Lifestyle physical activity in manual wheelchair users – an overlooked public health opportunity

Abstract

Public health guidelines and health promotion efforts have traditionally focused on weekly accumulation of moderate to vigorous physical activity (MVPA) via structured exercise. There has been a recent paradigm shift towards the organic incorporation of MVPA in daily leisure and non-leisure time, termed "Lifestyle Physical Activity" (LPA). However, this paradigm shift and the underlying research has neglected manual wheelchair users (MWCUs) with spinal cord injury (SCI), who could benefit from LPA. This article argues for expanding the LPA paradigm shift into research and health promotion efforts involving MWCUs with SCI. We suggest a working definition of LPA for MWCUs and candidate metrics for quantifying LPA. This is followed by brief overviews of LPA correlates, outcomes/consequences, and interventions and the need for theory based approaches to study these domains. We lastly suggest an approach for mitigating potential negative outcomes of increased LPA in MWCUs and suggest a research agenda.

The Push Forward in Rehabilitation: Validation of a Machine Learning Method for Detection of Wheelchair Propulsion Type

“…For wheelchair-bound stroke or amputee patients, sedentary time will be even more prevalent. For the activity level of this target group, it is more important that they use the capacities they still have [ 5 ] and thus minimize the obviously worse health conditions that occur within this group [ 6 ]. So, given that they are wheelchair-bound, it is important that they push the wheelchair manually as often as possible, and that the conditions for this are optimized [ 7 , 8 ].…”

Accuracy and Precision of Actigraphy and SMARTwheels for Measuring Push Counts Across a Series of Wheelchair Propulsion Trials in Non-disabled Young Adults

“…There has been a growing interest in the study of physical activity for management of health outcomes among wheelchair users and this has largely focused on participation in intentional, structured, and planned exercise training. 1,2 Nevertheless, there are many barriers for participation in this type of physical activity, and such barriers may underlie the low number of wheelchair users who achieve the recommended physical activity levels. [3][4][5][6] To that end, researchers have recently advocated for a paradigm shift towards organic incorporation of health-promoting physical activity into daily life, termed "Lifestyle Physical Activity" (LPA).…”

“…[3][4][5][6] To that end, researchers have recently advocated for a paradigm shift towards organic incorporation of health-promoting physical activity into daily life, termed "Lifestyle Physical Activity" (LPA). 1,5 The paradigm shift advocats for an application of concepts regarding LPA among those who use manual wheelchairs as a primary or only means of mobility (i.e., spinal cord injury, multiple sclerosis, cerebral palsy, and spina bifida). The paradigm shift includs suggestions for a working definition and metrics of LPA for manual wheelchair users followed by a brief discussion of LPA correlates, consequences, interventions, and safe movement considerations.…”