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Design and development of a wheelchair seating pressure relief reminder system for pressure ulcer prevention among paraplegics

Md Nadzri N, Hamzaid NA, Chung TY

J Med Eng Technol, 2021 Oct;45(7):574-581.
PMID: 34184592 DOI: 10.1080/03091902.2021.1936238

Individuals with paraplegia spend their time on the wheelchair for life. Adapting to prolonged wheelchair seating for almost all activities of daily living is challenging. The loss of abilities to sense any pain or excessive seating pressure cause them to remain seated on the wheelchair without any pressure relief activities. This situation leads to secondary complications including pressure ulcer which further degrades the individual's health. To overcome this, a wheelchair seating pressure relief training system (WSETs) was developed. Optimal placement of the force sensitive resistors (FSR) as seating pressure sensors on the cushion were determined, and their responses were investigated with 5 paraplegics. Two different FSR orientations, A and B, were compared. Each paraplegic sat in resting position and then performed pressure relief activities (PRA) which included whole body push-up, left and right lean and forward lean, before returning to resting position. Orientation B, with more forward positioned FSRs, showed higher sensitivity, implying better capture of high-risk area of pressure ulcer development. The FSR sensor readings were significantly different among pressure relief activities in all subjects (p

Matched MeSH terms: Wheelchairs*
Fulltext The Conceptual Development of a Multifunctional Stepladder for Older People and Caregivers

Gan KW, Ng PK, Liew KW, Ng YJ, Yeow JA

Int J Environ Res Public Health, 2022 Nov 03;19(21).
PMID: 36361278 DOI: 10.3390/ijerph192114399

Stepladders are compact, foldable ladders with flat steps and a platform. Despite all the research and design efforts, there are still limitations in terms of the multifunctionality, usability and simplicity of stepladders and related variants. By combining ideas, features and functions from patent literature, existing products and scientific journals, this study aims to conceptualise a multifunctional stepladder for improved usability. Five concepts are created, which are screened and evaluated against a set of criteria to select the best concept for improved usability, divided into three categories: simplicity, effectiveness and efficiency. The result is a versatile invention that functions as a stepladder, walker, wheelchair and Pilates chair, suitable for older people and caregivers in nursing homes. It allows medical records or supplies to be retrieved from high places without the need for inappropriate aids. The invention can replace wheelchairs and walkers and converts into a Pilates chair to provide a mobile exercise option for older people. The concept offers older people flexibility and independence in terms of mobility and healthcare, while saving space in the nursing home. Further design studies, prototyping and testing are needed before this idea can go into production.

Matched MeSH terms: Wheelchairs*
Modeling and Simulation of Two Wheelchair Accessories for Pushing Doors

Abdullah SJ, Shaikh Mohammed J

Assist Technol, 2018;30(4):165-175.
PMID: 28346064 DOI: 10.1080/10400435.2017.1293193

Independent mobility is vital to individuals of all ages, and wheelchairs have proven to be great personal mobility devices. The tasks of opening and navigating through a door are trivial for healthy people, while the same tasks could be difficult for some wheelchair users. A wide range of intelligent wheelchair controllers and systems, robotic arms, or manipulator attachments integrated with wheelchairs have been developed for various applications, including manipulating door knobs. Unfortunately, the intelligent wheelchairs and robotic attachments are not widely available as commercial products. Therefore, the current manuscript presents the modeling and simulation of a novel but simple technology in the form of a passive wheelchair accessory (straight, arm-like with a single wheel, and arc-shaped with multiple wheels) for pushing doors open from a wheelchair. From the simulations using different wheel shapes and sizes, it was found that the arc-shaped accessory could push open the doors faster and with almost half the required force as compared to the arm-like accessory. Also, smaller spherical wheels were found to be best in terms of reaction forces on the wheels. Prototypes based on the arc-shaped accessory design will be manufactured and evaluated for pushing doors open and dodging or gliding other obstacles.

