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Wheelchairs – stagnation, evolution or revolution in development

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– LIFE ACTIVATION, REHABILITATION – Ergonomics aspects

WHEELCHAIRS – STAGNATION, EVOLUTION

OR REVOLUTION IN DEVELOPMENT
Bogdan Branowski
Maciej Sydor

Functions of a wheelchair in the context of needs of a disabled person

Assistive technology compensating the dysfunction of the human locomo-
tive system constitutes a special class among the many man-made products
intended for handicapped people. Motion assistive technologies can be found on
the list of 10 most important medical technologies in the report from 2011 pub-
lished by the Markets and Markets consulting company [8]. The objective of the
application of motion assisting facilities is the fulfillment of the need to transfer,
from place to place in a way complying with the requirements of disabled per-
sons and which remains in conformity with the desideratum: ―I cannot but want
to relocate independently like a healthy person, that is to say, independently
of the surroundings‖. Wheelchairs occupy an exceptional position in the class of
assistive technology compensating disturbances of the man‘s locomotive system
[28, 29].
The following numbers characterise well the global wheelchair market in the
year 2010: 4.2 million manufactured wheelchairs of retail value of 3.2 billion
USD (according to other data – 3.5 million wheelchairs of 3 billion USD value)
of which: 2 million hand-operated wheelchairs of 1.5 billion USD value and
2.2 million motor-driven wheelchairs of 1.7 billion USD value. The number
of wheelchairs sold annually per 10 000 inhabitants depends on the territory
and the level of wealth of the population (for example, in Japan, it amounts to
59 wheelchairs, in Great Britain – 44, in the USA – 36, in Canada – 24, in Ger-
many, Italy and France – from 15 to 17; and the world average – 5 wheelchairs).
The number of wheelchair users in developed countries ranges from 3.3 million
in the USA, 0.264 million in Canada, 1.56 million in Germany, 1.2 million in the
UK, 0.36 in France, which corresponds to different proportions in the respective
populations (1.1% in the USA, 0.8% in Canada, 1.9% in Germany, 1.9% in the
UK and 0.6% in France [12]. According to the data from the Central Statistical
Office (GUS) in Poland – a country of 37.7 million population – there are
5.7 million persons with disabilities (15.9%), out of which wheelchairs are used
by approximately 5200 children up to the age of 15 (0.2% of children subpopu-
lation) and by about 560 000 adults (1.7% of adult subpopulation) (GUS) which
constitutes, respectively 0.565 million of users and about 1.5% of the entire pop-
ulation [30]. In the case of developing countries, the proportion of wheelchair
users in the entire population is considerably smaller (Tanzania – 0.005%,
Kenya – 0.007% Uganda – 0.15%) [12].
The needs for disability compensation of wheelchair users can be attributed
to a number of causes: geriatric diseases (including, in particular, joint diseases,

23
 ERGONOMICS FOR THE DISABLED

hemiplegia, circulatory disturbances and balance disorders), post-traumatic disa-

bility (e.g. paraplegia, tetraplegia, amputation within the area of lower limbs,
neurological defects), incurable illnesses and congenital defects (sclerosis multi-
plex, infantile cerebral palsy, rachischisis, limb defects and deformations). Table 1
collates the most important reasons making it necessary to use a wheelchair.
Considerable differences in disabilities combined with individual requirements
of a given person make it hard to match a wheelchair to an individual.

Table 1. Etiology of wheelchair users

Proportion among
Cause of disability making it necessary to use a wheelchair
users of wheelchairs
Acquired diseases of joints 28%
Congenital defects of the nervous system (without cerebral palsy) 14%
Strokes and brain injuries 13%
Bone diseases and injuries 11%
Leg amputations 9%
Cerebral palsy 8%
Post-traumatic paraplegia/tetraplegia (spinal cord injuries) 7%
Heart diseases and diseases resulting in respiratory insufficiency 3%
Source: our own elaboration on the basis of Brooks, Wertsch, Duthie 1994 [6].

From the point of view of the way of wheelchair utilisation , their users can
be divided into the following three categories within which specific subgroups
can be distinguished:
1. Persons with long-term or complete dependence on the wheelchair, with-
out possibilities of walking:
a) self-reliant persons, utilising active wheelchairs, conducting independent
lives,
b) persons with limited self-reliance who use electrically driven wheel-
chairs for independent movement and, when manually operated wheel-
chairs are employed, they need help of an assisting person,
c) persons with completely limited self-reliance requiring assistance in
day-to-day functioning.
2. Persons with long-term, partial dependence on the wheelchair – limited
possibility of walking:
a) changing possibilities of walking, depending on health conditions; small
dependence on the wheelchair – the wheelchair can be necessary in cer-
tain situations and in others – not
b) possibility of walking short distances; considerable dependence on the
wheelchair – the wheelchair is indispensable in everyday functioning
3. Persons with short-term dependence on the wheelchair – persons tempo-
rarily disabled, the need to employ a wheelchair is the result of an injury
or illness.

