It is obvious why this makes a difference. Someone in a wheelchair that they have to push up a hill him/herself would get more exercise than someone who simply pushes a lever to do the same thing. That is why when I push myself up a hill, I have a 50% chance of someone mentioning something like, "You must have good cardio" or "You must have strong arms." Does that mean people who use power wheelchairs cannot exercise? Of course not. Notice how I said earlier that people with impaired hand/arm function may n