DESIGN AND DEVELOPMENT OF CONCEPTUAL

WHEELCHAIR CUM STRETCHER

Sreerag C S1, Gopinath C2, Manas Ranjan Mishra3
1-M.Sc. [Engg] Student, 2-Professor, 3-Asst. Professor, Department of Design
M. S. Ramaiah School of Advanced Studies, Bangalore 560 058

Abstract
In India the number of disabled individuals is increasing every year. Mobility aids are useful for patients for
transportation and a replacement for walking especially in indoor and outdoor environment. Wheelchairs and stretchers
are the most commonly used medical equipment for the transportation of patients. Transferring the patients from
wheelchair to stretcher or to the medical bed is always an issue for the attendant or nurse. Understanding the various
issues regarding the mobility equipment and introducing a better design will be an asset for the medical field and a
helping hand for disabled individuals. There is a need for a wheelchair cum stretcher to facilitate the disabled patients
mobility and to provide a novel medical equipment for use in the Indian hospitals.
Adopting various kinds of research methods helped to obtain more information about hospital mobility aids and for
data collection. It has been observed that every year the numbers of disabled individuals are increasing by different kinds
of accidents. Presently wheelchairs and stretcher are the commonly used mobility aid for indoor and outdoor purpose.
From the user study it was found out that the need of a wheelchair cum stretcher can be an asset for the Indian hospitals.
Transferring the patients from wheelchair to the stretcher or to the bed is a difficult task in hospitals. The presently used
wheelchair and stretcher design is not meeting the users need. From the identified need, QFD was generated and the
main priorities should be given to ergonomic design, mechanism, safety and functionality. From the Quality Function
Deployment (QFD), Product Design Specification (PDS) was made. Considering the issues like safety, hygienic, cleaning
and functionality the concepts were generated.
New features like document holder, provision for oxygen cylinder, and rotatable handle have been introduced. Final
concept was selected using Pugh selection method by evaluating all the concepts with bench marked product. A 1:2 mock
up model had been made to validate the concept and feedback was collected from users. Our study shows that it is possible
to save 50% space by the wheelchair- cum- stretcher design. The product will thus likely be an efficient mobility aid in
hospitals.
Keywords: Mobility Aid, Dual Purpose, Wheelchair cum Stretcher, Convertible Type, Safety
Nomenclatur e
Kg
Kilogram
mm
millimeter

1.1 Wheelchair invention

weight
length

The first record of combining wheel to furniture

was in Greece in 530 BC. Oldest evidence of wheeled
chairs was found in China, and was spoke wheels on
chariots in 1300 BC. The first dedicated wheelchair was
made for King Phillip II for Spain in 1595. It was not a
self -propelled one, a servant's assistance is to be needed
for the movement. Self propelled wheels invention was
created enormous demand in the market and it was
better helping aid for the disabled individuals [2].

Abbreviations
CAD
PDS
QFD

1.

computer aided design

Product Design Specifications
Quality Function Deployment

INTRODUCTION

Chair and wheel were the earliest inventions of

man. A wheelchair is a wheeled mobility device
designed especially for disabled individuals. The device
is propelled either manually (by turning the wheels by
the hand) or via various automated systems.
Wheelchairs are used by people for whom walking is
difficult or impossible due to illness (physiological or
physical), injury, or disability. Early wheelchairs were
intended only to help a disabled individual to move
from one place to another but today the wheelchairs are
considered as not only for the transportation purpose but
also a way to express users individuality. In India the
number of disabled population had a tremendous
augment in the past few years. Huge amount of people
have congenital disabilities, another few percentages are
the victim of accidents and various kind of mobility
devices are inevitable part of their life [1].

Fig. 1 Wheelchair
2.