Matched MeSH terms: Wheelchairs*
Fulltext Technique for Early Reliability Prediction of Software Components Using Behaviour Models

Ali A, N A Jawawi D, Adham Isa M, Imran Babar M

PLoS One, 2016 Sep 26;11(9):e0163346.
PMID: 27668748 DOI: 10.1371/journal.pone.0163346

Behaviour models are the most commonly used input for predicting the reliability of a software system at the early design stage. A component behaviour model reveals the structure and behaviour of the component during the execution of system-level functionalities. There are various challenges related to component reliability prediction at the early design stage based on behaviour models. For example, most of the current reliability techniques do not provide fine-grained sequential behaviour models of individual components and fail to consider the loop entry and exit points in the reliability computation. Moreover, some of the current techniques do not tackle the problem of operational data unavailability and the lack of analysis results that can be valuable for software architects at the early design stage. This paper proposes a reliability prediction technique that, pragmatically, synthesizes system behaviour in the form of a state machine, given a set of scenarios and corresponding constraints as input. The state machine is utilized as a base for generating the component-relevant operational data. The state machine is also used as a source for identifying the nodes and edges of a component probabilistic dependency graph (CPDG). Based on the CPDG, a stack-based algorithm is used to compute the reliability. The proposed technique is evaluated by a comparison with existing techniques and the application of sensitivity analysis to a robotic wheelchair system as a case study. The results indicate that the proposed technique is more relevant at the early design stage compared to existing works, and can provide a more realistic and meaningful prediction.

Matched MeSH terms: Wheelchairs
Integrated modeling and design for realizing a two-wheeled wheelchair for disabled

Altalmas T, Aula A, Ahmad S, Tokhi MO, Akmeliawati R

Assist Technol, 2016;28(3):159-74.
PMID: 27187763 DOI: 10.1080/10400435.2016.1140688

Two-wheeled wheelchairs are considered highly nonlinear and complex systems. The systems mimic a double-inverted pendulum scenario and will provide better maneuverability in confined spaces and also to reach higher level of height for pick and place tasks. The challenge resides in modeling and control of the two-wheeled wheelchair to perform comparably to a normal four-wheeled wheelchair. Most common modeling techniques have been accomplished by researchers utilizing the basic Newton's Laws of motion and some have used 3D tools to model the system where the models are much more theoretical and quite far from the practical implementation. This article is aimed at closing the gap between the conventional mathematical modeling approaches where the integrated 3D modeling approach with validation on the actual hardware implementation was conducted. To achieve this, both nonlinear and a linearized model in terms of state space model were obtained from the mathematical model of the system for analysis and, thereafter, a 3D virtual prototype of the wheelchair was developed, simulated, and analyzed. This has increased the confidence level for the proposed platform and facilitated the actual hardware implementation of the two-wheeled wheelchair. Results show that the prototype developed and tested has successfully worked within the specific requirements established.

Matched MeSH terms: Wheelchairs*
Low-cost low-tech obstacle pushing/gliding wheelchair accessory

Jalal Abdullah S, Shaikh Mohammed J

Disabil Rehabil Assist Technol, 2019 11;14(8):849-858.
PMID: 30556753 DOI: 10.1080/17483107.2018.1539130

Purpose: Some wheelchair users continue to struggle in maneuvering a wheelchair and navigating through manual doors. Several smart wheelchairs and robotic manipulators were developed to minimize such challenges facing disabled people. Disappointingly, a majority of these high-tech solutions are restricted to laboratories and are not extensively available as commercial products. Previously, a low-tech wheelchair accessory (arc-shaped with many wheels) for pushing doors was modelled and simulated. This work demonstrates the fabrication and testing of the first-generation prototype of the accessory.Materials and methods: The accessory has side portions with a straight arrangement of wheels and a front portion with a straight-arc-straight arrangement of wheels. The accessory was fabricated using conventional manufacturing, off-the-shelf components, and 3D printed ABS fasteners. Stress analysis simulations were done for the fasteners that attach the front accessory to the wheelchair frame. The proof-of-concept of the prototype installed onto a powered wheelchair was tested with a door and an obstacle, each with ∼50 N resistance force.Results: Prototype tests demonstrate the ability of the accessory along with the mechanical robustness of the 3D printed fasteners to push open doors allowing easy navigation through doors and to push/glide against obstacles. The accessory is foldable and detachable.Conclusion: The low-cost of the accessory makes it affordable to many users intending to improve their quality of life. The current study provides an engineering perspective of the accessory, and a clinical perspective is crucial. Other potential applications of the wheelchair accessory include use with scooters, walkers and stretchers.Implications for rehabilitationLow-cost, low-tech accessory is foldable and detachable.Accessory is effective for pushing doors and pushing/gliding against obstacles.Protective nature of the front accessory could prove highly beneficial to some wheelchair users.

