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Wheelchair Buying Guide

Wheelchair Buying Guide

This guide is intended to help explain the features and factors to consider when buying a mainstream manual wheelchair.

There are many different types of wheelchairs available, some of which are designed for users who have complex requirements and who need to spend significant periods of time in the chair. Advice on more specialist needs is available from your therapist or local wheelchair services who may also be able to recommend funding for this type of wheelchair. This guide is not intended to replace this specialist help.



Things to Consider

Things to Consider

Self Propel or Attendant Propel

If you intend to propel yourself in the chair using pushrims on the rear wheels, you will need to look at ‘self propelling’ wheelchairs with have large back wheels. Whilst these chairs are designed to be used by the chairs occupant, they normally have pushing handles on the back so that someone can push you where needed. Indeed, the larger back wheels can be an advantage when being pushed up kerbs or over other obstacles. If you are not strong enough to propel yourself and intend to rely on someone else pushing the chair, you are normally better off with an attendant propelled or transit wheelchair. These have smaller rear wheels and can be easier to manoeuvre for the person pushing. They also tend to be easier to put in to the boot of cars, although most wheelchairs now feature quick release wheels. They are no hard or fast rules about which type of chair to go for. If you think you may want to propel yourself even a little you would be better off going for a self propel wheelchair. This generally gives you the best of both worlds. However, this should be balanced against the increased width of the chair from the pushrims on the rear wheels.



Overall Weight

The weight of the wheelchair is obviously important if you are intending to transport it by car and it can also effect how difficult the chair is to push. The lighter the frame the easier it will be to lift and therefore to put in to the car. It will also be easier to push the occupant as there will be less weight and the chair will be more manoeuverable. Whatever the weight of the user, the lighter the chair, the easier it will be for the person pushing it. Whilst lightest is normally best, the cost of lightweight wheelchairs increases sharply. Most standard chairs are constructed with a steel frame. The more lightweight chairs are generally made from an aluminium frame which can cost considerably more. Another factor to bear in mind when thinking about weight, is the number of detachable parts to the wheelchair. Most wheelchairs have detachable footplates, but some also have removable arms and wheels. This can greatly reduce the weight of the chair when lifting making a steel frame an option.



Storage

Most wheelchairs fold upwards by pulling up on the seat. This operates a scissor action folding mechanism, pulling the wheels together. Dependent on the specific type of wheelchair, a range of parts may also be detachable such as the footrest, arms and wheels. Typically the footrests have a quick release lever for easy removal. It may also be possible to fold down the back to half the normal height. Once all these part are removed, the wheelchair can normally be stored quite easily.

Features

Features

Wheels

Wheelchairs with large rear wheels are known as ‘Self-propelled’ wheelchairs as the user can self-propel themselves. The chairs with smaller rear wheels are called ‘Attendant Propelled’ or ‘Transit’ wheelchairs. In general, the larger the rear wheels, the lower the effort required to propel the wheelchair by the occupant. The rear wheels will either be pneumatic (air) tyres or solid rubber. Pneumatic tyres offer better shock absorption than solid ones but can of course puncture. Solid tyres have the benefit of being puncture proof but give the occupant a slightly harder ride. Many rear wheels have a quick release button, which enables them to be removed quickly. This aids transportation by reducing the overall size of the chair. The front castors normally have solid tyres, which will swivel a full 360 degrees. There can also be small wheels at the rear of the frame. These are called anti-tip wheels and are normally positioned a few inches from the floor. These wheels are there to stop the wheelchair tipping backwards and are a useful safety feature for self-propel wheelchairs. However, you need to be aware that the anti-tip wheels can be a bit of an impediment by restricting the gradient that you can climb. This may be frustrating where you have an assistant pushing you. For this reason, most anti-tip wheels are height adjustable and can be removed altogether if needed.



Footplates

The majority of footrests swing away outwards or sometimes both outwards and inwards. Having swing away footplates is important for safe transfers allowing you to stand at the front of the chair without having to step over the footplates. Being able to remove the footplates altogether is also important for transporting the wheelchair as it reduces the overall size of the frame. It is possible to get elevating leg rests where you need to raise your legs for long periods or you may need to keep your leg straight due to a cast for example. You can also get shorter, padded extensions for stumps.



Armrests

The arms on a wheelchair are essential for support whilst seated. However, they can become an obstacle to transferring, particularly if you use a transfer board. For this reason, many wheelchairs have detachable armrests which can be removed to allow sideways transfers. This can also be of benefit when transporting the chair by making the frame lighter when removed. An alternative to detachable arms is to have swing up arms which pivot at the back. This has the advantage of not having to completely remove the arm and find somewhere to put it whilst transferring. Some chairs have armrests which swing up and are detachable giving you the best of both worlds. One other impediment that arms can be responsible for is preventing access to tables. The normal height of an armrest does not allow the user to sit up to a table as the arms hit the edge of the table. For this reason, designers have developed cut away armrests which are lower height nearer the legs and allow the wheelchair to be pushed further under the table. Of course, the trade off is that the occupant has a shorter armrest of useable height. Some of the more sophisticated wheelchairs incorporate height adjustable armrests. This is particularly useful where you need to use a pressure cushion in the wheelchair which may add several inches to your seated position. Without height adjustable armrests you might find that the arms do not provide adequate support.



