Shoulder kinetics during start-up and propulsion with a manual wheelchair within the initial phase of uninstructed training.

These findings underline that individual adaptation strategies are essential to take into account when designing a rehabilitation protocol for wheelchair users. Implications for Rehabilitation The learning process of manual wheelchair locomotion is essential for the assimilation of motor tasks leading individuals to select their propulsion technique. Novice users display different learning strategies: some people increase shoulder loading very early but others spontaneously manage to increase the wheelchair speed while maintaining a constant level of shoulder loading. Wheelchair rehabilitation programs should be individualized to take into account the subject-specific learning strategy.