Institut de Robòtica i Informàtica Industrial, CSIC-UPC, Llorens i Artigas 4-6, 08028, Barcelona, Spain.
Biomechanical Engineering Lab, Department of Mechanical Engineering and Research Center for Biomedical Engineering, Universitat Politècnica de Catalunya, Diagonal 647, 08028, Barcelona, Spain.
J Neuroeng Rehabil. 2020 Oct 28;17(1):142. doi: 10.1186/s12984-020-00760-9.
Powered wheelchairs are an essential technology to support mobility, yet their use is associated with a high level of sedentarism that can have negative health effects for their users. People with Duchenne muscular dystrophy (DMD) start using a powered wheelchair in their early teens due to the loss of strength in their legs and arms. There is evidence that low-intensity exercise can help preserve the functional abilities of people with DMD, but options for exercise when sitting in a powered wheelchair are limited.
In this paper, we present the design and the feasibility study of a new version of the MOVit device that allows powered-wheelchair users to exercise while driving the chair. Instead of using a joystick to drive the wheelchair, users move their arms through a cyclical motion using two powered, mobile arm supports that provide controller inputs to the chair. The feasibility study was carried out with a group of five individuals with DMD and five unimpaired individuals. Participants performed a series of driving tasks in a wheelchair simulator and on a real driving course with a standard joystick and with the MOVit 2.0 device.
We found that driving speed and accuracy were significantly lowered for both groups when driving with MOVit compared to the joystick, but the decreases were small (speed was 0.26 m/s less and maximum path error was 0.1 m greater). Driving with MOVit produced a significant increase in heart rate (7.5 bpm) compared to the joystick condition. Individuals with DMD reported a high level of satisfaction with their performance and comfort in using MOVit.
These results show for the first time that individuals with DMD can easily transition to driving a powered wheelchair using cyclical arm motions, achieving a reasonable driving performance with a short period of training. Driving in this way elicits cardiopulmonary exercise at an intensity found previously to produce health-related benefits in DMD.
电动轮椅是支持行动能力的重要技术，但它们的使用与高度久坐的生活方式相关，这可能对使用者的健康产生负面影响。患有杜氏肌营养不良症（DMD）的人由于四肢力量丧失，在青少年早期就开始使用电动轮椅。有证据表明，低强度运动有助于维持 DMD 患者的功能能力，但坐在电动轮椅上进行运动的选择有限。
在本文中，我们介绍了一种新版本的 MOVit 设备的设计和可行性研究，该设备允许电动轮椅使用者在驾驶轮椅时进行锻炼。使用者不是通过操纵杆来驱动轮椅，而是通过两个动力移动臂支撑来进行周期性运动，这些臂支撑提供控制器输入到轮椅。可行性研究由一组五名 DMD 患者和五名未受损的个体进行。参与者使用标准操纵杆和 MOVit 2.0 设备在轮椅模拟器和真实驾驶课程中执行一系列驾驶任务。
我们发现，与操纵杆相比，两组在使用 MOVit 时的驾驶速度和准确性都显著降低，但降低幅度很小（速度降低了 0.26 米/秒，最大路径误差增加了 0.1 米）。与操纵杆相比，使用 MOVit 会使心率显著升高（增加 7.5 次/分）。DMD 患者报告说，他们对使用 MOVit 的表现和舒适度非常满意。
这些结果首次表明，DMD 患者可以轻松地通过周期性手臂运动过渡到驾驶电动轮椅，经过短时间的训练即可实现合理的驾驶性能。以这种方式驾驶会引起心肺运动，其强度以前被发现对 DMD 有健康益处。
