Biomechanical Evaluation of Graded Wheelchair Propulsion Technique in Individuals with Paraplegia

Puja Ruparel, MS, Sara J. Mulroy, PhD, Philip S. Requejo, PhD, Lisa Lighthall Haubert, MPT, Patricia Hatchett, DPT


Shoulder joint kinetic and kinematic during manual wheelchair propulsion on a stationary ergometer under free, fast and graded conditions were analyzed to identify risk factors for the development of shoulder pain in individuals with long standing spinal cord injury.  A unique technique of pulling up on the handrim during the beginning of the propulsion cycle was found in about 6.25 percent (10 out of 156) of the individuals during the graded condition.  The propulsion characteristics and shoulder joint kinetics of these individuals were compared to velocity and weight-matched individuals who propelled with the typical pushing down technique.  Peak vertical shoulder joint reaction forces and total forces applied on the handrim were found to be lower in the group that pulled up whereas fractional effective force was found to be higher, thus suggesting a more efficient method of propulsion that would benefit manual wheelchair users over time.


Spinal cord injury, wheelchair propulsion, kinetics, shoulder


This study was funded by the National Institutes of Health (NIH) Research grant # (R01)HD049774.

Author Contact Information:

Puja Ruparel, MS, University of Southern California
Rancho Los Amigos National Rehabilitation Center
7600 E. Imperial Highway, Building 800, Room 33, Downey, CA 90242