Wheelchairs Archives - Page 2 of 2 - Occupational Therapy Blog

Wheelchairs have long been used to help people with mobility issues get around. Yet wheelchairs are not intended to replace a person's movement method; instead, they should supplement it. Wheelchair-use is not restricted to age or disability. Finding the right wheelchair often depends on how and where it will be used. When selecting a wheelchair, look at factors such as how it will be used, its functionality, and its overall comfort; look for features that fit into your lifestyle. Also, the wheelchair should be the appropriate size so that it is easy to get in and out of, does not cause pain, and can move around with ease. There is no “one size fits all” when it comes to wheelchairs, so it’s essential to choose the elements that best suit your comfort and lifestyle. And for the chair to function the way that it should, it must fit the user properly. Below, we’ll break down all the features you should look for in a wheelchair, including how to find the right size. Which Type of Wheelchair Should You Get? Wheelchairs are often broken down between how they get their power. The two most common types of wheelchairs are either manual or power-based. Manual Wheelchairs People that have sufficient upper body strength will typically choose manual wheelchairs. The chair is powered by a person pushing the rims of the wheels forward. Alternatively, the chair may be moved from behind by an attendant. Manual wheelchairs may be used to fill a temporary health need, such as injury from an accident or when recovering from surgery. However, they can fill a longer-term need if the user has enough strength to power it manually. Today's manual chairs have a wide range of designs that vary in performance, materials, weight, and color; this has helped the traditional manual chair improve its overall efficiency and comfort for users. Key variations of manual chairs include: Lighter frames make it easier to lift and store the chair. The chair’s lightness also lets the user exert less energy to push it forward.Rubber trim is installed between the wheel and rim, which puts less of a burden on the person pushing the chair. The improved suspension absorbs the jostling impact that bumpy pavement may have on ride quality and comfort.Increased use of hand levers to push, turn, and stop the chair. The lever system lets the user maximizes each push, storing up more energy to propel the chair. Installed pedals let the user move the wheelchair by pedaling with their hands or feet. This may result in fewer shoulder injuries. Note: A motor can be added to a manual wheelchair to give it an extra boost of power. Power can be especially helpful to get up a steep hill or step in if you're tired. These motors are typically attached to the base of the chair or its wheel units. Power Wheelchairs A powered wheelchair is suitable for people who don't have sufficient upper body strength for a manual chair. They are powered by an electric motor with a battery pack and controlled by a joystick. (Electric scooters are a common alternative to a powered wheelchair. They typically come in with three or four wheels.) A powered wheelchair requires no physical exertion to operate. Plus, there is less chance of tipping over when getting in or out. Like their manual counterparts, power wheelchairs have undergone improvements over the years that impact their performance, function, and comfort: Many have lighter frames to improve their speed and power.They are highly customizable to fit the needs of people with disabilities.Powered wheelchairs may be foldable, which makes them easier to transport and store. What Kind of Batteries Does a Power Wheelchair Use? It’s worth noting that if you would prefer to use a power wheelchair over a manual one, you will need to also consider the different types of batteries they use to determine which power chair is the best option for you. When looking at a power wheelchair’s battery, its capacity, current, and type should be evaluated. Capacity refers to the length of time that a battery retains its power. The time is reported in ampere-hours (Ah). A battery that holds between 30 and 90 Ah keeps its power for 3 to 9 hours if the wheelchair operates at 10 Ah per hour. Current is the battery's flow of electrons. The higher the flow, the more capable the battery will be in challenging situations, such as uneven terrain or moving around obstacles. Power wheelchairs use 24-volt “deep-cycle” batteries, which release power over time. The term “deep-cycle” means that the battery must be completely discharged before it can be fully recharged. There are two types of batteries that power wheelchairs use within this category: Wet-cell batteries are powered by the interaction of lead and sulfuric acid. They typically have a greater capacity and are more affordable than gel-cell batteries, making them the more popular option. Since they are liquid-based, there is a danger that the acid may spill. Some batteries need to be filled up with distilled water, adding to the risk of injury.Gel-cell batteries are maintenance-free as they have no liquid to spill or fill up. While they typically have 10% - 20% less capacity and cost more than wet-batteries, they are safer to use. Wheelchair Varieties Beyond how the chair is powered, a handful of chairs are designed based on how they are