Education in Motion / Clinical Corner / February 2019 / Understanding Choices in Manual Wheelchairs

Understanding Choices in Manual Wheelchairs

There is no one perfect wheelchair that is right for everyone. Many factors exist that differentiate wheelchair models within the same category of wheelchair. When we understand some of the choices and the clinical implications of those choices, we can begin to see the value in understanding why several models of wheelchairs exist in the same category, even from the same manufacturer. This month, Clinical Corner will review some of the factors to consider that differentiate models of wheelchairs to allow for an optimal selection to be made with a client.

Before we begin on the factors to consider when selecting a model of a wheelchair within a category, let’s have a review of manual mobility. Clinical Corner has addressed manual mobility many times over the years as there is much to know about manual wheelchairs. For a review on any of the topics, click on the title for a link to the article.

Differentiating Products

With so many models of wheelchairs existing in one category, even from only one manufacturer, how do we differentiate them? Let's start with standard wheelchairs. Sometimes it is the available configurations on a certain model of a standard wheelchair that help to make the appropriate selection. For example, if a specific low seat-to-floor height is required, it may be available on one model, but not another model. Some models also differ on the options that are available, such as the types of leg supports, casters and rear wheels. This may guide the selection towards a certain model of wheelchair that has the required option available. In addition, some models of standard wheelchairs have quick-release axles, while others do not. Some standard wheelchairs accommodate one-arm drives while other do not. These choices may help in the decision of selecting one wheelchair over another. Lastly, the position of the fixed axle may influence the selection. For example, while many standard wheelchairs have the fixed axle position at the rear frame of the wheelchair, some models have a centre of gravity offset, which makes the wheelchair easier to propel.

When differentiating between models of folding wheelchairs, even within one manufacturer's product line-up, it is important to consider the configuration choices available. For example, some models will have more options available than others. If a particular option is required, it may influence the wheelchair selection to a particular model that has the choice available. Different frame choices exist in folding wheelchairs. The choice of box frame or modular fame will affect the available seat-to-floor height range as well as the ability to accommodate any future change in size or function. Another deciding factor may be the weight capacity of the wheelchair. Not all models of folding wheelchairs have the same weight capacity. Another consideration is a transit option if the client is going to remain seated in their wheelchair while in transit. Another distinction between some models of manual wheelchairs is whether they have been crash tested for occupied transit and if they are complaint with RESNA WC19 or ISO 7176-19.

Summary

There is never going to be one model of wheelchair that is right for every client. Manufacturers recognize this and often provide several models of wheelchairs within a category to meet the various needs and demands of clients. This allows for optimizing both fit and function for a client through the selection of an appropriate model of wheelchair. How we choose between models of wheelchairs goes back to the assessment and then matching the goals of seating and mobility with the choices that are available.

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