The Wheelchair's Journey to Today's Choices and Designs

Sally Madeley-Carr, OT
23 May 2021

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Crude design designs for a wheelchair were seen as far back as the sixth century in China.

What was then known as an invalid chair was designed for King Phillip of Spain way back in 1595.

The beginning of the twentieth century saw the invention of wheels with spokes and 1916 heralded the first powered model.

From the crude designs of yesteryear to today's manual and powered models, wheelchairs of today respect the needs of the individual, giving an abundance of choice, as well as being fit for purpose.

Manual or Powered?

Wheelchairs are not only used by people who can't walk but also by people whose health condition means that fatigue and weakness may make walking too tiring at times or momentarily impossible e.g. multiple sclerosis and ME (myalgic encephalomyelitis), as well as rehabilitation after illness or accident.

Today's models address both permanent and temporary use, as the user's individuality is paramount to success.

Manual Wheelchairs

The two main types of manual wheelchair are the self propelled and the attendant / transit propelled.

Self Propelled:-

the self propelled design has large wheels at the rear, to allow the user to be able to make contact with the push rims on the rear wheels, so as to use their upper body strength to steer.

the self propelled design also often has push handles, allowing someone else to push the chair, should circumstances merit this type of support.

the larger wheels at the rear make moving over uneven ground and mounting / dismounting kerbs much easier.

a lightweight self propelled wheelchair can weigh as little as 10 kg. (22 lbs. / 1 stone 8 lbs.), though thought would need to be given to what is expected of such a lightweight model and also its durability for those needs.

Attendant / Transit:-

for users who do not have sufficient upper body strength for the self propelled method of transport, the attendant chair with its smaller rear wheels offers easier steering and manoeuvrability for the person in attendance.

the transit model is narrower than the self propelled wheelchair, as it doesn't need the larger and wider wheels which house the push rims.

Powered Wheelchairs

Making the choice between manual and power operated depends on the individual's upper body strength and individual needs:-

powered wheelchairs are heavier than manual wheelchairs, as the battery which supplies the power significantly increases the overall weight.

transporting the heavier powered wheelchair will not be as easy and swift as transporting a folding manual wheelchair.

depending on the maximum storage of the battery, the user may be able to travel only short distances before a recharge is needed, so thought must always go into the user's lifestyle and keeping the battery at its maximum charge.

for people who have limited upper body strength, a powered wheelchair will be the better option.

storage space and access to an electrical point for charging the battery need to be addressed, before purchasing the right one for you.

Choosing the Right Wheelchair

The right wheelchair will always adapt itself to the user's needs, rather than the user adapting to the wheelchair design.

If the wheelchair will sometimes be transported by car, the lighter the weight the better.

Some wheelchairs have detachable footplates, as well as detachable arms and wheels, all making lifting the lighter weight easier.

Some wheelchairs fold up by pulling up the seat section and some allow the seat back to be folded down to half its height, making storage a lot easier.

How often the wheelchair will be used is a key factor in choosing the right model, as regular use models are much more durable and comfortable than those used occasionally e.g. for attending the odd appointment.

The tyres on the rear wheels can be either pneumatic (filled with air) or solid rubber. Whilst pneumatic tyres may at times puncture, the wheelchair user enjoys a softer ride than with the solid tyres, which make for a harder trip.

The smaller wheels (castors) at the front of the wheelchair may have a 360 degree swivel, which makes for seamless manoeuvrability.

Whilst the armrests are necessary for support, it is better that they are detachable, as removing an armrest allows for sideway transfers from the wheelchair to another chair, or into a car seat.

Some wheelchairs have pivot armrests, allowing the arm to be swung back rather than removed.

Brakes are usually applied to the rear wheels, though the attendant wheelchair might have the brakes on the pushing handles, for operation by the person in attendance.

Most wheelchair designs can bear weight up to eighteen stone. Users who weigh more than eighteen stone should look for a heavy duty / bariatric model.

When researching wheelchairs for sale, be sure that you have done your homework as to what the user needs and what is expected of the wheelchair e.g. the upper body strength of the user, frequency of use of the wheelchair, terrain and transportability.

The Importance of Getting the Right Seat Size

The right seat width will make you feel comfortable and give you comfortable access to the armrests.

Armrests should be at the right height on which to rest the lower arms, too high causing hunching and too low causing leaning to one side.

A seat which is too narrow could lead to the onset of pressure sores.

The most common seat widths are 16, 18 and 20 inches.

Too wide a seat width will reduce the support to the body and could bring about mild discomfort or serious injury.

With any kind of chair, seat depth should support your thigh right along to your knee. Too short will not allow you to bend at the knee and too long will not support the whole of the thigh.

Other Points to Consider

Standard wheelchairs tend to have fixed chair back heights and the smallest allowance for backrest recline (only five percent).

Getting something more suitable to your personal needs may mean looking at specialist designs.

Headrests give support to both the neck and head and are a sensible optional extra.

Wheelchair cushions as an optional extra not only give extra comfort but also prevent pressure sores, which can develop as a result of sitting for long periods without any real movement.

Be aware that the extra height given by the cushion will mean that the armrest height will need to be raised, to once again support the user's lower arms.

Depending on the user's level of risk of developing pressure stores, different types of cushion available include basic foam (low level of risk), memory foam or gel (medium risk) and gel or air-based cushions for higher risk users.

In bad weather conditions, a wheelchair Macintosh can cover you head to toe, keeping you dry and free from the cold.

Designs include sleeves, allowing the user to make or continue his / her journey unaided.

In cold conditions, a wheelchair blanket will cover both the lap and the legs of the user.

For keeping a wheelchair dry when not in use, a wheelchair storage cover will protect the chair and any electrics from the elements.

Covers are available for both folded and unfolded wheelchairs.

Storage bags are an optional but very important extra. With side loops which allow the bag to hang at the back of the wheelchair, capacity is big enough for personal items, as well as a small amount of shopping.

An under the seat storage bag has the advantage of a front opening, allowing the wheelchair user to access his / her own belongings without assistance.

These pannier designs even have small individual pockets for mobile phones, keys, money etc.

A smaller pannier bag sits inside the wheelchair and is attached to the armrest, making personal items immediately accessible to the user.

The Importance of Exercise and Keeping Fit

Yoga from a Seated Position

Yoga is a discipline in which almost every yoga pose can be adaptable for use from a seated position. Its benefits include:-

a reduction in aches and pains.

strengthened joints, muscles and connective tissues.

healthier bones and muscles.

an improvement in posture.

relief from long periods of sitting, via the yoga poses being performed.

increased strength and balance.

a better quality of sleep.

The Benefits of Wheelchair Dancing

Wheelchair dancing has many psychological and physical benefits:-

dancing is an emotional activity, allowing individuals to express themselves through movement.

this activity keeps us fit and raises our self-esteem.

physical activity increases lung capacity, strengthens the heart and also lowers cholesterol levels.

dancing promotes interaction with others and so increases social skills and inclusion.

Physical activity helps keep both the body and mind fit for purpose.

Summary

When looking at wheelchairs for sale, make sure you have taken everything into consideration:-

The upper body strength of the user the intended use of the prospective wheelchair (e.g. occasional use or for daily living)
The weight and transportability requirements (i.e. the lightweight self propelled wheelchair might prove the right one for holidays / travelling use)
the user's weight, as a weight over eighteen stone will mean that the right wheelchair Will be either a heavy duty or bariatric model
Storage space and, in the case of the powered wheelchair, access to an electrical point for charging the battery
The correct seat width and depth for the user's weight and frame.

Having all of this information at hand will not only hone your research but make sure your purchase meets your / the user's needs and specifications.