Matched MeSH terms: Wheelchairs/economics*
A study on safe accessibility for wheelchair user in selected KTM commuter station in Kuala Lumpur

Abdul Halim Imaduddin, Abdul Hamid Nor Hanani

Journal of Occupational Safety and Health, 2011;8(1):51-59.
MyJurnal

The research is focus generally to identify and investigate the issue of accessible design for wheelchair users on selected Keretapi Tanah Melayu Berhad (KTM) commuter stations in the city of Kuala Lumpur. The objectives are to ensure that the design of accessibility is comply with the law, regulations, standard requirements and guidelines; to understand the recent condition and their needs in commuter stations and to allow their secure equal rights and opportunities as others. The research began by gaining reliable information through literature study and a checklist for building audit was prepared to evaluate the accessibility. A building access survey was carried out on selected stations which enclosed three main stages to show the pattern of passengers’ path. Stage 1: From the road to the ticket counter. Stage 2: From the ticket counter to the platform. Stage 3: From the platform to the train. A series of structured questionnaire was also constructed to study and get a feedback from selected target of users. Result of findings in this study had been analyzed to assist the management and the station concerned in upgrading their station facilities to a comfortable, accessible, friendly and safe environment in order to encourage more users, including disabled persons to benefit from it.

Matched MeSH terms: Wheelchairs
Fulltext IoT-based smart wheelchair system for physically impaired person

Muhammad Afiq Mohd Aizam, Nor Shahanim Mohamad Hadis, Samihah Abdullah

ESTEEM Academic Journal, 2020;16(1):59-73.
MyJurnal

Disabled persons usually require an assistant to help them in their daily routines especially for their mobility. The limitation of being physically impaired affects the quality of life in executing their daily routine especially the ones with a wheelchair. Pushing a wheelchair has its own side effects for the user especially the person with hands and arms impairments. This paper aims to develop a smart wheelchair system integrated with home automation. With the advent of the Internet of Things (IoT), a smart wheelchair can be operated using voice command through the Google assistant Software Development Kit (SDK). The smart wheelchair system and the home automation of this study were powered by Raspberry Pi 3 B+ and NodeMCU, respectively. Voice input commands were processed by the Google assistant Artificial Intelligence Yourself (AIY) to steer the movement of wheelchair. Users were able to speak to Google to discover any information from the website. For the safety of the user, a streaming camera was added on the wheelchair. An improvement to the wheelchair system that was added on the wheelchair is its combination with the home automation to help the impaired person to control their home appliances through Blynk application.
Observations on three voice tones (low, medium and high) of voice command show that the minimum voice intensity for this smart wheelchair system is 68.2 dB. Besides, the user is also required to produce a clear voice command to increase the system accuracy.

Matched MeSH terms: Wheelchairs
Thought-Actuated Wheelchair Navigation with Communication Assistance Using Statistical Cross-Correlation-Based Features and Extreme Learning Machine

Nataraj SK, Paulraj MP, Yaacob SB, Adom AHB

J Med Signals Sens, 2020 11 11;10(4):228-238.
PMID: 33575195 DOI: 10.4103/jmss.JMSS_52_19

