OT 674
Wheeled Mobility
All Terrain
Wheelchair
Wheeled Mobility
Manual wheelchairs Power wheelchairs
standard chairs mid-wheel drives
lightweight chairs rear wheel drives
ultralight chairs front wheel drives
tilt in space chairs
reclining chairs
Scooters
History of the Wheelchair
Rolling chair - developed in the Renaissance
Current wheelchairs evolved from the 18th
century - heavy, large casters in front, one
small caster in back, needed to be wheeled
Civil war amputees and then World War II veterans with
disabilities were the spur for newer chairs to evolve
1932- Herbert Everest and friend Harry Jennings
developed a sling seat, folding chair out of aircraft steel
Evolution of Lighter Weight Chairs
The basic E & J chair was the standard for many years
After the Vietnam war, there were dramatic changes.
Persons with cord injuries living longer and healthier
lives
Wheelchair sports became popular
1975 - first wheelchair athlete to complete the Boston
Marathon - start of road racing for wheelchair users
1985 - first wheelchair racer to break the 4 minute mile
Technical advances for sports chairs quickly caught on
with standard chair users - lightweight chair development
followed
Specialized Seating
Cushions and pillows were initial seating aids
1970’s and 1980’s began the era of specialized
seating
First specialized seating - the Mulholland chair for
children and the Gunnell systems
Assistive device clinics in Canada (Hugh McMillan
Rehabilitation Centre, Winnipeg Shriner’s Hospital
did more with seating
University of Tennessee at Memphis - 1st place in
the US to do modular seating
Desmo Project in Alabama - first system to do
customized systems to the shape of the person’s
body
Today’s Focus
Manual Wheelchairs
Parts and Measurement
Standards for Wheelchairs
RESNA (Rehabilitation Engineering
Society of North America)
ANSI (American National Standards
Institute)
ISO (International Standards
Organization)
Chair Characteristics
Provision of mobility
Safe
Durable
Support of posture; prevention of further
deformity
Wheelchair Measurement
Chairs used to come in one size only
Now standard sizes for adults exist
Children’s chairs also come in standard
sizes and can “grow” with the child
Important to have correct size for ease of
pushing, comfort and to minimize potential
for increasing deformity
Wheelchair Components
Seat
Back
Legrests (including footplates)
Armrests (including clothing guards)
Wheels
Casters
Pushrims
Wheel locks
Type of drive (foot drive, one-arm drive)
Other Considerations
Client’s height
Client’s weight
How the chair will be moved (foot, one
arm drive)
Contexts in which the chair will be used
Measurement Focus for Today
Seat
Back
Leg rest
Arm rest
Other Measurement Concerns
Overall wheelchair height
Foot distance from the floor
Basic Seat Width Measurement
Width of the pelvis is used to determine the
width of the wheelchair
Measure distance between the trochanters
Need to consider surface client will be sitting on
- upholstery give should be considered
Allow 1-3 centimeters extra for clothing
Basic Seat Depth Measurement
Distance from the intersection of the seat and
back to the intersection of the seat plane with
the leg reference plane (an imaginary line
extending upward at a right angle to the
footrests)
Actual distance for seat depth is about 2 inches
less than the measured seat depth
Seat depth is affected by the angle of the
legrest and the width of the calf pad
Seat Back Measurement
Seat Height - determined by the degree of
back support the individual needs
The less back support needed, the lower
the backrest
Seat height is measured from the
intersection of the back and seat to the
desired height
Seat back width and seat
width are usually the same
measurement
Leg Rest Measurement
Influenced by the height of the individual
Very tall persons may need a greater seat to leg
reference plane angle and a chair higher off of
the floor
Leg rests are adjustable; to get a mid-range
assessment, person is measured from the
bottom of the foot to the back of the knee
Person should be seated on the same size
cushion they will be using with usual shoes on
their feet
Seat Height Measurement
Minimum seat height affected by the person’s height,
especially leg length
Need a minimum foot clearance of 2 inches
Maximum height for manual wheelchairs is limited by
the user’s ability to reach the drive wheels
Seat angle and back angle need to be considered in
deciding wheelchair height
Seat height affects chair stability, so lower is better
The height of surfaces the person will transfer to is an
important consideration in seat height measures as well
Arm Rest Measurement
Need to consider surfaces under which
individual needs to roll chair
Armrests can also be a trunk support, in
which case the maximum height needs to be
higher than the usual resting place of the
elbows
Measured from top of seat to angle of elbow
Adjustable arm rests are available and are
desirable
Seat to Back Angle
Usually 90 degree seat to back angle is
best
Sometimes back angle recline is needed,
but increasing seat to back angle can
cause sliding in the seat
“Tilt in space” option maintains 90 seat to
back angle and tilts the whole seat
Seat Angle
Usually a flat seat is preferred
When there is extensor thrust or hip
flexion contracture in the patient, the seat
can be angled to minimize the effect of the
extension; anti-thrust cushions can also
be used.