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Alternatives to manual wheelchair propulsion include an electric powered wheelchair, scooter and pushrim activated power assisted wheelchairs (PAPAW). ? PAPAWs provide greater physical activity, are easier to transport and may be an excellent alternative for the obese population. Identifying ways to overcome barriers to mobility and improving wheelchair prescription for overweight individuals with disabilities, and people with upper extremity pain, injury, impairment or weakness could lead to increases in functional independence, self-esteem, and community participation.