DESIGN METHODOLOGY

Design methodology helps to find out the best solution

for each design situations. A systematic approach and

TECH

SAS

78

Volume 10, Issue 2, Sep 2011

procedure is to be followed to achieve the suitable

solution. It involves the following steps.
Journals and patent research
Market study and user(GEMBA)survey
Bench marking
QFD matrix
PDS
Concept generation and selection
Final concept refinement
physical modeling and validation

3. LITURATURE REVIEW
Journal papers and patents explored here are
related directly or indirectly to the proposed area of
work that is design and development of a Wheelchair
cum Stretcher. These papers are to support and
enlighten the whole process of design in the specific
area.
3.1 Wheelchair and Stretcher

impairment and majority of these individuals are

dependent on others mobility. A smart power assistance
module (SPAM) for manual wheelchair is being
developed to provide independent mobility for this
population. The power assist wheelchair that provides
for obstacle detection and avoidance for those with
visual impairments. The control of the wheelchair will
be carried out by the microprocessor and also allow the
SPAM to provide a smoother and nuanced control.
3.5 Wheelchair Configuration
According to Mr. Rory A. Cooper, [6]
rehabilitation is a humanistic profession. Measurement
of the user and wheelchair are critical to achieving
maximum functional mobility. He says Biomechanics
and ergonomics provide the information necessary to
understand many aspects of wheelchair use. These
factors affect seating comfort and posture, propulsion,
efficiency and pain. Proper seating is an important
aspect of wheelchair selection, and wheelchair cushions
provide pressure relief and some postural support.
Electric powered mobility may be the best choice for
driving long distance and may be beneficial for people
with upper and lower extremity impairments.

A wheelchair is chair with wheels, designed to help

the disabled individuals. Stretchers are mobility devices
used to transport the patients from one place to other.
These both medical mobility aids are used in hospitals
and clinics for helping the patients. Stretchers are
simple in construction and the patient needs the support
of an assistant to transport from one place to other.
Whereas wheelchair is designed in such a way that
either patient can control the device manually or with
the help of someones assistance. The device consists of
proper handle with cushion in hand rest and seating
area. The direction movement is a critical part when it
comes to emergency situation. Proper selection of caster
wheels facilitates to overcome the situations.

Dr. Daniel E. Jolly, [7] says proper preparation

should be taken before transferring the patient from
wheelchair to bed or vice versa. Use of sliding boards
will be helpful for paraplegic patients. The best sliding
board is made of hard wood, smooth, tapered on ends.
Support of two assistance, support straps, belts etc will
facilitate easy transfer. The patient should not be slide
into chair, lift from the wheelchair and transfer is the
optional and safety method for patient transfer.

3.2 Selection of Wheelchair

3.7 Mechanical Principles for Wheelchair Design

According to Mr. Peter Axelson, Mr. Jean Minkel,

and Mr.Denise Chesney, [3] selection of an appropriate
wheelchair will lead a comfortable living to the user.
Performance, safety and dimensions are the three
categories which have to be considered while selecting a
manual or powered wheelchair. An excellent approach
to the wheelchair selection is to set priorities based on
users mobility and seating needs. It is highly
recommended that a novice can consult with the
rehabilitation specialists in order to select the
appropriate wheelchair.

Mr. Amos Winter, [8] says following the

mechanical principles will be helpful for a better design.
Understanding the centre of gravity location is
important in wheelchair design. Weight should be the
other important factor for wheelchair design. Reducing
weight will results the comfortable use for the user and
also lowers material cost. The best strategy is to
maximize the strength and minimize the weight of the
frame tubing. Calculating the moment of inertia and
weight results the best strength and can be used to make
the strongest frame at the least weight.

3.3 Caster Wheel Shimmy

3.8 Anthropometric Consideration

James J. Kauzlarich, [4] says self excited vibration

is one of the most interesting topics in the field of
vibrations and is the science prevailing caster wheel
shimmy. Self excited vibration is characterized by
vibration that is produced by the motion of the system
like wheelchair speed. It can be observed that in most of
the cheapest wheelchairs, the design of the casters
makes use of a sliding frictional damper in the spindle
support to improve the shimmy characteristics.
Understanding the theory of damping for the casters
show how shimmy prevention works in ultra-light and
powered wheelchairs.

