Background Research Appendix

Background​ ​Research​ ​Appendix​ f​ or​ G​ roup​ 3​The​ i​ nformation​ ​included​ i​ n​ ​this​ a​ ppendix​ ​is​ f​ rom​ ​background​ ​research​ ​conducted​ b​ y​ a​ ll​ f​ ourteams,​ ​and​ ​focuses​ m​ ainly​ ​on​ ​the​ c​ lients​ a​ nd​ ​the​ ​products​ ​associated​ w​ ith​ ​the​ ​slippage​ ​of​ p​ atientswith​ b​ rain​ ​damage​ f​ rom​ ​their​ w​ heelchairs.​ T​ his​ ​background​ r​ esearch​ ​bolstered​ ​our​ ​understandingof​ o​ ur​ c​ lient,​ h​ er​ r​ equests,​ ​and​ ​the​ m​ arket​ s​ urrounding​ ​the​ ​products​ t​ hat​ ​patients​ ​use.Specifically,​ ​we​ ​researched:​ ​(1)​ ​the​ ​client​ ​and​ h​ er​ c​ urrent​ ​wishes​ ​from​ ​our​ ​team;​ (​ 2)​ t​ he​ ​facilitythat​ ​our​ ​client​ ​works​ f​ or,​ t​ he​ S​ hirley​ R​ yan​ A​ bility​ ​Lab;​ (​ 3)​ ​the​ d​ efinition​ ​of​ ​a​ p​ roper​ w​ heelchairposition;​ ​(4)​ p​ atient​ u​ sage​ ​of​ ​wheelchairs​ ​at​ ​Shirley​ ​Ryan;​ ​(5)​ ​the​ ​price​ ​of​ c​ urrent​ s​ olutionsoffered​ b​ y​ ​various​ ​companies;​ a​ nd​ ​(6)​ i​ f​ ​these​ s​ olutions​ ​were​ ​competing​ ​in​ ​the​ s​ ame​ ​market.The​ c​ lient​ a​ nd​ h​ er​ ​project​ ​wishesMs.​ ​Preeti​ N​ ilofer​ ​Samraj​ i​ s​ ​a​ ​physical​ ​therapist​ ​based​ i​ n​ C​ hicago,​ I​ llinois.​ ​She​ c​ ares​ ​for​ ​patientswith​ ​health​ p​ roblems​ r​ esulting​ f​ rom​ ​injury​ ​or​ d​ isease,​ a​ nd​ ​assesses​ ​the​ ​following​ ​(but​ ​not​ l​ imitedto)​ ​qualities​ i​ n​ p​ atients:​ ​joint​ m​ otion,​ ​muscle​ s​ trength​ a​ nd​ ​endurance,​ f​ unction​ o​ f​ ​heart​ ​and​ l​ ungs,and​ p​ erformance​ o​ f​ ​activities​ ​required​ ​in​ d​ aily​ ​living.​ ​Ms.​ S​ amraj​ a​ lso​ a​ dministers​ t​ reatment​ f​ orpatients,​ ​including​ ​therapeutic​ ​exercises,​ ​cardio​ v​ ascular​ ​endurance​ t​ raining,​ a​ nd​ t​ raining​ ​inactivities​ ​of​ ​daily​ l​ iving​ ​[1].Ms.​ S​ amraj​ ​told​ ​the​ c​ lass​ ​during​ ​the​ c​ lient​ ​interview​ ​that​ s​ he​ w​ ants​ a​ ​ ​device​ t​ o​ a​ ssist​ ​patients​ ​inmaintaining​ g​ ood​ p​ osture​ ​and​ ​to​ ​help​ ​wheelchair-users​ f​ rom​ ​sliding​ ​off​ o​ f​ ​their​ s​ eats.