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Review

A Mapping Review of Existing Tools to Assess Physical Qualities of Manual Wheelchair Users

by
Corentin Barthod
1,2,
Jade Berthiaume
1,2,
Marie-Ève Schmouth
2,
Joanie Bédard
1,2,
François Routhier
1,2 and
Krista L. Best
1,2,*
1
School of Rehabilitation Sciences, Université Laval, Quebec City, QC G1V 0A6, Canada
2
Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale, Quebec City, QC G1M 2S8, Canada
*
Author to whom correspondence should be addressed.
Disabilities 2025, 5(2), 54; https://doi.org/10.3390/disabilities5020054
Submission received: 10 February 2025 / Revised: 21 May 2025 / Accepted: 27 May 2025 / Published: 3 June 2025
Browse Figure
Review Reports Versions Notes

Abstract

:
Background: Assessment of physical competencies is one way to enhance uptake and maintain participation in a leisure-time physical activity (LTPA) for manual wheelchair (MWC) users. Weineck’s model explains physical competencies through eight physical qualities. The use of this model may influence MWC users’ motivation for participation in LTPA. The aim of this study was to identify and categorize existing assessment tools designed for MWC users of physical qualities (strength, speed, power, muscular endurance, cardiovascular endurance, balance, and flexibility). Methods: A mapping review was conducted following the “Preferred reporting items for systematic reviews and meta-analyses (PRISMA)” guidelines. Two reviewers selected articles that documented assessment tools for the physical qualities of MWC users. Tools were extracted from each article to categorize them in a list. Results: A total of 149 articles that contained assessments of physical qualities were included in the review. A total of 97 assessment tools were extracted and categorized according to the eight physical qualities. Conclusions: These assessments are categorized into physical qualities that would facilitate the creation of test batteries aimed at assessing physical qualities in MWC users. This study is the first step in the construction of a test battery to assess the physical qualities of MWC users.

