Active Wheelchair Research Articles

Personalized modification of sport dance wheelchairs

Standard modifications of active wheelchairs are commonly performed, but they often do not take into account the individual needs of dancers. The presented article aims to propose the optimization and personalization of the Quickie Argon Ti dance wheelchair for a specific subject. A visualization of a personalized dance wheelchair was created, abiding by the dimensional frame. The quality of the performance of physically disabled individuals in sports dancing on wheelchairs is significantly influenced by its construction and parameters. In this article, a standard sports wheelchair, and the requirements placed on a sports wheelchair used for dancing were described. After addressing the shortcomings, the modifications of selected components of the disabled sports wheelchair were presented.

Cases of spinal cord injury: correlation among resilience, social support and psychological well-being

Background: Spinal injuries are highly prevalent and are a major cause of disability. Studying resilience, perceived social support, and psychological well-being in persons with spinal cord injury is important for better-managing patients with spinal cord injuries. Objectives: To analyze the correlation among resilience, perceived social support, and psychological well-being in persons with spinal cord injury. Methods: This cross-sectional correlational study was conducted at Riphah International University, Lahore Pakistan from September 2019 to February 2020. The study utilized a sample of 100 patients with spinal cord injury using purposive sampling. The sample included paraplegic patients 6 months following SCI, of both genders above 18 years of age who were active wheelchair users. A demographic sheet, scale of psychological well-being, resilience scale, and multi-dimensional scale of perceived social support (MSPSS) were used for data collection. SPSS Version 22 was utilized for data analysis & correlation was analyzed using bivariate statistics with p< 0.05 was considered statistically significant. Results: The study revealed a positive correlation (γ=0.57, p<0.001) between Resilience with Perceived Social Support; Resilience and Psychological well-being (γ=0.55, p<0.001); and Perceived Social Support and Psychological Well-being (γ =0.57, p<0.001). Conclusion: There is a positive relationship between resilience perceived social support and psychological well-being. Keywords: perceived social support; psychological wellbeing; resilience; spinal cord injury

The feasibility of a randomized controlled crossover trial to assess the effect of probiotic and prebiotic supplementation on the health of elite wheelchair athletes

BackgroundGastrointestinal (GI) problems represent a health burden in Para athletes and can ultimately reduce athletic performance. This study aimed to evaluate the feasibility of a randomized controlled crossover trial (RCCT) assessing the effects of probiotic and prebiotic supplementation on the health of Swiss elite wheelchair athletes.MethodsThe RCCT was conducted between March 2021 and October 2021. Athletes were randomized to receive either a daily probiotic (3 g of probiotic preparation, including eight bacterial strains), or a daily prebiotic (5 g of oat bran) supplementation first. After the first supplementation phase (4 weeks), a washout period (4 weeks) and the second crossover supplementation phase (4 weeks) followed. Data were collected at four study visits (every 4 weeks) and included 3-day training and nutrition diaries, the Gastrointestinal Quality of Life Index (GIQLI) questionnaire, stool samples, and fasting blood samples. The study assessed the feasibility criteria such as recruitment rate, retention rate, success of data collection, adherence to the protocol, willingness to participate, and safety.ResultsThis pilot study met the majority of the predefined minimum requirements for the feasibility criteria. Out of 43 invited elite wheelchair athletes, 14 (33%) consented (mean (standard deviation) age: 34 (9) years, eight females, 11 with a spinal cord injury). The desired sample size was not reached, but the achieved recruitment rate was modest, especially considering the population studied. All participating athletes completed the study. With the exception of one missing stool sample and two missing diaries, data were successfully collected for all athletes at all four visits. Most athletes adhered to the daily intake protocol for at least 80% of the days, both for probiotics (n = 12, 86%) and prebiotics (n = 11, 79%). Ten (71%) athletes would be willing to participate in a similar study again. No serious adverse events occurred.ConclusionDespite the limited number of elite wheelchair athletes in Switzerland and the modest recruitment rate, the implementation of a RCCT in elite wheelchair athletes is feasible. The data collected in this study provide essential information for the design of the subsequent study which will include a larger cohort of physically active wheelchair users.Trial registrationSwiss Ethics Committee for Northwest/Central Switzerland (EKNZ), 2020–02337). ClinicalTrials.gov, NCT04659408.

