Influence of wheelchair type on Wheelchair Propulsion Test performance in community-dwelling,adult wheelchair users 1

Abstract

BACKGROUND:

The clinimetric properties of the Wheelchair Propulsion Test (WPT) have not been developed thoroughly.

OBJECTIVE:

To determine inter-rater reliability and reference values for the Wheelchair Propulsion Test (WPT) for active wheelchair users and to compare WPT performance between various types of manual wheelchairs at different paces.

METHODS:

This was a cross-sectional, descriptive study. Participants propelled a manual wheelchair 10 m while time and the number of pushes were recorded. Trials were performed in three different manual wheelchairs (a lightweight wheelchair (LW), an ultralightweight wheelchair (ULW), and the participant’s personal, customized wheelchair) at a comfortable pace and a fast pace.

RESULTS:

The ICC values ranged from 0.861 to 0.999 for both speed and number of pushes. Comfortable wheelchair propulsion speed ranged from 1.51 (0.31) m/s to 1.65 (0.33) m/s depending on the wheelchair utilized. Across both pace conditions, participants were significantly faster when using their personal wheelchair compared to the ULW (P < 0.001) and LW (P < 0.001). Push frequency was significantly greater during the fast pace condition compared to the comfortable pace condition (P < 0.001).

CONCLUSIONS:

Reference values for the WPT in active wheelchair users have been identified. Participants who utilize their personal wheelchair demonstrate faster wheelchair propulsion speeds complemented by greater push frequencies.

Keywords

Locomotion mobility limitation reference values wheelchairs

Get full access to this article

View all access options for this article.

References

Andrews,

A. W.

, Vallabhajosula,

, Ramsey,

, Smith,

, & Lane,

M. H.

(2019), Reliability and normative values of the Wheelchair Propulsion Test: A preliminary investigation. NeuroRehabilitation, 45(2), 229–237. doi: 10.3233/NRE-192779

Askari,

, Kirby,

R. L.

, Parker,

, Thompson,

, & O’Neill,

(2013), Wheelchair Propulsion Test: Development and measurement properties of a new test for manual wheelchair users. Arch Phys Med Rehabil, 94(9), 1690–1698. doi: S0003-9993(13)00207-4

Boninger,

M. L.

, Koontz,

A. M.

, Sisto,

S. A.

, Dyson-Hudson,

T. A.

, Chang,

, Price,

, & Cooper,

R. A.

(2005), Pushrim biomechanics and injury prevention in spinal cord injury: Recommendations based on CULP-SCI investigations. J Rehabil Res Dev, 42(3 Suppl 1), 9–19. doi: 10.1682/jrrd.2004.08.0103

Boninger,

M. L.

, Souza,

A. L.

, Cooper,

R. A.

, Fitzgerald,

S. G.

, Koontz,

A. M.

, & Fay,

B. T.

(2002), Propulsion patterns and pushrim biomechanics in manual wheelchair propulsion. Arch Phys Med Rehabil, 83(5), 718–723. doi: 10.1053/apmr.2002.32455

Brown,

D. D.

, Knowlton,

R. G.

, Hamill,

, Schneider,

T. L.

, & Hetzler,

R. K.

(1990), Physiological and biomechanical differences between wheelchair-dependent and able-bodied subjects during wheelchair ergometry. Eur J Appl Physiol Occup Physiol, 60(3), 179–182. doi: 10.1007/BF00839155

Chan,

Y. H.

(2003), Biostatistics: correlational analysis. Singapore Med J, 44(12), 614–619.

Cowan,

R. E.

, Boninger,

M. L.

, Sawatzky,

B. J.

, Mazoyer,

B. D.

, & Cooper,

R. A.

(2008), Preliminaryoutcomes of the SmartWheel Users’ Group database: A proposed framework for clinicians to objectively evaluatemanual wheelchair propulsion. Arch Phys Med Rehabil, 89(2), 260–268. doi: 10.1016/j.apmr.2007.08.141

Gagnon,

D. H.

, Roy,

, Gabison,

, Duclos,

, Verrier,

M. C.

, & Nadeau,

(2016), Effects of seated postural stability and trunk and upper extremity strength on performance during manual wheelchair propulsion tests in individuals with spinal cord injury: An exploratory study. Rehabil Res Pract, 2016, 6842324. doi:10.1155/2016/6842324

Gagnon,

D. H.

, Roy,

, Verrier,

M. C.

, Duclos,

, Craven,

B. C.

, & Nadeau,

(2016), Do performance-basedwheelchair propulsion tests detect changes among manual wheelchair users with spinal cord injury during inpatientrehabilitation in Quebec? Arch Phys Med Rehabil, 97(7), 1214–1218. doi: 10.1016/j.apmr.2016.02.018

10.

Goosey-Tolfrey,

V. L.

, & Kirk,

J. H.

(2003), Effect of push frequency and strategy variations on economy and perceived exertion during wheelchair propulsion. Eur J Appl Physiol, 90(1-2), 154–158.

11.

Jung,

H. W.

, Jang,

I. Y.

, Lee,

C. K.

, Yu,

S. S.

, Hwang,

J. K.

, Jeon,

, ... Lee,

(2018), Usual gait speed is associated with frailty status, institutionalization, and mortality in community-dwelling rural older adults: A longitudinal analysis of the Aging Study of Pyeongchang Rural Area. Clin Interv Aging, 13, 1079–1089. doi: 10.2147/CIA.S166863

12.

Larraga-Garcia,

, Lozano-Berrio,

, Gutierrez,

, Gil-Agudo,

, & Del-Ama,

A. J.

(2019), A systematic methodology to analyze the impact of hand-rim wheelchair propulsion on the upper limb. Sensors (Basel), 19(21). doi:10.3390/s19214643

13.

Middleton,

, Fritz,

S. L.

, & Lusardi,

(2015), Walking speed: The functional vital sign. J Aging Phys Act, 23(2), 314–322. doi: 10.1123/japa.2013-0236

14.

Moore,

J. L.

, Potter,

, Blankshain,

, Kaplan,

S. L.

, O’Dwyer,

L. C.

, & Sullivan,

J. E.

(2018), A core set of outcome measures for adults with neurologic conditions undergoing rehabilitation: A clinical practice guideline. J Neurol Phys Ther, 42(3), 174–220. doi: 10.1097/NPT.0000000000000229

15.

Morgan,

K. A.

, Tucker,

S. M.

, Klaesner,

J. W.

, & Engsberg,

J. R.

(2017), A motor learning approach to training wheelchair propulsion biomechanics for new manual wheelchair users: A pilot study. J Spinal Cord Med, 40(3), 304–315. doi: 10.1080/10790268.2015.1120408

16.

Parziale,

J. R.

(1991), Standard v lightweight wheelchair propulsion in spinal cord injured patients. Am J Phys Med Rehabil, 70(2), 76–80. doi: 10.1097/00002060-199104000-00005

17.

Rogers,

, Berman,

, Fails,

, & Jaser,

(2003), A comparison of functional mobility in standard vs. ultralight wheelchairs as measured by performance on a community obstacle course. Disabil Rehabil, 25(19), 1083–1088. doi: 10.1080/0963828031000152048

18.

Singh,

S. K.

, Arya,

K. N.

, & Nagar,

(2008), To compare the physiological effects of standard and light weight wheelchair design during propulsion by persons with spinal cord injury (SCI). Indian J Occup Ther, 39, 73–78.