Brakes

These will normally be manual brakes mounted near the rear tyres. These should always be applied when the wheelchair is stationery or if you are making a transfer. subitem image

Some attendant propelled chairs have brakes fitted near the pushing handles. This gives greater control to the attendant and can help slow the wheelchair when descending steep hills or ramps. The only drawback is that the user cannot apply the brakes themselves.

Assessing the Correct Size

Assessing the Correct Size

User Weight

All wheelchairs have a maximum user weight. You should never exceed this as it will invalidate any warranty and it can lead to the wheelchair becoming dangerous. The normal weight limit for most standard chairs is around 18 stone. If you weigh in excess of 18 stone, you should look for a heavy duty wheelchair.



Seat Width

It is essential to get ensure that the seat size is suitable for you. You need to ensure that wherever possible your weight is evenly distributed over the seat area. This will provide the most comfortable sitting position and help prevent any pressure sores from forming. The majority of wheelchairs have height adjustable footplates which enable you to achieve a comfortable seated position. As the footplates are height adjustable the actual height of the seat is less important when buying a wheelchair than it is for an armchair. However, if you do find it difficult to get up from a wheelchair a higher seat may be beneficial. The ideal seat width should give you sufficient room to be comfortable but not too wide so that you don’t have the support of the arm rests. If the seat is too wide, you may lean more to one side in order to feel supported. A seat that is too narrow, will be uncomfortable and can increase the risk of pressure sores. Don’t forget to include your outdoor clothing (eg your winter coat), when measuring up for a wheelchair. Many of the standard manual wheelchairs come in different seat widths the most common being 16”, 18” and 20”. The most popular width is 18”. The seat depth is also an important factor. If the seat is too short, the full length of the thighs will not be supported and too much pressure will be transferred onto the buttocks. If the seat is too long, it may cause undue pressure behind the knee, and the user may not get adequate support from the backrest. You need to try and match the seat depth of the chair and the ideal seat depth for the user as most standard manual chairs do not offer the option of different seat depths.



Backrest Height

Most standard manual wheelchairs have fixed back rest heights. The level of padding will normally vary with the price of the wheelchair. Most standard chairs have a small degree of recline usually around 5 degrees. This can vary from chair to chair and if you are after more of a recline, it is worth comparing makes and models. It is possible to get adjustable angle back rests but these are normally only available on more specialist chairs which cost considerably more. You can buy optional headrests which can be fitted to any wheelchair. This supports the head and gives a chance to rest the muscles supporting the head if they get fatigued.



Armrest Height

The armrests should support your arms comfortably. If they are too high, this will cause your shoulders to hunch; if they are too low then you can end up leaning to one side. When a wheelchair cushion is used, this will raise up the seat base and hence lower the height of most standard wheelchair arms. Normally only the more specialist chairs have height adjustable arm rests.

Accessories

Accessories

Cushions

Wheelchair cushions is an area which could cover a whole buying guide in itself. The basic purpose of a wheelchair cushion is to provide additional comfort to the user when seated. Most wheelchairs are designed for you to use your own cushion and it is recommended that you buy a cushion when purchasing a new wheelchair even if it is just a basic foam one. The more advanced pressure care cushions are designed to prevent pressure sores. These can develop if you spend long periods of time seated in the chair. They can be made from a variety of materials and are rated according to the protection they provide to patients developing pressure sores. The basic foam cushions are suitable for those at low risk. Medium risk users should look for a cushion which uses a memory foam or foam and gel combination. High risk users should go for either a gel or air based cushion. This is a very basic introduction to the types of cushions available and if you think you may be in the medium or high risk categories you should consult your therapist, GP or local wheelchair services.



Walking Stick Holder

These are very handy if you use a non-folding walking stick and need to have it available at the end of your journey. They usually comprise a cup at the bottom of the frame for the ferrule with a clip further up to hold the stick in place. They are generally inexpensive and easy to fit.



Weather Protection

There is a wide range of different type of garments for protecting you and the chair against wet and or cold weather. The most common is the wheelchair mac which covers you head to toe with a waterproof Macintosh. Another popular garment is the elasticated blanket which is usually made from a fleece or waterproof material. The blanket wraps around your waist and legs and with the elasticated edge, it does not become entangled in the chair. Please see our Weather Protection section for other ideas.



Storage Bags

These are great for carrying your personal effects whilst in the chair and can be big enough to carry some shopping home as well. The standard type of bag is similar to a rucksack but with side loops which attach to the pushing handles at the back of the chair. The one disadvantage of these is that the occupant can’t get to them once they are seated. guide image An alternative design is the under seat bag which attaches to the seat of the wheelchair with the opening between the occupant’s legs. There is also a pannier style bag which attaches to the arm and is positioned inside the chair. These panniers can have pockets for things like a mobile phone, a purse etc. You can even get leather ones!



Wheelchair Pushing Gloves