ZonMw rehabilitation program I 'Restoration of mobility'
ZonMw rehabilitation program II 'ALLRISC'
1. Umbrella project Restoration of mobility
2. Wheelchair skills
3. Cardiovascular adaptation
4. Mechanical strain of the upper extremities
5. Spasticity reduction using FES
6. Coordination of the upper extremities in tetraplegia
7. Everyday physical activity
8. Hand-arm policy in tetraplegia
9. Handbiking
10. Transmural nursing care
11. Immigrants in SCI rehabilitation
12. Determinants of physical capacity
13. Patient involvement in SCI rehabilitation
14. Respiratory adaptations
15. Classification of paramedical intervention
16. Patient monitoring
17. Upper extremity task performance in high SCI
18. Quality of life during and after SCI rehabilitation
19. Pulmonary complications and   physical inactivity
21. Universal wheelchair mobility skills test
22. WHEEL-i
23. Life satisfaction & wheelchair exercise capacity
24. Shoulder pain & range of motion 
Related projects
NVDG research group




WHeelchair Expert Evaluation Laboratory





Lucas van der Woude, PhD (Project leader)

Sonja de Groot, PhD (Project coordinator)

Coen Vuijk, wheelchair professional of Motion Matters

Frank van Dijk, Master student Centre for Human Movement Sciences

Frank Ettema, physical therapist

Maurits Sloots, occupational therapist

Jenny van der Toorn, rehabilitation technician

Janneke Stolwijk, MD, PhD

Ferry Woldring, physical therapist

Sytske Teeninga, occupational therapist

Marga Tepper, MD, MSc



The main purpose of rehabilitation is to optimize social participation and quality of life. Independent mobility is an essential prerequisite for participation. People who are wheelchair dependent (in the Netherlands estimated between 225.000-250.000 persons), are threatened in their societal possibilities and their personal welfare. Of them around 90% uses a hand rim wheelchair. 

Currently, many Dutch rehabilitation centers have a laboratory where gait analyses are performed to diagnose deviations in the walking pattern, to evaluate an intervention and to be able to monitor changes in the walking pattern over time. With this analysis the patient's gait pattern can be assessed objectively. However, none of the rehabilitation centers analyzes wheelchair propulsion systematically while the academical expertise is available in the existing collaboration. Since wheelchair propulsion often leads to overuse injuries of the shoulder, elbow and wrist, it is important to evaluate and optimize the propulsion technique together with the wheelchair configuration and mechanics. 

The weelchair-user interface and propulsion technique have been studied (inter)nationally for 20 years. From this research it is known that there are several factors that relate to overuse injuries of the upper extremity. The forces necessary to propel the wheelchair are not always high but the frequency of force transmission is high. An estimated minimal daily period of 1 hour wheelchair propulsion may lead to 1800 bimanual pushes. Therefore, it is important to diminish the push frequency as well as the force. This can be achieved, for example, by making long strokes. Besides the propulsion technique also wheelchair-technical aspects (e.g. mass, maintenance) and the interface between the wheelchair and the user (e.g. seat height, position of the wheel axle) are important for the experienced physiological and mechanical strain. 

To evaluate the propulsion technique, wheelchair-user interface and wheelchair mechanics, (commercially available) measurement wheels (i.e. OptiPush or SmartWheel) can be used. These wheels can measure, among others, the forces and torques that are applied on the rim while the patient uses his own wheelchair. 

   OptiPush                                SmartWheel


Factors such as force, push frequency, speed and stroke length can be analyzed easily with data of such a measurement wheel. These data can also be compared with reference data to be able to assess whether these values are acceptable. Based on these objective measures, wheelchair users can learn a good propulsion technique or the wheelchair configuration can be adjusted to improve mobility. A repeated measurement can show whether this new propulsion technique or wheelchair adjustment is effective. Such an analysis of the propulsion technique is important for every wheelchair user, i.e. for the patient who has the learn wheelchair propulsion from scratch but also for the elite wheelchair athlete who want his propulsion technique and wheelchair to be optimal to be able to win medals! The propulsion analysis with the measurement wheel can be complemented with video recordings of the movement (kinematics), measurement of the oxygen uptake to determine whether the new technique or configuration is more efficient (lower energy expenditure), or by measuring the muscle activity (EMG). 

The purpose of this project is to implement a systematical analysis of the propulsion technique, the wheelchair-user interface as well as the wheelchair mechanics in the clinical settings of the rehabilitation centers Beatrixoord, UMCG and Reade (formerly known as RCA) analogous to gait analysis.  

Watch the WHEEL-i instruction video here! (made by JeepMedia)


Download the WHEEL-i manual here (in Dutch)


Read all about wheelchair selection in the court sports in the practical guidelines developed by the Peter Harrison Centre for Disability Sport, Loughborough University, UK. 


You can read more about this project in the Dutch newsletter of December 2010 or August 2011.




Contact address

Sonja de Groot / Lucas van der Woude

Center for Human Movement Sciences

University Medical Center Groningen

University of Groningen

Antonius Deusinglaan 1

9713AV Groningen,

The Netherlands