Manual wheelchair propulsion over cross-sloped surfaces: A literature review

Manual wheelchair propulsion may be facilitated or impeded depending upon the surface and the environment. One barrier may be the cross-slope of pathways. The purpose of this systematic literature review was to determine the quality of the evidence on the effects of cross-slopes on manual wheelchair propulsion. The goal was to identify and to understand the optimal design for cross-slopes that have the least negative impact for wheelchair users. Fifty-two articles were reviewed by 15 expert reviewers. Six were identified to be relevant to propulsion over cross-slopes. Most studies agree that traversing a cross-slope in a manual wheelchair is more difficult than propelling on a level surface. However, agreement has not been reached as to the percentage increase in effort or the optimal degree of cross-slopes that should be used as an acceptable standard. There is a paucity of research investigating the impact of cross-slopes on wheelchair mobility and community participation.