A Dynamic Wheelchair Armrest for Promoting Arm Exercise and Mobility After Stroke

Area of Science:

• Rehabilitation Engineering
• Biomechanics
• Neurorehabilitation

Background:

• Stroke survivors often require more arm exercise than provided during therapy sessions for effective recovery.
• Limited ability to reach, grip, and release wheelchair pushrims hinders independent exercise for many individuals with hemiparesis.

Purpose of the Study:

• To introduce and describe the design of Boost, a novel armrest for manual wheelchairs.
• To evaluate the biomechanical demands of operating Boost.
• To assess the feasibility and effectiveness of Boost for arm exercise in stroke patients.

Main Methods:

• Detailed design description of the Boost armrest.
• Biomechanical analysis to determine required joint torques for operation.
• Pilot testing with five stroke patients using Boost in stationary and overground ambulation modes.

Main Results:

• Biomechanical analysis indicated shoulder flexion and elbow extension torques ranging from -25% to +36% of pushrim propulsion torques.
• All five participants could use Boost in stationary mode.
• Three participants achieved overground ambulation speeds exceeding 2 m/s after minimal practice, including two who could not propel a standard wheelchair.

Conclusions:

• Boost offers a viable solution for increasing arm exercise frequency and intensity for stroke survivors with hemiparesis.
• The device allows independent, repetitive arm exercise directly within a manual wheelchair.
• Boost overcomes limitations associated with pushrim propulsion, making it accessible to a wider range of individuals post-stroke.