Biomedical subjects

Shirley G Fitzgerald

Publications and source records attributed to Shirley G Fitzgerald.

At least 19 recordsLinked to original sources

PubMed2006

Advancements in power wheelchair joystick technology: Effects of isometric joysticks and signal conditioning on driving performance.

OBJECTIVE: An estimated 125,000 Americans with movement disorders that preclude independent mobility in a power wheelchair could benefit from improved control devices. We developed variable gain algorithm (VGA) software for our isometric joystick (IJ) that allows it to emulate a commercially available motion-sensing joystick (MSJ) in performance but retain the unique customizable features of an isometric control. Force sensing algorithm (FSA) software allowed the IJ to function as a simple isometric device. DESIGN: Using a Fitts' Law paradigm, we compared driving performance with floor targets using a standard MSJ and an IJ with both FSA and VGA software in 11 electric power wheelchair users with a variety of impairments. Outcome measures were reaction time (RT), movement time (MT), and driving accuracy (DA). RESULTS: The IJ with FSA had a significantly shorter RT than the MSJ (P < 0.0020). The IJ with FSA had a significantly longer MT than the MSJ to far targets (P < 0.0159). No differences were found between the IJ with VGA and the MSJ with respect to RT or MT. No differences in DA were found among any of the joysticks. CONCLUSIONS: VGA software allowed the IJ to function similarly to the MSJ with respect to RT, MT, and DA.

Adult↗

PubMed2006

Development and qualitative assessment of the GAME(Cycle) exercise system.

Increased physical activity is important for reducing the risk of cardiovascular disease. However, among people with disabilities, inactivity is prevalent. In order to encourage exercise among members of this group, an exercise system combining arm ergometry with video gaming, called the GAME(Cycle) was previously developed. User input was received through an arm crank ergometer on a swivel, with the angular velocity of the ergometer resistance wheel controlling one axis and rotation of ergometer about the swivel controlling the other. The purpose of this study was to detail the algorithms used in this device and present novel features included in a second generation of the GAME(Cycle). The features include a wheel on base, a steering return mechanism, and wireless fire buttons. A focus group of clinicians (n = 8), wheelchair users (n = 8), and clinician wheelchair users (n = 2) was conducted to evaluate the features of the GAME(Cycle). The focus group suggested improvements to the steering mechanism and to reduce vibration in the system. However, the focus group enjoyed the GAME(Cycle) and felt that it would encourage exercise among persons with disabilities.

Algorithms↗

PubMed2006

Engineering better wheelchairs to enhance community participation.

With about 2.2 million Americans currently using wheeled mobility devices, wheelchairs are frequently provided to people with impaired mobility to provide accessibility to the community. Individuals with spinal cord injuries, arthritis, balance disorders, and other conditions or diseases are typical users of wheelchairs. However, secondary injuries and wheelchair-related accidents are risks introduced by wheelchairs. Research is underway to advance wheelchair design to prevent or accommodate secondary injuries related to propulsion and transfer biomechanics, while improving safe, functional performance and accessibility to the community. This paper summarizes research and development underway aimed at enhancing safety and optimizing wheelchair design.

Activities of Daily Living↗

PubMed2005

Vibration exposure of individuals using wheelchairs over sidewalk surfaces.

According to the International Standards Organization 2631-1 standard on human vibration, individuals in a seated position are at risk of injury due to whole-body vibrations when exposed for long periods of time. Wheelchair users fit this description perfectly; however, little research has been conducted to evaluate the amount of vibration transmitted to a wheelchair user. The vibration exposure produced by traversing nine surfaces was evaluated by having 10 individuals without disabilities propel over them in both a manual wheelchair at 1 m/s and a powered wheelchair at 1 and 2 m/s. Root-mean squared (RMS) vertical vibration was examined to determine if differences existed between surfaces. At 1 m/s for both the manual and the powered wheelchair the 8-mm bevel interlocking concrete surface produced significantly higher RMS vertical vibration than the other surfaces. At 2 m/s in the powered wheelchair, the poured concrete surface (control) produced the significantly highest RMS vertical vibration. Based on the manual and power wheelchair results of this study, use of selected ICPI pavers would be acceptable for any route traveled by individuals using wheelchair. Furthermore, a 90 degrees herringbone pattern is preferred over the 45 degrees pattern, and it is recommended that for safety reasons regarding vibration exposure a bevel of less than 6 mm should be used.

