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Choosing a New Wheelchair

A wheelchair can be a wonderful liberator. Someone with a spinal cord injury can get around as quickly in a wheelchair as someone else can walking. For an older person with arthritis, a wheelchair can provide access to the world outside the home. For an active sports person, a wheelchair is the means to participate in marathons, basketball, and tennis.

In some respects, a wheelchair is much like an automobile or a pair of shoes. It provides the interface between the body and the world around it. Like shoes, a proper fit is essential if a person is to maximize her/his potential and feel comfortable moving around in the world
An Occupational Therapy professional knowledge and experience can be very helpful in assisting you to select the best chair for you. The aim of occupational therapy is to enable you to live as independently as possible, occupational therapists have specialist knowledge and can advise you on disability equipment, housing adaptations and adaptations to the workplace.

Once an individual's needs have been determined, the next step is to choose the "right" chair. New wheelchair users may wish to talk with current chair users about their likes and dislikes. There is nothing like practical experience to provide feedback on specific features that may be desirable, as well as those that should be avoided.

Wheelchair Assessment

Many physical and medical factors are evaluated in the assessment and prescription of wheelchairs

While most people actively engage in all sorts of assessments throughout their daily life, a detailed assessment, (a so called wheelchair assessment) conducted in order to enable the best 'fit' possible to be found for someone wanting a wheelchair, is along process. Wheelchair assessment is usually undertaken by therapists - they may be either occupational therapists or physiotherapists - who have specialised in this work and undertaken specific training for it.
Such an assessment is very detailed and structured to include all the following aspects of the match between user and wheelchair:

The user's
- physical strengths and limitations
- size, weight and balance
- sensory faculties
- posture and long term effects of it
- intellectual and metal capabilities
- occupation and its demands upon the chair
- mobility requirements such as
- how far it has to go over a period of time
- whether or not it will be carried by a car

Environment factors
- the surfaces on which the chair will be used
- the gradients (up and down) it will have to go
- the spaces in which it will be used in e.g. bathroom
- the access there is to places the user visits
- the manner of its storage
- social considerations such as
- the physique and the fitness of an attendant/helper
- what effect the use of a chair will have on the user's home and social life
- relationships between the wheelchair user and helpers
- opportunities open to the user with added mobility and independence
- financial position

The wheelchair
- cost
- size in relation to the user's environment
- type of controls - manual or electric
- extra adjustments e.g. reclining back, folding chair, leg rests
- weight and bulkiness
- tyre type e.g. pneumatic, puncture proof or solid
- maintenance requirements
- upholstery, cushions and seating additions
- wheel arrangements

Once an individual's needs have been determined, the next step is to choose the "right" chair. New wheelchair users may wish to talk with current chair users about their likes and dislikes. There is nothing like practical experience to provide feedback on specific features that may be desirable, as well as those that should be avoided.

Basic Guide to Determine the Size Of the Chair

A. To Determine Seat Width:
Measure the widest point of the body, an easy way to do this is to place a book on each side of the hips while seated then measure the distance between the books. If the shoulders are the widest point of the body measure at that point. You should allow an additional inch for bulky clothing such as a winter coat. (same customers add two inches as a prefrerence)


B. To Determine Seat Depth:
Measure from the back of the buttocks to the inside of the knee, minus at least two inches. Some prefer more leg overhang to make room for their hand when lifting their leg.

C. To Determine Seat Height:
Sitting in a chair, measure from the chair seat to the top of the shoulders. If you prefer a high back seat or a seat with headrest, also measure from the chair seat to the top of the head.


D. To Determine Seat to Floor Height:
Measure the leg from the back of the knee to the heel of the foot. Next, add a minimum of two inches for footrest clearance. Do not add the footrest clearance if the wheelchair will be foot-propelled. Electric power wheelchairs are almost never foot-propelled by the user so excluding the additional two inch footrest height for propelling is very rare.

E. Wheelchair assesment should only be done by trained professional, who have specialised in this work and undertaken specific training . A good therapists should be able to, compare wheelchair specifications to find the chair that best fits your needs.

