in predicting their next move when near the wheelchair. This study introduces an on-ground projection-based shared eHMI approach for autonomous wheelchairs. By visualizing imminent motion intentions on the ground by integrating real and virtual elements, the approach quickly clarifies wheelchair behaviors for all parties, promoting proactive measures to reduce collision risks and ensure smooth wheelchair driving. To explore the practical application of the shared eHMI, a user interface was designed and incorporated into an autonomous wheelchair simulation platform. An observation-based pilot study was conducted with both experienced wheelchair users and pedestrians using structured questionnaires to assess the usability, user experience, and social acceptance of this interaction. The results indicate that the proposed shared eHMI offers clearer motion intentions display and appeal, emphasizing its potential contribution to the field. Future work should focus on improving visibility, practicality, safety, and trust in autonomous wheelchair interactions. [ABSTRACT FROM AUTHOR]

Featured Application: Quantifying the external and internal load of the wheelchair basketball will allow the coaching staff to analyze the physical demands of the players during training. The systematic and programmed control and evaluation of the external and internal load of high-performance athletes during training sessions and high-level competitions allows the coaching staff to know a great amount of information to evaluate the physical condition of the players and the tactical positioning as well as to identify optimal performance. Therefore, this study aimed to analyse the external and internal load of wheelchair basketball players during training and competition matches considering the functional classification of the players. WIMU PROTM inertial devices were used to collect the data. As independent variables, the sporting context and the functional classification were selected, and as dependent variables, the variables related to the external and internal load were established. The results reported significant differences between the contexts, with higher values in the competition than in the training sessions considering the internal and external load. Taking into account the functional classification, it is shown that the player with a higher functional classification obtained more differences and higher values. Understanding the external and internal load of the players during training and competitions is very important to personalise the training load according to the demands of the competition. It allows development of a progressive and modular training programme of loads to obtain the best performance. Consequently, injury risk of players due to overload will also be reduced. [ABSTRACT FROM AUTHOR]

This document is an editorial published in Frontiers in Neuroscience titled "Human-in-the-loop system design and control adaptation for behavior-assistant robots." The editorial discusses the coordination between humans, robots, and environments in the field of behavior-assistant robots, such as rehabilitation robots and homecare robots. It highlights the importance of human-in-the-loop control architecture for effective operation of behavior-assistant robots. The editorial also mentions various studies and advancements in the field, including the use of surface electromyography (sEMG) and pressure sensors for wheelchair user sitting posture improvement, the development of lower limb rehabilitation robots for stroke or spinal cord injury patients, and the integration of fault-tolerance control and neural supervised loop for safe human-robot interaction. The document emphasizes the challenges and potential applications of human-in-the-loop systems in the field of robotics and rehabilitation. [Extracted from the article]

This research paper introduces a comprehensive approach for evaluating material alternatives in the design of low cost robotic wheelchair chassis, incorporating a combined CRITIC (Criteria Importance through Intercriteria Correlation), EDAS (Evaluation based on Distance from Average Solution), and COPRAS (Complex Proportional Assessment) framework. Material selection has a significant impact on robotic wheelchair performance and longevity, offering issues due to many criteria and sophisticated decision-making in engineering design. The proposed framework solves these issues by combining three well-known multi-criteria decision-making (MCDM) techniques by considering 7 criteria and 12 potential alternate materials. CRITIC assesses the relevance of criteria, EDAS rates material alternatives, and COPRAS computes comprehensive performance ratings while taking interdependencies into account. Wheelchair Chassis Materials are assessed based on SOLIDWORKS analysis for mechanical qualities and online B2B market data for cost, weight, and other relevant factors. Gray cast iron emerges as the most favorable choice for the robotic wheelchair chassis, showcasing its exceptional balance of attributes. This study adds important insights to material selection for complex engineering systems and assistive technology design, resulting in better wheelchair design and user experience. [ABSTRACT FROM AUTHOR]

This article describes the design of indoor-outdoor mobility wheelchair for Indian settings. The design of such a wheelchair has not been available for the low resourced settings. This work developed a prototype wheelchair with features to provide variable elevation of seat (elevation of 300 mm: seat height from floor - 500 mm to 850 mm), 360 degree rotations of seat and ease of seat transfer to make the wheelchair relevant for accessibility in indoor settings. The device is powered by a battery (24 V 18 Ah LifePo4) and electric motor (350 watt with driving speed up to 20 km/hour) thereby making it suitable for indoor use rather than conventional fossil fuel powered vehicles. Its additional feature of having visibility from other vehicles, front light, and ability of driving on different terrains make it suitable for outdoor use. The mobility wheelchair is affordable (manufacturing cost for prototype was around 325 US $) in India. We have further provided justification for all the technical specifications of the components we used. The wheelchair was fabricated locally in our workshop. [ABSTRACT FROM AUTHOR]