Archive for the News category
Herb Cleansing Your Way to a Healthy Life
The propagation of different colon cleansing can be dangerous. This is due to people who might take advantage of the current situation. Bogus colon cleansing products can be dangerous to ones health. These products are often not backed by scientific research. The ingredients used in these products might be harmful to ones health. Products that promise fast and effective colon cleansing may not be as safe as you thought they would. To achieve their promise these products might contain dangerous ingredients. That is why it is best that you rely on herb cleansing.
Instead of artificial ingredients herb cleansing uses herbs. A number colon cleansing recipes uses herb cleansing. Some of these recipes may be tasty while others may be a bit appalling but it is very effective. When using herb cleansing the effect is gradual. The body is able to adjust with gradual colon cleansing. Be sure to cleanse your body at all times.
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Cover Letter Information Makes Writing a Cover Letter Easy!
You can find on the Internet all the cover letter resources you need to write your own great cover letter. Do a simple search using your favorite search engine. Then read cover letter samples that focus on your career choice. For example, if you want to apply for a job as a secretary, fitness coach, administrative assistant or sales rep, you can find plenty of cover letter information on any one of these careers to help you draft your own letter. So why wait? The job you’re looking for is out there. And you can ask for it in a well-written cover letter that is patterned after some of the fine examples on the web where you’ll find all the information for cover letters you need.
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Epson wide format inkjet printer supplies available
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Acai Extract: Superb Body Secret
The world may be experiencingan economic downturn but that doesnt mean that we should turn put aside our health. We have to keep in mind that in order for us to survive this crisis we must stay healthy as much as possible. We are well aware that health care can get really, really expensive especially during an economic crisis, this is the reason why getting sick should be avoided as much as possible.
The best way to avoid getting sick and staying healthy is by taking supplements that contain acai extract. Most acai products contain acai extract, so it is not a wonder why an increasing number of people are using it.
The reason that acai products is successful is because it contains high grade acai extract. This extract comes from acai berries which are often called a superfood because of the many health benefits we can get from it. The acai extract are concentrated so you are assured that you are getting the same level of antioxidants, vitamins and minerals and that you will still benefit from it. The acai extract are then turned into tablets or juices to be sold in the market. Such change is responsible for more and more people are gaining access to the acai products.
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Use This Amazing Tool to Become a Receptionist
Would you like to work full or part time as a receptionist in a medical, retail, or corporate office? You canby starting with a receptionist cover letter. Open with a friendly greeting. Then tell the hiring manager your qualifications: computer and telephone skills, ability to communicate with the public, the hours you’re available, and any related training or education that relates to this kind of work. All receptionist cover letter example should be written in an upbeat and confident tone. To find a sample of a receptionist cover letter, check the Internet and go from there.
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A Cover Letter Template That Really Works
Create a cover letter example and then rework it to fit each company you are targeting for a job interview. For example, all cover letter templates need five elements: heading (your name and contact information), date, inside address (hiring manager’s name and contact information), greeting or salutation (Dear Ms. or Mr. Hiring Manager), body of the letter (a friendly opening, a reference to your previous experience, an example of your particular duties), and a request for an interview. End with a complimentary closing (sincerely) and your signature. Create a cover letter sample like this and you’ll be on your way to the interviews you want.
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ZigBee-based wireless intra-oral control system for quadriplegic patients
A human-to-computer system that includes a wireless intra-oral module, a wireless coordinator and distributed wireless controllers, is presented. The state-of-the-art ZigBee protocol is employed to achieve reliable, low-power and power wheelchairs, handicap scooterscost-efficient wireless communication between the tongue, computer and controllers. By manipulating five buttons on the wireless intra-oral module using the tongue, the subject can control cursors, computer menus, wheelchair, lights, TV, phone and robotic devices. The system is designed to improve the life quality of patients with stroke and patients with spinal cord injury
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Why do cardio machines stink?
If you are needing a diet to improve your energy, and to clear up annoying little health issues, often following a detox diet, like the lemonade diet can help cleanse your system, and get you on the right track if you’re looking for a good lose weight fast exerciseIt is not one of those diets to lose weight fast for everyday purposes, but is highly effective for someone needing to reset their body to an optimum condition. I know when I have finished a good cleansing diet, my other diet efforts always have better results.
