Anthropometry for Persons with Disabilities: Needs for the 21st Century

Preface

August 22, 1997

prepared by: Bruce Bradtmiller, Ph.D.
Anthropology Research Project, Inc.
PO Box 307
Yellow Springs, OH 45387

James Annis
Annis Consulting
Yellow Springs, OH 45387

PREFACE

This document is the final report of Task 2 of the "Anthropometric Research Review" undertaken by Anthropology Research Project, Inc. (ARP) for the U.S. Architectural and Transportation Barriers Compliance Board (Access Board), and administered by the U.S. Department of Education under Contract No. QA96001001. The authors thank David Yanchulis, Research Coordinator at the Access Board, for his cooperation and support. They are grateful, also, for the many hours of painstaking work by ARP staff members Belva Hodge for producing and Ilse Tebbetts for editing this report.

Task 2: Analysis and Recommendations

INTRODUCTION

Under Task 1 of contract No. QA96001001, an annotated bibliography concerned with the anthropometry of people with disabilities, and its applications to the design of facilities, workspaces, and equipment, was completed. It appears in this report as an appendix. The objective of Task 2 is to assimilate the information gathered in Task l, to identify further anthropometric research needed to update guidelines and standards for accessible design, and to recommend the means of carrying out such studies.

The bibliography compiled in Task 1, while by no means exhaustive, incorporates a large body of anthropometric data on more than 11,000 persons of every age and a wide variety of disabilities. Unfortunately, most of the studies were conducted on specialized populations, many of them foreign. Dimension definitions and measurement techniques vary from study to study and, in many cases, samples were very small. In a recently published review of the anthropometry of people with disabilities (Kumar, 1997), A. Goswami examined six international studies of people with lower limb disorders and discovered that, for a combined total of 58 body size descriptors measured in the studies, not a single dimension was found in common. Goswami also could not find a single study that attempted to standardize either body landmarking or measurement procedures. These and similar findings are illustrative of the current state of affairs in regard to anthropometry of this group of individuals. Thus, while there is a great deal of existing anthropometric data, any attempt to combine them into a useful database would be futile.

Examination of the literature further reveals virtual unanimity among experts in the field regarding the undesirability of applying data from non-disabled populations to the design of equipment and spaces intended to accommodate populations with the full range of abilities and disabilities. This would be true of data from any non-disabled population, but is exacerbated in the U.S. by the fact that most existing anthropometric data on U.S. adults comes from military personnel. So poor is the status of applied anthropometry on U.S. civilians that the last major survey containing significant data applicable to design was completed in 1962 (Stoudt et al., 1965). This nationwide stratified random sample of men and women measured 14 anthropometric dimensions that can be used for the design of workspaces. Since that time three other large civilian surveys have been conducted but none contain anthropometric dimensions useful in design. As a result, many texts and guidebooks intended for interior and product designers in the U.S. are based on body size information collected from highly fit military populations.

The most recent of such comprehensive studies was conducted on U.S. Army personnel (Gordon et al., 1989). Although over 200 dimensions were measured on a group of 9,000 ethnically diverse soldiers, the data from this survey lack the range of variability found in the population of interest here. To examine this contention, a comparison was made for workspace dimensions from the Army survey and a compilation of seven separate studies of people with disabilities. Using the coefficient of variation (CV) as the statistic to compare the degree of variability, Table 1 presents the differences for 11 variables. The CV is a dimensionless statistic expressed in percent, so comparisons across dimensions that vary in magnitude are still valid.

TABLE 1

Coefficients of Variation (CV) for Selected Anthropometric Dimensions: Several Samples of Persons with Disabilities and U.S. Army Males

DIMEN-SION	PERSONS WITH DISABIL-ITIES¹	ARMY	DIFFERENCE
	Min and Max CV			No. of Studies	Average CV
Mass-Weight	5.5‒20.4	7	11.1	14.1	−3.0
Stature-Sitting	2.9‒8.3	6	6.6	3.9²	2.7
Shoulder Height, Sitting	6.9‒11.0	4	9.3	5.0	4.3
Elbow-Rest Height	12.7‒29.2	6	20.0	11.8	8.2
Thigh Clearance	18.3‒33.0	4	22.7	7.5	15.2
Shoulder Width	4.6‒8.9	5	6.8	4.5³	2.3
Elbow-Elbow Breadth	4.4‒13.4	5	8.7	8.0⁴	0.7
Popliteal Height	7.9‒10.2	4	8.9	5.7	3.2
Buttock-Knee Length	5.4‒8.0	2	6.7	4.9	1.8
Buttock-Popliteal Length	7.0‒10.4	4	8.6	5.3	3.3
Hip Breadth	7.8‒25.8	4	14.4	5.9	8.5

1. Disabled data computed from means and standard deviations given by Goswami (Kumar,1997).

2. Sitting height value used.

3. Biacromial Breadth value used

4. Forearm-Forearm Breadth value used.

Except for weight, the group with disabilities shows as much as twice the variability of the non-disabled sample in some cases. One reason for this result is, of course, the great number of disabilities, which, in turn, can cause a wide variety of changes in body size, posture, and function. This has led many investigators to a second finding relevant to Task 2: Anthropometric data obtained from individuals with a particular disability should not be used to draw up designs and standards for individuals with different disabilities. Nor are they applicable to a general U.S. population of people with disabilities.

The principal way to achieve good design is through the application of anthropometric data. In order to be effective, however, the data must not only be appropriate to the design at hand but must also be descriptive of the target user population. As noted above, much if not all the anthropometry so far collected on groups with disabilities involves specialized populations (Damon and Stoudt, 1963; Goswami et al., 1987; Molenbroek, 1987), and therefore has limited application for federal agencies that must concern themselves with the general U.S. population of individuals with a wide variety of disabilities.

NEAR-FUTURE RESEARCH NEEDS

In the best of all possible worlds, a major nationwide anthropometric survey of individuals with disabilities should be conducted. Such a study would be designed to collect information including body sizes, reach capabilities, range of joint motion, strength, and visual field data from several thousand children and adults, aged 2 and older with a wide variety of disabilities. The resulting database would be widely useful to engineers, architects, designers, and medical personnel as well as to the Access Board. Such an undertaking would, of course, be extremely costly. It is recommended here as a long-term goal that may ultimately be achieved, perhaps with funding from other interested groups. The current Civilian and European Surface Anthropometric Resource (CAESAR) program¹ is an example of how government and non-government organizations can pool resources to achieve a common goal. This anthropometric survey will obtain data from several thousand non-disabled civilians in the U.S. and abroad.

For the time being, we recommended a pilot study whose purposes would include:

providing specific data on a general U.S. population of people with disabilities for use by the Access Board in updating their Accessibility Guidelines.
providing the groundwork to support expanded anthropometric surveys in the future by establishing sampling strategies, and standardizing measuring and data handling procedures.

An anthropometric survey of this population presents a variety of challenges not encountered in similar studies of non-disabled subjects but, on the whole, planning and organization are the same for both. The major tasks to be completed in the planning stage of any survey are the following:

Select the target population.
Establish a sampling strategy.
Select and define variables to be measured.
Establish and test measuring techniques.
Determine able errors for measuring each variable.

The planning tasks will be discussed in some detail in the following sections, largely in terms relevant to the requirements of the proposed pilot study.

The Target Population

Perhaps the most difficult problem presented by this population is its diversity. Disabilities may be caused by a wide variety of diseases and injuries as well as genetic and congenital conditions. For purposes of the Access Board, we recommend that the proposed survey be limited to people who use wheelchairs. We make this recommendation for two reasons. First a modestly sized pilot study cannot adequately address the full range of anthropometric diversity, so it makes sense to focus on that portion of the range which is most different from the non-disabled population, and that portion of the range which is most challenging from the perspective of the designer or architect. The individuals who use wheelchairs fit both these criteria. Second, a major survey may well structure its sampling plan (see below) to proportionately reflect groups which use a variety of mobility aids. If this is done, wheelchair users might be statistically "outnumbered", and the result would be that reach ranges, for example, would not reflect their needs. In a concrete example of this effect, in the U.S. military, females represent about 8% of the total population. For many dimensions women represent the smaller end of the distribution. If they were measured in proportion to their representation in the military, and then the product or workspace design were created to accommodate the 5th percentile through the 95th percentile of the total population, nearly all the women would be excluded from the design because they fall disproportionately into the lowest 5 percent. What the military does instead is to measure men and women separately, and specify design targets which accommodate both men and women. This approach is likely to be effective in the present context, where people who use wheelchairs may be expected to fall at one end of the distribution of many dimensions, and where they may represent a minority of the total population of people with disabilities.

Trying to limit the scope of the pilot study, which should be exploratory in nature, we would also suggest restricting the survey group to an adult population aged 18 and over. The primary reason for this is to reduce diversity in the target population to a reasonable level. Human growth, whether or not there are disabilities involved, produces obvious and enormous anthropometric changes. Because of the anthropometric changes with age, sampling by age (see below) would require very small categories (a year or two) which would dramatically increase the sample size. In addition, methods to gain access to samples of children, measurement procedures and data analysis would all be different from the methods, procedures and analyses developed for adults. Certainly, children are candidates for future studies, and when the time is appropriate, their needs would be better served by a study targeted for their special requirements.

Recruitment of appropriate subjects must be carefully planned for, even when such subjects are widely available. In this case, appropriate subjects are not widely available. Arrangements will have to be made to seek out appropriate subjects in places where they are likely to be found in some numbers. One goal of major nationwide surveys is to maximize the diversity of the target population in the sample, not only with regard to sex, age, and racial/ethnic diversity but also with regard to geographic spread. For this preliminary study – and, perhaps even for larger future studies – geographic diversification is not likely to add anything useful to the variability of the sample. Thus, it should be possible for any qualified investigator living in or near a large city to recruit enough subjects within easy driving distance. The most likely locations would include large-hospital physical rehabilitation programs, nursing homes, and universities that enroll appreciable numbers of students with disabilities.

Sampling Strategies

Sampling involves the process of selecting a group of individuals thought to be representative of an entire population. To put it another way, the small number of individuals in a given sample must reflect a significant amount of the variability extant in the entire population. Accurate sampling is critical to the creation of a database that can be applied successfully to the purposes for which it is intended. As has been noted, the variability of the target population in this country is very great.

There are a number of sources of information on the size of various U.S. populations with disabilities, including the National Health Interview Survey (NHIS), as well as publications of various associations representing specific disabilities but these reports do not give the kind of breakdowns that would be useful in developing a sampling plan. A review of the literature leads inevitably to the conclusion reached by J.A. Sanford (1996), "There appears to be no single data source that directly assesses the prevalence of mobility impairments in the U.S. population."

Ordinarily in sampling for anthropometric surveys, a multi-dimensional matrix is drawn up to make sure that all critical sources of anthropometric variability are accounted for in the eventual sample. In the Army's most recent anthropometric survey, for example, (Gordon et al., 1989), the matrix included sex, race and age. This is because these three demographic parameters account for much of the anthropometric variability in a non-disabled population. While the matrix approach is useful for the population of interest here, the same three parameters are not particularly effective. This is because the type of disability has much more to do with eventual body size and shape differences than does race. Age and sex are still important in describing a population of people with disabilities, so those parameters remain. Indeed, sex is generally important enough that, for anthropometric purposes, designers do well to consider males and females separately, rather than combining them into an appropriately representative population.

Age is a continuous variable, along which anthropometric dimensions change continuously. What this means is that unlike sex, where one is either a male or female, a 35-year-old may not be anthropometrically different from a 36-year-old. Yet, individuals in their 30's are anthropometrically distinct from individuals in their 60's. As a result, when using age in a sampling plan, some arbitrary divisions are needed. For the pilot study, we recommend dividing the population roughly into quartiles. Such divisions might be, for example: 18‒25, 26‒38, 39‒50, and 51and over. There would be anthropometric distinction between the groups, but the distinctions are not so fine as to defy practical significance. To find the exact dividing points for age, one would research the age distribution of the population of wheelchair users, and place approximately 25% of the age distribution in each sampling unit. If such data are not available, then one would use the breakdown of the U.S. Census figures by age.

Dividing the wheelchair population into significant groups is also problematic. One approach is that suggested by Kumar (1997) in Table 2. When developing this into a sampling strategy for a pilot study, one would select the most frequent 4 or 5 conditions, and group the rest into a category "Other". For a full-scale survey, with a more complex sampling strategy, and a larger overall sample size, one would be able to use more specific categories, and reduce the number in the "Other" group. Following this scenario, a sampling matrix might look like the one shown in Table 3. This is based on a total sample of approximately 250 subjects of a single sex. The figure would be repeated for the other sex, for a total of 500 subjects.

TABLE 2

Frequency of Medical and Physical Conditions Necessitating Wheelchair Use

CONDITION	PERCENT
Arthritis	28
Organic nervous disorder	14
Cerebral vascular disease	13
Bone injuries and/or deformities	11
Lower limb amputation	9
Cerebral palsy	8
Traumatic paraplegia	7
Respiratory and cardiovascular disease	5
Obesity, congenital errors, spinal injury	5

TABLE 3

Hypothetical Sampling Matrix

AGE	ARTH-RITIS	ORGAN-IC NERVOUS	CERE-BRAL VAS-CULAR	BONE INJURIES	OTHER	TOTAL
18-25	17	9	8	7	21	62
26-38	18	9	8	7	21	63
39-50	17	9	8	7	21	62
50-65	18	8	9	8	22	65
TOTAL	70	35	33	29	85	252

Kumar's distribution is based on data which were gathered in the U.K. In the literature search undertaken to compile the annotated bibliography, we did not discover similar information for the U.S. Such information is critical if medical condition is to be used as a sampling parameter. It may be the case that another organization will carry out a questionnaire survey yielding appropriate information about: 1) the level and type of mobility aid used; 2) medical causes for using a mobility aid; and 3) other related demographic information. (A sample questionnaire has been developed.) If such a survey is done before planning for the pilot study is complete, then the resulting questionnaire data could be used. If another agency or researcher does not conduct such a survey, then we would recommend the questionnaire survey step prior to the beginning of the pilot anthropometric study.

Dividing the population of people who use wheelchairs into reasonable sampling units can be done in a number of ways. The key is to select a demographic parameter that has anthropometric significance, and then be sure the sampling matrix reflects the proportions of the population in each of the categories.

We have used the number 500 in our hypothetical sampling plan. This was selected to show how a sampling matrix could be developed. Let us now look more specifically at how many individuals should be measured, either in a pilot study or in a larger nationwide survey. In the extreme case, one could measure every wheelchair user, or every person in the U.S. with any kind of disability, and thus know exactly the anthropometric characteristics of that population. Such an approach is obviously prohibitively expensive, and not necessary. At the other extreme, one could measure a single wheelchair user, and assume his or her dimensions to be representative of the group as a whole. At a certain level, a single person could represent the whole group, in the sense that a single person could demonstrate that people using wheelchairs do not have an arm reach of 10 feet. This approach would estimate the population at a very low level of precision. It would also represent the population at a low level of confidence, in the sense that having measured only one, how could we be sure that there are no other individuals with a reach of 6 feet? Increasing our sample from one to some other number, would increase our confidence (since we would feel better about having more than one subject), and possibly increase our precision as well (since we would have more than one, and could observe that several individuals had a reach of less than 10 feet). These two concepts, precision and confidence, have been incorporated into a formula that allows statistical estimations of a sample size. For a specified level of precision at a specified confidence level, we know in advance how many subjects need to be measured. The formula is:

n = (Z · S_x)² / C²

Where: Z is the Z-score associated with a particular confidence level, S_x is the standard deviation of the dimension in question, and C is the desired precision

There are no hard and fast ways to determine an acceptable level of precision, just as there are no fixed ways of determining an acceptable confidence level. Statistical confidence has often been set at 95%, but this has more to do with tradition than any practical consideration. Indeed, 80% may be sufficient for many applications, and less than 80% might be sufficient for a pilot study. Similarly, precision is often targeted at 1½ % of the mean, but this figure is not sacred. Given that each of these parameters is flexible, it is sometimes useful to start with a sample size that is practically achievable, and then calculate back to find what levels of precision and confidence are associated with that n.

The other issue in calculating sample size, or the confidence and precision associated with a sample size, is the selection of a dimension. Note that in the formula, the S_x is the standard deviation associated with a particular dimension. Generally, in searching for a worst case (largest n) solution, a dimension with a high standard deviation is chosen. Typically, this is a circumference with a high correlation with weight (e.g., waist or hip). In the case of dimensions needed for ADAAG applications, circumferences are inappropriate. Here, the worst case dimension, of those needed for this application, would likely be one of the reaches. If the resulting n is unacceptably high (in view of budget considerations, for example) one could select a somewhat less variable dimension (one with a lower SD) which would sacrifice some degree of confidence and precision in favor of lower costs. With regard to the proposed survey, one might, for example, have 1½% precision for body breadth and settle for 2½% precision in the reaches.

The assumption in this approach is that we know what the standard deviation is. In studies of non-disabled individuals it is a simple matter to choose the standard deviation for a particular dimension from a similar population, or from an earlier study of the same population. These do not vary that much, and a good approximation is all that is needed for the formula to be effective. In the case of a population of wheelchair users, however, there is no such reliable resource for which to pluck SD's for given dimensions. A standard deviation from one of the published studies could be used, but all of these are from small or specialized samples that do not represent the entire U.S. population with the full range of disabilities. In the final analysis, however, we would have little choice, since those surveys are all that we have. We would use these values with caution, however, recognizing that they may be inadequate representations of the actual values.

