The occupational therapists from the Kettering Health Network NeuroRehab and Balance Center approached Dr. Bigelow’s EGR 100 class with a problem. They asked Team IO, consisting of Elizabeth Alexander, Rewaan Kassim, Tina Matavulj, Katie Weitzel, and Rachel Zuppa, to design a book holder that attaches to a power wheelchair so the user can read a book. The client wants this book holder because the wheelchair user loves books, but has spastic cerebral palsy and cannot hold a book very well. One of the main reasons a book holder is needed is to improve the posture of the user. As of right now, the user places their book in their lap and reads hunched over and when the user is done reading; they need help moving the book out of their lap.
The client, Kettering Health Network, is a faith based, non-profit organization that values innovation . Kettering Health Network has eight different hospital locations: Fort Hamilton Hospital, Grandview Medical Center, Greene Memorial Hospital, Kettering Behavioral Hospital, Kettering Medical Center, Soin Medical Center, Southview Medical Center, and Sycamore Medical Center . This organization’s mission is to improve the lives of people in the community. One of the ways they achieve this goal is through occupational therapy.
Occupational therapy is aimed to help individuals participate in daily activities they need or want to do. This relates to the goal of Kettering Health Network because occupational therapy helps improve the lives of people who need help with doing daily activities . Occupational therapists can work in schools, homes, hospitals, private practices, and nursing facilities . Some of the activities, or occupations, that occupational therapists work on are activities of daily life, resting and sleeping, eating, education and work, play and leisure, and social participation . Occupational Therapy can take many forms and is personalized for each patient. Occupational therapy can include rehabilitation of lost skills, development of needed skills, adaptations, and compensation . The book holder that Team IO designs will be used in occupational therapy in the NeuroRehab and Balance Center (NRBC), which is a center that is involved with neuromuscular reeducation, sitting and positioning, home modifications, and community reintegration .
The book holder is designed to be used by one with spastic cerebral palsy (SCP). SCP is the most common type of cerebral palsy which is a disorder due to damage to the motor cortex of the brain before birth . Cerebral palsy is not genetic but males and twins (or multiple births) are at a higher risk of developing cerebral palsy. Other factors that can increase the risk of cerebral palsy are premature birth and low birth weight . A person with spastic cerebral palsy has muscles that contract uncontrollably which results in stiff limbs, lack of range of motion, and decreased control of limbs. Someone with SCP would have exaggerated reflexes and awkward, stiff, and jerky movements . Most of the time SCP affects the legs and arms, but it can also affect the tongue and pharynx; this effect in turn can result in trouble breathing, eating, and swallowing. SCP causes a lot of stress on the body and a main concern is contracture, which is the constant contracting of muscles that results in joint deformities . The main limitations of someone with SCP are limited movement, strength, and range of motion, and posture.
The client wants us to design a book holder so the user can improve their posture when reading. One who has SCP normally tends to sit hunched over because of the contraction of muscles; so by having a design that holds a book at eye level, the user can train their body to sit up straighter. The user also does not have much strength or control of their muscles, so the book holder needs to be able to move the book in and out of their line of sight with little effort. Someone with SCP does not have much use and control of their fingers, so the book holder needs to be able to be moved and adjusted easily. The user loves to read both paperback and hardcover books so the design must be strong enough to hold different book sizes. The design must attach to a power wheelchair and cannot interfere with any of the control components. Also, the design must be small enough so that it does not add to the width of the wheelchair or make it more difficult to maneuver through doors. The design must be able to hold the book securely, but the pages of the book need to be able to be turned. In addition to holding the book securely while reading, the design needs to be able to store the book when the user is not reading.
To better understand the problem, the team watched videos that showed how people with spastic cerebral palsy move. The team watched a video a patient with cerebral palsy performing different tasks, like rolling over or standing up, during a physical therapy session. The team saw that a common characteristic among people with SCP is that they hold their arms close to their body with all of their muscles contracted. The team had to take this into consideration while thinking of a design to best help the patient.
