Manual Wheelchair Use: Bouts of Mobility in Everyday Life

Abstract

<jats:p><jats:italic>Background</jats:italic>. This study aimed to describe how people move about in manual wheelchairs (MWCs) during everyday life by evaluating bouts of mobility or continuous periods of movement.<jats:italic>Methods</jats:italic>. A convenience sample of 28 MWC users was recruited. Participants' everyday mobility was measured using a wheel-mounted accelerometer and seat occupancy switch for 1-2 weeks. Bouts of mobility were recorded and characterized.<jats:italic>Results</jats:italic>. Across 29,200 bouts, the median bout lasted 21 seconds and traveled 8.6 m at 0.43 m/s. 85% of recorded bouts lasted less than 1 minute and traveled less than 30 meters. Participants' daily wheelchair activity included 90 bouts and 1.6 km over 54 minutes. Average daily occupancy time was 11 hours during which participants wheeled 10 bouts/hour and spent 10% of their time wheeling. Spearman-Brown Prophecy analysis suggested that 7 days were sufficient to achieve a reliability of 0.8 for all bout variables.<jats:italic>Conclusions</jats:italic>. Short, slow bouts dominate wheelchair usage in a natural environment. Therefore, clinical evaluations and biomechanical research should reflect this by concentrating on initiating movement, maneuvering wheelchairs, and stopping. Bouts of mobility provide greater depth to our understanding of wheelchair use and are a more stable metric (day-to-day) than distance or time wheeled.</jats:p>

Everyday sitting behavior of full-time wheelchair users

“…Measurements of wheelchair occupancy and transfers were consistent with prior work investigating wheelchair use for individuals who use a manual wheelchair [31][32][33]. The low frequency of complete off-loading, or PRs, has been indicated in previous studies [33,35].…”

“…As expected, larger movements are typically done with a lower frequency than smaller movements. At this time, studies of the sitting behavior of wheelchair users have been limited to measurement of occupancy [29][30][31][32][33] or complete off-loadings [33][34][35] and a single pilot study that considered smaller movements but was never expanded to a full study [36].…”

Transfer component skill deficit rates among Veterans who use wheelchairs

“…The NDWSC is a noncompetitive event for Veterans of all abilities with activities that range from downhill skiing to snowmobiling. A comparison across studies composed of Veterans who participate in these events [49] to community-living non-Veteran manual wheelchair users [50][51][52] suggests that the activity levels (e.g., daily distance traveled and daily moving time) between the two groups in their usual environments are very similar. Transfer skills are also thought to be based less on activity level, strength, and agility and more on acquisition of movement skills [33].…”

Keep on rolling: functional evaluation of power-assisted wheelchair use

“…However, short and slow bouts of activity dominate daily wheelchair usage. [18][19][20] The acceleration during start-up requires more force than maintaining a constant velocity. Based on previous research, the external stresses on the upper extremities are 2 -3.5 times higher during acceleration than during constant velocity propulsion.…”

“…[94] In daily life short, slow bouts of active propulsion dominate hand-rim wheelchair usage. During daily hand-rim wheelchair use the number of starts / stops per 1,000 meter is estimated to be 141.8 (60.0) [20] ; the daily distance travelled ranged from 1.5 -2.5 km [18][19][20] which means 212.7 till 354.5 starts/stops a day. Approximately 63% of the wheelchair propulsion bouts are shorter than 30 seconds, less than 13 meter, and slower than 0.5 m/s.…”