Adult↗

PubMed2005

Fatigue testing of selected suspension manual wheelchairs using ANSI/RESNA standards.

OBJECTIVES: To evaluate the durability and value of 3 common suspension manual wheelchairs and to compare the results with those of previously tested lightweight and ultra-lightweight folding-frame wheelchairs. DESIGN: Standardized fatigue testing and cost analysis of 3 suspension manual wheelchairs from 3 different manufacturers. SETTING: A rehabilitation engineering center. SPECIMENS: Nine suspension manual wheelchairs. INTERVENTIONS: Wheelchairs were fitted with a standardized wheelchair test dummy and tested on a series of fatigue tests, consistent with those developed by the International Organization for Standardization. Main outcome measures Fatigue life (measured as the number of equivalent cycles completed) and value (equivalent cycles divided by cost) were compared among all wheelchairs. RESULTS: Analysis of variance revealed significant differences (P< or =.05) in the number of equivalent cycles among the suspension wheelchairs tested. When compared with previously tested ultra-lightweight and lightweight wheelchairs, the suspension wheelchairs failed to show significant improvements; however, significant improvements were found between individual suspension and lightweight wheelchairs. CONCLUSIONS: We found little evidence to suggest that suspension manual wheelchairs provide advantages in terms of durability or value over standard lightweight and ultra-lightweight folding-frame wheelchairs.

Equipment Design↗

PubMed2005

Effect of a pushrim-activated power-assist wheelchair on the functional capabilities of persons with tetraplegia.

OBJECTIVES: To test the differences between a pushrim-activated power-assisted wheelchair (PAPAW) and a traditional manual wheelchair while performing common driving activities and to assess their relative merits for people with tetraplegia. DESIGN: Repeated measures. SETTING: An activities of daily living (ADL) laboratory within a rehabilitation research center. PARTICIPANTS: Fifteen full-time manual wheelchair users with tetraplegia due to a spinal cord injury. INTERVENTIONS: Participants propelled both their own manual wheelchairs and a PAPAW 3 times over an ADL course. The order in which the 2 different wheelchairs were presented to the participants was randomized. MAIN OUTCOME MEASURES: Each participant's heart rate was monitored throughout testing by a digital, wireless heart-rate monitor. Time to complete the course was recorded, and participants were surveyed with a visual analog scale after the first, third, fourth, and sixth trials to determine the ease of completing each obstacle and their ergonomic preferences between the 2 wheelchairs. Participants also were observed throughout the trials to determine how much assistance they needed to complete each obstacle course. RESULTS: After using a Bonferroni adjustment, 4 obstacles (carpet, dimple strips, up a ramp, up a curb cut) were rated as being significantly easier ( P <.001) to complete when using the PAPAW. Participants also showed a significant decrease in mean heart rate throughout all 3 trials ( P =.015, P =.001, P =.003, respectively) when using a PAPAW. The amount of assistance needed by participants, the responses to ergonomic questions, and the overall time to complete the ADL course did not differ significantly between the 2 wheelchairs. CONCLUSIONS: For subjects with tetraplegia, PAPAWs have the potential to improve functional capabilities during certain ADLs, especially when propelling up ramps, over uneven surfaces, and over thick carpet.

Activities of Daily Living↗

PubMed2005

Development of the seating and mobility script concordance test for spinal cord injury: obtaining content validity evidence.

The appropriateness of a consumer's seating and mobility system varies considerably depending on the competence, proficiency, and experience of the professionals assisting the user. At present, there is a scarcity of skilled and knowledgeable therapists to evaluate and recommend seating and mobility devices. There is also a lack of measurement tests available to evaluate the impact of educational experiences or clinical practice on the ability to make specialized clinical decisions about seating and mobility needs. The Seating and Mobility Script Concordance Test (SMSCT) is a new assessment tool, grounded in the hypothetico-deductive and schema theories of clinical reasoning. The test is designed to assess therapists by examining the organization of their knowledge, associations between items of their knowledge, and the adequacy of their clinical decisions as compared to expert consensus. This article describes the interview, test development, and content/item review processes used for the collection of content validity evidence. The iterative process employed and the appraisal of the content validity evidence that resulted in the final version of the SMSCT are presented. The SMSCT appears to be a promising assessment tool representing content within the domain of seating and mobility for individuals with spinal cord injuries. The process utilized to develop the SMSCT in spinal cord injury can be replicated for other diagnoses and domains.

