If you have been looking to buy a wheelchair, chances are that you are a bit confused about the differences between different models. Or, you have specific needs, and you may not know that there are features that could provide you with a more comfortable product that meets your needs. Many times, manufacturers and advertisers use code words or part names that don’t really explain what the feature is, or how it can benefit you. This post then, is for you.
The first thing to consider when looking for a chair is the general use. Is the chair going to be pushed by an attendant? Is the chair going to be pushed by the individual in the seat, something we call self-propelled? Is the chair for everyday use, with many hours spent in the chair, or is it used mainly when going outside, or for long distances?
There are two basic chairs: a transport chair and a wheelchair. A transport chair is used for transferring from one area to another, such as from a hospital room to a waiting vehicle. It can only be moved by someone pushing the chair, and is often useful for going on short shopping trips with an aide. They weigh less than standard chairs, making them easy to get in and out of the car. However, they aren’t designed for prolonged sitting and lack many features that would make a wheelchair comfortable. A wheelchair is used for prolonged periods of sitting and maneuvering. They can be pushed by an aide or they can be self propelled. They offer different features designed to provide the most comfort and user friendly ability possible.
There are two basic categories in wheelchairs: Manual wheelchairs and Power wheelchairs. Manual wheelchairs are meant to be self propelled. They are generally foldable (as opposed to rigid) for ease in transportation and storage. Power wheelchairs come with some sort of power source that the user controls with a button or stick to manuever the wheelchair. The rest of this post will discuss the different features of manual wheelchairs.
Let’s consider the size of the wheelchair. Because a person will spend a large amount of time in the chair, it should be a good fit. Wheelchairs come in many sizes. Standard sizes are 16×16, 18×16, and 20×16, the first number representing the seat width, and the second number the seat depth. Some models feature a seat depth of 18 inches.
Wheelchairs also come in larger sizes, and they are called bariatric or heavy duty wheelchairs. These sizes do no indicate the overall width and depth of the wheelchair. That is determined by other parts of the chair such as wheel positions and sizes. Seat widths are important. If the seat is too narrow, the user will be uncomfortable, with the arms pressing into the thighs. If the seat is too wide, the user will have a difficult time reaching the handrims on the wheels to propel comfortably.
Standard seat depth is 16 inches with some models featuring a variation with 18 inch deep seats. There are a few models that also offer a seat extension, allowing you to find the perfect spot, although that might be irritating to the spot behind the knees. In general, the edge of the seat should end 1-2 inches before the back of the knee bend. Longer seat depths will provide more stability to the user, and distribute the weight over a larger surface, adding comfort.
The weight of the wheelchair is also important. Wheelchairs that are heavier are generally more difficult to propel, not to mention getting in and out of a car. Standard wheelchairs are made of steel, while lightweight models often are made of aluminum. However, lightweight models may not stand up to the same amount of wear and tear as the steel models. Be aware that when wheelchairs are touted as being lightweight, they are often weighing the model without the front rigging (the foot rests or legrests). So unless you are going to remove the front pieces each time you lift it, make sure that you know what the model weight is actually representing.
Seat height also plays an important role. Because the person in the chair will be maneuvering it with his upper body, the seat height is very important and can make the difference between an easy push, or sore muscles. In addition, seat height is important to the activities you do (sitting at tables etc.), as well as making transfers in and out of the chair. So if a standard seat height is not good for you, you may want to consider a model that features adjustable seat heights, also referred to as a hemi (low seat) model. This feature will be called a dual position axle and multi position castor, terms that just mean that the wheels can be adjusted higher or lower on the frame so that the arms can achieve a comfortable position for pushing. If you are considering an adjustable height wheelchair, you should consider how the wheels will be moved, whether they will need tools, or whether the model features a quick release button on the axle for easy adjustments. In addition, be aware that when positioning for a lower seat position, it will affect the way the legrests need to be positioned in order for the legs to clear the ground.
You can also purchase wheelchair cushions to achieve the height and comfort you want.
Mid range and high end wheelchairs will usually offer an adjustable center of gravity. The center of gravity determines where the weight is concentrated- more to the front, putting pressure on the castors, or more to the rear, putting pressure on the rear wheels. Too much pressure on the castors will make it difficult for the castors to swivel and move easily, especially over rough terrain, but will be much safer. Moving the center of gravity to the rear makes it easier for a user to propel the chair, but too much pressure to the rear increases the likelihood of wheelchair tipping over backwards. Getting the center of gravity just right is finding the balance between safety and efficiency. The center of gravity is different for different users, and depends on the make of the chair, the weight of the wheelchair, and the weight and strength of the user. Low end wheelchairs are made with predetermined centers of gravity that are more to the front, as manufacturers are more concerned with safety than efficiency. If the user will be fairly active, having an adjustable center of gravity may be important to provide an easy and comfortable ride.
