Training group will first receive 30 minutes of education about biomechanically efficient propulsion techniques. They will be tested on this knowledge to make sure participants understand the material. The participant then will be asked to come into the lab for 6 sessions of training, two times per week for three weeks. The training is an hour of the proper wheelchair propulsion techniques broken into 5 parts, 7 minutes each with breaks. Based on the motor learning principles, we gradually increase the components of the training by focusing either hand reaching toward the back of the wheel or hands reaching down toward the axle.

Control group will first receive 30 minutes of education about the biomechanically efficient propulsion. They will be tested on this knowledge to make sure participants understand the material. No further training will be implemented with this group.

The wheelchair propulsion (WP) intervention is based on our previous pilot work and the best available evidence on WP training. The CPGs recommend minimizing the force and frequency of pushes while using long strokes during propulsion. Each training session will include massed practice with repetitions overground. Each session is organized to limit the number of variables (i.e., long push strokes and dropping the hands down below axle) presented to the participant at one time. Propulsion Set A will focus on using longer push strokes. Propulsion Set B will focus on dropping the hand down toward the axle. Propulsion Set C will focus on both A and B.

Push angle during the push phase of propulsion is assessed with video motion capture (VMC). The VMC system consists of 14 Vero 2.2 digital cameras to detect the location of the reflective markers, specifically on the shoulder, elbow, and wrist. The 3D infrared coordinates will be recorded while participants propel their wheelchair over the ground and on a dynamic roller system. Push angle will be calculated by finding the inner product of the vectors formed by the elbow-shoulder and elbow-wrist. The push angles will be compared across the three testing sessions. This variable corresponds to the recommendations outlined in the clinical practice guidelines. We hypothesize that the increase of push angle will be greater in the training group than the control group.

Hand-axle distance during the recovery phase of propulsion assessed with video motion capture (VMC). The VMC system consists of 14 Vero 2.2 digital cameras to detect the location of the reflective markers, specifically on the axle and the third metacarpal joint. The 3D infrared coordinates will be recorded while participants propel their wheelchair over the ground and on a dynamic roller system. Hand-axle distance will be calculated by the magnitude of the vector formed by the third metacarpal joint and the axle. The hand-axle will be compared across the three testing sessions. This variable corresponds to the recommendations outlined in the clinical practice guidelines. We hypothesize that the increase of hand-axle distance will be greater in the training group than the control group.

The WPT assesses wheelchair mobility and performance of manual wheelchair users (MWU). The WPT requires MWU to propel using a self-selected natural velocity across 10 meters of a smooth flat surface from a static start. The number of pushes and the time will be recorded. The effectiveness of the propulsion is the displacement per push and will be calculated by the 10 meters divided by the number of pushes. We hypothesize that the increase in the effectiveness of propulsion will be greater in the training group than the control group.