Measurement and description of physical activity in adult manual wheelchair users

Catherine A. Warms, Ph.D., R.N., C.R.R.N., JoAnne D. Whitney, Ph.D., R.N., C.W.C.N., F.A.A.N., Basia Belza, Ph.D., R.N.
Biobehavioral Nursing and Health Systems, University of Washington, School of Nursing, Seattle, WA 98195-6157, USA

†This project was supported by NIH Research Grants 5 P20 NR008351-04 and NR008360-04 funded by the National Institute of Nursing Research and the National Center for Minority Health and Health Disparities (NCMHD).

Disability and Health Journal, October 2008 Volume 1, Issue 4, Pages 236–244




The purposes of this study were to (1) describe physical activity of adult manual wheelchair users as measured by wrist actigraphy and two self-report measures, (2) compare exercisers and nonexercisers on measures of physical activity, and (3) examine the relationships between three activity measures.


Fifty manual wheelchair users wore an activity monitor and completed a physical activity record for 7 days. At the completion of this period, a questionnaire that included the Physical Activity Scale for Individuals with Physical Disabilities, stage of exercise question, and demographic and health questions was completed.


Mean daily hours spent in bed or asleep was 9.1, mean hours of light intensity activity was 12.5, mean hours of moderate intensity activity was 1.3, and mean hours of strenuous activity was 0.33. Thirty-eight percent did not report any strenuous activity, and 56% reported less than the 150 minutes weekly of moderate or strenuous activity required to meet public health guidelines. There was variability in both self-reported and objectively measured physical activity. Regular exercisers were not significantly different from nonexercisers on objective measures of physical activity. Measured physical movement was weakly correlated with recall of physical activity or exercise.


Many wheelchair users do not meet public health guidelines for physical activity, but they are not a homogeneous group in intensity and frequency of physical activity. Multiple measurement methods can provide insights into the nature, intensity, and duration of physical activity that is more complex due to variations in abilities and ways of moving.