ERGO1

Physical Evaluation and Training for Wheelchair Users

Sérgio Augusto Albino Vieira

, Cleudmar Amaral de Araújo

and Silvio Soares dos Santos

Habilitation/Rehabilitation Center in Paralympic Sports, Federal University of Uberlândia,

Avenida João Naves de Ávila 2121 – Bloco 1M, Uberlândia-MG, Brazil

Specialized Training Centre in Adapted Physical Education and Parasports, Federal University of Uberlândia,

Rua Benjamin Constant 1286, Uberlândia-MG, Brazil

Keywords: Wheelchair Ergometer, Physical Evaluation, Paralympic Sport, Wingate Protocol.

Abstract: According to the literature, there's a lack of methods, procedures and equipments for proper physical

assessment. Physical tests applied to persons with disabilities are questionable due to their lack of

adaptation to the motor gesture executed in these equipments, which are not the same executed in real

wheelchair propulsion. Within this, was designed and built at the Habilitation/Rehabilitation Center in

Paralympic Sports/UFU the second version of a wheelchair ergometer prototype that allows physical

evaluation, being faithful to the specificity of movements. The equipment has several electronic systems

controlled by computer such as electromagnetic resistance system, load cell, torquemeter, dedicated circuits

and acquisition system. Preliminary results indicate that the evolution became more practical for the

evaluator and comfortable for the user. The addition of flywheels and new calibration method proved its

efficiency by improving the signal acquired. New evaluation procedures for physical capacity look

promising.

1 INTRODUCTION

Physical activity, especially when directed to sports,

is one of the ways to promote social integration at

the same time that leads to health improvement,

fighting sedentary lifestyle and avoiding future

complications related to inactive life styles.

Wheelchair users represent a part of the

population that, due to its mobility reduction, suffer

from problems like cardiac complications, obesity,

diabetes, shoulder and wrist injuries, among others.

Frequently some of these problems result from

activities developed in their daily life, such as seat

transfer that makes the shoulder go through

overcharges for which they are not prepared.

With regards to the generation of opportunities

for disabled persons, one can highlight a great need

for methods and processes for the evaluation of their

physical capacities, mainly in sports and especially

in high performance sport. However, Brazil has

shown great potential in this particular area. For

example, since the Olympics in Atlanta-1996 until

London-2012, Brazil left the 37º place with two gold

medals to the 7º place with 21 gold medals. In the

Parapan American Games of 2011 at Guadalajara,

Brazil reached first place with 81 gold medals.

According to this, Brazilian Paralympic Committee

(CPB) started in the last year partnerships with

academic teachers across the country to create the

Brazilian Paralympic Academy, searching to

establish the missing link between knowledge

production and its application. The first Specialized

Training Centre in Adapted Physical Education and

Parasports (CEFEP) was created in the School of

Physical Education at the Federal University of

Uberlândia.

Also based on this need, the Mechanical Projects

Laboratory from the Federal University of

Uberlândia created in 2007 a first prototype for a

wheelchair ergometer. During its test phase, several

structural and operational modifications were

identified. So, at the new Habilitation/Rehabilitation

Center in Paralympic Sports (NH/RESP), a new

version was designed and built. This paper will

focus on the differences between these prototypes

showing the advances made in this second version,

its preliminary results and some new features

planned for a third version.

Augusto Albino Vieira S., Amaral de Araújo C. and Soares dos Santos S..

ERGO1 - Physical Evaluation and Training for Wheelchair Users.

DOI: 10.5220/0005094800690076

In Proceedings of the 2nd International Congress on Sports Sciences Research and Technology Support (icSPORTS-2014), pages 69-76

ISBN: 978-989-758-057-4

 2014 SCITEPRESS (Science and Technology Publications, Lda.)

2 PHYSICAL CONDITIONING OF

WHEELCHAIR USERS

A low level of physical capacity is associated with

high risk of cardiovascular complications (Hjeltnes

and Jansen, 1990; Yekutiel, 1989) and may

contribute for reduction in life quality. This

reduction in physical capacity and, consequently, in

life quality, may lead to secondary conditions as

obesity, gastrointestinal problems, respiratory

complications, joint pain and others (Steele, 2004) –

coronary diseases are also highly related to physical

inactivity, high fat diet, smoking and stress

(Margonato, 2008). According to Margonato (2008),

people with spinal cord injury are also more exposed

to premature death due to cardiovascular accident.

