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BackgroundFor both sports and everyday use, finding the optimal manual wheelchair (MWC) configuration can improve a user's propulsion biomechanics. Many studies have already investigated the effect of changes in MWC configuration but comparing their results is challenging due to the differences in experimental methodologies between articles.PurposeThe present systematic review aims at offering an in-depth analysis of the methodologies used to study the impact of MWC configuration on propulsion biomechanics, and ultimately providing the community with recommendations for future research.MethodsThe reviewing process followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flowchart on two databases (Scopus and PubMed) in March 2022.ResultsForty-five articles were included, and the results highlighted the multiplicity of methodologies regarding different experimental aspects, including propulsion environment, experimental task, or measurement systems, for example. More importantly, descriptions of MWC configurations and their modifications differed significantly between studies and led to a lack of critical information in many cases.DiscussionStudying the effect of MWC configuration on propulsion requires recommendations that must be clarified: (1) the formalism chosen to describe MWC configuration (absolute or relative) should be consistent with the type of study conducted and should be documented enough to allow for switching to the other formalism; (2) the tested MWC characteristics and initial configuration, allowing the reproduction or comparison in future studies, should be properly reported; (3) the bias induced by the experimental situation on the measured data must be considered when drawing conclusions and therefore experimental conditions such as propulsion speed or the effect of the instrumentation should be reported.ConclusionOverall, future studies will need standardization to be able to follow the listed recommendations, both to describe MWC configuration and mechanical properties in a clear way and to choose the experimental conditions best suited to their objectives.

International audience; Purpose: Among the different resistances occurring during wheelchair locomotion and that limit the user autonomy, bearing resistance is generally neglected, based on a few studies carried out in static conditions and by manufacturer’s assertion. Therefore, no special attention is generally paid to the mounting and the maintenance of manual wheelchair bearings. However, the effect of inadequate mounting or maintenance on wheelchair bearing resistance has still to be clarified. This study aimed at filling this gap by developing and validating a specific device allowing the measurement of wheelchair bearing friction, characterized by low speed velocities, with an accuracy lower than 0.003 Nm.Methods: The bearing resistance measured by the device was compared to free deceleration measurement, intra and inter operator reproducibility were assessed. A factorial experiment allowed the effects of various functioning parameters (axial and radial loads, velocity) to be classified.Results: The device allowed significant differences in the bearing resistance of static and rotating conditions to be measured, even if a relatively high proportionality was found between both conditions. The factorial experiment allowed the expected impact of the radial load on bearing resistance as well as the predominant effect of the axial load to be demonstrated.Conclusions: As a consequence, it appeared that the control of the axial load is compulsory for measurement purposes or during wheel mounting, to avoid significant increase of global resistance during wheelchair locomotion. The findings of this study could help enhancing the models which assess manual wheelchair mechanical power from its settings and use conditions.

The development of Paralympics has done a lot for a more positive image of handicap and has opened up new opportunities for the practice of disability sport, known to be highly beneficial for the physical and psychological health of disabled people. Conducted in close partnership with a high level tennis player, this study focuses on the influence of the wheelchair settings on its behavior in order to adapt this behavior to wheelchair tennis playing. The study first highlighted the forces of resistance to straight line or rotating wheelchair movements, thanks to mechanical models validated by experiments. Then, the inertial parameters of the seated player's body segments were assessed by adapting a volumic model to the sitting position, and his propulsion at maximal velocity was studied, in order to understand the effect of the seat fore-and-aft position on this movement. Then, an experimental study proved the major influence of the center of gravity position on free rotation, which was modelized too.In a nutshell, this research work has led to a better understanding of the effects of the wheelchair settings on its behavior, its results have allowed to modify various settings on our partner's wheelchair and can be used as a basis for future wheelchair conception/design. They have also proved useful for conventional wheelchairs and in the meantime, our tennis player partner has become wheelchair tennis world champion…, Le développement et la médiatisation du sport de haut niveau, notamment en fauteuil roulant, ont changé l 'image du handicap et favorisé le développement d'infrastructures permettant la pratique handisport, reconnue comme bénéfique pour la santé physique et psychique des personnes handicapées...Dans ce contexte, en partenariat avec un joueur de tennis fauteuil de haut niveau, l'objet de ces travaux a été d'étudier l'influence des réglages du fauteuil roulant sur son comportement en match, afin de l'optimiser pour le sport concerné. Ces travaux se concentrent d'abord sur les résistances au mouvement, en particulier dans les paliers des roues, lors du roulement en ligne droite et en rotation. La méthode consiste à créer d'abord un modèle mécanique représentatif du mouvement pour ensuite le valider avec une série d'expérimentations et l'exploiter. L'étude du sportif en mouvement sur son fauteuil a nécessité l'adaptation d'un modèle volumique à une personne assise, avec estimation des paramètres inertiels par mesures rapides. Ce modèle a été appliqué à l'étude de la propulsion à vitesse maximale, pour vérifier l'influence de la position du siège sur ce mouvement. Enfin une étude expérimentale des paramètres influant sur la rotation du fauteuil a mis en avant la forte influence de la position du centre de gravité du sujet sur la rotation, corroborée par un modèle mécanique.Les résultats issus de ces travaux ont permis de mieux comprendre les influences des réglages sur le comportement du fauteuil, de modifier certains réglages pour le sportif et d'orienter la conception d'un nouveau fauteuil. Ces études ont par ailleurs eu des retombées sur les fauteuils conventionnels et entre temps, notre sportif est devenu N°1 mondial...

This article presents an examination and validation of a method to measure the field deceleration of a manual wheelchair (MWC) and to calculate the rolling resistances properties of the front and rear wheels. This method was based on the measurements of the MWC deceleration for various load settings from a 3D accelerometer. A mechanical model of MWC deceleration was developed which allowed computing the rolling resistance factors of front and rear wheels on a tested surface. Four deceleration sets were conducted on two paths on the same ground to test the repeatability. Two other deceleration sets were conducted using different load settings to compute the rolling resistance parameters (RPs). The theoretical decelerations of three load settings were computed and compared with the measured decelerations. The results showed good repeatability (variations of measures represented 6–11% of the nominal values) and no statistical difference between the path results. The rolling RPs were computed and their confidence intervals were assessed. For the last three sets, no significant difference was found between the theoretical and measured decelerations. This method can determine the specific rolling resistance properties of the wheels of a MWC, and be employed to establish a catalogue of the rolling resistance properties of wheels on various surfaces. The authors would like to thank the French National Research Agency (ANR) for its financial support to the SACR-FRM project (ANR-06-TecSan-020) and to the CERAH for the loan of all the manual wheelchairs evaluated in this work.