Original Research - Special Collection: Wheelchair-related topics for less-resourced environments

The health benefits and constraints of exercise therapy for wheelchair users: A clinical commentary

Terry J. Ellapen, Henriëtte V. Hammill, Mariëtte Swanepoel, Gert L. Strydom
African Journal of Disability | Vol 6 | a337 | DOI: https://doi.org/10.4102/ajod.v6i0.337 | © 2017 Terry J. Ellapen, Henriëtte V. Hammill, Mariëtte Swanepoel, Gert L. Strydom | This work is licensed under CC Attribution 4.0
Submitted: 31 October 2016 | Published: 08 September 2017

About the author(s)

Terry J. Ellapen, School of Biokinetics Recreation and Sport, Physical Activity Sport and Recreation (PhASRec), North-West University, South Africa
Henriëtte V. Hammill, School of Biokinetics Recreation and Sport, Physical Activity Sport and Recreation (PhASRec), North-West University, South Africa
Mariëtte Swanepoel, School of Biokinetics Recreation and Sport, Physical Activity Sport and Recreation (PhASRec), North-West University, South Africa
Gert L. Strydom, School of Biokinetics Recreation and Sport, Physical Activity Sport and Recreation (PhASRec), North-West University, South Africa


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Abstract

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 self-esteem, 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.

Keywords

wheelchair; exercise; injury; health; wellness

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Crossref Citations

1. Editorial
Jonathan Pearlman, Rory Cooper
African Journal of Disability  vol: 6  year: 2017  
doi: 10.4102/ajod.v6i0.423