{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T15:58:27Z","timestamp":1790524707968,"version":"4.1.0"},"reference-count":25,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2018,2,23]],"date-time":"2018-02-23T00:00:00Z","timestamp":1519344000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PM&R"],"published-print":{"date-parts":[[2018,10]]},"abstract":"Abstract<\/jats:title>Background<\/jats:title>Suspension systems are designed to reduce shock and vibration exposure. An aftermarket rear\u2010wheel suspension system is now available for manual tilt\u2010in\u2010space wheelchairs.<\/jats:p><\/jats:sec>Objective<\/jats:title>To compare quantifiable shock and vibration on a rigid manual tilt\u2010in\u2010space wheelchair to published data on manual wheelchairs and to determine whether aftermarket rear suspension system will significantly decrease shock exposure when traversing common obstacles.<\/jats:p><\/jats:sec>Design<\/jats:title>Cross\u2010sectional.<\/jats:p><\/jats:sec>Setting<\/jats:title>Research laboratory.<\/jats:p><\/jats:sec>Participants<\/jats:title>Ten healthy non\u2010wheelchair users.<\/jats:p><\/jats:sec>Methods<\/jats:title>Subjects seated in a manual tilt\u2010in\u2010space wheelchair were pushed over 4 different obstacles (an exterior door threshold, truncated domes, 2\u2010cm descent, and 2\u2010cm ascent) with the chair as manufactured and with the suspension system installed.<\/jats:p><\/jats:sec>Main Outcome Measurements<\/jats:title>Superior\/inferior and anterior\/posterior accelerations were assessed at the seat pan with and without the use of ISO 2631\u20101 standards. Peak accelerations were analyzed from the door threshold, 2\u2010cm descent and 2\u2010cm ascent. Root mean square acceleration (RMSa) values were analyzed from the truncated domes, and vibration dose value (VDV) was analyzed for all surfaces.<\/jats:p><\/jats:sec>Results<\/jats:title>There were no differences in time spent over the 4 obstacles between rigid and suspended conditions (P<\/jats:italic>.064). Suspension decreased the peak acceleration at the rear wheel when it initially impacted the door threshold, and when the rear wheel traversed the 2\u2010cm descent and ascent (P<\/jats:italic>.043). ISO 2631\u20101 frequency weighting, placing emphasis on frequencies most harmful to humans, also supports suspension reducing peak accelerations at the rear wheel both when it initially impacted and left the door threshold, and when the rear wheel descended 2 cm (P<\/jats:italic>.049). Suspension also reduced the truncated dome RMSa as well as the door threshold, 2\u2010cm descent, and total VDV (P<\/jats:italic>.041).<\/jats:p><\/jats:sec>Conclusions<\/jats:title>The results indicate that rigid manual tilt\u2010in\u2010space wheelchairs respond to rough surfaces in a similar fashion to previously studied rigid wheelchairs. Furthermore, the aftermarket suspension system reduces some aspects of shock and vibration exposure, also consistent with previously studied suspension systems.<\/jats:p><\/jats:sec>Level of Evidence<\/jats:title>NA<\/jats:p><\/jats:sec>","DOI":"10.1016\/j.pmrj.2018.02.009","type":"journal-article","created":{"date-parts":[[2018,2,23]],"date-time":"2018-02-23T05:22:21Z","timestamp":1519363341000},"page":"1040-1050","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Effect of Rear Wheel Suspension on Tilt\u2010in\u2010Space Wheelchair Shock and Vibration Attenuation"],"prefix":"10.1002","volume":"10","author":[{"given":"Molly","family":"Hischke","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"II","given":"Raoul F.","family":"Reiser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,2,23]]},"reference":[{"key":"e_1_2_6_2_2","unstructured":"M.Brault.Americans with disabilities. U.S. Census Bureau 2010 Available athttp:\/\/www.census.gov\/prod\/2012pubs\/p70\u2010131.pdf Accessed December 10 2016"},{"key":"e_1_2_6_3_2","unstructured":"Physical and Mobility Impairments: Information and News. Disabled World Available athttps:\/\/www.disabled\u2010world.com\/disability\/types\/mobility\/ Accessed March 3 2015"},{"key":"e_1_2_6_4_2","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1080\/00140139308967928","article-title":"Effects of seated posture on erector spinae EMG activity during whole body vibration","volume":"36","author":"Zimmermann C.L.","year":"1993","journal-title":"Ergonomics"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0146-0005(96)80056-5"},{"key":"e_1_2_6_6_2","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1080\/001401300404742","article-title":"Qualitative models of seat discomfort including static and dynamic factors","volume":"43","author":"Ebe K.","year":"2000","journal-title":"Ergonomics"},{"key":"e_1_2_6_7_2","first-page":"409","article-title":"Analysis of vibrations induced during wheelchair propulsion","volume":"3","author":"VanSickle D.P.","year":"2001","journal-title":"J Rehabil Res Dev"},{"key":"e_1_2_6_8_2","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1007\/BF02897920","article-title":"Relationship between questionnaire survey results of vibration complaints of wheelchair users and vibration transmissibility of manual wheelchair","volume":"8","author":"Maeda S.","year":"2003","journal-title":"Environ Health Prev