Article

PURPOSE: To review the scientific literature published in the last 14 years on
the different types of manual wheelchairs. METHOD:
A systematic review of the
literature was conducted to find the recent research on manual wheelchairs.
RESULTS: The findings of 77 references on pushrim-propelled wheelchairs,
crank-propelled wheelchairs, lever-propelled wheelchairs, geared manual
wheelchairs and pushrim-activated power-assist wheelchairs are reported.
CONCLUSION: The pushrim-propelled wheelchair is light, easy to steer and has good
indoor manoeuvrability but is very inefficient and causes serious upper body
overloading so that long-term use leads to steadily deteriorating capability for
the user and ultimately a transition to a powered chair. Whilst the latter is
less physically demanding, the sedentary lifestyle and decreasing muscle use lead
to several secondary health problems. Crank- and lever-propelled wheelchairs and
geared pushrim wheelchairs are more efficient and less demanding and may improve
the quality of life of the user by expanding the range of accessible
environments, reducing upper body pain, increasing independence and avoiding or
delaying the 'debilitating cycle'. However, wheelchairs with these alternative
modes of propulsion are often heavier, wider and/or longer and are less easy to
steer, brake and fold than the pushrim wheelchair. Implications for
rehabilitation Pushrim-propelled wheelchairs are difficult to drive on outdoor
paths (grass and gravel/sand surfaces) and ramps so that users are confined to
restricted environments and have limited participation in everyday activities.
The repetitive strain imposed on the upper body by pushrim propulsion leads to
very high prevalence of shoulder and wrist pain in manual wheelchair users.
Crank-propelled and lever-propelled wheelchairs are more efficient and less
straining than pushrim propelled wheelchairs, allowing users to access more
challenging environments, prolong independence and improve the quality of life.

Langue : ANGLAIS