SMARTWheel: From concept to clinical practice

Abstract

Wheelchair prescription is complex with thousands of choices and options. Theoretically, a higher quality or innovative wheelchair that is appropriately matched to the user and their unique needs will increase participation. It is well accepted that there is an alarmingly high incidence of carpal tunnel syndrome, and rotator cuff injuries among manual wheelchair users. Since the initial conceptualization, the SMART(Wheel) was intended to better understand the physiological and physical effects of wheelchair propulsion on the body. Initially, little was known about wheelchair propulsion and the SMART(Wheel) transformed the nascent field of wheelchair propulsion biomechanics. Although still an important area of clinical research, the SMART(Wheel) has been critical to the study of the relationship between the type of wheelchair, set-up, activity, technique, anatomy, and physiology and repetitive strain injury. There has been growing evidence that the wheelchair-user interaction explains a substantial portion of the risk of developing a degenerative injury and on community participation. A noteworthy contribution of this work was the release of the clinical practice guideline, entitled, Preservation of Upper Limb Function Following Spinal Cord Injury in 2005. The SMART(Wheel) has been used by other scientists in areas that were not originally envisioned to be applications. It has been used to support the design of tools for developing a trail mapping rating and description system. It has also supported the design of accessible pedestrian walkways standards, accessible playground surfaces, and to evaluate carpets for wheelchair accessibility. It is likely that there are more new areas of exploration to emerge. This article describes the evolution of the SMART(Wheel) as new technologies became available and its applications in the field of wheelchair biomechanics and clinical service delivery.

Figures

Figure 1

The first generation smartwheel designed for racing wheelchairs.

Figure 2

Building upon the experience with the original smartwheel, a new design was build around a plastic “mag” style wheel.

Figure 3

Power was brought to the on-wheel electronics circuit through a printed circuit board with circular traces and spring-loaded copper rods were used a contacts, a 4-channel mercury slip ring allowed the outputs from the amplifier boards to be brought off the rotating wheel.

Figure 4

The next significant transformation of the smartwheel came with the replacement of the analog circuitry with a digital circuit,

Figure 5

This first generation pre-production smartwheel.

Figure 6

The smartwheel over the years since first being introduced, several areas have been improved. Most notably, the battery was relocated to be less vulnerable to impact, and there have been a number of wifi and software upgrades.

Figure 7

Time courseof significant milestones to date.