The growth of wheelchair related research has been seen most in that of manual wheelchairs. There is diversity in this research which reflects the diversity of factors and variables that affect the fit of manual wheelchair to the person, in particular how it affects propelling the manual wheelchair. The first section reviews manual wheelchair propulsion studies in which kinetic and kinematic impact on the upper extremity and trunk are explored in relation to stroke patterns and propulsion on level and non-level surfaces. The sections that follow expand on other variables that effect propulsion. The Effects of Wheelchair Frame and/or Set-up on Propulsion subsection reviews studies of the effects of axle position, wheelchair weight, vibration, tire pressure, hand rim types and push rim-activated power assisted wheelchairs on propulsion. The Training subsection reviews studies related to propulsion training and the effects of propulsion on physical conditioning. The Wheelchair Use subsection reviews studies related to how wheelchairs are used, satisfaction and wheelchair skills.