Accelerometry-based 24-hour movement behaviour in manual wheelchair users: A cross-sectional study.

Abstract

To describe 24hour movement behaviour in manual wheelchair users using accelerometry, with a focus on differences by sex, severity of disability, and timing of disability onset. Cross-sectional study. Free-living conditions. Adult manual wheelchair users (N=72). Not applicable. Adherence to 24-hour movement guidelines, defined as ≥150 min/week of moderate-to-vigorous physical activity (MVPA), 7-9 h of sleep per night, and <8 h/day of sedentary behaviour. Movement behaviours were assessed using a wrist-worn ActiGraph wGT3X-BT over seven days and a sociodemographic questionnaire. No participants met all three guidelines because none met the sedentary behaviour criterion. Overall, 90% met the physical activity guideline and 69% met the sleep guideline. Compared with participants with congenital disabilities, those with acquired disabilities accumulated more physical activity (Z = 3.49, p < 0.001) and less sedentary time (Z = 3.85, p < 0.001), and were more likely to meet the physical activity guideline (χ² = 9.74, p = 0.0018), whereas participants with congenital disabilities more often met the sleep guideline (χ² = 6.29, p = 0.012). Sedentary behaviour was the most challenging 24hour guideline. These findings highlight the need for disability-specific movement guidelines that better reflect the unique circumstances and daily realities of manual wheelchair users.