OBJECTIVE: To compare the effects of two manual wheelchair propulsion training programs on handrim kinetics, contact angle and stroke frequency collected during overground propulsion. DESIGN: This study was a randomized control trial(RCT) comparing handrim kinetics between three groups (n = 27): a control group (CG) that received no training, an instruction only group (IO) that reviewed a multimedia presentation(MMP), and a feedback group (FB) that reviewed the MMP and visual real time feedback (RTF). SETTING: Human Engineering Research Laboratories, Department of Veterans Affairs, VA Pittsburgh PA PARTICIPANTS: Full time Manual Wheelchair Users with spinal cord injury living in the Pittsburgh area INTERVENTIONS: Propulsion training was given three times over three weeks and data was collected at baseline, immediately after training and at 3 months. MAIN OUTCOME MEASURES: Contact angle, stroke frequency, peak resultant force and peak rate of rise of resultant force. RESULTS: Both FB and IO groups improved their propulsion biomechanics across all surfaces (carpet, tile, ramp) at both target and self-selected speeds compared to the CG. While controlling for velocity, both intervention groups showed long term reductions in peak rate or rise of resultant force, stroke frequency and increased contact angle. CONCLUSIONS: Long term wheelchair users in both intervention groups significantly improved many aspects of their propulsion technique immediately after training and three months from baseline. Furthermore, training with a low cost, instructional video and slide presentation was an effective training tool alone.

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