A Compendium of Energy Costs of Physical Activities for Individuals Who use Manual Wheelchairs
Scott A. Conger and David R. Bassett, Jr.
University of Tennessee, Knoxville
The purpose of this study was to develop a compendium of wheelchair-related physical activities. To accomplish this, we conducted asystematic review of the published energy costs of activities performed by individuals who use wheelchairs. A total of 266 studies were identified by a literature search using relevant keywords. Inclusion criteria were studies utilizing individuals who routinely use a manual wheelchair, indirect calorimetry as the criterion measurement, energy expenditure expressed as METs or VO2, and physicalactivities typical of wheelchair users. Eleven studies met the inclusion criteria. A total of 63 different wheelchair activities were identified with energy expenditure values ranging from 0.8 to 12.5 kcal·kg1·hr-1. The energy requirements for some activities differed between individuals who use wheelchairs and those who do not. The compendium of wheelchairrelated activities can be used to enhance scoringof physical activity surveys and to promote the benefits of activity in this population. Keywords: compendium, disability, energy expenditure, exercise, electric, manual
Individuals with traumatic injury, congenital defects, mobility issues related to aging, and chronic diseases such as diabetes and cardiovascular disease often use wheelchairs to enhance their mobility and offset their physicallimitations (Fitzgerald et al., 2007). Wheelchair use has increased worldwide over the past two decades (LaPlante, Hendershot, & Moss, 1992; Le & Price, 1982; McGuire, Strine, Okoro, Ahluwalia, & Ford, 2007). Since 1980, wheelchair use in the United States has increased at a rate of about 5% per year (Fitzgerald et al., 2007; LaPlante et al., 1992; LaPlante & Kaye, 2010). Current estimates arethat 3.3 million people in the United States use wheelchairs (LaPlante & Kaye, 2010). Thus, it is important to be able to assess physical activity in this population to obtain more accurate quantifications of energy expenditure. Because of the reduced muscle mass involved in locomotion during wheelchair use, individuals who use wheelchairs have lower levels of leisure time and habitual physicalactivity energy expenditure than individuals who do not (Heath & Fentem,
The authors are with the Department of Kinesiology, Recreation, and Sport Studies at the University of Tennessee, Knoxville. 310
Energy Costs and Manual Wheelchairs
1997). In addition, people with any disability (defined as a persistent limitation in any activity due to physical, mental, or emotional problem thatlasts six months or more) have higher rates of obesity (Kinne, Patrick, & Lochner Doyle, 2004; McGuire et al., 2007) and lower levels of physical activity (Heath & Fentem, 1997; McGuire et al., 2007) than individuals without a disability. Diseases associated with low levels of physical activity and obesity, such as cardiovascular disease (CVD) and diabetes, are the leading causes of death inindividuals who use wheelchairs (Cooper et al., 1999; Dallmeijer, Hopman, & Van der Woude, 1997; Dearwater et al., 1986), as is the case for the general U.S. population; however, cardiovascular risk factors (elevated diastolic blood pressure, triglycerides, and c-reactive protein) are higher in people who use wheelchairs than in individuals who do not (Dallmeijer et al., 1997; Dearwater, LaPorte,Cauley, & Brenes, 1985; Devillard, Rimaud, Roche, & Calmels, 2007; Imai, Kadowaki, & Aizawa, 2004; Krum et al., 1992; Liang, Chen, Wang, Rimmer, & Braunschweig, 2007; Morse et al., 2008). The measurement of physical activity in individuals who use wheelchairs is important for several reasons, including (a) physical activity surveillance, (b) quantifying relationships between physical activity and...