Based on our experiences with anthropometric data collection, we believe that for a pilot study an n of 500 would be adequate. We think that it would show that the techniques are valid, and give a reasonably precise estimate of the mean values for the dimensions in the population, at a reasonable confidence level. A sample larger than 500 would just add to the expenses and the logistic difficulties. As it is, 500 will present some challenges in subject acquisition, but we believe that subject acquisition is potentially such a problem for a full-scale survey, that it is important in a pilot study to explore the magnitude of the problem. A sample smaller than 500 would be easier to collect, of course, but given the large variability in the population, a smaller n might not provide enough precision to form a useful interim database.

The sampling approach described above is a stratified random sample. This is not the only legitimate sampling method available. In Sampling and Data Gathering Strategies for Future USAF Anthropometry, Churchill and McConville (1976) describe simpler sampling strategies that can be perfectly reliable for limited purposes. One such is called a U-shaped sample: "When analysis of a design problem makes it clear that a design which accommodates both small and large men will of necessity accommodate those in between, it makes sense to sample only small and large men. This may be particularly true for arm-reach envelope studies (italics ours), for example, where the sample size is severely restricted because of the considerable time required to obtain the data from each subject. In this case, useful results more than compensate for the difficulties of selecting subjects and obtaining information." The authors suggest also the use of W-shaped samples that add subjects representative of medium sized individuals. In the case of the pilot study described here one might select subjects from the following arm-length categories:

Male Arm Length (thumbtip reach)	Female Arm Length (thumbtip reach)
up to 29"	up to 26.5"
30‒32"	28.5‒29.5"
over 34"	over 31"

Since arm length correlates very well with other linear measurements of the body, such as sitting height, this W-shaped sample is likely to work for the accessibility measurements as well. The choice of a sampling strategy is one of many determinations to be made by the investigator during the planning phase of the proposed survey.

Selection of Variables

Our own review of the ADAAG requirements, plus that of our subcontractor KRW, reveals that the single most needed anthropometric datum, by far, is arm length. Sitting height is also important for drawing up standards listed in the ADAAG, as are some dozen other assorted variables such as grip strength and foot length. Planning and executing even a relatively small anthropometric survey is a costly undertaking and if it is to be done, the addition of a reasonable number of variables for which there will clearly be other uses, such as wheelchair design, will not significantly add to the cost. For this survey we suggest variables that fall into five categories:

basic body size descriptors
reach and functional reach measurements
arm and hand strength measurements
field of vision measurements
wheelchair/user measurements

A tentative list of variables to be measured would be as follows:

A	Acromion height, sitting; arm length (acromion to fingertip); biacromial breadth; buttock-heel length; eye height, sitting; foot breadth; foot length; knee height, sitting; maximum elbow span; sitting abdominal breadth; sitting chest depth; sitting height from chair; weight
B	Reaches: all reaches measured forward, vertically, and out to the side; fingertip reach [toggle switches, buttons]; thumbtip reach [knobs]; grip reach [whole-hand operations]
C	Hand strength [operating equipment]; arm strength [transfers]
D	Field of vision [up, sideways, down]
E	Measurements of chair and user (floor to top of head, side to side, back to front, height to armrest, height to seat) [accessibility]

The two most basic dimensions measured in every non-disabled population are height and weight. Neither of these are used directly in the design of clothing, equipment or workspaces. They are taken for a number of other reasons having to do with comparability of samples and garment sizing indicators. Weight is included here as a recommended dimension because a variety of engineering problems require body weight. Stature (standing height) seems not to be relevant to a population that does not stand, but height to the top of the head while sitting in the wheelchair is potentially useful.

Measuring Techniques

The Body Size Descriptors

These measurements serve as basic population descriptors and are applied in the design of workspaces and the physical environment, as well as the sizing of personal items and equipment. Except for body weight, this group of measurements is made up of simple point-to-point distances in one or another of the principal body axes and some geometrically more complex circumferences and surface contours; they are typically obtained manually using an anthropometer, measuring tape, and a variety of special calipers. Modern technology currently provides alternate ways to obtain accurate and reliable data of this type. Among them are the Faro Arm (Faro Technologies, Inc.) which is a portable coordinate measuring system. It consists of a probe on the end of a 6 degree-of-freedom arm, which is linked to a laptop computer. The user touches the probe on a body landmark, presses a button, and the location of the point in three-dimensional space is recorded automatically in the computer software. Software later allows the calculation of point-to-point distances and other dimensions. Such a device might be useful here because some subjects in the proposed study may not be able to assume the rigid standardized postures often used in traditional anthropometry, and the Faro Arm probe might be able to access some critical body areas difficult to reach in seated subjects.

Reach

For reach and field-of-vision measurements, Air Force methodology is, once more, instructive. Since 1990, investigators at Wright-Patterson Air Force Base have been engaged in testing accommodation of aviators seated in the cockpits of a variety of aircraft. (Kennedy and Zehner, unpublished) In many ways, the problems presented by this project are similar to those faced by the Access Board and by designers of workspaces intended to accommodate wheelchair users. Among the seven major areas of accommodation this long-running AF project is specifically concerned with is "hand reach to, and actuation of, controls."

The functional reach dimensions listed above can all be measured in the traditional way by keeping the back, shoulder, and buttocks against the back of the seat and stretching the arm along a scaled wall chart (to the thumbtip, to the forefinger resting on the pad of the thumb, or the tip of the middle finger). Alternatively, the Faro Arm might be touched to the wall or reference plane (possibly the back of the chair), and then touched to the tip of the finger.

Air Force investigators take arm reach measurements one step farther, in that they measure arm reach in three "zones." Reach Zone 1 requires that the operator's shoulders be fully restrained by harnesses with the pilot held against the seat back by the inertial reel. Zone 2 requires use of the harness, but the operator is free to move his/her shoulders and torso forward and to the sides to a comfortable limit permitted by the total restraint system. Zone 3 specifies that the inertia reel be unlocked and the shoulders and torso permitted to move forward and to the sides as necessary for maximum reaches. Though it is not altogether clear that these kinds of distinctions should be made in conducting reach measurements on people using wheelchairs, there is certainly the possibility that the principle will be relevant.

Field of Vision

This is another area critical to cockpit accommodation. Air Force anthropologists measure maximum upward and downward lines of sight, forward and to the sides using a carpenter's inclinometer fitted with a sight tube to measure visual angle. The sight tube is equipped with cross hairs at each end. An Abney Level can also be used.

Strength

The ability of wheelchair users to operate equipment in work and living spaces depends not only on reach but also on sufficient hand strength to grasp and manipulate controls. The design and placement of grab bars are also guided by strength capabilities, chiefly in the hands and arms. Strength can be measured in a number of ways with pushing, pulling and twisting perhaps the most relevant to the present case. ADAAG standards currently specify that door opening and operation of assorted other control mechanism require no more than 5 pounds of pushing or pulling force, for example. Strain gauges that can be instrumented for direct computer readout, are probably the means of choice for taking these measurements.

Wheelchair/User Measurements

Accommodation and accessibility standards for individuals using mobility aids are worse than useless unless they take into account the wheelchair and its user as a single unit. Measurements from and to the most protruding points, whether they be located on the chair or on the user, are not difficult to make using either traditional manual instruments or a Faro Arm. The difficulty arises in the multiplicity of chairs and scooters on the market today. Investigators undertaking to make such measurements would have to do some research to determine at least the largest of such mobility aids and/or those with the highest seats in order to obtain results useful in creating guidelines for accessibility. One source of such information is a 1995 study (KRW Inc.) conducted for the U.S. Architectural and Transportation Barriers Compliance Board which incorporates a listing of more than 125 models of scooters and power chairs along with their lengths, widths, wheel base lengths, and seat heights.

From a sampling point of view, these chairs are very challenging. Ordinarily, one designs to accommodate a certain percentage of the population, or designs to a specific value (95th percentile forward arm reach, for example). This point is determined not only by the total range of variability, but by the frequency. Thus the relative number of certain chair types is very important. For example if a very large chair were infrequently purchased and used, it would have little effect on the value of the 95th percentile. However, if a very large chair were purchased often, then it would have the effect of raising the 95th percentile, and in turn, changing the design target. Thus it is not enough to know that the range in chair height is 30 to 39 inches. We would need to know the effective numbers of the chairs at various heights in the population of wheelchair users.

This need not be especially complicated, particularly for the pilot study. By measuring people in their chairs, one would automatically get a random sample of the chairs that people buy, in the approximate frequency in which they are seen in the population. In creating the sampling plan and subject acquisition plan, one would exercise caution to make sure that no bias in chair type is introduced. An example of one such bias might be conducting a pilot test in a geographic area where a certain type of chair is more readily available. If it develops in the pilot study that chair variability cannot be accommodated in this way, then the follow-up full study would have to include chair type as a parameter in the sampling plan. This would introduce complexity, however, and should be avoided if at all possible.

Measurer's Handbook

Crucial to achieving the second goal of the proposed survey is the creation of a measurer's handbook that would serve to ensure that future studies produce data that could be used to expand the original database. Such a handbook should include clearly worded definitions of the dimensions measured, detailed descriptions of the methods used to measure them, landmark descriptions would also be included, and illustrations to enhance the measurement descriptions. An example page is shown in Figure 1.

Data Entry

We have found through experience that an online data entry and editing system dramatically reduces the amount of observer error present in the final data set. The system we use was developed for the ANSUR survey and has been used extensively since that time. In this software, measured values are entered into a laptop computer, and are checked for reasonableness as they are entered. A suspicious value is flagged, and can be remeasured while the subject is still available. In this way, many types of measurement error can be reduced. The process is documented in detail in Churchill et al., (1988). We recommend such a system for any data collection effort for a population of wheelchair users.

Establish Allowable Error

Because anthropometric data are used in the design of workspaces, and equipment, excessive error in the data can result in badly designed workspaces and unsuitable products. Observer error is a fact of life in almost any scientific endeavor. Though it cannot be eliminated entirely, it can be considerably reduced.

Error analysis of anthropometric data is usually done after the data collection has been completed. While this gives the user of the data the information necessary to judge the effects of error on his/her use of the data, it does not allow observer error information to be used during data collection to improve the quality of data collection. The approach used in the Army's 1987‒1988 anthropometric survey and the one recommended here was to establish an allowable observer error for each dimension.

Standards for allowable error are established by a team of expert anthropologists conducting repeat measurements of the selected dimensions, and analyzing the inter- and intraobserver differences. Error allowances will differ: larger ones will be established for functional reach measurements, for example, than for breadths which tend, on the whole, to be more easily repeatable.

Allowable errors are used for two purposes. They are first used during the initial training period as an indicator that measurers have successfully learned their tasks. Team members make practice measurements on a group of subjects to learn their assigned dimensions. Intraobserver and interobserver error results are calculated regularly to assess the ability of each measurer to repeat measurements within fixed limitations, and the ability of each pair of measurers to achieve interobserver consistency.

Long-Term Research

As urgency dictates and funds permit, future anthropometric surveys should be undertaken to:

expand the working-adult database created during the pilot study.
expand the over-65 population whose members may well be the most common users of wheelchairs, and who certainly represent the fastest growing demographic sector of US society.
survey an appropriate children's population to keep up with design needs stemming from the trend toward mainstreaming in our schools.

Two other considerations for future study warrant mention: linkage and range-of- joint motion (ROJM) studies useful for the creation of dynamic human modeling software, and compilation of a three-dimensional database of individuals with disabilities obtained by use of scanning equipment.

Digital Human Models

Studies involving the biophysical aspects of wheelchair propulsion involve the anthropometric description of body links . lengths, breadths, and depths of body segments . [sic] that are important to the construction of dynamic computer models. [sic] Based upon concepts usually credited to Dempster (1955), the body is divided into segments defined by the major joint centers of the body. Although the true center of rotation remains unknown for most joints, especially for the more complex joints such as the hip and shoulder, anthropologists measure the length of various links by palpation of bony landmarks surrounding a given joint. For example, the segment called the lower leg link would extend between the center of the lateral malleolus at the ankle and the center of the lateral femoral epicondyle at the knee. While neither of these two points is located precisely at the center of rotation projected to the lateral surfaces of the respective joints, they can be reliably palpated and landmarked. Proceeding similarly, the linkage lengths for an entire body may be marked and measured. Such data can be treated statistically much like any other body size descriptor and when combined with ROJM data can be used to construct a scaled, dynamic computer model. Such models can represent an individual of specific dimension, or can represent whole groups of individuals. Motion around the linkage center is based upon ROJM data incorporated in the model's database. A number of such models are currently available for non-disabled analogues (e.g. JACK, CREWCHIEF, SAFEWORK, and RAMSIS) and some, reportedly, reflect elements of true 3-D motion.

Other physical properties of the whole body and of body segment can also be included in these models. Currently available non-disabled data include the center of gravity of the whole body, as well as its segments. Moments of inertia also are known. This class of measurements is used to estimate body dynamics in response to impact or instability, for example, and have the potential of contributing a great deal to the simulation of auto accidents or other events which would be unethical to investigate with human subjects.

Modeling individuals and their disabilities presents particular problems because the very data which make the models appear realistic (e.g., the range of joint motion, the centers of gravity and moments of inertia for body segments, etc.) are potentially different, and largely unknown, for this population. It is for this reason that collecting such data on this population is of critical importance.

3-D Shape Digitization

Currently in the forefront of measuring methodology for anthropometric studies is 3-D shape digitization. The first such instrument used by the Air Force was a small low- density laser scanner which rapidly passed over the head and face and, in combination with computer graphics software, produced a 3-D digital image on a computer screen. The Air Force, the Army, and NIOSH now all use larger scanners capable of producing 3-D images of the whole body and could digitize volumes large enough to include a positioned wheelchair user (in many, but not all, wheelchair models). Among the advantages of 3-D measurement is that resulting images record not only the size of objects (including the human body) but also their shape. Three-dimensional data from these scanners will also be extremely useful in providing shape to the digital human models. Large quantities of 3-D scan data have not yet been collected on any population (with disabilities or without) so the potential usefulness of the data is largely unexplored.

Capabilities, Resources, and Facilities

Any organization charged with the responsibility of carrying out an anthropometric survey such as the proposal suggested here should have the following capabilities:

a track record for the conduct of reputable research in applied anthropometry.
experience in planning and organizing anthropometric surveys.
hands-on experience with the measurement of all classes of anthropometric dimensions.
hands-on experience with experimental subjects and human use considerations.
experience in the area of field data collection, on-line data editing, and data processing.
experience with data analysis techniques.
experience with human measurement instrumentation.
experience in training measurers and minimizing observer error.
experience in dealing with people with disabilities.
access to an appropriate population.
experience in producing high-quality technical reports.

The resources needed are relatively minimal. Specifically the organization needs to have: 1) computer equipment sufficient to data entry and data storage needs; 2) a variety of appropriate anthropometric equipment; and 3) access to any specialized equipment the survey might require.

No large fixed facility should be required to conduct the proposed study, since it is envisioned that measurement would take place in the field, and once arrangements have been made, test sites at selected and prearranged locations could be established. At most, a temporarily empty room would be required.

It is often useful for long-term budgetary planning to have rough estimates of the cost of a project. We provide such an estimate here, with the proviso that many of the factors which will materially affect the cost of this research program are yet indeterminate. Nevertheless, this estimate may be useful in broad planning exercises.

Our estimate is based on collecting data at three locations, sampling 500 individuals, and three trips to Washington for planning and discussing results. Based on these parameters, we anticipate the pilot study requiring approximately 6 months and in the range of $250,000 to $350,000. Naturally, as various project parameters become more firm, the firmness of the cost estimate would increase as well.

References

Churchill E, and McConville JT (1976) Sampling and Data Gathering Strategies for Future USAF Anthropometry. Technical Report (AMRL-TR−74‒102) (AD A025 240). Aerospace Medical Research Laboratory, Wright-Patterson Air Force Base, OH.

Churchill T, Bradtmiller B, and Gordon CC (1988) Computer Software Used in the U.S. Army Anthropometric Survey, 1987‒1988. Technical Report (TR−88‒045) (AD A201‒185). U.S. Army Natick Research, Development and Engineering Center, Natick, MA.

Damon A, and Stoudt HW (1963) The Functional Anthropometry of Old Men.Human Factors, 5:485‒491.

Dempster WT (1955) Space Requirements of the Seated Operator Geometrical, Kinematic, and Mechanical Aspects of the Body with Special Reference to the Limbs. Technical Report (55‒159) (AD 87892). Wright Air Development Center, Air Research and Development Command, Wright-Patterson Air Force Base, OH.

Gordon CC, Bradtmiller B, Clauser CE, Churchill T, McConville JT, Tebbetts I, and Walker RA (1989) 1987‒1988 Anthropometric Survey of U.S. Army Personnel: Methods and Summary Statistics. Technical Report (TR−89‒044). U.S. Army Natick Research, Development and Engineering Center, Natick, MA.

Goswami A, Ganguli S, and Chatterjee BB (1987) Anthropometric Characteristics of Disabled and Normal Indian Men. Ergonomics, 30(5):817‒823.

Kennedy KW, and Zehner GF (forthcoming Technical Report). Anthropometric Accommodation in Aircraft Cockpits: A Methodology for Evaluation. Armstrong Laboratory, Wright-Patterson Air Force Base, OH.

KRW, Incorporated (1995) Requirements for Power Mobility Aids. Final Report (Contract No. QA94001001). The U.S. Architectural and Transportation Barriers Compliance Board.

Kumar, S (1997) Perspectives in Rehabilitation Ergonomics. Pennsylvania: Taylor and Francis, Inc.

Molenbroek JFM (1987) Anthropometry of Elderly People in the Netherlands; Research and Applications.Applied Ergonomics, 18(3):187‒19

Sanford (1996) A Review Technical Requirements for Ramps, Task 5: Executive Summaries and References). Final Report (Contract # QA930020). U.S. Architectural and Transportation Barriers Compliance Board.

Stoudt H, Damon A, McFarland, and Roberts J (1965) Weight, Height, and Selected Body Dimensions of Adults, United States, 1960‒1962. Public Health Service Publication 1000-Series 11, No. 8. US Government Printing Office: Washington, DC.