Shimada et al. (1998) described wheelchair

propulsion as the repetitive simultaneous bilateral

movement of upper extremities. Through training,

it’s possible to enhance the efficiency of the

propulsion force although, simultaneously, the real

mechanical efficiency decreases. From a mechanical

viewpoint, application of a non-effective force might

be ineffective, but in a physiological viewpoint

might be the optimal solution for upper extremities

injuries (Lin et al., 2009). One of the fundamental

aspects for wheelchair propulsion analysis is the

definition of the motor gesture made. The propulsion

cycle is described in two phases: impulse and

recovery (fig. 1). Impulse phase is the period since

the hand contacts the rims applying force to

maintain or increase speed of the wheelchair.

Recovery phase is the period between two

consecutive impulse phases when the arms are

retracted to prepare for the next impulse (Kwarciak

et al. 2009). This propulsion cycle can also be

executed in two different ways: one called

synchronous, where both hands propel the rims at

the same time, and one called asynchronous where

the hands work alternate to propel the wheelchair

(Goose-Tolfrey et al., 2003).

Figure 1: Definition of wheelchair propulsion cycle.

Source: Kwarciak et al., (2009).

According to Boninger et al. (2002), wheelchair

users receive few or none instruction about how to

propel their wheelchairs or how to best adjust it to

avoid injuries. Bjerkefors et al. (2006) affirms that

it’s essential for this population to maintain an

adequate function for the shoulder’s muscles and

that it’s important to consider an activity capable to

stimulate muscular growth without symptoms of

pain and excessive use.

Regarding available exercising equipments, both

for rehabilitation and physical evaluation, literature

indicates that the first ergometers aroused around

1950, whereas its first technological evolution

regarding load control and information processing

came up only in 1954 with the first cycloergometer

produced in large scale developed by Astrand

(Sousa, 2007). This kind of ergometer was often

employed in studies that aimed to quantify forces

and obtain physiological responses (Harman et al.,

1987). After, arm ergometers arrived. This type can

be used in the initial stages of rehabilitation

programs and in subsequent phases to enhance

muscular resistance (Andrews et al., 1998). Its use is

also possible by persons with spinal cord injury,

hemiplegia and for cardiac rehabilitation (Dicarlo,

1983; Nilsson et al., 1975). Although these apparels

might be used by wheelchairs users along an

adequate exercise program, they don’t represent the

real motor gesture made by this population in its

wheelchairs.

Gordon et al. (2004) studied the different types

of resistance generation for ergometers. The most

common type, brakes made with belts, shows to be

flawed because of the dependence of dynamic

friction coefficient. It is recommended that

ergometry exams make use of computer controlled

interface and that its systems should be electronic or

electromagnetic, allowing standardization of

techniques, better control for load variation and

monitoring signals (Guimarães et al., 2003). Haisma

et al. (2006) mentions that it is important to have an

adequate monitoring of exercises and trainings to

verify changes in physical capacity, indicating if the

training or rehabilitation program in question is

effective.

3 ERG-CR09:

FIRST PROTOTYPE

The first prototype developed was built in two

modules, one for propulsion and one for

electromagnetic resistance (fig. 2). This

electromagnetic system has a generator for self-

powering and an electromagnetic brake. The whole

system was controlled by computer through an

application made with LabVIEW. For physical

evaluation, Wingate test was used.

icSPORTS2014-InternationalCongressonSportSciencesResearchandTechnologySupport

Figure 2: ERG-CR09.

During the tests, it was possible to follow user’s

power and energy. These data, after the test end,

were used to calculate fatigue index. Figures 3 and 4

shows a test result to exemplify the characteristics of

the response obtained by the software.

Figure 3: Absolute Power result where x axle is time (s)

and y axle is power (W). Source: Salgado (2009).

Figure 4: Absolute Energy result for the same test. X axle

represents time (s) and y axle represents energy (J).

Source: Salgado (2009).

