Alternative modes of manual wheelchair ambulation - An overview

An estimated 90% of all wheelchairs are hand-rim propelled, a physically st raining form of ambulation that can lead to repetitive strain injuries in t he arms and, eventually, to secondary impairments and disability. Further d isability in wheelchair-dependent individuals can lead to a sedentary lifes tyle and thereby create a greater risk for cardiovascular problems. Studies on lever-propelled and crank-propelled wheelchairs have shown that these p ropulsion mechanisms are less straining and more efficient than hand-rim-pr opelled wheelchairs. This article reviews these studies and substantiates t hat the frequent use of these alternative propulsion mechanisms may help pr event some of the secondary impairments that are seen among today's wheelch air-user population.