Types of wheelchair
There are many different types of wheelchairs from standard to prescriptive chairs.
More standard, ‘out of the box’ products are suitable for individuals who need a more basic chair and they can either be self-propelled, attendant propelled or power chairs.
Prescriptive chairs are chairs which need to be prescribed, it is recommended they are prescribed by a healthcare professional such as an Occupational Therapist, Physiotherapist or Rehabilitation Engineer. All aspects of the chair are made to measure and recommended based on the client’s specific needs.
Self-propelled wheelchairs are wheelchairs in which you can push when sitting in the chairs. The rear wheels are usually 22” or 24”. In order to be able to propel yourself you will need good sitting balance and upper limb strength to manoeuver yourself around corners as well as up and down hills.
Attendant propelled wheelchairs
These wheelchairs have much smaller wheels, the rear wheels are usually 12”. Its is important to consider where you will be using the attendant wheelchair, for example, if you are using it around hilly areas it is important that the chair is pushed by someone who has enough strength to manage this.
Having brakes on the handle bars of the chair can be a good addition, they are often called hub brakes or attendant brakes. They reduce the need to bend down and apply the brakes on the wheels and can be useful when controlling a chair downhill.
Powered or electric wheelchairs provide independence for those who rely on a powerchair for short or long distance and are unable to self-propel a wheelchair. Powered wheelchairs can require a bit of practice initially, especially if they are being used in tight spaces. When purchasing a powerchair it is important to consider whether it is appropriate. It is recommended for those who have good eyesight, a 12-month history of no seizures or blackouts, sufficient memory and general cognition, sufficient coordination to control the chair.
It is always important to trial a powerchair before purchase, it may require some practice to gain confidence in using the chair indoors and outdoors.
It is important to get the right size chair for you. Prescriptive chairs require a full assessment to ensure their suitability and size, however, it is also important to ensure a standard wheelchair is the correct size.
Seat Width – Measure the widest section of your hips in a straight line. Add 1” to either side. Try to avoid making the seat width wider than necessary, as this can alleviate the postural support provided by your chair.
Seat depth – Measure from the back of your bottom to the back of your knees/calf. There needs to be around 2 fingers width of space between the back of the knees and the chair.
Chair height – Measure from the heel to the back of the knee. The thighs should be horizontal with the seat base.
Arm height – Measure from the the top of the seat to the underside of the elbow whilst their shoulders are in a relaxed position and arms are in a horizontal position
It is also important to consider the weight limits of the chairs, ensure yourself or the person using the chair is sufficiently within the weight limit. If the individual using the chair is over the weight limit this can invalidate the warranty.
It is important to consider how long you will be using the chair for and if you have a history of any pressure ulcers. If you have a pressure ulcer or a history of pressure ulcers it is important to consult an Occupational Therapist to advise about pressure care on the wheelchair. If you are using the chair for long periods of time it is important to consider comfort and your skin integrity and therefore the type of cushion you have on the chair.
Getting in and out of the chair
It is important to ensure it is easy and practical to get in and out of the chair, whether this is via using a transfer aid or by independently standing from the chair. This is where the seat height and armrests are important. A removable arm will be necessary if the person needs to use a transfer board to get into and out of the chair. In addition, if the arms are too short or far back then this can cause issues for someone pushing off the chair to standing.
Consider where the chair will be used. If it is to be used indoors ensure the doorways are wide enough and that the turning circles are big enough to accommodate a wheelchair with footplates.
Having a wheelchair can provide much more accessibility for going places and conserve energy for important tasks when fatigue is an issue. Therefore, it is important to consider where you will be using the chair or taking the chair. If you plan to fit the chair into the boot of the car it is important to consider the weight and size of the chair and if this will be practical. Car hoists can be installed into boots of cars if the wheelchair is too heavy to lift.
It is important to continue walking where possible to help maintain global muscle strength and maintain a good function respiratory and cardiac function. However, for those who have no independent mobility or struggle walking distances a wheelchair can help gain back that independence.