Pushrim-Activated Power-Assist Wheelchairs (PAPAWs)

PAPAWs require users to stroke the handrims to activate small, lighter weight motors, which then drive the wheels for brief periods of time (seconds). Find out more about Clair Toh's [...]

Claire Toh, a 24-year-old para-athlete, talks about the SmartDrive and the Alber E-motion after trialing both devices. “I am able to control the SmartDrive more easily because it is lighter. I find it is hard to control the Alber E-Motion as my grip is not good and because the device is heavier.

Claire was recommended the SmartDrive as she is able to wheel the device safely and efficiently. It provides a versatile alternative for her living an active lifestyle, making her able to go up hills and uneven terrains more easily. She can also go long distances by herself without having to rely on someone to assist her when she is tired. Furthermore, she can conserve adequate energy for her training sessions for the upcoming 9th ASEAN Para Games in September of this year.

Long-term manual wheelchair propulsion has been linked to a variety of upper limb disorders including rotator cuff tendonitis, lateral epicondylitis, cubital tunnel and carpal tunnel neuropathies, fibrocartilage metaplasia and calcific tendonitis. However, manual wheeling also provides aerobic exercise. The benefits of exercise are well known and include promotion of cardiovascular fitness, reduction of hypertension, improved glycemic control, improved lipid profiles, reduction of anxiety and an improved sense of well-being. Animal research studies suggests that regular exercise increases resistance to neural injury, and can promote neural plasticity (the ability of the brain and spinal cord to reorganize and restore function after injury). Positive self-image has also been related to manual wheeling.
Traditionally, the only wheelchair propulsion options available were manual and power. Manual wheelchairs have been prescribed for those who can self-propel while power wheelchairs and scooters are prescribed for those who cannot. Pushrim-activated power-assist wheelchairs are a third option. PAPAWs require users to stroke the handrims to activate small, lighter weight motors, which then drive the wheels for brief periods of time (seconds). To keep a PAPAW moving, users must continue to stroke the handrims as they would if they were propelling a standard manual chair.
Power-assist wheelchairs attempt to address several limitations of conventional manual and power wheelchairs. Compared to manual chairs, power assist chairs require less effort to propel, especially in environments such as inclines, uneven terrain, and carpeted surfaces. It is thought that long-term use of power-assist wheelchairs will reduce the magnitude of forces that impact the shoulder, elbow and wrist. These forces are believed to contribute to repetitive stress disorders of the upper limb including carpal tunnel syndrome and rotator cuff disease. Compared to standard power wheelchairs, power assist chairs are lighter and thus should be easier to transport. Additionally, because propulsion of PAPAWs requires continued stroking of the handrim, PAPAWs provide more exercise than guiding a joystick on a traditional power chair.

a. Must meet guidelines for motorized mobility.
b. Client desires to propel the wheelchair via the handrims.
c. Routinely confronts terrains or environments that are impractical/unmanageable with a manual wheelchair.
d. Client desires the opportunity to engage in mobility related exercise.
e. Desires the maneuverability and accessibility provided by PAPAW.
f. Client has plan in place to transport the PAPAW to intended environments as necessary.

a. General contraindications (inadequate cognitive function; seizure disorder; documented history of reckless behavior that threatens physical harm to self and/or others; frequent failure of prior prescribed wheeled mobility devices)
b. Client’s identified medical needs are better met by a power wheelchair (i.e. needs power tilt or recline).
c. An inability to control the PAPAW or lack of judgment sufficient to ensure safety.
d. An ability to meet rehabilitation goals with a manual wheelchair.
e. A lack of interest in propelling a PAPAW.
f. A progressive disorder likely to render a PAPAW impractical within a year.
g. Client or support systems are unable to transport the PAPAW to needed environments.



Smartdrive MX2 Alber E-motion


Max-Mobility Alber
Target group

Active Medium Active/Geriatric
Speed, driving performance

0.5 – 5.5 mph
Infinite drive
4 mph

Bluetooth LE Driver Control  

12.5 lbs 22 lbs per wheel

Two drive modes Two individual drive modes
Programmable starting time, assistance level, etc
Safety features   Brake assistance
Rollback-delay with ECS
Range 12 miles 15 miles
Wheelchair compatibility Small bracket
Rigid and folding chairs
Small bracket
Almost all wheelchairs
Manual wheels can still be used
Price S$5,850 S$8,830 with ECS