Authors of summary: Ursina Arnet and Timo Hinrichs (Swiss Paraplegic Research)
Original article: Arnet U, Hinrichs T, Lay V, Bertschy S, Frei H, Brinkhof MW; SwiSCI study group. Determinants of handbike use in persons with spinal cord injury: results of a community survey in Switzerland. Disability and Rehabilitation. 2015 Mar 18:1-6. [Epub ahead of print]
 

For the first time data on the use of handcycles by paraplegics were published in Switzerland: the study showed that almost 25% used a handcycle. These were mostly men between 31 and 45 years with a medium to high household income, German speaking and with a complete paraplegia. The most prominent reasons for not using a handcycle were lack of interest, lack of knowledge about handcycles and the high purchase price.

Summer is the perfect season for pleasant rides outdoors or for athletic challenges. For many paraplegics riding a handcycle is a good opportunity to get some exercise and to support their own health. It can be integrated easily into everyday life and is a lot of fun.

 

Riding a handcycle promotes health

Various studies have confirmed that riding a handcycle has many positive effects on the body (see figure 1): the power transmission is efficient and the shoulder load is much less compared to the use of a regular wheelchair. This decreases the risk of developing shoulder pain. In general regular exercising helps to improve stamina and decreases the risk for cardiovascular diseases and diabetes. Therefore riding a handcycle regularly can help to stay active into old age. Furthermore it enhances social integration: groups of handcycle users and cyclists, skaters and runners can, depending on fitness and speed, go on a tour or practice together. It is therefore no surprise that there are more and more handcycle users. Within many wheelchair sports clubs there is a specific section for handcycle users, and in 2015 also the UCI Para-cycling world championship took place in Switzerland.

Figure 1: advantages of the handcycle

What did the researchers discover?

The researchers analyzed the published data from the SwiSCI study which showed the use of handcycles by paraplegics in Switzerland for the first time. The study examined who are the typical handcycle users and for which reasons some persons do not use it.

Distribution

According to the study, almost 25% of the population with paraplegia in Switzerland was using the handcycle as means of transportation, in more detail: of 1,549 study participants 350 were using a handcycle (22.6%) (see figure 2). This is approximately in line with other European countries such as Denmark or the Netherlands.

More men than women were using a handcycle (78%). The biggest group of users was between 31 and 45 years old. The higher the age, the smaller the user group and there were hardly any persons 62 years of age or older who were using a handcycle; researchers assumed the reason therefore to be the declining muscle strength that comes with ageing.

Figure 2: distribution of handcycle users

Lesion level

The majority of the handcycle users (58%) had a complete paraplegia (see figure 3). For this form of paraplegia the handcycle is especially suitable since the persons concerned are dependent on a wheelchair but – unlike many persons with a complete paraplegia – they are able to use their arm-, shoulder- and partially their torso strength.

In case of an incomplete lesion a remainder of motor skills and/or sensitivity is still present. Persons with this kind of lesion are the smallest group of handcycle users since they can still partially walk or are not completely dependent on a wheelchair.

Figure 3: lesion level of handcycle users

Income

The handcycle users in comparison with the non-users tended to have a higher household income: 63% of the handcycle users indicated a medium (CHF 3,500 or more) or a high (CHF 4,643 or more) income, unlike the non-users with only 49% indicating a medium or high income.

Distribution according to language regions

The study data showed that the highest portion of handcycle users lived in German-speaking Switzerland: of all German-speaking study participants, 27% were using a handcycle. In French-speaking Switzerland they were only 13% (see figure 4).

Figure 4: distribution of handcycles according to language regions in Switzerland

Reasons for not using a handcycle

Within the group of non-users, 26% indicated that they were not interested in handcycles, 19% did not know it existed and for 14% the purchase price was too high.

Various handcycle categories

Handcycles can be divided into various categories: all-round cycles for everyday use can be attached to the own wheelchair using various systems. Persons who want to get around faster in their own wheelchair may want to use a sports cycle. Like an all-round cycle, it is attached to the wheelchair but by means of geometry, components and selection of materials used it allows for a speedy ride. Finally there are race cycles that are solely intended for sports activities and cannot be attached to the wheelchair (Deutscher Rollstuhlsportverband e.V.: Ein Sport für alle. URL: http://www.myhandicap.ch/sport-behinderung/sportarten/handbike-nicht-nur-fuer-menschen-im-rollstuhl/ (in German), accessed on August 11, 2015). Persons with limited arm strength may even equip their handcycle with a supporting electric motor.

Race cycle

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