1. Introduction

Physical activity (PA), defined as any movement produced by the musculoskeletal system requiring energy expenditure [1], is a critical factor for promoting the health, functioning, and well-being of people with disabilities [2]. The physical and psychosocial impacts of PA are well documented and include reduced risk of chronic diseases [3], reduced social isolation [4], reduced risk of depression [5], and improved well-being [6]. The recent PA guidelines indicate that adults without disabilities aged 18 to 64 should engage in at least 150 min of moderate-intensity endurance activity per week to accrue the health benefits [1]. Among manual wheelchair (MWC) users and, more generally, among people without disabilities, there are few physical activity (PA) guidelines aimed at achieving optimal health benefits. Existing recommendations primarily target people with spinal cord injury and multiple sclerosis. Some of these suggest three 20-min sessions of moderate to intense aerobic exercise per week, along with three sets of strength exercises for each major functioning muscle group, performed twice a week [7].
Compared to individuals without disabilities, using a MWC is associated with higher risk of physical complications (e.g., obesity [8], cardiovascular disease [6], pain in the upper limbs and trunk [9]), psychological complications (e.g., depression, anxiety [10,11]), and social issues (e.g., lower self-esteem, reduced confidence in social relationships [12]). However, regular participation in PA has a protective effect against the onset of these complications. For instance, on the physical level, one study showed that pain (assessed with the Wheelchair User‘s Shoulder Pain Index) among MWC basketball athletes decreased by 64% after an 8-week PA program that included both cardiovascular and strength training exercises [13]. Another study with a 36-week PA program showed a 56% reduction in shoulder pain among MWC users with a spinal cord injury [14]. Additionally, a study involving MWC users with SCI found that time spent practicing LTPA is associated with increased blood pressure and wrist circumference—factors linked to a reduced risk of cardiovascular disease [8]. On the psychological level, in a study involving 26 individuals using a manual wheelchair who engaged in LTPA, interviews were conducted to explore the perceived psychological benefits of LTPA [15]. Reported benefits included feeling good, staying focused in other areas of life, and relieving stress or aggression [15]. More than half (n = 15) of the participants stated that their self-perception had changed through sport and LTPA, including their thoughts, feelings, and behaviors. Another study showed a positive correlation between participation in wheelchair hockey and various variables associated with well-being (i.e., positive body image, quality of life, self-efficacy) [16]. On the social level, a scoping review revealed rugby players’ social perceptions of their sport [17]. Wheelchair rugby players reported that their LTPA fostered lifelong friendships, greater trust in others, pure joy and passion, while also helping them stay mentally and physically active [17].
To promote sustainable participation in physical activities, the World Health Organization (WHO) specifically encourages leisure time physical activity (LTPA) [1], defined as any activity that one chooses to do in their free time (e.g., sport, exercise, walking), to optimize physical and social benefits [18]. However, participation in LTPA by MWC users is low. In a study of 695 people with a spinal cord injury, 50% reported taking part in 0 min of LTPA per week [19]. Another study found that 8% of older adults who use a MWC participate in LTPA, compared to 49% of older adults who use their lower limb [20]. This low participation in LTPA is driven by the numerous barriers faced by MWC users. In fact, a systematic review identified over 200 factors that can act as barriers to LTPA participation among people with disabilities [21]. Among these, a systematic review identified the perceived barriers faced by Danish MWC users regarding their participation in leisure-time physical activities (LTPA) [22]. According to the results, MWC users are mostly confronted with a lack of support in their engagement in LTPA (e.g., low numbers of participants, coaches, or healthcare professionals), limited accessibility to transportation and facilities, and feelings of fatigue or pain. These barriers vary greatly depending on the context and living environment and can be exacerbated in rural settings. On the other hand, various environmental, social, and psychological factors can facilitate LTPA participation among MWC users [7,23]. For example, LTPA can be facilitated by creating physically accessible environments [24], developing customized and supportive programs [25,26], and making adaptations to both the environment and the activities themselves [27].
One understudied factor that could facilitate participation and adherence is physical competence. More specifically, a systematic review identifies aerobic fitness, strength, and body function as factors influencing LTPA participation for persons with disabilities [19]. These factors are part of a broader concept that can be referred to as physical competencies. Physical competence, defined as the “individual’s ability to develop movement skills and patterns, and the capacity to experience a variety of movement intensities and durations”, is one of the three pillars of participation (including participation in LTPA), along with autonomy and relatedness. A systematic review investigated the relationship between exercise PA and self-determination theory in the general population [27]. Among the 14 studies that investigated the influence of physical competence, 12 reported a positive correlation between feelings of competence and participation in LTPA. No studies demonstrated the beneficial effects of the sense of competence on participation in LTPA for MWC users. However, some studies showed that among people with disabilities, a low sense of competence is generally associated with lower participation in LTPA [28,29]. Another study of children with cerebral palsy showed that competence explained 24% of the variance in participation, and competence was identified as the second most important source of motivation to engage in LTPA after enjoyment [30].
Several tools are available to assess some physical competencies in MWC users, such as the Wheelchair Skills Test [31] and test batteries that target performance in a LTPA [32,33]. However, these assessments reflect the specific competencies for which they were developed (i.e., motor skills for MWC use or performance in a specific LTPA). The sports performance capacity model proposed by Weineck describes the integration of a broad range of physical competencies relevant across all types of LTPA (including people with and without disabilities) [34]. This model explains the broad range of physical competencies through seven physical qualities, including strength, endurance, speed, power, coordination, flexibility, and balance. These physical qualities originated from earlier studies (e.g., Fleischmann [35]) that used factor analysis to examine 85 skills required in LTPA and demonstrated that they could be explained by these seven physical qualities. The physical qualities of MWC users have been assessed using various laboratory and field tests for popular wheelchair sports, such as wheelchair basketball, wheelchair rugby, wheelchair tennis, and wheelchair fencing [36,37,38,39,40]. To the best of our knowledge, there are currently few test batteries available to assess the physical qualities required for one or more LTPAs intended for MWC users [32,39,40]. However, these test batteries are essentially designed to assess fitness components (such as cardiovascular and handgrip strength) and not to assess all physical qualities components. In the non-disabled population, test batteries that comprise multiple physical qualities have been used to assess and enhance performance, fitness, and health in children and adults [41,42]. A similar test battery for LTPA (i.e., targeting overall physical qualities) for MWC has not been documented in the scientific literature.
Creation of a test battery that comprises a global assessment of physical qualities could be used by coaches and trainers to aid in LTPA selection or to develop training programs for MWC users. In this way, targeting or enhancing competence may motivate MWC users to start and maintain participation in LTPA. Compiling assessment tools for the eight physical qualities into a test battery may help support LTPA selection and activity-specific training for MWC users. A similar initiative was carried out by the Council of Europe with the ALPHA project (Assembly for the Provision of Leagues on Health-Enhancing Physical Activity). It aimed to promote a healthy and active lifestyle across Europe by providing standardized tools to assess physical fitness and encouraging participation in LTPA. This project led to the creation of the Eurofit fitness test battery, whose approach greatly inspired the methodology used in this study [41]. During the process of creating the Eurofit fitness test battery, the first step was to identify all existing tools and their characteristics, so as to make the most informed choices in creating the test battery [41]. The aim of this study was to identify and categorize existing assessment tools designed for MWC users, focusing on eight physical qualities: strength, speed, power, muscular endurance, cardiovascular endurance, balance, and flexibility.

