Comparison of muscular activity and metabolic response between a novel handle-based and a push-rim wheelchair in a simulated daily mobility circuit

OBJECTIVE: To compare the muscular activity and metabolic response between a novel handle-based wheelchair drive (KURT) and conventional push rim propulsion in a simulated daily mobility circuit. DESIGN: Single-group comparative study between 3 wheelchair configurations. PARTICIPANTS: 22 healthy individuals without prior wheelchair experience. METHODS: Participants completed a multi--movement circuit including ramps, obstacle avoidance, and directional changes using KURT and 2 push-rim wheelchairs with different wheel sizes (small wheels, SW; large wheels, LW). Electromyographic data were collected bilaterally from 7 upper body muscles, and cardiopulmonary variables were -continuously monitored. RESULTS: Biceps brachii activity was significantly higher with KURT than with SW and LW for both arms (all p < 0.001), while triceps brachii and pectoralis major activity were significantly lower (all p < 0.001). Other monitored muscles showed smaller relative differences between configurations, often resulting in limited or no statistically significant effects. Metabolic demand was lower with KURT: heart rate, oxygen consumption, and carbon dioxide production were reduced compared with LW (all p < 0.05), while respiratory exchange ratio was unchanged and respiratory frequency was higher than with SW (p < 0.05). CONCLUSION: KURT appears to be a promising, more energy-efficient alternative to push-rim wheelchairs, reducing upper limb muscle demand and metabolic cost. These findings motivate studies in regular wheelchair users and longer-term use in daily living scenarios.