From The Ergoweb® Learning Center

The Role of Ergonomics in Rehab Engineering (Case Studies)

Ergonomics has an appeal and applicability, reaching far more than most people think or could ever imagine.  It can be life changing for some and for others it can be a means to do things that may otherwise be seen as impossible, or at the very least improbable. 

There is one such application of ergonomics that is little known, not practiced much, but has a HUGE impact on lives: Rehabilitation Engineering. A combination of the two disciplines can be life changing for a multitude of individuals, including paraplegics, quadriplegics, amputees and even for severely injured from occupationally related industrial accidents.  Especially applicable is the group of Wounded Warriors from soldiers returning from the Gulf Wars with the ultimate of occupational injuries.

Let me give you a couple of case studies that I’m involved in.

Fishing…Do you like fishing?  I certainly appreciate the elements of it.  The Zen of outdoors, around a lake, the sport of fighting and landing a fish, camaraderie of friends or family…  These elements are often told to me by a friend or acquaintance who perhaps grew up with the sport with their father or friends telling stories of the fun, communing with nature or simply sharing experience.  Who wouldn’t enjoy such experiences?  Imagine an industrial accident or unfortunate circumstance resulting in quadriplegia and the prospect of fishing comes up… would there be any potential to return to this activity as a quadriplegic?  Generally, the answer is a resounding No!

However, my colleagues and I (in our spare time) have come up with a working model of a device that Velcros onto wheelchair arms and allows a quadriplegic to cast a line, reel and pull in a fish.  It allows them to actually feel and fight the fish.  The working model involves a couple of servos, spinners, couplings, gearboxes and drives.  So far at our first testing we caught four fish.  The unit is small enough to be collapsed and carried in a small suitcase.  The next step is to make it waterproof and we’re working on that.

Now this may not be a spectacular solution to a significant occupational or recreational project, but can you imaging a wheel chair bound kid being able to fish?  Or to have a wheel chair bound adult return to an activity that they once cherished.  The only real parameter for our “Quad Fisher” is for the individual to have at least flexion or some sort of gross inward rotation of either arm

On another front, my team and I were presented with a wheelchair bound paraplegic young man (spina bifida since birth).  We’ll call him Justin.  Justin worked with his father in a family owned auto repair shop with dreams of working together in the family business.  Dad told Justin to go to school to learn the new high tech automotive computer diagnostics, fiber optics, electronic fuel injections and other assorted high tech automobile repair nuances.  Justin has always loved cars, hates motorcycles, 10-30 oil runs in his veins, a truly highly motivated young man. 

Justin found his way into a Voc-Tech educational institution in which he quickly encountered some barriers to his learning the high tech mechanics trade.  For instance, how do you change a tire while in a wheel chair?  A difficult task to be sure.  The disability manager at the school queried us as to whether we could indeed get Justin to be able to perform auto mechanic repair tasks and to complete his automotive training. 

We thought about it at first.  We figured we could raise the car and work under it like Midas Muffler in a wheelchair.  We also figured front end brake and suspension could be performed by lowering the vehicle, but how do you get Justin over the engine compartment?  Several of my colleagues suggested we hang Justin from a wire like Tom Cruise in Mission Impossible.  Yeah!! Right…what if there was stack fire or what if he had forgotten a tool.  Now no mechanic I know has ever done that.  Riiiight!

We settled on a design with a series of stanchions centered around the car in 5 points surrounding the engine compartment.  With the hood open, these stable stanchions could support a series of lightweight metal pipes forming a series or a singular stable truss.  Like a big tinker toy set, these would give Justin a structure to tie off from and support himself without leaning on the fenders or engine components (many of which are plastic and fragile anyway).  We also researched rock climbing hardware and determined that by  adapting these techniques, Justin could, with appropriate rock climbing training, secure, release and maneuver himself over and around the engine compartment.  Having good upper body strength, he gave thumbs up for the approach, as did his major professors as well as the disability manager of the school.  This project is currently ongoing. 

Oh yes, for handling the tires…  Justin and his professor determined all we had to do was bolt on one of our tire dollies to the front of his wheel chair and Voila!  Instant tire changing capability from a wheelchair.  Truly an application formulated by the TEAM using the application of ergonomics principles and a little brainstorming.

Another case on the automobile repair arena is a mechanic who had three of his right fingers amputated by a fan pulley while he was working on a water pump and a rookie mistakenly hit the ignition turning the engine over.  His right hand is currently highly sensitive to pain, limited grip and limited range of motion (ROM).  Naturally he is right handed.  So, how do we get a highly skilled mechanic with amputated fingers and a sensitive hand back to work in his job-of-injury?

We developed a special set of mechanics open ended / box end wrenches specific to his right hand limitations and in spite of his horrific occupational injury, he is now back to work as a full time mechanic. 

The most important theme in these three cases is combining the expertise of ergonomics and design to a level wherein anything can be accomplished using sound biomechanics principles, ergonomics principles, design principles and combining them in a team approach to have a high impact on lives. 

Think about it.  How much more practical, applicable effect could a science or discipline have on individuals or groups?  If ergonomics can get a quad to fish, ergonomics can indeed with proper forethought be life changing… much more than simply adjusting chairs or keyboards.  The next time you think of ergonomics, think outside the box… the application of ergonomics principles can really change lives and I mean REALLY change them!!!

Guest contributor Ian Chong, a Certified Professional Ergonomist with Seattle based multi-disciplinary Extreme Ergonomics Inc., designs and prototypes unique tools, equipment and workstations addressing occupational injuries in all occupational environments, industrial and office on a national level.  Ian holds advanced degrees in Ergonomics & Occupational Biomechanics, Industrial Design; and Architectural Engineering, and is also profiled in the Oregon Museum of Science and Industry.

This article originally appeared in The Ergonomics Report™ on 2010-09-29.