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. 2022 Jul;45(4):585-594.
doi: 10.1080/10790268.2020.1863897. Epub 2021 Mar 11.

User-centered design and development of a trunk control device for persons with spinal cord injury: A pilot study

John M Looft  1 , Robert Sjoholm  1   2 , Andrew H Hansen  1   2   3   4 , Stuart Fairhurst  1 , Greg Voss  1 , Clifford A Dellamano  1   4 , Jason Egginton  5 , Christine Olney  1   6 , Gary Goldish  1   2
Affiliations

User-centered design and development of a trunk control device for persons with spinal cord injury: A pilot study

John M Looft et al. J Spinal Cord Med. 2022 Jul.

Abstract

Context/objective: There are no wheelchair products designed to allow users to dynamically control trunk posture to both significantly improve functional reach and provide pressure relief during forward lean. This pilot study sought to (1) gather stakeholder desires regarding necessary features for a trunk control system and (2) subsequently develop and pilot test a first-generation trunk control prototype.

Design: Multi-staged mixed methods study design.

Setting: Minneapolis VA Health Care System, Minneapolis, MN.

Participants: Eight people with spinal cord injuries were recruited to participate in a focus group. Five participants returned to discuss, rate, and select a design concepts for prototype development. Two participants returned to test the first-generation trunk control prototype.

Interventions: The focus group members selected a trunk control device design that uses backpack straps with a single cable as the most desired option. Our design team then manufactured the first-generation prototype at the Minneapolis VA.

Outcome measures: Bimanual workspace capabilities (n = 1) and pressure map relief changes (n = 2) during supported forward lean were measured. Both participants also provided feedback on the trunk control devices usability.

Results: Bimanual workspace (for Participant 1) was increased by 311% in the sagittal plane with use of the trunk control device as compared to without. Pressure relief during a forward lean was increased with an overall dispersion index reduction of 87.6% and 27.7% for Participant 1 and Participant 2 respectfully.

Conclusion: This pilot study successfully elicited desired features for a trunk control device from stakeholders and successfully developed and tested a first-generation trunk control prototype.

Keywords: Assistive device; Focus groups; Pressure relief; Spinal cord injury; Wheelchairs.

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Figures

Figure 1
Figure 1
Study design overview.
Figure 2
Figure 2
A. Moving canes and chest strap; B. Hinged back; C. Harness with two cable; D. Backpack straps with 1 cable.
Figure 3
Figure 3
First-generation trunk control prototype.
Figure 4
Figure 4
Shows use of the harness (A), ability of device to improve bilateral reach (B) and use of joystick (C and D).
Figure 5
Figure 5
The black (darker) shaded area depicts the bilateral reach of participant 1 in the sagittal plane without the trunk control device. The gray (lighter) shaded area depicts his bilateral reach in the sagittal plane with the trunk control device.
Figure 6
Figure 6
Pressure maps demonstrating the changes in the pressure from upright seated position (Left) to a forward lean (Right) using the first-generation trunk control prototype. Where red depicts pressures ranging ≥100 mmHG and dark blue 5 mmHG. Values less than 5 mmHG are depicted as 0.
See this image and copyright information in PMC

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