Push-Rate Threshold for Physical Activity Intensity in Persons Who Use Manual Wheelchairs.

Only 17 participants had usable data; 28 were screened and 7 were excluded for data-recording errors. The sample was small and mixed across disability types, so the threshold may not fit every manual wheelchair user. The standard deviation around the push-rate cut-point was 26.06 pushes per minute, so the estimate is imprecise. The protocol used treadmill propulsion at three set speeds, not free-living wheelchair use. The study used SMARTwheels, not commercially available activity monitors, so the threshold may not transfer to devices patients use. The authors state the threshold would not be applicable for people with more severe upper-extremity impairments, other activities that involve moderate-to-vigorous effort, or people who do not use a manual wheelchair as their primary mobility. The sub-analysis compared only 7 participants with spinal cord injury and 10 with other conditions.

The supplied text does not report author conflicts of interest. The publication record lists research support from NIH extramural and non-U.S. government sources.

Do not treat 55.05 pushes per minute as a validated, general exercise prescription for manual wheelchair users. It was estimated from 17 participants during treadmill propulsion, with wide variation, and the authors say it is preliminary and may not apply to other tasks or people who do not use manual wheelchairs as their main mobility.