​ S​ herequests​ ​that​ ​the​ d​ evice​ ​not​ ​share​ t​ he​ s​ ame​ l​ imitations​ o​ f​ ​existing​ s​ olutions:​ t​ he​ t​ ilted​ w​ heelchairprevents​ t​ he​ ​user​ ​from​ r​ emaining​ u​ pright,​ ​the​ ​wedge​ s​ olution​ i​ s​ d​ ifficult​ ​for​ ​users​ t​ o​ ​get​ o​ ut​ o​ f,and​ ​the​ ​strap​ r​ estraint​ ​solution​ ​is​ u​ ncomfortable.The​ S​ hirley​ ​Ryan​ A​ bility​ ​LabThe​ ​Shirley​ ​Ryan​ A​ bility​ L​ ab​ i​ s,​ “​ the​ f​ irst-ever​ ​translational​ r​ esearch​ ​hospital​ ​where​ ​clinicians,scientists,​ ​innovators​ ​and​ t​ echnologists​ w​ ork​ t​ ogether​ ​in​ ​the​ s​ ame​ ​space,​ a​ pplying​ r​ esearch​ ​realtime​ t​ o​ ​physical​ ​medicine​ a​ nd​ ​rehabilitation”​ [​ 2].​ T​ heir​ ​goal​ ​is​ ​to​ ​combine​ c​ are​ ​with​ s​ cience,​ ​sothey​ ​are​ ​working​ ​to​ r​ ehabilitate​ p​ atients​ ​by​ d​ eveloping​ n​ ew​ m​ ethods​ ​of​ c​ are.​ ​The​ ​intersection​ ​ofso​ ​many​ f​ ields​ ​that​ a​ re​ k​ ey​ t​ o​ r​ ehabilitation​ ​reveals​ h​ ow​ S​ hirley​ R​ yan​ ​wants​ ​our​ ​final​ d​ eliverableto​ f​ unction​ -​ ​ a​ s​ a​ ​ c​ omponent​ t​ hat​ i​ nteracts​ w​ ith​ t​ he​ ​existing​ ​solutions​ a​ t​ ​their​ ​lab.Proper​ ​wheelchair​ ​positioning

In​ o​ rder​ t​ o​ f​ ulfill​ ​Ms.​ S​ amraj’s​ g​ oal​ ​to​ ​maintain​ g​ ood​ ​posture​ i​ n​ p​ atients​ ​without​ s​ lippage,​ ​it​ i​ svital​ ​to​ ​define​ w​ hat​ ​a​ ​good​ p​ osture​ ​is.​ ​To​ a​ chieve​ ​a​ ​proper​ s​ eated​ p​ osture,​ ​Cleveland​ ​Clinicinstructs​ ​a​ ​chair​ u​ ser​ ​to,​ ​“Sit​ ​up​ ​with​ ​your​ b​ ack​ s​ traight​ a​ nd​ ​your​ s​ houlders​ b​ ack.​ Y​ our​ b​ uttocksshould​ ​touch​ ​the​ b​ ack​ o​ f​ y​ our​ ​chair”​ ​[3],​ a​ s​ ​illustrated​ i​ n​ ​Figure​ ​1. Figure​ ​1:​ C​ orrect​ ​Sitting​ P​ ositioning​ ​[3]The​ ​solution​ ​to​ M​ s.​ ​Samraj’s​ p​ roject​ m​ ust​ ​not​ j​ ust​ p​ revent​ s​ lippage,​ b​ ut​ m​ ust​ a​ lso​ k​ eep​ ​awheelchair​ ​user’s​ t​ orso​ f​ ixed,​ p​ romoting​ a​ ​ ​good​ p​ osture.Patient​ ​wheelchair​ ​use​ a​ t​ t​ he​ ​Shirley​ R​ yan​ A​ bility​ ​LabThough​ ​each​ p​ atient​ ​at​ ​Shirley​ ​Ryan​ ​is​ u​ nique,​ m​ ost​ ​patients​ ​stay​ ​at​ ​the​ ​lab​ f​ or​ s​ hort​ p​ eriods​ o​ ftime,​ a​ nd​ ​do​ n​ ot​ r​ equire​ a​ ​ c​ ustom​ ​wheelchair.​ F​ or​ t​ his​ r​ eason,​ ​most​ ​patients​ a​ t​ ​Shirley​ ​Ryan​ ​usea​ ​standard​ w​ heelchair;​ ​as​ d​ efined​ b​ y​ t​ he​ A​ mericans​ ​with​ D​ isabilities​ A​ ct,​ ​a​ ​standard​ ​wheelchairis​ 4​ 2​ ​inches​ ​long,​ ​26​ ​inches​ ​wide,​ a​ nd​ 3​ 0​ ​inches​ ​to​ t​ he​ ​armrest​ f​ rom​ t​ he​ ​ground​ ​[4],​ ​as​ ​shown​ ​inFigure​ 2​ .