Mr. Debkumar Chakrabarti [9] says primary

consideration should be given for comfort, so that
people can sit for long time without feeling any physical
discomfort. Considering the suitable materials for seat
surface, frame and can make a comfortable seating for
the design. Without considering the ergonomics and
application can make a diverse effect to the user. Seat
cushions are so important in the design of wheelchair. A
wheelchair or stretcher design without cushion is not
recommended for the hospital purposes. A stretcher or
wheelchair design without cushion may create spinal
cord injuries to the patients.

3.4 Smart Power Assisted Wheelchair

3.9 Structure of Common Wheelchair

Mr. Richard Simpson, [5] says almost 10% of all

individual who are legally blind also have a mobility

Wheelchair is a wheeled chair consists of various

parts and each part with different functions. This is an

TECH

SAS

79

3.6 Patients Transfer System

Volume 10, Issue 2, Sep 2011

ergonomically designed medical equipment consists of a

foldable frame type mechanism for easy carry. Seating
and hand resting position are well designed for a
comfortable sitting. Adjustable foot rest with a heel loop
on the harper bracket is provided so that user wont get
problems while transportation. Handles are placed in the
back rest of wheelchair with suitable grip on that. Push
rims are the other features of the wheelchair when into
comes to the indoor purpose for the user. The user can
be independent by the help of push rim, which may help
the user to move from one place to other. Brakes are
provided for stopping the wheelchair on both the push
rim wheels. Caster wheels are another major part which
directs the way and for easy transportation.

Fig. 4 Wheelchair classification

3.12 Types of Manual Wheelchairs
Manual wheelchair classification is done based on
the use and type of material used. Travel, airport,
pediatric and stainless steel wheelchairs are the
commonly used wheelchairs in hospitals.

Fig. 2 Structure of wheelchair [10]

3.10 Structure of a common stretcher
Stretchers are the common transportation devices
in hospitals, in order to carry a patient who cant walk
or stand with the help of others assistance. Mostly the
accident cases and the people who are in critical stages
are carried in stretcher. It is a simple design with tubular
frame fixed with swivel caster wheels and metal
platform form on the top side for lay the patient.

Fig. 5 Types of manual wheelchairs [10]

3.13 Types of Electric Wheelchairs

Fig. 3 Structure of stretcher [10]

3.11 Wheelchair Classification
Wheelchair classification is done based on the type
and area of use. Mainly wheelchairs are classified to
manual, sports and electric wheelchairs.

TECH

SAS

80

Fig. 6 Electric wheelchairs [10]

Electric wheelchairs are the commonly used indoor
mobility devices. The specialty of these kinds of devices
is for their design especially because of the custom
design. The design can be done according to the users
convenience.

Volume 10, Issue 2, Sep 2011

3.14 Types of sports wheelchairs

Entertainments like sports and games are the part
of human life. Human who are physically challenged
will have the entertainment through these kinds of
wheelchairs. Various kinds of sports wheelchairs are
basket ball, tennis, rugby and athletic wheelchairs.

Fig. 9 Caster wheel mechanism [10]

Braking Mechanisms
Toggle clamp mechanism is fixed on rear wheel
for braking in manual wheelchairs. Lever type
mechanism is used in hand brake system. Hand braking
system is used in most of the manual wheelchair and
will be helpful for the users convenience.

Fig. 7 Types of sports wheelchairs [10]

3.15 Wheelchair Mechanisms
Kinds of
wheelchairs and
accessibility and
commonly used
explained below.

mechanism are incorporated with

stretchers. This helps to get more
usability to the product. Some of the
mechanisms in the wheelchairs are

Fig. 10 Braking mechanisms [10]

3.16 Types of Wheels in Wheelchair

Cross Brace Bar Mechanism

Cross bracing is a construction technique in which
braces are crossed to form an X shape to support
a frame. The main feature of this mechanism is the
folding facility, which helps to the product into a
foldable one. This folding technique helps the
wheelchair a portable type and can be carried easily
with less weight and less space consideration.

Wheelchair wheels are classified into two

categories, caster wheels and push rim wheels.
3.17 Wheelchair Cushions
Cushions are the integral part of wheelchair
where the patients are laid. A stretcher or wheelchairs
without cushions are never recommended for the
hospital purpose. So study has conducted in order to get
a better understanding with the types of cushions used
in these products. The use of quality material raises the
entire cost of the product and a comparison study has
done in order to understand the various types of
cushions used in wheelchair and stretcher.