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Acaiberry Food for the Brain
Most of the clippings we get to read talk about the health benefits we can get from taking acaiberry products. In fact the benefits are abundant, paving way for the acaiberry to be named as the miracle fruit or superfood or health food. In the articles, the benefits are often grouped generally and how it affects the body is often written in general statements. Very rarely do we see articles that discuss the effects of acaiberry on a specific body part. Indeed we are well aware that if we take acaiberry products every day we are on our way to achieving optimum health, this is due to the antioxidants, the vitamins and the essential minerals that this miracle fruit contains.
However, the acaiberry is also know to have significant effects on the brain.
Yes, studies have shown that acaiberry can indeed help keep the brain healthy. Aside from the antioxidants keeping the brain healthy, acaiberry consumption can also help improve memory. In addition to that it can also help improve gait, balance and even coordination, so for those individuals who have trouble with coordination, the acaiberry might be your solution.
The mind is a precious thing that is why it is of utmost importance that you take good care of it by taking acaiberry supplements.
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Community use of a pushrim activated power-assisted wheelchair by an individual with facioscapulohumeral muscular dystrophy.
The purpose of this case study was to report data from a clinical evaluation of an individual with fascioscapulohumeral muscular dystrophy (FSHMD) while using a manual medicare power wheelchairs versus the same wheelchair fitted with pushrim activated power-assisted wheelchair hubs (PAPAW). An individual with FSHMD was tested for change in heart rate (HR), rate of perceived exertion (RPE), propulsion speed (PS), time to completion (TC), and qualitative observation in a community-based environment. A modified Physiological Cost Index (mPCI) was calculated post hoc. Results indicate HR and mPCI for the PAPAW trials were lower; RPE was “Hard” for manual wheelchair propulsion and “Fairly or Very Light” for the PAPAW trials; PS was twice as fast in both conditions using the PAPAW; and TC was 53% faster with PAPAW than in the manual wheelchair. Qualitatively, the manual propulsion conditions had exaggerated trunk and hip flexion with simultaneous scapula elevation and upward rotation to initiate downward force on the hand rim more so than the PAPAW conditions. The data suggest that propulsion of a power wheelchairs enhanced by PAPAW is more energy efficient, biomechanically advantageous, and more timesaving than a manual wheelchair for the tested individual with FSHMD in his environment.
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Purposes of Acai Berry Pulp
The acai berry is a very well known fruit in the Amazon Region. People in this area have benefitted from this fruit for centuries and have continued to do so. The Amazonian people are made known by their strength and energy. When asked about their secret to staying healthy they would often credit it to the acai berry. That is the reason why acai berry is also known as the Amazonian superfood. Vitamins and minerals are found in the acai berry plant. The acai berry plant has a part known as the acai berry pulp.
The acai berry pulp is the fleshy part of the acai berry. This is the part that surrounds the acai berry seed. The acai berry pulp is very juicy and is the most common source of the acai berry juice. To get the juice acai berry pulp is squeezed dry. Several acai berry has to be used in order to get the juice since it is a relatively small fruit. Acai berry pulp can also be an ingredient in acai berry shakes and smoothies.
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Beware it might not be worth the trouble it might create
… as they often have a nasty membership program that will cost you forty plus dollars per month to teach people how to lose fat fastthat is listed in the fine print. If you see a product on the internet that fails to produce all the necessary details you might need to produce before your doctor, please dont go for it. You have to consider one major factor before to order a product over internet. If the manufacturer is located in another country and if their product is targeted to the fastest way to lose weightpeople living in their own country (they probably never say it or print in their labels) then there are possibilities the product is not that suitable for you. This is idiosyncracy.
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Handicap needs awareness
I would like to raise people’s awareness of handicap scooters needs around the Laboratory workplace. People on crutches, scooters and wheelchairs have some different needs than the ambulatory. I am the first to admit that when I was ambulatory I was unaware of the environment around me in these terms. However, now that I am in a wheelchair, I would like to share with my co-workers some needs and easy-to-do things for people around the Lab.
Doors are a big issue. People in power wheelchairs, scooters etc., need to place themselves to the side of the door to open it. Objects such as trash cans, tables and chairs placed next to the door result in a situation where a disabled person cannot open the door. Please make sure that a 3-foot-wide space is available between the side of the door that opens and any object placed along the wall.
