Clinical Relevance for the Veterans

Purpose of the Work. This study compared the propulsion biomechanics of manual wheelchair users with and without upper-limb impairment. Subjects and Procedures. Fortyseven manual wheelchair users (15 with upper-limb impairment and 32 without upper-limb impairment) propelled an instrumented wheelchair ergometer while a 3D motion analysis system was used to collect joint kinematic and temporal data, as well as hand rim and joint kinetics. Measures were compared between groups. Results. The group with upper-limb impairment propelled with a higher stroke frequency and reduced contact time; with smaller peak joint angles of the wrist, elbow, and shoulder during the contact phase; with reduced power output; and with reduced hand rim propulsive and resultant forces, moments, and joint compressive forces. Relevance to the Veteran Population. More than 175,000 veterans use manual wheelchairs for mobility, with 44,000 manual wheelchairs distributed annually, according to the Department of Veterans Affairs (VA) Prosthetics National Database. Manual wheelchair users with upper-limb impairment adopt strategies to remain independent, and some of these strategies may protect them from the development of secondary upper-limb pathologies. Margaret A. Finley, PhD, PT