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A wheelchair 'revolution'

Engineer Rory Cooper is working to make wheelchairs easier to push and maintain, more reliable and better looking

Monday, February 16, 1998

By Christopher Snowbeck, Post-Gazette Staff Writer

It used to be that wheelchair designers took a one-size-fits-all approach to their work.

Rory Cooper in his laboratory at the Veterans Administration Medical Center, Pittsburgh. (Tony Tye Post-Gazette)
"Now, the idea is that a wheelchair is more like a shoe than a sofa," said Rory Cooper, an engineer at the University of Pittsburgh and the VA Medical Center. "Wheelchairs are a lot more personalized than they used to be."

Cooper has been both an agent of that change and a beneficiary of it.

In Germany in 1980, he nearly died in a bicycle accident, in which a merging bus pushed him into oncoming traffic. He remembers lying on the ground, telling people around him he couldn't stand up.

Three weeks into his subsequent stay in an intensive care unit, doctors told Cooper he had a spinal cord injury and would have to live with a wheelchair.

The accident didn't immediately change the 20-year-old's plans for being an engineer. Newly discharged from the Army, he continued his plans for going to school and studying robotic and computer engineering.

But coming from a family of machinists, Cooper was unsatisfied with the state of the art in wheelchairs at the time. He spent time designing chairs for himself - an interest that eventually became his career.

Cooper now heads a research team, partially funded by the University of Pittsburgh and the VA Medical Center in East Liberty, that is studying how changing the wheel rims on chairs might prevent injuries to the shoulder, elbow, wrist and hand.

The study, part of a $3.5 million grant from the National Institutes of Health, is the latest in a series of projects Cooper has worked on to improve the design and safety of wheelchairs.

"Medical care has done a tremendous job in keeping people alive," Cooper said. "Longevity is still an important question, but it's also raised the question of quality of life.

"We're saying we need to focus on quality of life."

The options wheelchair users now enjoy are vastly different from those Cooper found when he was injured.

"I got a wheelchair and it was terrible," Cooper said. "My mom was an auto mechanic, my mom and dad had a machine shop, and so I said there's got to be a better way than this."

Wheelchairs weighed about 80 pounds at the time - four times the weight of the chair Cooper now uses. The chairs were poorly aligned and were difficult to push.

And they projected the image that the person in the chair was sick, Cooper said.

"When you looked at someone in a wheelchair, you just saw a person surrounded by a lot of chrome," he said. "Now, the idea is to see the person before you see the chair."

Cooper used his mechanical skills to outfit wheelchairs for daily living.

But he also designed chairs for competitive racing. Cooper raced motorcycles in high school and ran during his time in the Army, so after his injury he turned to racing as a competitive outlet.

The sport came naturally, even though his body wasn't particularly well suited for the sport.

"They're not very compatible activities -- if you have a runner's build vs. a wheelchair racer's build," Cooper said. "Wheelchair racers have big upper bodies. Runners are skinny little toothpicks."

As an undergraduate engineering student, Cooper was forced to think about wheelchair design.

California Polytechnic State University wasn't equipped for a disabled student in a wheelchair. Lab tables were beyond Cooper's reach and metal staircases thwarted his chair's ascent.

The college eventually installed an elevator to help Cooper get to class. But it broke down a lot, meaning Cooper became acquainted with the firefighters who rescued him.

For his senior design project, Cooper worked on plans for a standing wheelchair. He also started thinking about how to design chairs that could climb stairs.

But Cooper didn't follow that engineering path very far.

After graduation, he took a job for a year in a nuclear power plant and then went to graduate school, where he worked on robotics and space system engineering.

"I wanted to sort of prove that I could be an engineer and not that I could only be an engineer working on products for people with disabilities," Cooper said.

He regarded his work on wheelchairs as "tinkering" until an adviser suggested the work could fill an important void.