24
– LIFE ACTIVATION, REHABILITATION – Ergonomics aspects

The kind of disability (Tab. 1) as well as the method of wheelchair utilisa-

tion (permanently or temporarily) cause that persons with disabilities utilise
many kinds of wheelchairs. According to investigations conducted in Great
Britain on a group of 1052 wheelchair users [14], the greatest proportion of
wheelchairs utilised comprises hand-driven, universal wheelchairs (46.5%). The
popularity of individual kinds in wheelchairs is presented in Table 2.

Table 2. Kinds of wheelchairs utilised

Wheelchairs Persons moving exclusively Persons using Total
with the assistance a wheelchair
of a wheelchair and walking
Universal wheelchair 165 324 489
(hand-driven) 42.3% 48.9% 46.5%
Passive wheelchair 110 245 355
(pushed by an accompany- 28.2% 37.0% 33.7%
ing person)
Active wheelchair 26 33 59
6.7% 5.0% 5.6%
Scooter 4 2 6
1.0% 0.3% 0.6%
Electrically driven wheel- 61 35 96
chair (independent control) 15.6% 5.3% 9.1%
Electrically driven wheel- 7 5 12
chair (controlled by the 1.8% 0.8% 1.1%
carer)
Other 12 14 26
3.1% 2.1% 2.5%
Absence of indication 5 4 9
1.3% 0.6% 0.9%
Total 390 662 1052
100.0% 100.0% 100.0%
Source: our own elaboration on the basis of Sapey, Stewart, Donaldson 2004 [14].

The performed analysis of common types of wheelchairs made it possible to

identify a number of differences when trying to satisfy needs of various users:
(1) each person with a disability is characterised by a defect of the support-
motion system and the number of assistive technologies is limited; (2) in a group
of persons with identical disturbances, different physical possibilities occur
(e.g. strength of muscles) and the technical devices offered are the same; (3)
each disabled person requires several wheelchairs (e.g. for the house, for the
street, for sports purposes) and he/she or the health system cannot afford them;
(4) the outward construction of the wheelchair distinguishes the user from the
surroundings and creates a psychological barrier making rehabilitation difficult.
In order to assure ―useful relocation‖, the main components of the man –
wheelchair system fulfill specific principal functions which have been collected
in Table 3.

25
 ERGONOMICS FOR THE DISABLED

Table 3. Functions of the ―man – wheelchair‖ anthropotechnical system

Main functions Sub-functions

Wheelchair functions (with an antidecubital
cushion)
Locomotion  motion assurance (wheelchair driver with the assistance of the
user‘s muscles),
 ensuring system controllability,
Stabilisation of  body support to ensure static stability,
the user‘s body  ensuring cushioning of the body,
 ensuring the system dynamic balance when the user‘s trunk
leans excessively (e.g. balance driving on back wheels,

overcoming an obstruction),
 appropriate distribution of pressures (not to overload
the body),
Stabilization  making sure the wheelchair is adapted to the user
and locomotion and surroundings,
(function  ensuring ease of transfer to stretcher type of system transport
common area) in case of large obstacles (e.g. stairs),
 ensuring possibilities of simple assembly/disassembly by
the user for transport (e.g. when loading the wheelchair into
the car).
Main functions Sub-functions
Drive and control  ensuring independent movement of the system,
 ensuring active body functional movements.
Man‘s function (user of

Stabilisation  compensation of the gravitational load of lower limbs,

the wheelchair)

 compensation of the static balance,

 movement coordination of the system,
 compensation of the dysfunction of trunk muscles,
 compensation of the dysfunction of muscles of lower limbs,
 compensation of the dysfunction of muscles of upper limbs ,
Supervision  choice of the direction and speed of movement,
 control over the correctness of operation of sub-assemblies
of the wheelchair.
Source: our own elaboration.

In the current approach, functions of the ‗man – wheelchair‘ system are sep-
arated by ascribing some of them exclusively to the man as the subject of the
assistance, others are attributed exclusively to the technical facility, while the
remaining functions are allocated proportionally between the man and the tech-
nical device. This implies certain requirements with respect to the technical fa-
cility such as a wheelchair. A well-designed wheelchair should fulfil a number
of important requirements. It should be characterised, among others, by: (1)
possibility of purchase by the user, (2) effectiveness of action, (3) efficiency
(functionality)1, (4) personal acceptability (including appropriate, individually

1
A wheelchair assists functioning of a disabled person at home, at the work station,
during recreation as well as in many other situations ensuring mobility, allowing easy
transfer into and out of the car, bed etc.

