Environmental Barriers to Wheelchair Use

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Manual wheelchair users face many environmental barriers. Richter et al. (2007b) define cross slope as the slope of a surface perpendicular to one’s path of travel.  Sidewalks have some degree of cross slope in order to drain water.

Table: Environmental Barriers to Wheelchair Use


Richter et al. (2007b) investigated the effect of cross slope on wheelchair handrim biomechanics.  The data from this study indicates that more pushes are required to cover the same distance when on a cross slope and that the power required increased by a factor of 2.3 on a 6 degree cross slope. Users must push harder on the downhill handrim and this increased loading may result in overuse injuries.


There is level 4 evidence (from one case series study; Richter et al. 2007b) that wheeling cross slope results in increased loading on users’ arms and may lead to overuse injuries.

  • Wheeling cross slope can play a role on the cadence and power that is required for wheelchair propulsion.