Wheelchairs Types, Manual, Power, and Scooters, advantages and disadvantages

Understanding Wheelchairs

Styles of wheelchairs Broadly speaking there are three categories of products that are referred to as "wheeled mobility devices" � Manual wheelchairs, Scooters and Power Wheelchairs. As mentioned previously, many long-time wheelchair users have several of types of chairs � each chair functions differently in different environments, together they provide functional mobility for the person. Initially most people only purchase one device, but they hang on to that device later on and find "niche" uses.  Manual Wheelchairs- Manual wheelchairs are designed for two very different purposes �to be pushed by someone other than the rider or to provide self-prolusion by the rider. Dependent/Transport mobility bases, not designed for self-prolusion often have small rear wheels and may look and function much like a stroller. For transport purposes, these chairs often fold compactly to store in the trunk of a car and provide "light duty" mobility. You may find a transport chair is a convenient "back-up" to your primary chair, easily folded when not needed, but readily available if your chair breaks down. Specialty Positioning bases are dependent mobility devices that allow for changes in positioning by tilting the seating system or reclining the backrest or both. These devices are not easy to transport, but are designed to provide comfortable, full day seating for the user, who is not able to propel or operate a power wheelchair. Self-propelling manual wheelchairs are equipped with a large wheel used for propelling. Riders self-propel using either both arms, both legs or one arm/one leg. If you are using your leg(s) for propulsion, then the seat to floor height is a critical feature to insure maximum mobility. The most active manual wheelchair riders are able to balance the chair just on the back wheels. This is called, "doing a wheelie". The ability to do a wheelie significantly improves environmental access for the wheelchair rider. By "popping a wheelie" you can negotiate a high threshold, get over a 2" curb and, if able to ride in a wheelie, cross soft terrain like grass and gravel, without the front casters getting stuck and stopping the person in their tracks. Manual chairs with adjustable rear wheels (able to move the rear wheel forward and backward on the frame) need to be fitted to the user to get the best combination of "tippiness" (ease of popping a wheelie) and stability (not tipping over when just pushing on the wheels). If you have good balance and want to learn to do a wheelie, ask for training from your PT or OT.  Power Wheelchairs Historically, the power chair was simply a manual wheelchair equipped with motors, batteries and a joystick. Today the power chair is a dramatically different design. Most power chairs, today, are designed to have two major components, the power base (containing the motors, wheels, batteries and control module) and the seating component. Each component (power base and seat) are offered with a wide variety of options. The following is just a general list of options you may want to consider Power Base � The most obvious difference in power bases is the position of the drive wheel. Power wheelchair manufacturers now offer three types of "drives" � rear wheel, mid wheel and front wheel drive chairs. The placement of the drive wheel has a significant impact on "how" the chair moves. Each method has its advantages and disadvantages in both indoor and outdoor driving conditions. Your best bet is to arrange for a test drive, ideally with three different chairs, each with a different drive wheel position. Riders quickly identify the drive wheel placement, which feels most comfortable to control. Once a particular drive wheel placement has been chosen, there are several different models (from different manufacturers) from which to choose.  Wheelchair Seating There are many options available when looking at seating on a power chair. The options range from fairly simple automotive style seats, often referred to as "Captain's seats" to very sophisticated power seating which may tilt, recline, elevate your leg rests and some seats even provide a standing feature. For children, there is even a power-seating feature that lowers the entire seat down to the floor to participate in peer-to peer activities. Determining your seating needs requires a good look at your sitting balance (do you need external support to use both your hands) and your risk for pressure sores (do you need a mechanical method of taking weight off your buttock). If you have had "pressure sores" or you have trouble sitting up (over the edge of the bed for example), you should work with a health care provider to determine the seating options to best meet your needs. Many power chair and scooter riders are able to use the standard controls, which come on the chair, the joystick or the tiller. For those who are unable to use the standard controls, several manufacturers now offer "alternate controls". These alternate controls replace the joystick and use other voluntary movements to allow the person to operate the chair. Examples include Sip "n Puff, which uses a straw and the person's sips and puffs to control the direction of the chair or head arrays � a series of switches mounted into the headrest which allow head movements to operate the chair. If you are in need of an alternate control system, you will need to be evaluated by a seating team, a supplier and a therapist who specialize in customized assistive technology solutions. Power Assist A new technology is now available which offers hybrid or "cross-over" products, between traditional manual and power wheelchairs. The power-assist systems are equipped with new wheels (the larger rear wheel for a manual wheelchair) that are battery operated and designed to increase the number of revolutions the wheel makes with just one push on the rim.The goal is to increase the efficiency of manual propulsion while reducing the amount of effort the rider must put into the wheels. Add-on power systems are designed to give power chair operation, while mounted onto a manual wheelchair base. With a quick release system, these add-on power systems are more easily transportable than traditional power chairs, but do not have the long-term performance or durability of traditional power chairs.  Wheelchair type advantages and disadvantages:

Advantages Disadvantages Manual Wheelchairs 1. Lighter in weight 2. Greater reliability 3. Easier to transport 4. Less expensive 5. Provides a level of exercise 6. Easier to overcome accessibility problems Self-Propulsion: 1. Possible secondary complications (sore shoulders, wrists and elbows) after long-term use. 2. Requires physical effort to be mobile Scooters 1. Aesthetics, does not look like a wheelchair. 2. Increases mobility range without increased exertion 3. Swivel seat may allow for easier transfers in and out of the seat. 1. More complicated to transport in a car than a manual chair. 2. Needs charging 3. Less flexible to modify to changing physical conditions than a power chair. Power Wheelchairs 1. Greatest mobility range with least exertion. 2. Easier to modify over time, if needed. 3. Available with power seating options � tilt and/or recline. 1. More Expensive. 2. More difficult to transport. 3. Less reliable than manual wheelchairs.

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