Background: A simple data collection approach based on electroencephalogram (EEG) measurements has been proposed in this study to implement a brain-computer interface, i.e., thought-controlled wheelchair navigation system with communication assistance.
Method: The EEG signals are recorded for seven simple tasks using the designed data acquisition procedure. These seven tasks are conceivably used to control wheelchair movement and interact with others using any odd-ball paradigm. The proposed system records EEG signals from 10 individuals at eight-channel locations, during which the individual executes seven different mental tasks. The acquired brainwave patterns have been processed to eliminate noise, including artifacts and powerline noise, and are then partitioned into six different frequency bands. The proposed cross-correlation procedure then employs the segmented frequency bands from each channel to extract features. The cross-correlation procedure was used to obtain the coefficients in the frequency domain from consecutive frame samples. Then, the statistical measures ("minimum," "mean," "maximum," and "standard deviation") were derived from the cross-correlated signals. Finally, the extracted feature sets were validated through online sequential-extreme learning machine algorithm.
Results and Conclusion: The results of the classification networks were compared with each set of features, and the results indicated that μ (r) feature set based on cross-correlation signals had the best performance with a recognition rate of 91.93%.

Matched MeSH terms: Wheelchairs
Fulltext A smart wheelchair prototype based on hand gesture control

Shaari AR, Mohd Jani MN, Mohamed Yunus AS

Journal of Engineering and Science Research, 2017;1(2):209-214.
MyJurnal

Wheelchair has been an important assistive device and the demand are ever rising because of the increasing physically handicapped and old age populations. The recent development in the robotics artificial intelligence extends vast scope for developing the more advanced and intelligent one to overcome limitations of the existing traditional wheelchairs. The prototype smart wheelchair were present on this paper using hardware implementation with the help of simple hand gesture which is comprises of an accelerometer mounted on the hand glove senses the tilt angle of the user hand movements and transmits control signal to the receiver mounted on wheelchair. This will interpret the movement accordingly required by user. The wheelchair control unit is developed by integration of ATMEGA328 microcontroller with Arduino UNO. The wheelchair is developed to allow peoples to move safely and put reliability in accomplishment of some important tasks in daily life.

Matched MeSH terms: Wheelchairs
HMM based automated wheelchair navigation using EOG traces in EEG

Aziz F, Arof H, Mokhtar N, Mubin M

J Neural Eng, 2014 Oct;11(5):056018.
PMID: 25188730 DOI: 10.1088/1741-2560/11/5/056018

This paper presents a wheelchair navigation system based on a hidden Markov model (HMM), which we developed to assist those with restricted mobility. The semi-autonomous system is equipped with obstacle/collision avoidance sensors and it takes the electrooculography (EOG) signal traces from the user as commands to maneuver the wheelchair. The EOG traces originate from eyeball and eyelid movements and they are embedded in EEG signals collected from the scalp of the user at three different locations. Features extracted from the EOG traces are used to determine whether the eyes are open or closed, and whether the eyes are gazing to the right, center, or left. These features are utilized as inputs to a few support vector machine (SVM) classifiers, whose outputs are regarded as observations to an HMM. The HMM determines the state of the system and generates commands for navigating the wheelchair accordingly. The use of simple features and the implementation of a sliding window that captures important signatures in the EOG traces result in a fast execution time and high classification rates. The wheelchair is equipped with a proximity sensor and it can move forward and backward in three directions. The asynchronous system achieved an average classification rate of 98% when tested with online data while its average execution time was less than 1 s. It was also tested in a navigation experiment where all of the participants managed to complete the tasks successfully without collisions.

Matched MeSH terms: Wheelchairs*
Asynchronous brain machine interface-based control of a wheelchair

Hema CR, Paulraj MP, Yaacob S, Adom AH, Nagarajan R

Adv Exp Med Biol, 2011;696:565-72.
PMID: 21431597 DOI: 10.1007/978-1-4419-7046-6_57

A brain machine interface (BMI) design for controlling the navigation of a power wheelchair is proposed. Real-time experiments with four able bodied subjects are carried out using the BMI-controlled wheelchair. The BMI is based on only two electrodes and operated by motor imagery of four states. A recurrent neural classifier is proposed for the classification of the four mental states. The real-time experiment results of four subjects are reported and problems emerging from asynchronous control are discussed.

