Propelling a manual wheelchair is tough. Whenever I've had occupational therapy students learning about wheelchairs and related assistive technology, I've asked them to propel across the hospital campus to the canteen, buy an item, and return. It was a distance of around ¼ mile over mostly level indoor surfaces with a few ramps and moderately uneven sidewalks. The students were all young women who had no mobility limitations. Although none of them had a dedicated workout routine to build upper limb strength, they also had no history of upper limb problems. We used an entry-level, lighter weight configurable folding wheelchair. None of them made it all the way back to our clinic without being pushed.
Why use a folding powered wheelchair?
While the configuration of a manual wheelchair makes a huge impact, many people benefit from additional powered options to go everywhere they want in a day. Add-on power is one option. But these aren't right for some people who need a mobility boost, such as individuals who:
- Walk (with or without an aid), but fatigue or have pain over long distances.
- Use a wheelchair not compatible with add-on power, such as those with swing-away legrests.
- Need to use a wheelchair part-time to help with indoor activities that require carrying objects. For example, many amputees who walk (and even run) with a prosthesis, but may have a break from use at home at times for pain management and skin health. A compact powered wheelchair can keep hands free for cooking and other home activities.
- Are engaging in a long recovery from injury, stroke, or extended illness and may need help with mobility for a couple of years but may not need powered mobility support long-term. Thus it may not be suitable to make major home environment or vehicle adaptations.
- Have fluctuating needs, such as people managing the effects of remitting/relapsing multiple sclerosis1, long COVID 2,3, or ME (chronic fatigue syndrome)4.
In these situations, a folding power wheelchair can be a practical tool. They can go into car trunks, be folded for trains, and are much more compact than a mobility scooter at home or in shops.
The challenge is that power wheelchair frames are inherently heavy. They must be robust enough to withstand the forces associated with a powered mobility device, and carry the additional weight of batteries and motors. Folding is another consideration; the chair needs to remain fully secure when open, but remain easy to manage, lift, and store. This has inspired the latest innovation in power wheelchair technology: carbon fiber frames.
Carbon fiber chairs offer a solution for people who want to go further and faster while saving energy for the activities they enjoy. Lighter than their aluminum-frame counterparts, these go-anywhere wheelchairs can fit into a compact car and open a world of exploration. These are impressive bits of technology, but who are they best suited for?
Short to moderate periods of daily use
Carbon fiber folding power wheelchairs are designed to be used for up to a few hours at a time to complement other forms of mobility like walking with an aid or manual wheelchair use. Use a rollator but need to have hands free for cooking? Want to attend a concert at an expo center but can't walk the corridors without pain? Use a manual wheelchair but want to use power mobility part-time to explore a nearby hilly city? These chairs can be a good option.
However, carbon fiber folding power wheelchairs cannot accommodate the heavy components needed for powered seating functions like tilt, recline, or lift. They are comfortable for up to a few hours at a time alongside other places to sit such as sofas, desk chairs, or dining chairs. The QUICKIE Q50 R Carbon and similar designs also need to have small, lightweight batteries. Using lithium-ion battery technology helps with capacity, but range is still limited compared to the large batteries used with non-folding power wheelchairs.
Seating
Carbon fiber material helps to reduce vibration4,5 that can otherwise exacerbate the pain of arthritis or other joint problems. However, they are designed for people who have intact sitting balance; the frame is not designed to be used with prescriptive seating components. While the Q50 R Carbon and other similar chairs can take flexible-base cushions up to 2" thick for extra comfort, they do not have the adjustability for thick pressure-reducing cushions.
Sizing
Carbon frame folding power wheelchairs like the Q50 R Carbon prioritize lightness, requiring the design to shed heavy hardware needed for high levels of adjustability. Therefore, they come in effectively one size that fits many, but not all. Like most chairs of this type, the Q50 R Carbon accommodates people with hip widths up to approximately 18" across. Other options, such as power wheelchairs that have folding backs can provide an alternative with a larger size range, but will need a hoist for lifting.
Carbon folding frame power wheelchairs have a preset balance point, so this device suits people of a relatively 'typical' weight distribution within their body. Those with a very forward personal center of mass (e.g., extreme chronic lower limb edema) or very rear personal center of mass (e.g., bilateral above-knee lower limb amputees who are not wearing prostheses) may have difficulties with performance. More stable outdoor-minded folding models are an option to consider, or a more traditional scooter or power wheelchair may be needed.
When matched mindfully to the client, carbon fiber folding power wheelchairs can offer a practical mobility solution for active lifestyles.
References
- Souza, A., Kelleher, A., Cooper, R., Cooper, R. A., Iezzoni, L. I., & Collins, D. M. (2010). Multiple sclerosis and mobility-related assistive technology: systematic review of literature. J Rehabil Res Dev, 47(3), 213-23.
- Beauchamp, M. K., Joshi, D., McMillan, J., Erbas Oz, U., Griffith, L. E., Basta, N. E., Kirkland, S., Wolfson, C., Raina, P., & Canadian Longitudinal Study on Aging (CLSA) Team (2022). Assessment of Functional Mobility After COVID-19 in Adults Aged 50 Years or Older in the Canadian Longitudinal Study on Aging. JAMA network open, 5(1), e2146168. https://doi.org
- Leppä, H., Karavirta, L., Rantalainen, T., et al. Use of walking modifications, perceived walking difficulty and changes in outdoor mobility among community-dwelling older people during COVID-19 restrictions. Aging Clin Exp Res 33, 2909-2916 (2021). https://doi.org/10.1007/s40520-021-01956-2
- Drachler, M.d.L., Leite, J.C.d.C., Hooper, L. et al. The expressed needs of people with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: A systematic review. BMC Public Health 9, 458 (2009). https://doi.org/10.1186/1471-2458-9-458
- Chénier, F., & Aissaoui, R. (2014). Effect of wheelchair frame material on users' mechanical work and transmitted vibration. BioMed Research International, 2014.
- DiGiovine, C., Koontz, A., & Boninger, M. (2006). Advances in manual wheelchair technology. Topics in Spinal Cord Injury Rehabilitation, 11(4), 1-14.
Faith Brown is an HCPC-registered occupational therapist with over 20 years of international experience in the field of seating and mobility including the British National Health Service, as well as the private and NGO sectors. She has worked with all ages and levels of complexity, including leading an NHS special seating division. She is a research champion for the Royal College of Occupational Therapists and has a history of lifelong professional development. Her post-qualification education includes a postgraduate certificate in Postural Management for People with Complex Disabilities from Oxford Brookes University, an MSc in Health Research Methods from the University of Birmingham (UK) and completion of an engineering module in wheelchair design at the University of San Francisco.