"He basically said to me, 'Why should I work on problems for people with disabilities when you have a disability and you don't even want to work on them?' " Cooper said. "It took somebody else to give me a broader view" of the possibilities.

Cooper took up the challenge and worked on wheelchair design at California State University in 1989. He came to Pitt in 1994.

His work is a part of what Cooper calls a "revolution" in wheelchair technology during the past 20 years. That revolution brought wheelchairs that are easier to push and maintain, more reliable, better looking and easier to transport, Cooper said.

But there is still work to be done.

The incidence of carpal tunnel syndrome and rotator cuff tendinitis, for example, is greater than 50 percent for people who regularly use manual wheelchairs.

In the general population, the incidence for carpal tunnel syndrome is only about three percent; the incidence is even lower for rotator cuff tendinitis.

"If you're a keyboard operator, in the worst-case scenario, you might have to learn another trade" because of carpal tunnel syndrome, Cooper said. "If you're a wheelchair user, you may not be able to use a manual wheelchair anymore.

"You may have to go up to an electric-powered wheelchair, which has pretty profound implications for a person's independent mobility," he said.

Electric wheelchairs are bigger and heavier, so they're more difficult to transport. They rely on batteries and they're more expensive than manual chairs.

Cooper's human engineering research laboratory is studying how to outfit wheelchairs so they are less likely to cause stress at the shoulders, elbows, wrists and hands.

One possibility is that the wheel rims chair users push to propel themselves could be made out of vinyl rather than aluminum.

Vinyl, Cooper explained, "is a little easier to grab. It's got more friction, so your hand doesn't slip. It's also a little bit padded, so it's a little softer on your hand."

The study also is looking at the effects of changing the size and placement of the wheel rim as well as altering the back support, which changes the angle the chair user sits at.

Researchers are considering the pros and cons of seat and wheel arrangements by bringing in 40 wheelchair users and recording infrared images of them as they push their chairs. These wheelchairs are outfitted with a device called the SmartWheel, designed by Cooper to measure the direction and intensity of force wheelchair users apply when they push.

A computer then combines the infrared images with the readings.

"From that, we can tell, for example, that with the vinyl push rim people push more along the rim . . . so you reduce the amount of force going inward," Cooper said. "That means it should be less stressful on the joints -- the muscles aren't working as hard -- even though you're going the same speed."

Participants in the study are routinely polled on how they feel using differently configured wheelchairs. They also undergo X-rays and magnetic resonance imaging scans to document any rotator cuff tendinitis or carpal tunnel syndrome problems.

The lab, one of only about five in the country to focus on testing wheelchairs, employs odd equipment to put wheelchairs through their paces.

One room in the lab amounts to a torture chamber for wheelchairs.

Soccer balls filled with 50 pounds of lead shot are regularly dropped on wheelchair seats to test the quality of the upholstery. A curb-drop tester -- a machine that looks something like a medieval torture chamber -- lets researchers study how wheelchairs respond to two-inch falls.

The room includes crash simulators, tests for wheel quality and investigations into which casters -- the small, front wheels on wheelchairs -- work best.

In another room, Cooper and his colleagues run chairs over a test track that includes speed bumps, rumble strips and other obstacles wheelchair users must navigate.

A third room houses crash-test dummies that are strapped into wheelchairs for safety tests.

In the past, the lab used a crash-test dummy to study what happens to wheelchair users when they slam on the brakes in various chairs.

To the extent that the wheelchair industry is like the automobile industry, Cooper's work provides a sort of buyer's guide. His studies are published in medical journals, but they are often translated into language that consumers find useful and are printed in popular publications for disabled people.

The professional advice is useful because wheelchair manufacturers are becoming more competitive in marketing their products -- not just to users but also to the therapists who recommend which model a patient should use.

And patients have become more discriminating in chosing between products produced by the industry's Big Three manufacturers.

"People will move to the better product," Cooper said. "When you get people like the baby boomers in there, they don't want someone to tell them what they're going to use. They want choice. They want quality."

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