Adult↗

PubMed2005

Virtual reality and computer-enhanced training applied to wheeled mobility: an overview of work in Pittsburgh.

Some aspects of assistive technology can be enhanced by the application of virtual reality. Although virtual simulation offers a range of new possibilities, learning to navigate in a virtual environment is not equivalent to learning to navigate in the real world. Therefore, virtual reality simulation is advocated as a useful preparation for assessment and training within the physical environment. We are engaged in several efforts to develop virtual environments and devices for mobility skills assessment and training, exercise training, and environment assessment. Virtual reality offers wheelchair users a training tool in different risk-free environments without any indoor (e.g., walls, furniture, and stairs) and outdoor (e.g., curb cuts, uneven terrain, and street traffic) physical constraints. Virtual reality technology will probably become more common in the field of assistive technology, especially given the rapid expansion of gaming technology and the continued exponential growth of computing power.

Computer Simulation↗

PubMed2005

Upper limb strength in individuals with spinal cord injury who use manual wheelchairs.

INTRODUCTION: Manual wheelchair users have been found to be at risk for secondary upper extremity injuries. PURPOSE: The primary goal of this study was to compare shoulder strength and muscle imbalance of individuals with paraplegia to case-wise matched unimpaired controls (UC). A secondary goal was to evaluate the impact of age and neurologic level of injury (NLI) on weight-normalized strength (WNS). METHODS: The SCI group (n = 28) and the UC group (n = 28) completed bilateral shoulder isokinetic strength testing in the sagittal, frontal, and horizontal plane at 60 degrees/second using the BioDex system. Strength ratios, an indicator of muscle imbalance, were also calculated. RESULTS: No significant difference was seen in shoulder strength or strength ratios between the SCI group and the UC group. However, NLI was significantly related to WNS on several planes in the SCI group. Therefore, we dichotomized the SCI group into equal groups based on an NLI. The Low-SCI group was significantly stronger than the High-SCI group in most planes (P < 0.05). The High-SCI group was significantly weaker than the UC in extension (P < 0.01) and a trend (P < 0.01) was seen in flexion, abduction, and external rotation. The Low-SCI group was significantly stronger in abduction than the UC. CONCLUSION: WNS at the shoulder correlated with NLI. It is likely that this is related to contributions of the trunk and abdominal muscles during testing, since proximal trunk strength aids in generating forces distally. This study and others of strength in individuals with paraplegia may overestimate shoulder strength.

Adult↗

PubMed2005

Biomechanics and strength of manual wheelchair users.

BACKGROUND/OBJECTIVE: Previous investigations have identified muscular imbalance in the shoulder as a source of pain and injury in manual wheelchair users. Our aim was to determine whether a correlation exists between strength and pushrim biomechanical variables including: tangential (motive) force (Ft), radial force (Fr), axial force (Fz), total (resultant) force (FR), fraction of effective force (FEF), and cadence. METHODS: Peak isokinetic shoulder strength (flexion [FLX], extension [EXT], abduction [ABD], adduction [ADD], internal rotation [IR], and external rotation [ER]) was tested in 22 manual wheelchair users with a BioDex system for 5 repetitions at 60 degrees/s. Subjects then propelled their own manual wheelchair at 2 speeds, 0.9 m/s (2 mph) and 1.8 m/s (4 mph), for 20 seconds, during which kinematic (OPTOTRAK) and kinetic (SMARTWHEEL) data were collected. Peak isokinetic forces in the cardinal planes were correlated with pushrim biomechanical variables. RESULTS: All peak torque strength variables correlated significantly (P < or = 0.05) with Ft, Fr, and FR, but were not significantly correlated with Fz, FEF, or cadence. Finally, there were no relationships found between muscle strength ratios (for example, FLX/EXT) and Ft, Fr, FR, Fz, or FEF. CONCLUSION: There was a correlation between strength and force imparted to the pushrim among wheelchair users; however, there was no correlation found in wheelchair propulsion or muscle imbalance. Clinicians should be aware of this, and approach strength training and training in wheelchair propulsion techniques separately.

Adult↗

PubMed2004

Comparison of risk factors for vascular disease in the carotid artery and aorta in women with systemic lupus erythematosus.

