Comparison of muscular activity and metabolic response between a novel handle-based and a push-rim wheelchair in a simulated daily mobility circuit

Abstract

Push-rim wheelchairs are widely used but are associated with low energy efficiency and a high risk of upper limb overuse injuries. To address these issues, we developed a novel handle-based wheelchair aimed at reducing joint strain and improving propulsion efficiency. This study compared muscular and metabolic demands between handle-based and push-rim configurations during an everyday wheelchair course. 22 healthy, wheelchairnaive participants completed a course, including ramps obstacle avoidance, and directional changes, using 3 wheelchair configurations: 1 handle-based and 2 push- rim setups with different wheel sizes. Electromyographic recordings and continuous cardiopulmonary data were collected. The handle-based system resulted in a redistribution of muscle activity, with reductions in several key propulsion muscles and an overall decrease in metabolic demand compared with push-rim propulsion. These findings suggest that the handle-based wheelchair may offer a more energy-efficient and joint-friendly alternative to conventional push-rim designs, with potential benefits for long-term mobility and upper limb health.