If you are a manual wheelchair user (MWCU), chances are you’ve had shoulder pain at one point or another. Pushing the chair, transferring yourself into and out of the chair, using your arms to shift your weight—all of these maneuvers add up to an overload on shoulder joints and muscles. A study published in December of 2007 showed a significant overall reduction in shoulder pain after only two weeks of participants using chairs equipped with two-gear wheels.
Although wheelchairs have been around for hundreds of years, there had been little change in design until recently. The goal of today’s technology is to improve function and decrease chronic overuse of muscles and joints. MAGICWheels are designed to do this by providing a two-gear mechanism that assists when going over challenging terrain. The wheels can be attached to the chair that you are already using.
Going up inclines in second gear prevents backslide and theoretically requires less exertion. The wheels turn more easily, but they do have to make two revolutions to go the same distance as one revolution in standard gear. Going downhill is easier because less braking is required (similar to putting a car into a lower gear). The wheels can be clicked back into standard gear for smooth surfaces.
In the 2007 study, 17 full-time MWCUs participated first in a four-week baseline evaluation in which participants used their personal chairs. Following that baseline period, participants used MAGICWheels in place of their regular wheels for five months. The trial ended with switching back to each chair's original wheels and a four-week re-evaluation of shoulder pain and functional ability. Requirements to participate in the study included already-existing shoulder pain and already-established need to navigate hills, ramps, curbs, and uneven terrain on a daily basis.
Pain reduction continued for participants throughout the five-month period of using MAGICWheels, but there was no overall improvement in functional ability. This was attributed to the fact that the subjects picked for this study were of high functional ability to begin with. There was no reduction in perceived pain when the participants had to climb hills with the two-gear wheels. However, this could have been due to the fact that the ascent took longer and actually required more strokes per wheel turn (but less force because there was no backslide).
Some of the participants expressed frustration with the increased amount of time required to climb a hill. The MAGICWheels add about 10 pounds of weight to the chair, but this didn't seem to increase pain for those who had to lift their chairs into their cars. Although many of the participants reported favorable opinions about MAGICWheels, none of them felt able to purchase them because of cost.
The authors of the study felt that MAGICWheels showed a potential for reducing shoulder pain in MWCUs. However, this study was limited by lack of a control group, the possibility that involvement in the study itself may have been the reason for improvement in pain, and the fact that the selection process resulted in highly motivated participants. Four people did not complete the study for various reasons, but only one dropped out because of disliking the wheels.
For further information, refer to: "Effect of 2-Speed Geared Manual Wheelchair Propulsion on Shoulder Pain and Function;" Finley, M PhD PT; Rodgers, M PhD PT; Archives of Physical Medicine and Rehabilitation, December 2007, Volume 88.
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