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– LIFE ACTIVATION, REHABILITATION – Ergonomics aspects

perceived aesthetics) 2, (5) independence (self-reliance in function realisation),

(6) durability, (7) learnability of the wheelchair operations, (8) standard compat-
ibility, (9) service-free operation and possibility of easy service by the user, (10)
physical comfort of utilisation, (11) transportability, (12) safety of utilisation,
(13) professional repairability/reproducibility, (14) resistance to disturbance
(mechanical, electromagnetic, thermal, chemical and other environmental) [17].
Evaluation criteria of wheelchairs are based on their principal requirements
but different criteria hierarchy applies to users of manually-operated and motor-
driven wheelchairs3.

Functions and structure of wheelchairs in historical retrospect

The wheelchair as an object of historical considerations can be analysed
from the point of view of its technical functions which are of timeless nature in
contrast to the applied materials, form or construction structure. It was the new
functions that led to innovations, made tasks easier to perform, increased the
capability to move, improved comfort of utilisation and safety as well as inde-

2
Aesthetics understood as a subjectively perceived result of: preservation of proportions,
colour harmony and appropriateness/adequacy, moderation and usefulness of the
construction solutions applied.
3
For example, in the case of the evaluation of motor-driven wheelchairs by their users,
the criterion hierarchy is as follows [4]: 1. Effectiveness with respect to the improvement
of living situation (new living situations and/or independence, operational compatibility
with the manufacturer‘s offer, ability to fulfil individual wishes without endangering
other important needs); 2. Efficiency (ease of service and swift response to orders,
accessibility to displays, starting time, appearance of shapes, colours, audibility of
sounds, especially of alarms; 3. Work reliability (resistance to such environmental condi-
tions as temperature, moisture, dust, disturbances when used contrary to recommenda-
tions, resistance to permanent damage when used wrongly); 4. Purchase, upkeep and/or
maintenance and repair affordability (price, hidden costs, e.g. installation, user‘s partici-
pation in costs, warranty); 5. Personal acceptability, in other words psychological com-
fort of wheelchair utilisation, aesthetic attractiveness, compatibility with life style and
identity; 6. Ease of service allowing the user to maintain the efficiency and safety of the
facility (technical service, cleaning and control of threats, service procedures); 7. Elastic-
ity of option selection by the user (number, cost and importance of available options);
8. Service life (expected life, indispenasable level of maintenance); 9. Possibility
of repair by the supplier or repair shop (time of repair, spare parts availability, response
of the distributor to calls); 10. Physical comfort (lack of pain or discomfort during use,
e.g. noise, skin irritation, special functions of comfort improvement in the seat or shock
absorption systems); 11. Physical safety associated with body injuries or inflammations
(no physiological disturbances in blood circulation or urine flow); 12. Reparability by
the user, repair kit, kinds of repairs; 13. Present and future compatibility of interfaces
with other facilities, speed of aging with respect to interfaces; 14. Possibility of quick
learning how to use the wheelchair, necessity of training, procedures at starting; 15. Ease
of assembly by the user, assembly instruction, special devices.

27
 ERGONOMICS FOR THE DISABLED

pendence. Very often, low usefulness and poor adjustment to the environment,
failure frequency, difficulties in repair/service and lack of the acceptance of the
need led to complete abandonment of innovations.
The chronology of the history of the wheelchair (in German: Rollstuhl) func-
tions is the following [10, 15]:
 making it possible for a person in a sitting position placed in a chair
equipped with large wheels with spokes to move from place to place
(China, VI century AD);
 making it possible for a person sitting in a wheelchair to alter body po-
sitions by means of special mechanisms changing the angle of support
of the back and legs and allowing the entire trunk to swivel (Europe –
a wheelchair for the king of Spain, Philip the 2nd (1595); a wheelchair
for the king of Poland, Wladislav the 4th (1640), a rotating armchair
of the king of France, Louis the XIVth (about 1700));
 making it possible for the user to drive the wheelchair him/herself:
 by means of a rope (the so called ―endless rope‖ 1420 – G. Fontana
from Padua, 1420),
 by means of a crank-cog mechanism driving the front wheel of a three-
wheeled facility – B. Hacker, 1588 and S. Farfler, 1655,
 by means of two bevel transmissions, driving two front steering wheels
– J. Dowson, 1811;

Fig. 1. First patent of wheelchair construction solutions (source: US Patent and Trademark
Office 2012): a – regulated backrest and footrest (Blunt and Smith, US Patent No. 86,899 from
1899 [26]); b – dual-function wheelchair, combination of a wheelchair and a pram (Crandal,
US Patent No. 586,760 from 1897 [25])

 making it possible to move the ―active‖ three-wheeled wheelchair (with

the rear wheel self-adjusting) directly by hand (USA – 1850); the idea
developed later by the application of an additional wheel ring of driving
wheels (USA, about 1881; 1894 – a patent on which a wheelchair with
driving wheel rings is visible; S.A. Potter: US patent No. 531,300)
(Fig. 2a) [24];

