Type of Frame Rigid: This type of frame is robust, sturdy, lighter and can’t be folded in the middle. The backrest on a rigid frame wheelchair folds down to allow it to become smaller and easier to lift in and out of a car.
Folding: This type of frame can be folded in the middle and is not normally as light as the rigid frame wheelchairs. This type of frame requires the user to adopt a different method when lifting it in and out of a car due to its shape and size, but this depends on the method of transfer chosen.
Adjustable frame: This type of frame will allow more room for adjustment if you need to alter your seated position. This means that the axle and back angle of the wheelchair can be altered. It can be beneficial to have the option of adjustment so to be able continually to accommodate any change in your postural needs.
You can get both adjustable folding and rigid frames.
Before choosing your new wheelchair, it is worth checking how easy it is to take apart and if it is small and light enough for you or your carers to lift in and out of your car safely.
Material: Many wheelchairs are made from Chrome-moly steel and Aluminium. Titanium is also used and is lighter, stronger and more expensive.
Brakes
Position: The position of the brakes can vary. High brakes are easier to use but can get in the way when pushing the chair or when completing a transfer. Low brakes overcome these problems, as they are set lower down than the higher brakes. However, you need to make sure you have adequate balance to operate them.
Type: These can be standard, scissors or extended. Scissors brakes are usually located low on the wheel. They hinge away completely from the wheel, so reducing the risk of catching your thumb between the brake and the wheel. Extended brakes are typically installed for tetraplegics to allow easier access and greater wheelchair independence.
Backrest
Height: This should be at an appropriate height to allow you to achieve the level of functional ability that you want.
The height of the back rest should also provide you with comfort and the appropriate postural support.
Your primary therapy team will assess and advise you on the most appropriate height for the back rest of your wheelchair.
Angle: The angle or the recline of the backrest can help provide more postural stability and help with your balance.
Push Handles
These may be integral or detachable and could be beneficial if you are likely to require help propelling, negotiating steps or kerbs. You can also have height adjustable push handles, which can be beneficial if you require pushing to allow the person pushing you to be in the correct position.
Material
There are different materials available for the backrest of your wheelchair. These include: Canvas:• This is usually the back that is provided with a wheelchair unless you have specifically stated or requested a different type of backrest.
Leather:• This can make the chair look nice and can increase your comfort when you are sitting in the wheelchair. It is also easy to clean, although it can increase sweating when the weather is warm. It may also stretch over time. This option is more expensive.
Tension Adjustable
A tension-adjustable back is one that has a series of Velcro straps that are accessible by lifting the back cover. These can be adjusted to accommodate any changes in your posture that might occur over a period of time. Tension-adjustable backs can also increase your comfort when seated in the chair and help to maintain the natural curves in your back. You can discuss tension-adjustable backs with your primary therapy team.
Specialist Backs
There are a variety of specialist backs that are available. These may be used to help you with your posture and comfort in your wheelchair. These will be assessed and discussed with your primary therapy team if they are required.
Seat
Depth: This should allow enough room to adequately support your thighs, with approximately two finger spaces clear behind your knee.
Width: The chair should be wide enough to allow you to sit comfortably with space for two fingers either side of your thighs. In winter you may need to wear more clothes so you should make sure that there will be enough room for these. Your primary therapists will advise you on the appropriate width and depth of your wheelchair.
Bucketing: This is the alteration of the angle of the seat in relation to the backrest. This can help your posture in regard to the position of your pelvis and improve your comfort and stability in the chair. However this can also increase the pressure under your bottom, make transferring from the chair more difficult, and can constrict your diaphragm and digestive system.
Clothes Guard: These can be either rigid or fabric. They act in a similar way to mud guards to keep your clothes clean and clear of the wheels.
Cushion: It is vital to use the pressure cushion recommended by the pressure clinic at the Spinal Unit, even if your wheelchair comes with a cushion. This is because the cushion provided by the pressure clinic has been assessed to meet your specific pressure and skin care needs.
Footplates
Fixed: This type of footplate is an integral part of the wheelchair and cannot be swung away from the front of the wheelchair due to the fixed framework of the wheelchair. The angle of the fixed frame of the wheelchair can vary between 70°–90°. The steeper the angle, the closer the chair will be able to get to an object (such as if you need to work at a desk backed onto a wall). It is important to see how the fixed angle affects your transferring technique and your functional ability. It is also beneficial for you to know how your legs tolerate being at differing angles for long periods to ensure your comfort in the chair. This may also affect your spasms and muscle stiffness.