Wheelchair Terminology Explained

Transit Wheelchair	These wheelchairs have small sized rear wheels and restrict the occupant from turning the wheelchair himself.
Attendant Controlled Wheelchair	A wheelchair that is controlled by the carer such as a transit wheelchair
Self Propelling Wheelchair	These have larger rear wheels, which allow the occupant to manoeuvre the wheelchair him/herself.
Tilt-in-space wheelchairs	Seat and back angle remain constant at up to 45 degrees, the whole body is moved using leavers controlled by the attendant
Reclining Wheelchairs	Seat remains parallel to the floor; back reclines up to 90 degrees, Makes it easier to provide personal care, such as catheterization or changing, elevating leg rests are needed that can be raised, this are not always fitted as standard
Rigid Framed Wheelchair	Rigid Framed Wheelchair means that the wheelchair does not fold in the conventional manner
Electric Powered Wheelchairs	Battery powered wheelchairs usually is significantly heavier than a manual wheelchair
Joystick	The device used to "move" the power chair.
Controller	The device that allows joysticks to function. Not all joysticks have a controller.
Armrests	Where arms can rest during time spent on power chair.
Footplate	Where feet rest during time spent on the power chair.
Anti-tip Wheels	Wheels that allow slight tipping, or prevent tipping while driving.
Drive Wheel	wheels that move the power chair. These are the main wheels.
Caster Wheel	The front wheels, the smaller the size and narrower the castors are the higher is the chair's manoeuvrability (negative effect on rough ground)
Controller Harness Connectors	Joystick cables connect to the power wheelchair.
Free Wheel Levers	L-Shaped levers at the top rear part of the cover.
Wheelchair Camber	Depending on the wheelchairs frame the angle present on rear wheels is called the camber

What is a Self-propelling Wheelchair ?

Self-propelling manual wheelchairs are equipped with large rear wheels (20" diameter to 27") used for propelling . If the user intends to propel themselves in the chair using push rims on the rear wheels, they will need to look at 'self propelling' wheelchairs with large back wheels. Whilst these chairs are designed to be used by the chairs occupant, they normally have pushing handles on the back so that someone can push where needed. Indeed, the larger back wheels can be an advantage when being pushed up kerbs or over other obstacles.

What is a Transit ( Attendant ) Wheelchair ?

Transit chairs are not designed for self-propulsion, they have small rear wheels and may look and function much like a stroller. These chairs places all the emphasis on the attendant and thus some strength of the attendant (the person pushing the chair) is vital to ensure correct and effective use. The user of a transit chair normally does not have the upper body strength to propel themselves. Some of these chairs have been fitted with handbrakes which is an added safety feature.

It is important that once the needs of the user have been met, that the carer's needs are also taken into account. By reducing energy expenditure and increasing the chair's manoeuvrability and transportability, life will be made easier and the risk of back injury minimised. The chair should be easy to transport, versatile, manoeuvrable and easy to steer

Because, these chairs fold compactly to store in the trunk of a car and provide light duty mobility. You may find a transport chair is a convenient back-up to your primary chair, easily folded when not needed, but readily available if your chair breaks down.

What is a Positioning Wheelchair ?

Wheelchair seating system, which may include specialized supportive cushions, backrests, headrests, or trunk, arm and leg supports. Positioning wheelchairs such as Tilt in space or reclining chairs are designed to prevent pressure sores and alleviate pain

The Tilt In Space wheelchair seat and back angle remain constant at up to 45 degrees tilt. Tilt-in-space Wheelchairs are often used by children and adults who have Progressive medical conditions for example: Moderate to severe motor involvement, Poor head and trunk control, Limitations in range of motion, especially hips, Fluctuating muscle tone, Pain or pressure while sitting, Developing curvature of the spine (scoliosis or kyphosis),Limited ability to sit upright, Weakness, lack of endurance, Seizure or sleep disorders.When buying a Tilt-in-space wheelchairs it is important to consider relieve pressure cushion and contoured seating inserts

What is Rigid Frame Chair?

Rigid Framed Wheelchair means that the wheelchair does not fold in the conventional manner but the rear wheels are removed and/or the backrest folded, for the wheelchair to be put into a vehicle. Rigid frame chairs are at least three times more manoeuvrable and at least half the frame weight of folding framed wheelchairs to lift. unfortunately they are also very expensive and should only be purchase after a full assessment by a trained OT

Electric Powered Wheelchairs

Every new wheelchair user will have different features and needs in mind. You will find it helpful to consult with your doctor or occupational therapist before making your first purchase. Your wheelchair purchase should take your age, gender, body type (weight/size) and any physical specifications - such as level of endurance, missing limbs and body limitations - into consideration.

Consider also how much the equipment will be used, whether indoors or outdoors, and in what situations. For many users, neck support, armrests and/or footrests will be required. Our Powerchairs offer quality and value for money

People who use powered wheelchairs generally have limited strength in their arms, and thus need to use an external power source to enable them to get around. Powered wheelchairs use either gel cell or wet cell batteries that must be re-charged on a regular basis. A powered wheelchair usually is significantly heavier than a manual wheelchair to accommodate both the weight of the battery and the weight of additional adaptive equipment, such as body supports or respiratory equipment.

