Factors related to propulsion efficiency in manual wheelchair users with paraplegia due to spinal cord injury

Abstract

Introduction: Individuals with paraplegia due to spinal cord injury (SCI) perform manual wheelchair (MWC) propulsion to promote functional mobility to perform daily activities. However, the inefficiency of propulsion caused by inadequate MWC setting, as well as pain and upper limb injury (UL), can result in decreased user mobility. Objective: Through the methodology of the integrative review, sought to identify and evaluate factors related to propulsion efficiency in MWC of users with paraplegia due to SCI. Method: We selected indexed studies in PubMed, LILACS, and SciELO on the biomechanics of the propulsion of users with paraplegia due to SCI between 2008 and 2018. Results: Among the 10 studies included in the review, two studies were classified as level III-2 and eight as level IV evidence. Factors related to propulsion efficiency were identified as: non-propulsive moments; the speed of the UL in the recovery phase; the position of the hand in the release period; the size of the backrest; maintaining body weight; the level of daily activity and shoulder adduction strength; the intensity of the propulsion; the orientation of the UL and the SCI time. Conclusion: Evidence regarding the cycle and propulsion patterns, MWC settings, user characteristics, and pain and injury in the UL proved to be factors related to propulsion efficiency in MWC of users with SCI paraplegia.