As seen in these graphics, one cannot tell by

looking to the power curve when the user started to

lose its physical capacity nor in how much time that

happened. This information can only be seen at the

energy graph but this curve was only plotted after

the test.

Although this prototype was designed to be

comfortable and easily accessible to the user, several

modifications were identified during its tests.

Positioning of the user needed more adjustments,

dimensions were too big, signal was good but may

be improved, software interface may become more

friendly and many other aspects. In light of that, the

new prototype was designed in the search to fill the

gaps left by the previous one.

4 ERGO1

The second version of the wheelchair ergometer

prototype seeks to fill the gaps left by the first one.

Major modifications were made in some areas,

making it easier for the users and evaluators to work

with it.

4.1 Structure

The new structure was designed to reduce previous

dimensions. This was achieved changing the

configuration to combine both previous modules

into one. Material used was also changed to make

this version lighter, allowing its transport to become

easier.

According to the literature studied, in order to

improve comfort and also performance of the users,

it’s necessary for the ergometer to have structural

adjustments such as seat height, positioning related

to the wheels and many more (Boninger et al., 2000;

Sasaki et al., 2007; Sasaki et al., 2010).

To assess this structural project, a numerical

simulation using finite elements modelling tested it

with a maximum value chosen according to a load

cell linked to the structure. Maximum stress value of

this simulation was 19 MPa, which is much smaller

than the yield stress of the materials used (250

MPa).

4.2 Signal Improvement

One of the characteristics of the previous prototype

that led to the kind of signal seen on Figure 3 was

the result of braking torque during the test. The

pulsating brake and light rims caused the system to

completely stop each time the brake acted, even at

the its lowest level. This behaviour deviates the

ergometer from real operation of the wheelchair on

the ground.

Aiming to solve this, two inertial flywheels were

designed and added to the ergometer. Due to size of

these flywheels, the first pair of rims were excluded

making the most external part of these flywheels act

like rims.

The effect of this modification will be seen in the

sessions ahead about the calibration process and test

results.

4.3 Weight Acquisition

The load cell addition was made to the seat because

the test protocols need the user’s weight to calculate

the level of resistance to be applied.

ERGO1-PhysicalEvaluationandTrainingforWheelchairUsers

This feature has its own electronic circuit for signal

conditioning and it’s fully integrated to the software

that controls the ergometer, so all calculations are

made automatically.

After this modification, the beginning of test

protocol became easier for the evaluator – since he

only needs to press one button to obtain the

necessary information – and for the user – who

doesn’t need to go through a secondary equipment to

evaluate its weight.

4.4 Electromagnetic Resistance System

This part of the equipment remains almost the same

as the previous project, having gone through minor

modifications that are mainly structural to fit the

new composition.

This system is responsible for generating the

resistant torque and is controlled by computer

through a dedicated electronic circuit, allowing to

choose the brake level desired. The brake is based

on the Foucault principle (García, 2005).

4.5 Torquemeter

The electromagnetic brake generates resistance

levels triggered by respective voltage levels. Each

voltage level is responsible for promoting a resistant

torque range and receives an amplification through

transmission pulleys. To evaluate the power exerted

by the user in the equipment in accordance with the

effort being employed, a torquemeter was

developed. The equipment in question was mounted

in the ergometer.

Static calibration of this system was made by

locking the main transmission pulley and applying a

known load through standardized masses in a

support attached to the closest flywheel.

Due to limitations of the acquisition system, real

time acquisition of torque signal couldn’t be made

making it necessary to adjust a dynamic torque

curve in terms of angular speed. This way the torque

developed by the user along the test can be achieved,

allowing the calculation of power and energy spent

by the user during the test.

Experimental setup for this calibration was made

using a frequency inverter to control an induction

motor that is attached to the main axle of the

ergometer. The procedure consisted in acquiring a

torque curve for angular speeds from 10 to 70 RPM

with steps of 10 RPM.

More recently, this calibration was remade due to

changes in the project. Now the torquemeter is a

modular equipment that can be removed from the

system at any time (Fig. 4). Also, calibration

procedure now starts at 15 RPM and goes until 95

RPM since it was noticed that some users can

achieve higher speeds than previously predicted.

Figure 5: Torquemeter used in ERGO1 prototype.