Another issue is bathrooms. If there are multiple stalls available please do not choose the wheelchair accessible stall if you do not need it. It is frustrating and potentially unpleasant to have to wait for the bathroom stall because it is occupied when three other stalls are available.
Wheelchairs, scooters and crutches require more maneuvering room than just the typical human body. Objects piled in hallways can create impassible situations. Imagine not being able to go to a meeting or your office because the hallway was blocked and there was no way around.
Even though it seems like sitting in a wheelchair or scooter requires no effort, disabled people are often plagued by fatigue. And, little tasks such as opening doors can require a great deal of effort. Think about how we would feel to go about the day with a bungee cord around our legs and arms.
I want to thank people for spending an extra second to make life more normal for people who are disabled.
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Discover The Ultimate Way To Lose Weight Fast And Melt Away Fat For Good
Can you lose 20 pounds of weight in 3 weeks and it is healthy? Of course, but again, much of it is losing excess body fluid. If you are seeking to lose belly fat, then losing 2 to 3 pounds per week is probably the best goal. You can consistently lose 2 to 3 pounds of fat per week by reducing your calories, and adding a little exercise to help you burn more calories. If you can, use a combination of both aerobic exercise, and resistance exercise. The aerobic exercise will get your heart pumping, and burn calories right now. The resistance training will increase your overall muscle mass, which requires more energy, burning more calories, and helping you to lose weight.
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chlorine dioxide is a wonder substance
Hypochlorus acid is very important. So much so that the deficiency of this chemical is actually a disease and causes people to come down with other autoimmune problems later on. When you get sick or your body is fighting something off the demands for hypochlorous rise dramatically and so using MMS at that time would do just as well. Now if you happen to not need any of these amazing health affects them the compound just passes through benignly and does not affect you at all. The biggest advantage is that this chemical does all of this amazing work in only a few hours. It leaves only a small amount of carbon dioxide and water behind. No other medical interventions can claim to have such a powerful anti-pathogenic effect as the mms treatment, whilst maintaining such a benign presence. MMS is a revolution in medicine indeed!ss. Starting with a liquid diet and progressing to a life-long way of eating, patients will have the opportunity to add many regular foods to their diet as their body heals.
After the liquid post-surgical stage, food for derrickpizur.info patients will consist of protein shakes and pureed foods. Many patients are put on liquid protein diets before surgery, and these drinks will be used during recovery also. Protein helps bodies heal after surgery and because of the reduced absorption of nutrients from foods, it is essential to consume high protein levels as tolerated.
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Standardization of measuring power output during wheelchair propulsion on a treadmill Pitfalls in a multi-center study.
OBJECTIVE: In a multi-center study the power output of power wheelchairs propulsion, attained by a wheelchair drag test, differed among rehabilitation centers. The purpose of this study was to investigate what causes the differences in drag force among centers. METHODS: A set of standardized drag tests was performed while systematically varying the calibration set of the force transducer, the tester and the medicare power wheelchairs. In addition, the actual calibrated velocity and slope of the treadmill were measured. RESULTS: Difference in drag force among centers was due to variation in wheelchair set-up and differences in the slopes between treadmills. The drag force was not significantly different when different testers performed the test. The belt velocity in almost all centers was lower than the manufacturer specified (assumed) velocity. CONCLUSION: The drag test appeared a robust test as far as the tester is considered. Variation in wheelchairs and differences in the actual slopes of the treadmills affected the imposed drag force. The assumed velocity of the treadmill led to an overestimation of the power output. The power output in the multi-center study should be recalculated using the measured velocities and the wheelchair set-up should be more standardized.
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The Acai Plant and its Numerous Benefits
Products that contain acai berries are becoming more and more popular each day. More people are trying on these products hoping that they too can benefit from its amazing contents. Acai products go by different names and brands but one thing is for sure, the word acai is often included, this is a practice to let the consumers know that that particular product contains acai berries.
More and more people are now knowledgeable of the health benefits they can get by taking acai products that is why they are craving for more acai berry products. The success should not be credited to the acai berries alone but to the acai plant as well. You have to remember though that without the acai plant there will be no acai berries.
The acai plant is also known as the acai palm. The acai plant is normally found in South America more or less near the Amazon River. The natural home for the acai plant are swampy areas or grounds. In South America, people dont only eat the acai berries but the acai fruit as well along with palms and even the roots. Indeed it is safe to say that the acai plant is a health plant.