Table 23. Types of cushions [10]

Fig. 8 Cross brace bar mechanism [10]

Caster wheel mechanism
Caster angle is the angular displacement from
the vertical axis of the suspension of a steered wheel in
a vehicle measured in the longitudinal direction. It is the
angle between the pivot line (in a car - an imaginary line
that runs through the centre of the upper ball joint to the
centre of the lower ball joint) and vertical. Car racers
sometimes adjust caster angle to optimize their car's
handling characteristics in particular driving situations.
It is applied to ensure stability of direction by means of
a special arrangement. is the caster angle, red line is
the pivot line, grey area is the tire. A positive caster
angle is shown with the front of the vehicle being to the
left.

TECH

SAS

81

3.18 Bench Marking

These types are the commonly used wheelchair
cum stretcher type of medical equipments in the
hospitals. Some of the features are like foldable frame,
foldable arm rest, foldable and detachable foot rest, dual
brake system and detachable and adjustable type of head

Volume 10, Issue 2, Sep 2011

rest. The product is manufactured with high quality of

materials like stainless steel, carbon fiber etc

Cardiac failure patients will have problem while

using stretcher, so seating will be better preferred
position.
The most preferred position for getting rest for
heart will be seating posture.

4.2 Study of Technical Voices Findings from QFD

Technical voices from QFD are listed below.
These were studied and incorporated while concept
ideation stage.

Fig. 11 Bench marked product [10]

4. RESEARCH AND ANALYSIS

Ergonomics: When the wheelchair converted

to stretcher, ergonomic height is considered.
Mechanism: Easy to operate and simple
mechanism is considered.
Safety: Should not be harmful to the patients.
Product design specification (PDS) is arrived
from the QFD.

4.3 Ergonomic details

4.1 Gemba Study and User Survey

User study needs to be conducted in order to
experience the user and its environment. This may help
the designer to design an appropriate product which
suits the environment. User study has been conducted
around 8 hospitals in order to find the user experience
and various issues regarding wheelchair and stretcher.
Initially all the stake holders are considered and study
has conducted in order to get more information.

All dimensions are considered according to Indian

anthropometric data.
Human dimensions are considered for both male and
female and 95th percentile of hip breadth, elbow to
elbow and buttock to popliteal is taken for the sitting
posture.

Ethnography study helps to identify the need

of the product, product environment and users
experience. This technique helps to gain more
knowledge about the wheelchair/stretcher usage and
various situations which affect their working
environment. Wheelchairs and stretchers are the
mobility equipments used to transport the patients from
one place to other and various problems are identified
by conducting the user study. Medical equipments,
hospital environment and the stake holders related to the
product are considered for conducting the gemba study.

Fig. 113 Anthropometric data [9]

Elbow rest and popliteal dimensions are taken as 50th
percentile and combined dimension of 210mm and
419mm respectively for the design. Stature dimension is
taken as 95th percentile and the dimensions as 1771mm.

Fig. 12 User study

Observations from the Gemba study are,
Availability of numbers of stretchers are less
compared to wheelchairs, so patients have to wait
in the wheelchair if they need to transfer to the
stretcher.
Transferring of patients from vehicle to the
stretcher can be done only with the help of 2-3
people.
Transferring of patient from stretcher to the bed
also a problem for the patient.
Patients will be arriving to the hospitals with their
own vehicles so at first attender will be choosing
the wheelchair to transfer the patients.
Patients with fracture in bone will be preferred to
transfer in stretcher.
Patients with low blood pressure are better to use
stretcher.