Steering-by-leaning: Feasibility of Utilising Dynamic Backrests to Control Steering in Manual Wheelchairs

Steering-by-leaning is a promising innovation for manual wheelchairs. It may enable improved energy efficiency, one-handed manoeuvrability, and increased trunk activity during wheelchair use in daily life. To explore the feasibility of this concept, the lateral trunk function of active wheelchair users was assessed before comparing 3 preliminary dynamic backrest designs in a virtual steering exercise. Repeated measures, cross-over study. A convenience sample of 15 individuals who had been full-time users of manual wheelchair for at least 1 year. Active core strength and lateral leaning range of motion were captured while sitting freely. Participants subsequently tested 3 dynamic wheelchair backrest designs on an individually adjusted laboratory wheelchair prototype by performing a virtual steering exercise. Deviations from a target movement path were analysed using repeated measures analysis of variance and Pearson correlation coefficients. Functional leaning range of motion ranged from below 10° to almost 70°, but increased significantly with use of the simplest backrest design based on a 2-dimensional hinge joint. No correlation was found between functional levels and performance parameters in the virtual steering exercise. Using an individually fitted and calibrated design, upper body-actuated wheelchair steering using a laterally tilting backrest is accessible to wheelchair users across a wide spectrum of physical abilities.

Influence of wheelchair type on Wheelchair Propulsion Test performance in community-dwelling, adult wheelchair users1.

The clinimetric properties of the Wheelchair Propulsion Test (WPT) have not been developed thoroughly. To determine inter-rater reliability and reference values for the Wheelchair Propulsion Test (WPT) for active wheelchair users and to compare WPT performance between various types of manual wheelchairs at different paces. This was a cross-sectional, descriptive study. Participants propelled a manual wheelchair 10 m while time and the number of pushes were recorded. Trials were performed in three different manual wheelchairs (a lightweight wheelchair (LW), an ultralightweight wheelchair (ULW), and the participant's personal, customized wheelchair) at a comfortable pace and a fast pace. The ICC values ranged from 0.861 to 0.999 for both speed and number of pushes. Comfortable wheelchair propulsion speed ranged from 1.51 (0.31) m/s to 1.65 (0.33) m/s depending on the wheelchair utilized. Across both pace conditions, participants were significantly faster when using their personal wheelchair compared to the ULW (P < 0.001) and LW (P < 0.001). Push frequency was significantly greater during the fast pace condition compared to the comfortable pace condition (P < 0.001). Reference values for the WPT in active wheelchair users have been identified. Participants who utilize their personal wheelchair demonstrate faster wheelchair propulsion speeds complemented by greater push frequencies.

Effect of Manual Wheelchair Type on Mobility Performance, Cardiorespiratory Responses, and Perceived Exertion.

This study is aimed at comparing the design and configuration of the most commonly used manual wheelchair models through cardiorespiratory responses, perceived exertion, and mobility performance using two different manual wheelchairs, during mobility tasks. A within-group 2 × 3 × 2 controlled experiment was designed with three independent and four dependent variables. The independent variables included wheelchairs, with the levels active wheelchair with a rigid frame and passive wheelchair with foldable frame; conditions with the levels straight line, slalom, and agility; and speed with levels comfortable and fast. Dependent variables included oxygen uptake (VO2), distance travelled, speed, and perceived exertion. Results show that the active wheelchair yielded more beneficial characteristics although only the effect of wheelchair type on VO2 efficiency (oxygen uptake per meter travelled) was statistically significant with a large effect size (F(1, 14) = 118.298, p < 0.001, η2 = 0.541). The better VO2 efficiency was achieved with the active wheelchair under all tested conditions. The effect of wheelchair type on Borg scores was also statistically significant, although with a small effect size (F(1, 14) = 10.340, p = 0.006, η2 = 0.119); thus, active wheelchair use had lower Borg scores under all trials and was considered less exhausting than the passive wheelchair. In summary, use of the active wheelchair resulted in the users expending less energy per meter travelled and at the same time experiencing less fatigue. This may benefit overall wheelchair mobility and possibly reduce health complications.