2. Materials and Methods

2.1. Design

A mapping review was conducted by following the “Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)” guidelines [43]. According to James et al. [44], mapping reviews are a transparent, rigorous, and systematic approach to identifying, describing, and cataloging evidence on a broader topic area that permits collating and cataloging available evidence. The steps of the mapping review are described in Figure 1.

2.2. Search Strategy

A comprehensive search strategy was developed in collaboration with a librarian scientist. Keywords were designed around three concepts: (#1) wheelchair users (“Wheelchair”), (#2) physical qualities (“Strength” OR “Speed” OR “Power” OR “Muscular endurance” OR “Cardiovascular endurance” OR “Coordination” OR “Equilibrium” OR “Flexibility”), and (#3) exercise evaluation (“Exercise evaluation”). The selection of physical qualities was guided by the LTPA performance capacity concept, which identified the physical qualities of LTPA [36]. A more detailed search strategy was then developed using MeSH terms and keywords related to the three basic concepts and synonyms (Table 1). The search strategy was conducted using three online electronic databases: Medline (Ovid), Embase, and CINAHL. Two authors independently performed the search.

2.3. Review Process and Eligibility Criteria

The online platform, Covidence systematic review software (Veritas Health Innovation, version Extraction 1, Melbourne, Australia, URL www.covidence.org (accessed on 25 January 2025), was used to guide the systematic review process. Two reviewers conducted the initial screening of titles and abstracts, followed by a second review of full-text articles. To be included in this review, the studies had to: (1) Assess at least one physical quality (i.e., strength, speed, power, muscular endurance, cardiorespiratory capacity, flexibility, coordination, equilibrium); (2) include a sample of MWC users; (3) describe methodology to assess the physical quality; (4) be published in English or French. Studies for which only abstracts were available were not included. All articles published before the year 2000 were excluded. The last update was carried out in January 2025. There were no restrictions on the selection of tools, but if the article did not detail the assessment methods or materials required, it was excluded. Two reviewers independently assessed the eligibility of each article. Discrepancies regarding the eligibility of articles were solved by a third researcher.

2.4. Data Extraction

Two authors independently extracted data using a study-specific evidence table using Microsoft Excel spreadsheets online (Version 2402, Redmond, WA, USA). For each article, the following data were extracted: date, title, authors, population studied, name of assessment, validity and reliability of the assessment tools (if documented), materials and equipment required to conduct the assessment, references of tools, and a complete description of outcomes. When the article proposed several assessments, each physical quality assessment was independently extracted and classified.

