van der Woude Lucas H V, de Groot Sonja, Janssen Thomas W J
Institute for Fundamental and Clinical Human Movement Sciences, Faculty of Human Movement Sciences, Vrije Universiteit, Van der Boechorststraat 9, Amsterdam, The Netherlands.
Med Eng Phys. 2006 Nov;28(9):905-15. doi: 10.1016/j.medengphy.2005.12.001. Epub 2006 Feb 28.
Those with lower limb disabilities are often dependent on manually propelled wheelchairs for their mobility, in Europe today some 3.3 million people. This implies a transfer from leg to arm work for ambulation and all other activities of daily living (ADL). Compared to the legs, arm work is less efficient and more straining, and leads to a lower physical capacity. Also, there is a major risk of mechanical overuse. Problems of long-term wheelchair use are not only pain or discomfort, but also a risk of a physically inactive lifestyle. Subsequently, serious secondary impairments (obesity, diabetes and cardiovascular problems) may eventually emerge. Wheelchair quality, including the ergonomic fitting to the individual may play a preventive role here, but also other modes of physical activity, and the understanding of training, rehabilitation, active lifestyle and sports on health and wellbeing. The 'International Classification of Functioning, Health and Disability' (ICF) model, a stress-strain-work capacity model, as well as the ergonomics model that relates human-activity-assistive technology are instrumental to the concepts, structure and aims of research in assistive technology for mobility. Apart from empirical developments and innovations from within wheelchair sports, systematic research has played a role in wheelchair development and design in three important areas: (1) the vehicle mechanics, (2) the human movement system and (3) the wheelchair-user interface. Current practical developments in design and technology are discussed. A position stand on the key-issues of a current and future research agenda in this area is presented.
下肢残疾者通常依靠手动轮椅出行，如今在欧洲约有330万人如此。这意味着步行及所有其他日常生活活动（ADL）的工作从腿部转移到了手臂。与腿部相比，手臂活动效率更低且更费力，导致身体能力下降。此外，还存在机械性过度使用的重大风险。长期使用轮椅的问题不仅包括疼痛或不适，还存在身体缺乏活动的生活方式的风险。随后，严重的继发性损伤（肥胖、糖尿病和心血管问题）最终可能会出现。轮椅质量，包括与个体的人体工程学适配度，在此可能起到预防作用，但其他身体活动模式以及对训练、康复、积极生活方式和运动对健康和幸福的理解也很重要。“国际功能、健康和残疾分类”（ICF）模型、一种应力 - 应变 - 工作能力模型以及将人类 - 活动 - 辅助技术联系起来的人体工程学模型对移动辅助技术研究的概念、结构和目标具有重要意义。除了轮椅运动内部的实证发展和创新外，系统研究在轮椅开发和设计的三个重要领域发挥了作用：（1）车辆力学，（2）人体运动系统，（3）轮椅 - 用户界面。讨论了当前设计和技术方面的实际发展情况。提出了关于该领域当前和未来研究议程关键问题的立场声明。
