The significance of this study is in the identification of body mechanics used during wheelchair propulsion that are potentially injurious. In addition, information that contributes to better wheelchair locomotion economy and reduction of potentially harmful stresses could improve the performance of everyday activities (including job-related activities) for wheelchair users. They would be able to increase their activity levels without undue risk of musculoskeletal injury and cardiopulmonary stress.

     The aim of this study was to determine the effect of a specific training program in manual wheelchair users. Our hypothesis was that an exercise program that combined stretching, strengthening, and aerobic training would result in more biomechanically economical wheelchair propulsion and decreased joint stresses. Biomechanical economy was defined by the propulsive moment.