Practice-based skill acquisition of pushrim-activated power-assisted wheelchair propulsion versus regular handrim propulsion in novices.
Rick de Klerk, Thijs Lutjeboer, Riemer J K Vegter and 1 others
PMID 29940986WHAT IT FOUND
Novices improved wheelchair propulsion efficiency and steering with practice.
Power-assisted wheels used less energy and felt easier, but were harder to control. Switching between power-assisted and regular wheels did not show clear carryover.
Key findings
01Mechanical efficiency rose by 0.71% in the regular handrim group and by 0.62% in the power-assisted group over practice.
02The power-assisted group had 1.21% higher mechanical efficiency, used 68 W less energy, and rated exertion 1.4 points lower than the regular group at the final session.
03After switching between regular and power-assisted wheels, differences in efficiency, energy use, heart rate, perceived exertion, push frequency, and steering deviation did not reach significance.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The participants were able-bodied university students, not people with disability, so the findings may not apply to clinical wheelchair users. The sample was small: 17 men and seven women. Practice was tested on a narrow treadmill belt, 2.0 m long by 1.2 m wide, without obstacles or real-life steering demands. The power-assist contribution could not be separated from the user's technique because the assist algorithm was unknown. Safety stops were more frequent in the power-assisted first session, with a mean of 3.25 stops, which may have affected control results. Kinematic data were missing on three occasions. Individual differences were large, but the sample size did not allow analysis of those differences. Transfer between modes did not reach significance, so skill carryover is unclear.
The easy way to misread this
Do not conclude that power-assist wheels are easier for disabled novice wheelchair users. The study used able-bodied novices on a treadmill, and the power-assisted group had more steering variability and no significant carryover when switching modes.