Comparison Between Objective Biomechanical Cost and Perceived Physical Demand in Manual Wheelchair Users During Propulsion Tasks

Wheelchair users must be able to move around freely and access public buildings and transport, but current accessibility standards (e.g. maximum 8% ramp slope) are based on limited scientific evidence about the real biomechanical and perceived difficulties encountered by manual wheelchair users in daily life. Manual wheelchair propulsion is not purely a motor activity: it also involves cognitive and emotional demands (attention, trajectory planning, stress and frustration management) that contribute to a mental workload. This cognitive dimension is still rarely integrated into biomechanical evaluation protocols. This exploratory (pilot) study aims to test the feasibility of a protocol combining objective biomechanical data (shoulder joint loading estimated from motion capture and instrumented handrims) with the subjective experience of participants (perceived physical demand from the NASA-TLX questionnaire, perceived exertion from the Borg scale), during standardized and more realistic manual wheelchair propulsion tasks, including tasks performed under an added cognitive load (auditory-verbal 2-back dual task).

Inclusion Criteria: * Adult participant over 18 years of age * Person having signed the informed consent form * Duration of manual wheelchair use prior to the experiment greater than 2 weeks * Ability to perform transfers autonomously, with or without a technical aid * Functional criterion: patient who uses the wheelchair autonomously during the day Non-inclusion Criteria: * Refusal of the person to participate or to sign the consent form * Diagnosed cognitive disorder * Upper limb amputation * Refusal of the person to propel the wheelchair bimanually * Upper limb injury * Average upper limb pain over the past two weeks, on a 0 (no pain) to 10 scale: \< 4 * Person aged over 70 years