Appendix: Revised Annotated Bibliography

ANTHROPOMETRY FOR PEOPLE WITH DISABILITIES

prepared by
Shirley Kristensen
Bruce Bradtmiller, Ph.D.
Anthropology Research Project, Inc.
PO Box 307
Yellow Springs, OH 45387

PREFACE

This document is the final report of Task 1 of the "Anthropometric Research Review" undertaken by Anthropology Research Project, Inc. (ARP) for the U.S. Architecture and Transportation Barriers Compliance Board, and administered by the U.S. Department of Education under Contract No. QA96001001. The authors thank David Yanchulis, Research Coordinator at the Barriers Compliance Board, or his cooperation and support. They are grateful, also, for the many hours of painstaking work by ARP staff members Belva Hodge, Ann Lisa Piercy, and Ilse Tebbetts in indexing, editing, and producing this annotated bibliography. Special thanks to Luan Heit for her thorough and meticulous editing job.

ANNOTATED BIBLIOGRAPHY: ANTHROPOMETRY FOR PEOPLE WITH DISABILITIES

INTRODUCTION

With passage of the Americans with Disabilities Act (ADA) of 1990, the rights of Americans with disabilities to work, travel, and do business in all public facilities were legally recognized. Barriers that had previously prevented people with disabilities from gaining access to offices, schools, airports, libraries, and courthouses, to name but a few, began to come down thanks to the codification of ADA Accessibility Guidelines (ADAAG). These guidelines, intended to provide the basis of design standards for living and working spaces that would accommodate people with disabilities, particularly wheelchair users, were largely based on the results of anthropometric research in human body size and reach obtained in the 1960s and 1970s.

ADAAG standards no longer suffice to ensure the accessibility they were meant to provide for a number of reasons. For one thing, many of the original standards were, in all likelihood, based on seated measurements of adults without disabilities. This model no longer defines today's population of persons with disabilities. With advances in medicine and rehabilitation techniques, and the rapid proliferation of technology, increasing numbers of persons with a wide variety of disabilities have entered the mainstream of American life. We are also living longer and, in many ways, the needs of a swelling older population intent on maintaining independence mirror the needs of people with disabilities.

Perhaps as a result, a considerable amount of research on the size, shape, and functional capabilities of persons with disabilities has taken place in the last decade. A number of the studies in this bibliography include comparative research that makes it clear that the anthropometry of people without disabilities simply does not reflect the size, reach, and strength data of persons with disabilities and the elderly.

Most of the entries on the following pages describe recent anthropometric studies. Most of them provide measurement data obtained from specifically persons with disabilities and/or elderly subjects. Many are concerned with applications of anthropometry to the design of equipment, workplaces, or public facilities. The entries are categorized in a general way, and indexed by author to provide maximum usability.

BASIC ANTHROPOMETRY

1. Brown, R., Rogers, N., Ward, J., Wright, D. and Jeffries, G., 1995
The Application of an Anthropometric Database of Elderly and Disabled People
Biomedical Sciences Instrumentation, 31:235‒239.

This paper reports on the development of an anthropometric database of elderly and people with disabilities for use by designers of consumer products and rehabilitation engineers. A review of existing anthropometric databases indicates that there is a serious lack of data for these populations, particularly dynamic data. The computer database under development by the authors will focus chiefly on dynamic anthropometry of the elderly and persons with disabilities. The data will be collated from new and existing studies, and will include clinical data specific to individual impairments. Measurement techniques will be standardized and documented. The database will be made compatible for use in computerized human analogues.

2. Chumlea, W.C., Guo, S.S. and Steinbaugh, M.L., 1994
Prediction of Stature from Knee Height for Black and White Adults and Children with Application to Mobility-Impaired or Handicapped Persons
Journal of the American Dietetic Association, 94(12):1385‒1388, 1391; quiz 1389‒1390.

No adequate methods exist for predicting stature to help assess the growth of handicapped (including mobility-impaired) children or to help in developing indexes of obesity or equations for estimating basal energy expenditure for adults. In this project, equations were developed to predict stature in white and black adults and children from nationally representative samples, for application to mobility-impaired and handicapped persons. Representative samples of adults without disabilities (n=5,415) and children (n=13,821) were selected from cycles I, II, and III of the National Health Examination Survey (NHES) conducted by the National Center for Health Statistics from 1960 to 1972. NHES-measured variables appropriate for predicting stature (e.g., stature, sitting height, knee height, and buttock-to-knee length) were used in equations designed to select a prediction variable. Knee height best predicted stature for white and black men, but the predictor variables for white and black women were knee height and age. For predicting stature in children 6 to 18 years of age, the predictor variable was knee height for all children. The equations presented here were developed for use with persons having mobility impairments or other disabilities, but the measurements were collected from ambulatory people by means of standard techniques. The use of recumbent anthropometric data from these populations in the equations will expand the errors of prediction over those presented in this report.

3. Chung, K. and Weimar, W., 1989
Anthropometric Studies for the Physically Disabled Population - Vol. II, Spinal Cord Injury
University of Virginia, Rehabilitation Engineering Center, Charlottesville, VA, Report No. UVA-REC 102‒89.

The purpose of this study was to provide disability-specific anthropometric information that can be used by designers of devices for individuals with physical disabilities. This volume focuses on wheelchair-bound subjects with spinal cord injuries. A number of anthropometric measurements were made on some 32 paraplegic and quadriplegic men and women seated in their wheelchairs. Findings were compared with comparable available data obtained from subjects without disabilities. Resulting analysis showed marked differences between the two groups C a clear indication that, in general, the information from people without disabilities is not directly applicable as design parameters for the majority of people with disabilities. Eighteen additional anthropometric parameters, specifically related to the needs of people with disabilities, were identified in this study, and measurement techniques and presentation methods developed. These additions are, in general, the result of body asymmetries caused by deformities to the lower extremities, pelvis, and spine. Tables and charts provide information that can be used as guidelines for the design or adjustability of equipment used by people with disabilities. Data collected include: sitting height, acromion height (maximum) and l-r difference, elbow height (maximum) and l-r difference, back-plane-to-under-knee (maximum) and l-r difference, leg length (maximum) and l-r difference, ground-to- top-of-knee (maximum) and l-r difference, ground-to-heel (maximum) and l-r difference, knee width, shoulder width, chest width at axilla, waist width, hip/pelvic width, foot length, elbow-to-knuckle, angle of back surface, angle of seat surface, angle of leg surface (maximum) and l-r difference, and angle of foot (maximum) and l-r difference.

4. Damon, A. and Stoudt, H.W., 1963
The Functional Anthropometry of Old Men
Human Factors, 5:485‒491.

Means, standard deviations, and percentiles are presented for 47 functional measurements of 133 ambulatory Spanish-American War veterans with a mean age of 81.6 years and an age range from 72‒91 years. Practical applications of the data are noted. Compared with younger men, the veterans were smaller, lighter, weaker, and had shorter reaches but deeper chests. Their skinfolds did not differ. Data collected: weight, stature, erect sitting height, normal sitting height, sitting trunk height, sitting knee height, sitting popliteal height, span, span akimbo, forward arm reach, shoulder-elbow length, elbow-middle finger length, buttock-popliteal length, buttock-knee length, head length, face length, nose length, ear length, hand length, foot length, biacromial breadth, bideltoid breadth, chest breadth, sitting elbow-to- elbow breath, bi-iliac breadth, sitting hip breadth, sitting knee-to-knee breadth, head breadth, face breadth, nose breadth, ear breadth, hand breadth, foot breadth, chest depth, abdominal depth, resting chest circumference, inspired chest circumference, expired chest circumference, waist circumference, upper arm circumference, right and left calf circumferences, head circumference, triceps skinfold (mm), and subscapular skinfold (mm).

5. Das, B. and Kozey, J., 1994
Structural Anthropometry for Wheelchair Mobile Adults
International Ergonomics Association, Volume 3: Rehabilitation, 63‒65.

The purpose of this study was to develop a reliable and accurate anthropmetric database of paraplegic adults in wheelchairs. Data were collected on 42 males and 20 females. The dimensions recorded indicate that designs based on individuals without disabilities would not be suitable for this population. Data collected: seated stature; eye, shoulder, forearm, knee, toe, and maximum reach height; overhead, normal, and maximal reach; radial and overall arm length; trunk depth, and bideltoid and acromion width.

6. Gordon, C.C., Bradtmiller, B., Churchill, T., Clauser, C.E., McConville, J.T., Tebbetts, I.O., and Walker, R.A., 1989
1988 Anthropometric Survey of U.S. Army Personnel: Methods and Summary Statistics
Technical Report NATICK/TR−89/044, U.S. Army Natick Research, Development and Engineering Center, Natick, MA.

Results of the 1987‒1988 anthropometric survey of U.S. Army personnel are presented in this report in the form of summary statistics, percentile data and frequency distributions. These anthropometric data are presented for a subset of personnel (1,774 men and 2,208 women) sampled to match the proportions of age categories and racial/ethnic groups found in the active duty army of June 1988. Dimensions given in this report include 132 standard measurements, 60 derived dimensions, and 48 head and face dimensions reported in traditional linear terms but collected by means of an automated headboard designed to obtain three- dimensional data. Measurement descriptions, visual indices, and a glossary of terms are included to help identify and locate dimensions. Also appearing in this report are descriptions of the procedures and techniques used in this survey. These include explanations of the complex sampling plan, computer editing procedures, and strategies for minimizing observer error. Tabular material in Appendices A and C are designed to help users understand various practical applications of the dimensional data, and to identify comparable data obtained in previous anthropometric surveys.

7. Goswami, A., 1997
Anthropometry of People with Disability
In Shrawan Kumar, (Ed.), Perspectives in Rehabilitation Ergonomics, Taylor and Francis LTD, Bristol, PA.

The author extensively documents a series of anthropometric surveys conducted on a variety of groups with disabilities. Variables included body size variables as well as strength, reach, and mass measurements. A consensus finding among the studies is that body dimensions of persons with disabilities are smaller than those of persons without disabilities except for dimensions of the shoulder region. While a considerable body of anthropometric data has been measured on populations with disabilities, the variation in techniques, terminology, and the dimensions measured in different studies is a considerable drawback in using this body of knowledge in any organized way. Not a single study could be found which had made an attempt to standardize the landmarks and measurements. Available studies have either used the definitions of the measurement applicable to persons without disabilities or have devised a new variable. The author concludes that the anthropometric investigation reported on persons with disabilities is in no way sufficient to form a common pattern for various design applications

8. Goswami, A., Ganguli, S. and Chatterjee, B.B., 1987
Anthropometric Characteristics of Disabled and Normal Indian Men
Ergonomics, 30(5):817‒823.

This article describes a preliminary study of the anthropometric characteristics of Indian men with disabilities, undertaken in order to facilitate the design of mobility aids. Fourteen anthropometric measurements were made on 61 men with disabilities of the lower extremities caused by poliomyelitis or spinal cord injury, and on 140 men without disabilities. The study reports reduced growth of the affected parts and also some acquired deformity in the upper limbs. Intercorrelations between the body dimensions were different in people with and without disabilities. Data collected: age, weight, stature, acromial height (sitting), elbow rest height (right), popliteal height (right), buttock-knee length, buttock popliteal length, arm grasp (maximum), arm reach from wall, elbow-to-elbow breadth, hip breadth, hand breadth at thumb, and hand thickness at metacarpal III.

9. Hobson, D.A. and Molenbroek, J.F.M., 1990
Anthropometry and Design for the Disabled: Experiences with Seating Design for the Cerebral Palsy Population
Applied Ergonomics, 21(1):43‒54.

The purpose of this study was to examine briefly why the anthropometric needs of individuals with disabilities may be different from individuals without disabilities, and to develop an anthropometric data resource that can be used in the design of seating and mobility devices for a population with a specific disability. Ninety-four variables were obtained from each subject in a sample of 133 cerebral palsied individuals. Both qualitative and quantitative factors were assessed and measured. The qualitative factors are used to define the unique characteristics of the sample group. Twenty quantitative variables are analyzed and the results presented in a tabular format. Eleven of the 20 variables are not available from existing anthropometric sources, but were deemed important for use in the design process for the study population. The paper references a supplementary manual that contains the complete results, including descriptive statistical tables and scattergram plots. The paper also discusses the implications for application of the results, possible limitations of their use, and precautions that should be observed when considering extrapolations to other populations of people with disabilities. Data collected include: sitting height, back plane to back of head, buttock to popliteal, difference in left and right buttock to popliteal, lower leg length, foot length, shoulder breadth, chest breadth, waist breadth, hip breadth, knee width, occipital protuberance to center line, acromial height, difference in left and right shoulder height, body breadth, knee breadth midpoint to center line, buttock to patella, knee height, elbow height, knee clearance, recline angle, seat to back angle, seat plane angle, seat/legrest angle, and legrest/footrest angle.

10. Hobson, D.A., Shaw, C.G., Monahan, L. and McLaurin, C.,1987
Anthropometric Data for Design of Specialized Seating and Mobility Devices: A Preliminary Report
RESNA 10th Annual Conference, San Jose, CA, 480‒482.

The purpose of the project described here was to obtain critical anthropometric data that can be used by designers for improving the quality of body support in wheelchairs and other mobility devices for people with disabilities. This has been made necessary because existing data from the non-disabled population is often inappropriate for designing for people with disabilities. To date, approximately 140 subjects of various ages and common disabilities have been measured at both the University of Virginia and the University of Tennessee Rehabilitation Engineering Centers. The data collected have been analyzed for 12 variables considered to be of immediate interest. The initial results, although not sufficiently representative of the complete population of persons with disabilities, illustrate the differences between people with and without disabilities in terms of critical body dimensions. Data collected: weight, sitting height, thigh length, shoulder width, chest width, and hip width. Dimensions on subjects with disabilities only: knee to heel length, shoulder to knuckle length, hip angle, and recline angle.

11. Jarosz, E., 1996
Determination of the Workspace of Wheelchair Users
International Journal of Industrial Ergonomics, 17:123‒133.

The aim of this study was to obtain anthropometric data of adult wheelchair users. A sample of 101 men and 69 women with impairments in the lower extremities requiring the use of a wheelchair were tested. Eighteen anthropometric dimensions were measured in the sitting position. The results of the study constitute a set of basic anthropometric data for the design of workstations and home interiors for this group of users. These data can also be used by wheelchair designers. The graphic method used for determining maximum extremity reaches showed that the workspace accessible to this population was smaller than that available to the population without disabilities, and this should be taken into account when designing devices and machines for all users (people with and without disabilities). Data collected: stature; eye, shoulder, elbow, knee, and popliteal height; trunk and popliteal depth; thigh thickness; shoulder and hip breadth; maximum elbow span; arm overhead reach; arm reach forward; arm reach down; lateral reach; and arm span.

12. Laubach, L.L., Glaser, R.M. and Suryaprasad, A.G., 1981
Anthropometry of Aged Male Wheelchair-Dependent Patients
Annals of Human Biology, 8(1):25‒29.

A number of anthropometric dimensions, including stature, weight, circumferences, estimated body fat from skinfolds, and handgrip strength, were measured on a sample of 33 male wheelchair-dependent Veterans Administration patients. These patients had a mean age of 71.2 years, had been wheelchair-dependent for a mean of 5.2 years, and had various disabilities. When the anthropometric dimensions for these wheelchair-dependent patients were compared with those previously reported for ambulatory veterans of similar age, similarities in stature, total body fat percentage, and limb circumference were found. In contrast, the wheelchair- dependent individuals tended to have smaller upper body skinfolds, and greater body weight, trunk circumferences, lower body skinfolds, and handgrip strength. These differences may be due in part to the biomechanics of wheelchair locomotion and the rather sedentary lifestyle of many wheelchair users. Data collected: sitting height; stature, predicted; weight; circumferences of chest, waist, flexed biceps, flexed forearm, and calf; skinfolds of triceps, biceps, subscapular, suprailiac, and calf; body fat, predicted; and grip strength.

13. McFarland, R.A., Domey, R.G., Duggar, B.C., Crowley, T.J. and Stoudt, H.W., 1968
An Evaluation of the Ability of Amputees to Operate Highway Transport Equipment
Vocational Rehabilitation Administration, Final Report, RD−592.

The purpose of this study was to provide objective data to those concerned with the regulation of commercial drivers that may assist them in reaching decisions based on factual information about the accident experience and driving ability of persons with and without disabilities. This research was conducted in three phases: a literature search, a survey of the driving records of known amputees in Massachusetts, and an experimental analysis of simulated driving performance of the physically impaired. Performance data were obtained for three groups of drivers: 20 non-commercial non-amputees, 20 commercial non-amputees, and 60 amputees. Results showed no evidence that orthopedically-impaired persons have greater accident frequencies than do unimpaired drivers. In performance tests, commercial non-impaired drivers performed better than impaired drivers; amputees performed as well as or better than non-impaired, non-commercial drivers. Anthropometric variables measured on all subjects in this study included: weight; stature; span; anterior arm reach; span akimbo; grip strength; lengths: buttock- knee, elbow-middle finger, face, foot, hand, head, nose, radius, shoulder-elbow, tibia, and upper arm; breadths: ankle (l, r), biacromial, bideltoid, biiliac, bitrochanteric, chest, elbow-elbow, femur (l, r), foot, hand at metacarpale and at thumb, head, hip, humerus (l,r), knee-to-knee, nose, tibia (l, r), and wrist (l,r); chest and abdomen depth; circumferences: abdomen (umbilicus), ankle (l,r), biceps (l,r), calf (l,r), chest (normal, maximum, minimum), forearm (l,r), head, shoulder, thigh (l,r), upper arm, and wrist (proximal), (l,r); heights: eye, head, knee, sitting (normal and erect), shoulder, and trunk; diameters: bigonial, bizygomatic, and minimum frontal; skinfolds: knee, subscapular, suprailiac, thigh, and triceps.