The Preliminary Criterion Validity of the Activ8 Activity Monitor to Measure Physical Activity in Youth Using a Wheelchair.

The aim of this study was to assess the criterion validity of the Activ8 to detect "active wheelchair use" and to distinguish 6 types of wheelchair activities using video recordings as a gold standard. Ten participants who use a manual wheelchair were participants in this study. Data of 2 participants were used for adapting the algorithm and data of 7 participants were used for assessing the criterion validity. Criterion validity for detecting "active wheelchair use" had a relative time difference of 7.4%, agreement of 96%, sensitivity of 98.3%, and positive predictive value of 90%. Results for distinguishing 6 types of wheelchair activities had an agreement of 73%, sensitivity of 67.1%, and positive predictive value of 65.5%. The Activ8 is able to detect "active wheelchair use" in youth using a manual wheelchair. Further development of the algorithm is necessary to distinguish between different types of wheelchair activities.

The Effectiveness of Active Rehabilitation Camp on Physical Performance of Disabled People Moving in Wheelchairs

(1) Background: Regular participation in physical activity (PA) prevents many medical complications and improves the physical fitness of people with spinal cord injury, and in turn improves the functional independence, psychosocial status and quality of life. The goal of Active Rehabilitation Camps (ARCs) is to use various forms of PA in order for the participants to obtain the greatest efficiency and independence in everyday life. (2) Purpose: To evaluate the improvement in physical performance of people with chronic spinal cord disabilities moving in wheelchairs taking part in the Active Rehabilitation Camp depending on (a) sex, (b) type of disability, (c) the level of injury and (d) the type of wheelchair. (3) Methods: The study included 42 wheelchair users: 28 men and 14 women aged 18–65 years (34.7 ± 14.9 years) taking part in the Active Rehabilitation Camp. Finally, the study involved 27 paraplegics, 9 tetraplegics and 6 individuals with myelomeningocele. The participants took part in four fitness tests: (1) sprint test (SP)—individual time to cover a distance of 15 m in the wheelchair; (2) slalom test (SL)—time to ride between four cones front and back; (3) basketball ball throw at a distance (BT), (4) zig-zag test (ZZ)—riding continuously for 6 min on the designated track. The tests were performed at the beginning and at the end of the ACR. Active wheelchairs were used by 32 participants, and 10 participants used the classic wheelchairs. (4) Results: Paraplegics achieved the best average results in all the tests and the best improvement in physical performance in comparison to individuals with myelomeningocele and tetraplegics. People in active wheelchairs achieved a statistically significant improvement in the results of SL and ZZ (p < 0.001). People with injury above Th-9 level of the spinal cord achieved a statistically significant improvement in the results of SP (p < 0.01), SL and ZZ (p < 0.01). People with injury below Th6 achieved a statistically significant improvement (p < 0.05) in SP, SL and ZZ. (5) Conclusions: Regular PA during the Active Rehabilitation Camp improves the physical performance of disabled people in wheelchairs, but the scale of improvement of physical performance fitness depends on the type of wheelchair used and the level and the type of injury.

Training for the HandbikeBattle: an explorative analysis of training load and handcycling physical capacity in recreationally active wheelchair users

