Clinical Significance of Age-Related Changes in Wheelchair Propulsion Biomechanics in Older Adults

Abstract

       In spite of the highest prevalence of older adults using a handrim self-propelled wheelchair or manual wheelchair, compared to other populations, study on how the ageing affects wheelchair propulsion biomechanics is still scarce. Manual wheelchair propulsion is a repetitive cyclic movement with low mechanical efficiency. This could result in upper limb injuries, which are commonly found in manual wheelchair users. Biomechanically, older adult wheelchair users propel their wheelchair with a lower self-paced speed and higher push frequency, which are considered as a high demanding task. The biomechanical inefficiency coupling with inactive and degenerative conditions put the older adult wheelchair users at the highest risk of the injuries. However, more in-depth researches into ageing propulsion biomechanics are required. The objectives of this article were 1) to review the existing and relevant literature on propulsion biomechanics in older adults, and 2) to increase awareness of the differences in propulsion characteristics between older adults and their younger counterparts. These may enable clinicians to design and prescribe the well-fitting wheelchairs regarding the propulsion biomechanics, and exercise to prevent the injuries and to improve fitness, propulsion effectiveness and overall quality of life.