Recumbent handcyclists with good trunk function but impaired legs, who can use the trunk fully to drive the cranks.
H4 is the least impaired of the recumbent handcycle classes. Riders have full arm and trunk function but significant leg impairment, so they cannot kneel to race. They can use the full range of trunk movement to power the handcycle, giving them a performance advantage over H3 within the recumbent group.