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The term natural for a rapid weight loss diet is used very loosely in the food industry
And thanks to great marketing people are very confused and do not understand what healthy really is or even know of a good rapid weight loss diet.Please research before you buy the products. Is the natural ingredient added going to be any use for you? I have to say, its just their marketing trick. I see many people buy these products, like the rapid fat loss handbook and happy that they are all natural. If you are suffering with any severe weight loss problem, dont be a victim. Be an action taker and start by changing your diet and exercise program. If you need more help, then you can consult a health care professional who can put you on a good program.
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Acupuncture for chronic shoulder pain in persons with spinal cord injury: a small-scale clinical trial
OBJECTIVE: To determine the efficacy of acupuncture in the treatment of chronic musculoskeletal shoulder pain in subjects with spinal cord injury (SCI). DESIGN: Randomized, double blind (participants, evaluator), placebo (invasive sham) controlled trial. SETTING: Clinical research center. PARTICIPANTS: Seventeen manual wheelchair-using subjects with chronic SCI and chronic musculoskeletal shoulder pain. INTERVENTIONS: Participants were randomly assigned to receive 10 treatments of either acupuncture or handicap scooters, invasive sham acupuncture (light needling of nonacupuncture points). MAIN OUTCOME MEASURE: Changes in shoulder pain intensity were measured using the power wheelchairs User’s Shoulder Pain Index. RESULTS: Shoulder pain decreased significantly over time in both the acupuncture and the sham acupuncture groups (P=.005), with decreases of 66% and 43%, respectively. There was no significant difference between the 2 groups (P=.364). There was, however, a medium effect size associated with the acupuncture treatment. CONCLUSIONS: There appears to be an analgesic effect or a powerful placebo effect associated with both acupuncture and sham acupuncture. There was a medium treatment effect associated with the acupuncture, which suggests that it may be superior to sham acupuncture. This observation, along with the limited power, indicates that a larger, more definitive randomized controlled trial using a similar design is warranted
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Acai Weight Loss is for You
The sight of overweight or obese people is no longer shocking to us. It shouldnt be a wonder why more and more people are overweight if you consider the type of lifestyle that we have.
A lot of people get fat because the excess calories we get from the food we eat get kept and if unused, it will eventually turn into fat, thus adding one or two more pounds to our current weight. If we continue eating more and doing less by the time we notice how big our waistline is it is probably too late. When we realize our shortcomings, we would then find ourselves looking for the exceptional weight loss program. However, for best results, weight loss programs are often merged with supplements like the acai products. When it comes to effective weight loss you can rely on acai products to help you achieve it, and this effect is otherwise known as the acai weight loss.
Acai weight loss is the result of combining exercise, healthy diet and taking acai berry products. This is because acai berries are known to increase the bodys metabolism which leads to increased burning of fat while still giving us more energy and stamina for when we are exercising. The acai weight loss is indeed a great result, especially if you were working hard just to get it.
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Healthy weight loss needs to become a way of life.
Many people cringe when they think about “dieting” for a life time. But irregardless, you’re always on a diet. Does your diet consist of tacos with sour cream and cheese sauce, or does your diet consist of a bowl filled with fresh strawberries, and a bowl of smooth creamy cold yogurt. Both can be part of your daily diet, just one leads to a healthy body, with quick weight loss, and more energy, while the other leads to clogged arteries, weight gain, and lack of energy. I know I prefer to feel energetic and alive, rather than feeling the afternoon energy slump as my body tries to process a belly full of fat and sugars.
While not everyone needs rapid weight loss, everyone has a need for healthy eating tips and a healthy diet program. By taking control of our food choices, we cannot only control our weight more effectively, but also decrease our incidence of high blood pressure, heart disease, kidney disease, diabetes, and a whole list of additional medical conditions we all want to avoid.
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Monitoring seat feature usage among wheelchair users.