The team created a design that holds a book on a power wheelchair for a user with spastic cerebral palsy. The team was committed to creating a design that helps increase the user’s independence and posture and is easy to use without much control of the arms or legs. The design is small, strong, and adjustable, so the user can move books in and out of their line of sight with ease. The book holder was designed so that it allows the user, who loves reading, to read different sized books and to adjust the holder to the perfect reading position. NEED OBJECTIVES AND CONSTRAINTS IN BULLET POINTS
Generation of Design Alternatives:
The team started the brainstorming together by looking at existing book holders on Google.com . While looking through the images, the team selected different aspects of different existing designs to include in the new design. In order to create unique design alternatives, Team IO used the method of using “unrelated stimuli.” When using this method, the team went onto websites and searched random pictures that do not directly relate with the proposed problem. The team then brainstormed ideas that related the “unrelated stimuli” with the problem. Some unrelated stimuli that the team used were Pokemon  and a college dorm chair . The team then finished brainstorming individually by using morphological charts. This form of brainstorming includes a table with a column with all of the functions of the design and then in each row are different means of completing each function. Then to create a design alternative, one idea is picked from each row to create a “functionally complete” design that satisfies all of the functions. This was a really good way for the team to brainstorm because each idea could be paired with any other combination of ideas since there are three different main parts of the design, which are as follows: the actual stand that holds the book upright, the part that holds the book open, and the arm that attaches the design to the wheelchair. Once each team member created a morphological chart, they each picked out two completed designs, drew sketches, and presented their designs to the rest of the team. Then the team modified and combined the different design ideas into four design alternatives.
Figure 1 shows the first design option, Accordion. The Accordion design has four main parts; the book holder, the accordion joint, the stiff arm, and hanging weights. As shown in Figure 1, the Accordion design features a book holding surface that is like a music stand. There is a small ledge that holds the book open and secures the book so that it does not fall out. The accordion joint allows the user of this design to move the book in and out of their sightline. This joint also increases the amount of weight the book holder can hold which makes this design adaptable to many different book sizes. Figure 1 also shows that the book holder is attached to a stiff arm that has a C-clamp that allows the design to be attached to a power wheelchair. The hanging weights are magnets that hang from a chain; this was inspired by a book holder that the team found online . As shown in Figure 1, the weights will sit on the pages of the book to keep the book from closing.
Figure 1. Design Accordion consists of a music stand holder, accordion joint, and stiff arm.
Along with the book holder, Figure 2 shows a sticky and magnetic bracelet meant to help the user turn the pages easily. As shown in Figure 2, the bracelet has a sticky material, like a lint roller, on one side and a magnet on the other. The bracelet will be made of a rubber material so it is comfortable for the user. The magnet on the bracelet is to easily move the magnetic weights when the user wants to flip the pages and the sticky side is used to easily turn the pages without using fingers.
Figure 2. Sticky
Figure 3 shows the second design option, Bungee Framed. The main features of this design are a stiff arm with clamp attachment and a stiff frame with a bungee net backing that folds in the middle. As shown in Figure 3, the design has a rectangular frame with a bungee net backing. The bungee net was inspired by a college dorm bungee chair . The bungee backing allows the frame to be folded around any size of book for storage. As shown in Figure 3, the frame has two hinges so it can be folded in half with a book placed inside. There are magnets on the inside of the frame that keeps the frame folded when the user is not reading a book. As shown in Figure 3, there are four straps that are attached diagonally at each corner of frame. The function of these straps are to hold the book in the frame. The user can tuck the corners of the book under these straps. The straps would be made of bungee cord so that they could be able to stretch to different sizes of books. As seen in Figure 3, the book holder is attached to the stiff arm with a large hinge. This allows the book to be moved to the desired angle and it allows the holder to be folded down when not in use. The book holder is attached to the wheelchair by the stiff arm. As seen in Figure 3, the stiff arm has a C-clamp that attaches the stiff arm to the wheelchair. The highlight of this design in the bungee backing. Bungee is both strong and stretchy so this allows the book holder to be used for any size of book.
Figure 3. Design Bungee Frame has a stiff frame, that folds in half, with a bungee backing.
Figure 4 shows the third design option, Onix. The main features of this design are two pieces of hard plastic that attach to the book with bungee cords and a flex arm that attaches the book holder to the wheelchair with a clamp. As shown in Figure 4 there are two bungee cords on each side of the book holder. The bungee cords will attach to the edge of the book on each side and will hold the book to the holder. The two pieces of hard plastic will lay flat on the cover of the book. As shown in Figure 4, there is an arm that folds out that holds the book flat. Figure 4 shows that the book holder is attached to the wheelchair by a flex arm. The flex arm aspect of this design was inspired by the Pokemon “Onix” . The benefit of using a flex arm is that the book holder can be adjusted to any height. The flex arm has a clamp that can be attached to surfaces other than a wheelchair. The highlights of this design are the flex arm and the flexible holder. Since the book holder has bungee cords, it can adapt to any size of book. It can also be folded around the book and latch so the book can be stored easily. The flex arm allows for more adjustments to be made so the user’s posture can be improved. The flex arm is strong and easy to adjust.
Figure 4. Design Onix features a flex arm and a book holder with bungee straps.