14. Molenbroek, J.F.M., 1987
Anthropometry of Elderly People in the Netherlands; Research and Applications
Applied Ergonomics, 18(3):187‒199.

Twenty-five functional body dimensions of 822 elderly people in The Hague, Netherlands, were measured using methods based on international standards. The results were used to compile a set of ergonomic recommendations and are being implemented in an existing CAD-model called ADAPS. This paper presents and discusses the findings of the investigation, and compares them with the English results from Loughborough and with the German DIN 33402. There were no major differences between the Dutch data for stature and weight and data obtained from the elderly in the UK and Germany, although differences did appear among younger people. Data collected: body weight, standing; stature, standing; eye height, standing; reach height, standing; elbow-fingertip length; hand length; hand breadth (metacarpal); shoulder breadth (bideltoid); elbow-to-elbow breadth; hip breadth; sitting height; cervical height; back plane to C7; back plane to sacrum; shoulder height; eye height; body depth; reach height, sitting; elbow-rest height; thigh clearance; buttock-popliteal depth; popliteal height, sitting; heel height; fist height; and palm height, standing.

15. Nowak, E., 1997
Anthropometry for the Needs of Disabled People
In Shrawan Kumar, (Ed.), Perspectives in Rehabilitation Ergonomics, Taylor and Francis LTD, Bristol, PA.

This article describes basic types of anthropometric measurements that can be of use in meeting the needs of people with disabilities, and documents a number of studies in which anthropometric data on a variety of variables have been obtained from elderly or persons with disabilities. The author emphasizes the numerous anthropometric differences that exist between populations of persons with and without disabilities in terms of size, reach, and range of joint motion. He also discusses the applications of anthropometry in designing living interiors, workspaces, handrails, seats, and other products for the elderly and persons with disabilities.

16. O'Brien, S.J., 1989
Anthropometric Alterations in the Aged
In Harris, R. and Harris, S., (Eds.), Physical Activity, Aging and Sports, Volume I, Scientific and Medical Research, Center for the Study of Aging, Albany, NY, 389- 398.

This paper reviews some of the pioneer and contemporary anthropometric literature on older human populations with respect to the following parameters: height, weight, girths and circumferences, somatotype, and body composition. In addition, certain factors relating to longevity, such as food intake and exercise, are identified.

17. Steenbekkers, L.P.A. and van Beijsterveldt, C.E.M., (Eds.), 1998 (projected)
Aging Users and Product Design: A Dutch Survey of Design Relevant Data
Delft University Press, Delft, Netherlands.

Six hundred elderly persons were measured for a number of physical, sensory, and cognitive variables. The results were compared with comparable data obtained from younger people, ages 20‒30 years. The data include anthropometry, joint motion, and reach envelopes.

18. Stoudt, H.W., 1981
The Anthropometry of the Elderly
Human Factors, 23(1):29‒37.

The elderly, arbitrarily defined as those 65 years and above, are a distinct subgroup with special human factors needs. They are significantly smaller in stature and in many other body dimensions than the general population. This smaller size results both from the secular trend (people are currently growing taller and larger than in the past) and from various biological changes inherent in the aging process. Weight and certain other dimensions are less age-affected, however, except at more advanced ages. Existing information on the anthropometry of the elderly is reviewed, and tabular data are presented on selected "human engineering" dimensions. Additional, more comprehensive, functional anthropometric data are needed for this population.

19. Ward, J.S. and Kirk, N.S., 1967
Anthropometry of Elderly Women
Ergonomics, 10(1):17‒24.

Anthropometric dimensions of 100 elderly Birmingham, England women, measured in 1964, are compared with similar dimensions measured by Roberts in 1960 on elderly women in the Home Counties. The authors conclude that, from a practical design viewpoint, the body dimensions of both groups of subjects are similar. Data collected: standing shod stature, shod eye height, shod shoulder height, shod elbow height, shod vertical upward reach, seated seat to elbow, seat to vertex, seat to eye, seat to shoulder, sacral plane to popliteal angle, shoulder width, back of shoulder to pencil clasped in fist, and shod popliteal height from floor.

MEASURING TECHNIQUES

20. Chumlea, W.C. and Roche, A.F., 1984
Nutritional Anthropometric Assessment of Non-Ambulatory Persons Using Recumbent Techniques
American Journal of Physical Anthropology, 63:146 (abstract).

This report provides methodology for collecting "recumbent anthropometry" so as to remove the effects of a subject's mobility status. Techniques for the following recumbent measurements are presented: arm and calf circumference; elbow and bicristal breadths; skinfolds at the triceps, biceps, subscapular, midaxillary, and lateral calf locations; and knee height. These measurements were selected because of the frequent usage of many of the corresponding standing measurements in nutritional assessments, and studies of growth and body composition and their reportedly significant associations with estimates of body fatness. Means and standard deviation values for corresponding measurements collected in either a standing or recumbent position, and inter-observer errors, are very similar. By using these recumbent measurements, accurate anthropometry can be collected from nonambulatory persons.

21. Chumlea, W.C., Roche, A.F. and Mukherjee, D., 1987
Nutritional Assessment of the Elderly Through Anthropometry
Ross Laboratories, Columbus, OH, Document No. P527 .

Anthropometric reference data for children and adults, published by the National Center for Health Statistics, are widely used. However, no similar set of reference data is available for persons aged 75 years and older. Furthermore, national reference data have not been established for measurements taken in the recumbent position, although such positioning is commonly necessary with the elderly. To fill this gap, data were collected from 199 men and 150 women aged 62 to 104 years. All subjects were ambulatory Caucasian residents of several institutions in Ohio. Data were collected on 16 nutritional anthropometric measurements: (1) stature, (2) weight, (3) thigh length, (4) knee height, (5) wrist breadth, (6) elbow breadth, (7) mid-arm circumference, (8) thigh circumference, (9) calf circumference, (10) lateral calf skinfold, (11) front of the thigh skinfold, (12) paraumbilical skinfold, (13) midaxillary skinfold, (14) biceps skinfold, (15) triceps skinfold, and (16) subscapular skinfold. All but the first two measurements were taken on subjects in the recumbent position. Analysis of the data revealed that seven of these measurements (1, 2, 4, 7, 9, 15, and 16) are useful indicators of nutritional status in this sample. In addition, four computed measurements (stature from knee height, weight from anthropometry, weight/stature squared, and midarm muscle area) provide useful data for this group. These 11 measurements are recommended for assessing the nutritional status of the elderly.

22. Das, B. and Kozey, J.W., 1994
A Computerized Potentiometric System for Structural and Functional Anthropometric Measurements
Ergonomics, 37(6):1031‒1045.

A prototype computerized potentiometric system was developed for structural and functional anthropometric measurements. The system uses four potentiometric units, a power supply unit, and computer with analog/digital converter to measure the position of a movable stylus in three (X, Y, Z) dimensions. The system is easy to use, more accurate, and more cost-effective than other existing systems. It was found to be accurate for the intended application, faster than the manual methods available, and much less expensive than the photographic and opto-electric systems currently available. A portable version of the system is envisioned for use in the industrial setting.

23. Duncan, P.W., Weiner, D.K., Chandler, J. and Studenski, S.,1990
Functional Reach: A New Clinical Measure of Balance
Journal of Gerontology: MEDICAL SCIENCES, 45(6):M192‒197.

A new clinically accessible measure of balance, functional reach (FR), is the difference between arms length and maximal forward reach, using a fixed base of support. The purposes of this study were to (1) establish FR as a measure of the margin of stability versus the laboratory measure, center of pressure excursion (COPE); (2) test reliability and precision; and (3) determine factors that influence FR, including age and anthropometry. FR was evaluated in 128 subjects, ages 21- 87. It was measured with a precise electronic device and a simple yardstick. FR correlates well with COPE and is a precise and stable measurement. It was found to be influenced by age and height. FR is portable, inexpensive, reliable, precise, and a reasonable clinical approximator of the margin of stability. FR may be useful for detecting balance impairment and change in balance performance over time, and in the design of modified environments for impaired older persons. Dimensions measured and reported: height, weight, right arm length, right foot length, stance width, and functional reach. Dimensions measured but not reported: range of motion, right elbow and shoulder; trunk length; acromial height; and anterior foot length.

24. Jarzem, P.F. and Gledhill, R. B., 1993
Predicting Height from Arm Measurements
Journal of Pediatric Orthopedics, 13(6):761‒765.

Height data are required to standardize measures of physical capacity (e.g., pulmonary function), and to adjust drug dosage for persons with disabilities. To estimate height in wheelchair-bound patients, the authors examined the relation of four different upper extremity measurements to height in 119 individuals without disabilities aged 24.5‒56 years. Regression analysis was performed for each of the following: (1) interacromioclavicular distance, (2) upper arm, (3) lower arm (cubit), and (4) arm span-with height. Correlation coefficients of .937, .967, .975, and .989, respectively, were obtained for upper and lower arm measurements. Authors concluded that height can be predicted reliably from arm measurements.

25. Loebl, W.Y., 1967
Measurement of Spinal Posture and Range of Spinal Movement
Annals of Physical Medicine, IX(3):103‒110.

This paper describes a new, simple method for accurate clinical measurement of spinal posture and movements, and the first results of measurements in health and certain diseases. A simple instrument has been designed to indicate the incline of any portion of the spine and its relationship to the vertical. This provides a method of recording the posture of the spine, and by remeasuring in full flexion and full extension, it will record the range of movement in any portion of the spine. The method's accuracy and reproducibility were investigated. Spinal posture and movement were recorded in 176 adults without disabilities aged 15 to 84 years. The upper dorsal incline and the dorsal curvature were found to increase with age. Women under 40 years of age were about five degrees straighter than men, but after the age of 40 they became equally flexed. The dorsal spine in young adults is capable of an average of 35 degrees of flexion and extension; this decreases with age. Only five degrees of this movement, on average, is used in maximal respiratory excursions. In the lumbar spine the decrease in range of flexion and extension with age is readily demonstrated. Lumbar curvature in full extension has a fairly uniform limit. The clinical implication of the relationship between lumbar curvature and range of extension in patients with fixed flexion deformity of the hip are discussed. The findings in 38 rheumatoid patients and in 15 patients with ankylosing spondylitis are presented.

26. Nichols, P.J.R., Morgan, R.W. and Goble, R.E.A., 1966
Wheelchair Users -- A Study in Variation of Disability
Ergonomics, 9(2):131‒139.

This paper describes a method of studying the variation of space requirements between different wheelchair users. Twenty wheelchair patients performed five tasks involved in opening a door (toward and away from them), passing through the doorway, and closing the door. Their space requirements were analyzed statistically according to their functional disability, and the variations between groups of patients were calculated. Variations between wheelchair measurements accounted for half the variation among patients. Allowing for this and observer errors, it was not possible to bring the standard deviation much below 4 in. Variations also depended on the difficulty of the task, but different patients found different tasks more difficult. Although there is some correlation between skill and functional disability, psychological factors also played a large part in the few patients who did badly. While this experiment furnishes no direct information about space requirements of wheelchair users, it establishes a possible technique for such experiments. The problems involved in sampling patients for further experiments are discussed.

27. Nowak, E., 1996
The Role of Anthropometry in Design of Work and Life Environments of the Disabled Population
International Journal of Industrial Ergonomics, 17:113‒121.

This article describes several ways in which standard anthropometric methods can be adopted for use by workspace and clothing designers for people with disabilities. Work space can be defined as Maximum Transverse Reach and Maximum Sagittal Reach, which can be determined using several anthropometric measurements. Clothing designed for people with disabilities requires special construction that is based on anthropometric measurements. Data collected: stature, trunk depth, arm overhead reach, arm reach forward, and lateral reach.

28. Nowak, E., 1992
Practical Application of Anthropometric Research in Rehabilitation
International Journal of Industrial Ergonomics, 9:109‒115.

Range of motion (ROM) measurements on the arm, leg, hand, foot, and head were made on a sample of 406 men and 454 women without disabilities, aged 18 to 65, to provide a basis for assessing motor efficiency of patients with disabilities undergoing rehabilitation. ROM measurements were made using a set of measuring devices designed and built at the Institute of Industrial Design in Warsaw, Poland. The instruments and methods described are useful for evaluating ROM deterioration and improvement in patients with disabilities.

29. Ward, J., Rogers, N., Brown, R. , Jeffries, G. and Wright, D., 1995.
Techniques in Anthropometry Applied to Disabled and Elderly Populations
Biomedical Sciences Instrumentation, 31:281‒285.

Authors discuss the requirements of anthropometric and biomechanical data for specific application to the design of assistive devices and other products for the elderly and people with disabilities, including body size, shape, range of motion and strength data, and analyze the practical and statistical problems involved in the collection of data from such populations. They review a range of available measurement techniques, including manual, mechanical, optical, and electronic systems, and discuss their relative fitness for the task in question. The authors propose an approach to the collection of multivariable biomechanical data from the analysis of various tasks, and discuss the issue of computer models and other means of interpreting such data to make it available to product designers and engineers.

RANGE OF MOTION AND REACH

30. Becker, J.C. and Thakor, N. V., 1988
Study of Range of Motion of Human Fingers with Application to Anthropomorphic Designs
IEEE Transactions on Biomedical Engineering, 35(2):110‒117.

The human hand serves as a model for anthropomorphic manipulators and prosthetic devices. In order to better guide the design of these devices, a study of the range of motion of human fingers is presented. The role of tendons in the actions of human fingers is modeled, and results of experimental studies on the range of motion of fully functioning fingers are presented. Further study of persons with hand disabilities reveals constraints imposed by deficient tendon mechanisms. The basic investigation of persons with and without hand disabilities guide the design of tendon-based actuators for mechanized fingers. The design of a prototype finger, actuated by a shape-memory alloy material serving as a tendon, is discussed.

31. Chari, V.R. and Kirby, R.L., 1986
Lower-Limb Influence on Sitting Balance While Reaching Forward
Archives of Physical Medicine and Rehabilitation, 67:730‒733.

To test the hypothesis that the lower limbs contribute to sitting balance when a person reaches forward, investigators measured the limits of forward reach in 20 volunteers without disabilities. While sitting on the buttocks alone (ischial support) or with the thighs also supported, and with both feet on, one foot off, or both feet off the floor, each subject reached as far forward as possible at table height at 0E, 15E, 30E, and 45E to the sagittal plane. With full thigh support, the reaches at all angles were greatest with both feet on the floor, and decreased progressively with one foot off (when reaching toward the foot off the floor) and both feet off. Thigh support permitted significantly greater reach than ischial support alone at all angles with both feet off the ground, but not in other conditions. These results have implications for seat design, and when considering prostheses for patients unlikely to walk. Data collected: age, height, weight, single arm span, and forward reach angle.

32. Curtis, K.A., Kindlin, C.M., Reich, K.M. and White, D.E., 1995
Functional Reach in Wheelchair Users: The Effects of Trunk and Lower Extremity Stabilization
Archives of Physical Medicine and Rehabilitation, 76:360‒367.

The purpose was to compare the effects of using trunk and lower extremity stabilization on sitting trunk mobility and functional reach of wheelchair users. Seven paraplegic subjects and nine control subjects without disabilities participated in this study. Each subject's functional reach in the transverse and sagittal planes were video-recorded in each of three conditions: (1) without a belt, (2) with a neoprene chest belt, and (3) with a webbing thigh belt. The area circumscribed by each subject's functional reach under each condition was processed using the Motion Analysis Expert Vision Flextrak program. Functional reach in each belting condition was compared within each subject and between controls without disabilities and subjects with high and low thoracic levels of paraplegia. This study showed that in the sagittal plane, subjects with both high and low thoracic levels of paraplegia were able to substantially increase the area of their functional reach when using a chest belt compared with the thigh belt or no-belt condition. However, in the transverse plane, only those individuals with lower thoracic paraplegia (T8 to L1) gained substantial benefit from chest strapping. In contrast, control subjects without disabilities gained no benefit in functional reach from either belting condition. These results demonstrate that wheelchair users with motor levels L−1 and above who use a chest belt gain a distinct advantage in functional reach.

33. Curtis, K.A., Roach, K.E., Applegate, E.B., Amar, T., Benbow, C.S., Genecco, T.D. and Gualano, J., 1995
Reliability and Validity of the Wheelchair User's Shoulder Pain Index (WUSPI)
Paraplegia, 33:595‒601.

Many long-term wheelchair users develop shoulder pain. The purpose of this study was to examine the reliability and validity of the Wheelchair User's Shoulder Pain Index (WUSPI). This 15-item functional index was developed to assess shoulder pain during transfers, self care, wheelchair mobility and general activities of wheelchair users. To establish test-retest reliability, the index was administered twice in the same day to 16 long-term wheelchair users, primarily male athletes, and their scores for the two administrations were compared by intraclass correlation. To establish validity, the index was administered to 64 long-term wheelchair users and scores were compared with shoulder range of motion measurements. Results showed that test-retest reliability of the total index score was high (0.99). There were statistically significant negative correlations of total index scores to range of motion measurement of shoulder abduction, flexion, and shoulder extension, indicating that there is a significant relationship of total index score to loss of shoulder range of motion in this sample. The WUSPI shows high levels of reliability and internal consistency, as well as a significant relationship with loss of shoulder range of motion. As a valid and reliable instrument, this tool may be useful to both clinicians and researchers in documenting baseline shoulder dysfunction and for periodic measurement in longitudinal studies of musculoskeletal complications in wheelchair users.

34. Floyd, W. F., Guttmann, L., Noble, C. W., Parkes, K.R. and Ward, J., 1966
A Study of the Space Requirements of Wheelchair Users
Paraplegia, 4(1):24‒37.