Purpose (1) to analyze training characteristics of recreationally active wheelchair users during handcycle training, and (2) to examine the associations between training load and change in physical capacity. Methods Former rehabilitation patients (N = 60) with health conditions such as spinal cord injury or amputation were included. Participants trained for five months. A handcycling/arm crank graded exercise test was performed before and after the training period. Outcomes: peak power output per kg (POpeak/kg) and peak oxygen uptake per kg (VO2peak/kg). Training load was defined as Training Impulse (TRIMP), which is rating of perceived exertion (sRPE) multiplied by duration of the session, in arbitrary units (AU). Training intensity distribution (TID) was also determined (time in zone 1, RPE ≤4; zone 2, RPE 5–6; zone 3, RPE ≥7). Results Multilevel regression analyses showed that TRIMPsRPE was not significantly associated with change in physical capacity. Time in zone 2 (RPE 5–6) was significantly associated with ΔVO2peak, %ΔVO2peak, ΔVO2peak/kg and %ΔVO2peak/kg. Conclusion Training at RPE 5–6 was the only determinant that was significantly associated with improvement in physical capacity. Additional controlled studies are necessary to demonstrate causality and gather more information about its usefulness, and optimal handcycle training regimes for recreationally active wheelchair users. IMPLICATIONS FOR REHABILITATION Monitoring of handcycle training load is important to structure the training effort and intensity over time and to eventually optimize performance capacity. This is especially important for relatively untrained wheelchair users, who have a low physical capacity and a high risk of overuse injuries and shoulder pain. Training load can be easily calculated by multiplying the intensity of the training (RPE 0–10) with the duration of the training in minutes. Results on handcycle training at RPE 5–6 intensity in recreationally active wheelchair users suggests to be promising and should be further investigated with controlled studies.

Developing a rigid frame wheelchair in Brazil

Purpose Describing the development process of a rigid frame wheelchair using user-centered and open innovation approaches, as envisaged by the WHO Wheelchair Guidelines. Methods Unstructured interviews and group discussions with conveniently sampled active wheelchair users oriented the initial brief, product design and selection. The initially approved prototype was subject to ISO 7176 tests, leading to further product adjustments. The long-term follow-up was inclusive of a new group of purposively selected active wheelchair users and measured user satisfaction and safety, as well as user mobility and wheelchair fitting. Data on user satisfaction, safety and effectiveness was produced using QUEST 2.0 and WHO Wheelchair Service Training Package’s forms and checklists in Portuguese. Results Iterative design and selection led to a prototype that was found appropriate by multiple stakeholders. ISO testing ensured its safety and durability. Follow-up trials included 40 active wheelchair users, who used the studied wheelchair for at least two months. They were 80% male, on average 36.3 years old, and had received their rigid frame wheelchair approximately 4.7 years after disability onset. 92.5% of them had SCI, 7.5% had bilateral transfemoral amputations. Users’ assessments showed satisfaction with products (4.4) and services (4.1). Users spent an average of 4.2 h/day sat in their wheelchairs. 7.5% and 20% of users reported pressure sores and falls, respectively. Conclusion A user-centered, open innovation approach led to the development of a good quality, affordable, and acceptable rigid frame wheelchair model that increased the range of manual wheelchairs available through the Brazilian public healthcare system. Implications for rehabilitation The feedback of rehabilitation professionals with respect to new products’ features is fundamental in order to understand how these devices will be adequately serviced and delivered to users. Engaging users of assistive products and rehabilitation professionals in developing new and innovative products facilitates the iteration and selection of the best project alternatives and saves considerable time and resources. Rehabilitation professionals are in the best position to work with user of assistive products and other stakeholders, such as the industry and research and development centres, to identify the impact of new assistive products in users' functionality, acknowledging their conditions and environments and exploring their potential. Working with users and other stakeholders from different backgrounds and areas of expertise makes the moto “Nothing about us, without us” real. Working towards improving functionality often requires developers to challenge the usual top-down development process in order to adopt a user-centered perspective.

Association of musculoskeletal pain, fear-avoidance factors, and quality of life in active manual wheelchair users with SCI: A pilot study