Med"},{"key":"e_1_2_6_9_2","doi-asserted-by":"crossref","first-page":"985","DOI":"10.1682\/JRRD.2008.01.0006","article-title":"Effect of rear suspension and speed on seat forces and head accelerations experienced by manual wheelchair riders with spinal cord injury","volume":"45","author":"Requejo P.S.","year":"2008","journal-title":"J Rehabil Res Dev"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/annhyg\/mer068"},{"key":"e_1_2_6_11_2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2014\/852607","article-title":"Combined effects of long\u2010term sitting and whole\u2010body vibration on discomfort onset for vehicle occupants","volume":"2014","author":"Mansfield N.J.","year":"2014","journal-title":"ISRN Automotive Eng"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1080\/00140139.2014.943302"},{"key":"e_1_2_6_13_2","volume-title":"Mechanical Vibration and Shock: Evaluation of Human Exposure to Whole\u2010Body Vibration, part 1: General Requirements","author":"International Organization for Standardization (ISO)","year":"1997"},{"key":"e_1_2_6_14_2","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1016\/j.medengphy.2004.06.005","article-title":"Using the absorbed power method to evaluate effectiveness of vibration absoprtion of selected seat cushions during manual wheelchair propulsion","volume":"26","author":"Wolf E.J.","year":"2004","journal-title":"Med Eng Phys"},{"key":"e_1_2_6_15_2","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1682\/JRRD.2006.05.0049","article-title":"Longitudinal assessment of vibrations during manual and power wheelchair driving over select sidewalk surfaces","volume":"44","author":"Wolf E.J.","year":"2007","journal-title":"J Rehabil Res Dev"},{"key":"e_1_2_6_16_2","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1179\/2045772313Y.0000000124","article-title":"Health risks of vibration exposure to wheelchair users in the community","volume":"36","author":"Garcia\u2010Mendenz Y.","year":"2013","journal-title":"J Spinal Cord Med"},{"key":"e_1_2_6_17_2","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1080\/10400430902945769","article-title":"RESNA Position on the application of tilt, recline, and elevating legrests for wheelchairs","volume":"21","author":"Dicianna B.E.","year":"2009","journal-title":"Assist Technol"},{"key":"e_1_2_6_18_2","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1682\/JRRD.2006.11.0142","article-title":"Curb descent testing of suspension manual wheelchairs","volume":"45","author":"Kwarciak A.M.","year":"2008","journal-title":"J Rehabil Res Dev"},{"key":"e_1_2_6_19_2","doi-asserted-by":"crossref","first-page":"459","DOI":"10.2340\/16501977-0360","article-title":"Influence of hand\u2010rim wheelchairs with rear suspension on seat forces and head accelerations during curb descent landings","volume":"41","author":"Requejo P.S.","year":"2009","journal-title":"J Rehabil Med"},{"key":"e_1_2_6_20_2","unstructured":"Wheelchair suspension\/shock absorption. 2009 Available athttp:\/\/atwiki.assistivetech.net\/index.php\/Wheelchair_suspension\/shock_absorption Accessed May 18 2017"},{"key":"e_1_2_6_21_2","unstructured":"Instruction manual: QX\u20101L. 2017 Available athttp:\/\/quadshox.com\/instruction\u2010manual\u2010qx\u20101l\/ Accessed August 9 2017"},{"key":"e_1_2_6_22_2","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1053\/apmr.2003.50069","article-title":"Seat and footrest shocks and vibrations in manual wheelchairs with and without suspension","volume":"84","author":"Cooper R.A.","year":"2003","journal-title":"Phys Med Rehabil"},{"key":"e_1_2_6_23_2","volume-title":"Performance analysis of suspension manual wheelchairs","author":"Kwarciak A.M.","year":"2003"},{"key":"e_1_2_6_24_2","unstructured":"M.T.Gregg T.R.Derrick.Wheelchair vibrations using shock\u2010absorbing front castor forks. Frog Legs Inc June 1998 Available athttp:\/\/cdn.shopify.com\/s\/files\/1\/0229\/9999\/files\/Frog_Legs_study.pdf?6260 Accessed February 15 2017"},{"key":"e_1_2_6_25_2","doi-asserted-by":"publisher","DOI":"10.1887\/0750303433"},{"key":"e_1_2_6_26_2","doi-asserted-by":"publisher","DOI":"10.1080\/09638288.2017.1292322"}],"container-title":["PM&R"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1016%2Fj.pmrj.2018.02.009","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S193414821830100X?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S193414821830100X?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.pmrj.2018.02.009","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,14]],"date-time":"2023-09-14T13:04:51Z","timestamp":1694696691000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1016\/j.pmrj.2018.02.009"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,2,23]]},"references-count":25,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2018,10]]}},"alternative-id":["10.1016\/j.pmrj.2018.02.009"],"URL":"https:\/\/doi.org\/10.1016\/j.pmrj.2018.02.009","archive":["Portico"],"relation":{},"ISSN":["1934-1482","1934-1563"],"issn-type":[{"value":"1934-1482","type":"print"},{"value":"1934-1563","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,2,23]]},"assertion":[{"value":"2017-09-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-02-15","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-02-23","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}