The health benefits and constraints of exercise therapy for wheelchair users: a clinical commentary
View/ Open
Date
2017Author
Ellapen, Terry J.
Hammill, Henriëtte V.
Swanepoel, Mariëtte
Strydom, Gert L.
Metadata
Show full item recordAbstract
Background: There are approximately 1 billion people living with chronic lower limb disability,
many of whom are wheelchair users.
Objectives: Review cardiometabolic and neuromuscular risk profiles of wheelchair users,
benefits of regular exercise and the causes of neuromuscular upper limb and hip injuries that
hinder regular adherence.
Method: Literature published between 2013 and 2017 was adopted according to the standard
practices for systematic reviews (PRISMA) through Crossref Metadata and Google Scholar
searches. Individual paper quality was evaluated using a modified Downs and Black Appraisal
Scale.
Results: The literature search identified 16 600 papers which were excluded if they were non-
English, non-peer-reviewed or published before 2013. Finally, 25 papers were accepted,
indicating that sedentary wheelchair users have poor cardiometabolic risk profiles (PCMRP)
because of a lack of physical activity, limiting their quality of life, characterised by low selfesteem,
social isolation and depression. Their predominant mode of physical activity is
through upper limb exercises, which not only improves their cardiometabolic risk profiles but
also precipitates neuromuscular upper limb overuse injuries. The primary cause of upper limb
injuries was attributed to poor wheelchair propulsion related to incorrect chair setup and poor
cardiorespiratory fitness.
Conclusion: Wheelchair users have a high body mass index, body fat percentage and serum
lipid, cholesterol and blood glucose concentrations. Empirical investigations illustrate exercise
improves their PCMRP and cardiorespiratory fitness levels. Although literature encourages
regular exercise, none discusses the need to individualise chair setup in order to eliminate
wheelchair pathomechanics and upper limb neuromuscular injuries. Wheelchair users must
be encouraged to consult a biokineticist or physiotherapist to review their wheelchair setup so
as to eliminate possible incorrect manual wheelchair propulsion biomechanics and consequent
overuse injuries
URI
http://hdl.handle.net/10394/25820http://dx.doi.org/10.4102/ajod.v6i0.337
http://www.ajod.org/index.php/ajod/article/view/337
Collections
- Faculty of Health Sciences [2377]