28
– LIFE ACTIVATION, REHABILITATION – Ergonomics aspects

 allowing side stabilisation of a paraplegic sitting in a light, four-

wheeled wheelchair with a wicker seat (end of the 19th century), simi-
larly as in a passive, two-wheeled Confucius wheelchair pushed with
the assistance of a rear drawbar (about 1680);
 first ―material revolution‖, replacement of wood by steel; elaboration of
a rigid, non-collapsible frame (years 1860-1880);
 engine-driven wheelchairs (England, 1912 – prototype, 1916 – serial
production);

Fig. 2. Hand-driven wheelchairs: a – from 1894 according to a sketch in the patent application
of Samuel A. Potters (US Patent No. 531,330 [24], source: US Patent and Trademark Office
2012); b – a photo from an advertising leaflet of H&J Company from 1930s (collapsible cruciform
frame construction of this wheelchair was patented by Everest and Jennings in 1937 – US Patent
No. 2,095,411 [23], drawing prepared on the basis of Gugel 2012 [9]); c – contemporary universal
wheelchair from 2012 (type HF601, source: Kangshen Medical Equipment Factory – 2012 [11])

 first collapsible universal, passive wheelchair (to be transported e.g.

in a car) with a cruciform frame (USA, H. Jennings – 1932: Fig. 2b)
which survived in an unchanged form until today (Fig. 2c);
 hybrid drive function (inclusion of an additional electric motor; Everest-
Jennings Company, 1950);
 second ―material revolution‖; introduction of light aluminium alloys
(1970s);

29
 ERGONOMICS FOR THE DISABLED

 functions of independent life on an active wheelchair (Quickie Designs

Company, 1978);
 third ―material revolution‖ – large-scale application of carbon compo-
sites for frame constructions (end of the 20th and beginning of the 21st
centuries).
The historical overview should be concluded by reviewing functions/
constructions of wheelchairs for developing countries as their ‗roads of evolu-
tion‖ were different. Thanks to the support of the United Nations, various
foundations as well as governmental organisations from different developed
countries undertook design actions on a new wheelchair adapted to road condi-
tions, economic and technological possibilities prevailing in the developing
countries of Africa, Asia and South America [27]. Construction concepts of
these kinds of wheelchairs are based on the utilisation of existing bicycle assem-
blies and simple technologies and aim at the minimisation of manufacturing
costs.

Fig. 3. Wheelchairs from the USA and Europe designed to suit the Third World requirements
Source: [31-33].

Fig. 4. Students‘ wheelchairs (MIT 2009)

30
– LIFE ACTIVATION, REHABILITATION – Ergonomics aspects

The best technical universities (e.g. MIT in the USA) are now offering de-
sign-execution courses dealing with assistive technology for disabled persons
whose operations are verified in the natural conditions of developing countries.
However, they are characterised by low innovativeness echoed in the following
quote: ―an old wheelchair concept of the western world adjusted to the condi-
tions of the Third World using specific requirements‖ (Fig. 4).
It is worth stressing that, simultaneously, in all the third world countries of
the above-mentioned continents, very simplified, sometimes ingenious, native
constructions developed by craftsmen of diverse degree of functional advance-
ment are utilised.

Antinomies occurring in wheelchairs

Introducing the concept of antinomy [18], in other words of an intrinsic con-

tradiction resulting from inconsistencies of different – separately valuable –
improvement directions of operations often seen as crossroads [22], it is also
possible to distinguish categories of efficient action antinomies: activity – pas-
sivity, preparation – improvisation, offensiveness – passiveness. To travesty
Tadeusz Kotarbiński‘s phrase ―all necessary effort should be made‖ to achieve
independence of life on a wheelchair, but to ―make only necessary efforts‖ to
meet this demand in conditions of a specific person with a disability, it is neces-
sary to adopt a compromise approach to preparations and realisation because,
according to Aristotle ―we should be doing what we do, having learnt the given
job and, instead, we are learning a given job by doing it‖; it is necessary to be
active but not overactive because it is impossible to predict consequences of our
actions. Antinomies in the world of technique are the result of technological
contradictions between co-dependent features of an object, when an improve-
ment of certain parameters of a given object brings about deterioration of other
parameters with evident difficulties for a compromise [3].
Basic antimonies of the system: disabled person – wheelchair are associated
with: a wrong selection of a manual wheelchair in the set of various passive,
active, sports, special (of small weight) wheelchairs or of mechanically
driven vehicles according to the disability of a specific person, his/her passive or
active mobility as a user, the area in which this mobility is utilised (indoors,
outdoors or in a mixed area) and the age of the user (from a child to a senior
person).
The wheelchair, as a technical object, exhibits a number of simple antino-
mies, i.e. contradictions or ambiguities (Tab. 4) resulting from a demand to
improve one property/characteristic without taking into account possible deterio-
ration of another property/characteristic.