OBJECTIVE: To examine and compare risk factors for various stages of subclinical vascular disease in different vascular beds (carotid and aorta) in women with systemic lupus erythematosus (SLE) who have not yet developed clinical cardiovascular disease. METHODS: This cross-sectional study was conducted in 214 women without clinical cardiovascular disease who were enrolled in the Pittsburgh Lupus Registry. B-mode ultrasound was used to measure carotid plaque and intima-media wall thickness (IMT). Doppler probes were used to collect pulse-wave velocity waveforms from the right carotid and femoral arteries as a measure of aortic stiffness. All risk factor data were collected on the day of the ultrasound examinations. RESULTS: The mean +/- SD age of the women was 45.2 +/- 10.5 years and the median SLE disease duration was approximately 9 years. Sixty-eight (32%) of the women had at least 1 focal plaque. The mean +/- SD IMT was 0.71 +/- 0.1 mm, and the mean +/- SD pulse-wave velocity was 5.96 +/- 1.6 meters/second. Using logistic regression, we found that determinants of plaque included older age, higher systolic blood pressure, lower levels of high-density lipoprotein 3, and antidepressant use. Determinants of plaque severity were older age, higher systolic blood pressure, lower levels of albumin, and smoking. Independent determinants of the highest quartile of IMT were older age, higher pulse pressure, lower levels of albumin, elevated C-reactive protein levels, high cholesterol, and higher levels of glucose. Higher aortic stiffness was associated with older age, higher systolic blood pressure, higher C3 levels, lower white blood cell count, higher insulin levels, and renal disease. CONCLUSION: In women with SLE, the risk factors associated with carotid plaque and IMT are those typically associated with cardiovascular disease in the general population, whereas the risk factors associated with vascular stiffness include SLE-specific variables related to immune dysregulation and complement metabolism. The high prevalence of cardiovascular disease among lupus patients may result from both early adverse effects on vascular stiffening as well as later promotion of wall thickening and plaque through inflammatory-mediated processes. These observations provide clues for future mechanistic studies.

Adult↗

PubMed2004

Evaluation of selected electric-powered wheelchairs using the ANSI/RESNA standards.

OBJECTIVES: To compare the performance characteristics of different electric-powered wheelchairs (EPWs) and to evaluate the effectiveness of the American National Standards Institute/Rehabilitation Engineering and Assistive Technology Society of North America (ANSI/RESNA) wheelchair standards. DESIGN: Five types of EPWs were selected. Three wheelchairs of each type were tested according to the ANSI/RESNA wheelchair standards. SETTING: Rehabilitation engineering center. SPECIMENS: Fifteen wheelchairs. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Static tipping angle; dynamic tipping score; braking distance; energy consumption; static, impact, and fatigue strength; and climatic conditioning. RESULTS: There were significant differences (P<.05) among the 5 types of EPWs for static stability when facing both uphill and downhill in the most-stable and least-stable configurations. There were significant differences (P<.05) among the EPWs on most of the dynamic stability tests. There were also significant differences (P<.05) among EPWs for all the effectiveness of brakes conditions, as well as between 2 wheelchairs for the energy consumption testing. There were several failures among the wheelchairs during the static, impact, and fatigue strength testing and during the climatic testing. CONCLUSIONS: The results show that EPWs can vary greatly with respect to static and dynamic stability, braking distance, range, strength testing, and climatic conditioning. All these factors have a substantial effect on safety and performance.

Equipment Design↗

PubMed2004

Manual wheelchair pushrim dynamics in people with multiple sclerosis.

OBJECTIVES: To define differences in pushrim dynamics during manual wheelchair propulsion by users with multiple sclerosis (MS) relative to 2 control groups of subjects with spinal cord injury (SCI) and no disability (ND) and to investigate changes in propulsion biomechanics at different speeds and with fatigue. DESIGN: Case-control. SETTING: Biomechanics laboratory. PARTICIPANTS: A convenience sample of 42 people, 8 women and 6 men per group. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The propulsion pattern, mean maximum speed, percentage of time in push and recovery phases, push angle, push frequency, mean maximum resultant pushrim force, mean work and push cycle, and hand-to-pushrim coupling and decoupling effects. RESULTS: The MS groups tended to use an arcing propulsion pattern more than did the control groups (Pmax=.003). The MS group pushed at a lower mean maximum velocity (v) when allowed to choose the speed of propulsion (v(MS),.67+/-.20m/s; v(SCI), 1.10+/-0.23m/s; P=.001), when asked to push at 1m/s (v(MS),.91+/-.26m/s; v(SCI), 1.12+/-0.11m/s; v(ND), 1.05+/-0.13m/s; P=.010), and were unable to maintain a self-selected speed during a 5-minute trial (Deltav(MS),.15+/-.02m/s; Deltav(ND),.03+/-.06m/s; P<.001). The MS group spent a higher proportion of time in the push phase of propulsion (Pmax=.001). In general, the MS group had smaller push angles, but push frequencies similar to the controls. Statistically adjusted MS group pushrim forces and work per push measures varied depending on context, but in all trials the MS group displayed a braking effect when grasping and releasing the pushrim. The MS group had declines in most measures when pushing at a self-selected speed for 5 minutes. In all trials, the MS group was more likely to display asymmetry between right and left sides in biomechanic parameters. CONCLUSIONS: Manual wheelchair users with MS have difficulty grasping and releasing the pushrim and maintaining speed during a fatigue trial. This likely leads to a slow self-selected speed of propulsion that may not be functional. Clinicians should remember these results when prescribing manual wheelchairs for people with MS.