The seat back supports good posture, and, though less commonly addressed, should be considered as well. Seat backs come in different sizes, with the standard size being about 161/2 inches, but some models feature 15 or 18 inch backs as well. Some models will even offer a seat back extension to provide a larger back for more support.
The material of the wheelchair seat (upholstery) depends on your comfort and hygienic needs. Models are either of nylon or vinyl, with some models offering both options. Nylon is porous, and offers more breathability and better insulation. However, it is harder to clean, and retains fluids, necessitating frequent upholstery replacements. Vinyl is not porous, and will increase a users perspiration. It will also stretch and sag much faster than nylon. However, it is extremely easy to clean. If the user is allergic to natural rubber latex, ensure that the upholstery was not manufactured with that material.
Now lets talk about the arms. The arms come in two sizes: a full arm, and a desk arm. The desk arm is a shorter arm, that allows you to rest your elbows, but doesn’t support the full arm until the wrist. The advantage of the desk arm is that it enables the user to be wheeled right up to a desk or table comfortably, so that normal continuation of activity can be maintained comfortably. Full arms are more comfortable for prolonged periods of sitting away from the table. Upgraded models offer detachable arms (for changing arms types), height adjustable arms, or swing-away arms for ease of getting in and out of the wheelchair. Some models offer space saver arms, which are a bit narrower, but don’t take away from the seat width.
On to the legs. Wheelchairs (not transport chairs) feature one of three types of footrests: the elevating legrest, the swing-away footrest, or the articulating leg rests.
The elevating legrest is good for users that need to keep their leg(s) elevated. These legrests allow the user to adjust the angle at which their legs will be supported, and each leg can be adjusted individually. Some models come with predetermined angles of adjustment. Others come with a pneumatic piston that allows for a more individualized angle setting with infinite angle positions. Elevating legrests also allow the footplate to be adjusted as well, to allow for differing leg lengths. They come with a calf rest, to support the lower leg, and mid range models will offer padded calf rests for added comfort.
The swing away footrest is preset at a certain angle, generally between 60 and 70 degrees, allowing the user’s legs to clear the floor. The footplates are usually adjustable to accommodate different leg lengths, but the preset angle may not allow for longer leg lengths. Many footrests will come with heel loops to keep the foot from slipping off the footplate, others sell the heel loops separately. These riggings will swing to the side to allow the user to transfer in and out of the chair with ease.
Articulating Leg Rests are elevating legrests that adjust for length as they are raised or lowered, without having to manually readjust the footplate each time the angle is adjusted. These legs are important for those that will be changing their leg positions often.
When buying a wheelchair, be aware that not all models come with front riggings; some need to be purchased separately. Look for tool free rigging, enabling you to easily put them on or off for transport, or change of rigging according to need. In addition, consider whether the rigging is included in the advertised weight of the wheelchair. If it isn’t, estimate 5-6 lbs of additional weight.
The next two features are not usually part of the advertised features of a wheelchair, but are important to look for or ask about.
Firstly, the full width of the wheelchair. This is measured from the widest part of the wheels (which are often placed on a bit of an angle called a camber) from one side to the other. This may make a difference if you have narrow doorways or hallways. Secondly, the width of the wheelchair when it is folded. This may make a difference for those who are storing the wheelchair for infrequent use, and have small spaces.
Wheelchairs always come with a maximum weight capacity. Manufacturers are specific that this does not mean that the seat can hold the maximum weight. Rather, it refers to the maximum weight of the user, which is evenly distributed among all parts of their body, so that only a portion of their weight (torso and above) are actually putting pressure on the wheelchair seat. Therefore, a wheelchair that has a maximum weight capacity of 250 lbs. will not be a good choice for a patient that weighs close to or exceeds 250 lbs.
Many wheelchairs have compatible accessories that are sold separately, but that are designed to fit to that specific wheelchair, such as oxygen holders, belts, or wheel locks.
Anti-tippers are another accessory that is generally sold separately. Upgraded and lightweight wheelchairs often include anti-tippers and wheel locks and don’t need to be purchased separately. When looking for a wheelchair, check to see if the accessories you need are available or not.
You will often see that the models come with a compliance to a specific Medicare (HCPCS) code. Knowing these codes can clue you in to the general type or category of wheelchair of the model.
Lastly, be sure that you know the warranty for your product. Similar products may or may not offer a similar warranty, making a difference to your decision.
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