Objective: Limited evidence examines the association of psychological factors, such as fear of movement and pain catastrophizing, with musculoskeletal pain patterns in active manual wheelchair users with spinal cord injury (SCI). This study investigated the relationship among musculoskeletal pain, fear avoidance factors, quality of life (QoL), activity and duration of injury in individuals with SCI. Design: Cross-sectional correlational. Setting: Community setting. Participants: Twenty-six individuals with SCI (age = 42 ± 14 years, duration manual wheelchair use = 17 ± 13 years, work/school/volunteer hours/week = 31 ± 14; recreation/sports hours/week 10 ± 12). Outcome Measures: Demographics and self-report measures including the Musculoskeletal Pain Survey (MPS), Wheelchair Users Shoulder Pain Index (WUSPI), Tampa Scale of Kinesiophobia (TSK-11), Pain Catastrophizing Scale (PCS), Fear of Pain (FPQ), Subjective Quality of Life Questionnaire (SQoL), and the Social Interaction Inventory (SII). Spearman’s rho (ρ) assessed correlation among measures. Results: Strong association existed between age and duration of injury (ρ = 0.66, P < 0.001). SQoL offered a strong, direct correlation with age (ρ = 0.63, P = 0.01), duration of injury (ρ = 0.70, P = 0.001), and strong, inverse relationship with MPStotal (ρ = −0.66, P = 0.003) and MPS shoulder subscore (ρ = −0.64, P = 0.004). WUSPI demonstrated strong, inverse association with self-reported work hours (ρ = −0.52, P = 0.02) and a strong, direct relationship to PCS (ρ = 0.79, P = <0001). PCS demonstrated a strong, inverse relationship to work/school/volunteer hours (ρ = 0.71, P < 0.001) and strong association to TSK-11_total (ρ = 0.61, P = 0.001). A moderate, inverse relationship was identified for recreational/sports hours and FPQ (ρ = 0.48, P = 0.03). Conclusion: This cyclical relationship of musculoskeletal pain, reduced activity, and maladaptive psychological factors allude to interdependence of factors, supporting the multidisciplinary approach to care.

Validity of consumer-grade activity monitor to identify manual wheelchair propulsion in standardized activities of daily living.

BackgroundHypoactive lifestyle contributes to the development of secondary complications and lower quality of life in wheelchair users. There is a need for objective and user-friendly physical activity monitors for wheelchair-dependent individuals in order to increase physical activity through self-monitoring, goal setting, and feedback provision.ObjectiveTo determine the validity of Activ8 Activity Monitors to 1) distinguish two classes of activities: independent wheelchair propulsion from other non-propulsive wheelchair-related activities 2) distinguish five wheelchair-related classes of activities differing by the movement intensity level: sitting in a wheelchair (hands may be moving but wheelchair remains stationary), maneuvering, and normal, high speed or assisted wheelchair propulsion.MethodsSixteen able-bodied individuals performed sixteen various standardized 60s-activities of daily living. Each participant was equipped with a set of two Activ8 Professional Activity Monitors, one at the right forearm and one at the right wheel. Task classification by the Active8 Monitors was validated using video recordings. For the overall agreement, sensitivity and positive predictive value, outcomes above 90% are considered excellent, between 70 and 90% good, and below 70% unsatisfactory.ResultsDivision in two classes resulted in overall agreement of 82.1%, sensitivity of 77.7% and positive predictive value of 78.2%. 84.5% of total duration of all tasks was classified identically by Activ8 and based on the video material. Division in five classes resulted in overall agreement of 56.6%, sensitivity of 52.8% and positive predictive value of 51.9%. 59.8% of total duration of all tasks was classified identically by Activ8 and based on the video material.ConclusionsActiv8 system proved to be suitable for distinguishing between active wheelchair propulsion and other non-propulsive wheelchair-related activities. The ability of the current system and algorithms to distinguish five various wheelchair-related activities is unsatisfactory.

The effect of caster types on global rolling resistance in manual wheelchairs on indoor and outdoor surfaces

ABSTRACTAn important aspect of reducing the strain of wheeling is to decrease rolling resistance. Previous laboratory research, using a treadmill, determined that smaller casters significantly increased rolling resistance. The purpose of this study was to determine the effect of caster size on various indoor and outdoor surfaces on global wheelchair rolling resistance. Three caster types with sizes 4 in, 5 in, and 6 in, three indoor surfaces, and three outdoor surfaces were studied. A manual wheelchair was passively pulled along each surface at 1.11 m/s (3.64 ft/s) by a power wheelchair, and the global rolling resistance of the manual wheelchair was measured using a calibrated force transducer. A 3×3 repeated measures analysis of variance (ANOVA) was conducted for both indoor and outdoor environments. The 4-in casters resulted in the highest global rolling resistance on most surfaces. The 5-in casters had the least rolling resistance on most indoor surfaces, and the 6-in casters had the least rolling resistance on most outdoor surfaces. Although 4-in casters are more popular among active wheelchair users, larger casters were shown to have lower rolling resistance on most surfaces. This study may help users select the best caster size depending upon their daily activities and lifestyle.

