More Than Just Games

For more than ten years, the Human Engineering Research Laboratories (HERL) of the Department of Veterans Affairs (VA) Rehabilitation Research and Development Service and the University of Pittsburghhas conducted research at the annual National Veterans Wheelchair Games (NVWG). The generosity of the veterans who have participated in these studies has contributed to some noteworthy advances in technology as well as rehabilitation research. These same veterans have led the way in educating the next generation of rehabilitation scientists and clinicians. It is invaluable for people entering the field of medical rehabilitation to gain exposure to veterans who have adapted to their disability and are capable of tackling the challenges of participating in sports activities.

About 75 students, residents, and fellows have participated in HERL’s research at NVWG. Many have collected data for their master’s theses or doctoral dissertations, and a number have completed their residency research requirement.

The example set by the veterans participating in NVWG serves as a model of what people with disabilities can achieve, especially as the competitors are at many different points in their lives post-disability. Through exposure to veterans at the Games, many students, fellows, and residents go on to pursue careers in VA or other government agencies.

Since 2005, residents in physical medicine and rehabilitation at Walter Reed Army Medical Center have joined the HERL team at NVWG. Three of these individuals have won awards for their Games research, and all have gained greater insight into the long-term outcomes of medical rehabilitation.

One of the amazing attributes of many veterans is their willingness to volunteer and to help one another. Some come to our booth at the NVWG Exposition every year to learn about our current studies, and to sign up to participate. Past studies have included the following areas:

  • Examining wrist and shoulder pain
  • Studying wheelchair-propulsion biomechanics
  • Surveying interest in video gaming as exercise
  • Recording wheelchair driving activity during various sports
  • Determining NVWG’s impact on participants
  • Collecting data to support the Americans with Disabilities Act Access Guidelines (ADAAG)
  • Investigating new technologies

Positive Results

HERL is working with U.S. Paralympics to develop a throwing chair for field events that is suitable for use by clubs and organizations.

What are some of the outcomes from this research? The use of high-frequency ultrasound was introduced to clinical practice in physical medicine and rehabilitation (PM&R), which also led to results showing relationships between the type of wheelchair, the setup of the wheelchairs, and the style of propulsion to injuries of the wrist, elbow, and shoulder.

The SMARTWheel®, a device that measures how people push on their pushrims, was validated as a useful clinical tool and is now used widely throughout VA and in other medical rehabilitation programs.

NVWG veterans have made important contributions to ADAAG and will impact how buildings, communities, and appliances are designed to be accessible to people with disabilities.

Community participation is critical to being able to live a full and healthy life. Through the data-loggers HERL developed, we have been able to determine how far, how fast, and how often people push or drive their chairs. These data have shown that people are more active in their chairs while at the Games than they are at home. Studies of basketball, rugby, and power soccer showed that the movement in a single game is about the same as an entire day of pushing or driving during the remainder of the day.

This research led to larger nationwide  studies that are helping improve the availability of high-quality wheelchairs, and have pointed out the frequent maintenance issues facing wheelchair users.

NVWG has been the initial proving ground for prototype technologies. Among the devices tested at the Games are GAMEWheels, an exercise and neuro-rehabilitation system that uses handcycling with computer gaming; the SMARTWheel; and algorithms to compensate for tremor and movement disorders when using a computer or electric-powered wheelchair. A number of studies have also shown the positive benefit of participating in the Games: higher self-esteem, greater knowledge about exercise opportunities, goal setting for fitness, and learning greater independence.

Coming Up…

Veterans who went to Denver for the 2010 NVWG (July 4–9) had the opportunity for involvement in research. There was at least one study in which athletes could participate between competitions.

HERL is working with U.S. Paralympics to develop a field-event throwing chair suitable for use by clubs and organizations. The throwing chair has adjustable features to accommodate various disabilities and differing throwing styles. Athletes will be asked to provide feedback on the design to help make the chair more functional.

ADAAG needs more supporting data regarding transfers from a wheelchair to various surfaces or seating systems, including amusement-park rides. HERL will conduct a study to evaluate critical aspects of transfers such as difference in height, width of the gap, the angle of the wheelchair, and the location of grab bars. The information gathered will help make hotels, public facilities, and amusement parks more accessible.

The type of wheelchair, its fit to the user, and the quality of the training provided to users impact community participation and preservation of upper-limb function, and help to manage pain. Therefore, we will continue to investigate how people propel their wheelchairs during a series of different activities.

As you might imagine, it takes a lot of work and money to organize the Games, and it is important to identify the benefits to athletes and local VA programs. We are developing a brief survey to allow athletes and coaches to report on how NVWG has affected them.

Veterans and their coaches participating in the Games have always been an excellent source for new ideas for devices, research studies, and contacts. Being part of the NVWG is something the people who work at HERL look forward to each year.

Contact: HERL for more information.

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