Figure​ ​2:​ ​Dimensions​ o​ f​ A​ dult-Sized​ ​Wheelchairs​ ​[4]Current​ ​solutions​ ​offered​ b​ y​ ​companiesThe​ ​tilt-in-space​ w​ heelchair,​ ​wedge,​ ​strap​ r​ estraint,​ ​chest​ v​ est​ a​ nd​ ​positioning​ ​cushion​ ​are​ a​ llcommon​ ​solutions​ t​ o​ p​ revent​ s​ lippage.​ E​ ach​ ​offers​ ​its​ ​own​ ​advantages​ a​ nd​ d​ isadvantagestowards​ s​ olving​ t​ his​ ​problem:Tilt-in-space​ ​wheelchairA​ t​ ilt-in-space​ w​ heelchair​ i​ s​ a​ ​ s​ pecial​ k​ ind​ o​ f​ w​ heelchair​ ​with​ a​ n​ i​ nclined​ ​seat​ ​and​ ​a​ d​ eclinedbackrest,​ e​ ffectively​ ​rotating​ t​ he​ ​chair​ ​relative​ t​ o​ ​the​ ​ground,​ a​ s​ ​seen​ ​in​ F​ igure​ 3​ .

Figure​ ​3:​ I​ RIS​ ​Manual​ ​Tilt​ ​Wheelchair​ [​ 5]This​ p​ revents​ s​ lippage,​ a​ s​ g​ ravity​ n​ ow​ p​ ositions​ ​the​ p​ atient​ b​ ack,​ ​rather​ ​than​ ​sliding​ ​themforward.​ A​ ​ ​popular​ ​brand,​ ​QUICKIE,​ ​offers​ t​ heir​ ​model​ o​ f​ w​ heelchair,​ t​ he​ Q​ UICKIE®​ ​ ​IRISManual​ ​Tilt​ ​Wheelchair,​ ​for​ ​$2745​ [​ 5​ ].WedgeA​ w​ edge​ i​ s​ ​an​ a​ uxiliary​ ​device​ f​ or​ ​manual,​ ​upright​ w​ heelchairs​ t​ hat​ ​creates​ a​ n​ ​acuteseat-backrest​ ​angle,​ ​allowing​ g​ ravity​ ​to​ ​position​ t​ he​ u​ ser​ ​back,​ ​rather​ t​ han​ ​sliding​ t​ he​ u​ serforward,​ p​ ictured​ i​ n​ ​Figure​ ​4. Figure​ ​4:​ C​ ool​ C​ omfort​ ​Gel​ ​Foam​ ​Seat​ ​Cushion​ ​[6]The​ ​wedge​ ​also​ p​ rovides​ p​ ressure​ ​point​ r​ elief​ ​for​ ​patients​ ​by​ m​ ore​ ​evenly​ ​distributing​ t​ he​ n​ ormalforce​ e​ xerted​ o​ n​ t​ he​ ​patient​ ​by​ t​ heir​ s​ eat.​ A​ ​ p​ opular​ m​ odel​ ​of​ ​wedge​ i​ s​ ​the​ C​ ool​ ​Comfort​ G​ elFoam​ S​ eat​ ​Cushion,​ w​ hich​ ​is​ p​ riced​ a​ t​ $​ 34.99​ [​ 6].Strap​ ​restraint

A​ s​ trap​ ​restraint​ i​ s​ ​an​ ​auxiliary​ d​ evice​ f​ or​ ​manual,​ u​ pright​ ​wheelchairs​ t​ hat​ ​restricts​ a​ ​ ​user’sconscious​ a​ nd​ ​subconscious​ m​ ovement,​ r​ educing​ t​ he​ r​ ate​ ​at​ ​which​ ​slippage​ o​ ccurs​ w​ hile​ l​ imitingthe​ u​ ser’s​ r​ ange​ ​of​ ​motion,​ a​ s​ i​ llustrated​ b​ y​ F​ igure​ ​5. Figure​ ​5:​ Q​ ’Straint​ ​Q5-6327​ [​ 7]Strap​ r​ estraints​ ​can​ b​ e​ ​used​ ​for​ m​ ore​ ​than​ ​one​ b​ ody​ r​ egion,​ ​however,​ m​ eaning​ ​strap​ r​ estraints​ ​arealso​ ​the​ m​ ost​ ​customizable​ ​option.