When the rear axle is set correctly for a self-propelling manual wheelchair user the wheelchair feels better and opens up the most independent performance. Set poorly and the wheelchair can become unstable, painful and even more immovable than the current parliamentary Brexit debate.
One of the first concepts most high-end manual wheelchair prescribers learn is that, generally, moving the rear axle forward makes propulsion easier but reduces the rear stability. This isn’t inherently a bad thing, as a little rearward ‘tippiness’ is needed to clear small everyday obstacles.
Have you ever sat in a chair and tried balancing yourself by tilt backwards onto the back two legs of the chair? (I am not recommending anyone try this while sitting in a chair - it can be dangerous and you can fall backwards and get hurt! I just realize that it is something I have done in my youth and I have seen my own children do it, too - and, of course, I cautioned them against it.) Perhaps you held onto the table in front of you and used your arms to push yourself backwards to find the balance point? You may remember doing this when you were a child in either grade school or high school. Some of you may have experienced going past the tipping point and having the chair fall behind you or if you were lucky enough, you quickly recovered by moving your weight forward to prevent falling backwards.
A little known secret about why pediatric therapists like working with children so much is because we get to continue to play on a daily basis and get paid for it. However, in an instant you can go from feeling like Peter Pan to realizing just how old you really are when a former client comes back into clinic to have his or her chair adjusted or replaced to meet growth needs.
Typically, for full-time power wheelchair users, we look to power seat functions to reduce skin risk, create rest, provide relief, and increase comfort. But how do we know what to recommend to our clients? The research tells us a few key facts.
Power seating functions such as tilt, recline, seat elevate, and elevating leg rests provide users with improved positioning, the opportunity to redistribute pressure, and an increased level of independence. However, no matter how beneficial the power seating functions may be, if he/she cannot independently and quickly operate the control device it greatly decreases the odds that the user will utilize the power seating functions.
DISCLAIMER: FOR PROFESSIONAL USE ONLY. THIS WEBSITE (AND THE DOCUMENTS REFERENCED HEREIN) DO NOT PROVIDE MEDICAL ADVICE. Sunrise Medical (US) LLC (“Sunrise”) does not provide clinician services. The information contained on this website (and the documents referenced herein), including, but not limited to, the text, graphics, images, and descriptions, are for informational purposes only and should be utilized as a general resource for clinicians and suppliers to then use clinical reasoning skills to determine optimal seating and mobility solutions for individual patients. No material on this website (or any document referenced herein) is intended to be used as (or a substitute for) professional medical advice, diagnosis or treatment. Never disregard your professional medical training when providing medical advice or treatment because of something you have read on this website (or any document referenced herein). Clinicians should review this (and any other materials) carefully and confirm information contained herein with other sources. Reliance on this website (and the information contained herein) is solely at your own risk.