31
 ERGONOMICS FOR THE DISABLED
Table 4. Simple antinomies – list of advantages and disadvantages of a wheelchair with
active manual drive (including an ultralight wheelchair with a manual drive equipped
drive rings)
No. Advantages Contradictions, ambiguities,
antinomies
1 Small weight of the Considerable strength effort
wheelchair Large elastic and/or plastic
deformations
Sensitivity to static and dynam-
ic load changes, including to
accidental loads
Difficulties in developing con-
nections of load-carrying ele-
ments
Sensitivity to concentration of
stresses
Reduced safety, durability and
reliability and possible damage
of the wheelchair
2 Small dimensions of the
wheelchair due to re-
quirements of architectur-
al environment, body
stabilisation, considerable
manoeuvrability, ergo-
nomics of drive pulls
3 Small transport volume Reduced wheelchair stiffness
of the foldable or disas- Increased friction and wear
semblable wheelchair in nodes
4 Low resistance of motion Internal drive dynamics
(in a system of 2 large, of the system
heavily loaded drive
wheels with rings and
2 small, self-adjusting
unloaded wheels)
5 Comfortable utilisation No possibility of rest in a relax-
ing position as well as signifi-
cant rehabilitation possibilities
on the wheelchair.
High backrest and rich addi-
tional equipment (e.g. handles,
armrests) for comfort of trunk
support when sitting or low
backrest with loin support but
absence of equipment for com-
fort of driving, balancing of the
body and increase of arms
driving range.
32
Disadvantages
Highly resistant materials
(costs)
Thin-walled load-carrying
profiles (complex technology
of manufacture and joining)
Movement dynamics of
human body and variability
of the drive moment (at un-
paralleled, in technique, ratio
of man‘s weight to the weight
of the wheelchair of approx-
imately 10) as a source of
non-stationary movement,
especially when the ground
is uneven.
Low cross-sectional and
longitudinal system stability
during static and dynamic
movement conditions
Large number of moving
pairs in foldable wheelchairs
More difficult handling
of a monolith frame during
self-loading into a car
Low efficiency at interrupted
energy transfer (variability
of the drive moment on pulls
and braking moment
at self-aligning movement
of the body trunk
Body „pressed into the frame
of a standard wheelchair‖
with only small side space,
with poor support of the loin
area, lack of arm or head
support when the wheelchair
stands still, lack of ventilation
at the interface clothing –
pillow.
– LIFE ACTIVATION, REHABILITATION – Ergonomics aspects

5 Is ride in the balance of an

6 Simple carrying structure and
easy assembly or disassembly
of modules with a small num-
ber of elements; simple, cen-
trally located stop brakes of
wheels individually fitted to the
user
7 Simple drive structure
Easy disassembly of modules
(quick release coupling)
experienced user resulting
in deterioration of drivabil-
ity (as a result of diplace-
ment of the centre of
gravity) necessary for the
wheelchair used inside
buildings?
Lack of answer:
- stiff or flexible frame?
- shock absorption of drive
wheels and/or steering
wheels?
Drive system going back
to middle ages or other
manual drive (lever or
crank) with transmission-
gear and change of wheel
drive?
Manual, electrical drive
(in drive wheels, some-
where else or hybrid)?
Variations in the drive for
riding inside buildings or
outdoors.
Lack of protection against
atmospheric influence
Lack of lighting
Lack of drive brakes
Too small and excessively
loaded self-adjusting wheels
causing self-activated vibra-
tions or rapid braking when
one of the wheels falls into an
irregularity in the road
Negative influence of atmos-
pheric conditions (rain, snow,
temperature) on manual
driving of slippery, wet and
cold pulls carrying away heat
from hands.
Lack of mud-guards.
Lack of self-cleaning of tyres
following an outdoor ride.

Source: our own elaboration.

