Mechanical & Materials Engineering, Department of


Date of this Version



Burnfield JM, Shu Y, Buster TW, Taylor A, Nelson CA (2011). Impact of elliptical trainer ergonomic modifications on perceptions of safety, comfort, workout and usability for people with physical disabilities and chronic conditions. Physical Therapy, 91(11): 1604-1617. DOI: 10.2522/ptj.20100332. PMCID: PMC3367158.


PubMedCentral MS


Background The popularity of elliptical training has grown in rehabilitation, fitness, and home settings as a means for improving fitness and walking, yet many people with physical disabilities and chronic conditions experience difficulties when trying to use elliptical trainers.

Objective The purpose of this study was to compare, for people with disabilities and chronic conditions, perceptions of safety, comfort, workout, and usability of 4 elliptical trainers before and after the development of a set of low-cost adaptations.

Design This study was a quasi-experimental repeated-measures investigation.

Methods Twenty adults with diverse medical conditions and functional abilities evaluated 4 elliptical trainers for safety, comfort, workout, and usability. Barriers to the use of the elliptical trainers and solutions to improve the use of the trainers were identified. Prototype modifications were designed, and participants reassessed the same features after the modifications were made.

Results An integrated system (steps, bench, side rails, center rail or handle, deeper foot wells, and 1-handed heart rate monitor) was developed. Although at least 25% of participants required physical assistance to get on or off the elliptical trainers before modification, only one required this after modification. Before modification, only 1 participant was able to mount each device independently; after modification, 6 to 8 participants were able to do so. Up to 25% of participants continued to require assistance to initiate or sustain pedal movement. Compared with participants' ratings of the elliptical trainers before modification, those after modification were higher for safety (55% increase in visual analog scale ratings), comfort (43% higher), ability to achieve a good workout (23% greater), and usability (24% increase).

Limitations To date, only 4 elliptical trainers have been studied with a small sample of convenience.

Conclusions Elliptical trainers posed access challenges to people with disabilities, chronic conditions, or both. Implementation of low-cost modifications successfully reduced barriers and the need for assistance, enabling greater access for people who could benefit from using the devices for functional training and fitness.