SmartWheel: Out of Rehab Centers, Into RTS’ Hands

SmartWheel, the tool traditionally used in rehab centers to teach safe and efficient manual wheelchair propulsion, is now a bona fide tool for clinicians and rehab technology suppliers (RTS) specializing in seating & mobility.
Why the change? SmartWheel continues to examine a user’s propulsion technique by measuring and analyzing how much force is exerted with each push, the length and smoothness of each push and how frequently force is exerted. Having that information can enable a rehab professional to teach a manual chair user to propel in a way that is more efficient and that causes less overall stress and injury to arms and shoulders.

But Out-Front (aka, Three Rivers) has worked hard to support its SmartWheel with the type of objective evidence that today’s funding sources crave.Among the resources supporting SmartWheel users are clinical practice guidelines created in 2005 by the Consortium of Spinal Cord Medicine. Says Out-Front’s Ron Boninger, “Those were evidence-based practice guidelines, and they were set up to try as much as possible to look at evidence objectively and then make recommendations that make sense.”

The guidelines therefore discuss the nature of manual chair propulsion and best practices.
“The two main themes that come out of the guidelines,” Boninger says, “are reduced force and reduced repetition, which makes sense. If you’re reducing the force it takes to push a chair, it’s less likely that you’ll have pain and injury. If you’re pushing on a wheelchair 2,000 to 3,000 times a day, and you can reduce that a small amount, you just have more pushes left in your body over an extended time. Let’s make sure that you’re pushing with a force that makes sense and with a number of pushes per second that makes sense.”

In addition to these guidelines, which lay a foundation for effective and healthy propulsion, there is also the SmartWheel Users Group, made up of such rehab heavyweights as Craig Hospital, Ohio State University and the University of Pittsburgh.The Users Group enables SmartWheel users to share their information and findings as they work with clients.

“When we first started to offer the SmartWheel as a product, we very early on decided that we wanted to have a standard clinical protocol,” Boninger says. “We wanted to develop reference values for the average force, for example, it takes the average person to push a wheelchair.” SmartWheel Users Group findings are due to be published in the Archives of Physical Medicine.

All of this means SmartWheel is now positioned not only to measure propulsion, but also to help with medical justification and documentation — which could make it most welcome to RTS’s. And because the number of rehab centers using SmartWheel is still relatively limited, an RTS with SmartWheel in his or her arsenal could have a competitive advantage and could partner with clinicians who want to use SmartWheel for evaluations or client training, but don’t have a SmartWheel-equipped rehab center nearby. Out-Front also promises SmartWheel is easier than ever to use. Want proof? Visit to view its online in-service, or call (480) 833-1834 for more information.

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