used. Varieties for people who enjoy outdoor activities include: Sport wheelchairs Standard wheelchairsAll-terrain wheelchairsBeach wheelchairs There are a handful of wheelchairs designed for those with mobility issues in mind. These provide extra support and comfort: Bariatric wheelchairsErgonomic wheelchairsHigh-back wheelchairsReclining or tilt-in space wheelchairsPediatric wheelchairsStand-up wheelchairs Finally, there are wheelchairs built for easy portability or temporary usage. These may be found in places such as shopping malls and airports: Lightweight (and ultra-lightweight) wheelchairsAisle (or transfer) wheelchairs Consider How the Wheelchair Will Be Used People's activity levels in wheelchairs can vary, so it is essential to consider who the chair is for and where it will be used. It is also necessary to consider the person's lifestyle and surroundings when selecting the right chair. Who is the Wheelchair for? The type of wheelchair you need varies based on who is using it and how much they rely on this as their mode of transportation. For example: Someone using a wheelchair temporarily will have limited needs. Broken bones, sprains, or surgery may only require a wheelchair during a recovery period. If the person has an active lifestyle, a manual chair may work best to provide some exercise. The chair should be easy to get in and out of. People who remain active may also drive, so it’s a good idea to consider a lightweight chair and be stored easily in a car's trunk. When a person relies on a wheelchair as their primary means to get around, their needs will be very different. There may be physical or cognitive disabilities that impair their mobility: If they have weaker upper body strength or can’t propel the chair by themselves, a power option works best.Additional support and comfort features may be necessary for a person using the wheelchair for extended periods. A person that has difficulty sitting upright for a long time may need a tilted or reclining back. This can help to relieve pressure on their back and make for a more comfortable experience. When someone has difficulty getting in and out of the chair, additional support may be necessary to prevent tipping. Where Will the Wheelchair Be Used? The type of wheelchair you select may be influenced by where it will be used. Wheelchair usage may vary if it is used outdoors or indoors. Outdoor Use For a person who frequently travels outside their home, the wheelchair should be easy to move yet durable in build and quality. Using public transportation may require a lighter wheelchair that is easy to maneuver in tight spots. Wheels need to be tough enough to withstand uneven pavement in parking lots or sidewalks. Exposure to weather elements may influence the type of materials used in the design. Wider tires can improve traction on snow, sand, and in the rain. Aluminum is commonly used as it is a lighter material and is resistant to rust. There are also specially designed wheelchairs that can be used around or in pools. These are usually designed with PVC pipe. Indoor Use Close quarters, tight halls, and compact bathrooms may call for a narrower chair. The chair's turning radius should be considered, especially if a person doesn’t have a lot of room to turn around with. Some people use different wheelchairs, depending on what they are doing. Those who remain active may choose an all-terrain or pool chair yet also choose to have one chair dedicated to using indoors. Why Functionality is Important When Selecting a Wheelchair The design and quality of a wheelchair impact how well they serve their purpose. Considering factors like stability, maneuverability, and reliability when narrowing down your choice can help you find the one that best fits your lifestyle. Stability Manual wheelchairs must have a stable design to prevent them from tipping over. Static stability refers to the potential for tipping over when the wheelchair is stopped; this may occur when a person is getting into or out of the wheelchair or is bending over the side. On the other hand, dynamic stability is the wheelchair’s ability to travel on elevated slopes, such as ramps, without falling over. A stable wheelchair considers the person’s center of gravity and the wheelbase of the chair. Key concepts to understand when picking out a wheelchair include: General Stability – By lowering the seat of the wheelchair, there may be less chance of tipping over. A lower seat helps people who frequently sit at desks or want to use their feet to help them move. One drawback of lowering the chair's seat to improve the overall stability is that a person may not be able to reach higher objects. It can also cause more pressure on the lower body. Rearward Stability – Enhancing rearward stability helps to keep the wheelchair from tipping over backward. In this case, the rear wheels are moved back further behind a person's center of gravity; this may be done for above-the-knee amputees whose center of gravity is naturally farther back.Note: While this helps to even out the center of gravity, it can create a more significant amount of stress on a person's body as they need to reach further forward to grab the hand rims. With the limited span, it may be harder to go up elevated surfaces like ramps.Forward Stability – Lengthening the distance of the front wheels—or castors—in reference to the seat helps prevent