Ninety-one male and 36 female paraplegic and tetraplegic patients at the National Spinal Injuries Centre, Stoke Mandeville, England, were the subjects of a study to determine the body dimensions and space requirements of wheelchair users with spinal cord lesions. Apparatus was designed to measure nine anthropometric body dimensions, including head, eye, shoulder, and elbow heights; shoulder and thigh widths; and lower leg length. Measurements were taken with the subjects sitting upright in their usual chairs and relevant details of age, time spent in chair, level of spinal cord lesion, whether complete or incomplete, and the type of wheelchair used were recorded. In making measurements of reaching distances for 76 male and 26 female paraplegic subjects with full use of their arms, the aim was to determine the boundaries of a three-dimensional shell which would outline the space in which wheelchair users could manipulate objects and use equipment around them. Comfortable and maximum reaching distances in various directions were measured and a total of 35 reaching measurements for each subject was recorded. The data obtained were analyzed by computer to derive means, standard deviations, and 5th and 95th percentile values for males and females. These values are presented in a series of tables and diagrams.

35. Hakala, M. and Nieminen, P., 1996
Functional Status Assessment of Physical Impairment in a Community Based Population with Rheumatoid Arthritis: Severely Incapacitated Patients are Rare
Journal of Rheumatology, 23(4):617‒623.

The objective of this study was to determine the severity of impairment due to rheumatoid arthritis (RA) in a community-based population. The level of impairment in the study group, which represented 88% of the subjects known to have RA in a rural community in Finland, was assessed using the Keitel Function Test (KFT), a series of 23 range of motion tasks, with scores ranging from 96 (worst) to 0. Results showed that only 10% of the subjects had severe impairment with a KFT score of 65‒96; the mean hand function index was 22.6 out of a possible score of 42, and the mean lower limb function was 8.9 out of 44. Findings showed that severely incapacitated patients with RA are rare in the community. The reasons remain speculative. Multidisciplinary care, including early and active treatment with antirheumatic drugs and a high number of orthopedic operations may be an explanatory factor. Total joint replacement surgery of the large joints, performed in 19% of patients, may explain the absence of marked restriction in mobility and the divergence between the limitations in upper and lower limb functions in this series.

36. Kirby, R.L. and Chari, V. R., 1990
Prostheses and the Forward Reach of Sitting Lower-Limb Amputees
Archives of Physical Medicine and Rehabilitation, 71:125‒127.

The hypothesis that prostheses improve the forward reach of sitting lower-limb amputees was tested in this study. While sitting with only ischial support, ten unilateral below-knee (BK) amputees could reach farther when they wore their prostheses than when they did not, when reaching at 45E toward or away from the side of the amputation, with mean differences of 10.7 cm and 4.4 cm, respectively. With ten unilateral above-knee (AK) amputees, the differences were not statistically significant. Seven bilateral amputees (mixed levels) were able to reach farther with their prostheses on than off. With the prostheses off, their reach was significantly greater when their thighs were supported than when they were sitting with only ischial support. These findings suggest that (1) prostheses improve the anterolateral reach of unilateral BK amputees, and the straight forward and anterolateral reach of bilateral amputees; (2) when prostheses are not worn, a sitting surface that provides support through the residual limbs improves forward reach; and (3) the design of AK prostheses should reflect the patient's needs, both standing and sitting.

37. Li, S. and Xi, Z., 1990
The Measurement of Functional Arm Reach Envelopes for Young Chinese Males
Ergonomics, 33(7):967‒978.

The purpose of this study was to measure and determine functional arm reach envelopes. The article describes a rapid, accurate, and all-orientation instrument, which was developed for collecting such data. The instrument was of optimum accuracy ("5Fm), ing the rapid measurement of maximum arm reach to 231 positions in space around each subject, while its repeat accuracy was 2.5Fm. The measurements were made on a representative sample (in terms of height) of a young Chinese Han adult male population aged 18 to 25 years. Data were collected for both forefinger tip and grasp-knob arm reaches. Values were characterized by means of 5th, 50th, and 95th percentiles and expressed in tables and diagrams. The data provide a basis considered to be more suitable for Chinese users in designing spatial structures for machines, installations, and workspaces. Data collected: stature; acromion, eye, and olecranon height; sitting height; acromion, eye, elbow rest, and suprasternal to seated surface; shoulder breadth; thigh and chest depth; knee height, sitting; hip breadth, sitting; abdominal depth, sitting; buttock-knee length, sitting; armreach from back; functional armreach from back; and weight.

38. Link, C.S., Nicholson, G.G., Shaddeau, S. A., Birch, P. and Gossman, M. I., 1990
Lumbar Curvature in Standing and Sitting in Two Types of Chairs: Relationship of Hamstring and Hip Flexor Muscle Length
Physical Therapy, 70(10):611‒618.

A purpose of this study was to determine the difference in the lumbar curves of subjects while standing compared with sitting in two chairs with different seat angles: the Balans Multi-Chair (BMC) and a standard conventional chair (SCC). An additional purpose was to determine the relationship between lumbar curvature and (1) anthropometric factors and hamstring and hip flexor muscle length during standing and sitting in the two chairs, and (2) amount of time spent sitting. Sixty- one men between 20 and 30 years of age served as subjects. Lumbar curve measurements were taken with a flexible ruler with the subjects first standing and then sitting in the chairs. Hamstring and hip flexor muscle lengths were indicated by range-of-motion measurements taken with a gravity goniometer. Age, number of hours spent sitting per day, upper body length, and right leg length were also recorded. Subjects had significantly more lumbar extension when they sat in the BMC than when they sat in the SCC. Hip flexor length was the only factor that appeared to relate significantly to the difference between the standing lumbar curve and the lumbar curves in the BMC and SCC.

39. Powers, C.M., Newsam, C.J., Gronley, J.K., Fontaine, C.A. and Perry, J., 1994
Isometric Shoulder Torque in Subjects with Spinal Cord Injury
Archives of Physical Medicine and Rehabilitation, 75(7):761‒765.

The etiology of shoulder pain in spinal cord injured (SCI) patients has been attributed to overuse, with dysfunction becoming more prevalent as the time since injury increases. Impingement syndrome, the most common diagnosis in this population, may be related to weakness of the rotator cuff and shoulder girdle musculature. Shoulder dysfunction is greater in subjects with SCI than in controls without disabilities. Peak isometric torque for internal rotation, external rotation, and scapular elevation were assessed using a Lido isokinetic dynamometer. The strength (torque) values of the quadriplegic group were significantly lower than those of the control group and the paraplegic group for all motions tested. The only significant difference between the paraplegic and groups without disabilities was found in internal rotation. These results indicate that quadriplegic patients may be at greater risk for shoulder pathology because of both muscular limitation and increased functional demand.

40. Vasen, A.P., Lacey, S.H., Keith, M.W. and Shaffer, J.W., 1995
Functional Range of Motion of the Elbow
Journal of Hand Surgery - American Volume, 20(2):288‒292.

One hundred upper extremities in 50 adults without disabilities were studied in a Bledsoe brace, which limited elbow motion. The amount of flexion and extension of the elbow was serially limited in 15E increments. At each setting, the subjects were asked to perform 12 activities of daily living. The percentage of subjects who completed each task with the specified range of motion was determined. Overall, 49 of the subjects performed all of the tasks with extension limited at 75E and flexion limited at 120E. By isolating the allowable range of motion of the elbow and allowing for compensatory motions and strategies of the adjacent joints, the functional elbow range of motion is established as 75E−120E flexion. Thus, the functional status of a patient with a specific elbow range of motion can be predicted more accurately.

41. Wright, U., Kumar, G.M. and Mital, A., 1994
Reach Design Data for the Elderly
Proceedings of the Human Factors and Ergonomics Society 38th Annual Meeting, 137‒141.

The increased life expectancy of the elderly may require substantial redesigning of environments in order to accommodate age-related body changes. One of the most important aspects allowing the elderly to function independently is the ability to reach for items comfortably during daily activities. Designing for an independent elder requires knowledge of reach measurements that determines the optimal design of working/living environments. This paper provides reach capability design data of elderly males and females between 65 and 89 years of age. Results show that direct and indirect reach indicators decrease substantially above the age of 80. The elderly subjects participating in this study showed significantly lower reach capabilities than younger subjects with whom they were compared. This indicates the necessity of considering anthropometric data, such as reach, in designing for the elderly. The need is particularly dire for those above 80 years of age. Data collected: stature, acromial standing height, sitting height, acromial sitting height, bideltoid breadth, vertical reach, vertical reach angle, horizontal grip reach at 0E, horizontal grip at 90E, maximum grip reach, horizontal tip reach at 0E, horizontal tip reach at 90E.

POWER (Strength, Biomechanics)

42. Bäckman, E., Odenrick, P., Henriksson, K.G. and Ledin, T., 1989
Isometric Muscle Force and Anthropometric Values in Normal Children Aged Between 3.5 and 15 Years
Scandinavian Journal of Rehabilitative Medicine, 21:105‒114.

Isometric muscle force was measured in 217 children without disabilities aged 3.5- 15 years. Age, weight (kg) and height (cm) were also recorded. Reference values for isometric force are given for boys and girls separately. With regard to 7 of the 10 muscle groups tested, the force was significantly greater in boys than in girls as early as about 10 years of age. Age and weight were the most important predictors of muscle force.

43. Bednarczyk, J.H. and Sanderson, D.J., 1995
Limitations of Kinematics in the Assessment of Wheelchair Propulsion in Adults and Children with Spinal Cord Injury
Physical Therapy, 75(4):281‒289.

The purpose of this study was to examine the effect of weight on the kinematics of wheelchair propulsion in nonathletic adults and children with spinal cord injury. Five and 10 kg of weight were added to identical new low-weight wheelchairs (9.3 kg). The subjects C 10 adults and 10 children with spinal cord injuries C performed level wheeling with and without additional weights at a speed of 2 m/sec. The pediatric group was found to have significantly lower wheeling speeds than did the adult group. The addition of weight, however, did not alter the wheeling speeds in either group. Neither the proportions of the wheeling cycle spent in propulsion nor the angular kinematics of wheeling changed with additions of weight in either group, although the angular kinematics of the pediatric group differed from those of the adult group. These results indicate that adding weight in the range of 5 to 10 kg did not affect wheeling style under the level-wheeling, low-speed conditions of the study.

44. Bednarczyk, J.H. and Sanderson, D.J., 1994
Kinematics of Wheelchair Propulsion in Adults and Children with Spinal Cord Injury
Archives of Physical Medicine and Rehabilitation, 75(12):1327‒1334.

This study examined the kinematic features of wheelchair propulsion in two neurologically matched groups of adults and children with uncomplicated spinal cord injury. Each subject propelled his/her own chair, and new low-mass wheelchairs at a steady nominal speed of 2 m/sec across a level surface. Three- dimensional video analysis determined the movement of upper body angles (elbow, shoulder, trunk, and shoulder abduction) based on reflective markers placed on the subjects' shoulders, elbows, wrists, and hip joints. Analysis showed that although the velocities of the adult group (2.4 m/sec) were significantly greater than the pediatric group (2.3 m/sec), the two groups spent comparable proportions of the wheeling cycle in propulsion (24%). Analysis of the angular kinematics showed that whereas the pediatric group did show significant absolute angular differences from the adult group, the angular changes over time were the same in both groups. The implications of this work are that published data from adult wheelchair users may be applied to pediatric wheelchair users, thus providing a basis for pediatric wheelchair prescription.

45. Bergström, E.M.K., Frankel, H. L., Galer, I.A.R., Haycock, E.L., Jones, P.R.M., and Rose, L.S., 1985
Physical Ability in Relation to Anthropometric Measurements in Persons with Complete Spinal Cord Lesion Below the Sixth Cervical Segment
International Rehabilitation Medicine, 7(2):51‒55.

This study was undertaken to determine whether the ability of patients with complete tetraplegia below the cervical sixth segment to transfer (from wheelchair to bed/toilet/car) can be predicted from anthropometric characteristics. Thirty-six chronic patients were assessed and spasticity was measured. A discriminant function analysis was carried out to assess the extent to which a number of static and dynamic variables could predict the patient's final ability to effect a transfer. Using 9 of the original 23 predictor variables, it is possible to correctly classify a patient's eventual ability to transfer in 92% of cases. Data collected included age; weight; stature; sitting height; cervicale to datum; right and left shoulder flex; biacromial and bitrochanteric width; functional arm length; acromion to floor, static and lifting; triangular base, static and lifting; head circumference; spasticity; skinfolds; fat percentage of body weight; and fat and fat-free mass.

46. Bernardi, M., Canale, I., Felici, F., Macaluso, A., Marchettoni, P. and Sproviero, E., 1995
Ergonomy of Paraplegic Patients Working With a Reciprocating Gait Orthosis
Paraplegia, 33:458‒463.

In Italy, a reciprocating gait orthosis (RGO) is the most widely used device for restoring the standing and walking capability of paraplegic patients. The aim of the present study was the evaluation of the energy demand (O2), and cardiopulmonary load (HR and E) imposed on the subject by different working tasks while sitting in a wheelchair, and standing with the aid of an RGO. Subjects without disabilities were used as controls. The use of RGO produced a dramatic improvement in subjects' mobility and reach space in the workplace. The energy demand and the cardiorespiratory load imposed on the subjects using the RGO did not differ from those observed while sitting in a wheelchair. Nor did they differ from those observed in the controls. The energy demand slightly exceeded the values typical of light work and was, thus, compatible with the duration of a normal working day. Cardiac load values, on the other hand, corresponded to those typical of moderate activity, thus limiting the duration of the working task to 5‒8 hours. Age, stature, and mass (kg) are reported. Standing and seated comparisons of arm reach, foward and lateral, are given.

47. Bloxham, L.A.H., 1995
Time Motion Analysis and Physiological Profile of Elite Level Wheelchair Basketball Players
Masters Abstracts International, 34(04):1483.

Wheelchair basketball (WCBB) has unique physiological demands. During the summer of 1994, the Gold Cup World Wheelchair Basketball Championships were held in Edmonton, Canada. This provided an opportunity to evaluate the physiological profiles of elite WCBB players, and to determine their heart rate responses and time spent performing various activities during a WCBB game. Physiological measurements included: peak oxygen consumption measured with wheelchairs mounted on a set of rollers; maximum anaerobic power performed on an arm crank ergometer; shoulder flexion and extension isokinetic strength at 60E and 180E per second respectively; anthropometric measures including body weight; skinfolds; and shoulder flexion and extension flexibility. Categories of activity included: sprint, sprint with ball, shooting, shooting with movement, gliding, struggling, and resting. Preliminary time/motion results indicate that the majority of the time spent on the court was either sprinting, gliding, or struggling. These results indicate that the game of WCBB stresses primarily the anaerobic metabolic systems. However, a strong aerobic base was required to promote quick recovery and sustain play for the entire 40 minutes.

48. Brown, D., Knowlton, R.G., Hamill, J., Schneider, T.L. and Hetzler, R.K., 1990
Physiological and Biomechanical Differences Between Wheelchair- Dependent and Able-Bodied Subjects During Wheelchair Ergometry
European Journal of Applied Physiology and Occupational Physiology, 60:179- 182.

The purpose of this study was to compare the physiological and biomechanical responses of wheelchair-dependent persons (WCD) to persons without disabilities (AB used in the article) using a wheelchair ergometer. Five WCD and five AB performed a discontinuous wheelchair ergometer test starting at 12.8 W (power output) with increments of 7.0 W at 6-minute intervals. Biomechanical data were collected 3.5 minutes into each stage followed by the collection of physiological data. After the fifth stage, peak oxygen consumption was determined. The WCD had significantly higher net mechanical efficiency at 26.7, 33.6, and 40.6 W than did the AB. The WCD had significantly greater shoulder extension at the point of initial wheel contact as measured by the shoulder angle, while the AB had significantly greater shoulder range of motion at all work rates. The biomechanical differences between AB and WCD were found to be a prominent factor contributing to the higher mechanical efficiency of WCD over AB. Investigators concluded that basic physiological and biomechanical differences exist between WCD and AB in manual wheelchair locomotion, and that these differences are important considerations in the interpretation of data in wheelchair ergometry studies. Anthropometric data collected: weight and sitting height.

49. Cooper, R.A., 1992
The Contribution of Selected Anthropometric and Physiological Variables to 10K Performance of Wheelchair Racers: A Preliminary Study
Journal of Rehabilitation Research and Development, 29(3):29‒34.

The purpose of this study was to determine the relationship between selected anthropometric and physiological variables and time achieved in a 10K wheelchair race. Eleven male wheelchair athletes with spinal cord injuries, in training for national competition, performed continuous progressive exercise tests on a wheelchair ergometer to determine maximal metabolic and cardiorespiratory values. Anthropometric data were also collected. The laboratory data were analyzed for correlation with the best 10K time of each subject during the test period. The subjects averaged 27 minutes 30 seconds for their 10K races, 2.49 L.min−1 for VO2max, and 35% for maximal gross mechanical efficiency during submaximal exercise. Speed at peak oxygen consumption, gross mechanical efficiency, and body density were found to be significantly correlated with 10K time. The results show very little correlation between VO2max and 10K time. Further study is indicated for the relationship between gross mechanical efficiency, speed at maximal oxygen consumption, body density, and 10K time; these variables may be useful in evaluating training programs for improving race performance. Data collected: height; trunk, upper arm, forearm, and hand lengths; body mass; body density; and hand grip.

50. Davis, G.M., Moore, N., Tupling, S.J., Pierrynowski, M.R. and Shephard, R.J., 1986
Isokinetic Strength and Physical Activity in Paraplegic and Able-bodied Males
IEEE/Eighth Annual Conference of the Engineering in Medicine and Biology Society, 576‒578.