4.6 Software Developed in LabVIEW

Platform

To the execution of physical evaluation tests that

include controlling the electromagnetic resistance

system, acquiring user’s weight and giving

responses such as power levels, fatigue index and

energy parameters, an application using LabVIEW

platform was designed to perform the interface with

the user and to execute all control and acquisition

necessary to the system. This language was chosen

due to its easiness not only to implement a friendly

interface, but also for acquisition and signal

manipulation.

This interface aims to be friendly and easy to

use, allowing the tests to be executed by any person

without previous knowledge of the application.

4.7 Test Protocols

Two protocols that stand out to assess the fitness and

training are the Wingate and incremental. The first

was developed in 1970s in Israel and lasts for 30

seconds in which the user being tested must

overcome a resistance level doing maximum

possible effort. Due to this characteristic, this

protocol aims to assess physical conditioning

through anaerobic performance of the person (Bar-

Or, 1987; Franchini, 2002).

In the other hand, incremental protocols seek to

evaluate physical conditioning through aerobic

performance. Normally, the user has to maintain a

certain pace while the resistance is incremented at

determined time intervals. Test ends when the user is

no longer able to keep pace. Because of that, each

training or evaluation program sets its levels and

increment intervals.

icSPORTS2014-InternationalCongressonSportSciencesResearchandTechnologySupport

To evaluate test results, parameters as absolute and

relative power, absolute and relative average

equivalent energy and fatigue index are used, in

addition to torque curves and angular speed.

For the purpose of this paper, only Wingate

protocol was used. Three males and three females

with average age of 30 years were assessed. None of

them is an athlete. They are all able-bodied and have

performed the protocol at the first resistance level.

5 RESULTS

5.1 Test Protocols

Data from volunteers evaluated are shown in Table

1. Figure 5 shows a user ready to begin the test.

Tables 2 and 3 shows the result in terms of power,

energy, fatigue and heart rate for each individual.

Figures 6-11 shows the graphics for absolute power.

Figure 6: User ready for the test.

Figure 7: Absolute power for volunteer 1.

Figure 8: Absolute power for volunteer 2.

Figure 9: Absolute power for volunteer 3.

Figure 10: Absolute power for volunteer 4.

Figure 11: Absolute power for volunteer 5.

Figure 12: Absolute power for volunteer 6.

In all power curves from Fig. 6-11 there's a

behaviour tendency in which the power first reaches

a maximum value and then diminishes until the end

of the test, reaching a minimum value. This

behaviour cannot be clearly seen for subjects 1, 2

and 4.

The latter had problems with seat fixation,

causing its performance and data acquisition to be

impaired, leading to the curve observed. Subjects 1

and 2 seems to not have done the maximum effort

required for Wingate protocol, which could explain

why their power output could still rise at the end of

the test.

Another characteristic observed in these results is

the general value of power output. According to

literature (Baker et al., 2011) they should be higher,

meaning that the system responsible for torque

acquisition must be reanalysed.

Despite these problems, comparing recent results

ERGO1-PhysicalEvaluationandTrainingforWheelchairUsers

Table 1: Volunteers data for Wingate protocol.

Volunteer Gender Age (years) Weight (kg)

1 F 24 45

2 F 25 63

3 F 32 63

4 M 45 88

5 M 27 80

6 M 28 85

Table 2: Results in terms of power and energy for the Wingate protocol.

Volunteer

Absolute Power

(W)

Relative Power

(W/kg)

Average Equivalent

Energy (J)

Relative Average

Equivalent Energy (J/kg)

Max Min Max Min Max Min Max Min

1 138,30 113,09 3,07 2,58 249,36 164,41 5,54 3,65

2 146,58 114,91 2,33 1,91 255,89 203,75 4,06 3,23

3 151,86 116,14 2,41 1,88 253,76 204,48 4,02 3,24

4 241,79 203,06 2,75 2,38 426,89 368,35 4,85 4,18

5 225,84 147,69 2,82 1,92 388,92 244,01 4,86 3,05

6 219,30 144,70 2,58 1,77 386,88 250,75 4,55 2,95

Table 3: Fatigue index for the Wingate protocol.

