Category Archives: Occupational Therapy

For people with limited mobility Wheelchairs can often be a game changer. But with so many options on the market how do you know what to look for?

We’ve put together this 3 part blog to help you learn more about the different types of chairs on the market, what customisations are available and the important considerations around seating and positioning in a wheelchair.

• Part 1: Different Types of Wheelchairs and what to consider.

• Part 2: Standardisation vs Customisation.

• Part 3: Seating and Positioning guideline.

Part 1 – Different Types of Wheelchairs and what to consider.

When looking at purchasing a Wheelchair it’s important to think about the following things as this will steer you in the right direction to choosing the right chair for you.

• What is the primary use of the chair?
• How often will the chair be used?
• Will the chair be used indoors, outdoors or both?
• Will you be propelling the chair or will you need someone to propel it for you?

Once you have a good understanding of the above you can then look at the different types of chairs to determine what will suit your needs. Ideally having a Physiotherapist, Occupational Therapist or Equipment Provider involved in this process is highly recommended to help guide you down the right path and make sure you end up with a chair that is right for you!

Manual vs Electric

Generally, the first differentiating factor when prescribing a wheelchair is whether the requirement is for a Manual or Electric Wheelchair. Manual Wheelchairs are the most common types of wheelchairs and require someone to “manually” push the chair. This can be either self propelled or require someone to push the chair. Electric chairs on the other hand are (as the name suggests) chairs that are propelled  by an electric motor.

Standard

Standard wheelchairs are the common “off the shelf” type of chair and generally quite basic and economical. They come with a durable steel frame and standard sizes of 16 x 16, 18 x 18 and 20 x 20inch chairs (the size refers to the seat’s width and depth). These chairs can often be folded but are generally quite heavy and cumbersome due to the steel frame.

Lightweight

In comparison to a Standard Wheelchair a Lightweight Chair is well…much lighter. The main reason for this is that these are made with lighter metals, generally aluminium, titanium or carbon fibre. They are generally used as a transit chair (transport someone from one place to another) and come with castors as opposed to large wheels with spokes and tyres which means you can’t propel yourself and will need someone to propel the chair for you.

The Castors along with the change in metal have a significant impact on the chairs weight and can often be half the weight of a standard wheelchair (Standard chairs are generally~15kgs vs a lightweight chair which weighs ~8kgs if not lighter!) These chair are commonly used in people that are ambulant but may not be able to walk long distances so are ideal for a family member to fold it up and easily lift it into the car.

Tilt in Space

Tilt in space chairs are often prescribed for clients that may spend most of their day in a chair. Tilt in Space chairs have the ability of tilting the entire chairs frame as one solid unit. This means that you can maintain the angles of key joints (hips, knees and feet – Part 3 of this blog will provide more info on seating posture and positioning) and help redistribute pressure to offload the ischial tuberosities (the bony parts of your bottom) to support comfort and reduce the risk of pressure sores from developing as a result of constant pressure due to lack of movement.

Some Tilt in space chairs come with a recline function which enables the chair’s backrest to change position on its own. This is especially helpful in clients with limited hip flexion and can be adjusted to ensure comfort as well as reduce the risk of sliding off the chair.

 …

Part 2 – Standardisation vs Customisation

Now that you’ve worked out what type of wheelchair to purchase it’s time think about the next question. Will a “standard off the shelf” wheelchair suffice or do i need to “pimp my ride?”

Well…it really depends on the individual using the chair, the frequency the chair will be used and how the chair will be used.

Some simple indicators may exclude the suitability of a standard chair for example:

Size:

Most standard wheelchairs come in 16/18/20inch x 16/18/20inch. When referring to chair sizes the first number always refers to the chairs width (measurement across someones hips) and the second number refers to the chairs depth (in a seated position measure from the back of the knees to the end of the bottom).  Modifications to chair width and depth may be required as most standard chairs come in common sizes.. It is recommended you speak with an Equipment Supplier such as FIsherlane Mobility or Rehabhire around available customisations on particular chairs prior to purchasing.

Frame:

Standard chair frames are commonly made from steel or aluminium. For people looking at lightweight or sports chairs it might be better to look at chairs made from titanium or carbon fiber. Many accessories like wheel rims and foot plates can also be customised to match.

Upholstery:

The two most common types of upholstery on wheelchairs are Vinyl and Nylon. They both have their pros and cons. Nylon is more breathable and lighter in weight but can be difficult to clean and is more expensive than Vinyl. Vinyl on the other hand is the cheaper alternative, easier to clean and can be disinfected but not recommended for everyday use as the non-porous material makes you more likely to sweat!

Physical ability:

The physical ability of the  user is paramount as this will determine the level of customisation required. For example someone who has sustained a stroke and has limited function in one side of their body can still independently propel themselves with a one arm drive system. One Arm Drive (OAD) Systems like the lever drive or double hand rim enable the user to propel and steer with one arm.

In circumstances with significant physical disability many customisations can be made to a chair. Most people are familiar with Professor Stephen Hawking who suffered from Motor Neuron Disease yet still excelled as a visionary scientist. Check out some of the customisations to his chair below!

 …

Part 3 – Seating and Positioning Guideline

…