To help manage pressure ulcers and adjust posture, power wheelchairs can be equipped with seat tilt and backrest recline features. Clinicians usually prescribe these features for wheelchair users who are vulnerable to pressure sores or have difficulty changing postures, but little data has been collected to determine whether or not, and what extent, these features are used. This study examined how handicap scooters users use power wheelchair seat features such as seat tilt, backrest recline, and seat elevation, during typical daily activities. A Seat Feature Data Logger (SFDL) was attached to 11 subject’s wheelchairs for 10-14 days to gather data regarding daily usage of these features. The results showed that while subjects did not always use large angles of tilt and recline as many clinicians recommend, these features were used frequently and their use resulted in lower peak pressures. The information collected by the SFDL allows for a novel and quantitative description of the effectiveness and use of power seat features, and can also be used as a clinical compliance tool
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Knowing the Acai Berry Benefits
Due to its known benefits a lot of people are seeking acai supplements. The acai berry was just a regular fruit until someone discovered its potential and the health benefits it can give. To fuel its popularity a tv personality introduced this fruit to the public through her talk show. As a main ingredient this fruit is found in many dietary supplements. These supplements are generally known as acai products or acai berry products. All supplements that contain acai berry and placed under this classification. The reason why people are buying these products is the acai berry benefits. Due to the extreme desire to stay in shape a lot of people are willing to try acai berry products.
Acai berry benefits are numerous. One of which is weight loss. Acai berries are known to effectively aid in weight loss. This benefit is present in every single acai berry product. It is due to that reason why people that have weight issues take this kind of supplement. Another benefit is that it boosts the immune system. The acai berry products help keep the immune system strong thus preventing infection and keeping the body healthy. Lastly, the antioxidants help protect against toxins.
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Acai Berries Now Labelled As the Best Antioxidant
The overwhelming levels of antioxidants in the acai berry has made it quite easy to label it as the best antioxidant know today. For years medical professionals have told to us to consume berries simply because these fruits contain antioxidants. These antioxidants prove to be powerful in protecting us against the free radicals that can be found in our food or simply the environment. However the antioxidant levels in acai berries are way higher than those in other berries, this is the primary reason why more and more people use acai supplements: antioxidant is its main content.
Truly acai berry is the best antioxidant especially if you take into account the number of antioxidant it contains. Acai berries contain Vitamins like A C and E and even folic acid. They also contain iron which has been known to work well with antioxidants in keeping us healthy.
It is important that we keep our bodies healthy from inside out and the best way to do that aside from changing our hazardous lifestyle, is adding exercise to our life as well as to take supplements like acai berry products, which contain high levels of antioxidants.
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Influence of hand cycling on physical capacity in the rehabilitation of persons with a spinal cord injury: a longitudinal cohort study
OBJECTIVE: To investigate the influence of handicap scooters on outcome measures of physical capacity during and after rehabilitation in persons with paraplegia and tetraplegia in The Netherlands. DESIGN: A longitudinal cohort study with measurement moments at the start (t1) and end (t2) of clinical rehabilitation and 1 year after discharge (t3). Hand cycle use was assessed by means of questionnaires at t2 and t3. SETTING: Eight rehabilitation centers in The Netherlands. PARTICIPANTS: Subjects (N=162) with a recent spinal cord injury. INTERVENTIONS: All subjects followed the regular rehabilitation program. MAIN OUTCOME MEASURES: Peak oxygen uptake (Vo(2)peak) and peak power output (POpeak) determined in a handrim medical scooters peak exercise test, peak muscle strength of the upper extremities, and pulmonary function. RESULTS: A significantly larger increment in Vo(2)peak, POpeak, and elbow extension strength was found in subjects with paraplegia during clinical rehabilitation. No such effect was found in subjects with tetraplegia. In the postrehabilitation period, no influence of hand cycling on any outcome measure was found in subjects with paraplegia or subjects with tetraplegia. CONCLUSIONS: After correction for baseline values and confounders, regular hand cycling (once a week or more) appeared to be beneficial for improving aerobic physical capacity in persons with paraplegia during clinical rehabilitation. The small and heterogeneous study groups may have hampered the finding of positive results of hand cycling in persons with tetraplegia.
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Be Happy and Healthy With ACai Nutrition
The acai berry so by far the most popular fruit at present. Since its introduction this fruit has remained popular. Since more and more people are taking it becomes more popular each day.Acai nutrition is one to option that people can choose in order to keep them healthy.People take acai berry supplements everyday in order to achieve the so called acai nutrition. These acai berry supplement contains acai berries, a lot of health benefits is said to be found in this fruit. These supplements can provide the same amount of benefits as the fruit. Acai nutritionhas truly come a long way.