Figure 5 shows the final design option, Bendy. The main features of this design are a flexible middle section, curved outer edges, straps to secure the book, and a stiff arm. As shown in Figure 5, the middle section of the book holder is made of a flexible material similar to the track of a treadmill. This flexible material would allow the design to be folded around the book so the book could be stored when the user is not reading. The book holder would be made from hard plastic, and, as shown in Figure 5, the outer edges curve around; the curvature of the edges allows for holding of the book in order to keep it open. As seen in Figure 5, there are two straps that would slide over the cover of the book to keep the book from falling out. Shown in Figure 5, this design has an arm that folds out of the back of the design so it can keep the book flat when the user is reading. The book holder will be attached to the wheelchair by a stiff arm that has a C-clamp on the end. This allows for the book holder to be moved up and down so the user can store the book. The highlights of this design are the flexible middle part and the movable, stiff arm. The flexible material allows the user to store the book in the holder so the user can read at anytime without having to re-secure the book. The stiff arm with the clamp allows some movement so the book can be positioned in a comfortable reading position, but there is not too much motion where the user could bend the design in a way or direction that would not be easy to fix. The stiff arm would provide a sturdy base for the book and would allow the user to read without help from another person
III. Design Selection process
The first step in the team’s design selection process was listing a brief description of the four design options, then going into further detail of each design. The four designs were the Accordion Design, the Bungee Design, the Onyx Design, and the Bendy Design. After having all four of the design options selected, the team made a list of the criteria that should be included in the evaluation of each design. These criteria included: sturdiness, material efficiency, aesthetics, durability, feasibility, cost, ease of building, time needed to build, universal design, user friendliness, weight, and strength. These criteria were chosen to ensure that the selected design would be the design with the biggest potential for success. The next step in the design selection was to weigh the importance of each criteria. This was done by ranking each criteria in its importance to the design’s success from 1 to 10, 1 being not very important and 10 being extremely important. The team decided that some of the most important criteria were sturdiness, durability, feasibility, ease of building, user friendliness, and strength. Since these were found to be some of the most important aspects of the design, they received a 9 out of 10 on the weighting scale. Other criteria, like aesthetics, were less important to the design’s success and received a weight of 3. After going through and weighing each design, the team was then ready to rank how well each design had fit the criteria. This was done by going through each design and determining how well they fit each of the criteria. If a design was very sturdy, it would receive a 9 or ten for that category. However, if the design was not user friendly, the design would receive a 2 or 3 for that category. Once each design had been ranked on how successful it would be in each category, all of these numbers were placed into a table and totaled. The final total of each design was composed of the sum of all of the products of the designs rank of the category and the weight of that category. After this was completed, the final totals of the designs were calculated to be 529, 682, 623, and 573 for the Accordion, Bungee Famed, Onix, and Bendy designs, respectively. Once the design scores had been totaled, it was easy to see that the Bungee Framed design had the highest likeliness of success. The table of weights, rankings, and totals can be seen below.
Although the design with the highest score for likeliness of success has been found, there were still a few more things to check to ensure that the chosen design would fit the requirements of the project. The criteria necessary for the final design to complete were as follows: the design must be able to hold a book for an individual in a power wheelchair, it must be able to be moved in and out of the patient’s sightline, it must support a minimum of 5 pounds, it cannot interfere with the controls of the wheelchair, it does not interfere with components of the wheelchair, and it must be able to turn the pages of the book. To make sure that each design fit all of these criteria, a table was made that listed each constraint and checked whether or not each design fit those constraints. This can be seen in the table below.
Design Bungee Framed
Must hold book for individual in power wheelchair
Must be able to be moved in and out of sightline
Must support 5lbs
Cannot interfere with controls on wheelchair
Does not interfere with components of wheelchair
Must be able to turn pages of book
Since every design fit all of the criteria in the table, the constraints did not play a role in the decision of the final design. The Bungee Framed design fit all of the criteria and had the highest total for likeliness of being successful, so the Bungee Framed design was chosen to be the final design.
Technical Aspects of the Design
Testing the Design:
Two sets of testing were done on the final prototype. The first one was performed by the team with a spring-measure. Various movements were performed with the spring-measure in order to measure the amount of force, in pounds, that was necessary to operate the book holder. Some of these movements included opening and closing the holder, putting it in and out of view, and adjusting the holder between different angles. The second was performed by the occupational therapists at Kettering Health Network, essentially determining if the prototype did its job.
The following is a table documenting the data collected from the movement testing with the spring-measure.
Hardcover Book (lbs)
Soft Cover Book (lbs)
Pull arm strap to take out peg and adjust the angle to the middle peg
Open book holder
Close book holder
Flip the book holder up
Pull arm strap to take out peg and adjust the angle to the lowest position
Pull arm strap to adjust the angle from the lowest position to the middle peg
Take velco off
Conclusion: selling points, impactful- no other device that is pre-existing that fulfills the requirements- bungee framed is lighter and inexpensive
Recommendations: better wood, thinner bungee cord,
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