Volunteer

Fatigue

Level (%)

Max Heart

Rate (BPM)

Blood Pressure (mmHg)

Initial Final

1 34,06 171 115 x 76 112 x 68

2 21,60 178 113 x 75 114 x 67

3 23,52 149 113 x 69 125 x 71

4 16,01 131 130 x 92 129 x 79

5 37,25 153 104 x 22 135 x 74

6 35,19 182 170 x 87 134 x 85

with results from the first prototype (Fig. 3 and 4),

one can see that now signal has improved. The

addition of flywheels in each propulsion rim with

the new torquemeter and calibration process made it

possible to identify performance levels while the test

is happening. This was only possible in the first

prototype after test completion when energy was

calculated.

Regarding heart rate, all subjects presented

similar behaviour. Subjects 3, 4 and 5 showed lower

maximum value because they have the habit of

regularly exercising.

5.2 Physical Capacity Curve

During the analysis of test results, a new way to

evaluate physical conditioning was proposed. This

new analysis is based on the calculation of average

equivalent energy and fatigue index, resulting in the

calculation of how much physical capacity the

person showed during the exercise.

For this analysis to be performed, the point of

maximum energy developed by the user became its

point of 100% of physical capacity. From this point,

every drop of energy level was considered a loss of

physical capacity. In case the energy level returned

to a higher value than the previous point, it was

considered that the physical capacity remained the

same, i.e. equal to the last calculated value. At the

end of calculations, plots of the physical capacity for

the test were generated. Points used in these plots

Figure 13: Curve of physical capacity for volunteer 3.

PC=‐1,4783.t+108,6

R²=0,9387

100

120

0102030

PhysicalCapacity(%)

Time(s)

icSPORTS2014-InternationalCongressonSportSciencesResearchandTechnologySupport

Figure 14: Curve of physical capacity for volunteer 5.

Figure 15: Curve of physical capacity for volunteer 6.

are the ones that show the moments of drop in

performance. Figure 12-14 presents the graphs for

subjects 3, 5 and 6.

The adjustment curves translated in equations

shown in the figures calculate physical capacity drop

rate in time for each subject. Concerning training

and rehabilitation of physical conditioning, this

curve becomes interesting, making it possible to

visualize the fatigue evolution of each person

analysed.

5.3 Ergonomics

Subjects from the previous prototype, ERG-CR09,

answered some questions about ergonomics. Results

are seen in Fig. 15. Two major criticisms made by

those volunteers were about backrest position, which

was a single fixed position, and seat belt – more

accurately, lack of it.

Although in this version users were not asked

about ergonomics because no subject with injury has

participated, structural modifications applied came

from those reports of ERG-CR09's volunteers.

Doing so, one believes that ERGO1 severely

improved its condition with regards to user's comfort

and safety.

Figure 16: Evaluation of ERG-CR09 prototype. Source:

Novais (2010).

6 CONCLUSIONS

The new wheelchair ergometer prototype has

reduced dimensions and weight compared to the

previous one, and the propulsion and

electromagnetic resistance modules were mounted

on the same structure. This prototype allows the user

to position himself more comfortably with respect to

the motor gesture, by adding ergonomic adjustments

for the seat and backrest. Seat belt can now provide

support to the torso. Beginning the test also became

more practical since the user's weight is

automatically captured.

Inertial flywheels added fulfilled their role,

softening the acquired signal and preventing the

braking force of causing interruption of the

movement as it used to happen in the first prototype.

The tests performed showed a behaviour

tendency for the new method proposed for

determining the physical capacity, despite the low

number of tests performed. This trend should be

confirmed by performing tests with a larger number

of volunteers.

ACKNOWLEDGEMENTS

The authors want to thank the funding agencies

CAPES, CNPq and FAPEMIG, the postgraduate

program at the School of Mechanical Engineering of

the Federal University of Uberlândia and the

NH/RESP – Habilitation/Rehabilitation Center in

Paralympic Sports.

PC=‐1,716.t+113,65

R²=0,9165

100

120

0 102030

PhysicalCapacity(%)

Time(s)

PC=‐1,8847.t+114,04

R²=0,9363

100

120

0 102030

PhysicalCapacity(%)

Time(s)

ERGO1-PhysicalEvaluationandTrainingforWheelchairUsers

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58-62.

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