Wheelchair selection and adaptation

Authors: Lu Shiwei, Wang Yan, Chen Jibao; Chief Judge: Zhai Hua

Unit: Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center)

This popular science work is one of the popular science materials in the series "Don't be afraid of spinal cord injuries, there are ways to prevent and rehabilitate them"

Wheelchairs are important companions for patients with spinal cord injuries. When choosing a wheelchair, the dazzling array of choices always makes people dazzled. How to choose a wheelchair that suits you? Let us follow the steps below and choose together.

Look at the budget

Budget is the most important part of choosing a product. Higher-priced wheelchairs often provide a better user experience. When choosing a budget range, you need to consider your personal financial situation and usage needs.

Customized style

Different styles of wheelchairs have their own suitable groups of people. Sports cars are fast, and Wuling is the best for hauling goods. The choice of wheelchair style needs to be based on its functional status.

1. Fixed frame wheelchair

▶Advantages:

Economy, stability.

▶Disadvantages:

It is bulky, takes up a lot of space, has poor durability, and is not easy to transfer.

▶Summary:

Can the electric tricycle used as a wheelchair be used? Yes, but is it easy to use? Not easy to use. It can be used in transitional situations, but it is generally not recommended for patients with spinal cord injuries.

2. High-back wheelchair

▶Advantages:

Fully functional, economical and stable.

▶Disadvantages:

Bulky, takes up a lot of space and has poor durability.

▶Summary:

The MPV among wheelchairs is fully equipped and powerful, and is suitable for patients with early spinal cord injuries to adapt to sitting positions, or for patients whose functional conditions are still weak.

3. Lightweight frame wheelchair

▶Advantages:

Affordable, lightweight, takes up little space, durable, and easy to transfer.

▶Disadvantages:

No obvious disadvantages.

▶Summary:

The SUV among wheelchairs has slightly weaker functions than an MPV but is still powerful. It is suitable for patients with relatively stable conditions who need to rely on wheelchairs for a long time.

4. Sports wheelchair

▶Advantages:

Small and light, fast, easy to turn and good looking.

▶Disadvantages:

The price is high, the stability is poor, and it is not easy to transfer.

▶Summary:

The coupe type of wheelchair is easy to drive and control, but it has high requirements for the operator and is more expensive.

5. Electric wheelchair

▶Advantages:

No manpower required.

▶Disadvantages:

The range is limited by the battery power and requires certain driving skills training.

▶Summary:

Automatic driving in a wheelchair does not require the passenger to drive it, and a joystick can control the wheelchair. It is suitable for patients with insufficient upper limb function or long-distance needs.

6. Special purpose wheelchairs

A special vehicle among wheelchairs, the special design can support various functions such as standing on the wheelchair and climbing stairs.

Select Brand

Choose the material

Wheelchairs can be divided into steel wheelchairs, alloy wheelchairs, and carbon fiber wheelchairs based on their materials.

Steel wheelchairs are heavy, difficult to drive, and cheap, making them suitable for situations with a low budget and when someone is pushing the wheelchair.

Alloy wheelchairs are generally made of aluminum alloy, which is light weight and high strength. Their prices are higher than those of steel ones. They can meet the needs of most patients without special needs.

Carbon fiber wheelchairs are the king of wheelchair materials. They are the lightest of the three, generally have better designs, and are well adapted to operations, but they are expensive and are suitable for patients with sufficient budgets.

Read Data

Measure the hip width (A), thigh length (B), calf length (C), back height below shoulder blades (D), elbow and forearm height (G) and other data. If conditions permit, you can find a therapist to measure all the data of AJ and inform the wheelchair salesperson of the data to fit the appropriate wheelchair size.

►Note:

Seat width:

Fit according to hip width (A), with about two finger widths between the hips and the guard.

Seat Depth:

Adjust the seat according to your thigh length (B). When you sit down, the distance between your calf and the seat cushion should be about one fist deep.

Pedals:

Adjust the seat according to the length of your calf (C) so that your thigh can fit comfortably against the seat cushion, not too high or too low.

Backrest:

The backrest is adjusted based on the back height below the shoulder blades (D). For those in good condition, the backrest should be lower than the lower edge of the shoulder blades. For those with poor head and neck control, consider purchasing a headrest component.

armrest:

The fit is based on the elbow and forearm height (G) so that the elbow can be bent forward about 30° when sitting and can be placed relaxedly on the armrest.

Find accessories

Anti-tilt wheel:

Prevent the wheelchair from tipping over.

Anti-slip ring:

Increase friction to assist passengers in pushing the wheelchair.

Custom cushions:

Reduce the pressure on the buttocks and leg skin and reduce the occurrence of pressure sores. (Note: regular pressure relief is essential)

seat belt:

Prevent patients with trunk instability from falling forward.

(Some pictures are from the Internet)

References:

[1] Zhai Hua, Liu Jun. A Guide to Rebuilding the Capacity of People with Spinal Cord Injury. Shanghai: Shanghai Science and Technology Press, 2017.

[2] Xu Guangxu, Cai Keshu. Physical therapy for spinal cord injury. Beijing: Publishing House of Electronics Industry, 2019.

[3] Fliess-Douer, O., Vanlandewijck, YC, Manor, GL, & van der Woude, L, H. (2010). A systematic review of wheelchair skills tests for manual wheelchair users with a spinal cord injury: Towards a standardized outcome measure. Clinical Rehabilitation, 24, 867–286.

[4] Mills, T., Holm, MB, Trefler, E., Schmeler, M., Fitzgerald, S., & Boninger, M. (2002). Development and consumer validation of the Functional Evaluation of a Wheelchair (FEW) instrument. Disability and Rehabilitation, 24, 38–46.

[5] Hastings, J., Robins, H., Griffiths, Y., & Hamilton, C. (2011). The differences in self-esteem, function, and participation between adults with low cervical motor tetraplegia who use power or manual wheelchairs. Archives of Physical Medicine and Rehabilitation, 92, 1785–1788.

[6] Mortenson, WB, Miller, WC, & Auger, C. (2008). Issues for the selection of wheelchair-specific activity and participation outcome measures: A review. Archives of Physical Medicine and Rehabilitation, 89, 1177–1186.