OBJECTIVEClarify the relation between the complaints of wheelchair users and the vibration characteristics of the wheelchair, to improve wheelchair comfort and design.

METHODSThe question naires were distributed to 33 wheelchair users directly by the experimenter in order to identify the causes of complaints from wheelchair vibrations that they experienced. The vibration transmissibility of wheelchairs of ten subjects was measured to clarify the causes of complaints of wheelchair vibration according to the ISO 10326-1 standard in the laboratory using a broadband random vibration spectrum with a frequency-weighted vibration magnitude of 0.1 ms(-2) r.m.s. over the frequency range from 0.2 to 100 Hz. Each vibration exposure lasted 60 seconds.

RESULTSThe following findings were clear from the questionnaire results; (i) the vibration rom the wheelchair affected psychological comfort; (ii) the effects of different riding surfaces were important engineering issues affecting wheelchair ride comfort; (iii) the wheelchair users felt the vibration during wheelchair usage at locations on the neck, lower back and buttocks; (iv) vertical vibration was the most noticeable vibration from the wheelchair to each participant's body. The following findings were clear from the results of the transmissibility measurement of the wheelchair; (i) the resonance frequency-ranges of the transmissibility of the wheelchair showed significant differences between the subjects; (ii) intra-subject variability from three repeated transmissibility measurements was small; (iii) the first resonant frequency occurred approximately 5 to 7 Hz and the second resonant frequency occurred at around 8 Hz and the third resonant frequency occurred approximately 13 to 15 Hz; (iv) the magnitude of the peak transmissibility varied from 1.3 to 2.6.

CONCLUSIONFrom the comparison of the results of questionnaires and the transmissibility measurement of the wheelchair, the resonance frequency-ranges of the maximum vibration transmissibility of the manual wheelchairs were consistent with the frequency-ranges of the body parts of the causes of the complaints of wheelchair users. In addition, from these experimental results, it was suggested that the main point for improving a wheelchair user's comfort was to reduce the wheelchair seat vibration transmissibility at around 8 Hz and also to design wheelchair stiffness and damping characteristics to minimize vibration transmission at specific frequencies at body locations that caused the discomfort reported by wheelchair users.

We report two cases of patients with intractable upper abdominal pain and histories of injury or surgery. The patients' pains were successfully treated with tokishigyakukagoshuyushokyoto (TSG). Case 1 involved a 59-year-old woman with left upper abdominal and thoracodorsal pain lasting 5 years. Kampo drugs such as tokito or prescriptions containing saiko were ineffective. Two years after her first visit, we noticed an injury scar from childhood that passed near the left hikon (pi-gen, ExB4) and induration and tenderness of the left hikon. TSG was administered, and the pain promptly improved. Case 2 involved a 66-year-old woman. She complained of epigastric, right­-upper-­quadrant abdominal and back pain lasting 7 years. Two years before presentation, the pain had worsened, but the cause was unclear. Although keishibukuryogan or Kampo drugs containing saiko were ineffective, her pain improved when TSG plus bushi was administered. A wound from a cholecystectomy was observed on her right abdomen. Induration and tenderness of the right hikon were demonstrated. The combination of past history of injury or surgery of the upper abdomen or back and induration of hikon can be associated with development of indications for TSG.