Thirty lower-limb persons with disabilities (PARA) and 12 males without disabilities (WD) were assessed on an isokinetic dynamometer for measures of upper-body dynamic strength and endurance. People with disabilities and subjects without disabilities were further subdivided into highly active (HA: PARA=15, WD=6) and less active (LA: PARA=15, WD=6) groups based on their daily activity patterns. Peak moment, peak power, and average power of shoulder and elbow flexion/extension were tested at five joint velocities. PARA HA subjects displayed greater peak and average powers than PARA LA subjects for shoulder flexion and extension (37‒43%), and elbow flexion (24‒27%) and extension. Analysis of power- velocity curves demonstrated that AB men had strength scores similar to PARA LA subjects at low angular velocities, but were significantly weaker at higher movement speeds. These data suggest a specific training effect of daily wheelchair ambulation upon the neuromuscular recruitment patterns or fiber type characteristics of PARA individuals, and a further conditioning response in highly active wheelchair users.

51. Davis, G.M. and Shephard, R.J., 1990
Strength Training for Wheelchair Users
British Journal of Sports Medicine, 24(1):25‒30.

Sedentary adult males with spinal lesions, all habitual wheelchair users, were divided into exercise (n = 11) and control (n = 4) groups. A Cybex II dynamometer was used to assess peak power, average power, total work, and muscular endurance for elbow flexion/extension, shoulder flexion/extension, and shoulder abduction/adduction at five angular velocities, on recruitment and after 8 and 16 weeks of forearm ergometer training (three days/week). Small sub-groups of the exercised subjects were assigned to high or low intensity endurance effort and long or short training sessions. Despite the aerobic nature of the activity, gains of average power were registered by the two muscle groups most involved in the ergometer task (shoulder extension and elbow flexion). In keeping with current theories of training, gains were largest with prolonged, high intensity activity at angular velocities approximating those adopted during training.

52. Gass, G.C. and Camp, E.M., 1979
Physiological Characteristics of Trained Australian Paraplegic and Tetraplegic Subjects
Medicine and Science in Sports, 11(3):256‒259.

Sixteen male Australian paraplegic and tetraplegic subjects competing at the 1977 FESPIC games underwent a physiological assessment. The assessment included a neurological examination, anthropometry, spirometry, maximum oxygen consumption using a wheelchair and motor driven treadmill, and a five-minute post- exercise blood lactate test. Eight subjects had won gold medals at international competitions for people with disabilities and, at the time of testing, two of the subjects were world record holders in track and field events. Spirometry was consistent with other reported values. The cardiorespiratory data and postexercise lactate results revealed that the Australian subjects, at rest and during maximum work, were comparable to other trained athletes with disabilities. Data collected: weight; sitting height; chest, arm, and waist circumferences; subscapular, suprailiac, triceps skinfolds; and grip strength.

53. Hughes, C.J., Weimar, W. H., Sheth, P.N. and Brubaker, C. E., 1992
Biomechanics of Wheelchair Propulsion as a Function of Seat Position and User-to-Chair Interface
Archives of Physical Medicine and Rehabilitation, 73(3):263‒269.

This study investigated the biomechanics of lever and handrim propulsion and the effects of seat position on propulsion mechanics. Nine persons without disabilities and six paraplegic spinal cord injured persons participated. Subjects performed handrim and lever propulsion on a wheelchair test simulator at a speed of 3 km/hr and load of 7.5 watts/side. Three-dimensional motion measures of the trunk, shoulder, elbow, and wrist were collected over four-second sample periods for each seat position. Hub torque and stroke arc measurements were determined. Upper extremity motions were significantly different for the two methods of propulsion. Handrim propulsion required less elbow motion, greater shoulder extension, less shoulder rotation, and less arm abduction, than did lever propulsion. Both methods of propulsion required a substantial amount of internal rotation at the shoulder. Seat position changes had a greater effect on joint motion ranges with handrim propulsion. No significant differences were found for trunk motion. The findings provide additional information for development of a model for the optimization of wheelchair propulsion.

54. Ide, M., Ogata, H., Kobayashi, M., Tajima, F. and Hatada, K., 1994
Anthropometric Features of Wheelchair Marathon Race Competitors with Spinal Cord Injuries
Paraplegia, 32(3):174‒179.

Anthropometric data from the health check program in the Oita Wheelchair Marathon Race were analyzed. In the past 10 years, a total of 2,677 competitors participated in this program. Age, height, body weight, body fat, lung vital capacity, chest girth, upper arm girth, grasping force and upper arm power of 710 competitors with good results were compared with comparable data from 99 competitors with poor results. Findings suggested that upper arm power and lung vital capacity played a major part in the successful results.

55. Knight, K.L., 1965
A Study of the Functional Anthropometry of Two Groups of Wheelchair Users, and a Description of a Method of Measuring the Upper Limb Strength of One of These Groups
Unpublished report submitted in part fulfillment of the requirements for the post- graduate course in Ergonomics and Cybernetics, Loughborough College of Technology, Loughborough, England.

This report is based on data from two wheelchair user groups: 29 men and 30 women with multiple sclerosis, and 8 men and 30 women with rheumatoid arthritis. The report is divided into five main sections: (1) project plan and general information about the two groups; (2) equipment and methods; (3) and (4) for each group, tables and graphs with means, standard deviations, and percentiles for body measurements, comfortable and maximum reaching distance, and for the multiple sclerosis group, arm strength; 5) tables with body measurement data of the combined groups and comparison data from other sources. Body measurements include: floor to vertex, eye, shoulder, knuckle, and thigh heights; shoulder and hip widths; and lower leg and foot lengths. Reaches recorded were upward, downward, forward, 45E angle, and sideways. Arm strength measurements were pull, push, and lift in the forward, 45E angle, and sideways planes.

56. Rao, S.S., Bontager, E.L., Gronley, J.K., Newsam, C.J. and Perry, J., 1996
Three-Dimensional Kinematics of Wheelchair Propulsion
IEEE Transactions on Rehabilitation Engineering, 4(3):152‒159.

This paper describes a three-dimensional kinematic model for quantifying upper extremity movement during wheelchair propulsion (WCP). Some advantages and limitations of the model are discussed after using it to establish a database of WCP kinematics from 16 subjects with low-level paraplegia. The motion patterns presented in this paper are representative of the most able customary wheelchair users and thus may be used for comparison with data from subjects having higher levels of spinal cord lesions.

57. Rodgers, M.N., Gayle, G.W., Figoni, S.F., Kobayashi, M., Lieh, J. and Glaser, R.M., 1994
Biomechanics of Wheelchair Propulsion During Fatigue
Archives of Physical Medicine and Rehabilitation, 75(1):85‒93.

Musculoskeletal injuries can result from overuse or incorrect use of manual wheelchairs, and can hinder rehabilitation efforts. The purpose of this study was to investigate wheelchair propulsion biomechanics of spinal cord injured, non-athletic wheelchair users. The authors studied changes in the variables that occur with fatiguing wheelchair propulsion to determine how the user's physical characteristics and the state of fatigue influenced risk of injury. Twenty male paraplegic patients were videotaped during propulsion to fatigue on a stationary, instrumented wheelchair positioned on a roller with adjustable frictional resistance. Peak handrim force was significantly correlated with concentric shoulder flexion and elbow extension isokinetic torques. Significant changes with fatigue were found in increased peak handrim force, decreased ulnar/radial deviation range of motion, and increased trunk forward lean. Of the three upper extremity joints, highest calculated joint moments were found in shoulder flexion. These biomechanical results suggest that potentially harmful changes occur with fatigue, and that the shoulder may be the most prone to musculotendinous-type overuse injury. Data collected: biceps, triceps, subscapular, suprailium, thigh, abdomen, pectoralis, and medial calf skinfolds; biceps, forearm, chest, waist, thigh, and calf girths; and stature, shoulder width, sitting height and width, upper and lower arm, hand, and trunk lengths.

58. Sanford, J.A., Story, M.F. and Jones, M.L., 1996
Accessibility Requirements for Ramp Slope: Results of Human Subjects Testing

RESNA '96, 455‒457

This paper reports the results of a study aimed at evaluating the usability of the range of ramp slopes allowed under the current ADA accessibility guidelines. One hundred seventy-one subjects of all ages, using different types of mobility aids, traversed a 30-foot ramp varying in slope from 1:8 to 1:20. Data were recorded for pulse rate, energy expenditure, rate of travel, distance traveled, and the location of rest stops. Findings show that only a few manual wheelchair users had difficulty traversing all 30 feet in ascent, even on slopes as steep as 1.8.

59. Skelton, D.A. and McLaughlin, A.W., 1996
Training Functional Ability in Old Age
Physiotherapy, 82(3):159‒167.

Among the aims of this study were to determine whether an eight-week period of moderate intensity exercise could improve the strength, flexibility, balance, and selected functional abilities of women ages 74 years and over. Twenty women were matched for age and randomly assigned to either a control or a training group. At the end of the first eight-week period, the control group undertook training. Pre- and post-training measurements were obtained from women (median age 81 years) and pre- and post-control and post-training results obtained for 9 women (median age 81 years). Strength, anthropometry, flexibility, balance, and functional ability were measured. There were training-associated improvements of 9‒55% in quadriceps and handgrip strength, flexibility, balance, and selected tests of functional ability. Authors concluded that repeated moderate-intensity exercise that involves the practice of functional tasks and mobility can produce substantial increases in strength, balance, flexibility, and selected tests of functional ability. Data collected: weight, height, upper arm circumference, triceps skinfold, isometric knee extensor strength, isometric elbow strength, and handgrip strength.

60. Skelton, D.A., Greig, C.A., Davies, J.M. and Young, A., 1994
Strength, Power and Related Functional Ability of Healthy People Aged 65- 89 Years
Age and Aging, 23:371‒377.

This cross-sectional study was designed to examine the effects of healthy aging on muscle strength, power, and potentially related functional ability. Subjects were recruited through local and national newspapers and inclusion was based on strict health criteria. Isometric knee extensor, isometric elbow flexor and handgrip strength, leg extensor power, timed rise from a low chair, lifting a weighted bag on to a surface, and stepping unaided on to boxes of different heights were measured in 50 men and 50 women, evenly distributed over the age range 65‒89 years. The differences in isometric strength and leg extensor power over the age range were equivalent to losses of 1‒2% per annum and approximately 3.5% per annum, respectively. The decline of explosive power was faster than the decline of knee extensor strength in men, but not significantly so in women. Power standardized for body weight influenced chair rise time and step height. Isometric knee extensor strength, standardized for body weight, influenced chair rise time. Data include height and weight.

61. Sullivan, S.L., 1991
The Effects of Dynamic Constant Resistance Training in Spinal Cord Injured Quadriplegic Men
Dissertation Abstracts International, 53(04):Section A:1093.

The primary aim of this investigation was to determine the effects of dynamic constant resistance exercise in spinal-cord-injured quadriplegic men. Six male quadriplegics (C5-C7) trained eight weeks, three days per week, on the Freedom Machine (Olympic Enterprises, Inc.), a pully-weighted apparatus for the lower-limb persons with disabilities having impaired hand function. Pre- and post-treatment measures included: arm circumferences, diameters, skinfolds, volume measurements to determine hypertrophy, body weight, biceps and triceps isometric strength and endurance, a transfer lifting test, 100-meter sprint, and 12-minute endurance wheelchair tests, and one-repetition maximum (RM) tests for the five upper-body resistance training exercises. Significant decreases were observed for right and left triceps skinfolds. Performance variables that were significantly increased included right triceps isometric strength, one RM left biceps curl, and right and left shoulder extension. No significant strength gains were seen in the bilaterally performed resistance exercises, wheelchair sprint, or endurance transfer lifts. Strength gains appeared to be a result of enhanced neurological function rather than hypertrophy of upper arm muscle tissue. Performance appeared to be related to level of injury in the spinal cord.

62. Viitasalo, J.T., Era, P., Leskinen, A.L. and Heikkinen, E., 1985
Muscular Strength Profiles and Anthropometry in Random Samples of Men Aged 31‒35, 51‒55 and 71‒75 Years
Ergonomics, 28(11):1563‒1574.

Maximal isometric muscular strength and anthropometric variables were studied among three random samples, each containing about 180 Finnish men in three age groups averaging 32.7, 53.1, and 72.7. Strength was measured on special dynamometers for grip, trunk and knee extension, and trunk and elbow flexion. The anthropometric variables included height, weight, body-mass index, skeletal weight, fat weight, and a weight factor. The youngest group had the highest, and the oldest group had the lowest values for strength as well as body height and fat-free body weight, while the middle-aged group had the highest, and the youngest group the lowest values for body weight, fat weight, body-mass index, and for the weight factor. Among the strength variables studied, grip strength was found to have the highest correlation with chronological age and to be least affected by anthropometric variables. The body-mass index was found to be an important variable to be controlled in studying differences between age groups in muscle strength.

BODY COMPOSITION

63. Bulbulian, R., Johnson, R.E., Gruber, J.J. and Darabos, B., 1987
Body Composition in Paraplegic Male Athletes
Medicine and Science in Sports and Exercise, 19(3):195‒201.

The goals of this study were (1) to describe and compare density (Db) and anthropometric characteristics of paraplegic male athletes with counterparts without disabilities; (2) to determine the validity of existing anthropometric Db equations for athletes without disabilities, when used on paraplegic athletes; and (3) to derive and validate an initial series of Db prediction equations for paraplegic male athletes. The sample included 22 male paraplegic athletes (PARA), and a comparison group of 53 subjects without disabilities, moderately to highly trained. A series of anthropometric measurements were taken on all subjects. Density was obtained using hydrostatic weighing methods. The validity of 12 Db prediction equations (four generalized) reported in the literature were tested on the PARA subjects. Results showed that these models did not yield accurate predictions for this group. Anthropometric variables and Db values obtained from the PARA subjects were used in a stepwise multiple regression procedure to develop several more suitable Db prediction equations for the paraplegic athlete. Data collected: height; weight; fat; density; diameters of biacromial, chest, bi-iliac, elbow, and knee; skinfolds of pectoral, tricep, subscapula, suprailiac, abdomen, thigh, and calf; circumferences of neck, shoulder, chest, waist, hip, thigh, calf, deltoid, bicep, bicep (flexed), and forearm; and somatotype.

64. Duval-Beaupere, G. and Robain, G., 1991
Upward Displacement of the Centre of Gravity in Paraplegic Patients
Paraplegia, 29(5):309‒317.

The centers of gravity of 44 chronic spinal-cord-injured patients and 24 subjects without disabilities were measured using a gamma ray scanner. The results are expressed as a percentage of body length and as anatomical levels. The mean weight of paraplegic patients was 12 kg less than the controls. The center of gravity was 5% of body length higher in the paraplegic patients than in the controls, equivalent to 3 to 4 vertebrae levels. The importance of such differences in the center of gravity for the design of stable wheelchairs is discussed.

65. Reed, R.L., Yochum, K., Pearlmutter, L., Meredith, K.E. and Mooradian, A.D., 1991
The Interrelationship Between Physical Exercise, Muscle Strength and Body Adiposity in a Healthy Elderly Population

Journal of the American Geriatrics Society, 39(12):1189‒1193.

The goal of this study was to determine the relationship between habitual physical exercise and body adiposity in a healthy elderly population. Physical exercise was measured by a questionnaire previously adapted for use with the healthy elderly. The level of exercise was converted into calories expended over the previous 14 days. Body adiposity was measured at six sites by anthropometry, and overall percent body fat was measured by bioelectric impedance. Some 213 healthy ambulatory subjects over the age of 60 (116 females and 97 males) were recruited from a large retirement community in Southern Arizona. The mean age of the subjects was 70.0 years. Percent body fat was similar in men with different levels of physical activity (averaging about 28%). The percent fat in women averaged 37%. A statistically significant increase in muscle strength measured in five muscle groups with a hand-held dynamometer occurred with increasing levels of activity. These data indicate that level of physical exercise, over the range of 0 to 1,528 Kcal/day, does not predict body adiposity in the healthy elderly population. To decrease body fat without a change in dietary habits would require a more intensive exercise regimen than currently being undertaken by most healthy elderly people. Data collected: weight; height; body mass index; percent fat; fat-free mass; subscapular, suprailiac, triceps, chest, abdominal, and thigh skinfolds; and waist, hip, arm, and thigh girths.

66. Zechar, D.L., 1988
Tests for Measurement of Percent Body Fat in Paraplegics

Dissertation Abstracts International, 50‒01:Section A:0098.

Body composition assessment has proven to be a useful tool in determining optimal weights for individuals for clinical, nutritional, and general health reasons. There is a need to measure body composition in a group of persons with disabilities such as paraplegics. Maintenance of an ideal body weight for wheelchair-dependent individuals is important to help prevent pressure sores and to aid in transfers and other activities of daily living. Studying body composition also provides a tool for evaluating treatment modalities. Eight male spinal-cord-injured paraplegic volunteers, ages 19‒54, were tested on two separate dates. Eight controls without disabilities, matched for age, height, weight, and race were also tested. Residual volume and other pulmonary functions were measured by helium dilution, both in the air and in the water. Underwater weighing, skinfolds, and circumferences and diameters were taken. Skinfold and circumference measurements proved to be reliable methods for estimating percent body fat in spinal-cord-injured paraplegics. Data collected: height; weight; calf, waist, chest, biceps, and forearm circumferences; ankle, knee, elbow, and wrist diameters; and bitrochanter, bi-iliac, chest, biacromial, and shoulder girths.

GROWTH (In Children)

67. Duval-Beaupere, G., Lougovoy, J., Trocellier, L. and Lacert, P., 1983
Trunk and Leg Growth in Children with Paraplegia Caused by Spinal Cord Injury
Paraplegia, 21:339‒350.

