08 March 2026 : Clinical Research
Comparison of Muscle Load, Comfort, Usability, and Time-On-Task Across 3 Wheelchair Handle Orientations and Ground Types: A Randomized Crossover Study
Yen-Hui Lin
ABCG 1,2, Chien-Chun Chang BEF 3, Victor Ei-Wen Lo ABE 4, Ting-Jen Chen EF 1, Wei-Hsien Hong ABCDF 3*
DOI: 10.12659/MSM.951420
Med Sci Monit 2026; 32:e951420
Table 1 Comparisons of upper-limb EMG among handle orientations and ground types, with 95% CIs (n=28, unit: %MVC).
| Ground muscles | Ramp | Level ground | Cone path | p-value (Factor: H, G, I) | 95% CI |
|---|---|---|---|---|---|
| Right ECR | |||||
| Parallel handle | 47.3±19.6 | 24.0±8.4 | 33.1±13.4 | H:<0.001,,* | 30.6–39.0 |
| Vertical handle | 25.5±10.0 | 17.9±8.3 | 26.9±10.2 | G:<0.001,,* | 20.5–26.4 |
| Lateral handle | 31.0±13.1 | 17.8±9.3 | 25.5±8.1 | I:<0.001* | 21.6–27.9 |
| Right FCU | |||||
| Parallel handle | 44.2±15.8 | 25.2±14.9 | 30.0±11.0 | H:<0.001,,* | 29.0–37.3 |
| Vertical handle | 24.8±8.9 | 17.2±7.0 | 25.7±11.8 | G:<0.001,,,* | 19.6–25.5 |
| Lateral handle | 28.9±11.2 | 16.6±7.8 | 27.8±12.0 | I:<0.001* | 20.9–27.9 |
| Left ECR | |||||
| Parallel handle | 41.2±17.1 | 19.0±6.8 | 27.0±8.9 | H:<0.001,,* | 25.7–32.4 |
| Vertical handle | 23.4±9.9 | 14.2±6.7 | 23.9±8.9 | G:<0.001,,,* | 17.9–23.1 |
| Lateral handle | 27.4±12.0 | 14.0±7.5 | 22.8±7.6 | I:<0.001* | 18.6–24.2 |
| Left FCU | |||||
| Parallel handle | 38.2±13.1 | 20.6±10.1 | 25.3±9.0 | H:<0.001,,* | 24.7–31.4 |
| Vertical handle | 20.9±6.9 | 14.4±7.1 | 22.8±10.6 | G:<0.001,,* | 16.8–22.0 |
| Lateral handle | 24.7±7.7 | 13.7±8.3 | 24.8±11.0 | I:<0.001* | 18.0–24.1 |
| Right BB | |||||
| Parallel handle | 21.0±7.4 | 13.1±4.8 | 15.1±4.6 | H: 0.001,,* | 14.8–19.1 |
| Vertical handle | 16.8±6.9 | 10.9±4.9 | 14.1±5.9 | G:<0.001,,,* | 12.3–15.6 |
| Lateral handle | 17.1±6.9 | 10.6±5.3 | 15.0±6.6 | I: 0.088 | 12.4–16.1 |
| Values are given as mean±SD; CI – confidence interval; ECR – extensor carpi radialis; FCU – flexor carpi ulnaris; BB – biceps brachii; H – handle orientations. G – ground types; I – interaction; CI – confidence interval; * a p b c p @ # § p | |||||