The use of wheelchairs has several effects on its users. Researchers have conducted several studies and found that users using wheelchairs could experience some of the following effects:
- Change Position Effect
- Seating Function Effect
- Habits Effect
- Mechanisms Effect
- Psychological Effects
Effect of Reaction (Tropp, Nylander, Gerdle & Samuelsson, 2004; Dan, Leister, Cooper, Cooper, Kelleher, Fitzgerald, et al., 2008; Arthanat & Strobel, 2006; Van der Woude, De Groot & Janssen, 2006; Requejo, Kerdanyan, Minkel, Adkins & Waters, 2008; Wretstrand 2007).
All the above studies indicate that the function effect has been found to be larger than all the other effects and that a change in position will affect the wheelchair user substantially. Changes in position have a crucial impact on the user of the wheelchair due to the effect on prolusion technique which aims to provide the user with relatively the best condition and position.
Change Position Effects
According to Tropp, Nylander, Gerdle & Samuelsson (2004), the effects of ergonomics on the propulsion efficiency and estimated comfort of the user are also related to several other aspects including the individual position of the user such as the eating habits, postural control, and the overall work capacity of the cardiorespiratory system of the user. The work capacity of organs including the arm, shoulder, and trunk range of motion and muscle strength are additional factors that impact user comfort due to the changes in a position related to uncomfortable design and lack of space around the user of the wheelchair. Additionally, a change in the position of the rear wheels has a strong effect on user comfort, because the weight distribution and seat angle of the wheelchair are significantly affected by propulsion ergonomics related to push frequency and stroke angle (Tropp et al., 2004). However, if the design is appropriately designed according to the environment of the user, the change position will be less thereby reducing the overall effects on the user.
Seating Function Effects
A study by Dan, Leister, Cooper, et al. (2008) estimated the seating functions of the wheelchair by measuring its usage patterns with the help of a customized portable device. This device consistently monitored the seating functions effects throughout the day as users spent most of their time in tilted or reclining positions and did not reposition themselves as frequently as recommended by the clinical practice guidelines (Dan, Leister, Cooper, et al., 2008).
In their study, Arthanat & Strobel (2006) investigated and found occurrences of pain, discomfort, and postural complications among people using WCs (PUWs), which is a cause for concern to their vocational participation at the ergonomic and biochemical guidelines of WC usage. The researchers display increased concern over work-related disorders including back pain, carpal tunnel syndrome, and workstation ergonomics and stress on the study of body mechanics in order to pay more attention to overcome these effects (Arthanat & Strobel, 2006).
A study by Van der Woude, De Groot, & Janssen, (2006) points out the effects of underlying mechanisms of tissue damage, peak exertion, and repetitious effects on wheelchair users. Mechanism effects are due to the direct effect of materials of wheelchairs on inertia. Some wheelchairs are equipped with suspension in the castors or at the rear and these materials have a positive effect on inertia and could tend to be comfortable but lead to increased energy consumption (Van der Woude, De Groot, & Janssen, 2006). It was found that all wheelchairs effectively reduced forces and accelerations but showed variations in their ability to absorb shocks and suppress vibrations. The study also reported the complete absence of whole-body forward momentum. It was also noted that bumps were applied only to the rear wheels. However, the study did not record the effects of front casters which encountered obstacles and front-wheel suspensions. The researchers found that the effect of reaction forces applied to the wheelchair as well as the rider, limited mobility, and community participation. These results affirm a negative biochemical chain of events which consequently contributes to increased discomfort and pain in the neck and back (Van der Woude, De Groot, & Janssen, 2006).
Researchers have tried to study the psychological effects on wheelchair users and user data of wheelchair users getting into a bus. It was found that wheelchair users required assistance from the driver or an attendant in order to deploy the safety equipment. This is a time-consuming process and could be demanding for the operator which may lead to negative feelings in the wheelchair user who may consider themselves as being burdensome to other passengers.
In a study by Requejo, Kerdanyan, Minkel, Adkins & Waters (2008), the researchers estimated that only significant forward preference could be seen when the speed situation effect on the wheelchair user was considered. Some effects including forward, backward, age, gender, a tendency to feel dizzy, some kind of visual impairment, and motion sickness were some of the effects experienced by wheelchair users during commuting in buses (Wretstrand, 2007). Thus it can be affirmed that the use of wheelchairs may reduce the user’s independence and lead to greater isolation and feelings of helplessness. Pithon, Weiss, Richir & Klinger (2009) assert that society continues to display bias against people who use wheelchairs and reflect negative attitudes with regard to their abilities in spheres including education and work.
There are several policy effects according to the Federal Law System pertaining to different kinds of chairs including general-purpose chairs, manual wheelchairs, power wheelchairs, manual sports wheelchairs, and power alternatives. There are several difficulties faced by users such as difficulty in sitting in the chair without special body support and operating a wheelchair or its locks during which bending or reaching could require extra efforts. However, the Federal Law System has very poor policies with regard to design and creations of invention and development of wheelchairs (Washington, D.C.: Congress of the U.S., 1984).
Arthanat S, Strobel W, (2006). Wheelchair ergonomics: Implications for vocational participation. Journal of Vocational Rehabilitation, 24(2) p. 97-109.
Ding D, Leister E, Cooper RA, Cooper RM, Kelleher AR, Fitzgerald SG, Boninger ML, (2008). Usage of Tilt-in-Space, Recline, and Elevation Seating Functions in the Natural Environment of Wheelchair Users. Journal of Rehabilitation Research and Development, pp. 973-984, Vol. 4, No. 7.
Requejo PS, Maneekobkunwong S, McNitt-Gray J, Adkins R, Waters R. J (2009). Influence of hand-rim wheelchairs with rear suspension on seat forces and head acceleration during curb descent landings. Rehabil Med: 41(6):459-66. PMID: 19479159.
Samuelsson K., Tropp H., Nylander E., Gerdle B. (2004). The effect of rear-wheel position on seating ergonomics and mobility efficiency in wheelchair users with spinal cord injuries: A pilot study. J Rehabil Res & Dev: 41(1).
Van der Woude L, de Groot S, Janssen T. (2006). Manual wheelchairs: research and innovation in sports and daily life. Sci Sports: 21: 226-35.
Washington, D.C.: Congress of the U.S. (1984). Office of Technology Assessment: For sale by the Supt. of Docs., U.S. G.P.O.
Wretstrand, A. (2008). Analyzing perceived safety and self-reported accidents in public transit, in De Smets, A. (Ed.) Transportation Accident Analysis and Prevention, pp. 193-208. Hauppauge NY: Nova Science Publishers.