Moving forward: A review of continuous kinetics and kinematics during wheelchair and handcycling propulsion

Abstract

Wheelchair users (WCUs) face high rates of upper body overuse injuries, especially in the shoulder. As exercise is recommended to reduce the high rates of cardiovascular disease among WCUs, it is becoming increasingly important to understand the mechanisms behind shoulder soft-tissue injury in WCUs to help prevent future injuries. Understanding the kinetics and kinematics during upper-limb propulsion in wheelchair users is the first step toward evaluating soft-tissue injury risk during both everyday and athletic propulsion modes. This paper examines continuous kinetic and kinematic data available in the literature for four common propulsion modes. Two everyday modes (everyday wheelchair use and attach-unit handcycling) are examined, as well as two athletic modes (wheelchair racing and recumbent handcycling). These athletic modes are important to characterize, especially considering the higher contact forces, speed, and power outputs often experienced during these athletic propulsion modes that could be putting users at increased risk of injury. Understanding the underlying kinetics and kinematics during various propulsion modes can lend insight into shoulder loading, and therefore injury risk, during these activities and inform future exercise guidelines and programs for WCUs.