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Spinal Cord Injury Paralysis Resource Center

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Wheelchairs, Seating, Positioning

Folding - Colours Challenger

Folding Wheelchair -
Colours Challenger

The common saying is wrong: people are not "confined" to their wheelchairs – they are in fact liberated by their wheels. A person with paralysis can get around as quickly in a wheelchair as anyone else can walking. A wheelchair offers people access to work or shopping or any other travel outside the home. For some, a wheelchair enables them to participate in races, basketball, tennis and other sports.

In some ways a wheelchair is like a bicycle – there are many designs and styles to choose from, including imports, racing models, etc. The chair is also like a pair of shoes – there are models for special purposes, such as sports or rugged trail use, but if the fit isn’t just right the user can’t get comfortable or achieve maximum function.

Selecting the right chair, especially for a first-time wheelchair user, can be confusing. It’s always a good idea to work with an occupational therapist who has experience with various kinds of wheelchairs, but here are some mobility basics on wheelchairs.

Folding - Invacare ProSPIN X4

Folding Wheelchair -
Invacare ProSPIN X4

Manual chairs

People with upper body strength typically use a manual – they propel it with their arms on the rims of the wheels. A generation ago the standard chair was a chrome-plated behemoth that weighed about 50 lbs. Today’s standard comes in every color you can think of and is much less than half that weight., and designed for much superior performance. The newer chairs ride truer and are much easier to push than the clunkers of yesteryear. The lightweights, whether with either a rigid frame or a folding frame, are also easier to transfer in and out of cars.


Folding - Invacare ProSPIN X4

Power Wheelchair -
Permobil C350 PS

Power

Many people cannot push a wheelchair with their own arm strength and may require a wheelchair powered by batteries. Power chairs come in several basic styles. The traditional style looks like a beefed up standard manual plus the batteries, motor and control systems. There are also platform-model power chairs with a more ordinary seat fixed atop a powered base. Scooters come in three- and four-wheel configurations and are typically used by people who don’t require them full time.

Until just a few years ago, the power chair market was limited to just a few brands and models. Innovation has expanded the choices, though, with lighter, more powerful, and much faster chairs. Because power chairs are often quite expensive, reimbursement is a key issue. Work with your funding sources, OT, seating specialists and rehab supplier to get the best set up.


Folding - Invacare ProSPIN X4

Pediatric Wheelchair -
Colours Little Dipper

Child/Junior Chairs

Because their bodies are growing and changing, chairs for children and adolescents must be changed or replaced more often than an adult chair. Since chairs are not cheap and insurance providers often place limitations replacement, manufacturers offer chairs that allow adjustments to be made to accommodate a growing child. Wheelchair companies also offer chairs for kids that don’t look as "medical" as the old styles. This includes more streamlined designs and cooler upholstery and/or frame colors.

People with paralysis have a high risk for pressure sores and therefore usually require special cushions and seating systems to give the skin some relief. There are three basic kinds of cushion materials, each with benefits for certain types of users: air, foam or liquid (e.g., gel). Work with your seating specialist to determine which is the right one.


Folding - Invacare ProSPIN X4

Tilt Wheelchair -
Invacare Pronto M51-CG Tilt

Tilt or Recline

Some people use special wheelchairs to distribute pressure and thus reduce the risk of skin sores. These chairs also increase comfort and sitting tolerance. One type of chair, called "tilt in space," changes a person's orientation while maintaining fixed hip, knee, and ankle angles. The whole seat, in effect, tilts. The other chair option is called a recline system, which basically changes the seat-to-back angle, flattening out the back of the chair and in some cases raising the legs to form a flat surface.

A tilt system redistributes pressure from the buttocks and posterior thighs to the posterior trunk and head. The system maintains posture and prevents sheer (the friction on tissues from dragging across a surface). A drawback: If a user sits at a workstation, for example, the tilt requires that he or she must move back from the table to avoid hitting the table with the elevated footrests.

Folding - Invacare ProSPIN X4

Tilt Wheelchair -
Quickie TS

Recline systems open the seat-to-back angle and, in combination with elevating legrests, open the knee angle. There are some advantages to recline for eating, making transfers or assisting with bowel or bladder programs (easier lying down). Generally speaking, recline offers more pressure relief than tilt, but with a higher risk of sheer. Elevating the legs may be beneficial to people with edema.

Both tilt and recline must be fitted and prescribed by seating and positioning experts.


Cushion-Gel---Jay-J2-Recline

Cushion - Gel
Jay-J2-Recline

Seating

People with paralysis have a high risk for pressure sores and therefore usually require special cushions and seating systems to give the skin some relief. There are three basic kinds of cushion materials, each with benefits for certain types of users: air, foam or liquid (e.g., gel). Work with your seating specialist to determine which is the right one.


Folding - Invacare ProSPIN X4

Standing Wheelchair -
Levo C3

How to choose

It is important to determine how the wheelchair will be used: indoors only? Outdoors or heavy-duty use? Does it take apart easily for traveling? Choosing your chair often comes down to what will be reimbursed and depends on your eligibility.

Sources: American Occupational Therapy Association, WheelchairNet, AbleData

A Reeve Foundation Fact Sheet on Wheelchair and Equipment Donations (PDF)

Assistive Technology (AT) Resources: Proper fit of a wheelchairThe National Academy of Neuropsychology (NAN) has compiled a list of various Assistive Technology (AT) resource agencies around the nation, including resources on driver education, independent living, state agencies, mobility equipment and more.