The carrying and driving structures are the simplest of all the possible ones,
whereas the functional structure of the human – wheelchair is exceptionally
complex in each of the two acts of wheelchair operation: an armchair for a stable
body support and a comfortable seat during manual manipulations in the course
of various work operations as well as a wheelchair acting as a universal vehicle
for riding – frequently in extremely difficult conditions of the surroundings
(rough roads often with obstacles, extreme surface irregularities, staircase
slopes, manoeuvring on extremely small surfaces). Contradictory requirements
of the active wheelchair [5] are difficult to reconcile for the assumed function
structure of the man – wheelchair system; movement compensation, relief, static
and dynamic balance, manipulation. This refers, in particular, to the antinomies
of the following pairs of requirements of the active wheelchair:
 ―light and/or cheap vs. tough‖ or ―light vs. stiff‖;
 ―safe, also in the condition of intended instability vs. manoeuvrable
and/or compact, especially due to small width dimensions and wheel
tread‖;

33
 ERGONOMICS FOR THE DISABLED

 ―simple with respect to the carrying structure vs. comfortable in every-

day use, maintaining supported sitting body position, ergonomic in the
area of body contact and manipulation (especially when mechanically
driven) and individually regulated‖;
 ―beauty of the wheelchair construction vs. wheelchair hidden in the
background of a sitting user‖.
The state of the construction fatigue strength effort of a dynamically loaded
construction (descents, hits against obstacles) causes a number of damages (frac-
tures of the frame, axle and rear wheel spokes as well as forks and self-adjusting
wheels, frame and wheel deformations and distortion, jamming of the frame
folding or wheel detachment, wear of protective covers, excessive friction of
movement and difficulties in uniform braking). The following priorities emerge
from the analysis of requirements and expectations of disabled persons: opera-
tional safety, price accessibility, utilisation comfort combined with independent
assembly/disassembly and transfer. New possibilities of active and independent
life of a handicapped person on a wheelchair fail to ensure safety. Hazard analy-
sis carried out by PHA on the basis of possible accident scenarios in the course
of wheelchair exploitation confirmed risks of developing bedsores or acquired
faulty postures during static sitting, risks of dangerous falls when riding down
steep driveways, stairs or kerbs, not to mention riding up the stairs [16].

New requirements concerning wheelchairs

General requirements for wheelchairs aiming at the fulfillments of users‘
requirements and quality improvement can be presented as follows:
 The type of wheelchair drive should first and foremost correspond to
physical abilities and requirements of a specific user;
 The way of controlling the direction and speed of riding should meet
the requirements of a specific user;
 The wheelchair should be equipped with a supportive electrical drive
for the best possible utilisation of muscle force in changing road condi-
tions;
 The wheelchair should guarantee comfortable movement of a disabled
person indoors and outdoors at minimal energy losses of the user and
the battery;
 The wheelchair should be equipped with appropriate devices for the
regulation of the electrical drive and its rational cooperation with muscle
drive;
 The wheelchair should allow movement even when the battery runs
flat;
 The utilisation of the wheelchair should not be restricted only to sum-
mer time;
 Wheelchair dimensions should allow its movement through doorways;

34
– LIFE ACTIVATION, REHABILITATION – Ergonomics aspects

 The wheelchair should make rapid disassembly and assembly possible

to allow comfortable storage and transport by car;
 The wheelchair design should make it possible for the disabled person
to merge with surroundings;
 The price of the wheelchair should be lower than that of contemporary
electrically-driven wheelchairs.
The above descriptions reflect the results of the ZFE Technische Hochschule
Darmstadt research project regarding the development of a multifunctional
wheelchair for outdoor and indoor use [13]. On the basis of analyses of many
catalogued wheelchair constructions in their 600-year history of development,
sometimes debatable disadvantages of renowned solutions were determined
and requirements marking out new vistas of development were collated. Some
of those development proposals deserve attention:
 a wheelchair coupled with a steering system controlled by a right- or
left-turn of the user‘s trunk;
 a developed drive or a drive matched to the contemporary and not me-
dieval state of driving technique, e.g. attachable electrical drive;
 wheels separated from drive rings or entirely separated drive switched
on and off by a multi-gear transmission;
 supplementary anti-capsize protection thanks to additional bigger
wheels;
 a rigid wheel for driving straight on equipped with a simple lever is
added to two small non-controllable, self-adjusting wheels restricting
driving over obstacles and small wheels allow tilting while turning or
only one bigger wheel controlled by the movement of the trunk;
 installation of two or one additional brake in all vehicles;
 many module variations of the wheelchair standard seat suitable for
individual disabilities;
 sitting position more suitable to a natural posture of ―riding in a saddle‖;
 dissemination of the wheelchair spring suspension, for example, when
separating drive forces;
 mudguards and lights in standard wheelchair equipment;
 expansion of wheelchair possibilities as a therapeutic tool (at the present
time, wheelchairs are anti-therapeutic).