TECH

SAS

82

Fig. 14 Anthropometric data [9]

5. CONCEPT GENERATION
Based on Product Design Specification concepts
are generated using mind mapping tool.

5.1 Mind Mapping

Volume 10, Issue 2, Sep 2011

Mind mapping technique is used to visualize

various ideas. So this classification considered all the
aspects for the concept design.
5.2 Concept 1
The main criteria considered for this concept is the
convertible wheelchair and stretcher. So in order to
convert the wheelchair into stretcher, some sort of
mechanism needs to be added. In this concept a sliding
tubular frame is attached to the back rest of the
wheelchair. A handle is provided in the back rest so that
the user can be pulled it easily and can be converted to
stretcher easily. So a proper balance should be
maintained in the back side because the centre of
gravity of human body will be lying in between the seat
and back rest portion. A caster wheel support is given so
that proper balance will be achieved.
A pair of bigger wheels is provided in the middle of the
wheelchair, so that more strength will be attained and
front caster guides the wheelchair according to the
direction. The provision for oxygen cylinder is another
demand which has observed during the user study and
the drip holder location is provided by the sides of the
wheelchair. The hand rest is designed in such a way
that, it can be rotated and a removable type so that it
will act as a support side for transferring the patients.

5.4 Concept 3
This is concept is operated with hydraulic
mechanism, so that the height can be adjusted according
to the users convenience. The handle is designed in
such a way that, the user wont get any difficulty while
handling the product. A simple design of oxygen
cylinder holder is provided below the seat so that it can
help to withstand stretcher with a supporting element for
adjusting the weight.

Fig. 17 Concept 3
A hydraulic scissor lifter mechanism lifts the
entire wheelchair into stretcher. The telescopic
arrangement supports the back rest so that weight of the
body will be evenly distributed in the stretcher.

Fig. 15 Concept 1
5.3 Concept 2
This concept is slightly different from the concept
one. The back rest is providing with an adjustable
handle with a comfortable holding position. The length
can be adjusted and the length can be maintained by
adjusting the knob. The frame design is made in such a
way that proper strength is provided to the wheelchair.

Fig. 18 Concept 3 wheelchair

5.5 Concept 4
A double caster wheel mechanism gives more
strength to the design, so that weight of the body can be
evenly distributed. Front portion is lifted with the help
of hydraulic mechanism so that the patient wont get
trouble while lifting.

Fig. 16 Concept 2
Fig. 19 Concept 4

TECH

SAS

83

Volume 10, Issue 2, Sep 2011

5.6 Concept 5
This concept is based on the gear mechanism.
According to the rotation of the middle wheel, the front
and back seats are rotated in opposite direction and
stretcher arrangement is achieved.

Fig. 23 Caster wheels

It can be observed in hospitals that most of the
drip holder will be in separate location. This is
a serious ergonomic problem for the nurses
and in this concept the problem can be
devastated by adding a telescopic type of drip
locator in one side. Document holder helps to
keep the documents safely. A rail mechanism
with telescopic arrangement helps to maintain
the centre of gravity of the stretcher.

Fig. 20 Concept 5
5.7 Concept selection and evaluation
The generated concepts were compared and
studied using Pugh method with the bench marked
product. Concept 3 was selected as the final concept
and it was verified with user opinion. The selected
concept is modeled using Alias studio tools and
rendered in Hyper shot for visualization

Fig. 24 Features

The most important area of a wheelchair or

stretcher is the cushioning part. Here the design is
done with foam material and various sectioning is
given so that it can be easily folded.

Fig. 21 Final concept

Fig. 25 Wheelchair cushion

5.8 Final concept detailing

The function of the hydraulic mechanism is mainly for

adjusting the height. It should be easy for an operator to
lift the entire chair into stretcher height by the use of a
button.

Base is the area where the cushion sits. It is

designed in such a way that easy folding should be
possible when a wheelchair is converted to
stretcher.

Fig. 26 The base

Fig. 22 Hydraulic mechanism

Easy movement is the best performance required

for the mobility devices. Caster wheels help the
wheelchair or stretcher to relocate the product
according to the direction of motion.

TECH

SAS

84

Oxygen cylinder holder is required for each of the

stretcher. Most of the existing designs are very
complex in design. Here a very simple oxygen
cylinder holder is designed. By construction vice, it
is so simple with bending. The base of the
wheelchair design is constructed with the help of
tubular frame. This material helps to reduce the
weight of the entire product. The use of stainless

Volume 10, Issue 2, Sep 2011

steel material to the frame gives more strength and

product will be long lasting.

