Using a manual wheelchair seems simple enough at first glance, but effectively using it requires mastering a few essential skills and specific propulsion techniques. The latter methods in particular not only make navigation easier but also help protect the shoulder joints and muscles from strain or injury—a crucial consideration for long-term wheelchair users. In fact, understanding and applying the correct propulsion methods is just as vital as selecting the right wheelchair.
As such, we’ll delve into the fundamentals of wheelchair propulsion, providing insights into how to move this tried-and-true PMA in Singapore effectively and safely.
An Overview of Wheelchair Propulsion
Wheelchair propulsion refers to moving a wheelchair forward by gripping and pushing the hand rims on the wheels. While it may seem like a simple task, the movement actually involves two distinct phases:
- Push Phase: This phase begins when your hands touch the hand rims and continues as you apply force to move the wheels forward, ending when you lift your hands off the rims to conclude the stroke.
- Recovery Phase: In contrast, the start of this phase begins the moment your hands leave the push rims. During this time, your hands return to their starting position to prepare for the next push phase.
Both phases play an integral role in maintaining a smooth and efficient propulsion cycle.
The 4 Main Wheelchair Propulsion Techniques
Propulsion techniques are categorised based on the stroke patterns, or the trajectory of hand movements during the push and recovery phases. Biomechanics experts have established four primary patterns, each named according to the distinct motions of the hands in both phases:
1. Single Loop-Over Propulsion
In this technique, the push phase begins slightly behind the topmost position of the hand rims, around the 11 o’clock position. The recovery phase then follows with the hands rising significantly above the hand rims before going back to their starting position, creating a distinctive loop motion.
2. Double Loop-Over Propulsion
The double loop-over technique’s push phase shares similarities with the single loop-over but differs in the recovery phase, where the hands first rise over the hand rims, cross over, and then drop below them before returning to the initial position. This pattern involves a more complex looping motion.
3. Arc Propulsion
The arc propulsion technique begins at the topmost position of the push rim (12 o’clock) and covers a quarter or less of the rim’s circumference. During the recovery phase, the hands trace back to their starting position in a smooth, arc-like motion. This technique is straightforward and commonly used for short, controlled movements.
4. Semicircular
The semicircular propulsion technique starts at the farthest point at the back of the hand rim (typically the 10 o’clock position) and pushes forward to the farthest point in the front (around the 2 o’clock position). During the recovery phase, the hands drop downward in a natural motion before retracting to the initial position. This technique is considered one of the most energy-efficient due to its smooth and continuous movement.
Which Technique Should You Use?
There is no single propulsion technique that works best for everyone. The ideal method depends on several factors, including the user’s physical abilities, the design and size of their wheelchair, and the terrain they are navigating. Below, we outline the most effective techniques for different scenarios.
On Level Ground
When moving on flat ground, the semicircular propulsion method is the most efficient. This method involves starting and ending the push phase at the farthest points the user is comfortable reaching, resulting in a long stroke. Each push covers a significant distance, making it energy-efficient and reducing the number of strokes needed.
Additionally, in the recovery phase, the hands naturally drop down, minimising strain on the shoulders. This movement keeps the shoulder joint within a mechanically advantageous and healthy range, reducing the risk of long-term damage. As a result, semicircular propulsion conserves energy and ensures minimal wear on the shoulders.
While Going up an Incline
When navigating uphill, the arc propulsion technique is the most suitable. This method uses short, frequent strokes, allowing the user to maintain consistent contact with the hand rims and prevent the wheelchair from slipping back. The hands trace the same path during the recovery phase, ensuring stability and control.
Pro Tip: Leaning slightly forward while ascending helps distribute weight more effectively, making the climb easier and reducing the risk of tipping over backwards.
Other Factors to Consider
Knowing the proper propulsion techniques is only part of the equation. If you find it challenging to adopt the correct method, the issue might lie with your wheelchair. Here are some important considerations:
- Axle Position: The position of the rear wheel axle significantly impacts propulsion efficiency. Ideally, the axle should align with your shoulders when you sit upright without slouching. This alignment ensures optimal leverage and reduces strain on the arms.
- Customised Seat Size: Long-term wheelchair users should have a seat tailored to their dimensions. A seat that is too wide makes reaching for the push rims difficult, increasing shoulder strain and potentially causing pain over time.
- Handrest Height: Handrests that are too high force your shoulders into an awkward position while pushing, leading to discomfort and potential long-term issues. Ensure the handrest height allows for natural, comfortable movement.
Conclusion
Propelling a manual wheelchair all day involves innumerable repetitive movements that can take a significant toll on the back and shoulders if not done right. While there is no means to fully negate its impact on the upper body, it can be greatly reduced by following the proper propulsion techniques discussed above. Thus, make sure to practice those four methods not just to maintain mobility with minimal discomfort but also to enhance your speed and efficiency.
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