​ A​ ​ p​ opular​ ​model​ ​of​ ​strap​ r​ estraint​ i​ s​ t​ he​ ​Q’Straint​ ​Q5-6327,which​ ​is​ p​ riced​ a​ t​ $​ 39.13​ [​ 7​ ].Chest​ ​vestChest​ v​ ests​ a​ re​ ​a​ ​form​ ​of​ ​strap​ r​ estraint​ t​ hat​ t​ akes​ t​ he​ ​form​ o​ f​ a​ ​ v​ est,​ r​ estraining​ t​ he​ ​torso​ ​fromthe​ h​ ips​ ​to​ t​ he​ s​ houlders,​ a​ s​ ​pictured​ i​ n​ ​Figure​ 6​ . Figure​ 6​ :​ B​ odypoint​ ​Stayflex​ ​Narrow​ ​Front-Pull​ ​Chest​ S​ upport​ [​ 8]Chest​ v​ ests​ ​are​ e​ ffective​ a​ t​ ​preventing​ s​ lippage​ ​in​ u​ sers​ ​and​ ​in​ ​maintaining​ a​ n​ ​ideal,​ ​uprightposture.​ ​However,​ ​chest​ ​vests​ ​also​ s​ everely​ l​ imit​ ​the​ ​mobility​ ​of​ t​ he​ ​user,​ ​and​ a​ re​ ​a​ v​ ery​ ​visiblerestraint.​ A​ ​ p​ opular​ ​model​ o​ f​ ​the​ ​chest​ v​ est​ ​is​ t​ he​ ​Bodypoint​ S​ tayflex​ ​Narrow​ ​Front-Pull​ ​ChestSupport,​ ​which​ i​ s​ ​priced​ ​at​ ​$119.00​ ​[8].

Positioning​ ​cushionPositioning​ c​ ushions​ a​ re​ ​very​ s​ imilar​ i​ n​ d​ esign​ t​ o​ w​ edges,​ ​however,​ ​these​ ​cushions​ ​use​ g​ rooves,rather​ t​ han​ a​ ​ s​ lope,​ t​ o​ ​prevent​ ​slippage,​ a​ s​ ​can​ b​ e​ ​seen​ i​ n​ F​ igure​ 7​ . Figure​ 7​ :​ C​ urve​ W​ heelchair​ ​Cushion​ [​ 9]Like​ w​ edges,​ ​positioning​ c​ ushions​ c​ an​ b​ e​ a​ ttached​ ​to​ ​a​ w​ heelchair​ a​ nd​ ​also​ ​removed.​ D​ ependingon​ ​the​ ​quality,​ t​ he​ ​price​ ​of​ ​a​ p​ ositioning​ c​ ushion​ c​ an​ ​range​ b​ etween​ $​ 20​ ​to​ ​$400.​ A​ ​ p​ opularmodel​ ​of​ p​ ositioning​ ​cushion​ i​ s​ ​the​ C​ urve​ W​ heelchair​ ​Cushion,​ ​which​ ​is​ ​priced​ a​ t​ $​ 61.56​ [​ 9].Market​ r​ elationship​ o​ f​ s​ olutionsWhile​ ​all​ ​three​ ​solutions​ ​aim​ ​to​ ​prevent​ s​ lippage,​ ​they​ ​are​ n​ ot​ ​all​ c​ ompeting​ ​in​ ​the​ ​same​ m​ arket;the​ t​ ilt-in-space​ w​ heelchair’s​ a​ stronomically​ ​higher​ ​price​ p​ laces​ i​ t​ ​into​ ​a​ m​ arket​ f​ or​ c​ ustomwheelchairs,​ w​ hile​ ​wedges​ a​ nd​ s​ trap​ r​ estraints​ c​ ompete​ i​ n​ ​a​ ​market​ ​to​ ​customize​ ​manual,​ u​ prightwheelchairs.​ ​However,​ ​only​ t​ he​ w​ edge​ e​ xists​ i​ n​ ​the​ m​ arket​ ​to​ p​ revent​ ​pressure​ ​points,​ f​ urthersplintering​ i​ t​ f​ rom​ t​ he​ s​ trap​ ​restraint​ s​ olution.ConclusionThe​ b​ ackground​ r​ esearch​ ​conducted​ b​ y​ t​ he​ ​class​ ​centered​ ​around​ ​the​ ​client​ a​ nd​ ​the​ p​ roducts​ t​ hatcan​ p​ revent​ s​ lippage,​ w​ hich​ ​impacted​ o​ ur​ t​ eam’s​ d​ ecision​ ​making​ ​by​ ​inspiring​ ​us​ ​to​ ​create​ a​unique​ p​ roduct​ t​ hat​ s​ hared​ ​no​ ​drawbacks​ ​with​ e​ xisting​ ​designs.