People with weight problems can certainly benefit from acai nutrition.Weight loss is a part of acai nutrition this is due to the fact that the acai berry is efficient in helping someone lose weight. Therefore people who are overweight can benefit greatly from this acai nutrition. Acai berry supplements can be helpful and beneficial if taken at a regular basis and according to instructions. Despite the fact that the ingredients are natural it is still best that instructions should be followed even when taking acai berry.
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Advantages of Herbal Colon Cleanse
When you cleanse your colon, you are keeping yourself healthy. Doing it on regular basis is even more beneficial. There are other ways to cleanse your colon and a common way is the herbal colon cleanse. This type of colon cleansing has been practiced by a lot of people.
The herbal colon cleanse functions by converting or neutralizing the bodys toxic wastes in to healthier products. However, a lot of medical professionals would like to stress that a healthy colon is a clean colon. It is of utmost importance that we cleanse our colon because if we neglect to cleanse our colon the toxins in our body will accumulate and later cause problems for us.
There are several benefits you can get from using herbal colon cleanse. One benefit is that the results are immediate; second is that we can incorporate it in our daily routine and third, herbal colon cleanse utilizes materials that are coming from nature.
If you opt to pursue using herbal colon cleanse make sure to do it faithfully and regularly in order for you to get the maximum effects. On top of that, use only the best ingredients or materials for herbal colon cleanse.
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Real-time head movement system and embedded Linux implementation for the control of power wheelchairs
medicare power wheelchairs has become very important for our quality of life. A loss of mobility due to an injury is usually accompanied by a loss of self-confidence. For many individuals, independent mobility is an important aspect of self-esteem. Head movement is a natural form of pointing and can be used to directly replace the joystick whilst still allowing for similar control. Through the use of embedded LINUX and artificial intelligence, a hands-free head movement wheelchair controller has been designed and implemented successfully. This system provides for severely disabled users an effective power wheelchairs control method with improved posture, ease of use and attractiveness.
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You and More Acai Benefits
Staying in shape is important in order to go through the day. Eventually stress can take a toll on our health. When this happens we become vulnerable and we get sick easily. When we get sick we are forced to leave from work in order to recuperate. Absence from work often results to lesser pay. This is because most of these absences are unpaid. People are always looking for that dietary supplement that will give them enough energy throughout the day. This is also the reason why acai berry supplements are well known amongst health buffs. People who are aware of the acai benefits will certainly make it a point to take acai supplements every day.
Acai berry supplements are widely sold in the market and all you have to do is find the right one for you. Acai benefits were first discussed on a tv show. Some acai benefits include protection from free radicals, brain boosting benefits, boosting the immune system and a whole lot more. Using acai berry products everyday is the only way to enjoy acai benefits. Acai berry supplements can certainly make you healthier and let you do things more than the usual.
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Dieting to lose weight quickly in a healthy way - Part 2
Now let’s get down to what you really need to know, what are the diets that work for you, to help you www.fatlossfactor.com. To start with, you need to have a healthy diet program to cover the basic needs for health. Your diet should include a high amount of vegetables and fruits, some lean meats, fat free dairy items, and whole grain products. By having a good balanced diet you will get all the nutrition you need. Avoiding preprocessed foods which include high amounts of salt, sugars, preservatives, and other additives should top your list as www.fatlossfactor.com . All of those additive just add to your weight, and potential health problems.
