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Stimulation-Assisted Transfers after Spinal Cord Injury

Project Full Title:

Modeling Conventional Sitting Pivot Transfer Techniques of Individuals with Paralysis

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Project Description:

Hope Students Only, Pending Funding: This interdisciplinary project will incorporate the disciplines of engineering, nursing, and pre-health professions. However the project is specifically housed within the Hope College Department of Engineering. Individuals with lower limb paralysis rely on their arms and upper body to accomplish activities of daily living. The mobility and independence of these individuals impacts their ability to safely perform transfers from their wheelchairs to a bed, tub/shower bench, toilet, couch, etc. The most common type of transfer is the sitting pivot transfer. To initiate this type of transfer, individuals position their wheelchair as close as possible to the target surface. Moving towards the edge of the wheelchair seat, they place one hand on the wheelchair and the other on the target surface. Leaning forward and sideways, they use their arms to lift themselves, rotate their body, and lower themselves onto the target surface. Even with assistance from a family member or caregiver, the repeated performance of these weight-bearing tasks places high mechanical loads on the shoulders, thus significantly increasing the risk for shoulder overuse and injury. It is critical to preserve the joint and functional integrity of the shoulders during transfers since they can exacerbate the shoulder pain and instability that are prevalent in the SCI/D population. In this pilot project, electrical stimulation will be used to assist individuals with paralysis performing conventional transfers (moving from one surface to another: i.e., moving from wheelchair to bed) across surfaces of different heights, using their preferred transfer strategies. They will wear sensors to track their motion as they perform the tasks. The data will be analyzed with a mathematical model and imported in a computational model of the body to determine shoulder and chest joint angles and forces. In addition. user-reported measures of perceived stress at the shoulders, effort, comfort, and safety as well as impressions of the technology will be captured.

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