Accelerometry-Based 24-Hour Movement Behavior in Manual Wheelchair Users: A Cross-Sectional Study
Alena Vernerova, Jan Dygrýn, František Chmelík · Archives of Physical Medicine and Rehabilitation · 2026
OBJECTIVE: To describe 24-hour movement behavior in manual wheelchair users using accelerometry, with a focus on differences by sex, severity of disability, and timing of disability onset. DESIGN: Cross-sectional study. SETTING: Free-living conditions. PARTICIPANTS: Adult manual wheelchair users (N=72). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Adherence to 24-hour movement guidelines, defined as ≥150 min/wk of moderate-to-vigorous physical activity, 7-9 hours of sleep per night, and <8 hours/day of sedentary behavior. Movement behaviors were assessed using a wrist-worn ActiGraph wGT3X-BT over 7 days and a sociodemographic questionnaire. RESULTS: No participants met all 3 guidelines because none met the sedentary behavior 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<.001) and less sedentary time (Z=3.85, P<.001), and were more likely to meet the physical activity guideline (χ²=9.74, P=.0018), whereas participants with congenital disabilities more often met the sleep guideline (χ²=6.29, P=.012). CONCLUSION: Sedentary behavior was the most challenging 24-hour guideline. These findings highlight the need for disability-specific movement guidelines that better reflect the unique circumstances and daily realities of manual wheelchair users.