the chair from tipping forward. But this also makes the wheelchair longer, making it harder to maneuver in tight spots or transport.Sideways Stability – Widening the wheelchair helps to keep it from falling over sideways. The wider seat can improve overall comfort; the wider stance can make it hard to reach the hand rims. It may also be harder to maneuver through narrow hallways. Maneuverability When considering the right wheelchair to fit a person's lifestyle, maneuverability is a crucial factor. Wheelchairs must be able to navigate safely around objects, as well as over items. Narrow Hallways – The wider a wheelchair, the harder it may be to move down narrow hallways or maneuver around in smaller bathrooms. If a person lives in an apartment, condominium, or small home, the width of a wheelchair may pose a problem.Turning Around – The ability to turn around in tight spots is aided by having a smaller and narrower chair. Pulling Closely to Objects – A person in a wheelchair should have the ability to draw close to such household objects as sinks, toilets, and countertops. How far a wheelchair juts out in the front and on the sides determines how close it can get to household objects and furniture.Maneuver Under Low-Lying Items – A wheelchair should be able to pull under furniture such as desks and dining room tables. If the armrests or knee placement is too high, the user may be unable to fit their wheelchair comfortably under the table. A shorter wheelchair with removable footpads can help a person move closer. Reliability The reliability of a wheelchair depends mostly on how durable it is and how long it lasts. To maximize the wheelchair's reliability, choose one made with quality materials and a solid build. Wheelchairs with few removable parts may mean less time and cost to maintain and repair them if something breaks. It is also helpful to choose a wheelchair that can be fixed locally; this helps avoid unnecessary delays if you must ship the wheelchair off to be repaired or wait for replacement parts. It is essential to learn how to use and care for the wheelchair properly. Not only can proper usage extend the life of the chair, but it can also cut down on physical ailments that happen when it is not used correctly. Other Functionality Considerations for Wheelchairs Along with stability, maneuverability, and reliability, other functional design capabilities should be considered when choosing a wheelchair: Pushing the Chair – The ability of a person to propel the wheelchair through pushing is dependent on many factors. The width of the chair impacts the ability to reach the hand rims. A narrower chair pulls the hand rims closer, making it easier for the person to move the chair.The Right Tires – A solid tire has less resistance, making it easier to move the chair. A reliable tire does not absorb energy as an inflatable tire would. However, hard tires have little shock absorption, which can make the ride bumpy and uncomfortable. Conversely, an inflatable tire has greater resistance, but it can soak up the jolts from the uneven pavement. Inflatable tires are easier to repair and maintain than solid tires.Transporting the Chair – If you regularly transport the chair, the weight and size can play a significant role. Lighter materials can make it easier to carry, but it can impact the durability of the chair. Removable footrests and wheels can reduce the total weight and make it lighter to transport, but you do run the risk of these critical items being lost. Foldable frames make the chair more compact, but they do add to their weight. Consider the Wheelchair User’s Comfort In addition to function, people in wheelchairs need to be comfortable when using them. By their nature, wheelchair use may result in pressure on a person’s back and painful sores. To make wheelchair use feel as relaxed as possible, you should measure the key areas where comfort is critical; this includes evaluating the chair’s seat width and depth, arm and leg height, and back support. Wheelchairs can be equipped with other comfort features like: Padded armrestsSupportive back cushionsAnti-tip devices to keep the wheelchair stable.Tilt-in-space which helps to support the backShocks to absorb dips and bumpsAdjustable armrestsReclining backrests Consider the Wheelchair’s Cost Wheelchair prices vary based on how they are powered and what types of accessories you choose. A manual or powered wheelchair can range from £150 to over £1,000. If you need help paying for the cost of a wheelchair, you may be able to get assistance such as: Personal wheelchair budgets provide financial assistance to qualified individuals to help offset the cost of a wheelchair, repairs, and accessories (when applicable). This program will eventually replace the wheelchair vouchers that are currently in effect.Through the Motability Scheme: you may be able to trade in your Motability Allowance to lease an electric wheelchair. Prices for an electric scooter start at £400 and can exceed £5,000. To help defray the cost of a scooter, you may be able to get a grant from a charity or use funds through the Motability Scheme. What Size Wheelchair Should I Get? Finally, to ensure optimal performance and comfort from your wheelchair, it should be sized based on the individual's dimensions and needs. You should discuss this with your Occupational Therapist. A few key measurements