​ T​ hese​ ​drawbacks​ ​were​ d​ efinedby​ ​Ms.​ ​Samraj​ ​in​ h​ er​ ​client​ ​interview​ w​ ith​ ​the​ c​ lass,​ ​so​ t​ he​ c​ lient​ r​ esearch​ c​ onducted​ ​also​ ​had​ ​agreat​ ​impact​ ​on​ t​ he​ b​ eginning​ ​of​ t​ he​ d​ esign​ p​ rocess.​ M​ y​ t​ eam​ ​internalized​ ​the​ r​ esearch​ i​ n​ t​ hisappendix​ ​and​ m​ oved​ f​ orward​ t​ o​ c​ reate​ ​a​ m​ ockup​ ​centered​ ​around​ ​restraining​ a​ ​ ​wheelchair​ ​user’scalves,​ a​ n​ ​approach​ ​which​ ​avoids​ t​ he​ q​ ualms​ M​ s.​ S​ amraj​ ​had​ ​with​ ​other​ ​products.References

1. “Ms.​ P​ reeti​ ​Nilofer​ S​ amraj,​ ​Physical​ ​Therapist​ ​in​ ​Chicago,​ ​IL,”​ ​Orthopedic.​ ​ ​[Online]. Available:​ ​http://orthopedic.io/physical-therapist/ms-preeti-nilofer-samraj-dpt-chicago. [Accessed:​ 0​ 9-Oct-2017].2. “AbilityLab​ H​ ome,”​ ​AbilityLab.​ ​ [​ Online].​ ​Available:​ h​ ttps://www.sralab.org/.​ [​ Accessed: 09-Oct-2017].3. “Posture​ ​for​ a​ ​ ​Healthy​ B​ ack,”​ C​ leveland​ ​Clinic.​ ​ ​[Online].​ A​ vailable: https://my.clevelandclinic.org/health/articles/posture-for-a-healthy-back.​ ​[Accessed: 24-Oct-2017].4. Figure​ A​ 3.​ D​ imensions​ ​of​ A​ dult-Sized​ ​Wheelchairs.​ ​ [​ Online].​ A​ vailable: https://www.ada.gov/descript/reg3a/figA3ds.htm.​ [​ Accessed:​ 2​ 4-Oct-2017].5. “QUICKIE®​ I​ RIS​ ​Manual​ ​Tilt​ W​ heelchair,”​ ​Sunrise​ ​Medical​.​ [​ Online].​ A​ vailable: http://www.sunrisemedical.com/manual-wheelchairs/quickie/tilt-in-space-wheelchairs/iri s.​ [​ Accessed:​ 0​ 9-Oct-2017].6. “Cool​ ​Comfort​ ​Gel​ ​Foam​ ​Seat​ C​ ushion,”​ C​ ool​ C​ omfort​ ​Gel​ ​Foam​ S​ eat​ ​Cushions​ ​- PadAlarm.com.​ ​ ​[Online].​ A​ vailable: http://www.securesafetysolutions.com/CGSC-2_gelcushion.htm.​ [​ Accessed: 09-Oct-2017].7. “Q5-6327​ ​Postural​ L​ ap​ B​ elt,”​ ​Wheelchair​ S​ afety​ ​Store​.​ [​ Online].​ ​Available: http://wheelchairsafetystore.com/q5-6327-postural-lap-belt/.​ ​[Accessed:​ ​09-Oct-2017].8. “Bodypoint​ ​Stayflex​ ​narrow​ f​ ront-pull​ c​ hest​ ​support,”​ ​www.​ ​medicaleshop.com​.​ [​ Online]. Available: http://www.medicaleshop.com/bodypoint-stayflex-narrow-front-pull-chest-support.html. [Accessed:​ 2​ 3-Oct-2017].9. “Curve​ W​ heelchair​ C​ ushion,”​ R​ ehabmart.com.​ ​ ​[Online].​ ​Available: https://www.rehabmart.com/product/curve-wheelchair-cushion-27207.html.​ [​ Accessed: 23-Oct-2017].