Concept of an ideal wheelchair

In the taxonomy of technical changes, the following four innovation types
can be distinguished: (1) increment innovation, (2) radical innovation, (3)
changes of the technology system and (4) changes of the techno-economical
paradigm [7].
Construction innovativeness of human products can be analysed against the
background of the development of historical artifacts, against the backdrop of

35
 ERGONOMICS FOR THE DISABLED

expanding fulfillment of a wide range of different functional needs in contempo-

rary times or in the environment of the model of the so called ideal solution
known from the methodology of technical design.
Historical development of wheelchair functions has shown a rapid accelera-
tion in recent years4. This is associated not only with the general progress of
technique and selection of an independent way of development by the wheel-
chair, separately from other areas of technique (e.g. bicycle of pushchair tech-
nique). At the present time, the wheelchair is described as ―a compensatory-
functional prosthesis‖ [19]. What is more important is the global change of
needs of a disabled person with her/his ―independent and active‖ life rooted in
the concepts of universal design. However, this development takes place on the
basis of increment innovation which assumes an improvement of something that
already exists. This kind of development process fails to activate the essential
potentials which could bring designers closer to an ideal fulfilment of motility
requirements by contemporary wheelchairs.
The concept of an ideal wheelchair is connected with an ideal construction
solution [1]. The comparison of the parameters and quality indices of the best
in their class (―first wheelchair in its class‖) wheelchairs in the world (according
to disabled users and internet studies) provides a certain approximation of the
concept (Tab. 5).
The design structure of a wheelchair can be presented in the form of a dia-
gram (Tab. 6). It was described by the selection of specific kinds of structural
elements: frame bearer – R, riding system – U, seat – S, suspension – Z, drive –
N and equipment – W. In the example presented in Table 6, 2 kinds of frame
bearers, 3 kinds of driving systems, 5 kinds of seats, 3 kinds of suspensions,
8 kinds of manual drives and 5 possibilities of equipment in devices facilitating
the access were distinguished. Therefore, in the design of a manual wheelchair,
a finite set <2x3x5x3x8> = 720 of possible variants of construction solutions
(without taking into account equipment W) is theoretically considered in the
Cartesian space of structural elements. A definite solution is represented by a
definite diagram pathway < Ri→Uj→Sk→Zn→Nm>. For example, the following
diagram pathways are represented by the most commonly used wheelchairs:
universal wheelchair <R1→U1→S1→Z1→N1> and universal wheelchair
<R2→U1→S1→Z1→N8> which differ with respect to the kinds of frames and
drive.

4
One of the examples can be the MIT Intelligent Wheelchair Project developing a voice-
commandable robotic wheelchair (2011) [20] realised at the Massachusetts Institute
of Technology or the Wheelchair Project Mobile Robot Programming Lab. (1997) –
at Carnegie Mellon University [21]. These are examples of: robotic wheelchairs with
gyroscope stabilisation, exoskeletons of disabled persons, mechatronic wheelchairs
with self-teaching microprocessor software as well as new generations of sports wheel-
chairs.

36
– LIFE ACTIVATION, REHABILITATION – Ergonomics aspects

Table 5. Parameters and quality indices of selected wheelchairs considered best

in the world in their respective classes
No. Area of Wheelchair Drive Technical parameters Quality indices Remarks
C m G
application type m C G D
(kg) (PLN) (m2) (m) m m min m
1 Home active R 9.20 7700 0.51 1.03 837 2.19 0.06 Küschall Ag:
K-Series
2 passive O 13.0 5350 0.46 1.12 412 3.10 0.04 Invacare
Spinx
3 passive E 145 18500 0.98 1.57 128 34.52 0.01 Vermeiren;
Ascend
4 Home + car active R 4.20 17000 0.49 1.02 404 1.00 0.12 Panthera;
8 Panthera X
5 Health care passive O 18.5 1000 0.50 1.19 54 4.40 0.03 Sunrise Medi-
facility cal; Unix
6 Street / active R 6.60 12000 0.42 0.97 181 1.57 0.06 Küschall Ag;
open area 8 R33
7 passive O 21.3 1900 0.54 1.28 89 5.07 0.03 Meyra; City-
liner 415+
8 passive E 164 7500 0.94 1.54 46 38.93 0.01 Sunrise Medi-
cal; Breezy
121
9 Sport/recrea sport-type R 33.0 20000 0.84 1.39 606 7.86 0.03 Quickie-
tion Shark
10 Rehabilita- special M 28.0 4500 1.02 2.06 161 6.67 0.04 Handicare;
tion Emineo
Designations:
Drive: E – electric; R – manual by user; O – manual – by assisting person
Parameters: m – wheelchair mass; C – wheelchair price; G = area taken up by wheelchair (a x b;
a – length; b –width); D – minimal diameter of U-turn
Indices: C/m-cost consumption; m/mmin – mass at mmin – minimal mass from Table; G/m = a·b/m –
manoeuvrability
Remarks refer to the manufacturer/type/wheelchair designation; all wheelchairs were selected for
50-percentyle male; high-tech applications in the area of materials, steering, new functions

Source: our own elaboration.

