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Commentary on "Considering Propulsion Pattern in Therapeutic Outcomes for Children Who Use Manual Wheelchairs".

“How should I apply this information?” This research article is addressing an area of need in pediatrics. There is limited research for users of manual wheelchair, especially in the area of biomechanics. The research that is available has been adapted from adults. There is an increased incidence of teenagers and young adults who use manual wheelchair and have overuse injuries based on their propulsion patterns and decreased incidence of strengthening and stretching the antagonist muscles. The intensive approach described in this research is desirable because it occurs at camp and was functional and fun. “What should I be mindful about when applying this information?” The intensive intervention approach described in this article affected speed, distance, and effectiveness of manual wheelchair propulsion. It is unclear how this translated to daily life outside of camp. The children were in an environment with uneven terrain, which may affect their propulsion skills, especially if the expectation was that they would self-propel, rather than receive assistance. The outcome measures provide meaningful information to make goals clinically relevant at initial evaluation, reevaluation, and discharge. Future directions should track propulsion patterns through the lifespan, recreate this approach clinically, and investigate whether manual wheelchair-directed interventions have more of an effect in comparison to more generalized interventions.