Acceleration↗

PubMed2004

Durability, value, and reliability of selected electric powered wheelchairs.

OBJECTIVE: To compare the durability, value, and reliability of selected electric powered wheelchairs (EPWs), purchased in 1998. DESIGN: Engineering standards tests of quality and performance. SETTING: A rehabilitation engineering center. SPECIMENS: Fifteen EPWs: 3 each of the Jazzy, Quickie, Lancer, Arrow, and Chairman models. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Wheelchairs were evaluated for durability (lifespan), value (durability, cost), and reliability (rate of repairs) using 2-drum and curb-drop machines in accordance with the standards of the American National Standards Institute and Rehabilitation Engineering and Assistive Technology Society of North America. RESULTS: The 5 brands differed significantly (P<or=.05) in durability, value, and reliability, except in terms of reliability of supplier repairs. The Arrow had the highest durability, value, and reliability in terms of the number of consumer failures, supplier failures, repairs, failures, consumer repairs and failures, and supplier repairs and failures. The Lancer had the poorest durability and reliability, and the Chairman had the lowest value. K0014 wheelchairs (Arrow, Permobil) were significantly more durable than K0011 wheelchairs (Jazzy, Quickie, Lancer). No significant differences in durability with respect to rear-wheel-drive (Arrow, Lancer, Quickie), mid-wheel-drive (Jazzy), or front-wheel-drive (Chairman) wheelchairs were found. CONCLUSIONS: The Arrow consistently outperformed the other wheelchairs in nearly every area studied, and K0014 wheelchairs were more durable than K0011 wheelchairs. These results can be used as an objective comparison guide for clinicians and consumers, as long as they are used in conjunction with other important selection criteria. Manufacturers can use these results as a guide for continued efforts to produce higher quality wheelchairs. Care should be taken when making comparisons, however, because the 5 brands had different features. Purchased in 1998, these models may be used for several more years. In addition, problem areas in these models may still be present in newer models.

Electricity↗

PubMed2004

Assessing the influence of wheelchair technology on perception of participation in spinal cord injury.

OBJECTIVE: To investigate factors related to the wheelchair, impairment, and environment that affect perception of participation of persons with spinal cord injury (SCI) in activities performed in 3 settings: in the home, in the community, and during transportation. DESIGN: Cross-sectional study. SETTING: Research centers and a specialized assistive technology (AT) clinic in Pittsburgh (Pitt). Research centers and community-based rehabilitation technology suppliers in Saint Louis (SL). PARTICIPANTS: Seventy wheelchair users with SCI. INTERVENTIONS: Subjects from Pitt and SL completed a written survey of AT usage in daily activities. MAIN OUTCOME MEASURES: Subjects were asked 5 questions within each setting (home, community, transportation) related to their perceived reason for functional limitations. RESULTS: The wheelchair was the most commonly cited factor limiting participation, followed by physical impairment and physical environment. Twenty-one percent of subjects with paraplegia reported pain as a limiting factor for their transportation use, significantly more (P=.047) than subjects with tetraplegia (3%). A trend (P=.099) was seen toward a higher percentage of subjects with tetraplegia (tetraplegia, 7%; paraplegia, 3%) reporting lack of equipment as a limiting factor for use of transportation. Differences were also seen across sites. CONCLUSIONS: The wheelchair was the most commonly cited limiting factor, followed by physical impairment and physical environment. The wheelchair is the most important mobility device used by persons with SCI and the one that users most associate with barriers.