2.5. Data Synthesis

Classification of physical qualities. The assessments selected were categorized according to the physical quality they evaluated using the LTPA performance capacity model. The categorization of assessments respective to each physical quality was achieved by a clear agreement between the assessment attributes and the definition of each physical quality (Table 2). If the assessment measured two or more physical qualities, it was added to each category according to the physical qualities measured. After categorization, the number of existing assessments for each physical quality was noted.
In the current study, the assessment of endurance was divided into two components: cardiovascular endurance and muscular endurance. This choice was made to highlight the importance of muscular endurance for MWC users, as it is an essential element for reducing pain and preventing injuries associated with participation in LTPA. Indeed, two interventions incorporating muscular endurance exercises have been associated with reductions in pain and injury following participation in LTPA [14,36].

2.6. Measurement Properties

Measurement properties were documented in the table for those articles in which they were provided according to the type of measurement property (validity or reliability) and population studied. A percentage of the number of validated tools was calculated by dividing the number of validated tools (with at least one measurement property) by the total number of assessments.

3. Results

Figure 1 presents the PRISMA flow diagram, detailing the flow of information during the mapping review and the progression from Phase 1 to Phase 2 (i.e., the number of studies and assessment tools identified at each phase). A total of 2330 articles were identified in the initial search, of which 149 contained assessments of physical qualities and were included in the review. A total of 97 physical quality assessments were extracted and categorized.
The 97 physical quality assessment tools are presented in the Supplementary Material (Table S1), which shows the population studied, the name of the assessment, validity and reliability of the assessment (if documented), the material and equipment required to conduct the assessment, the reference of the assessment tools, and a complete description of outcomes. Assessments of physical qualities included strength (n = 14) [32,39,45,46,47,48,49,50,51,52,53,54,55], speed (n = 9) [32,46,51,54,55,56,57,58], speed and power (n = 1) [55], power (n =8) [59,60,61,62,63,64,65,66], power and cardiovascular endurance (n = 8) [67,68,69,70,71,72,73,74], cardiovascular endurance (n = 19) [33,46,56,74,75,76,77,78,79,80,81,82,83,84,85,86,87,88,89,90,91,92,93], muscular endurance (n = 4) [48,51,94,95], muscular endurance and coordination (n = 1) [96], coordination (n = 23) [34,41,53,57,61,63,96,97,98,99,100,101,102,103,104,105], flexibility (n = 2) [105,106], flexibility and equilibrium n = 1) [107], equilibrium (n = 7) [108,109,110,111,112]. Of the 97 assessment tools, 68% (n = 64) had documented measurement properties. The majority of studies documented criterion or construct validity (n = 58), and the others documented reliability (n = 6). The populations studied included people without disabilities who used a wheelchair, wheelchair athletes, wheelchair basketball players, wheelchair rugby players, people with spinal cord injury, older adults, wheelchair tennis players, people with vestibular hypofunction, people with cerebral palsy, people with spina bifida, and people with osteogenesis imperfecta. Physical qualities with more than 50% of assessment tools without measurement properties were flexibility (100%), cardiovascular endurance (58%), and muscular endurance (50%). Assessment tools with less than 50% of tools without measurement properties were power (0%), tools combining power and cardiovascular endurance (14%), coordination (21%), balance (25%), strength (27%), and speed (33%). Table 2 provides a summary of each tool.