to help find the right wheelchair fit include: Seat Width – To ensure maximum comfort, the person's hips should not be touching or rubbing against the chair's sides. To find the right width, measure the hips from side to side. Add two inches to the total to get the optimal seat width.Seat Depth – A person should fit comfortably in the seat and have enough space behind their knees so that they aren’t touching the chair. A recommended distance from the back of the knee to the chair is two inches. You can also find a good seat depth by measuring the person from the end of their hip to the back of their knee and subtracting two inches.Seat Height – If you plan to use your feet to help move the wheelchair, you need to ensure that the heels of your feet can comfortably reach the floor; this can be done by measuring the distance between the back of the knee and the back of the heel. From there, the seat could be adjusted up or down to accommodate the space.Back Height – To ensure that the rear height is sufficient, measure from the seat to the collarbone. The chair needs to be high enough to provide support but not too high that it interferes with the range of shoulder movements required to propel the wheelchair. However, if more support is needed, the chair back may need to be higher. You might also consider additional back support for improved comfort.Arm Height – This may vary based on individual needs. The right height promotes good posture. It may impinge on the shoulders or put undue pressure on the elbows if it's too high. But if it's too low, it may cause the person to lean too far forward. To get the right arm height, have the person bend their elbows at a ninety-degree angle while holding up their arms. Measure from the elbow to the seat to find the right size. If cushioned armrests are used, add another inch.Note: You may choose different armrests based on what the user will be doing. If they are working at a desk, shorter armrests will help them to move in closer. A full-length arm is helpful for people needing more support to stand up.Footrests – To find the footrest's length, measure from the back of the knee to their foot's heel. In some cases, elevated leg rests may be necessary for people with swelling or injuries that require that they keep their legs raised. Strength – For people who plan to transport or store their wheelchair, the heaviness of the chair. If they struggle with upper body strength, a lighter chair may be needed. Weight – Be sure to consider a person's weight when fitting them for a wheelchair. The total weight that the chair can support may be limited. How Does an Adequately Sized Wheelchair Benefit Me? It is estimated that 80% to 90% of wheelchairs are not fitted properly for their users; this can lead to pain and injury. Yet when a chair is fitted correctly, it can benefit the user in a variety of ways, including: Mobility – A person is more likely to use a wheelchair to get around when it is comfortable and easy to use. Mobility gives the freedom needed for an active lifestyle.Confidence and Independence – People with mobility issues may feel insecure in social environments, such as shopping or eating at restaurants. Yet if they can't use a wheelchair effectively because of poor sizing, it may discourage them from using it at all. Finding the right size can give the user the confidence they need to use their chair in public.Comfort – An adequately fitted chair makes the experience comfortable. It relieves pressure on the back and the pain associated with rubbing and propelling the chair.Reduce Injury – Unstable chairs, a wide seat that forces a person to stretch to reach handrails, and poor back support can lead to injury. When the chair is the right size, it reduces pressure points and shoulder injuries associated with pushing. Final Thoughts Wheelchairs should accentuate a person's lifestyle, not replace it. Doing your homework and considering how and who will be using the chair is key to finding the right fit. Critical factors to look for in a wheelchair include its comfort and functionality. Beyond that, narrow down the features that align with you or your loved one’s lifestyle. Generally speaking, it would help if you looked for the necessary features for the chair to serve its purpose. For example, if you have minimal upper body strength, a power wheelchair may be the best option; a wheelchair made with lighter materials may be necessary if you plan to transport and store the chair. Additionally, finding the right chair size not only improves its comfort, but it can also make it easier to navigate through narrow corridors or ramps when used. Not only can the right wheelchair help people get around, but it can give them the confidence and independence they seek to lead a fulfilling life! For help in deciding on a wheelchair you can contact HT Neuro Rehab here. Content Disclaimer The information contained above is provided for information purposes only. The contents of this Blog article are not intended to amount to advice, and you should not rely on any of the contents of this Blog article. Professional advice should be obtained before taking or refraining from taking any action as a result of the contents of this Blog article. OccupationaltherapyBlog disclaims all liability and responsibility arising from any reliance placed on any of the contents of this Blog article.