Movement skills are fundamental to all other skills so it is important that proper push mechanics are developed from the outset. Proper biomechanics ensure individuals reduce stress on their joints, as well as reduce repetitive stress injuries.
Other Wheeling Skills
While the push mechanics above mirror the mechanics that a child would use in their ‘everyday’ wheelchair, it is also important to develop skills outside of that linear movement. Repetitive stress injuries from constantly pushing in a forward, linear motion can occur, so it is important that children develop other areas of their upper arm and shoulders to reduce this danger.
Skills that can be taught that develop other modes of moving the wheelchair are:
- Pulling: moving the chair by pulling themselves backward or forward using other stationary objects (ropes, tables, chairs, ledges).
- Pushing: moving the chair by pushing themselves backward using other stationary objects (tables, chairs, walls).
- Rowing: using implements to propel the chair forward in a rowing motion. For example, using two inverted hockey sticks in contact with the floor on each side of the chair to propel it forward.
Understanding the Range of Skills
To go from novice to mastery means being able to do the skill faster with greater technical proficiency in more complex and demanding environments. For pushing forward this includes being able to go faster, weaving in and out of stationary and moving obstacles, and turning around others - avoiding (or absorbing) contact and within the context of the activity.
For individuals that retain trunk function, it would also be prudent that they learn to move their wheelchair without the use of their hands directly on the wheels. This movement can be achieved by firing the abdominal muscles that are functional, moving the hips, as well as manipulating the feet and legs within the chair where that is possible. Swinging the arms and moving the trunk back and forth and side to side will produce movement in a well fit sport wheelchair.
It is also important that children learn to move their wheelchair in movements that are not linear. This is achieved by teaching them to both hop and tilt their chair. Being able to lift one wheel off the ground at a time will help them find their balance point. Also, teaching the skill of ‘wheelies’ (being able to balance the chair while leaning backward with the front castors off the ground) is an important development for the child. With the acquisition of this skill, the individual can learn to move their wheelchair over top of small objects. The skill that is being worked towards is the ability to ‘jump’ curbs or ease themselves over small drops in uneven surface levels (not possible in sport chair with 5th wheel).