Physiologic comparison of forward and reverse wheelchair propulsion.

OBJECTIVES

Conventional wheelchair propulsion is physiologically demanding because of the small muscle mass that is used and the low mechanical efficiency of the movement. Previous research has suggested that a reverse wheeling technique might be more economical than conventional forward wheeling. The present study sought to compare the physiologic demands of forward and reverse wheeling techniques.

DESIGN

A repeated measures design was used to compare the dependent variables between forward and reverse wheeling techniques in the same subjects.

SETTING

Human exercise research laboratory.

PARTICIPANTS

Ten able-bodied men.

INTERVENTION

Subjects completed graded, discontinuous exercise tests on a wheelchair ergometer, using both forward and reverse wheeling techniques.

MAIN OUTCOME MEASURES

Oxygen uptake (VO2), ventilation (VE), and heart rate were measured during the last 30 seconds of each 3-minute exercise stage. Blood lactate concentration ([La]) and rating of perceived exertion (RPE) were determined immediately after each stage.

RESULTS

Repeated measures analysis of variance demonstrated that VO2, VE, heart rate, [La], and RPE were all significantly greater (p < .05) with reverse wheeling compared with forward wheeling. VO2, values with reverse wheeling averaged 9% higher than forward wheeling at identical power outputs.

CONCLUSIONS

Reverse wheelchair propulsion is physiologically more demanding than conventional forward wheelchair propulsion and does not appear to offer potential for improving the economy of wheelchair propulsion.