After a survey of the bibliography on the subject of clinical and experimental data on retarded growth in children affected by lesions of the peripheral nervous system, the authors present a semi-longitudinal analysis of the anthropometric values obtained by spinal cord section in the case of young paraplegics. By this means, they demonstrate an average growth defect of the order of two standard deviations which only affects the body distal to the neurological lesion in cervical or dorsal injuries. The lower the level of the cord lesion and the earlier the paralysis, the greater the growth defects.

68. Pryor, H.B. and Thelander, H.E., 1967
Growth Deviations in Handicapped Children: An Anthropometric Study
Clinical Pediatrics, 6(8):501‒512.

Marked differences in growth and development were noted in body measurements on a total of 678 handicapped children. Growth was most adversely affected in those with Down's syndrome caused by chromosomal aberration, and next in those with multiple congenital anomalies presumably due to environmental insults. Growth was less severely affected in those with cerebral palsy, presumably due to birth injury and severe hypoxia after normal gestation, and not at all in children with minimal brain damage from mild hypoxia at birth. Data collected: standing height; body weight; cephalic circumference, length and breadth; face height; bizygomatic diameter; inter-pupillary space; ear length, breadth, and placement; bi-iliac, lateral thoracic, and antero-posterior trunk diameters; and sitting height.

69. Roberts, D., Shepherd, R.W. and Shepherd, K., 1991
Anthropometry and Obesity in Myelomeningocele
Journal of Paediatrics and Child Health, 27(2):83‒90.

Anthropometric data in relation to age, sex, level of lesion, and ambulation were studied on 110 myelomeningocele (MMC) subjects to investigate growth and the occurrence of obesity in MMC. In 52 subjects, indices of obesity were validated against body composition analysis of total body fat (%BF) using body potassium and body water techniques. Most subjects were short and light compared to reference data and became relatively shorter and heavier with age. Overall trunk growth was not affected by the level of lesion, but sitting height was affected by kyphoscoliosis. Arm spans were similar to reference data, but were significantly greater for wheelchair users. Leg length was greatest in those who walked. Body composition data showed excess adipose tissue in many MMC subjects; this tendency increased with age. When correlated with %BF determined from body composition analysis, common clinical indices of obesity had variable r values ranging from .74 to .82. Anthropometric measures, taken with cognizance of the level of disability and mobility, can accurately assess body growth and the occurrence of obesity in MMC. The influence of ambulatory activity in promoting normal growth is emphasized.

70. Stevenson, R.D., Roberts, C. D. and Vogtle, L., 1995
The Effects of Non-Nutritional Factors on Growth in Cerebral Palsy
Developmental Medicine and Child Neurology, 37:124‒130.

This study was designed to evaluate the effects of non-nutritional factors alone on the growth of children with cerebral palsy (CP). Twenty children with hemiplegic CP, normal stature, and normal triceps skinfold measurements were measured for 16 anthropometric variables on each side of the body (affected vs. unaffected). All measures of breadth, circumference, and length were significantly smaller on the affected side. Skinfold measurements had a tendency to be larger on the affected side. These results suggest that non-nutritional factors related to disease severity have a significant influence on the growth of children with CP, even in the absence of malnutrition. Data collected: elbow breadth, knee breadth, hand length, foot length, upper-arm length, ulnar length, tibial length, knee height, arm circumference, calf circumference, triceps skinfold, biceps skinfold, subscapular skinfold, supra-iliac skinfold, mid-thigh skinfold, and mid-calf skinfold.

PRODUCT DESIGN

71. Canale, I., Felici, F., Marchetti, M. and Ricci, B., 1991
Ramp Length/Grade Prescriptions for Wheelchair Dependent Individuals
Paraplegia, 29(7):479‒485.

The aim of this work was to provide well-defined criteria for ramp construction for wheelchair dependent individuals (WDI). Force capability was measured in 140 WDI who presented different levels of motor impairment. Levels of impairment were established on the basis of the answers given in a questionnaire regarding the degree of self-sufficiency at home and outside the home, and active participation in sports events. Taking into account those WDI who exhibited at least a minimal level of self-sufficiency, the following prescriptions are indicated. For a 1-meter ramp length, allowable maximal incline 15%; up to a 3-meter ramp length, maximal incline 10%. The reliability of such prescriptions was confirmed by having 43 WDI traverse a test ramp. These values are suggested as confidence limits for public building accommodations. Special prescriptions could be adopted for selected populations of WDI.

72. Cappozo, A. , Felici, F., Figura, F., Marchetti, M. and Ricci, B., 1991
Prediction of Ramp Traversability for Wheelchair Dependent Individuals
Paraplegia, 29(7):470‒478.

The purpose of this research was to obtain a single objective criterion that would constitute a reliable prediction of length and grade limits for ramps that can be traversed by any category of wheelchair dependent individuals (WDI). The maximal voluntary force (MVF) is the main limiting factor in the performance of WDI; thus the force required to traverse a ramp was established by means of a simple mechanical model. The real-time course of force application during ascent was experimentally obtained. Then, a simplified law of force application was introduced in a computer simulation program of kinetics and kinematics of ascent. Inputs to the model were also the mass of the subject plus wheelchair, the initial velocity of the chair, and the ramp length. The output of the program was the force requirement for any given length/grade. When capsizing conditions were encountered the simulation ended. We tested the results on WDI successfully traversing ramps with the predicted length/grade specifications.

73. Cooper, R.A., 1993
Stability of a Wheelchair Controlled by a Human Pilot
IEEE Transactions on Rehabilitation Engineering, 1(4):193‒206.

Wheelchair/pilot systems are extremely complex. A wheelchair/pilot model was developed to analyze stability for various dynamic situations. Several innovations are introduced in this paper: human control of path and lean, a coordinate transformation approach to modeling the roadway, and the relationships of general dynamic to fixed dynamic analyses. Results show that fixed dynamic stability are special cases of general dynamic analyses. The models incorporate human factors (physiology, psychology, anthropometry, and kinesiology), wheelchair design factors (frame and steering geometry), and environmental factors (road surface orientation and visibility). All of these factors affect performance and safety. Data for pilot anthropometry and wheelchair design factors were collected. Systems with three and four wheels were simulated. Results show that both three- and four- wheeled systems can be stabilized with respect to path changes and disturbances under human control. Three-wheeled systems are shown to be more responsive, whereas four-wheeled systems are more stable. Data collected: total body weight, trunk length, and wheelchair variables.

74. Guerette, P., Sanford, J., Jones, M. and Story, M.F., 1995
Technical Requirements for Ramps: An Analysis of Current Accessibility Standards and Literature
RESNA '95, 594‒596

Current standards for ramp slope and length have generally been established based on performance of young, strong, male wheelchair users. However, evidence suggests that current standards may not be appropriate for a wide range of older users and users with more severe functional limitations A literature review was conducted of previous ramp evaluations and government standards to determine recommended ramp specifications, previous populations evaluated, and methodologies used to evaluate ramp performance. Findings of the literature review are presented.

75. Institute for Consumer Ergonomics, Loughborough University of Technology, Loughborough, England, 1981
Seated Anthropometry: The Problems Involved in a Large Scale Survey of Disabled and Elderly People
Ergonomics, 24(11):831‒845.

This paper draws attention to a number of problems in the collection of anthropometric data for the design of easy chairs for persons with disabilities and elderly people. These problems include gaining access to representative subjects in sufficient numbers, developing anthropometric instruments appropriate to the required measurements, training staff, and establishing intra- and inter-measurer variability so that appropriate chair specifications can be more readily defined. A description is given of approaches to these problems, and the solutions adopted, from an anthropometric survey carried out on 1,260 elderly and people with disabilities by the Institute for Consumer Ergonomics. Data collected: seat plane to back of head, seat plane to palpated seventh cervical vertebra (C7), seat plane to eye, seat plane to lowest back contact, seat plane to point of maximum lumbar concavity, back plane to back of head, back plane to C7, back plane to point of maximum lumbar concavity, lumbar profile, type of posture, points of back contact, popliteal height, vertical seat height, horizontal seat depth, back plane to back of buttocks, thigh thickness, back of elbow to wrist, back of elbow to knuckles, seat plane to underside of elbow, maximum abdominal protuberance, width across the outside of elbows, width across the shoulders, sitting hip/thigh width, palm height, and stature. No data were included in this paper; statistical summaries were published in a later paper.

76. Johnson, M.W. and Peckham, P.H., 1990
Evaluation of Shoulder Movement as a Command Control Source
IEEE Transactions on Biomedical Engineering, 37(9):876‒885.

The purpose of this study was to evaluate the use of scapular shoulder movement as a command control source. The focus of this study was on the evaluation of movement signals from quadriplegic subjects, as well as on the processing of these signals for use as command inputs to a functional neuromuscular stimulation (FNS) hand-grasp system. The shoulder movement of three C5-level quadriplegic and nine subjects without disabilities was studied using externally mounted two-degree- of-freedom transducers overlying the sternum and clavicles. The C5-level quadriplegic subjects had a considerably poorer range of motion than the subjects without disabilities. The vertical command resolution of the quadriplegic subjects ranged from eight to 13 command levels, whereas the horizontal range contained four or fewer command levels. Subjects without disabilities were able to produce 26 to 79 command levels along the vertical axis and 18 to 85 along the horizontal axis. Subjects were able to maintain a static command level within several percent of their range in trials lasting from 10 to 30 seconds. Shoulder movement in quadriplegics is suitable as a command control source for an FNS hand-grasp system requiring one proportional command signal and at least one logical command signal with appropriate processing of the signals. The available transducers are cosmetically acceptable and are easy to don and doff. Use of shoulder movement as a command control source does not interfere with other activities of the user such as eating or talking. Shoulder movement also provides a command control source that is easy for the user to learn and provides some feedback to the user through shoulder proprioception.

77. Kenward, M.G., 1971
An Approach to the Design of Wheelchairs for Young Users
Applied Ergonomics, 2(4):221‒225.

Sixty-six children between the ages of 5 and 16 who had various physical disabilities took part in an anthropometric study of young wheelchair users. All those involved had at one time used a wheelchair regularly, and only nine in the study habitually walked. Using a standard body measuring instrument, 13 measurements of bodily dimensions were taken with the children sitting in their usual chairs. An assessment was also made of the degree of support afforded by the backrest. Five dimensions normally used in prescribing wheelchairs to patients were used as a basis for working out the sizes of the various sections of a wheelchair, such as seat, backrest, armrest, and frame size. The raw data indicated that appreciable inconsistencies in body shape existed that were not allowed for in present wheelchair design. A new approach is proposed in which wheelchairs would be assembled from interlocking sections of variable size. This arrangement would allow wheelchairs to be fitted more completely to the individual. Data collected: sitting height, shoulder height, elbow height, seat height, buttocks to knee, foot to popliteal, foot to knee, ankle to toe, popliteal to knee, forearm length, buttocks width, scye width, shoulder width, and assessment of backrest support. Summary statistics for all dimensions were not published. However, ranges of buttock width, buttock-popliteal length, foot to popliteal height, shoulder to elbow length, and elbow to seat height were given for design purposes.

78. McLaurin, C.A., 1990
Current Directions in Wheelchair Research
Journal of Rehabilitation Research and Development, Clinical Supplement No. 2: Choosing a Wheelchair System, 88‒98.

This article discusses current research on wheelchair seating comfort and mobility. Anthropometric data were collected on 52 subjects diagnosed with cerebral palsy, muscular dystrophy, spina bifida, paraplegia, quadriplegia, arthritis, and other disabilities. Data collected: sitting shoulder and elbow heights; elbow to knuckle of small finger; back to kneecap; back to underside of knee; ground to top of knee; ground to heel; chest width at axilla; shoulder, waist, acromion, and hip widths; width at knees; and foot and leg length; and angular measurements to horizontal from seat surface, back surface, posterior leg surface, foot, and forearm.

79. Nowak, E., 1994
Anthropometric Measurements of the Young for the Needs of Clothing Design
International Ergonomics Association 1994, Volume 3, Rehabilitation:58‒59.

The objective of this study was to develop anthropometric data for clothing design for youthful wheelchair users with lower extremity disorders. Seventy-seven young men and women, aged 15‒18, were measured for 18 anthropometric variables. The study confirmed somatic differences between the persons with and without disabilities, and indicated the need for developing separate tailor's tables used for clothing design for people with disabilities. The results of the research were used to design clothes for this group. Data collected: stature; shoulder breadth; arm overhead reach; arm reach forward; arm span; chest, waist, hip, maximum arm, wrist, and thigh circumferences; front chest length, back length, shoulder breadth, and upper limb length arc; hip height; and perineum height and length.

80. Petzäll, J.,1995
The Design of Entrances of Taxis for Elderly and Disabled Passengers: An Experimental Study
Applied Ergonomics, 26(5):343‒352.

This paper presents a study aimed at determining suitable dimensions for the entrances of cars used in taxi service for people with disabilities. Eleven ambulant people with disabilities and six wheelchair users participated in the trials. Travelers with disabilities have found it difficult to enter and leave cars due to the narrow doorways. The most difficult measure is lifting their feet into and out of the cars. In the study the subjects got into and out of a mock-up car whose entrance could be altered by changes to the width and height of the doorway, the height of the sill, the location of the seat, and the angle to which the door opens. Results showed that, in large part, much the same entrance dimensions are required both by people confined to wheelchairs and ambulant people with disabilities. The paper presents suitable dimensions for the front entrances of cars in order to suit people with mobility impairments.

81. Steenbekkers, L.P.A. and Molenbroek, J.F.M., 1990
Anthropometric Data of Children for Non-Specialist Users
Ergonomics, 33(4):421‒429.

In a pilot study, 33 anthropometric variables were measured on 633 children aged up to 5.5 years. The variables were chosen on the basis of international standards for selected products, and on the results of preliminary analysis of accidents. This paper discusses: (1) anthropometric aspects of current regulations for cribs, playpens, and toys, and (2) anthropometric aspects in the selection of wheelchairs for children. The paper concludes with a discussion of how to present anthropometric data for non-specialist users. Not all of the anthropometric variables collected are listed. Among those mentioned are: stature; acromial height, standing and sitting; sitting height; popliteal height; buttock-popliteal depth; hip breadth, sitting; and elbow height, standing and sitting. Complete data results are reported in Steenbekkers, L.P.A., 1989 "Ergonomische Gegenvens Voor Kinderveiligheid, Verslag Van Ben Proefonder Zoek Hij Kinderen Tussen 0 En 5.5 Jaar in Zuid-Holland" (Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands).

82. Sweeney, G.M., Harrison, R.A. and Clarke, A.K., 1989
Portable Ramps for Wheelchair Users - An Appraisal
International Disability Studies, 11(2):68‒70.

This paper describes a study designed to establish values for gradients which could be achieved by wheelchair users, while using two different lengths of otherwise identical portable ramps. Sixty subjects each tested gradients between 1:14 and 1:6 on portable ramps of 1 meter and 1.8 meters in length. The results demonstrated that the majority of attendant-propelled, self-propelling, and powered wheelchair users could negotiate gradients of 1:8 and 1:6.

WORKSPACE DESIGN

83. Abdel-Moty, E. and Khalil, T.M., 1991
Computer-Aided Design and Analysis of the Sitting Workplace for the Disabled
International Disability Studies, 13(4):121‒124.

This paper describes an easy-to-use microcomputer-based program for use in the design of sitting workplaces for individuals with disabilities. The model, which is part of a computer package for designing and analyzing general sitting workplaces, allows the individual with a disability to analyze and adjust his/her workplace accurately and without trial and error. It also provides basic measurements and proportions that can be used when planning workplace modifications. The computerized analysis is intended to make workplace design guidelines usable by people in wheelchairs. It also considers visual impairment, hearing impairment, reaching disability, and extremes of physical size. It combines standards set by ANSI for buildings and facilities with known design principles to achieve accessibility and comfort. The program is based on functional requirements of people with disabilities, and can be applied to the original design, remodeling, or alteration of an existing facility.

84. Boussena, M. and Davies, B.T., 1987
Engineering Anthropometry of Employment Rehabilitation Centre Clients
Applied Ergonomics, 18(3):223‒228.

The authors were involved in a project entitled "Providing Ergonomics Services to Employment Rehabilitation Centres (ERC)". This paper describes the part of the study dealing with the anthropometry of ERC clients. Analysis of the results shows anthropometric differences between ERC clients, other groups with disabilities (who differ from the ERC group in various demographic variables), and persons without disabilities. Findings suggest that the ERC clients should be considered as a distinct group with regard to workplace design specification, especially in the ERC workshop. Data collected included age, weight, height, standing eye and elbow height, sitting height, sitting elbow height, thigh clearance, knee and popliteal height, buttock-knee and buttock-popliteal length, hip breadth, shoulder width, arm reach, and right and left hand grip.

85. Das, B. and Behara, D.N., 1995
Determination of the Normal Horizontal Working Area: A New Model and Method
Ergonomics, 38(4):734‒748.

A new model was developed for the determination of the normal horizontal working area by extending Squires' concept. The elbow not only moves freely straight ahead, but also to the right and left of the operator in describing the working area. The parametric equations developed in this research enabled the authors to determine working area curves that lie on both sides of the body median. Experimental results showed that the relevant anthropometric parameters were poorly correlated. A new method was developed to determine correctly the normal horizontal working area curves for the 5th, 50th, and 95th percentiles of male and female populations. When compared with the corresponding curve generated by the new method, Squires' curve for the 10th percentile male considerably overestimated the normal horizontal working area to the right of the body median and underestimated it to the left.

86. Das, B. and Sengupta, A.K., 1995
Computer-Aided Human Modelling Programs for Workstation Design
Ergonomics, 38(9):1958‒1972.