Aquila Wheelchair CushionsThe Aquila Corporation offers a line of alternating pressure wheelchair cushions along with a two-zone static manual inflate cushion. These cushions are designed to meet pressure relief needs thereby helping to prevent pressure sores from developing down the road.

BrunoBruno Independent Living Aids has become known for its: power chairs, scooters, high quality stair lifts and Turning Automotive Seating.

ColoursFor people who like to think outside the box, check out the chairs put out by Colours In Motion.

e.motionA standard manual wheelchair can get extra help with special rims containing small yet powerful motors.

Frog LegsFrog Legs Inc. makes a product that makes mobility a much smoother experience. A flexible hinge allows the castor wheels on wheelchairs to move more easily over bumps and obstacles thereby reducing the impact normally felt by the person seated. Think of them as shock absorbers for your wheelchair.

The Jay CushionSunrise Medical produces a cushion for wheelchairs called The Jay which is filled with a slow-flowing gel. The Jay addresses posture, skin and functional needs.

PermobilPermobil produces chairs ideal for those requiring the flexibility to constantly change positions. Technology and comfort combine to allow for active sitting.

Pride MobilityFor tight and precise control, Pride Mobility Products Corporation makes the very popular Jazzy Power Chairs.

Rehabilitation Institute of Chicago: Wheelchair Seating & PositioningHaving mobility is an important factor in being able to lead a productive and fulfilling life. If an individual is unable to walk, an appropriate mobility base and seating system are imperative to enhance the ability to interact and perform functional skills.

ROHOThe ROHO is a brand of cushion seats designed for protection and comfort. Each cushion is based on a support system of evenly distributed air.

The Spinal Cord Injury Information Network: Wheelchairs & SeatingInformation on seating and positioning.

Spinlife.comOnline durable medical equipment (including wheelchairs and cushions).

SportaidOnline catalog for durable medical equipment.

TiLiteTitanium wheelchairs; lightweight and strong.

UCP Wheels for HumanityA non-profit organization that refurbishes donated wheelchairs and hand fits them to children and adults with disabilities in developing nations.

Wheelchairjunkie.comA resourceful and opinionated website owned and operated by self-described "power chair gonzo" Mark E. Smith, who also designs power chairs for Pride Mobility Products. Says Smith, "WheelchairJunkie.com is about mobility, not manufacturers, so the voices expressed here represent only users."

WheelchairNetA federally funded virtual community for people who have an interest in wheelchair technology.

Wheelchair FoundationOver 100 million of the world's citizens today are deprived of mobility because of warfare, disease, disaster or advanced age. The wheelchairs they need simply to get across the street - or across the room - are out of reach. The Wheelchair Foundation believes that these people deserve the independence and dignity that comes with owning a wheelchair, regardless of their nationality. This is a nonprofit organization leading an international effort to deliver a wheelchair to every man, woman and child in the world who needs one. For those individuals, the Wheelchair Foundation offers freedom, self-reliance, mobility and hope.

Whirlwind Wheelchair InternationalWhirlwind Wheelchair International (WWI) is the communications hub of the Whirlwind Wheelchair Network of independent wheelchair-producing workshops in developing countries. Founded in 1989 as the Wheeled Mobility Center (WMC), WWI's primary mission is 1) to teach wheelchair riders in developing countries to design, build, and repair their own wheelchairs; 2) to enable rider/builders to create businesses for the manufacture and distribution of wheelchairs to others; and 3) to foster the ever-widening Whirlwind Network of rider/builders around the world who exchange ideas for the continuous improvement of wheelchair design.

World Wide Wheelchairs & Used Medical EquipmentScott Dier began this company in July 1998. He wanted to sell a hearing aid on the Internet. Then people started asking about wheelchairs and other medical equipment! Mr. Dier then proceeded to look for equipment around North America and found many items available. World Wide Wheelchairs exploded into a company that was needed throughout the world! They have sent medical equipment and wheelchairs to India, Saudi Arabia, Chile, Japan, Mexico, Jamaica, Canada, England, Brazil and all over the U.S. and the U.S. Military.

Wheelchair AccessoriesClick on this link to see how you can accessorize your chair or scooter and improve matters. Backpacks, cupholders, trays, canopies and umbrellas are just a few examples.

Paralysis Resource Center The Reeve Foundation Paralysis Resource Center Information Specialists are reachable business weekdays, Monday through Friday, toll-free at 800-539-7309 from 9:00 am to 5:00 pm ET. You may also schedule a call or send a message online.

Reeve Foundation Online Paralysis Community Connecting people living with paralysis, families, friends and caregivers so we can share support, experience, knowledge, and hope.

Quality of Life Grants DatabaseFind resources within the PRC Quality of Life Grants Database. Search by Zip Code, State or an Entire Category.

Library Books and VideosFind resources within the PRC library catalog.

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The Reeve Foundation Paralysis Resource Center Information Specialists are reachable business weekdays, Monday through Friday, toll-free at 800-539-7309 from 9:00 am to 5:00 pm Eastern U.S. Time. International callers use 973-467-8270. You may also schedule a call or send a message online.

The information provided in the Paralysis Resource Center was supported by Cooperative Agreement number 1U59DD000838-01 from the Centers for Disease Control and Prevention (CDC). Its contents are solely the responsibility of the Reeve Foundation and do not necessarily represent the official views of the CDC.