4. Discussion

The review resulted in a list of 96 tools that were used to assess physical qualities of MWC users, and categorized according to eight physical qualities (i.e., strength, speed, power, muscular endurance, cardiorespiratory capacity, flexibility, coordination, equilibrium) [34]. This list aims to facilitate the identification and use of physical quality assessments for MWC users for various purposes. A description of the tools, the equipment required, and the measurement qualities (i.e., validity and reliability) of the assessment tool are all key elements that will enable users to make the best choice of assessment tools according to their specific needs (e.g., for precise assessments or for field assessment with low cost).
This list of tools provided an overview of existing assessments of physical quality. The results of this mapping review are encouraging, since most physical qualities (i.e., strength, cardiovascular endurance, speed, power, coordination, and flexibility) have assessment tools with documented measurement properties, and tools available for use in the field or laboratory. On the other hand, other physical qualities (i.e., equilibrium and muscular endurance) require a little more development in order to better assess the requirements of LTPAs for MWC users. For instance, only 4 tools were available for assessing muscular endurance. However, MWC users indicated a heightened emphasis on muscular endurance in LTPAs involving wheelchair use [113,114]. Supporting this perspective, certain studies revealed that MWC users seldom attained maximal cardiovascular endurance during prolonged wheelchair propulsion due to constraints imposed by muscular endurance [113,114]. Assessment tools still need to be developed to better evaluate the muscular endurance of wheelchair-related muscles.
Trunk flexibility was also suggested to be a key determinant of the performance of LTPA for MWC users, such as wheelchair fencing [38]. It assumes better sitting balance control for adjusting the positioning of the wheelchair for more efficient movement. As an example, trunk flexibility is essential to balance the sled in the curling throw or for cross-country skiing [115]. Four assessments tools (Multidirectional reach test [107], Static sitting balance test [116], Adapted functional reach test [109], Limits-of-stability test performed [110]) identified in this study measure balance and trunk flexibility; however, they generally required specific tools for laboratory assessment like strength platform, physiotherapist professional, telemetric laser or motion capture analysis [110,117]. With the aim of ensuring accessible assessment tools, these measures may pose barriers due financial or time investment. These assessments would therefore be too restrictive to implement in the field, although certain adaptations could be made to make the assessment more accessible. The current list of assessments for MWC users does not include field trunk flexibility assessments, despite their importance in LTPA for MWC [38,117].
This list of assessments will, in a future study, facilitate the creation of a specifically designed test battery aimed at gathering evidence on the development of MWC users’ physical qualities. Organizations supporting LTPAs for people with disabilities, including MWC users, need to assess physical qualities and obtain relevant information related to the LTPA practiced. For instance, it could enable the assessment of physical quality characteristics associated with each LTPA. This would then allow for the proposal of an optimized and adapted training structure to provide the best benefits to the person [37,38]. Conversely, it could be used to identify the optimal LTPA for a person based on their physical quality characteristics [37,38]. As an example, services offering LTPAs for MWC users propose applications that help people with disabilities find their sport based on their own characteristics, which could be further enhanced with such a test battery [118]. The creation of a test battery designed to assess physical qualities may support the participation of MWC users in LTPAs by providing tools and relevant information to improve their physical qualities in their LTPA participation [119,120,121].
The proposed list of tools will serve as a central component in the creation of a test battery designed to meet the needs of all services offering LTPAs for MWC users. The selection of assessment tools to be included in the test battery will be determined through a consensus among a panel of potential users (e.g., MWC users, trainers, and kinesiologists). One of our future objectives is to recommend certain assessments over others based on their usability, validity, and prominence in the literature. Similar work has already been conducted with people without disabilities to develop the Eurofit fitness test battery, which is now a reference for assessing the health-related component of individuals without disabilities [120,121].