Computer-aided human modeling programs can be used advantageously in designing a workstation. The analysis is performed within a three-dimensional computer graphics environment. To illustrate the current state of development, six representative programs were selected: CYBERMAN, COMBIMAN, CREW CHIEF, JACK, SAMMIE, and MANNEQUIN. The programs differ considerably in terms of system requirement, operating characteristics, applicability, and the various ergonomic evaluation functions available in the human modeling programs. Comparative analysis of the programs will aid the user in selecting the appropriate program for a particular workstation design.

87. Kozey, J. and Das, B. 1997
The Determination of the Maximum Reach Envelope for Wheelchair Mobile Adults
In Biman Das and Waldeniar Karwoski (Eds), Advances in Occupational Ergonomics and Safety 1997 IOS Press Inc., Burke, VA.

Both the concept and the determination of the maximum reach envelope (MRE) are important in the design of industrial workstations. The purpose of this study was to determine 5th, 50th, and 95th percentile MRE for individuals who require a wheelchair. Subjects included 42 male and 20 female wheelchair users with full physical function of their upper extremities. An adjustable table was set at the proper work height for each subject. They used a pointer that was part of a computerized potentiometric system for anthropometric measures (CPSAM) to determine maximum reach. Equations were derived to calculate 5th, 50th, and 95th percentile MRE for both men and women.

88. Kozey, J., Das, B. and Kirby, L., 1996
The Determination of the Normal Reach Area in the Horizontal Plane for Wheelchair Mobile Adults
Proceedings of the 28th Annual Conference of the Human Factors Association of Canada,41‒46.

Both the concept and the determination of the normal reach area (NRA) are important in the design of the industrial workstation. The published research regarding the NRA has been devoted to designing for the worker without disabilities. The present study determined the shape and dimensions of the 5th, 50th, and 95th percentile NRA for a sample of wheelchair mobile adults.

89. Kozey, J.W. and Das, B., 1992
An Evaluation of the Existing Anthropometric Measurements of Wheelchair Mobile Individuals
25th Annual Conference of the Human Factors Association of Canada, 307‒312.

The published structural and functional anthropometric data of wheelchair-mobile individuals were evaluated and compared with a selected sample without disabilities. Large differences were found in the reported anthropometric dimensions. These differences were attributed to the nature and degree of physical impairments, sample sizes, measurement definitions, and measurement techniques. Applying the existing data to industrial workstation design even for a specific physical dysfunction would be rather difficult. Consequently, further research to generate data specific to industrial applications using a reliable measurement system, is warranted.

90. Nowak, E., 1989
Workspace for Disabled People
Ergonomics, 32(9):1077‒88.

This paper describes a method for determining workspaces for young people with disabilities with motor dysfunction of the lower extremities. Seventeen measurements were taken on 32 boys and 45 girls aged 15‒18. There are significant differences in functional dimensions of the arm between populations with and without disabilities which clearly indicate the need for different shaping of work spaces used by people of limited motor efficiency. The method used by the author -- a modification of the Das and Grady concept -- allows determination of workspace by means of several simple anthropometric measurements. The results of the investigation constitute data for design and estimation of workplaces for young people with disabilities in classrooms, school workshops, and educational and rehabilitation centers. Data collected: stature, eye level, shoulder height, elbow height, knee height, popliteal height, trunk depth, buttock-popliteal length, thigh thickness, shoulder breadth, maximum elbow breadth, elbow breadth, arm overhead reach, arm reach forward, arm reach down, lateral reach, and arm span.

91. Wieland, K. and Schutte, M., 1985
Concept of Ergonomic and Systematic Work Design for Disabled Workers
International Journal of Rehabilitation Research, 8(2):143‒151.

In order to support industries and offices in designing work places for workers with disabilities, a systematic classification of technical aids needed by people with disabilities is outlined in this article.

ARCHITECTURAL MODIFICATIONS

92. Eriksson, J. and Johansson, G., 1996
Adaptation of Workplaces and Homes for Disabled People Using Computer- Aided Design
International Journal of Industrial Ergonomics,17:153‒162.

A computer-based tool has been developed to support the planning of adaptations for people with disabilities. The prototype development and evaluation were based on six case-studies, which provided information on the needs and requirements in real-life planning situations. The software was designed in an iterative process, with active input by persons with disabilities, occupational therapists, and others affected or involved. It was positively evaluated by the participants, as a means of enhancing understanding and encouraging active participation. It was also found useful in supporting the design and evaluation of aspects such as accessibility clearance and reach. The present prototype's deficiency was that modeling was relatively time-consuming. Besides rationalizing the 3-D modeling, future development should also include an approved measurement control, collision detection, and a simplified control of view angles and objects.

93. Fox, P.L., 1995
Environmental Modifications in the Homes of Elderly Canadians with Disabilities
Disability and Rehabilitation, 17(1):43‒49.

This study was performed to (1) determine whether the use of architectural modifications in the homes of the elderly with disabilities can reduce the level of disability, (2) estimate the degree of need for environmental modifications, and (3) determine the predictors of the use of architectural modifications. The degree of need was estimated using data from 8,895 respondents (55 years and older) from the Canadian Health and Disability Survey (1983‒84). A subgroup of 1,520 respondents who needed architectural modifications was selected to determine the need for architectural modifications and the extent to which those needs are being met. These data were analyzed using multiple linear regression. Approximately 37.9% of the elderly with disabilities required at least one modification to their homes. About 40% did not have the architectural modification that was needed. Income was found to be a predictor of the use of architectural modifications. Users of architectural modifications were more independent in performing instrumental activities of daily living than non-users. The author concluded that there is a substantial need for environmental modifications in the homes of the elderly with disabilities. Furthermore, architectural modifications should be made available at a low cost.

94. Goldsmith, S., Nichols, P.R.J., Rostance, B., Angell, J. and Angell, L., 1966
Designing a Public Convenience for the Disabled
Annals of Physical Medicine, 8(8):307‒317.

Five separate designs for lavatory compartments were studied through practical tests with 28 patients. The suitability of shape and size of the cubicle, door fittings, sanitary fittings, and grab rails were analyzed. Two possible designs are presented as a basis for further trials. The authors stress the importance of accessibility of public conveniences in all buildings likely to be used by people with disabilities.

95. Herbert, H., 1994
Wheelchair Field Testing at the Central Train Station and Airport in Frankfurt [Germany] (Rollstuhtest im Hauptbahnhof und Flughafen Frankfurt.)
Rehabilitation, 23(2):66‒72.

The article reports the findings obtained from wheelchair field testing at Frankfurt central train station and airport, initiated by the working group on "Public Transport Accessibility" of the Federal Rehabilitation Council. Relevant information concerning access of wheelchair users to intercity and suburban traffic as well as to air transport facilities is presented. Planning and implementation of the field test are described; major test findings and their evaluation are presented in detail.

96. Malassigne, P.M., 1977‒1978
Design of Bathroom Fixtures and Controls for the Able-Bodied and Disabled
U.S. Department of Health, Education and Welfare, Rehabilitation Services Administration, Annual Report, Grant 23-P−57959/3‒01.

Project research has illustrated the serious lack of data concerning body dimensions and reach characteristics of the population with disabilities. Such a lack of pertinent data indicated the need for a limited anthropometric study of certain body measurements of people with as many types of disabilities as necessary to project the range of the disability. The study sought to do the following: (1) document body sizes and reach capabilities of the whole population with disabilities, illustrating the range of dimensions by percentile; (2) show specific disabilities of the whole population and the range of dimensions by percentile; (3) determine the existence and extent of any deviation present when the anthropometry of the population with disabilities is compared with identical measurement data from the population without disabilities; and (4) provide designers with information that would assist in sizing bathroom fixtures and seating areas, and locating controls, accessories, and grab surfaces. Twenty-one female and 61 male students from the Woodrow Wilson Rehabilitation Center participated in the study. Eighty-two types of disabilities were represented in the sample. The results indicate that differences in body measurements between people with and without disabilities appear to exist; however, future research should increase the number of people with disabilities in the sample and include disabilities not represented in the first study.

97. Mohler, S.R. and Sirkis, J.A., 1972
Airport Medical Design Guide
Aerospace Medicine, 43(8):903‒911.

This paper provides guidelines for the design and/or upgrading of commercial airport terminals with emphasis on serving persons with a variety of disabilities. Recommendations for passenger flow, toilet facilities, signs, water fountains, public telephones, and other airport facilities are included. Specific standards relevant to mobility and sight-impaired travelers are also given.

98. Nelson, C.M.S., 1983
The Validation of the American National Standards Institute (ANSI) A117.1 for Functional Accessibility by Physically Handicapped Young Adults
Dissertation Abstracts International, 44(09):Section A:2736.

This study determined the extent to which the American National Standards Institute (ANSI) A117.1 prescriptive standards for accessibility result in functional accessibility for young adults with physical disabilities. Eighteen young adults meeting the study's disability criteria used a checklist developed to rate the functional accessibility of the ANSI A117.1 standards. Areas which met ANSI standards were selected from three secondary school buildings. Eighteen of the 20 ANSI accessibility standards areas resulted in functional accessibility when the prescriptive specifications are met. Modifications were recommended for four of these areas: ramps, elevators, drinking fountains, and toilet stalls. ANSI accessibility standards for stairs and telephones did not result in functional accessibility even though the prescriptive standards were met. Strict adherence to the ANSI standards does not provide total accessibility to public buildings for physically persons with disabilities in the lower 2.5% of anthropometric norms. Human errors in applying the ANSI A117.1 standards reduce the functional accessibility otherwise provided by the standards.

99. Steinfeld, E., Schroeder, S. and Bishop, M., 1979
Accessible Buildings for People with Walking and Reaching Limitations
U.S. Government Printing Office, Washington, DC, Accession Number ED184280.

Research was conducted regarding the accessibility of buildings for persons with disabilities. Data on the following topics are reported: eye level and reach limits for ambulant, semiambulant, and wheelchair bound persons; wheelchair maneuvers; maximum travel distance for people with limitations of stamina; push- pull forces against windows and doors; ramps (maximum slopes); toilet stalls (dimensions, use of grab bars, need for seat); showers (dimension of shower stalls, usability of wheel-in showers and those with a curb); bathroom layouts; kitchen layouts (dimensions, heights of shelves and work surfaces); doorways; elevators (size, location of control panels, timing of elevator doors); public telephones, and public mailboxes. A final section compares data with previous research.

MISCELLANEOUS

100. Frisbie, J.H. and Brown, R., 1994
Waist and Neck Enlargement after Quadriplegia
Journal of the American Paraplegia Society, 17(4):177‒178.

Changes in waist and neck size in quadriplegic patients after paralysis, noted clinically, were assessed systematically. Twenty quadriplegic men, aged 60 ±13 years, and 20 neurologically intact men, aged 63 ±17 years, selected by absence of weight gain, were questioned about changes in their waist and shirt collar sizes since the onset of paralysis (at age 20 ±13 years), or during the previous 20 years for control subjects. Changes in waist size of approximately 7.0 inches for quadriplegic and 1.7 inches for control subjects were found. Similar discrepancies were found between the two groups in neck-size changes. Authors concluded that quadriplegia is often followed by increased waist and neck size. These changes may relate to impaired breathing mechanisms.

101. Glaesener, J. J., Maske, A., Petersen, W. and Steinberg, K., 1992
Traumatic Paraplegia with Injury of the Upper Extremity -- Effect on the Success of Rehabilitation (Die Traumatische Querschnittlahmung mit Verletzung der Oberen Extremitat -- Auswirkungen auf den Rehabilitationserfolg)
Rehabilitation, 31(4):224‒230.

The evaluation of a large number of patients with traumatic paraplegia and tetraplegia showed that more than 20% of them had associated injuries of the upper limbs. In view of the fact that arms and shoulders of the paraplegic person take over a decisive weight-bearing function, authors were interested in the effects of these special injuries on rehabilitation outcomes. Injuries of the lower arm were found to have more serious repercussions for achievement of the rehabilitation aim than injuries of the shoulder girdle and the upper arm. Serious limitations were found in the range of motion of the affected joints in persons with lower arm injuries. Compensation was due only to the skill of the paraplegics in dealing with these deficits in motion and in using the uninjured extremity. This is the main reason why functional deficits in independence were relatively minor among these persons.

102. Paquette, S.P., 1990
Human and Analogue Models for Computer-Aided Design and Engineering Applications
Technical Report NATICK/TR−90/054, Natick Research, Development and Engineering Center, Natick, MA.

A review of six computerized human analogue models (SAMMIE, COMBIMAN, CREW CHIEF, CAR, JACK, and SAFEWORK) was conducted to identify the state of the art in ergonomic modeling software. All the models included here demonstrate some utility as ergonomic design tools and were developed to enable materiel designers and engineers to conduct preliminary human factors analysis prior to prototype construction. These human figure models vary widely with respect to primary function and analytical capabilities. Essentially they fall within one or more of the following categories: anthropometric accommodation analysis, biomechanical/strength modeling, or human-machine interface analysis. This report includes the developmental background of each model, the hardware requirements, and the major functions provided by each system, e.g., reach/clearance analysis, strength modeling, and computer simulation. The underlying anthropometric databases that support model generation are also reviewed. In addition, the techniques used to construct the human figures in terms of skeletal link structure and geometric representation of body segment shape and volume are discussed. Finally, some challenges are presented that confront future refinement of human figure models.

103. Pentland, W.E. and Twomey, L.T., 1994
Upper Limb Function in Persons with Long Term Paraplegia and Implications for Independence: Part I
Paraplegia, 32(4):211‒218.

The intent of this study was to describe the effects of long term paraplegia and wheelchair use on upper limb function. Bilateral upper extremity isokinetic and grip strength, pain, and active range of motion were compared in 52 men with paraplegia [mean age 44 years, mean duration of spinal cord injury (SCI) 17 years] and 52 age- and activity-level matched men without disabilities. The impact of upper limb pain on activities of daily living (ADL) performance was examined in the paraplegic sample. Strength was not significantly different between the two samples except for bilateral shoulder flexion (stronger without disabilities) and bilateral elbow extension (paraplegic stronger). Strength changed similarly with age in the two groups. The effect of duration of SCI on strength, excluding age, was significant for grip strength only. Duration of paraplegia and activity level were better predictors of strength than was age in 9 of 14 muscle groups tested, whereas in those without disabilities, age was the best strength predictor. The paraplegic subjects' pain intensity ratings revealed mild to moderate levels of upper limb pain. Shoulder pain was associated with duration of injury, exclusive of age. The tasks most reported to cause upper limb pain were work/school, sleep, wheelchair transfers, outdoor wheeling, and driving. Data collected: age; height; weight; upper limb activity levels (present), sedentary and moderate/heavy; duration of spinal cord injury in years; range of SCI duration (years); and lesion levels of T2‒5, T6‒10, and T11-L2.

104. Pentland, W.E. and Twomey, L.T., 1991
The Weight-Bearing Upper Extremity in Women with Long Term Paraplegia
Paraplegia, 29:521‒530.

Bilateral upper limb pain, isokinetic strength, grip strength, range of motion, and activities of daily living (ADL) performance were compared in 11 women with long term paraplegia and 11 activity-level-matched women without disabilities of similar age, to determine whether long-term wheelchair use is associated with pain and altered function in the upper extremities. The results suggest that the development of pain in the upper limbs is clearly associated with paraplegia in women. Pain was reported by the paraplegics most frequently in the shoulders and secondly in the wrists and hands. ADL where the paraplegics experienced pain most often were work/school, outdoor wheeling, household work/childcare, and loading the wheelchair to and from the car. While paraplegics reported intermittent rather than constant pain, the group's relatively young age (mean = 43 years) and average duration of injury of only 15 years suggests that preventative and management steps are required to ensure continued independence and quality of life of paraplegics as they age. Data collected: concentric isokinetic shoulder and elbow flexion/extension strength; concentric and eccentric isokinetic shoulder adduction strength; grip strength; and active shoulder and elbow ranges of motion.

105. Snyder, R.G., 1977
Anthropometry and Biomechanics of Selected Populations
National Institute for Occupational Safety and Health, Technical Report UM- HSRI−77‒52.

This study reviews the limited literature and data available on the anthropometry and biomechanical aspects of human factors, range of motion, strength, and kinematics of the body under different working conditions for selected U.S. populations. Particularly emphasized is the capability of females in general, pregnant women, persons with disabilities (amputee, paraplegic, left-handed), obese, and the elderly to safely perform occupational tasks. Based on evaluation of the literature, recommendations are made with regard to future research needs and priorities.

106. Woo, J., Ho, S.C., Sham, A., Yuen, Y.K. and Chan, S. G., 1995
Influence of Age, Disease and Disability on Anthropometric Indices in Elderly Chinese Aged 70 Years and Above
Gerontology, 41(3):173‒180.

To determine the influence of age, disease, and other factors on anthropometric indices in elderly subjects aged 70 years and above, body mass index (BMI), arm muscle circumference (AMC), corrected arm muscle area (CAMA), fat-free mass (FFM), and total body fat (TBF) were determined in a random sample of 990 Chinese men and 1,021 women. Old age, presence of disease, self-perceived poor health, poor functional ability, lower level of physical activity, lack of dentures, depression, and cognitive impairment were all factors associated with lower anthropometric values. Hemoglobin, total cholesterol, and walking speed were also associated factors, although the latter two became insignificant after adjusting for age. When subjects with a history of disease or cognitive impairment were excluded, an age-related decline in BMI, AMC, CAMA, and TBF was still observed in men, although FFM remained unchanged. However, in women, only TBF showed an age-related decline. Authors concluded that in the old-old population, both age and disease affect anthropometric indices, the change being more marked in men. Data collected: height, weight, arm circumference, and bicep/tricep skinfolds.

[MORE INFO...]

*You must sign in to view [MORE INFO...]

Solutions

Documents

Resources

Anthropometry for Persons with Disabilities

Preface

TABLE 3

Hypothetical Sampling Matrix

TOTAL

Related Keywords

Related Section Numbers

User Comments/Questions

[MORE INFO...]