Risk analysis for operating active wheelchairs in non-urban settings

A wheelchair is a special vehicle designed specifically for people with walking limitations. One of the types is an active wheelchair. This is a manually propelled wheelchair, the design and structure of which maximise the mobility of its given user at the expense of accepted instability. The aim of this study was to identify and present a hierarchy of potential incidents causing a health hazard and reducing the mobility of individuals with ambulatory disability who use active wheelchairs in non-urban settings. Information about incidents connected with wheelchair use was collected from interviews with disabled individuals, based on a questionnaire. Recorded data were analysed using the Preliminary Hazard Analysis (PHA). The results comprise a list of hazards for wheelchair user with ascribed priority numbers metrising their significance. An ordered list of hazards connected with wheelchair operation situations is useful when designing active wheelchairs and when learning the technique of wheelchair riding.

Characterizing the community use of an ultralight wheelchair with "on the fly" adjustable seating functions: A pilot study.

An ultralight manual wheelchair that allows users to independently adjust rear seat height and backrest angle during normal everyday usage was recently commercialized. Prior research has been performed on wheelchair tilt, recline, and seat elevation use in the community, however no such research has been done on this new class of manual ultralight wheelchair with “on the fly” adjustments. The objective of this pilot study was to investigate and characterize the use of the two adjustable seating functions available on the Elevation™ ultralight dynamic wheelchair during its use in the community. Eight participants had data loggers installed onto their own wheelchair for seven days to measure rear seat height, backrest angle position, occupied sitting time, and distance traveled. Analysis of rear seat height and backrest adjustment data revealed considerable variability in the frequency of use and positions used by participants. There was a wide spread of mean daily rear seat heights among participants, from 34.1 cm to 46.7 cm. Two sub-groups of users were further identified: those who sat habitually at a single typical rear seat height, and those who varied their rear seat height more continuously. Findings also showed that participants used the rear seat height adjustment feature significantly more often than the backrest adjustment feature. This obvious contrast in feature use may indicate that new users of this class of wheelchair may benefit from specific training. While the small sample size and exploratory nature of this study limit the generalizability of our results, our findings offer a first look at how active wheelchairs users are using a new class of ultralight wheelchair with “on the fly” seating adjustments in their communities. Further studies are recommended to better understand the impact of dynamic seating and positioning on activity, participation and quality of life.

Outcomes after acute traumatic spinal cord injury in Botswana: from admission to discharge.

Prospective follow-up study. To increase the knowledge regarding clinical and functional outcomes after traumatic spinal cord injuries (TSCI) in a resource-constrained setting. A special focus was placed on secondary complications such as pressure ulcers. The national referral hospital in Gaborone, Botswana. The study included all patients admitted with an acute TSCI during a 2-year period (n=39). Data collection was conducted at the time of discharge, and clinical characteristics, length of stay and pressure ulcers were analysed using descriptive and inferential statistics. Completeness of injury and presence of pressure ulcers were the factors found to significantly prolong hospitalization, which was 5 months (median). One patient died before discharge and one was discharged to rehabilitation in South Africa; all other patients were living with close or distant family members after discharge. Patients were supplied with electrical or manual active wheelchairs. Self-catheterization or suprapubic catheters were the main methods for bladder management, and ano-rectal stimulation to manage the bowel. Pressure ulcers, urinary tract infections and pain were the most frequent complications during in-patient care. Rehabilitation of patients with TSCI in Botswana has been going through big changes, and new rehabilitation objectives, such as techniques used for the management of bladder and bowel dysfunctions and the provision of technical aids, have been implemented, which likely can contribute to an overall improvement in the outcomes. However, basic care at the general wards is still lagging behind, causing high rates of pressure ulcers that significantly extend hospitalization periods.

