Special Collection: Affordable Rehabilitation and Assistive Technologies Identifying key experience-related differences in over-ground manual wheelchair propulsion biomechanics

Objectives The purpose of this study was to investigate technique differences between expert and novice manual wheelchair users during over-ground wheelchair propulsion. Method Seven experts (spinal cord injury level between T5 and L1) and six novices (non-wheelchair users) pushed a manual wheelchair over level ground, a 2.5% cross slope and up a 6.5% incline (7.2 m length) and 12% incline (1.5 m length). Push rim kinetics, trunk and shoulder kinematics and muscle activity level were measured. Results During the level and cross slope tasks, the experts completed the tasks with fewer pushes by applying a similar push rim moment over a greater push arc, demonstrating lower muscle activity. During the incline tasks, the experts required fewer pushes and maintained a greater average velocity, generating greater power by applying a similar push rim moment over a greater push arc with greater angular velocity, demonstrating greater trunk flexion and higher shoulder muscle activity. Conclusions This study identifies experience-related differences during over-ground manual wheelchair propulsion. These differences are particularly evident during incline propulsion, with the experts generating significantly greater power to maintain a higher velocity.