Options, accessories and critical components for power wheelchairs

A power wheelchair can provide safe, timely and independent mobility for an individual, yet the ability to sit in and function with it for 12–18 hours a day is primarily due to the critical components and accessories used to enhance quality of life. Complex rehab power wheelchairs are designed to provide fit and function for the person it is prescribed for, and that typically includes additional components that are essential for successful use of the chair. A chair can have numerous options, accessories and critical components that address the physical, functional and environmental needs of the user. Many of these items can be funded by third-party payors; although some may need to be purchased by the individual. In this article, Jay Doherty, OTR, ATP/SMS, Director, Clinical Education, Quantum Rehab, discusses the components that are often considered the most significant and why it is important for this information to be available to a wheelchair user so he or she can make an informed decision.

What components are most important and what do they provide?

Power Tilt
Power tilt is a critical component that provides significant benefits for the wheelchair user. Tilt maintains the angles of the seated position, while shifting the body weight rearward. The main reason tilt is added to a power wheelchair is for pressure management. This is essential for the individual to offload the seating surface and minimize the risk of developing a pressure ulcer. There are many other benefits of tilt, such as but not limited to: independent repositioning for greater sitting tolerance, changing the effect of gravity for improved breathing and speech production, orientation in space for improved line of sight and gravity-assisted support for head and trunk control.

Power Recline
Power recline is also a critical component that further enhances the capabilities of the wheelchair. Power recline allows the person to lay almost entirely flat, which assists with pressure management as it allows body weight to be distributed over the largest surface area possible, so bony prominences are not causing discomfort or increased pressure in these areas. Recline also allows the person to take breaks from gravity, rest and recover. The individual can stretch his or her muscles, ligaments and joints, as well as position him or herself where bowel and bladder management can occur, especially when he or she is unable to transfer out of the power chair to perform do these activities. It is also essential for individuals who require a supine transfer. To maximize the benefit of power seating, a combination of tilt and recline allows the person to achieve all angles and positions necessary to sit comfortably and function from their power wheelchair throughout the day.

Power Leg Rests or a Power-Articulating Foot Platform
Power elevating leg rests or power articulating foot platform (Also called AFP) is another critical component that is necessary whenever power recline is used. It enables the legs to be elevated while the power recline moves and is needed to ensure proper body movement and prevent the pelvis from sliding forward when recline is utilized. In addition, power elevating leg rests or an AFP are needed for some individuals who have swelling or edema in their legs. Leg elevation, along with tilt and recline, raises the feet 12 inches above the heart for circulation and lymphatic return. There are other reasons for this component as well, including the ability to change the position of the hips and knees to prevent contractures or to accommodate lower extremity contractures if they are present. In addition, the ability to raise and lower the legs may improve access to the wheelchair user’s environment by keeping the seat height low enough to get under tables and allow the footplate to move out of the way when navigating ramps and thresholds.

Power Adjustable Seat Height
Another component that is critical to a wheelchair user’s independence is power adjustable seat height. This allows a person to maintain their seated position and control the height of their seating system along the vertical continuum. It also enhances safety and ensures timely and efficient transfers, increased reach and function and an improved line of sight while driving the power chair. In addition, power adjustable seat height allows the individual to change the height of the chair while driving at 4.5 mph, as well as safely operate the chair in the fully elevated position. Essentially, it increases the functionality of a power wheelchair.

What accessories are most important and what do they offer?

Ventilator Tray and/or Oxygen Tank Holder
One medically necessary accessory that must be considered for individuals who either breathe by mechanical assistance or may need to do so in the future is a ventilator tray. There are many different types of ventilators, so manufacturers of power wheelchairs have different options available to fit most of the equipment being used. An oxygen tank holder may also be medically necessary for a person that requires supplemental oxygen, either with or without a ventilator. Although the mobility a power wheelchair provides may decrease the oxygen demands of the user, oxygen may be critical for a person to function in their environment.

Transit Tie-down Brackets and Occupied Transit Components
Transit tie-down brackets are essential for anyone who transports their chair in a moving vehicle. If the individual remains in his or her chair while in a moving vehicle, then additional occupied transit components are required. An occupied transit system is also available, which add the transport belt so an individual can be transported in a vehicle while remaining in her or her power wheelchair, if it meets occupied crash testing criteria.

Lights
Another accessory that offers safety and convenience for power chair users is a lighting package.Lighting can be integrated into the fenders of the power wheelchair or added onto the frame. Front and rear fender lights allow the individual to see and be seen at night whether they are navigating outdoors or indoors. The user driving the wheelchair can easily turn the lights on and off, depending on his or her environment. Lights are critical for wheelchair users to see their surroundings and for vehicles or pedestrians to see them.

Transfer Handles
A simple yet significant accessory, a transfer handle enables for independent transfers to occur safely. The transfer handle encompasses a handhold in a location that is accessible to the individual to use and bear his or her weight, providing greater independence.

USB Charger, Cell Phone or Tablet Holder
Other important accessories for wheelchair users include a USB charger and cell phone or tablet holder. Many people consider a cell phone not to be a critical device, but for individuals who have significant limitations due to a disability, a cell phone is a gateway to communicating with others, especially in an emergency. It is also a means to control their environment.

The USB charger port allows a cell phone or tablet to remain charged, so the device is readily available for the individual to use when needed. Often, people with disabilities cannot access a landline phone so a cell phone allows individuals to remain alone during the day and still have a way to reach assistance if needed. The cell phone or tablet holder positions the device where it can be easily seen and accessed independently.

Conclusion

There are many accessories and components available to wheelchair users, and each one plays a critical role in ensuring a person’s independence. While some items may be funded by third-party payors, other items need to be paid for by the individual, yet all these components and accessories enhance the lives of people with disabilities. Anyone who is going to receive a new power wheelchair should explore what options, accessories and critical components are available to them and see what would enhance his or her power chair experience the most. The choice is truly theirs.

This article was sponsored by Quantum Rehab.

Quantum RehabWritten by Jay Doherty, OTR, ATP/SMS
Director, Clinical Education
Quantum Rehab

Resources

If you are looking for more information on wheelchairs or have a specific question, our information specialists are available business weekdays, Monday through Friday, toll-free at 800-539-7309 from 9:00 am to 5:00 pm ET.

Additionally, the Reeve Foundation maintains fact sheets on wheelchairs with additional resources from trusted Reeve Foundation sources. Check out our repository of fact sheets on hundreds of topics ranging from state resources to secondary complications of paralysis.

We also encourage you to reach out to other support groups and organizations, including:

This project was supported, in part, by grant number 90PRRC0002, from the U.S. Administration for Community Living, Department of Health and Human Services, Washington, D.C. 20201. Grantees undertaking projects under government sponsorship are encouraged to express freely their findings and conclusions. Points of view or opinions do not, therefore, necessarily represent official Administration for Community Living policy.