Matched MeSH terms: Wheelchairs*
A review of disability EEG based wheelchair control system: Coherent taxonomy, open challenges and recommendations

Al-Qaysi ZT, Zaidan BB, Zaidan AA, Suzani MS

Comput Methods Programs Biomed, 2018 Oct;164:221-237.
PMID: 29958722 DOI: 10.1016/j.cmpb.2018.06.012

CONTEXT: Intelligent wheelchair technology has recently been utilised to address several mobility problems. Techniques based on brain-computer interface (BCI) are currently used to develop electric wheelchairs. Using human brain control in wheelchairs for people with disability has elicited widespread attention due to its flexibility.
OBJECTIVE: This study aims to determine the background of recent studies on wheelchair control based on BCI for disability and map the literature survey into a coherent taxonomy. The study intends to identify the most important aspects in this emerging field as an impetus for using BCI for disability in electric-powered wheelchair (EPW) control, which remains a challenge. The study also attempts to provide recommendations for solving other existing limitations and challenges.
METHODS: We systematically searched all articles about EPW control based on BCI for disability in three popular databases: ScienceDirect, IEEE and Web of Science. These databases contain numerous articles that considerably influenced this field and cover most of the relevant theoretical and technical issues.
RESULTS: We selected 100 articles on the basis of our inclusion and exclusion criteria. A large set of articles (55) discussed on developing real-time wheelchair control systems based on BCI for disability signals. Another set of articles (25) focused on analysing BCI for disability signals for wheelchair control. The third set of articles (14) considered the simulation of wheelchair control based on BCI for disability signals. Four articles designed a framework for wheelchair control based on BCI for disability signals. Finally, one article reviewed concerns regarding wheelchair control based on BCI for disability signals.
DISCUSSION: Since 2007, researchers have pursued the possibility of using BCI for disability in EPW control through different approaches. Regardless of type, articles have focused on addressing limitations that impede the full efficiency of BCI for disability and recommended solutions for these limitations.
CONCLUSIONS: Studies on wheelchair control based on BCI for disability considerably influence society due to the large number of people with disability. Therefore, we aim to provide researchers and developers with a clear understanding of this platform and highlight the challenges and gaps in the current and future studies.

Matched MeSH terms: Wheelchairs*
The use of unconventional pressure redistributing cushion in spinal cord injured individuals

Ooi AL, Julia PE

Spinal Cord, 2011 Dec;49(12):1203-5.
PMID: 21788957 DOI: 10.1038/sc.2011.81

Case report.

Matched MeSH terms: Wheelchairs
Fulltext Locally made paediatric rehabilitation and seating systems for cerebral palsy children in Sarawak

Ling, Sui Hui, Chua, Soh Yian, Habsah Razak, Muhamad Rais Abdullah, Wong, See Chang, Toh, Teck Hock

Int J Public Health Res, 2011;1(2):146-151.
MyJurnal

Introduction Children with cerebral palsy (CP) are often prescribed Rehabilitation and Seating Systems (RSS) to assist in daily activities, posture improvement and prevention of muscular-skeletal complications. In Sarawak, a special project to produce RSS was started under a partnership of a Japanese physiotherapist, health department and the community using local material.Aim To document the RSS project and to determine usefulness and costaffordability of these systems for cerebral palsy children and their families.
Methods The details of RSS manufactured were retrieved from the clinic notes and secretary file. Parents of children who received the seating systems between July 2004 and September 2008 were invited to complete a 5-point Global Parental Perception Questionnaire (GPPQ) between December 2008 and January 2009.
Results 277 RSS were manufactured between July 2004 and February 2011 (which included modified wheel chair, wooden chair, corner chair, buggy chair and standing frame), and used by children all over Sarawak. Parents of 73 children who used the seating systems completed the 5-points GPPQ. Ten families required full sponsorship. Children spent more time sitting up and brought outdoor more often after the systems became available. Majority of parents reported positive experience in their children with sitting ability, smiles, interaction with people, learning skills and easiness of doing physiotherapy. No change was noted with passing of motion drooling / oral secretion. Most parents agreed that the cost was affordable and worth paying.
Conclusions A community based initiative to manufacture RSS by using locally available material and skill, at affordable price for the parents was feasible and useful for the family/children with CP.

