Shoulder Muscle Demand during Lever-Activated Wheelchair Propulsion

Sharon Eun J. Lee, BS, Philip S. Requejo, PhD, Lisa Lighthall Haubert, MPT, Ernest Bontrager, MS, Sara J. Mulroy, PhD.


Lever-activated wheelchairs have been presented as a less demanding and more efficient alternative mode of manual wheelchairs (WC). The purpose of this study was to evaluate the electromygraphic (EMG) activity and propulsion characteristics in individuals with tetraplegia and paraplegia propelling a standard wheelchair and a commercially available lever-activated WC on a stationary ergometer.  We hypothesized that lever WC propulsion would reduce the shoulder muscle demand compared to standard WC propulsion.

Decreased median EMG intensity and duration of primary push-phase muscles activity were significantly lower during Lever propulsion than in standard propulsion, particularly at greater speeds and increased resistance.  The distribution of muscular demand shifted to anterior muscles of the glenohumeral joint. Manual WC users may benefit from the use of this alternative form of manual wheelchair propulsion. However, further studies are needed to determine the impact of lever activated wheelchair propulsion on long-term shoulder function.  


wheelchair propulsion, lever-propelled wheelchair, spinal cord injury, electromyography.


NIDRR grant H133E020732, Sunrise Medical (Quickie GPV®), SuperQuad (Wijit®)


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