Physiologic comparison of forward and reverse wheelchair propulsion.

OBJECTIVES Conventional wheelchair propulsion is physiologically demanding because of the small muscle mass that is used and the low mechanical efficiency of the movement. Previous research has suggested that a reverse wheeling technique might be more economical than conventional forward wheeling. The present study sought to compare the physiologic demands of forward and reverse wheeling techniques. DESIGN A repeated measures design was used to compare the dependent variables between forward and reverse wheeling techniques in the same subjects. SETTING Human exercise research laboratory. PARTICIPANTS Ten able-bodied men. INTERVENTION Subjects completed graded, discontinuous exercise tests on a wheelchair ergometer, using both forward and reverse wheeling techniques. MAIN OUTCOME MEASURES Oxygen uptake (VO2), ventilation (VE), and heart rate were measured during the last 30 seconds of each 3-minute exercise stage. Blood lactate concentration ([La]) and rating of perceived exertion (RPE) were determined immediately after each stage. RESULTS Repeated measures analysis of variance demonstrated that VO2, VE, heart rate, [La], and RPE were all significantly greater (p < .05) with reverse wheeling compared with forward wheeling. VO2, values with reverse wheeling averaged 9% higher than forward wheeling at identical power outputs. CONCLUSIONS Reverse wheelchair propulsion is physiologically more demanding than conventional forward wheelchair propulsion and does not appear to offer potential for improving the economy of wheelchair propulsion.