Limitations

The choice of Weineck’s model, a French model that is less commonly used than others in English-language studies, may be perceived as a limitation to permit discussion in relation to other, more commonly used models. However, a review of literature has shown that Weineck’s model is more complete in assessing physical qualities, whereas others are more designed to assess health-related components. Another limitation relates to the reporting of measurement properties for each of the tools retrieved in the mapping review. When measurement properties were not explicitly reported in the articles, no further investigations were conducted to find these details. Therefore, some tools included in this review may lack documented measurement properties. These tools could have been removed from the selection process, but their inclusion highlights the need for validation studies to confirm the reliability and validity of these tools. Future research may consider reporting measurement properties for all tools or conducting studies to validate additional tools. One final limitation concerns the assessment tools for some wheelchair related outcomes, which may have integrated physical qualities, such as the Wheelchair Skills Training test, that were not necessarily included in this mapping review. This decision was made because these assessments are not specifically designed for LTPA practice and do not specifically assess one of the seven physical qualities. However, some assessments could be relevant and should be explored in future studies.

5. Conclusions

This study identified and categorized existing tools to assess eight physical qualities for MWC users. Such a study will facilitate the development of future test batteries for professionals and researchers. This work represents the first step in creating tools aimed at enhancing physical qualities and then facilitating participation in LTPAs for MWC users.

Supplementary Materials

The following supporting information can be downloaded at: https://www.mdpi.com/article/10.3390/disabilities5020054/s1, Table S1: Summary of all studies identified on physical quality measurement. References [122,123,124,125,126,127,128,129,130,131,132,133,134,135,136,137,138,139,140,141,142,143,144,145,146,147,148,149,150,151,152,153,154,155,156,157,158,159,160,161,162,163,164,165,166,167,168,169,170] are cited in the supplementary materials.

Author Contributions

We would like to acknowledge the authors for their contributions. Conducting the mapping review and selecting pertinent articles: C.B., and J.B. (Jade Berthiaume). Data identification, extraction, analysis, and interpretation: C.B., J.B. (Jade Berthiaume), and K.L.B. Conception, design, Manuscript review, final endorsement: J.B. (Joanie Bédard), M.-È.S., J.B. (Jade Berthiaume), K.L.B., and F.R. Writing the article: C.B. All authors have read and agreed to the published version of the manuscript.

Funding

Corentin Barthod received doctoral scholarships from Mitacs Acceleration (IT26465), Quebec Health Research Funds-Tremplin Award (308933), Quebec Rehabilitation Research Network (1107804) and a graduate scholarship from the Cirris (winter competition 2020). Jade Berthiaume received an undergraduate scholarship from the Cirris (summer competition 2021). Drs. Best and Routhier both had salary support from Quebec Health Research Funds Scholar Awards (Junior 2 #330062 and Senior #296761, respectively).

Institutional Review Board Statement

Not applicable.

Informed Consent Statement

Not applicable.

Acknowledgments

We would like to acknowledge Parasports Québec for their contribution to a better understanding of the needs of services that they provide and for their support in the project. We would like to acknowledge the librarian Martine Gagnon from Université Laval for her help in implementing the research strategy. Finally, we would like to thank Mika Kaye for her assistance with article screening and selection.

Conflicts of Interest

The authors declare no conflicts of interest.

Abbreviations

The following abbreviations are used in this manuscript:
LTPALeisure-time physical activity
MWCManual wheelchair
PRISMAPreferred reporting items for systematic reviews and meta-analyses

