You are certainly wrong if you think there’s no right or wrong way of propelling a wheelchair. There are wheelchair propulsion techniques that have been proven to be better than others in the long term as well as the short term. Learning the right way of propelling a wheelchair is as important for a wheelchair user as choosing the right wheelchair. The propulsion techniques have a direct impact on a person’s long-term well-being.
In this write-up, we are discussing everything one needs to understand about propelling a manual wheelchair the ‘right’ way.
What is a Wheelchair Propulsion?
Wheelchair propulsion, in the simplest term, is the act of propelling a manual wheelchair by a user. Wheelchair users hold and push the hand rims aka push rims attached to either of the rear wheels to get the wheel moving.
When you look closely, you will realize that the act of propelling a wheelchair consists of two phases – the push phase and the recovery phase. These phases are based on the movement of the hands.
- Push phase – The push or propulsive phase starts when the hands of the user come into contact with the push rims and continue to the point where a stroke ends and the user removes their hands from the rims.
- Recovery phase – The recovery phase starts as soon as the hands break contact with push rims. This is the phase when users remove their hands from the push rims and swing back to the original position to start the next propulsive phase.
Types of Wheelchair Propulsion
Wheelchair propulsion techniques are classified based on stroke patterns i.e. the trajectory or the movement of the hands. Experts have identified four patterns of wheelchair propulsion and these have been named based on the movement of hands during each propulsive and recovery phase.
- Semicircular – In the semicircular propulsion technique the user starts by holding a position to the farthest at the back (let’s say 10 o’clock position) and goes to the farthest position in the front (say 2 o’clock position). During the recovery phase, the hands simply drop down before retracting back to the original push position.
- Arc Propulsion – Arc propulsion technique is the one in which the starting point is the topmost position of the push rim and the user covers a quarter or less of the circle. In the recovery phase, the hands trace back to the original position forming an arc.
- Single Loop-Over Propulsion – In the single loop-over propulsion technique the propulsion begins from the point slightly behind the topmost position on the hand rim (let’s say at 11 o’clock position) and covers the distance similar to the arc propulsion. The difference between the two becomes visible during the recovery phase where the user brings their hand way above the push rim before returning back to the original position.
- Double Loop-Over Propulsion – The double loop-over propulsion is similar to the single loop-over propulsion in the push phase. During the recovery phase, the hands first rise above the push rim and then cross over and drop below the push rim before returning to the original position.
Which Wheelchair Propulsion Technique is the Best?
When users adopt the wrong propulsion technique they put themselves at risk of putting damaging impact on their shoulder joints and muscles used in pushing the wheelchair. So, it is important that wheelchair users are informed about the right technique and the risk factors associated with the wrong techniques. However, you should know that the propulsion technique used by a wheelchair user depends on a few other factors including the physical abilities of the user and the size and design of their wheelchair in addition to their awareness level. But, before we talk about other factors let us first discuss the right techniques for wheelchair propulsion.
Best Technique On Level Ground
When you have to push your wheelchair on level ground, the best propulsion technique is the semicircular propulsion technique. This is the best because the push phase starts and ends at the farthest point the user can reach thus creating a long stroke. This means the wheelchair can cover quite a good distance with each push. Further, hands drop down during the recovery phase thus putting the least pressure on the shoulders. The shoulder movement in this propulsion technique is within a healthy and mechanically advantageous range. This ensures the damage to the shoulders will be least even in the long-term.
Every manual wheelchair user should try to practice the semicircular propulsion technique as it is beneficial in the short as well as long term. It is good for the body in the long run and it conserves energy with every stroke.
Best Technique While Going Uphill
When you have to push your wheelchair over an inclined position you will need to change your propulsion technique. While going uphill (e.g. on a ramp) you cannot use the long strokes of the semicircular technique because you have to constantly hold your wheelchair and prevent it from slipping backward. The arc technique is the best-suited propulsion technique for going uphill. The short and frequent strokes with hands tracing the same line while returning back to the starting point ensure that the user is always in full control of the wheelchair.
[Pro Tip: A slight forward lean makes going upwards easier while also preventing the wheelchair from tipping backward.]
Other Things to Keep in Mind
Just knowing the right propulsion technique is not enough. If you have noticed that you are not using the right propulsion technique, the problem may as well lie in your wheelchair! First of all, remember wheelchairs are designed for different purposes; for example, there are sports wheelchairs, hemiplegic wheelchairs, power wheel chairs etc. Having the right equipment is important for adopting the right technique. We have discussed choosing the right wheelchair in earlier articles too. Let us brush up on a few important pointers here.
- If you are a long-term wheelchair user, you must have a wheelchair seat customized to your size. If your seat is wider than what you need, reaching the push rim will be tougher. This may also cause shoulder pain in the short-run and unpleasant results in the long run.
- For a similar reason, your hand-rest should not be too high. With a high hand rest the shoulders are always in an awkward position while pushing the wheelchair. This will undoubtedly cause issues in the short and long term.
- While choosing a wheelchair you also need to pay attention to the axle position which is an important factor in efficient wheelchair propulsion. The general rule of thumb says that the axle of the rear wheels should be in a straight line with your shoulders when you sit straight or without slouching.
Wheelchair propulsion is something that a wheelchair user has to do innumerable times every day. This repetitive movement can take a serious toll on shoulders and back as they are not naturally meant for this. Impact on shoulders is inevitable but we significantly can reduce the risk by adopting the right technique of propulsion.
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