Is Synchronous Handcycling Less Straining than Handrim Wheelchair Propulsion?

INTRODUCTION The upper extremities especially the shoulders are at serious risk for overuse in handrim wheelchair users. It has been shown that upper extremity complaints frequently occur within the wheelchair user population [1]. However, physical activity and an active lifestyle are important to maintain general fitness and to prevent long term health problems. Because handrim wheelchair propulsion has been shown to be an inefficient and mechanically straining form of ambulation [2], alternative propulsion mechanisms have been developed and studied. The handcycle has been proven to be an energetically more efficient and less straining alternative to the wheelchair [3]. However, the magnitude of the mechanical load of handcycling has not been subject of report. Due to the fact that the external power output needed for propulsion is produced with a considerably larger muscle mass, the mechanical load of handcycling on the upper extremity is believed to be lower.