Swingaway: This type of footplate can be swung away from the front of the wheelchair. This can make transfers easier as because they move out of the way, you may not need to move your bottom as far forward in the wheelchair to negotiate the footplates. Additionally, this will enable you to get nearer to objects, although this can also be dependent on the angle of the footplate, which can stick out further than a fixed footplate.
Wheels:
Camber: This is where the wheels are angled to create a wider base of support for the chair. This increases the stability and manoeuvrability of the wheelchair and helps it to move in a straight line when being propelled. However, you will need to consider your home and the places that you visit, as every degree of camber adds an extra ¾” to the overall width of the wheelchair. There are some lightweight wheelchairs that have an adjustable camber on them.
Position: The wheel position can be moved backwards and forwards on the majority of lightweight wheelchairs. As you move the wheel position backwards, it makes the wheelchair more stable as it increases the area where weight can be put through to the floor. Moving the wheel position forwards decreases the stability and makes the wheelchair more ‘tippy’. This can make achieving advanced wheelchair skills easier, but can also increase the risk of falling out of the wheelchair.
Rims: These can be metal, plastic coated or rubber. Rubber is especially good if you have reduced grip strength.
Size: The size of the wheels that can be provided for a lightweight wheelchair varies. There is a relationship between your height, arm length and size of the wheel. It is important that you have the right sized wheels to allow you to gain a good purchase on the wheels and therefore travel further with each push.
Rubber rims: These are rubber rims that fit over the wheel rims of the wheelchair. They increase the grip on the wheels and can make the wheels easier to push – particularly if you have decreased strength, range of movement or power in your upper limbs.
Capstans: These are raised rubber projections that are set at intervals attached to the metal wheel rim.
Capstans can be beneficial for individuals with reduced hand strength, power and range to increase the purchase available on the wheels and assist in self-propelling. The disadvantage of using capstans is that the user needs to coordinate each push with reaching each capstan.
Spinerg ywheels: These are carbon wheel spokes that decrease the weight of the wheels. This makes the wheels easier to lift in/out of a car. As the spokes are made of carbon, the risk of them breaking is reduced. Spinergy wheels come in different colours and are more expensive than normal wheel spokes. If you decide you would like a set, you should discuss this when you complete the lightweight wheelchair specification.
Composite: Like Spinergy wheels, composite wheels offer a different type of wheel spoke. They are made of carbon fibre, which reduces the weight of the wheel. The spokes are wider and there are fewer of them. This can be beneficial if you have reduced power or strength in your upper limb.
Again, as the wheel spokes are made of carbon there is a reduced risk of the spokes breaking.
Axles: Quick release or tetra release axles are available to enable wheel release.
Tyres: There are many types of tyres which can vary in cost. Solid tyres are more popular than pneumatic tyres, although they can be more expensive. Some people can find that solid tyres are too ‘bumpy’ when propelling. However, they do not puncture and can last up to four times as long.
Castors: There are two main types of castors, - solid or pneumatic. Pneumatic castors can make the wheelchair more difficult to push indoors and run the risk of developing punctures due to the castors hitting objects on the ground first. Solid tyres do not puncture and, as described above, can last longer than the pneumatic tyres.
Castor Size: Larger castors are more suitable for outdoors to absorb bumps, but they will increase the turning circle of the wheelchair. Smaller castors can be used for sporting activities, as they are more manoeuvrable.
NB – For your safety, if adjustments are made to the back of the wheelchair, it is important to check that the castors are at an angle of 90° to the floor.
Armrests
Some people do not have armrests on their chair as they can hinder the pushing of the chair, and transfers. However, armrests can be beneficial for safety and comfort especially for people with balance difficulties. They are usually either completely removable, swing back out of the way and are adjustable in height.
Anti-tips
These attach to the back of the chair and help to prevent it from falling over backwards. This can be beneficial if you find back-wheel balancing challenging or lack confidence in your wheelchair skills.
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Contributor's Note
This intel reflects only one of my activities. I also write about and/or have websites on Vespa Scooters, Lambretta Scooters, Hardy Banana plants, Medical memorabilia, reborn baby dolls and much more. Hope you enjoyed the read, Philip Davey
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