# COMPARISON OF MUSCULAR ACTIVITY AND METABOLIC RESPONSE BETWEEN A NOVEL HANDLE-BASED AND A PUSH-RIM WHEELCHAIR IN A SIMULATED DAILY MOBILITY CIRCUIT

## TL;DR

A new handle-based wheelchair reduces muscle strain and energy use compared to traditional push-rim wheelchairs during daily tasks.

## Contribution

A novel handle-based wheelchair design is introduced and compared to push-rim models for energy efficiency and muscle demand.

## Key findings

- The handle-based wheelchair reduced biceps activity and metabolic demand compared to push-rim models.
- Triceps and pectoralis major activity were significantly lower with the handle-based design.
- Metabolic cost was lower with the handle-based wheelchair, suggesting improved energy efficiency.

## Abstract

To compare the muscular activity and metabolic response between a novel handle-based wheelchair drive (KURT) and conventional push rim propulsion in a simulated daily mobility circuit.

Single-group comparative study between 3 wheelchair configurations.

22 healthy individuals without prior wheelchair experience.

Participants completed a multi-movement circuit including ramps, obstacle avoidance, and directional changes using KURT and 2 push-rim wheelchairs with different wheel sizes (small wheels, SW; large wheels, LW). Electromyographic data were collected bilaterally from 7 upper body muscles, and cardiopulmonary variables were continuously monitored.

Biceps brachii activity was significantly higher with KURT than with SW and LW for both arms (all p
< 0.001), while triceps brachii and pectoralis major activity were significantly lower (all p < 0.001). Other monitored muscles showed smaller relative differences between configurations, often resulting in limited or no statistically significant effects. Metabolic demand was lower with KURT: heart rate, oxygen consumption, and carbon dioxide production were reduced compared with LW (all p < 0.05), while respiratory exchange ratio was unchanged and respiratory frequency was higher than with SW (p < 0.05).

KURT appears to be a promising, more energy-efficient alternative to push-rim wheelchairs, reducing upper limb muscle demand and metabolic cost. These findings motivate studies in regular wheelchair users and longer-term use in daily living scenarios.

Push-rim wheelchairs are widely used but are associated with low energy efficiency and a high risk of upper limb overuse injuries. To address these issues, we developed a novel handle-based wheelchair aimed at reducing joint strain and improving propulsion efficiency. This study compared muscular and metabolic demands between handle-based and push-rim configurations during an everyday wheelchair course. 22 healthy, wheelchair-naive participants completed a course, including ramps, obstacle avoidance, and directional changes, using 3 wheelchair configurations: 1 handle-based and 2 push-rim setups with different wheel sizes. Electromyographic recordings and continuous cardiopulmonary data were collected. The handle-based system resulted in a redistribution of muscle activity, with reductions in several key propulsion muscles and an overall decrease in metabolic demand compared with push-rim propulsion. These findings suggest that the handle-based wheelchair may offer a more energy-efficient and joint-friendly alternative to conventional push-rim designs, with potential benefits for long-term mobility and upper limb health.