About this trial
Over one million Americans rely on their upper extremities for manual wheelchair propulsion. Shoulder overuse injuries are prevalent among manual wheelchair users and these injuries often result in shoulder pain. Severe shoulder pain can lead some wheelchair users to transition from manual to powered mobility, complicating transportation, and reducing independence in activities of daily living. This project will expand the understanding of a new wheelchair design that allows better positioning of the hand rims and allows for different gearing. The investigators will study steady-state propulsion efficiency with different gear ratios and develop a new system with multiple gear ratios. The advanced gearing will allow for a low gear when initiating movement, going uphill, or when moving over carpet, and then a higher gear option for movements on hard flat level terrain. This system has the potential to dramatically improve shoulder ergonomics and reduce pain in many future manual wheelchair users.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Uses manual wheelchair daily
Mass less than 125 kg
Age 18 or older
Decisional competency to provide consent and cognitive ability to participate fully in study procedures
Disqualifiers
Sitting surface pressure injuries
Flap procedure to address pressure injury less than one year earlier
Unable to obtain clinically acceptable seating system for study wheelchairs
Not able to propel a manual wheelchair
Trial design
Crossover
Treatments tested in this trial
Single Speed Ergonomic Wheelchair
DeviceErgonomic wheelchair. The ergonomic wheelchair was developed by the MADE program and has anterior placed hand rims that are connected with a bicycle chain. In Aim 1, Participants will use the ergonomic wheelchair to test 3 different gear ratios. 1. 2:3 2. 1:1 3. 3:2
Multi-Speed Ergonomic Wheelchair
DeviceThe multi-speed ergonomic wheelchair will be developed by the MADE program and will use a two-hand rim design so the participant can change gears by changing hand rims.
Treatment groups
Trial outcomes
Primary outcomes
20 Meter Push Test - level surface, Gear Ratio 1:1
Individuals self-propel a wheelchair 20 meters at their chosen pace
20 Meter Push Test - level surface, Gear Ratio 2:3
Individuals self-propel a wheelchair 20 meters at their chosen pace
20 Meter Push Test - level surface, Gear Ratio 3:2
Individuals self-propel a wheelchair 20 meters at their chosen pace
20 Meter Push Test - uphill, Gear Ratio 1:1
Individuals self-propel a wheelchair 20 meters at their chosen pace
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