Exploring the ecological validity and variability of a 10-min bout of wheeling

Abstract Purpose: To determine the ecological validity of using able-bodied participants to perform a 10-min wheeling trial by (1) evaluating changes in biomechanics over the trial in manual wheelchair users and able-bodied participants naïve to wheeling and (2) describing differences in changes and variability between groups. Materials and methods: Manual wheelchair users (n = 7, 2–27 years’ experience) and able-bodied participants (n = 11) wheeled for 10 min. Kinetic and temporal variables were collected and averaged over each minute, while wheeling strategy (movement pattern) was categorized at minutes 1 and 10. Results: There was a main effect of time for push angle, and a main effect of group for average push angle, tangential force and total force. Manual wheelchair users used larger push angles and forces compared to able-bodied participants. Surprisingly, intercycle variability did not differ between groups. Conclusion: Using able-bodied participants to represent manual wheelchair users performing a 10-min wheeling trial is not ecologically valid and caution should be used when interpreting push angle and forces applied to the pushrim. Considering that push angle was the only variable that demonstrated a main effect of time, long durations (e.g., 10 min) of wheeling may be appropriate for use in study designs acknowledging potential changes in wheeling strategy and push angle. Implications for Rehabilitation Some experienced wheelchair users and non-wheelchair users modify their movement pattern from an arc to a circular pattern within a 10-min wheeling trial. There are clear biomechanical differences in push angle and forces applied to the pushrim between wheelchair users with experience and able-bodied non-wheelchair users. Able-bodied participants who have no prior manual wheeling experience are no more variable than long-term wheelchair users. Variability may play an important role in wheelchair propulsion.