Power Wheelchairs have Front wheel, Mid wheel and Rear wheel drive options, they are controlled through a joystick or an alternate control device and available with multiple seating options. The joysticks can general be fitted to suit a right or left handed user, some powerchairs also offer a dual control for attendant use.The level of sophistication in electric wheelchairs varies widely, from just using standard batteries and a joy stick controller, right up to using microprocessor

Front-wheel drive models offer good indoor maneuverability but tend to fishtail at higher speeds
Mid-wheel drive chairs are excellent for indoor maneuverability. The small models are good for use in apartments and nursing homes
Rear-wheel drive power wheelchairs are not as maneuverable as the mid-wheel drive electric wheelchair, but are stable and well suited for active all around use

If you opt for an electric wheelchair, find out the type of batteries used and how long they last. Ease of servicing/repair and availability of parts are other matters not to be overlooked. Manufacturers are required to keep spare parts in stock, however if their distributors go bust it is very difficult to get parts

Power Wheelchairs vs. Manual Wheelchairs

Power Wheelchairs	Manual Wheelchairs
Powered by a battery - Less physical exertion	Lightweight - easier to push (transit chair)
Easily go uphill - Manual chairs could have difficulty	Unlimited Range
No need for someone to assist you	Easier to transport and to manoeuvre
Freedom	Allow for more physical activity

It is very important that the needs of the carer are taken into consideration when purchasing any equipment. For example if you want to purchase a wheelchair:

• The size and weight of the type and model of wheelchair you consider will be important - for pushing it, particularly up and down kerbs and steps,
• If you have pour sight dark colours could made it difficult to see where parts and catches are
• Try folding and putting up any wheelchair you are thinking about - the more straightforward the better.
• Storage space, does the wheelchair fit into your car
• Where are you planning on using the chair, not all wheelchair are suitable for off road usage for example, if you want to use the chair on the beach

Walkers

It is important to select a frame that matches the individual's requirements so that it is comfortable to use. The main factors to consider are your height, weight and how stable you are, remember your limitations , for example do you have the strengths, in your hands to use the brake

Understanding the jargon can be a big problem !

Pulpit ('Zimmer')	traditional walking frame, where the frame is lifted, placed in front then the user steps up to or into the frame.
Reciprocal	allows each side of the frame to be moved forward alternately as the user moves forward.
Rollators	walking frames on wheels that do not require the user to lift the frame. This type allows a more normal walking pattern.
Gutter Frames	permits the user to transmit bodyweight through the forearms
Triwalkers	walkers with 3 legs where the user walks in the frame generally take up less floor and storage space than a four wheeled walker (Four leg walkers ) and are very manoeuvrable but less stable.
Four leg walkers walkers with 4 legs	where the user walks behind the frame stable configuration with excellent manoeuvrability characteristics

Many people ask what is a rollator? A rollator is essentially a walker with tires, it combines an adjustable height walking frame with small wheels, rather than lifting the walker to move, you just push why not have a look at our range of walkers

Cane or Walking Stick?

The key is to get the cane fitted to be the right height. Ideally when you hang your arm by your side, your hand should hang just over the top of the cane, your wrist lining up with the very top of the cane. An adjustable cane is easiest to use when seeking the right height. Once you have established the height, if you are a long time user, you may choose to use a non-adjustable (cut to your specific height) cane or even a walking stick - to add a little style. When you grasp the top of the cane, your elbow should bend about 30 degrees. If you are using a cane because of weakness on one side of your body, place the cane in the hand of the stronger (opposite) side. Always keep in mind that the shoes you wear will affect the height of your cane.

How to Measure the Correct Height for a Walking Aid

For all types of walking aid that have a handle make sure that you are wearing the shoes you normally walk in and are standing as in line as possible, with your feet slightly (shoulder width) apart. With your arms relaxed by your sides, ask someone to measure from the floor to the bone that sticks out on the little finger side of your arm, just above the wrist. It is at this height that the handle should be adjusted to.

Range of Walking Stick Handles

• Ergonomic shape of Handles are ideal if you place a lot of weight on to your stick and you use it a lot. The design of the handle is essentially a mould of each palm and you therefore need to be either a right or left handed version depending on which side you use your stick.
• The Swan Neck Handles can be use if you are very unstable on your feet and place a lot of weight on to your stick
• The Ergonomic and Contour type Handles are made from moulded plastic, they are designed for those who place a lot of weight on the stick and use it very regularly ( similar to the ergonomic handle - smaller version)
• Crook Handles are a traditional stick that can be hung over your forearm, they are not recommended if you need to place a lot of weight on to the stick
• The Derby Handles is a cross between the crook and the standard handle they can provide excellent support ( made of wood)
• Walking Sticks are not exempt from VAT

There is a massive range of walking sticks on the market today, take your time and you will find the right stick for you!