Given the unique challenges faced by manual wheelchair users, improving methods to accurately measure and enhance their participation in community life is critical. This study explores a comprehensive method to evaluate the real-world community mobility and participation of manual wheelchair users by combining GPS mobility tracking, heart rate, and activity journals. Collecting qualitative and quantitative measures such as the life space assessment, wheelchair user confidence scale, and physical performance tests alongside GPS mobility tracking from ten manual wheelchair users provided insight into the complex relationship between physical, psychological, and social factors that can impact their daily community mobility and participation. This study found significant, strong correlations between the recorded journal time outside of the home and the GPS mean daily heart rate (r = −0.750, p = 0.032) as well as between the upper limb strength assessments with cardiovascular assessments, physiological confidence, and GPS participation indicators (0.732 < r < 0.884, 0.002 < p < 0.039). This method of manual wheelchair user assessment reveals the complex relationships between different aspects of mobility and participation. It provides a means of enhancing the ability of rehabilitation specialists to focus rehabilitation programs toward the areas that will help manual wheelchair users improve their quality of life.

Traditional VO_2max testing methods are often impractical for manual wheelchair users, as they rely on lower-body exercise protocols, require specialized equipment, and trained personnel. The 6-Minute Push Test (6MPT) is a widely used cardiovascular assessment that may provide a feasible alternative for estimating aerobic capacity in this population. This study aimed to develop a predictive model for VO_2max using physiological variables recorded during the 6MPT. Twenty-eight participants (14 novice and 14 expert manual wheelchair users) completed the test while wearing a VO₂ mask and heart rate monitor. Spearman correlation analysis showed that distance covered during the 6MPT significantly correlated with VO_2max (r = 0.685, p < 0.001). A stepwise linear regression identified two predictive models: one using distance alone (R² = 0.416, p < 0.001) and another incorporating both distance and maximum heart rate (R² = 0.561, p < 0.001). These models offer practical estimations of VO_2max, eliminating separate protocols. Our findings suggest that the 6MPT can serve as a simple, cost-effective alternative to laboratory-based VO₂ testing, facilitating routine cardiovascular fitness assessments for manual wheelchair users in clinical and community settings. Future research should focus on validating these models in a larger, more diverse cohort to enhance their generalizability.