Matched MeSH terms: Wheelchairs
Fulltext Effects of Graded Exercises Integrated with Education on Physical Fitness, Exercise SelfEfficacy, and Activity Levels in People with Spinal Cord Injury: A Quasi-Experimental Study Protocol

Hisham H, Justine M, Hussain H, Hasnan N, Manaf H

Asian Spine J, 2019 08;13(4):577-583.
PMID: 30866621 DOI: 10.31616/asj.2018.0172

Study Design: A quasi-experimental single-blinded study.
Purpose: To investigate the effects of 'graded exercise integrated with education' on physical fitness, exercise self-efficacy (ESE), and physical activity (PA) levels among subacute and chronic wheelchair-dependent paraplegia patients.
Overview of Literature: Most of the chronic spinal cord injury (SCI) patients had low physical fitness due to a sedentary lifestyle and lack of ESE after discharge from a rehabilitation program. Education may encourage them to engage with exercise to regain and maintain their physical fitness. However, there is a lack of research to support the effects of exercise integrated with education after an SCI.
Methods: A total of 44 participants will be assigned to either the experimental group (graded exercise integrated with education) or active control (conventional physical therapy). The experimental group will receive graded strength and aerobic exercise training according to their progression criteria. They will attend an education program during and after the rehabilitation program. The control group will only receive conventional physical therapy during their in-rehabilitation program. This study will be conducted during a period of 16 weeks, consisting of 8 weeks of in-rehabilitation and 8 weeks post-rehabilitation. Statistical analysis will be performed using the IBM SPSS ver. 21.0 (IBM Corp., Armonk, NY, USA) at a significance level of p≤0.05.
Results: The primary outcome measures will be upper-limb isokinetic strength, isometric grip strength, and cardiorespiratory fitness. The secondary outcomes will be ESE and PA levels.
Conclusions: An intervention that combines exercise training and education may be warranted to enhance the physical fitness, ESE, and PA levels in SCI patients. This trial was registered with ClinicalTrials.gov (NCT03420170).

Matched MeSH terms: Wheelchairs
Compressive radial neuropathy induced by 'hooking' manoeuvre in a tetraplegic person

Julia PE, Mazlina M, Nazirah H

Spinal Cord, 2011 Oct;49(10):1082-3.
PMID: 20877330 DOI: 10.1038/sc.2010.137

Case report.

Matched MeSH terms: Wheelchairs/adverse effects*
Fulltext Four nucleotide deletions of exon 47 in Dystrophin gene: a case report of a Kelantanese Duchenne Muscular Dystrophy patient

Fatimah Azman, Rose Adzrianee Adnan, Norhafizah Che Abdul Razak, Nazihah Mohd Yunus, Sarina Sulong, Rozita Abdullah, et al.

Journal of Biomedical and Clinical Sciences, 2017;2(202):11-13.
MyJurnal

Muscular dystrophy is a group of diseases that result in progressive muscle weakness and atrophy. Duchenne Muscular Dystrophy (DMD) is classified as dystrophinopathy and is an X-linked recessive disease. It is caused by alterations in the dystrophin gene at Xp21.2 encoding 79 exons [1]. It is characterised by progressive muscle wasting that begins at 3 to 5 years, delay in motor development and eventually wheelchair confinement followed by premature death at about 30 years from cardiac or respiratory complications [2]. Genetic etiology of cases of DMD in Malaysia are still scarcely reported. Here, we report the genetic cause in the case of an 11-year-old Kelantanese Malay boy who has progressive muscle weakness since 5 years old. He has difficulty in getting up from sitting and supine position also in climbing up stairs until 1st floor. He has a strong family history of DMD and musculoskeletal problems. His younger brother was diagnosed with DMD by molecular analysis and his maternal uncle died at the age of 16 with musculoskeletal problems but was never investigated. Physical examination revealed no dysmorphic features, positive Gower sign with absent tounge fasciculation. On neurological examination, tendon reflexes and muscle tone for limbs were normal. Muscle power for bilateral upper limbs were normal, however, bilateral lower limbs showed slight reduction in muscle power with calf hypertrophy.