The Influence of Physical Activity on the Shoulder Load and Ultrasonography Findings in Manual Wheelchair Users

The Influence of Physical Activity on the Shoulder Load and Ultrasonography Findings in Manual Wheelchair Users The aim of this study was to determine whether physical activity affects the forces applied on the shoulder and the development of shoulder ultrasonography abnormalities in manual wheelchair users. Following a high intensity wheelchair propulsion test, changes in shoulder kinetics and ultrasound variables were compared in a group of 17 physically active (PA) and in 12 less physically active (LPA) wheelchair users (WUs). The variables analysed were shoulder kinetics and ultrasound variables at the beginning and at the end of the test. In both groups, the test increased the peak shoulder forces and moments in almost all directions, although these changes were stronger for horizontal and superior forces in PAWUs.

Use of active wheelchairs in everyday life: experiences among experienced users of active ultra lightweight rigid frame wheelchairs

Purpose: The aim of this study was to describe the everyday life experience of being an experienced active wheelchair user in Sweden. Method: A qualitative approach, based on interviews, was chosen. Eleven active wheelchair users were interviewed; the results analysed by means of a thematic content analysis. Results: Two main categories, each with two sub-categories emerged: (1) Challenges and changes (life-course perspective); and (2) the ambassador of differentness (activities and situations). The first sub-categories: (1a) the changing self (attitudes and values); and (1b) getting older (the meaning of experiences for future expectations). The second sub-categories: (2a) the responsible representative (having to represent a general image of disability); and (2b) other's attitudes (interactants' expressions of attitudes). Conclusions: An active wheelchair user can be seen as an open person, a representative of other wheelchair users. Interactants can actively engage in solving non-existing problems, or over-estimate actual problems, i.e. over-attentiveness. The personal experience can change over time, e.g. to care less about over-attentiveness, or to engage less in situations where over-attentiveness is likely to occur, i.e. impression management. Also, regular interactants can learn to see the wheelchair as something normal, sometimes even forgetting it. Implications for Rehabilitation To use an active wheelchair affects interaction in everyday life, rendering the user an open person, possible to address at will as a representative of other users as well. The experienced user of an active wheelchair is the expert concerning her/his present capacity in activities in everyday life; possible obstacles remain inert until defined otherwise by the user.

Self Efficacy and Wheel Chair Skills among Active Wheelchair Dependent T2-L4SCI Clients in Delhi and NCR: A Co-Relational Study

Self Efficacy and Wheel Chair Skills among Active Wheelchair Dependent T₂-L₄SCI Clients in Delhi and NCR: A Co-Relational Study

No. 327 Evaluation of Posture and Its Relationship With Shoulder Pain in Active Wheelchair Users

PM&RVolume 6, Issue 8S2 p. S157-S157 Poster Presentation No. 327 Evaluation of Posture and Its Relationship With Shoulder Pain in Active Wheelchair Users Ivett Quiñones Urióstegui, Ivett Quiñones UriósteguiSearch for more papers by this authorCarlos Jorge, Carlos JorgeSearch for more papers by this authorGonzález Flores, González FloresSearch for more papers by this authorRamiro López Zavala, Ramiro López ZavalaSearch for more papers by this authorAlberto Isaac Pérez San Pablo, Alberto Isaac Pérez San PabloSearch for more papers by this author Ivett Quiñones Urióstegui, Ivett Quiñones UriósteguiSearch for more papers by this authorCarlos Jorge, Carlos JorgeSearch for more papers by this authorGonzález Flores, González FloresSearch for more papers by this authorRamiro López Zavala, Ramiro López ZavalaSearch for more papers by this authorAlberto Isaac Pérez San Pablo, Alberto Isaac Pérez San PabloSearch for more papers by this author First published: 18 September 2014 https://doi.org/10.1016/j.pmrj.2014.08.077Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume6, Issue8S28th World Congress of the International Society of Physical & Rehabilitation Medicine (ISPRM)August 2014Pages S157-S157 RelatedInformation