Abstract :Our study examined associations between wheelchair propulsion technique and vector magnitude (VM) obtained from a wrist worn triaxial accelerometer. Participants who were full time wheelchair users (n= 17) propelled on a treadmill at common (1.34 m/s), and fast (2.0 m/s) speeds in their own wheelchairs with instrumented wheels attached. Accelerometer and energy expenditure (VO2) data were recorded simultaneously. Outcome measures included kinetic and spatiotemporal propulsion technique variables occurring at the wheelchair handrim as well as subject characteristics like shoulder pain (WUSPI) and physical activity level (PASIPD). Regression analysis found peak total force, contact angle, shoulder pain and physical activity level to be predictive of VM at the common speed while stroke frequency, peak total force, and shoulder pain were predictive of VM at the fast speed. Our findings, although preliminary, underscore the increasing potential of wearable sensors to serve as an upper limb preservation tool in MWUs in real world settings.