Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

Considering Propulsion Pattern in Therapeutic Outcomes for Children Who Use Manual Wheelchairs

Rammer, Jacob R. PhD; Krzak, Joseph J. PT, PCS, PhD; Slavens, Brooke A. PhD; Winters, Jack M. PhD; Riedel, Susan A. SM, PE; Harris, Gerald F. PhD, PE

doi: 10.1097/PEP.0000000000000649

Purpose: Children who use manual wheelchairs encounter pain and injury risks to the upper body. Current literature does not describe how propulsion pattern and physiotherapeutic training methodologies impact response to treatment.

Methods: This study assesses the effect of community-based intensive physical and occupational therapy on functional outcomes over a 7-week period in pediatric manual wheelchair users.

Results: Key results include significant joint and musculotendon kinematic differences at the shoulder, improved speed and propulsion effectiveness, and changed propulsion pattern.

Conclusions: Statistics also revealed that propulsion pattern was a predictor of response to therapy, as was weekly therapeutic duration, wheelchair-specific focus by the therapists, and stretching.

This study assesses the effect of community-based intensive physical and occupational therapy on functional outcomes over a 7-week period for children who use manual wheelchairs.

Orthopaedic and Rehabilitation Engineering Center (Drs Rammer and Slavens and Ms Riedel), Marquette University Department of Biomedical Engineering and Medical College of Wisconsin Department of Orthopaedic Surgery, Milwaukee, Wisconsin; Shriners Hospitals for Children (Drs Krzak, Slavens, and Harris), Chicago, Illinois; Physical Therapy Program (Dr Krzak), Midwestern University, Downers Grove, Illinois; University of Wisconsin-Milwaukee (Dr Slavens), Milwaukee, Wisconsin; and Biomedical Engineering (Dr Winters), Marquette University, Milwaukee, Wisconsin.

Correspondence: Jacob R. Rammer, PhD, Orthopaedic and Rehabilitation Engineering Center, Marquette University, Olin Engineering Ste 323, Milwaukee, WI 53201 (

Grant Support: The contents of this article were developed under a grant from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR Grant number 90RE5006-01-00, Formerly H133E100007). The NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS).

The contents of this article do not necessarily represent the policy of the NIDILRR, ACL, and HHS, and you should not assume endorsement by the Federal Government.

The authors declare no conflicts of interest.

Copyright © 2019 Academy of Pediatric Physical Therapy of the American Physical Therapy Association