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Disabilities 05 00054 g001
Figure 1. Prisma diagram showing the item selection process followed by the assessment extraction and selection process.
Figure 1. Prisma diagram showing the item selection process followed by the assessment extraction and selection process.
Disabilities 05 00054 g001
Table 1. Details of the search strategy used for Ovid, including the three concepts and their synonyms. Note: * and ti.ab represent essential syntax for conducting searches in Ovid.
Table 1. Details of the search strategy used for Ovid, including the three concepts and their synonyms. Note: * and ti.ab represent essential syntax for conducting searches in Ovid.
ConceptsResearch Strategies
1exp wheelchairs/
2("wheelchair*").ti,ab. OR ("chair wheel").ti,ab. OR ("chairs wheel").ti,ab. OR ("wheel chair").ti,ab.
1 and 21 OR 2
3exp physical fitness/ OR exp exercise tolerance/ OR exp physical functional performance/ OR exp psychomotor performance/ OR muscle strength/ OR exp hand strength/ OR exp physical education and training/ OR exp motor skills/ OR exp range of motion, articular/ OR exp arthrometry, articular/ OR exp postural balance/ OR exp physical endurance/ OR exp cardiorespiratory fitness/
4("coordination").ti,ab. OR ("performance*").ti,ab. OR ("aerobic exercise*").ti,ab. OR ("exercise training").ti,ab. OR ("acute exercise").ti,ab. OR "physical Exercise" OR "speed movement " OR stamina OR "joint range of Motion " OR flexibility OR "passive range of motion" OR postural OR posture OR equilibrium OR "postur* control*" OR "physical fitness" OR "exercise tolerance" OR "psychomotor performance " OR "muscle strength" OR "hand strength" OR "physical education and training" OR "motor skills" OR "range of motion, articular" OR "arthrometry, articular" OR "postural balance" OR "physical endurance" OR "cardiorespiratory fitness" OR "physical competenc*" OR "physical capacity"
3 and 43 OR 4
5exp circuit-based exercise/ OR exp aptitude tests/ OR exp exercise test/ OR exp outcome assessment, health/ OR exp aptitude/
6("test* battery").ti,ab. OR ("fit* test*").ti,ab. OR ("exercis*").ti,ab. OR ("measure*").ti,ab. OR ("scor*").ti,ab. OR ("circuit-based Exercise").ti,ab. OR ("exercise test").ti,ab. OR ("outcome assessment, health").ti,ab. OR ("aptitude").ti,ab.
3 and 45 OR 6
Table 2. Definition of physical qualities according to Weineck’s model, including a distinction between cardiovascular and muscular endurance.
Table 2. Definition of physical qualities according to Weineck’s model, including a distinction between cardiovascular and muscular endurance.
Physical QualityDefinition
StrengthThe ability to overcome or oppose external resistance through muscular contraction [34].
SpeedThe ability to perform motor actions in the shortest possible time, taking into account external conditions, thanks to the mobility of neuromuscular system processes and the capacity of the musculature to develop force [34].
PowerThe ability to deliver maximum effort in an extremely short space of time [34].
Endurance
  Cardiovascular
  Muscular		 
A person’s maximum oxygen consumption capacity [34].
The ability to prolong a continuous contraction or to repeat it optimally for as long as possible [34].
CoordinationThe ability to learn new motor skills more quickly and easily [34].
FlexibilityThe ability to perform movements with the greatest possible amplitude, whether actively or passively [34].
BalanceThe ability to stabilize oneself in a given environment (land, air, water) [34].
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MDPI and ACS Style

Barthod, C.; Berthiaume, J.; Schmouth, M.-È.; Bédard, J.; Routhier, F.; Best, K.L. A Mapping Review of Existing Tools to Assess Physical Qualities of Manual Wheelchair Users. Disabilities 2025, 5, 54. https://doi.org/10.3390/disabilities5020054

AMA Style

Barthod C, Berthiaume J, Schmouth M-È, Bédard J, Routhier F, Best KL. A Mapping Review of Existing Tools to Assess Physical Qualities of Manual Wheelchair Users. Disabilities. 2025; 5(2):54. https://doi.org/10.3390/disabilities5020054

Chicago/Turabian Style

Barthod, Corentin, Jade Berthiaume, Marie-Ève Schmouth, Joanie Bédard, François Routhier, and Krista L. Best. 2025. "A Mapping Review of Existing Tools to Assess Physical Qualities of Manual Wheelchair Users" Disabilities 5, no. 2: 54. https://doi.org/10.3390/disabilities5020054

APA Style

Barthod, C., Berthiaume, J., Schmouth, M.-È., Bédard, J., Routhier, F., & Best, K. L. (2025). A Mapping Review of Existing Tools to Assess Physical Qualities of Manual Wheelchair Users. Disabilities, 5(2), 54. https://doi.org/10.3390/disabilities5020054

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