Activities of Daily Living↗

PubMed2004

Impact of a pushrim-activated power-assisted wheelchair on the metabolic demands, stroke frequency, and range of motion among subjects with tetraplegia.

OBJECTIVES: To determine differences in metabolic demands, stroke frequency, and upper-extremity joint range of motion (ROM) during pushrim-activated power-assisted wheelchair (PAPAW) propulsion and traditional manual wheelchair propulsion among subjects with tetraplegia. DESIGN: Repeated measures. SETTING: A biomechanics laboratory within a Veterans Affairs medical center. PARTICIPANTS: Fifteen full-time manual wheelchair users who had sustained cervical-level spinal cord injuries. INTERVENTIONS: Participants propelled both their own manual wheelchairs and a PAPAW through 3 different resistances (slight, 10W; moderate, 12W; high, 14W) on a wheelchair dynamometer. Each propulsion trial was 3 minutes long. MAIN OUTCOME MEASURES: Primary variables that were compared between the 2 wheelchairs were participants mean steady-state oxygen consumption, ventilation, heart rate, mean stroke frequency, and maximum upper-extremity joint ROM. RESULTS: When using the PAPAW, participants showed a significant ( P <.05) decrease in mean oxygen consumption and ventilation throughout all trials. Mean heart rate was significantly lower when using the PAPAW for the high resistance trial. Stroke frequency was significantly lower when using the PAPAW for the slight and moderate resistances. Overall joint ROM was significantly lower when using the PAPAW. CONCLUSIONS: For subjects with tetraplegia, PAPAWs reduce the energy demands, stroke frequency, and overall joint ROM when compared with traditional manual wheelchair propulsion.

Adult↗

PubMed2004

Demographic and socioeconomic factors associated with disparity in wheelchair customizability among people with traumatic spinal cord injury.

OBJECTIVES: To determine if a standard of care for wheelchair provision exists within the participating centers and if there is disparity in wheelchair customizability among the study sample. DESIGN: Convenience sample survey. SETTING: Thirteen Model Spinal Cord Injury Systems that provide comprehensive rehabilitation for people with traumatic spinal cord injury (SCI) and that are part of the national database funded through the US Department of Education. PARTICIPANTS: A total of 412 people with SCI who use wheelchairs over 40 hours a week. INTERVENTION: Survey information was obtained from subjects via telephone and in-person interviews and from the national database. Collected information included age, race, education, level of injury, and wheelchair funding source. MAIN OUTCOME MEASURES: Number and type (manual or power) of wheelchairs. Wheelchair customizability as defined by design features (eg, adjustable axle position, programmable controls). RESULTS: Ninety-seven percent of manual wheelchair users and 54% of power wheelchair users had customizable wheelchairs. No power wheelchair user received a wheelchair without programmable controls. Minorities with low socioeconomic backgrounds (low income, Medicaid/Medicare recipients, less educated) were more likely to have standard manual and standard programmable power wheelchairs. Older subjects were also more likely to have standard programmable power wheelchairs. CONCLUSIONS: The standard of care for manual wheelchair users with SCI is a lightweight and customizable wheelchair. The standard of care for power wheelchairs users has programmable controls. Unfortunately, socioeconomically disadvantaged people were less likely to receive customizable wheelchairs.

Activities of Daily Living↗

PubMed2004

Outcomes of wheelchair systems intervention with residents of long-term care facilities.

This pilot study was designed to measure the effects of individually prescribed wheelchair systems on posture and reach, mobility, quality of life, and satisfaction with technology for residents of long-term care facilities. Thirty persons 60 years of age or older who resided permanently in a long-term care facility and who used seating and mobility systems for 6 hours or more each day were recruited for this project. Outcomes included timed independent mobility, forward and lateral reach, quality of life, and satisfaction with assistive technology. The study used semicrossover design with participants measured three times. Measurements were first made in the existing seating and mobility system and a second time immediately after participants were provided with individually prescribed seating and mobility systems. The final measurement was 3 months after the delivery of the individually prescribed system. Results indicated that individually fitted wheelchair systems for elderly residents of long-term care facilities are beneficial. Participants had less difficulty independently propelling their systems and increased forward reach, quality of life for social function and physical role, and satisfaction with the new wheelchair technology. Persons residing in extended care facilities benefit from receiving individually prescribed wheelchair systems. The individual systems enhance elderly persons' independent mobility, functional reach, feeling of well-being, and satisfaction with their assistive technology.

Activities of Daily Living↗