Fig. 29 Concept validation

Fig. 27 The frame

5.9 Mock Up Model for Selected Concept
A 1:2 Mock-up model is developed by using MS
frames, MDF wood and spray painted to validate the
concept. Fig 1.29 shows the dimensional drawing and
mock-up model of the final concept.

The nurses and attendant are satisfied with the

proposed design mainly because of the usability and
functionality of design. The hydraulic mechanism which
is operated by button control will be more user friendly
to the operators. The additional features like drip
holding locator, oxygen cylinder holder and the folder
location for keeping the medical documents are the
required features of the product. It has been concluded
that the final product fulfils the requirement of the user.

7. SUMMARY
The present study was intended to develop a
concept for a wheelchair- cum- stretcher, with the
motivation of saving space and precluding exertion by
the patient. By adopting various research methods
helped to identify the various issues of the topic,
importance of safety and hygiene and significance of
materials and manufacturing process involved in the
whole product. From the identified needs ergonomic
design, mechanism and safety were prioritized by
Quality Function Deployment. Product Design
Specification was generated based on QFD and five
different concepts were created through mind mapping
technique. Digital modeling was done using Alias studio
tools and hyper shot software was used for better
visualization. Final concept selection was done using
Pugh selection matrix by comparing the bench marked
product. A 1:2 mock up model of selected concept was
made for validating the final concept. Our study shows
that it is possible to save 50% space by the wheelchaircum- stretcher design. The product will thus likely be an
efficient mobility aid in hospitals.

Fig. 28 Mock-up model

6.

VALIDATION AND DISCUSSION OF

RESULTS

In order to understand the ergonomic issues of the

wheelchair cum stretcher, a mannequin of human is
made and the validation has been done. Though it is not
a working model, functioning of hydraulic mechanism
cannot be shown or validated through the mannequin.
The hydraulic mechanism which is proposed for lifting
the wheelchair seating to the stretcher position will be
the most appropriate method for lifting. The design of
the handle and the arm rest are ergonomically designed
so that the user wont get any problems while operating.

8.
[1]

[2]
[3]

[4]

[5]

TECH

SAS

85

REFERENCES
Anonymous,
Wheelchair
history
and
development, www.newdisability.com, retrieved
on 27th Sept. 2010.
Anonymous, History of the wheelchair,
www.inventors.about.com, retrieved on 27th Sept.
2010.
Peter Axelson., A guide to wheelchair
selection, paralyzed veterans of America,
Library of Congress Cataloguing-in-publication
data, Washington 1994.
James J. Kauzlarich., Wheelchair caster shimmy
II: Damping, Journal of Rehabilitation Research
and Development, Volume. 37, No. 3, pp 305313, May/June 2000.
Cooper R, Corfman T, Fitzgerald S, Boninger M,
Spaeth D, Ammer W, Arva J., Performance
Assessment of a Pushrim Activated Power

Volume 10, Issue 2, Sep 2011

Assisted Wheelchair, IEEE Trans Control Sys

Tech, Volume 10, ISSN: 1063-6536, Jan 2002.
Dr. Rory A. Cooper., Wheelchair selection and
configuration, ISBN 1-888799 18 8, March
1998.
Mr. Daniel E. Jolly., Wheelchair transfer, The
Ohio state university college, Columbus, ohio,
retrieved on 24th Sept. 2010
Mr. Amos Winter, Mechanical principle of
wheelchair
design,
Graduate
Student,

[6]

[7]
[8]

TECH

SAS

86

Department
of
Mechanical
Engineering,
Massachusetts Institute of Technology, US,
retrieved on 24th Sept. 2010.
[9] Debkumar Chakrabarti, Indian Anthropometric
Dimensions for Ergonomic Design Practice,
National Institute of Design, Ahmedabad, 1999.
[10] Unknown, wheelchair, stretcher, hydraulic
lifting, www.googleimages.com, retrieved on 8th
.
2010

Volume 10, Issue 2, Sep 2011