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An experimental method for measuring the moment of inertia of an electric power wheelchair
This study describe an experiment measuring the moment of inertia of an electric medicare power wheelchairs (EPW) using a torsional pendulum method. Inertia of the wheelchair is an important factor for control, which is a key issue in wheelchair driving. The experimental test platform consisted of a bottom circular wood plate, an upper metal plate, and four ropes. Materials with known moments of inertia such as the metal disk and cylinder were used to test the accuracy of the system. The EPW used in the experiment was Invacare G3 Torque SP Storm Series. The measured result of the moment inertia of the wheelchair was 5.2280 kg.m(2) and handicap scooters the errors of the system are less than 10% even when the object is only 25lbs. The results are consistent when compared with other approximate methods. In addition, the experimental method could be used to measure the moment of inertia of manual wheelchairs and other irregular objects
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Powered mobility for middle-aged and older adults: systematic review of outcomes and appraisal of published evidence
OBJECTIVE: To identify the outcomes of power mobility devices for middle-aged and older adult users, and to critically appraise the research evidence. DESIGN: Systematic review of primary source studies involving adults aged 50 and over using medicare power wheelchairs, handicap scooters mobility devices (1996-2007). Articles were (i) mapped to the Taxonomy of Assistive Technology Device Outcomes, which describes categories of impact of assistive devices from the vantages of effectiveness, social significance, and subjective well-being; and (ii) appraised using the Grading of Recommendations, Assessment, Development, and Evaluation criteria. RESULTS: This review retained 19 studies and identified 52 different categories of impacts of power mobility devices spanning the three vantages of the taxonomy. The coverage of outcome dimensions was not as extensive for adults age 50 and over as it was for mixed-age groups. Most of the research designs were assigned very low evidence grades. Three studies were low to moderate in quality of evidence, among which one was a randomized trial. CONCLUSIONS: A vast array of potential impacts of powered mobility devices have been described in the last decade. The level of quality of this evidence is improving, but most of these studies were not designed to verify causal relationships, and this is largely responsible for the absence of unequivocal evidence for directly attributing benefits to devices themselves and for quantifying relationships between power mobility device intervention and outcome. To raise the level of evidence about power mobility device interventions in older adults, studies are needed that use prospective designs, better-defined user groups, and well-grounded conceptual frameworks for measuring interventions and outcomes
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Evaluation of selected sidewalk pavement surfaces for vibration experienced by users of manual and powered wheelchairs.
BACKGROUND: Obstacles such as bumps, curb descents, and uneven driving surfaces cause vibrations that affect the wheelchair, and in turn, the wheelchair user. Chronic exposure can cause low-back pain, disk degeneration, and other harmful effects. Little research has been conducted to assess the vibrations experienced by wheelchair users. OBJECTIVE: The purpose of this study was to conduct an evaluation of the vibration exposure during electric-powered wheelchair driving and mechanical energy requirements for manual wheelchair propulsion over selected sidewalk surfaces. The goal was to determine the criteria for a wheelchair-pedestrian access route that does not require excessive propulsive work or expose medicare power wheelchairs users to potentially harmful vibrations. METHODS: Ten unimpaired individuals participated in this study. Six sidewalk surfaces were tested. Measured variables included power of the acceleration per octave, mechanical work to propel over surfaces, peak acceleration, and frequency at which peak acceleration occurs. RESULTS: For both the manual and electric-medical scooters
wheelchair, at 1 m/s, significant differences were found in peak accelerations between the seat and footrest (P < 0.0001) and between the sidewalk surfaces (P = 0.004). The greatest risk for injury caused by shock and vibration exposure occurs at frequencies near the natural frequency of seated humans (4-15 Hz). The values for work required to propel over the surfaces tested were not statistically significantly different. Besides appearance and construction, the only distinguishing characteristic was surface roughness caused by the joints. CONCLUSION: When treating the poured concrete sidewalk as the standard, surfaces 2, 3, 5, and 6 compared most favorably in terms of vibration exposure, whereas surface 4 produced mixed results. Surfaces 2, 3, 5, and 6 yielded results that were similar to the poured concrete sidewalk and could be considered acceptable for wheelchair users. In conclusion, surfaces other than the traditional poured concrete can be used for pedestrian access routes without adding vibration exposure or reducing propulsion efficiency.
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Upper-limb fatigue-related joint power shifts in experienced wheelchair users and nonwheelchair users
This paper evaluates power transfer or shifting across upper-limb segments, resulting from fatigue-inducing wheelchair propulsion. Nineteen manual wheelchair users (WCUs) and ten non power wheelchairs users (NUs) participated in this study. Subjects propelled an instrumented wheelchair ergometer at a workload corresponding to 75% of the peak oxygen uptake attained during a maximal-graded exercise tolerance test. Subjects were required to propel the medicare power wheelchairs for as long as they could at a constant velocity of 3 km/h (32 rpm). The test was terminated when subjects could no longer maintain the target velocity. Peak Performance video-capture system was used to determine upper-limb kinematics. Handrim forces and joint kinematics were used to calculate joint moments and power with the use of an inverse dynamics approach. Results showed that with fatigue, joint power shifts from the shoulder joint to the elbow and wrist joints. Implications for joint injury and propulsion efficiency are discussed.
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