In decision models of the EW wheelchair construction structure selection,

the adopted form of the integral description of wheelchair model structure must
be supplemented with R relationships of the model, i.e. with a set of interrela-
tionships between elements of the model field. The solution of the selection task
is an arranged triplet <<<SW, R, C>A>D, PR>, containing a system of decisions
(D) and a positive result (PR) arrived at by using active knowledge (A) whose
cooperation ensures convergence of the construction (SW, R) and design objec-
tive (C). The positive result (PR) is a concept model containing a compromise of
the objective function and quality measures. Active knowledge (A) represents
the knowledge utilised by the designer to solve tasks.

37
 ERGONOMICS FOR THE DISABLED

Table 6. Diagram of possible variants of structural solutions of a wheelchair

with manual drive
Frame bearer Ri R1 R2
(i = 1,2)
Riding system Uj U1 U2 U3
(j = 1,2,3)
Seat Sk
(k = 1,2,3,4,5) S1 S2 S3 S4 S5

Suspension Zn
(n = 1,2,3) Z1 Z2 Z3
Drive Nm
(m = 1,2,…,8)
N1 N2 N3 N4 N5 N6 N7 N8
Equipment Wp
(p = 1,2,3,4,5)
W1 W2 W3 W4 W5
Designations:
Frame bearer: R1 – permanent (frame or consol), R2 – folded (cruciform or parallel clamp);
Riding system: U1 – 4-wheeled (large wheels at the back or in front), U2 – 3-wheeled;
U3 – other (e.g. additional safety wheel or 2x3-backwheels in a ―planetary‖ system of the
wheelchair to climb stairs);
Seat: S1 – permanent (e.g. with foldable backrest), S2 – lifted (lift or hoist), S3 – verticalising
(active or passive), S4 – tilted (toilette, shower), S5 – other (e.g. with a mobile footrest);
Suspension: Z1 – rigid of wheels, Z2 – elastic of wheels, Z3 – elastic – absorbing of wheels
(e.g. elastomeric);
Drive: N1 – independent of pulls without transmission, N2 – independent of pulls with trans-
mission, N3 – dependent of pulls (e.g. single-handed), N4 – lever without transmission,
N5 – lever with chain transmission, N6 – crank-chain (front wheel), N7 – lever-crank (rear
wheel), N8 – without drive (with service, e.g. universal, for travelling);
Equipment (integral of the wheelchair): W1 – folding table top or transport tray, W2 – container
(files, bags or cup), W3 – fastening of crutches, walking stick, W4 – hand gripper, W5 – tele-
scope ramp

Source: our own elaboration.

This knowledge is being formed following ex post externalisation of new

object properties and supplementation of the task by new, earlier unnoticed ele-
ments of the design context. This knowledge is of systemic nature and deals with
the requirements and possibilities of a person with a disability appropriate to
constructional characteristics and properties of a wheelchair and system sur-
roundings (kind and geometry of surface, performed activities and their duration,
access conditions to the space of surroundings). The solution of the wheelchair
selection problem perceived in this way constitutes a set of ordered, logical
and coordinated activities terminating in a choice of the optimal structure of
the wheelchair construction.

38
– LIFE ACTIVATION, REHABILITATION – Ergonomics aspects

Recapitulation
Innovations and human needs are the driving force of all changes in tech-
nique. The quality of technical products (artifacts) can be analysed: (1) by means
of the assessment of the degree they fulfill users‘ requirements thanks to their
specific utility characteristics; (2) against historical background or (3) against
the background – known in the methodology of technical design – of quest for
the so called ideal solution totally fulfilling a specific need.
Technical progress originates from a natural human assumption that all or, at
least, an overwhelming majority of contemporary articles, are, in fact, only tran-
sitory solutions and imperfect ―substitutes‖ of still unachievable ideal solutions.
Therefore, an expected and natural outcome of assessment results of a given
article (from the point of view of the extent to which it fulfils its usefulness re-
quirements) is a conclusion that it is imperfect and fairly easily improved in the
existing state of knowledge. Historical retrospection of a product development
does not usually provide a direct answer to the question how to improve this
product; it can only indicate which construction solutions of the product do not
give good prognostication for the future. It should, however, be remembered that
an evolutionary failure of a historical solution need not necessarily result from
its inappropriateness, but could be attributed to the lack of suitable technology.
The basic needs that are fulfilled with the assistance of a wheelchair include
free movement and adoption of appropriate body position in space. The first of
these needs, in the case of able-bodied persons, is realised by walking (possibly,
running), the second is realised by skeleton muscles. On the basis of the analysis
of the state of technique in the field of facilities assisting locomotion, it can be
responsibly stated that contemporary wheelchairs are incapable of suitably
fulfilling the above-mentioned functions.
Each wheelchair user should be equipped with some wheelchairs which
could be used alternatively depending on a specific situation.

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