Matched MeSH terms: Wheelchairs
Fulltext Modified Unipolar Hemiarthroplasty for the Treatment of Metastatic Lesions of Proximal Femur with Pathological Fractures: Case Series of Six Patients

Lim CY, Mat-Hassan S, Awang M, Md-Ariff MF, Hau-Abdullah MA

Malays Orthop J, 2019 Nov;13(3):21-27.
PMID: 31890106 DOI: 10.5704/MOJ.1911.004

Introduction: Proximal femur resection and endoprosthetic reconstruction is the preferred treatment for extensive bony destruction and pathological fractures. Due to the relatively high cost of endoprosthesis, we adopted the modified unipolar hemiarthroplasty (MUH) for reconstruction when the mode of treatment was for palliation. Materials and Methods: This is a retrospective case study of six patients, who had bone and multi-organs metastases with extensive proximal femur involvement with pathologic fractures who underwent resection and MUH reconstruction during the period 2013 to 2017. All patients were classified as Group B / C based on Scandinavian Sarcoma Group survival scoring, with estimated survival of maximum six months. The basic MUH construct consisted of Austin-Moore prosthesis which was secured to a Küntscher nail using cerclage wire and cemented into the femoral canal. Subsequently, the whole length of the prosthesis which remained outside the canal was coated with cement. Results: The mean age was 61.8 years. The mean survival was 3.9 months, post-operation. There was no implant failure during patients' life span; however, a third of the patients developed infection. Wheel chair ambulation was started immediately post-operation for all patients, and two patients progressed to walking frame ambulation. The total cost of each construct was below US$490 in comparison to long-stem hemiarthroplasty (roughly US$ 1700). Conclusion: Our aim was to alleviate pain, facilitate rehabilitation, ease nursing care and improve quality of life for metastatic bone disease patients until end of life. MUH for the treatment of pathological fracture in proximal femoral metastases is a feasible palliative surgical modality in resource-limited settings.

Matched MeSH terms: Wheelchairs
Adaptive invention: independence and mobility through modifications

Mairami FF, Allotey P, Warren N, Mak JS, Reidpath DD

Disabil Rehabil Assist Technol, 2018 10;13(7):658-664.
PMID: 28836873 DOI: 10.1080/17483107.2017.1369586

BACKGROUND: Stroke is a leading cause of disability that limits everyday activities and reduces social participation. Provision of assistive devices helps to achieve independence and social inclusion. However, due to limited resources or a lack of suited objects for their needs, individuals with disabilities in low and middle income countries (LMIC) often do not have access to assistive devices. This has resulted in the creation of purpose built innovative solutions. Methodology and case content: This paper uses a single case derived from a larger ethnographic study of stroke survivors in rural Malaysia to demonstrate the role of assistive devices in shaping stroke recovery and how existing structures can be modified. Second, the concept of affordances in relation to structures within the environment, issues of affordability and accessibility of assistive devices for individuals in LMIC are discussed.
FINDINGS AND CONCLUSIONS: Stroke recovery involves adapting to new limitations and discovering the support necessary to live life. These changes are influenced by a range of environmental factors. Healthcare professionals need to support stroke patients in identifying challenges and work to find innovative ways to address them. Stroke survivors may benefit from the use of an assistive device beyond its clinical function to participate purposefully in activities of daily living. Implications for Rehabilitation Stroke is a cause of disability that limits everyday activities and reduces social participation. Assistive devices help achieve independence, social inclusion and shape stroke recovery. Individuals with disabilities in low and middle income countries often do not have access to assistive devices and resort to innovative solutions that are purpose built. Stroke recovery involves adapting to new limitations and discovering the support necessary to live life as best as possible.

Matched MeSH terms: Wheelchairs

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