Effect of travel direction and wheelchair position on the ease of a caregiver getting an occupied wheelchair across a soft surface: a randomized crossover trial

Abstract

Purpose

To test the hypotheses that, in comparison with pushing an occupied upright manual wheelchair forward, pulling backward on the push-handles improves the objective and subjective ease with which a caregiver can get the wheelchair across a soft surface (e.g., grass, mud, sand, gravel); and the ease with which a caregiver can get the wheelchair across a soft surface improves if the wheelchair is tipped back into the wheelie position.

Methods

We used a randomized crossover trial with within-participant comparisons to study 32 able-bodied pairs of simulated caregivers and wheelchair occupants. The caregiving participants moved an occupied manual wheelchair 5 m across a soft surface (7.5-cm-thick gym mats) under four conditions (upright-forward, upright-backward, wheelie-forward and wheelie-backward) in random order. The main outcome measure was time (to the nearest 0.1 s) and the main secondary measure was the ease of performance (5-point Likert scale).

Results

The upright-backward condition was the fastest (p < 0.05) and had the highest ease-of-performance scores. In the forward direction, there was no statistically significant difference in the time required between the upright and wheelie positions, but the wheelie position was considered easier.

Conclusions

Although further study is needed, our findings suggest that caregivers should pull rather than push occupied wheelchairs across soft surfaces. In the forward direction, caregivers may find the wheelie position easier than the upright condition. These techniques have the potential to both improve the effectiveness of and reduce injuries to caregivers. Clinical Trial Registration Number: NCT 04998539

IMPLICATIONS FOR REHABILITATION

• Caregivers should pull rather than push occupied manual wheelchairs across soft surfaces.

• In the forward direction, caregivers may find the wheelie position easier than and preferable to the upright condition.

• These techniques have the potential to both improve the effectiveness of and reduce injuries to caregivers.

Keywords:

• Wheelchair
• training
• motor skills
• rehabilitation
• ergonomics
• caregiver

Disclosure statement

The authors report there are no competing interests to declare.

Additional information

Funding

The work was supported by Nova Scotia Health Research Fund (#1024707).