The aim of the study was to evaluate the external applied forces, the effectiveness of force application and the net shoulder moments of handcycling in comparison with handrim wheelchair propulsion at different inclines. Ten able-bodied men performed standardized exercises on a treadmill at inclines of 1%, 2.5% and 4% with an instrumented handbike and wheelchair that measured three-dimensional propulsion forces. The results showed that during handcycling significantly lower mean forces were applied at inclines of 2.5% (P < .001) and 4% (P < .001) and significantly lower peak forces were applied at all inclines (1%: P = .014, 2.5% and 4%: P < .001). At the 2.5% incline, where power output was the same for both devices, total forces (mean over trial) of 22.8 N and 27.5 N and peak forces of 40.1 N and 106.9 N were measured for handbike and wheelchair propulsion. The force effectiveness did not differ between the devices (P = .757); however, the effectiveness did increase with higher inclines during handcycling whereas it stayed constant over all inclines for wheelchair propulsion. The resulting peak net shoulder moments were lower for handcycling compared with wheelchair propulsion at all inclines (P < .001). These results confirm the assumption that handcycling is physically less straining.
Ursina Arnet (Corresponding Author) and Stefan van Drongelen are each with Swiss Paraplegic Research, Nottwil, Switzerland, and with Research Institute MOVE, Faculty of Human Movement Sciences, VU University Amsterdam, The Netherlands. DirkJan (H. E. J.) Veeger is with Research Institute MOVE, Faculty of Human Movement Sciences, VU University Amsterdam, The Netherlands, and with the Department of Mechanical, Maritime and Materials Engineering, Delft University of Technology, The Netherlands. Lucas H. V. van der Woude is with the Center for Human Movement Sciences and Center for Rehabilitation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.